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Home My Public Portal About8633 GARIBALDI AVE_Building__ i 76A638A CE4803 6-62 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ULDDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 3< BUILDING AND SAFETY DIVISION LOCALITY 1 JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A. JENSEN, SUPT OF BUILDING CROSS ST. DISTRICT O. G UP TYPE R BY FOR APPLICAN TO FILL coNsr. A. BUILDING STATISTICAL CLASSIFICATION SEWER MAP �; ADDRESS CLASS. NO-0-DWELL. UNITS LOT NO. - BLOCK WATER CERTIFICATE: NOT REQUIRED ❑ RECEIVED ol TRACT O� MAP HIGHWAY STATE MAJOR SECON LOCAL NO. OF -LOGS. NO.•- G� C/ (CIRCLE) SIZE OF LOT /� NOW ON LOT USE ZONEPECIAL _ USE OF CONDITIONS EXISTINCnBLDG. JAT OWNE - BUILDING EXIST. ,p y � SETBACK YARD HWY STREET NAME "112TH ADDRESS ( .�G�'Z�•d�+7�' FRONT ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE P. L. Y 1- ADDRESS �O CONTRACTO ADDRESS " \ DESCRIPTION OF WORK LLA M E ADD ALTER REPAIR DEMOLISH a H .FT.- y NO. OF NO. OF SIZE �7 STO S F MILIES - USE OF STRUCTURE � 12- SIGNATURE OF APPLICANT- VALUATION 5 PPLICANTVALUATIONS /r APPROVALS DATE IN CTOR'SSIGNATURE P.C. PMT. FOUNDATION: LOCATION .A FEE S FEE S ) .-- 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. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATI ) GAS VENT. DUCTS v` BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE W K AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN V LA' TH, INT. -21 TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA LAT ING TO WORKMEN'S COM PENiATION INSU CE. LATH, EXT. SIGNATURE OF J' HOUSE NUMBER COR- PERM ITTEE OR-PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.U. CASH \ Z 13 2 3 A r, 6.7 5 Li1LC7 9 y:U AA APPLICATION FOR BUILDING PERMIT COUNTY.OF L03 ANQEI...ES B_ UIk..DING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUNG 1 hereby ixfrd that I have a conaemt to he, BUILDING ADORE or Zp .OF BLDGB NOW ON LOT ❑ Cedtfi7!9z NEAREST CFKM Sr. ❑ CarnTRACT BLOCK LOT N0. USE ZWE MAP Na Gate A83E890R MAP BOOK Pl�L3E PARCt3 wECv,L cDNxrIONB CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE VATi N 1000 FT.OF adios-?ADDRESS NO (Thta eectlon need not be cortpk*d If the permlt Is for one hundred � DISTRICT GROUP FRE MNE PROCESSED BY ddters.(E 100)or leve)' CITY /� I certify that In the performance of the work for whkb TfIa permf( /7 is 15&T I shaft not en*y any person to any-manner so as to ARCHITECT OR T?IC1tF�R TEL NO D� become mb}eaf to the Workers'Comper Ion Laws 8DUT8T1<JILq FX�gION SPT CONDO Deis "Icamt ADDRESS CLA88 Na cv ELL UMTS MOTCE TO APPLK. NT- If, after ntQklrlg' thiB Certtlloate of I RECUIFED TOTAL SE-r&&"FROM E>SST Eminp ion, you shcLdcl become suh}ect. . to the Workers' SET BACK )AFO HWY FROP LNE wfDTH Compeneaflon Vovisiore of the Labor Co* you must forttnvith FRONT conpty vft such provisions or this permft shall be deemed revoked. P L SDE LICENSED CONTRACTORS DECLARATION CfTI' LIC. P L I hereby affhmt4 I am licensed Underprwfeiore of C 8 SEWER NW (commencing 7 Mviebn 3 of 8Q FT.S✓g Na OF STORES Na OF FAMLEB Prokmviorrs hT full toroe NEW BK pa , Llceree Lb.Class ADD ❑ Contactcc or rZ�ff ALT1:R ❑ $ r ❑ 1 am exempt under Sec. �r aaff4elfiREPAIR ❑ BAP.C.for this reason DEMOL ❑ LDMA P/C+ DetG: USE OF EX18T1NG BLDG URM ❑ slonature APPLICdNT(PRM) TEL Na LDMA Perm I 1 ❑ I, as owner of the property, or my errpbyees with wegee as t that sole cornpwvafior4 will do the work and the ebuohue IB ADDRESS �•T 189.1` t Intended or offered for sale (Section 704-4, Bushoas and OOM Proleealorm Code.) M-L THE APPLIGWT OR RrrURE O=FANT WVDLE A HAZAFDOI� FNAL ro �O-k% owner d ❑ 1, as ownthe property, am exckmlvely oortractl V with OR A roTLFE CON-MING A mAE AL EouAL To ort awrm YFh N THE 1 ITEM ode.0AMOUITS s�ON n-e HA7_AF�OUe W UT SUM GUIDE? FIAL BY fkxrlsed con R ore b odia.lat the project (Section 7044, Ea❑ No❑ TATAL 1S9 — 1Fi Bustrleae and PrO(eesiorle C ) YM-L THE NTBOED USE OF THE MAD- O SY THE AMLICJJm OR RmA#B110li0 �{��{/ O0aU RUU EA PEAfT PCR CONSTRUCTION OR NOdFIG4rON"cm TI-E SOUTH �� CFEC:rl 189.15 CONSTRUCTION LENDING AGENCY ' GGAU AIT OUALr UWZ0A m DWrFiCQW r T WASEE PB:M a-ECPCLM FOR o ce gra I hereby afftrm that there Is a construct n ierding agency for YEe❑ No❑ v the performance of the work for wfTictl this perm ft to k;sued(sec i H6016 FEAD THE HAZARDOUS wvIMwLS rr'orDkvl)N GLIDE Aro THE 8CACW PEFS&TMO 3097,CIV.C.) O-EdalaT.I UPCER"M WY QTS UREA THE L0e A00ELES COUNTY COOL; (y'y(��y(}�} _ rTLE 2.Q-MPTFA 2.70 DEGTIONL 2.Pa 100 THROUGH 2.2a 140 C04MW 0 NAZA CL13 0000-OW 1 - 6/r—/95 Lenders Narne WTEFLALa F*D ORrM AND FOR COWING A PEJ:lLT FROM THE SCAMa (U, jwfthnty o«,.,oa 1 1012 1 PM 4:�7 5Q01a+e this appAcalfon and state under penalty PC FEE PERMT FEE the klforrrrefbn I epTse to comply }� and relcft to bukkva of thie IS9UVNCE FEEforIrNESTIGQION FEE TOTAL FEE Mr or SEE REVERSE FOR EXPLANATORY LANGUAGE I APPLICATION FOR BUILDING PERMIT COUNFPr.OFatiOS ANGELES. BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO F1L4.IN � 3 I hereby affirm that 1 have a certificate of consent to self Insure, « a oertfkafe of Workers'Compensation Insuranoe,« a oerttfied copy thereof(Sec.3800,Lab.C.) aTY ZIP LOG4lJTY PoFIcy No, d S7f OF LOT 11 NO.OFNOW ON LOT ElCertified oopy to hereby fuT-hiehed. 5D rKq IlLr NEAREST Cuss 8T. ❑ Certified copy Is filed wI h the=+Tty burano Vapectlon TRACT BLocx LOT Na t USE Z0411£ MAP NO Date AppflCant ASSESSOR BOOP( PAOE PARCEL SPECIAL CONDfT10f78 CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ADDRESA 6� YE8 NO COMPENSATION INSURANCE wrn-2N 1000 FT.OF SCHOOL? (This section need not be completed If the permit is for one hundred DOTTY-7 GROUP TYPE CONST. FIRE ZYJE PROCESSED BY doLam ($100)or leea.) I certify that In the performance of the work for wi lch ttM permR ClrYJIM4 0— t✓ �� `� oz- Is Ismred, I shall not errooy arty person In any manner so as to ENGNEER �I become&A)Od to the Workers'Conpeneatbn Laws. 8ml8TY(.rLC'LA68LFlCNION APT CONDO Date t ADDRESS C1.A88 NO n4�/L D►ME1L uNrm NOTICE TO APDL MCWT H, after 'makhip this C&tfloate of REQUIRED TOOL SETBACK FROM EXIST Exemption, you dxxdd become subOct to the Vkrkars' CONTRACTOR TEL Na 8ET BACK )AAD HWY PROP LNE WOTH Comperimaiion prwlslore of the Labor Code, you most fbr tnrtth FRONT conpfy with such provfabne or this permH ahalI be deemed revoked. LIC.NO. PL SDE LICENSED CONTRACTORS DECLARATION qTy LIC.CLASS PL I hereby affirm that I am licensed underprovial«ti of Chapter 0 SEWER MAP (cohrnenokV with Se(3iaT 7000)of Dfvkelon 3 of the Buslne88 and 90 NO.OF(TORES NO.OF FA LJEe Professions Code,and rry License Is h full force and effect DESCFtJPT1oN OF ❑ I NEW 11 BK PG , License Number LIc,Class ADD � 0 8 Contactor Date ALTER ❑ 1 ❑ I am exempt under Seo. REPAIR ❑ $ Bb P.C.for thb reason DEMOL ❑ L)MA P/C+ W Date_ USE OF COUnNO URM ❑ 23 ' APPUGANf(PFNr) TF1.NO. LDMA PWM,# t I, as owner of the property, or my ermloyees vvltn wages .as o IGT.T thetr sole cornpenea5ocn wN do the work and the stnrcture Is ASS not htended or Offered for sale (Section 7044, Bushme and FWAL 3 3 51'5 Professions Code.) vu FE MfIJCJJrr oR FYfRFE a■ OGCUFMNT HM► x HAZAFoale rwve� 1 CR ATW TUE C01l1, f A FwzKoam W4�3-L Eouu ro ars 9FE4ER n w+THE El1, as OWnnar Of the property, am exckmtvoly cont oting O AL60(KM�ON THE PAZAFCOLM NU EFMlb lFrr OFA0JQ OIDET FDIAL BY ACCT.loaned CORtad«e to COnablict the pro}ect ( YED El No T1 BLrOwa and Professions Code.) PALL THE r FENDED U8E OF THE BLNXM BY THE APPL".N7 OR FUnrE OLM DWG3203 149.�� Oca"AT FC-OXCE A Pe#FT FOR carerralcmor OR uOOFicr7M FRM OTHE 9WTH Lr CONSTRUCTION LENDING AGENCY COAST AIR QLAU7Y 6WW3ELE?4T DOTFICT I8'1OW SEE PEFSA7TNo a-Esser FOR ^ t TEM !J rx Ee wa I hereby affirm that Biers Is a conatr ctlon ferding agernoy for Yae❑ NON L N the performance of the work for which thle pwmft Is Issued(Sec. TOTAL 199 - 60 HAVE RFlD OuoF Aril THE d"J�D�rMHa . 3087,Civ.C.) a Ec+�rar,JW�-=tffi- C, NCFa THE LOB AH3ELM% GOOF, i Lenders Name ►w wA+� y = Lenders Address �r I cer Ify Brat I have read thh appllcafion and state under penalty of per)ury that the above Ud«metion Is cored.I agree b comply P.C.FEE � PETMT FEE 4 wb aflWdy Ordinances and state IR" rektLrQ to buWng , 01DIH 01 6I 2/9,:A const-ilbrijand hereby authorize repreeentady" of t* Canty ISSUANCEFEE 65 � 1 AM 3: 40 b enter Bee pr for h>apectbn purposes F4VE8TIGATION FEE TO FEE SEE REVERSE FOR EXPLANATORY LANGUAGE