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Home My Public Portal About9082 BROADWAY_Building__ DEPARTlhENT OF BUILDING AND SAFETY (] k _ COUNTY OF LOS ANGELES U � —T 1 WM. J. FOX, CHIEF ENGINEER APPLICATION •- - -�FOR APPLICANT TO FILL IN y _ 7 FOR OFFICE USE ONLY t D IBTRI T NO. PLAN CK. OR REQ:NO.' P MIT NO: ADDRESS g'g(��, •JI�WM RECEIVED BY DATE OF APPL. DATE ISBUED _LOCALITY I nn /�•\\`� �J�]/(/j]]�•JL� �//I I, > NEAREST �� L� 1.l's'•A.I•IV l W 1 CROSS ST. BUILDING DWNER {1 J AIDIR LOCALITY MAIL L ✓� Q L.�._9� ADDRESS `., �^') rp C1T�• �1 NEAREST: TEL I O� CROSS L� / CITY 1 5-M a6NO. FIRE - NO.OF I TYPE GROUP,' ARCHI �.A C 1 I • TEL �y ZONE I PLANS -•1 1 ENGINEER •SPA•ULD11.3G N0. A'f` lea yO9/ iBLDG. H T \ ./ CORD 40. �- ,2 SETBACK,LINE ( - /�C/ LLQ 2_ ADDRESS T�� 7Q-C. 1"d0 W-/ . '*44%4 1 GBE A _f APPROVED ` I /y, TEL&I ZONE({ BY I ,DATE CONTRACTOR IJI�WS W_. NN0 &I— - T\/O1/ HOUSE NUMBERING _ ADDRESS Y• `� ,J 1'-II 999I4-&j •MAP NUMBER N0, ASSIGNED BY — LEGALCORRECTIONS DESCRIPTION I LOT NO. ` B OCK - r TRACT ' 1 -VA � SIZE OF LOT �INOW F LOT- ��5 NO. OF BOT ' USE OF • F� 1 NO. OF EXISTIN BLDG. Y�'E'zA I FAM I LIE. DESCRIPTION OF WORK - °a NEW ALTERATION ADDITION Z i D REPAIR DEMOLITION SIZE i SS RO MS 1 'STORIES I EXT.WALL �y ROOF COVERING PLA-¢-r. COVERING �C'Yn.ua•A USE OF STRUCTURE �j 1 �lrXl \11 C,1G/ /J \/4r� 4 IIk A� � cam/ OXL7 -a.tal�.�Ei-Ci� ,ZK ,�K ..0 r Aj. INSPECTION FOR APPROVALS OCCUPANCYAS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION _ FORMS. MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- _ PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPB, CORRECT. BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAW\N11R,EGULATING BUILDING CON ,TRUUDTION. GAS VENT, DUCTS _ SIGNATURE OF yl//^ �' � U LATH. INT./,S/007) PERMITTEE-- /"'/^^^�111 ADDRESS •• `A� �4 AJ'Cii�llw LATH. EXT. `\ —r�� PLASTER. INT. �L1I� 't ALITIYFo ser. _�_�� - - PLASTER, EXT. o l U O FEE ® HOUSE NUMBER COR- RECT AND POSTED ` ��,�////• VALUATION / ® Z-0 FEE FINAL 76A636A DOS 3 7-51 - c T 6A63RH CE 9803 1/71 V l�Z4L XL '"�`�• � ' �'• APPLICATION F '_ BU bING P MIT COVNTY.OF LOS ANGELES 4 ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING /� ADDRESS. �(L� L(-!(L �... t COLEMAN W. JENKI NS, SUPT OF BU LDING (,,LOCALITY FOR APPLICANT TO FILL IN' CRAREST Print or 1 e onl CROSS ST. BUILDING � DIScT�RICT pNO. r GROUP TYPE �• R ESSEOBY ADDRESSI� r.OJ �b CONST./ V b JL _QiL1✓'�j •� STATISTICAL CLASSIFICATION SEWER MAP LOT T S 8L CK CLASS NO. 711 DWELL.UNITS_ BK L PG7 TRACT 1/ '�-• / p USE ZONE MAP �7� NO.OF BLDGS, ,n- NO. 20 1 SIZE OF LOT NOW ON LOT Y SPECIAL USE OFEXISTING BLDG., f E?6 a&e- � ��••-- y/ ' CONDITIONS _ OWNER C; D NO. . y- 7 p• BLD ET_BACK FROM ' ADDRESS A!l-ID 1•>)4 11 FRONT P - LINE OF (STREET) TYPE OF E%ISTING ACK HIGHWAY } YARD = TOTAL CITY �[�• .F HIGHWAY WIDTH FROM - ARCHITECT OR ITEL. } ENGINEER - .fi NO. . /J �/ / v BLDG.SETBACK FROM.. ADDRESS r/I`n (�IC�jlte (O, /I.{,E1ap SIDE PROP.LINEOF (STREET) y •TEL. 4 TYPE OF EXISTING -SETBACK. 'HIGHWAY } YA RO = TOTAL L CONTRACTOR A }J ) NO.� n }�� HIGHwgY WIDTH FgOM C.L:' CD LIC.ADDRESS/'/ `Y ..J/}JN // NO. �J USA' } = p LI CITY /_ �/ 0. q� H- LiJJ'N CLASS l✓ CORNER CUTOFF YES ❑ NO ' W EFi NAMEANDBIRANCHNDER Rl Ar4r X _ SEE REVERSE SIDE FOR SPECIAL APPROVALS ? ADDRESS - SQ. FT.30g1 IS ORIES FAOMIOLFES NEW .Ze SIZE LVA ® �J USE OFf-/ ADD' '( STRUCTURE J 1 .Q-]"k ALTER ❑ SIGNATUREOF pp -REPAIR[] .. APPLICAN T •l, DEMOL ❑ VALUATION 9 ✓7/ APPROVALS PATE INSPECTDR•S SIGNATURE FEE S FEE S rOFORMS IMATERIAA SIGN /� J `--_ z.z s FRAME: FIRE STOPS, A I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING, BOLTS 4 Zi AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS ' ST RUC TION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED - HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH.-INT. LABOR CODE QF THE STATE 'CALIFORNIA IN RELATING TO WORKMEN'S CO PEN ATIOI URA NCE. LATH, EXT. SIGNATURE OFHOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS ¢ FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL NG E PLAN CHECK VALIDATION CK. M O. DASH _ PERMIT VALIDATION CK. NO C,BH 1 D 6 2.25 L9CO2 s 0 s SEP 10 ••`�� WORKERS' COMPENSATION DECLARATION �[/�a //p�� I��fp� FOR BUILDING ,r��L ,a - M((/�� PERMIT F��y'//Ff��Tg/�IT' T'here�ora certificate that haver certificate of consent to self aPPdUV' AUTIOU V Il OUB -BUB UDI N`/ II', EUUMIT -jn:yre: or a certificate of Workers' Compensation Insurance, or a ccuified copy thereof (Sec. 3800, Lab. C.) COUNTY.OF LOS ANGELES - BUILDING AND SAFETY - U Polio No.' - -Company BUILDING ❑ Certified copy is hereby furnished. . . FORAPPLICANTTO FILL IN ADDRESS ' C>e:,Z• Q0A0WAN - ❑ Certified copy is filed with the county building inspec- BUILDING Q yY��..�� ,, ..S,LAA -- - - - - 82 tion department. ADDRESS �� G11�•c•AOLI 4 VK LL LA-r�j CA . - aTr _. L C.L.T (A• ZIP V76d' LOCALITY KL 1, CLTY Date - Applicant NO. OF BLDGS. NEAREST f1 CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT - NOW ON LOT Z CROSS ST. Lie V.V"d PWD. - COMPENSATION INSURANCE . s' 6 a ASSESSOR p (This section need not be completed if the permit is for one TRACT-L I ZL$' BLOCK -l3 LOT NO. rJ MAP BOOK S 388 PAGE Ott Z' PARCOEP-5 hundred dollars ($100) or less.) Ea •'' _ QA TEL' USE ZONE h\AP It / li OWNER C• ','A. GQA NO. NO. / 7 �'•!a J I certify that in the performance of the work for which this yn SPECIAL - Y permit is issued, I shall not employ any person.in any manner ADDRESS aCIZICIIV I£" ."9"' - '�/ CONDITIONS a- so as to become subject to the Workers' Compensation Laws. - - 0 . CITY " - .. ZIP ' Date Applicant - ARCHITECT OR TEL. DISTRICT GROUP TYPE - -- FIRE PROCESSED BY Q' NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST ZONE Exemption, you should become subject, to, the Workers' . r G 1� // w Compensation provisions of the Labor Code,•you must forth- ADDRESS - J �O z� ✓ 3 L.c2'�' R with comply with.such provisions or this permit shall be l TEL. STATISTICAL CLASSIFICATION - APT. CONDO. Z ' deemed revoked. - CONTRACTOR �.2A.' — LICENSED CONTRACTORS DECLARATION UC. CLASS NO._J6 DWELL. UNITS - I hereby affirm that I am licensed under provisions.of Chapter ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY - - CLASS BK./— PG VALIDATION SO. FT.w NO. OF NO. OF CHECK License Number Lia Class SIZE 4OO STORIES S FAMILIES O ONE . EVALGATION NEW Contractor Date " -7 Z 4O• cI DESCRIPTION OF WORK LL• ' ADD ElD I am exempt under Sec. ALTER 11f , B.BP.C. for this reason - REPAIR El f. .. .. __ • . . Date'. USE OF DEMOL EXISTING BLDG. Signature APPLICANT TEL. FINAL --- - OWNER-BUILDER DECLARATION (PRINT) NO. + DATE I hereby affirm that am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS —A FINAL`. + - , Professions Code): PRESENT - - - - BY BUILDING r: t ❑ I, as owner of the property, or my employees with ADDRESS t 74 )) H'-'-i •z: - wages as their sole Compensation,will do the work and - LOCALITY the structure is not intended or offered for sole(Section •-- 7044, Business and Professions Code.) MOVING TEL - - _.T_r_' _ CONTRACTOR NO. I I,L. I, as owner of the property,.am exclusively contracting with licensed contractors to construct the project (Sec- ADDRESS ' I1-If�� 129 - :33 .tion 7044, Business and Professions.Code.) _ "♦ - ``!! _ REQUIRED TOTAL SETBACK"FROM EXIST. f_f1f:C;I� "ty`�'•,j.� CONSTRUCTION LENDING AGENCY _ SET BACK YARD HWY ' PROP. LINE4WIDTH - I hereby affirm that there is a construction lending agency for FRONT I _ - -- LYHr�Ut the performance of the work for whichthispermit is issued 'Y P.I. - -- (Sea 3D97, Civ. C.). - -SIDE • Lender's Name 1iJ0IQ5 - - 1000—CILL11 67 4/? LDMA Ref. It yy m P.C.fee $ Permit Fee // . )�• i ffl! Lender's Address - g ' a I certify that I have read this application and state that the - _ Issuance Fee �7 ' LDMA P/C# D Babove information is correct. I agree to comply with all County Investigation Fee' ordinances and State laws relating to building construction, Total Fee _ 1 • 33 LDMA Perm, # , a an�hr authoriz rep rooves of this County to enterupbov a tion operty for inspect�io�n,,p�urpo�ses�. Il SEE_ _ t SEE REVERSE FOR EXPLANATORY LANGUAGE Signotu a of Applicalit or A m Date 1, COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING DREpp5 - I hereby affirm that I have,a certificate of consent to self,insure, BUILD G ADDRESS 7,q5 or a certificate of Workers' Compensation Insurance,or a certified O Z �A L"' - - copy thereof (Sec.3800,Lab.C.) CITU ZIP Q TY Policy No. Ia_ LOCALI Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ElCertified Copy is hereby furnished. Z, NEAREST CROSS ST. ❑ Certified Copy is filed with.the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK- PAGE PARCEL -- - - SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNS EL NQ. COMPENSATION INSURANCE n./ S^^Z 17 WITHIN 1000 FT OF SCHOOL? YES NO . (This section need not be completed if the permit is for one hundred AD ESS DISTRICT GROUP TYPE ONST. FIREZONE PROCESSED BY dollars ($100)or less.) CITV - ZIP - Icertify that in the performance of the work for which this permit ( 8O �p�p `�• is issued, I shall not employ any person in any manner so as to become subject f0 the Workers' en$atiOn ARCHITECT OR ENGINEER TEL NO. I � STATISTICAL CLAS�;SIFICATION APT CONDO Date t(=A -Applicant ADDRESS - - GLASS NO. o�( DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject. l0 the Workers' NTRACTOR �(( TEL NO SET BACK YARD MY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith �.1 7 it31 tar FRONT comply with such provisions or this permit shall he deemed revokea.. ADDRESS O. P L LICENSED CONTRACTORS DECLARATION Zl71 -7-1 SIDE Cl �- LIG.CLASS P L 1 hereby affirm that I am licensed underprovisions of Chapter 9 - (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE-.'` NO.OF STORIES NO.OF FAMILIES SEWER MAP Professions Code,and my license is in full force and effect ' "Z� NEW ❑ BK PG d License Number�77gp6"=7c LL,ic.Class C�� DESCRIPTION OF WORK — ADD O VALUATION D, Q Contractor V�j �Dale L ALTER ❑ $ V W ElI am exempt under Sec 6k REPAIR ❑ '$ B.&P.C.for this reason .c E C L DEMOL ❑ V LDMA P/C p W Date: USE OF.EXI ING BLDG URM ❑ n' Signature A ICAN (PRINT TEL NO. LDMA Perm IF ? ❑ I, as owner of the property, or my employees with wages as L-L 'Z -W2l 18 2 their sole compensation, will do the work and the structure is ADD SS ;,ji 2 not intended or Offered for sale (Section 7044, Business and . _ FINAL DATE ;Q -' Professions Code.) I C G " EMS WILL THE APPLICA OR G A IRE-It WCUPAL H NDLE A RAGREATES MATERIAL /1- ,[� J 1'.+��- ❑ 1, as Owner of the property, am the p Iojec contracting tmg Wlth ORA NTSMIXSPE CONTAINING AZAR HAZARDOUS MATERIAL EQUAL INFORTO MATION GREATER THAN THE t a AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY � D '' � licensed contractors to construct the protect (Section 7044, � �1(I HL � ---° � +3' Business and Professions Code.) YES El NOX _ijL_ i - WLL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING %�HECK 100.�ll OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH AL� CONSTRUCTION LENDING AGENCY cu EUAI RQUAUTV MANAGEMENT DISTRICT(SCAOMDI SEE PERMITTING CHECKLIST FOR ��1"IN1,E ul Il I I hereby affirm that there is a Construction lending agency for YES❑ NX I the performance of the work for which this permit is issued(Sec. m 9097,('iv.C)•'' •' HAVEREADTHE HAZARDOUS MATERIALS INFORMATION GUIDE AND THESCAOMDPERMITTING - N OHEOKLIS UNDERSTAND MV REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, RTLE 2. PTEH 2.20$EC 2.20/100 THROUGH 2 20 FROM E SCA RNING HAZARDOUS Lender's Name M4 I R EPOHO AN BT/(M APERMIT 'IF IRO`M THE RCAOMO. 0 Lender's Address �. PNM1 p1 AGENT r o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE $ with all county ordinances and State laws relating to building i m cans on, and here authorize representatives of this County ISSUANCE FEE / - AP to er u on tlr ab - tip ed property for inspection purposes. m & INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION DECLARATION /� T�^ I hereby affirm that hover certificate of consent to self O'll u U U C n �� N FOR B (�� MNG P E RM T ylull insure, or a certificate of Workers' Compensation Insurance, (� �`� u V u� urn or a certified copy thereof (Sec. 3800, Lob. C.) - COUNTY OF LOS ANGELES BUILDING'AND SAFETY Policy No. 'Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS BUILDING •O E O ❑ Certified copy is filed with the county building inspec- BUILDING '�pp / tion deportment. ADDRESS O O 011 �. a i� Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' - NO.OF BLDGS. NEAREST ss�� COMPENSATION INSURANCE SIZE OF LOT 6 rG o NOW ON LOT CROSS ST. IG f (SIR- — - (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACTBLOCK- LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP I certify That in the performance of the work for which this OWNER •i NO. NO. permit is issued, 1 shall not employ any person in any manner SPECIALt so as to become subject to the Workers'Compensation Laws. ADDRESS a CONDITIONS Do te.4�App l icant. '7/y/T .//U121/t CITY ZIP - NOTICE TO APPLICANT: If, offer making this Certificate of ARCHITECT OR TEL.NO. �� DISTRICT GROUP TYPE FIRE PROCESSED BY C1 Exemption, you should become subject to the Workers' ENGINEER CONST. ZONE - V Compensation provisions of the Labor Code, you must forth- ADDRESS W with comply with such provisions or this permit shall be d deemed revoked. / TEL. STATISTICAL CLASSIFICATION APT. CONDO.- - Z CONTRACTOR N a / YQ NO. S.3a7 LICENSED CONTRACTORS DECLARATION LIC CLASS NO. DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS O j•. ./((e NO. C'W 2RZv (commencing with Section 7000)of Division 3 of the Business andLIC SEWER MAP , Professions Code, and my license is in full force and effect. CITY Q. 3� CLASS BX PG - VALIDATION SO. FT. NO.OF NO. OF. CHECK License Number _T�i R7 to tic.Class 3 SIZE STORIES�� FAMILIES ONE ( � y ro VALUATION Contractor�l%)Q L'WO - _11UVYI l�I Date �/—�U—�o DESCRIPTION OFWORK C.0 N ❑❑ $ � I ADD D am exempt under1 .Sec. ' 6T fJ'[�/r - 0.. ' ALTER q B.BP.C. for this reasonata 'ilkirIP f& REPAIR f # USE OF �Da)ta: EXISTING BLDG. r / g DEMOI I • • 6 &6 3 Signature APPLICANT / TEL. FIN OWNER-BUILDER DECLARATION PRINT ) NO.. f$J — DA I hereby offiim that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 0La s. 1/'C(. .4Ue_ f /CFIN y Professions Code): - PRESENT ❑ BUILDING - 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and -' the structure is not intended or offered for sale(Section LOCALITY . 7044, Business and Professions Code). MOVING - TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). - CONSTRUCTION LENDING AGENCY REQUIRED SET BACK YARD HWY TOTAL SETBACKPROP. LINE -WIDTH I hereby affirm that there is a construction lending agency for FRONT - the performance of the work for which this permit is issued PA. (Sec. 3097, Civ. C.). SIDE - P.L. Lender's Name ' LOMA Ref. N m Lender's Address P.C. Fee f Permit Fee r I certify that I have read this application and state that the Issuance Fee / 'E�G LDMA P/C ii D 9 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee R and hereby authorize representatives of this County to enter i LOMA Parm. R ' upon the above-mentioned property for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date -