HomeMy Public PortalAbout8606 GARIBALDI AVE_Building__ APPLICATION FOFt, BUILDIN.C3 PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
FOR APPLI NT TO �1�L BUILDING IN ADDS r
At—
BUILDING /4 Y _0CAL
A DD RE55 '
NEAREST -
aTY ZIP S ST.
NO:OF BLDGS.. ASSESSOR _
SIZE OF LOT IiN4
OWN LOT MAP.BOOK.• AGE - ARca
KM
G{2Qllp .TYPE FIRE'" FD BY
TkACT OCC' LOT
CONST
ZONE
OWN IBJ •_ i$1 / . J
STICAL7ASSIFITION '-i; 'SEWER
ADDRESS CASs NO. DNC UNIT$ BX
arY -5'ao ..ZIP ' V'177s.
ARCHITECT OR Ta- _ VALUATK?N $
ENGI N EER
ADDRESS
TEL FRONT PROP.LINE OF ISTREEII
CONTRACTOR 2 NO. TOTAL SETBACK FROM TYPE OF EXISTING
NIC4IWAY •f YARD FRONT PROP.LINE HIGHkAY WIDTH
ADDRESS
- 'LIC f.
CO CLASS BLDG,SETBAQCfROM _
S I DC P RO R: N E OF IST REETI
NAMEAND B TOTAL SETBACK FROM TYPE OF STING
ADDRESS CITYHIGHWAY + YARD SIDERROP.UNE HIGHWAY WIDTH
SO.FT-: NO.OF NO.OF CHECK } •V
SI 7F ,' STORIES EAMUES ONE
D&JZIPTiON OE WORK NEW P.G Fee$ Perm f Fee .
ADD.
Issubnce Fee '
'.r.• ALTER, -
REPAIR 'Tota F FQe T.
LISE OF . _. OEAAKJE _
EXISTING Bi DG: ,
APPLICANTTEL
(PRINT) �- --� ., NOBY ISI.GNATURE) --
IHEilHY AOQJOWUDG3 THAT I HA T}i U AN D�S'fr.TE - -
r mll THE i,BOVE l5 CORRU MID IAQ�TO Y All
AND LA ]1NC�'�UILIXNGOOf6T%1CilON.J K�iT1 FY THAT IIF DOI THE. ' '
WORK AY I VJII�L.NOT OY MfY p�SpN TION Q� a r, ._ •. ..- — .
THE LABOR-CODE OF THE SfA1 OF U]JFOR1 II�I�RHATIFJG70 W�•15COA4 .
PSZA ZION I . .,.� i�'F ., _, c. - : I . - '5 2'6 .A'_ .
GNATURE OF og�TO
PFRhlfffEE
co VK O
ADDRESS
TES
CITY- �.�1' `( ,` NO, CLI
ZONE MAP
DATE44
/C
wo�a5'COMpBySAT1ON DEdARATIQN
ti -
�,I h�"affirm that I have a.certtflcate of consent.tq seff-' _, _ - _ - _ _.
I.re: of b ceftfflcc"of Workers'ComperisaZl Irourance, A .�'I�.ICA I,C�N. :. ,Q R. .B U I1, I N G PERMIT' cli
or a certified copy thereof'fSec: 3800;Lab. C_) _
--4OUKN y OF.LOS ANGELES BUILDING AND SAFIFtY,
Pol"No. Company -
Certlfied copy is,hereby furnlshed. I
FOR APPLICA To Ify.• _
Certified copy Irr filed with the'County bulldlrlg Inspec- BU NG
' Itlon'departm'ent: ADDRESS.
ell
Do-to-7' a Applicant CITYZ1P LGG111-Y
'`C1 nFICATt QF EXE/WPTION FROM WORKERS" SLa OFLOT ONBLDG&
CONDENSATION aNSURAtJCE' LOT
(3Trbriectlon'treed nat be completed ifvhe It as for,ane __ _. _ I c;t4'
b.0 ed dollars.(51291 Iw ) TRACT eaocx Lor NO. i �P Bba�"' I 1 PAGE: PARca
usE zoNE .
I.�rtffy that tri th's perfonlance of thi work for wf�lch this ZT_ NO.
Perm it ti'IssUed, I shall not employ any n In any manner. SPEC m
dt
so as to becornersuble 'to the Workers pensetl fa - ADDRESS-- -
Applh CTfY
rlOT10E'TD''APPtJ(`11fJT:'ff, making' I ARCH=OR TEL RISTRICT_- GROUP' -TYPE_ _ _ .FI RF. _ _ BY
.-
CONST.you should b subject the 1N �T• zOt
Compensation pcovlslow ofyhe labor Code,- nth ADS �. —
with comply with such provisions or:thla,•perrnk "I be -- 'fg- - - - STAI15T1CAt CVS�IF PION. 1. Al'f.-
deerned,revoked. , . , , L. • - , ;r[ ,..' CONTRACTOR NO. isl- '
UCY4SED CONU42ACTORS DECIAMMON ,: _. -- - - --- - -- .. .. _�. _ -. •_ CLASS 46. DWEU_ UNITS - .
I herTby affirm that I am Ilcprsed ender provWQns of Chapter 9 ADDRESS
jcgmmendnp with Section 7004)of Won 3.qf the&Mtm and _._.. _ - SEWER MAP : . .- y ,
-LiG• - [
PrnfMloro Code, end my lkense Is In full fors a�d;efF t. CITY aASS -VALIDATION
Clcin}iTlumBir "LIG Clan - FAM U ES
" VALUAT10N - -- - - t
NEW
Contractor pates D6SCZWTK I orwoR1C- ADD
I am exempt undw-Sec .A.L
TER
B.d8.C. for th N reason5y
Abu RJPA1R - - -. -
EXISTfNG IN DG DEHMOL -_
# 6- -o
Slglre .._ r APPUCANT TEL �Al
OWNER-BUILDER DECLARATIONnNT) NO. r
--I hereby,affirm that I am exempt-from the Contractor's License DATE w - - -1 ��o ' ��8 8 -�
Law for the following¢Teh;otv' 703.1.5, Business and ADORES FINAI'.
Profeula .° •
�
� BUILDING
RJ- It,as,,owner of the property, or.my employees with - .. _ ADDRESS 1•2,3 1 +6
wage as theta soli th
tomperisatlon,will do e work and
the structure Is not Intended or offered for sale on tOCALrrY
7@41;Bwlnesr and Professlom'Code� ' -• -- - MgvltdG .. _; . . .- ..... _. .-. _ _ .TEL .-_.. _ _ :- _. _ ---• -_ .___ ..
1 as owner of the property, am exclusively contracting CQNTRACTOR
. NO.
J Y.
• with•Ifcerried contractors 7o:conttnact7heRro(ect (Sec- ADDRESS
- ._.-_. _ _ ...- . -- —., _ ,-_-- __-.-- __ _ _ •__ C..-' , _.� =, _. _
tion,7044, Buslnew and Professions Coded r
TOY
CONSTRL7CT1ON LENDING AGENCY - - "IRM - ' PARD MWY PROP:utF NnD -
'I hereby affirm that there is a conitruction lending agency for �T
the performance of the work•for-which,thls permit Is hsued -. P - - - --. - --
(SeC 3097, Clv_C.� SIDE } - '
F-L.
Lenders Name J
- - _.% ._._
LDmA Ref. f ""
y, 1
Lender s Address P.0 F..f Penins
-.1 urttfy that_L have read this application and state that the - __ - - _ ` fee
-- LDMA P/G#
abovq Infbrtnatbn is correct. l agree to comply with all County Inveptlgrrtlon Fee
gcdlr>Qfrcer! and $tate- IQws rslatlnfl,t9.bulldllrg-4onstrutlon, ►`�i r1t� U)MA Perm. f {
and hereby authorize representatives of this County to_enter
upon t above-men pr for Inspectlgn.purposes.
_ - 1 M W1/¢U X0LANATOkY L.ANGUAGM i
gr�
a
^ knit Dote �_..
rRKERS}COMPENSATION DECLARATION
--` APPLICATION FOR BUILDING PERMIT
I affirm that I have a certtflcats of consent to self
InsJre, or a certtfimte of Workers'Compensation Insurance,
or a certffled copy thereof(Sec 3800, Lab. C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
Certified copy Is hereby furnbhed. FOR APPLICANT TO FILL IN A S
❑ Certified copy h filed with the county building Inspec- BUILDING
tion,deportment. ADDRESS LOG411T1
NEAREST
Date Applicant CITY7Z5110ALP CROSS ST.
CERTIF)CATE OF EXEMPTION FROM WOOURS' �g OF LOT I O NO.OF ON LST� MAP BOOK PACS PARCa
ASSESSOR
COMPETJSAT}ON INSURANCE3
(This section need not be com leted if the permit is for one TRACT BLOCK
hundred dollars (;100)or less. �� J }
SPECIAL
I cwttfy that In the performance of the work for which thl,! � NO. 11 CO►DMONS tL
DISpermit Is Issued, I shall not employ any Person In any manner ADDRESS TACT17,51p �/
ZRE BY,
so as to become subject to the Work Corrtpensatlon15 5t/� CIT ZIP O
Date 2Y
'Appllcant STATISTICAL CLASSIRCATION APT. r
NOTE TO APPLICANT: ffifff after making s Certtficat , of 'moi �OR V
Exemption, you should become subject to the Workers ENGINEER �' CLA55�' DWEL� UNITS a
Compensation provisions of the Labor Code, you must.forth- Alm SEWER MAP rn
with comply with such provisions or this permit shall be z
deemed revoked. CONTRACTOR TEL.. Bic F PG, VALIDATION
LICENSED CONTRACTORS DECLARATION LIC
I hereby affirm that I am licensed under provbions of Chapter 9 ADDRESS NO. VALUATION
(commendrp with Section 70D0)of Dlvhlon 3 of the Busin ass and LIC
Professiora Code, and my License Is In full force and effed. CrrY CLASS i ,
SQ. Fr. NO.OF NO. OE' CHECK
License Number LIc.Class Sig STORES LIES ONE
i
Contractor pate DESCR-IMON OF WORK � ❑
ADD ❑
I am exempt under Sec.
ALTER ❑ FlN/►L ��
❑ DATP
B.BP.0 for this reason REPAIR
USE OF FIN
Date. EJ(1STING BLDG. DEMOL .❑ z
Signature APPLICANT TEL
OWNER-BUILDER DECLARATION (PRI NO.
I hereby affirm tftcrt I am exempt from the Conb-ac o s License
Law for the following reason (Section 7031.5, Business and
P�ro{J"ns Code):
I, as owner of the BUILDING
property, or my employees with ADDRESS
wages as their sole compensation,will do the work and LOCALITY o o
The sfi,tcturo b not Intended or offered for sale(Section ( I ( 2 y
7044, Business and Professions Code}. MOVING TEL.CONTRACTOR f
I, as owtmw of the property, am exclusively.contracting �'
with licensed contractors to construct the project (Secy ADDRESS
tion 7044, Business and Professlons Code
FROM
CONSTRUCTION LENDING AGENCY SET I YARD HWY pROp u� WIDTH
(hereby affirm that there b a construction lending agency for FRONT ,
the performance of the work for which this permit Is Iqued P
JSec 3D97, Civ. C.)• r SIDE _
Lenders Name w ::2�-2 f`� &C ,
Lenders Address P.C. Fee i Permit Fee
I certify that I have read this application and state that the hsuance Fee
above Irtforrrwtion h correct. I agree to comply with.all County Investigation Fee
ordinancee and Mate laws relating to building conatnrctlon, Total Fee
and hereby authorize representatives of this County to enter
upon above-mentioned pro for Inspection purposes,r -
/ M F2VWM POR EXPLANATORY LANGUAGNie JeA
�t
of Appikont or A4e" J Date
WORKERS-COMPENSATION DECLARATION ,
Mure� r that
of Workers'Compensationconsent
"If
�I► P,L1 AT�01 FOR BtJILDIN� PERMIT
or a certified copy thereof (Sec. 3800, Lab. C.)
COUNTY OF LOS ANGELES, BUILDING AND FETY
Polley Nd. Company BUITDING !
Certified copy u herby,furn lshed.;,. EOR APP ICANT TO•FILL FN ,ppm,. Q
Certtfled co Is filed with the county Inspgc.; BTJILDINC
PY
/
{�
tlortidopa"ent. ',r.. ADDRMri
. ,
Date Applicant CIT1G10 ZIP 21 7-5 LOC.&IrTY
CERTIFICATE OF OMPTIOfv 12oM WORKERS' NO.of BLDG& NEAREST
COAAPENSAT1bN INSURANCE SIZE OF LOT Njow Sfi:
(Thb section need not be completed elf-the Permit Is fog one ' -
1 h u odred�o1I ars'($I OO)or I e*a. TRACT BLOCx LOt NiO. AMP DDOIc PARCCL
�. Te
- Al' /! L
I certify tIw} iA perfo�manoe-0f the wbrk for+tvhlch•this v;'; r /
permit Is,l�sued,1 t1Wil not employ qhy n7n-ony'manner ' r mow•
+ 4o a. becodle:subjeGct to the
peIa 10ri ADDRESS' 4 — �T
XWS
NOT1Ci TO APPCI¢4NT: It, trfter igbkl la Certfflwte of- OR .
• MR K-7 TYPE FlRf BY
Exernptton, you should bicome wbl •-to the Workws' I OOMSi. ZONE
Compensation provlslora bf the Labor Code, you must forth- Alibi �. �.
with comply with' such previsions or this permit shall be Ta.
deemed revoked. STAT15T1CAL CIASEIHUTION APT.
;
LKINSEO CONTRACTORS DECLAR �T10N .. _ .t� CL
tASS NO. DWELL UNrrs' J z
I hwebyafflrm that 1 am Ircenstd 0nOw provisions of Chaptec 9 ADOMS SEWER AARP
{cornFrtertd with on 7000)df Divbfon 3 of the Busine�and _ /,' _ LK_
ProfeMlOat CadR arfq my Ilarne'Ts In Evil forcr.a effett. CrtY' / yMRAT�M .
{.. .. S4 Fr. No. Of NO..OF C-EC]c
•Llcensei�lumber r �Ic.Clo.: SIS
Contrecibr' Date IOW
I am exertl't under Sec. (! A h
�° •—, um OF
VWNQ a=. AIDAPRJCAW
Wt� odNo1
. 1I AJA Ta � oS9nature INT ,o
OWER-BUILDER DECLARATION .
DAT1
ere
I hafflrmahat.l am exem from the ContraFtoes License ` `
Law.fb �
the following reason (Section 7031.51 Butinees ao4L 1'1.03'-,-$7
f!rofeetlorn Code):' *y
-, I, cm owner of the•property, or.my.employ*",with
wages as their soli Gontpensotlon;will do the wv r -and
r.
the structure Is not Intjnded or offered for sale(Section- J�
704A, Buslrl*W and Profestlons Code)_• Y NO -
r, at owner.Oyhf property, onr exfl`ualvely contracting-
with licensed contractors to construct the prblect (Sec-
tlon 70", Business and PrbfestlonFCode}
CONSTRUCTfON LENDING AGENCY YARD FIVYY ,
I hereby affirm thaf th"is a construction lending agency,for FRONY1_
= the performance of the work for which this-p�rmIt It Issued p
(Sr- 3997,.CIv: t
Lenders Name r
19 � - . � IDM, Ref. i
J end r`s Address : P.G FM i n :
certify.that, have r*od thli applI atlon and state that the Ws ance Fe... O' LDAkA P/C ti
ai?a"lrrformotion-is correct,r agree to campy with all County InvsRtigatioq F«
$ ordirx n-c�yi and Srate lave r relating to building bDrah-uctton, ,. T L Fee LDA"Perin_
! and auth'brize repr}sentutives of this County to enter
$ upon a Ngned for Impaction purpbs♦a• l
= - 7, SW R,ri Err Pot RMA,fAT69Y l 16
l►,tOUAO.
%rA3KW6jf.Applkmt orAgent - Dale
WCQXFW-COA4P4JSAnON ON
hereby affirm?hut I have a cetttfioN. of I �ro T APPLICATION .FOR. B U I L D I N G PERMIT
Insure, or a c»rtlficate of Wo�icersYi
f., or a certified thereof (Sec 3800�ab..� ) �.e COUNTY OF LOS ANGELES ��... . BULDING AND SAFETY
(/V J 67 Com h S C `' y Y
-'policy Pa Y c \
Cgrtifiedl copy is hereby fumishecl. EQR A. I TQ. F t I K, AL b to C�BUFJMNG
ro
Cecttfled'copy is filed with the coon bulldlrrg Inspec- -�
tion department.
Date � 2 Appllcarit ` QTY �n TIP
LOCAUTY
FICATE•OF E tkw.rION FRom WORt�RS' SLE,OF LOT NOW ON LOT d4=-ST. O S Q
T --
COMPENSATION INSURANCE-
(This
NSURANCE
_ (This sectlon.r4ed not be corn let*d If the perrnit,is for one TRACT OEC LOT NO.'
hundred 8oIIa"rz ($400)"6r lea. ` ^^rIC& PAGE PARCH "
0.W ER. L Q L 2 — / USE ZONE MAP.
I certify that In ihn"performance of.thq work.for whlth this cc
permit.I4.lssued, l ihall not•rmploy Cny Person In any manner t}f�.Q.�' d���\p `�•.._ . f. �
�� COND OM
so as to become subject to"tlae Wofken Compersatlon haws O .
` 1 ZI R _ _.. U
Date Appllcant ARCHITECT OR .— 'TEL. IASMCTGROUP TYPE P BY,
NOTICE.TO APPLICANT: If; after'making this Cwll4ltpte of ENGINEER NO. '
'Exemption, you. should b*corne subject to .the .Workers OONST./ ZONE
Compensation provisions of the Labor Code,•you must forth- ADDRESS ;��! 'L` +i.
N
with comply with such provlslotu.or This permll,s},all be TEL STATISTICAL CLASSIFlIO
CATN AFT!: CONDO Z
deemed revoked: CONTRACTOR / _
UCB�LSED.COfJTRP.CTORS•DECLr,RAT10N ADDRESS D I g' C.I � NO. 5 I � 3.-7 CLASS N4• UNITS
I hereby affirm that I am licensed under proybions-of•Chaptm 9
(commencing with Section 9000)of-Division 3 of the Business UC. SPH�MAF
SS
and Professions Code,arid my license Is Ih full force ani effect_ �t w.. ds I C— Br< PG.90 VAUDAt0N'
S(]. CF t,40. OF - CHECK: 1
License Number-S17'3-7,Z :yl� clq,. ��'3 Z � O D SrORZ FAAIIUES l Ota
-.0VALUATION
Contractor DESCR:11`710N OF WORK ADD- ❑ 2 1 p J
0 I am exempt under Sec.
ALTER ❑ - ►
B.$P.G for this riason - T O sr- 0�.� L o`er" ;
REPA1 R _
' ..
'Date: USE QF
Slgrwture APPLICANT. TEL
-'OWR-BUILDER.DECLARATION . �� �•y��L t�tJO,S 9
NESc-07 DATE
I hereby affirm that I am exempt from the Contractors License A ..�O �,` lJ - i
Lliw for the followJng reason (SedL drr 7031.5, Buslness'and FINAL,;'
Professions Code): :' _ w * TJL
❑ 1, as owner of,the l r or•m -employees with BUILDING F �a
ft'�°P°fTY, Y P�s �
wages as t6lr solttompersatlon,WHI do the work and LOCALITYI . - _ S�)� ,.� 7 12W3.63
the structure Js not Inthnded or offered for sale(Section 'y� r
7044, Business and Professions Code. . MOVING. . -. TEL
t
❑ 1,as owner of the ooNTRACT60 NO. � �� TOTAL
128 - 6,3
property, am exclualvefy contractlpg •
with licensed contractors to construct the-proled ($et- _ _. ._ _ _
tlpn 7044, Business and Professions Code.).,. ADD 22), &
CONVRUCTION LDMIN�{G AG44CY .YARD- HWY _
1 hereby affirm that there Is a construction lending agency for'` FRONT 'l��
the performance pf-the-:work for which thts--pgrrnit rs Issued P.L: - -
(Sec. 3047, Civ. C.). S1DE.
�i Lenders Name P.L. COMp p -E.031 5/12.1./.T2
.
n Lenders Address , p G"FM Permit FM �!t'0" LDMA W. 347 1. 17!f U J 1
I certify that I have read this appllcation and state #hat the Issuariu _ �7 / LDMA P/C I
above Information Is correct. I agree to,cpmply with all County Investlflotlon fee'
ordinances and State laws'relating.to building construction,_ To1oi Fee � • -� LDMA Perm.
and hereby authorize representatives of this(county toenter
uponp4 above-rnsntloned.property for,1 loci p rposee. -
Z\ �'� iia iiV■tiat l'o�EULAXAT0[Y U06GUAW
Suture of Appllcr or AQsrlt Date