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Home My Public Portal About9814 BROADWAY_Building__ 76A636A CE0803 9-60 e/ - "y APPLICATION FOR BUILDING PERMIT( COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS D/¢ BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST COLEMAN W. JENKINS, SUPT OF BUDDING CROSS ST. G'p FOR APPLICANT TO FILL IN DISTRICT NO. GROUP vPE PROCESSED BY (' (Print Or type only) 4�0 = CONS T.1` _ p BUILDING U /' �D STATISTICAL CLASSIFICATION .n SEWER MMAAPC•__ ADDRESS L — CLASS NO.�DWELL,UNITS_S•_' BK�PG�=. LOT NO. BLOCK USE ZONE MAP p NO. TRACT 3p Q,J/^ / CONDIITL O -'� SIZE OF LOT �� 1� /Az CI NOW ON LOTS USE OF EXISTING BLDG. _L,0- - BLDG.SETBACK FROM TEL. FRONT PROP.LINE OF (STREET) OWNER _ NO. o eo TYPE OF EXISTING .SETBACK HIGHWAY } YARD = TOTAL ADDRESS p � C' � HIGHWAY WIDTH FROM C.L. CITY A LGL 1 60 1s`o Ue; + -2-a = J-a SETBACK ARCHITECT OR f TEL. SIDEGPROP.LINE OFOM (STREET) ENGINEER NO. TYPE OF EXISTING SETBACK HIGHWAY } YA RO TOTAL 10 ADDRESS p HIGHWAY WIDTH FROM C.L. ' CONTRACTOR , Tp�� Fa ,5 } A DDR ESS,I,?/�j Np " CORNER CUTOFF YES ❑ NO ❑ C clry CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS 4 CONSTRUCTION LENDER q Q - a NAME AND BRANCH �_'o_'Z� z ADDRESS SQ. FT. NO. O SIZE STORIEF S FAMI/ NO. OLIF ES NEW, ❑ �� G CAL Gfl �O/? USE OF _ AD l s C7-/an/ eO ON6 OMT G• STRUCT URES'� v/G..p ALTER 0155 B C REPAIR❑ SIGNATURE OF y'7 APPLICANT t l�/• DEMOL ❑ VALUATION S 6feA_v--Q a -p APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. ��, �� FOUNDATION: LOCATION FEE S FEE 5 FORMS, MATERIALS FRAME: FIRE STOPS, /- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUC TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. /��ir" LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMP CSATION INSURANCE. ry LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED . ADDRESS - qq I FINAL 7, c/�d y //Y /.r.R•irY JOHN F. LEWIS, PRINCIPAL STR T.URAL ENGINEER PLAN CHECK VALIDATION. CK. M.O. CASH _ PERMIT VALIDATION cK i M.o, CASH Itr9024 PILM27 e 22:50- L APPLICATION FOR COUNTY OF LOS ANGELES BUILDING PERMIT DEPARTMENT BUILDING AND AFETY DNIS ON ENGINEER BUILDING FOR APPLICANT TO FILL IN ADDRESS / BUILDING �/ 4 ADORES" DORESS LOCALITY .,,L. NEAREST CITY (/ ZIP CROSS ST. NO.OF Bl-,OGS. ASSESSOR SIZE OF'LO X�. NOW ON LOT MAP BOOK PAGE PARCEL y e �1 DISTRICT GROUP TYPE F1ftE PROC EO BY TRACT/' p D S BLOCK LOT NO"' 4 v C) CONS T. ZONE �p TEL. C/ I 3 OWNE NO. STATISTICAL CLASSIFICATION , // SEWER MAP ADDRESS CLASS NO.�DWELL.UNITS .t BK/) F0— USE ZONEMAP oo.. CITY ZIP NO. OO u ARCHITECT OR TEL. / SPECIAL ENGINEER NO. CONDITIONS D KESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ TEBLDG.SETBACK FROM NO FRONT PROP.LINE OF (STREET) LI . D. n HIGHWAY } YARD TOTAL SETBACK FROMI TYPE OFEXISTING LIC. FRONT PROP. LINE HIGHWAY WIDTH Z - CLASS 'CONSTRUCTION LENDER + NAME AND BRANCH y BLOG.SETBACK FROM O ADDRESS CITY SIDE PROP. LINE OF (STREET) U SQ. FT ' NO. OF NO. OF { CHECK HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF E%(STING C 512 STORIES FAMILIES/ ONE SIDE PROP. LINE HIGHWAY WIDTH /` _ U DES RIPTION OF WOR e ' NEW X + G" N DD ❑ CORNER CUTOFF YES ❑ NO ❑ Z / LTER IN OPEN SPACE YES ❑ NO ❑ PAIR❑ US OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ IN G BLDG E yyyy A PL TEL !. V Y IGNA V NE KNOWLEDGE HAT I HAVE READ THIS APPLICATION ♦NO S HAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUC TIO RTIFY iMAi IN 001X4 THE WORK AUTHORIZED NEREB WILL T EMPLOY ANY PERSON IN VIOLATION OF THE LAB. CODE OF HE STME OF CAL IFO IN RELATING TO WOP MEN'S CO-PE SAT IMB VPANC E. L/ ' SIGNA RE FINAL F'_z2-77 BY PERMIT - CATE !/ ADORE 9'1d-- 't clry �'iU No w P.C. Fee$ Permit Fee - cc ,F.-�� Issuance Fee VALUATION Y V Total Fee �ZJam'@ PLAN CHECK VALIDATION CK.' M.O. CASH PERMIT VALIDATION CK CABN 4''2 6MAR 31, 1` 8 2.: es8 •7ew438A CEae.GB Iz/TB X I Tua ial cE gem.I<I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DMSION LOCALIT JOHN A. LAMBIE, COUNTY ENGINEER NEAREST lJ. WILLIAM A. JENSEN SUET OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO, GROUP TYPE PRO ESSED BY v_ 1 CONST. BUILDING STATIST AL CLASSIFICATION SEWER MAP ADDRESS /4/ p B PG �a - CLASS.NO._9—DWELL. UNITS_ LOT NO. Oc BLO ( WATER NOT,REQUIRED RECEIVED 3 O CERTIFICATE: ��LJJI Li TRACT // ,`�'['1HIGHWAY SIZE OF LOT L7 NO.OF SLOGS. USOPZ d I SPECIAL STATE MAJOR SECOND, LOCAL Xl i�- I NOW ON LOT _ USE OF / CONDITIONS EXISTING BLDG. TEL. OWNER NO. BUILDINGYARD HWY STREET NAME EXIST. C' SETBACK W112TH ADDRESS C FRONT ARCHITECT O EL r P. L. ENGINEER No J SIDE ADDRESS / P L 1 TEL. / INSPECTION RECORD O CONTRACTO , NO. p 6 ADDRESS V. 1 a J f /�.L�/N/ JL6'e�4� �J.�M/9�/ Ix DESCRIPTI WDA% Y /�,ay �' �.� e�elt7C X- 'In.� ;rV+ NEW D ALTER REPAIR DEMOLISH SZET 070 C/I,�I/l- o� .0/�S�T-ORIELS q ,.a FAMILIESUSEOF �,(� STRUCTURESq(-74,(C�.yl �{�Lcp /LL�/LCd.A� A'225 d� IX0� SIGNATUREOF - APPLICANT r VALUATION S `O C—0 — APPROVALS APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. 6-0 FOUNDATION: LOCATION FEE S FEE FORMS. MATERIALS i FRAMENG: FIRESTOBOLTPS, w La�I !, I / yy HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACI , S IV V AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, 1 WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS (� BUILDING CONSTRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY IWILL NOT EMPLOY ANY PERBON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE, "�-�., LATH, EXT, i PERMAITTE E F C HOUSE NUMBER COR- RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, P INCIPAL STRUCTURAL ENG R PLAN CHECK VALIDATION DK. M.O. CABH PEANIIT VALIDATION cK, M.O. CweN ' I LA,r.9 7 2 3 JUL7 1 D 5.00M WORKERS' COMPENSATION DECLARATION sure, o a cert hot ( have-a certificate of consent to self f 7U` IprF��C �T�®N ®R'.�n' n�n' D��n� �O 2.�� ,�S l� insure, or a certificate of Workers' Compensation.Insurance,_ AB !!'\l `lJf L� (f�f (r E u�u u or 6 certified copy thereof (Sec. 3800;lab..C.) - • - - COUNTY OF LOS ANGELES ' 'BUILDING AND SAFETY '.Policy No t Company = ElBUILDING certified copy is hereby furnished. ".FOR APPLICANT TO FILL IN - ADDRESS Elcertifiedcopy is filed with the'county building ms BUILDING BUILDING - _ •- - - - - - _. . 'tion department. ADDRESS �) A 6U^ ,..L`, .^..._. C/6� ZIP .� LOCALITY — -. Date - - Applicant - _ N .WOF BLD S.. - CERTIFICATE OF EXEMPTION:FROM WORKERS' SVZE OF LOT - N ON LOT - NEAREST CROSS ST. COMPENSATION INSURANCE �'' (i _. ASSESSOR /y '.hung section.ddollars,($100) not.be completed if the permit is For one - TRACT - BLOCK LOT NO:"• MAP BOOK p J '-� O O. PAGE V�� PARCEL�Q • hundreddollars,($100) or less.) TEL ' OWNER /�. \ `NO. USE ZONE MAP' + I•certify that in the performance of the work for which this .. - NO. P4 rmit is issued, I shall not employ any,person in any manner ADDRESS - - - SPECIAL CONDITIONS' so as to becomesu�bjed to the Workers Compen_safion Laws .- / ../. /y _ _ 0 /4/�i 2 �} Cm p Lf. ' l ZIP 5 U Date Applicant A� ARCHITECTORTEL. - DISTRICT GROUP I TYPE -FIRE PROCESSED BY NOTICE TO,APPLICANT: If,.aft r making-this.Certificate of ENGINEER _ _ - NO. ' CONST. ' ZONE Exemption, you should become subject to. the Workers' w Compensation provisions of the Labor Code, you'-mushforth- - - ADDRESS _ •�jJQ --3 Y - d with comply with such .provisions or,this;permit shall' be �` T /n .,/ STATISTICAL CUSSIFICATION APT.. CONDO. Z deemed rev.ked - CONTRACTOR - /uY Xa -� _ LICENSED CONTRACTORS DECLARATION it CLASS N0,2F w u. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 . r ADDRESS 3 0 ) . i4iXC TFL N62PI Sr LIC. - SEWER MAP ;(commencing with Section 7000E of DiJtsion 3 of the Business �• '.. and Professions Code,and my license is in full force and effect. . CITY J 71 A 2l Lf L CLASS 'Q BK. PG. VALIDATION ' SQ. ET. NO. OF NO. OF CHECK - 'License Number 3fl Li c:-CBss SIZE STORIES' FAMILIES ONE s. r �13 7 VALUATION rrTz Contracto ,w Iz_ W /L3 O.pfato -L DESCRIPTION OF WORK ? LA r U v NEW ❑_ S ? /.0 00 _ . .. - ADD ❑ V / D . ❑I'am exempt under Sec. / u -^ _' -. ALTER " - ,B.BP.C. for ' this reason l-(,!.✓+t I h 7y, // - .._ ,..- ". � l,E. - N REPAIR ❑ $__ Date: - EXISTINGNG BLDG. DEMOL ❑ - 1 APPLICANT- FINALSi nature �'� PRINT) ,_ d N �Ig _ I �RRATION�-BLER ! 1 DATE�—�R" — hereby,off irm that I am exempt from the Contractor's.License - - - /- - Low for' ow the folling,reason;(Sectioo07031.5, Business and ADDRESS J� - .( 56+ FINAL Professions Code) - PRESENT - -- - - - - B3' - - ❑ y . 1, as owner of. the property, or my employees.with ADDRESS wages as their sole compensation;will do the workcind •—the structure is not intended or offered for sale(Section LOCAUTY 7044, Business wand Professions Code.) - - MOVING ' TEL - - y_. ❑ I, as owner of the property, am exclusively contracting' CONTRACTOR NO. 1 u!. with licensed contractors to construct the project (Sec- 93- I'-II - 97 3 _';63 tion 7044; Business and,Professions Code.)' _ REQUIRED TOTAL SETBACK°FROM E%IST. '- CHECK CONSTRUCTION LENDING AGENCY. - SET BACK' YARD HWY PROP. LINE 'WIDTH - I hereby affirm that there is a construction lending agency for FRONT CHANGE i t-�' 1.H� -. theperformanceof the workfor which'this permit-is issued ' -P.L"— (Sec.'3097, Civ. Ci). SIDE Lender's Name. / g i-i . _. - Q. G2 LDMA Ref: #- - - PC Fee$V- Permit Fee Lender's Address ,�, _ _ - D Jijr I certifyy-that I have read this application and state that the • - Issuance Fee LDM , DO A P2# - 8 above information incorrect. I agree to comply with all County Investigation Fee - - - ordinances and State laws relating` to bbilding construction, .Tmal Fee �+Z� 3 LDMA Perm. a and hereby authorize representatives of.this County to enter 3 upon the above-mentioned property for inspection purposes: SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of,Applicant or Agent Date < -