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HomeMy Public PortalAbout9154 BROADWAY_Building__ 90A690A CE 9805 11.57 APPLICATION FOR BUILDING PERMIT. COUNTY OF LOS ANGELES BUILDING p� n DEPARTMENT OF COUNTY ENGINEER nooREss1J - ..— BUILDING AND SAFETY DIVISION LOCALITY JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN.SOFT OF BouoING CROSS ST. DISTRICIj . G`IOUP TYPE SEWER MA/P FOR APPLICANT TO FILL. IN Y (CONST. I – iv ADDRESS . /1 .� V4/fLSTATISTICA��Lf�,,CLASSIFICATION - CLASS.NO% DWELL. UNITS LOT NO. BLOCK .MAP G STATE- ' NUMBER HWY. YES NO Uy`�E ZONE SPECIAL ,,/ NO OF BLD GS. [,/ �L CONDITIONS SIZE OF LOT.�'¢'� /�- I NOW ON LOT USE OF EXISTING BLDG.' BUILDING YARD HWY STREET NAME EXIST." 7' / SETBACK Jill WIDTH OWNER..�i©�C..- 'P X 1..( - - FRONT MAIL P.L: ADORESS�DLS(( //r� ._ Ey C ���C1.1_ 'SIDE CITY i(id.'i'l. ,4 NOL 1 FiC^' P.L. ARCHITECTO TEL. INSPECTION RECORD - - ENGINEER NO. ADDRESS !\ li �.. \ 1 - TE . - CONTRACTOR � `` C:Lo\ul pN ADDRESS - (— DESCRIPTION OF WORK / EW ADD ALTER REPAIR DEMOLISH i _ SOlFT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE— SIGNATURE OF cL� (1+ APPROVALS APPLICANT -- • ` �� / L "' DATE INSPEC OR=S. GNATURE ADDRESS ..CI_ ��L < )s .`. FOUNDATION: LOCATION FORMS,MATERIALS �G r R O FRAME: FIRE STOPS. — FEE B ME FI E STOBOLT �o1.49 VALUATION S ' FURNACE: LOCATION. TA FEEVENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH.INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ' STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH.EXT. ' SIGNATURE OF / �- HOUSE NUMBER COR. A PERMITTEF • /_� l /I r> RECT AND POSTED' ADDRESS �t� � �• L3L 'i FINAL CLYDE N. DIRLAM. PRINCIP L STRUCTUR NE R PLAN CHECK VALIDATION cx. M.O. c 5H PERbW VALIDATION CK. M.O. x [ 'p 11"0.6;8' '.MAY 2 0 1'6 A 2.7-5'A`p ;Or6'9.' :sFviY2O 1.'A` `Z 1.0'.0" V/ I DSS-3 25 SETS B-45 l r - . ' DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT _�.ZOUNTY OF LOS ANGELES yy�L+,5 19$� f� fl fl fl D f�fl WM. J. FOX, CHIEF ENGINEER UU l9� luJ L� 11V FOR APPLICANT TO FILL IN' I FOR OFFICE USE ONLY BUILDING / O/D / ,1 / DISTRICT N°. PL/AN CK. NO. PERMIT NO. ADDRESS • LOCALITY �/ Jy ( � , RECEIVED BY DATE'/OF APPtL... DATE ISSUED NEAREST ✓ J/ 'a-415 42 CROSS ST. OWN i ,y� /��� BUILDING / Cr/© 'r /� DINER �,p �) / •. s ADDRESS / �j , /1 ADDRESS os'- R/f/'vv�v!• y LOCALITY 4,�.J/[� (�Q,/�' MAIL ) //� TEL. /J nS-a CROSSSST. Jllw-44 / N O. LU L FIRE NO.OF •-r I TYPE I GROUP ARCHITECT OR TEL. ZONE PLANS O// ENGINEER NO. _ BLDG. �,� /� ORD. NO. ADDRESS SETBACK LINE r vc� APPROVED TEL3 09 BY DATE CONTRACTOR ^LI NO.. DATT - ADDRESS [IOJ 11'V �it USE // BVPROVEDn Y/ + Jn DATE /v-T ZONE19%/- AYY/ LEGAL CORRECTIONS - DESCRIPTION LOT LOT NO. IBJ BLOCK ' TRACT / / t SIZE OF LOT D V� I NOWOON LOTS USE OF NO.OF NO. OF EXISTING BLDG. FAMILI[8 / I ROOMS DESCRIPTION OF WORK NEW ALTERATION I ADDITION D A REPAIR MOVING DEMOLISH r D BO• FT. .�! NO.OF � STORIES Y SIZE 1// L] 4 ROOMS r WALL n^\"�D I. ROOF COVERING O COVERIN! USE OF NEW BUILDING 5� A. APPROVALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ, THIS APPLICATION AND STATE THAT THE'ABOVE 19 CORRECT FOUNDATION: LOCATION, INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF //���' BRACING, BOLTS OWNER // / LATH, INT.: AUTHORIZED AST. / "^""'� ��� i LATN. EXT.: 1 I U� P. D. B ^ , m /1 PLASTER. INT. L9 F w 7��8 IEE PLASTER. EXT. a 0 VALUATION ��. FINAL ISEfEE' WORKERS'COMPENSATION DECLARATION I hereby affirm that I hove rkerscertificate of consenttoself -r- APPLICATION FOR BUILDING", PERMIT LI IS ' ' insure, or a certificate of Workers' Compensation Insurance,or certified copy thereof (Sec:3800, Lab. C. 0 ^r COUNTY OF LOS ANGELES BUILDING AND SAFETY ,Policy NfCd 3^21i2�c�ampo�ny BUILDwG Certified copy is hereby furnished. e,ya •„y[.- •. FOR APPLICANT TO FILL IN ADDRESS OCertified copy is filed with the county building inspec- BUILDING, A '. tion.departmerlt.; ADDRESS >.O 6 d G LOCALITY .0.xp i__ `r - ✓4 NEAREST ,/ t, r Date Applicant CITY riy. lr ZIP CROSS ST. �11yC t✓1 L - CERTIFICATE OF EXEMPTION FROM WORKERS' - O.OFBLDGS. 'ASSESSOR - - L'. COMPENSATIOWINSURANCE - SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not ba completed if the permit is for one - - USE ZONE MAPF hundred dollars($100)or less.) - TRACT BLOCK LOT NO. , NO. - ' � - 1 TEL � - �� SPECIAL certify that in.the performance of the work for which this OWNER s TEL CONDITIONS d permit is issued,'I shall not employ anyperson in any manner' - DISTRICT .GROUP TYPE FIRE "PR E OB 0. AY O ...y� /,� 'so as to become subject to the Workers'Compensation Laws. - DDRESS CON ZONE-•�• �.,�� �, � CITY r• 1-f s.� 'y Ct ZIP - _ Date � Applicant - STATISTICAL CLASSIFICATION APT. CONDO. It- NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR iEL. Exemption, you .should become subject to the Workers ENGINEER NO. ' CLASS NO. DWELL.UNITS_ _ ,1 Compensation;provisions of_the Lobor-Code you must forth ADDRESS- - - - SEWER MAP with comply with such provisions -or this permit sholl be _ _ N Z ,deemed revoked.• _ CONTRACTOR C rz.� f^l� BK. PG, _ —'VALIDATION' ' LICENSED CONTRACTORS DECLARATION �/L��•�a-1 �� "I^hereby affirm that Pam licensed under proyisioris of Chapter 9 ---; ADDRESS. ..0_Y_ o ✓s N `F / ._- LUA (commencing with Section 7000)of Division 3 of the Business and TION UC. VALUATION Professions Code;.pndmy license is in full andeffect. CITY (^ p' d L CLASS $ 16 ► SQ.FT. NO.OF NO.OF CHECK .License Number' 'Lic.Class + SIZE STORIES FAMILIES ONE s� t� Contractor ' � Date � DE;RIPTION OF WORK 1 NEW ❑ $ ❑ I am exempt under Sec. C • O•� - d b v ADD ' ALTER ❑ FINAL /�� B.BP.C. for this reason + ( fr �' O Us^� REPAIR DATE a T Date: EXISTTIING BLDG. <9 lC�✓S, DEMOL ❑ BY NALJ' � A 2;6 7,'8 A Signature ` APPLICANT - TEL OWNER-BUILDER DECLARATION PRINT NO.. - - - • e • a I hereby;affirm that I am exempt from the Contractors License Low for the following reason (Section 7031.5,,Business and ADDRESS . . '�2,2,a,06 Professions Cade): - PER � ❑ BUILDING - _ 2.2.af.Q;Q o 1, as owner of.the property, or my.employees with ADDRESS wages as their sole compensation,will clothe work and ' - ^ - 0,Q o 9 8 3 .the structure is not.intended or offered for sale(Section - LOCALITY , 704, Business and.Professions Code).' MOVING ,TEL, - - Oas owner of the property, am exclusively contracting CONTRACTOR " NO. with licensed contractors to construct the project (Sec- lion 'tion 7044, Business and Professions Code). - r' CONSTRUCTION LENDING AGENCYREQUIRED SET BACK YARD HWV TOTAL SETBACK FROM EXIST.PROP. LINE- "' WIDTH - hereby affirm that there is a construction lending agency for FRONT. 1 . - - r - the performance of the work for which thispermit is issued P.L. .. (Sec.'3097, Civ. C.). - .SIDE P.L.- Lender's .L-Lendeis Name q L $ Lende'r's Address - P.C. Fee$ ' - - Permit Fee I certify that I have read this application and state that the. Issuance Fee ji,Q J ' above information is correct.I agree.to comply with all County Investigation Fee �-ordinonces and State laws relating to building construction; Total Fee U '00 c. 'G and hereby authorize representatives of this Countylo enter - mention fd-property-for Inspeclio pu poses. - - ' - $EE REVERSE FOR EXPLANATORY LANGUAGE- - Signatur of APPI' ant or Agent o6te t WORKERS' COMPENSATION DECLARATION I herE�y•affirm that have a certificate of consent to self /O\ IrPU ' — 7M V II OBI BURr"�II.V V LL LSU�111V T �JllInsure, or a certificate of Workers' Compensation Insurance, !/'"klU Il `V- ._ r`a ceraffiierd co thereof (Sec. 3800, Lo• C ` COUNTY bF LOS ANGELES - BUILDING AND SAFETY Pol icy.... Company- —,-'`' G•� - _ BUILDING EJ Certified copy is hereby furnished. FOWAP LICANT TO FILL IN "` ADDRESS ICJ- Certified copy is filed with the county buildinginspec- BUILDING tion department. - AN, Date Applicant — - CITY O NO. O BLDGS.• _ LOCALITY "' 165- et 27 "CERTIFICATE OF EXEMPTION FROM WORKERS'- -— SIZE OF LOT _ 'NQW ON LOT NEAREST L A J CROSS ST. y 7-24 - - COMPENSATION INSURANCE 7 / 04. i ASSESSOR (This section need not be completed if-the permit is for one TRACT "( cP BLOCKr- r dT NQ MAP BOOK PAGE - PARCEL hundred dollars ($100) or less.) - TEL, OWNER .NO.• L USE 7.OjJE NO MAP certify that in the performance of the work for which this /Cl/ NO d- permit is issued, I shall not employ any person in any-manner ADDRESS _7 permit _ _ / - SPECI L CONDITIONS i O so as to become subject to the Workers Compensation Laws. - V CITY - Divr zlP t/& /� _. .- . Date Applicant - ^ ARCHITECT OR TEL DISTRICT G P I TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate,of ENGINEER - _ NO. CONST. ZONE _ - - Exemption, you should become. subject to the Workers' _ FNS /j�J/�j/ y//' "' U Compensation provisions of the Labor Code, you must forth- ADDRESS with comply .with such provisions or this permit shall be ' TEL. - STATISTICAL CLASSIFICATION - APT. CONDO.' deemed revoked. CONTRACT . NO. - — - - / - - - _ LICENSED CONTRACTORS-DECLARATION -- -- - -- _ LIC. ••f CLASS NO. DWELI. UNOS (_ N Z' I hereby affirm that lam licensed under provisions of Choptero ADDRESS - - `'NO'.- - SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. -- , and Professions Code,and my lice se 'n full forc nd effect. CITY _ CLASS BK VALIDATION _ BQ. FT. T06 OF �7 NO. OF - 'CHECK" la License Number Lic. Class SIZE STORIES 6 FAMILIES ONE VALUATION �1 Contractc�/lJ'�� L(fate /��(� DESCRIPTION OF WORK NEW ❑ $ D ADD ❑ D • ❑I am exempt under Sec ALTER ❑ 71 B.BP.C. for this reason - NREPAIR ❑ $ Data: USE OF .. q _ . _ .. . EXISTING BLDG. / �'� DEMOL Signature APPLICANT TEL-To(PRINT) EL '- - - OWNER-BUILDER DECLARATION- (PRINT) f/�' NO. u - FINAL )�,/ DATE % / J . I hereby affirm that I am exempt from the Contractor's License d� Law for the following reason (Section 7031.5, Business and ADDRESS /s+� � 1Jq Professions Code): - PRESENT _ By AL • •.. Q�-�T.T El 1, 60 t,' INaJ07 -!R1 I, as owner BUILDG of the property, or my employees with ADDRESS - wages as their sole compensation,will do the work andLOCALITY ' ` ` `77'' l �..Z - 1 ITEMS the structure is not intended or offered for sale(Section-, '� 7044, Business and Professions Code.) MOVING C -,J - =':''semTEL A' �y 0 El . - CONTRACTOR \ NO Aw r/' .,LD'7 L. TOTAL 60 - ' c I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec- - -- - - --0: 'CHECKt f O.13 tion 7044, Business and Professions Code.) ADDRESS �L���� r, REQUIRED ..TOTAL SETBACK FROM. EXIST. . _ - ...ti1F1I'IOE _ . . _.OU CONSTRUCTION LENDING AGENCY - SET BACK YARD HWY PROP. 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 P.L. _ (Sec. 3097, Civ: C.). SIDE 0000-0001 9/12/89 Lender's Name 5660 1 - AM11:0 P.C. Fee $ Permit Fee � Q �' LDMA Ref. # -, Lender's Address _ - _ - a 0­ I . _ . . 0 certify that I ave read this application and state that the Issuance Fee LDMA P/C# 8. above infor, ion is r ct. I agree to comply with all County Investigation Fee _ - R ordinances d to I ws lacing to building construction, _ total Fee �i LDMA Perm. # a and here ut orize epr eWWives of this County to enter upon th ov me ion property for inspection purposes. - a I —it 7 SEE-REVERSE FOR EXPLANATORY LANGUAGE• " Signature Applicant or Agent