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Home My Public Portal About9141 BROADWAY_Building__ Os 76A63%A CE N8031REV.6/78) . APPLICATION FOR BUI ING PERMIT COUNTY IOFLOS ANGELES, BUILDING AND SAFETY .;,FOR APPLICANT TO FILL IN ' BUILDING .Q ADDRESS L /'��Q A DIDRESS LDING 1�4 LOCALITY `_( 4-' NEAREST aiv`— "''' ''=" - zip 780 CROSSST. SIZE OF LOT.S S� .Le""'-AIIW ON LOT OF FLOGS' ASSESSOR Z MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE ESSED BY TRACT C17S BLOCK LOTNO. 2 CONST ZONE rc e- - x...,..L.., TEL. S.Ub E-3 t,/ ' c OWNER 3Eu dfcA2 Q NO. -O _ p - --- - - STATISTICAL CLAS9FICAiION SEWER MA ADDRESS a�QO CLASS NO. �Z� DWELL.UNITS BK PG CITY -` - ZIP c7 17ROD ARCHITECT 3EpiL OR - i' _ TEL VALUATION $ U ENGINEER _IZ E NO.�'/ -'9.3 ova ADDRESS f / /-lZ0515mjEAoi BLDG.SETBACK FROM p TEL FRONT PROP.LINEOF —ISTREET) CONTRACTOR > LF NO. HIGHWAY + YARD _ TOTAL SETBACK FROM TYPEOF EXISTING LIC. � FRONT.PROP.LINE HIGHWAY WIDTH ADDRESS NO. _ - LIC. + CITY CLASS BLDG.SETBACK FROM CONSTRUCTION LENDER - - SIDE PROP:LINE OF (STREET] NAME AND BRANCH WOLV` C TOTAL SETBACK FROM PE OF EXISTING HIGHWAY + YARD = SIDE PROP.LINE HIGTYHWAY WIDTH G ADDRESS CITY _ 0 50.FT. SIT OF NO.OF CHECK + = V SIZE STORIE/S� FAMILIES ONE / 04 DESCRIPTION OF WORK L - _ NEW P.C. Fee S. ,� Permit Fee Lo ADD* ❑ 6 - Fee yR ALTERUSE $_ REPAIR Cl Total Fee EXISTTIING BLDG. `, :�„�.R DEMOL ❑ �_/ �� C APPLICANT ST/ //1� TEL « IPRINTI'—L4TUElCAAJ CW,,f CLl NOS _ .23 G BY ISIGNATUR Y_Zo [?I,... j - HEREBY A NOWLEDGE THAT I HAVE READ THIS APPLICAT OON ISTATE ` LYS THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCESb'-7 ly AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY TWILL NOT EMPLOY ANY PERSON IN VIOLATION OF U ' THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM _ PENSATION INSURANCE. s 6 SIGNATURE ;2 b 1 5 7 A PERMITTEE ° 1 ADDRESS Z TEL - 2.° O47d'o0 CITY NQ - 210 .Q . USE ZONE ° o ° 4 3.0 C v SPECIAL. H CONDITIONS. - F . . FINAL DATEO ZS 79 BY Q L 0 a InV I wooRelsa `TV APPLICATION e1 LOCALITY. NEAREST DIVISION OF BUILDING AND SAFETY CROSS IC p AT DBjlSitalBOt o1 •O�BHnty Engineer - DISTRICT NO. Q-REC^E�IPT NO. PERMIT NO. QOOHty of •AIH AHg01� d O VrM.O 6 6, 44 WM. J. FOX, COUNTY ENGINEER p0 P DATE RECEIVED DAT[IHHUED CABBATT O. GRIPPIN, BUF•T or BUIlDIN6 (/ /,?�u 4 ' ISSUED APPLICANT TO FILL IN TYPE CONST. 4/ a i � OWNERIL4 'I 2tt-fA"—' ' / STATE EYEH MAPO MAIL ISC/ � /,/W, Q, NUMBR W ADDLE / .G I N USEZONE SPECIAL CITY TEL. / t [ CONDITIONS / is. l - NO ARCHITECT OR / - TEL. ENGINEER ! NO. BUILDING YARD HWY :STRCCT NAME E%IST. ADDRESS yj '/ y,1� SETBACK W71DTH CONTRACTOR/�S'1.L!—'` / .1 ' NO. J`h / /-SLS.J•. PL-- - FRONT -r BIDE ' 0 ADDRESS 7 L ��i I�.. -/C/c _ ^ P.L. _ , DATE CORRECTIONS INSPECTOR All ... `) LOT NO. 1X •L '-BLOCK OfC-- TRACT 812E OF LOT /'7 / X ) I NOW ON LOTNO. OF S EXISTING �. I TTIN V x-20 DESCRIPTION OF WORK z° a NEW ADD ALTER REPAIR DEMOLISH = OF ND.OP > BTOR IES FAMILIES P UBE OF STRUCTURE �(n .�✓J7 nlb�d� y - ad NO.OF MP OY 8 I HEREBY ACKNOWLEDGE THAT 1 HAVE READ TRIO AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECT 'B SIGNATURE DATE CORRECT. IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION. AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS IFRAME: FI RE STOPS, BI GNATURE OF/, j y�.� BRACING, BOLTS /Illy-r-��. lA tt PERMITTEE'�I��1M FURNACE! LOCATION. ADDRESS / .h �A^C.!' _ �• r- , iJ. , GAS VENT,DUCTS Q /I V AUTHORIZED ASk�— LATH, INT. T. LATH, EXT. I, L`O /oC G�L�CI FEE H�I/ G� HOUSE NUMBER COR- (1 1114 !!! SECTAND NUMBER CO //n vALUATI �3a 0� FINAL u Y FEE 7"6313A DBS 3 4-61 �F ]6A638A CE#8031REV.6/761 .. APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING n BUDDING //-- - LOCALITY ADDRESS 'Ti4 �, 'IZ.p NEAREST CITY tT ZIP ogb CkOSS ST_ ASSESSOR SIZE OF LOT $ t"-'CIG NNOOF ON for 1 MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCES BY TRACT BLOCK LOT NO. Z 0 Q CONST., / E _ TEL v' (l V OWNER S5 ' LNO. r STATISTICAL CLASSI�ON EWER MAP ADDRESS /� CLASS NO. � DWELL.UNITS BK PG CITY 21 P. pv ARCHITECT OR TEL.. VALUATION ENGINEER NO. ADDRESS BLDG.SETBACK FROM TEL FRONT PROP.LINE OF IST REETI CONTRACTOR NO. HIGHWAY + YARD _ TOT AL SETBACK FROM TYPE OF EXISTING LIC FRONT PROP.LINE HIGHWAY WIDTH ADDRESS NO. LIC + CITY CLASS BLDG,SETBACK FROM CONSTRUCTION LENDER NAME AND BRANCH 01) SIDE PROP.LINE OF ISTREEiI I ,U� TOTAL SETBACK FROM I TYPE OF 1EXISTING HIGHWAY + YARD O'_ ADDRESS Ttr"!7 CITY SIDE PROP.LINE HIGHWAY WIDTH SO.FT SNT OF NO.OF CHECK + = H SIZE STORIES FAMILIES ( ONE ryry O DESCRIPTION OF WORK NEW ❑ P.C. Fee S Permit Fee pt ADD ❑ ❑ Issuance Fee y� ALTER X REPAIR ❑ Total Fee e USE DEMOL EXISTING BLDG. 2 APPLICANT s7 iEl C I PRINT) �-- O BY ISIGNATUREI Q I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE aaY� THAT THE ABOVE 6 CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES TL AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE S WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'SCOM. Z ;05891 A PENSATION INSURANCE. SIGNATURE # o 0 o o o t PERMITTEE ADDRESS -1 Q– = 2 0 o 3 1.0 0 ° TEL o e o 31.005 CITY P t NO. USE ZONE MAP // Q 0 8 0 1 -79 6 NO. O O SPECIAL CONDITIONS L- l DA EL /�/�� BY !f/C/2� JF e. APPLICATION FOR BUILDING PERMIT - `'CO&ftY OF LOS ANGELES- BUILDING AND SAFETY '• �� - WORKER'S COMPENSATION DECLARATION -.FOR APPLICANT TO FILL IN BUILDIN;;;ESS BUILDING ADDRESS - - C7/J� I hereby affirm.that I have a certificate of consent=to self,insure; XRES, ' 8/ZOHD:•eyA- - or a certificate of Workers'Compensation Insurance,or a certified - - ' copy thereof(Sec.3800,Lab.C.) �, ,0,P 78o' .•LOC LI Policy Na Company SIZE OF LOT NO OF SLOGS.NOW ON LOT ❑ Certifiedcopy is hereby famished`` NEAREST CROS ST. TRACT BLOCK LOT NO. - ❑ department. Is filetl with the county building inspect = qq / _«._. "_ - .. __ .-._.,.{.9'S:( :.. _ _ _ : _.. . _ =. �USEZONE :MAP NO. 'ASSESSOR MAP BOOK PAGE PARCEL J Date Applicant SPECIAL CONDITIONS ' . CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER .COMPENSATION INSURANCE _ �/B 'WITHIN 1000 IT.OF SCHOOL' YES NO 'ADDRESS ' (This section10 )need lnot ess.) completed if the permit is for Onehundretl � �j� DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY tlonars'1$t00(or less.) � `" _ .. I.certify that a the performance of the.work for which this permit is Issued, Shall Got employ arty person in any manner BO a5 10 q CHITECT OR ENGINEER TEL + become subject t0 the Workers Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS "` -CLASS NO.� DWELL UNITS NOTICE TO APPLICANT: It, after making this'Certificate Of - , REQUIRED TOTAL SETBACKTROM EXIST - Exemption, you should become Subject to the •WorkersCONTRACTOR TEL NO. - I SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,'you must forthwith FRONT comply with such provisions Or this permit Shall be deemed revoked. ADDRESS - LIC:NO, P L .. ' r LICENSED CONTRACTORS DECLARATION _ _ 'SIDE • , CRY "LIC.CLASS A L • I hereby affirm that I am licensed underprovisions of Chapter 9r EWER MAP } (commencing with Section 7000)of Division 3 of.the Business and SO,F�T.SIZ^E NO,OF STORIESFAMILIES fl Professions Code,and my license is in full force,and effect. ;, e ` Q NEW BK PG O .. DE$CflIPTIOW OF WORK ADD ❑ .VALUATION , V LicenseNumber Lia Class J Contractor - DateE — 00��(/L• ALTER , ❑ '$ ❑ I-am exempt under Sec. - r - � L TS-30ye T� REPAIR ❑ B+&P.C,for this reason' /(.� lJ �'17�— DEMOL 1:1L 1 ,1 W - 'CDMA P/C< Date: USE O XISTING BLDG. - 'URM ❑ iL t/1 .G't G i Z Signature ' - AR CANT PRINT) EL�NO. -LOMA Perm s _ '. Z i -. I, as owner of thepioperty, or my employees with wages as Hr_'.T.a - - their sole compensation, will do the work and the structure is q S ,,, O p �55 V"r•Y/}'D/L� P/� FINAL DATE Q J_`'LI:' jl•-`•1 .rwt intended or offered for sale (Section 7044, Business and T_ _ Professions Code.), WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL. f_ _ 1 ITEM EMJ ❑ ,'as oWGeF Of the property, am 2%CUSIVey CWtfaCting WRIT OR A MIXTURE,CONTAINING AHAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE 1 -Q _ _ _e , AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMA71O`GUIDE? FINAL BY �j 2 Y' licensed contractors-to construct the-project (Section 7044, p� IIIiAL �-• -•®P '- YES o . NOp Business and Professions Code.) [' �J .WILL THE INTENDED USE OF THE BUIDUNG BY THE.APPLICANT OR FROM T BUILDING r_11G1.'(t OCCUPANTOASTIR REQUIRE A PERMIT FOR CONSTRUCTION[a EE PERMITTING FROM THE SOUTH CONSTRUCTION LENDING AGENCY cogsT AIR OuquTv MANAGEMENT DlsrRlcr Isuouor SEE PERMITnNc cHEcxusT FOR CHANGE, p(li t . GUIDELINES i I hereby affirm that there is a construction lending agency.for YES 13 NO . r, the performance of the work for which this permit is issued(Sec. ! _ HAVEREAD THE HAZARCOUSMATERIALS INFORMATIONGUDE AND THE SCAOMOPERMITTING '1 { -- 3097,(.IV.L).) - ,. CHECKLIST. UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. i lUl Ii -I li�lj_1 1L% TITLE 2.CHAPTER 2.20 SECTIONS 2,20 100 THROUGH 220 140 CONCERNING HAZARDOUS Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lender's Address .'Ol ';t! ' .Alt 3,4=•. . o.- wNCP DR.CENT . 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 PC.FEE _ - PERMIT FEE n with all county ordinances and State laws relating to building - m -. to atfUCt10 Gd he ve authOrize'repl2Sentatives 01.This County - - ISSUANCE FEE /•�D ' to n n the above- ed property for.maps TOO Wrposes. 6 AR: INVESTIGATION FEE TOTAL FEE ,i 2/• �J a Avm iDle - O LJ • - SEE REVERSE FOR EXPLANATORY LANGUAGE -