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Home My Public Portal About8814 GARIBALDI AVE_Building__ APPLICATION FOROUILDING PERMIT �1 FOR APPLICANT TO FILL IN (Print or tvaG only) LI BUILDING . � I COUNTY OF LOS ANGELES ADDREss DEPARTMENT OF COUNTY ENGINEER CITY I I zIP Q 1`l O BUILDING AND SAFETY DIVISION l O .OF BLDGS. BUILDING SIZE OF LOT—Az /3Q X NOW ON LOT ADDRESS TRAC BLOCK L T NO. /O3 LOCALI � L T . NEAREST OWNER L..-n EE0.L — CROSS ST.' ASSESSOR ADDRESS SBJ4 MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE SSED BY CITY ZIP q 1'7 19 0 4Y�' CONST.. ZONE ARCHITEC OR TEL, J ENGINEER C1 W QFC NO. STATISTICAL CL/ASSSIFICATIONSEWER MA ADDRESS - CLASS NO._L_LGDWELL,UNIT_S 11 BK TEL. CONTRACTOR NO, USE ZONE MAP LIC. NO. V ADDRESS NO. SPECIAL LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES NO ❑ CONSTRUCTION LENDER NAME AND BRANCH h�r� BLDGS TBACK FROM FRONT ROP.LINEOF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY } YARD p� SQ. FT NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ' ONE n _ + DESCRIPTION OF WORK C.,t� NEW ® BLDG.SETBACK FROM DD ❑ SIDE PROP.LINE OF (STREET) ALTER OTAL SETE)ACK F TYPE OF EXISTING HIGHWAY + _ YARD = EPAIRSIDE PROP. LINE IGHWAY WIDTH —R -, ❑ - . USE OF 1 oen EMOL ❑ + EXISTING BLDG, cL7 APPLICAN TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) N0. _ BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ 4 IN COASTAL ZONE YES E] NO ❑ VALUATION$ 000. 00 CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDSE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AHD STATE THAT THE ABOVE IS CORRECT AND.AGREE TO COMPLY IMPACT EXEMPTION DECLARATION BIVNED (DATE) WITH ALL ORDINANCES ANO LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTH PRIZED IMPACT REPORT PROCE96ED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURANCE SIGNATUREO PERMITTEE ADDRESS ` FINAL MY TE CITY NO. DATE MAKE CHECKS PAYABLE TO:GINEEF FEE FEE Y,� HARVEY T. BRANDY, COUNTY ENR ` r PLAN CHECK VALIDA'T'ION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CAGH� 1 4 4 MY 13 1 0 3 5.2 5 ,&5c 76AB38A CE110e03 7179 _ WORKERS'C6MPENSATION DECLAR,�TION hereby affirm that I have a certot;npe of consent to .elf APPLICATION F O I L D I N G PERMIT Insure, or a certlflPate of Workers'Coatpenatlon Insurance, or o aified co th re (Sec. 3800, Lab. ) COUNTY OF LOS ANGEL � BUILDING AND SAFETY P N Company Certified copy Is hereby fu s FOR APPLICANT TO ILL IN ADDBU RLLA NG ESS rct r I[rj/�rtified copy is filed with the county building Inspec- BUILDING F tion department. AD-DRESS a , LOCALITY NEAREST Date Applicant CITY G 1 ZIP CRO55 ST. M f✓ -G CERTIFICATE OF'EXEMPTION FROM WORKERS`. ASSESSOR �g OF LOT O .Z NOW ON LO MAF BOOK PAGE COMPENSATION INSURANCE PARCEL (This section need not be completed if the permit Is for one MAP hundred dollars ($100)or leu.) TRACT BLOCK L T' NO Q a Z ` TEL SPECIAL �- I certify that In the performance of the work for which this OWNER NO. CON DITIONSO permit Is Issued, I shall not employ any person In any manner DISTRICT GROU TYPE FIRE BY v so as to become subject to the Workers Compensation Laws.. ADDRESS `Q-CITY Date Applicant ARCHITECT OR ZIP STATISTICAL CLPSSIF�A,TION AFT.-TONDO. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER- NO O�%� W Exemption, you should become subject to the Workers' CUSS NO. C?VJElI_ UNITS N Compensation provlsions of the Labor Code, you must forth- ADDRESS SEWE z with comply with such provisions or this permit shall be deemed revoked. CONTR4CT( NCO _ p PG VALIDATION LICENSED CONTRACTORS DECLARATION s I hereby affirm that I am licensed under provisions of Chapter 9. ADcLeFA <r'!'� q rl� AJ NO. 3 VALUATION - (commendng with Section 7000)of Dlvtalon 3'of the Business and /� r Lr_ J Profoulons Code, and my license is In full force and effed. CITY (Ik bt t CLASS 7 $ SQ. FT NO.OF NO.OF - CHEC.IC License Humber S�LIc.Class SIZE �' STORIES FAM,LIES ONE f , Contract or to DES( OF WO" Adj Z C NEW. ADD I am exempt from the licensing requirements as I am a As^r-r%]7sl�G lIV icensed architect or a registered professional engineer ALTER FINAL acting In my professional 'capacity (Section 7051, REPAIR DATE 3 Business and Professions Code). OF FINAL EXISTING BLDG. f DEMOL ❑ By Lic.or Reg. No Date' APPLIgANT TEL. Y OWNER-BUILDER DECLARATION PRIM NO. I hereby affirm that I am exempt from the Contractor's License Law for the following reason (,5ectlon 7031.5, Business and ACES Professlons Code): El1, I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,wlll do the work and the structure Is not Intended or offered for sale(Sectign LOCAUTY 7044, Business dad Professions Code). MOVING TEL 7 � ❑ I, as owner of the property, am exclusively contracting ACTOR NO. 1- 0 `7 '7 C A with licensed contractors to construct the project (pec- = / / tion 7044, Business and Professlons Code). ADDRESS L c c REQUIRED TOTAL SETBACX FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD Fr�vY PROP, LINE WIDTH [y alt C < � I hereby affirm that there Is a construction lending agency for FRONT � �' alt— the performance of the work for which this permit Is Issued P.L t ! o (Sec_ 3097, Civ. C.). SA P.L. DE / Lender's Name / $ Lenders Address Eln—�,.Ion �/ Permit Fee I certify that I have read this application and state that the lauance Fee t above Information b correct. I agree to comply with all County , `� .. ordinances and State laws relating to building construction, Total Fee ` 1 Ll and hereby authorize representatives of this County to enter upon the above-mention props A for Inspection purposes. ��• "7 SU RLl/tJtS!FOR h?(rLAIIATORY LANGUAGEIN`1` C I�` ` S gnature of Applkont or Agent Date ' 1 r-ADRKERS'GOMPENSATION X-dARATICtr Y _ • I hereby affirm that I ohpvhf o cprUhc4te of. rtinspcQnsent to .elf_ APPLICATION FO UiLDINC PERSAIT. . Insure, or a certificate of Workm'Com lor;Insurance, or Ifl c f(Sec, co�� COUNTY OF LOS ANG LES BUILDING AND SAFETY o Campahy BUILDING /Ictiorp(delparfmprit." rifle¢copy Is hergbjf fu sh � FOR APPLI NT TO FILL I rttfted'copy is fllgdwith the county bullr�l.ng Inspec- 1 BUILDING e I r t7 { LOCAIrry Date, Appllc ant' CITY � ZIP ST. CE t]FICATE OF EXEMPTION FROM WORKERS' .1 NO.OF BLDGS. ASSESSOR.' COMPENSATION•dNSURANCE SI OF LOT O % rlbW ON LOT MAP BOOK PAGE ARC�L (lhls seciloh need not be co lehad.if the FSermlt Is for one hundred dollar ($100)or less TRACT BLOIX LO7 tVO. U5 NO TEL CL I'cert,Ify'that In the`perfprmance,-of the work-for which this _ OWNER �� NO CC�ID c O pandit.is Issue, I shall not employ any person In any manner - ICT < Ot1 TYPE FIRI BY V so as to become subject to the Workert'Compensation Laws: ADDRESS �✓L►2 ` p�y CONST�— OC r• CfTY ZIP. Data Applicant'''` ARCHITECTOQ - TEL . . .. STATISTICALaA55lJ = NOTJ�TQ APPLiCANf<'If;'bfter nlakln� thls'Certlflcate of ENGINEER .NO ' eMptloh,• you-should,become �subl'ect eta. th'e Workers' 4 NO' UNQS now- �ompenzation•provlsions,of,the Labor Code, you must forth- tSEWER MAP Z witb 'cpmpfy with' such--prodisions oc-1his permit sball,be deemed tevgked.'•'-, OR (� B PG, �j VALIDATION LLCENSFD CONTRACTORS DKLARATtQN- ' .r C I hereby offlrm that I am licensed undgr provislon}oi Chapter¢ _. _ G 3 VALUATION , (cammenging with SediW 7000).of Dlvblon 3 of the Business olid _ Li t Prbfeuions Code, di;d my license Is In full force 8rxf effect. CLASS f SQ.f r h}O-OF NO.OF. CH ClSerlie Number Llc.CI SIZE STORIES FAMILIES ONE _ CgriTrpL♦ C eZ? DESCRI WORK Nom' A[5d � _ I am exempt from the lrcensing requlrementd cd f am a .licensed archlteaf or a registered professloridr engrneer,. ALL PAS f -acting ins my professional rapacity -Sectlon 7051,. REPAIR Builneu:qnd Ptofesnlons.Code), " USE OF FINAL �f IXISTING BLDG. DEMOL ay tic.or Req.Na Date APPLICANT TES ` OWNER$UILDER pKLARATION PRINT id0 I hereby affirm that I ahs exempt from the Contta tor'silcensq � ? , _Law for the following reason-(,Seolon 7(JM.$,. Business and ADDRESS Professions Code): BUILDING. n `r,' Qa-owner of the prgperty, or my'employees with ADDRESS wages as their sore'compensotion,will do the work and the stnduro Is nof'Infehded or'pfferedfor sale(Section LOCALITY '7041, Buslneu and �rofeuioris Code). MOVING TEL. ❑ CONTRACTOR NO. . 'r, 4s owner of the property, 4m exduslvely,contwding. with licensed cohtractors to.c4nstruct the project (Sec. tion.70",-$uslneu and Profeuions Code). REQUIRED TOTAL SETBACK FROM EXIST. o'o o • e CONSTRUCTION LENDIW_- p4GENGY SETBACK YARD HWY PROP LINE WIDTH {? # -: I-hereby dfffr`m.that jhere Is p construction lending agency for FRONT the performance oT the work for which this permit is Issued P. 2;,7 ° 3 4_Q Q� „ (So,'-.3097', Clv..C.): SIDE Lender's Name i�, 2*_ $ Address- P G. Fee f P•rm I t Fee Lenders ��' I cel-ufy thbt r hpve read-this application and state that the Isuance F•• r above Information h correct. I agree to Qomply.With all County Inv gation Fon - - - - '� r orcli' Q ices and laws rolpting to building' construction, Total Fee' and•h'oreby authorize representatives of this County to enter +S� upoh`the p o-mehtloned prop for rnapectlon purpose;, 2 SIS RE'VEM FOR RXFLANATOR1 LANGUAaf . Slgnatur•of Applicant or Agent Dat• - - �� WORKERS'COMPENSATION DEC1,AlfAT" s l su r&y~dffco that l hwe certtftcote ofconsent to .eAPPLICATION FOR. BMJ I L D I N G" PERMIT , RM fT' t . Inwrbi;,pr a certlficat¢ of Wor iceri<'Compdrtsatfon Insurorxe, ` .or a-,certified copy thereof(Sec. 3800, Lab. C.), ; COUIM OF"LOS ANGELES _ BUILDING AND`SAFEW . Policy No.__Company ' {L—JI Cirtlfled copy-ts hereby furhlbb : FOIA A Ic4NT TO FILONURNNG ADDRESS n Cert[ied copy Is filed.With the county biillding lnap - BUILDRJG �-+ tion deportment.. ADDRESS LOGkifTY Date App l Ica n t- (31 Y CROSS ST., CERTIFICATE OF FRCA WORKERS' NO.OF NDG,S. ASR Ta01�,IN$URAN SfZE OF 7 NOW AMP BOOK AGE PARCEL ' (lfiII sgctlon,need riot.be-cGrti ig1bd if the`perm N;Is fpr onb ZUM CINO. hundred¢dllmrs ($.100)orIaeL) . _ SPECIAL } IL I cwj1fy that•ln.rhe perfo'rmanba of the work for which this OWNER S permit Is Issyed,i shalFnot-employ any n In any(Wanner '. DISTRICT GRQL►P 1YPf Z� BY 0 to as to become sublect ta'tha Worker mpg on LrnW. ADDRESSr l C 0 D . -3 �/ ,3 1K 78'O r (7FY I L zip srATlsTir r L�]/tSSI FK:�T10N Ddte �ppl non . NOTK;E TO APPLICANT: ff, afttir•maklri .E;ertlfictrte bf � TEL Q NO. ¢ASS.NO DYI_'C1NfT5 W '']=xpmptlon, you. shoyld become subject, to':tfyp--lKpHcen. .d.' Compensation provlslons of the Labor Code;you meal forth ADb 55 :�4 SEyygz M,P Z " with to'mpry with such,provisions 'or.;thl1 permit-sh all be. /y� /y f — deert»d t,Ta- BIU r E a'G, V 10 bTK1 pATlg1 -L'iCaZED CONTRACTORS DKLARAT" LIC, I hereby affirm I a Ik*nsed under krov7slohs of Chapter'9 NO VALIIAT}Oli` ` (commanding Sedlon 7000)of Dtvislory3.of the"remand. L>c 4 -I Frofislorn.Code,-and my Incense I►Ira fuII force and effgd.. C rry C3J.S5 1' SQ. FT. NO.OF Na.of LlceftwNumber Lk:Clan. SU:E (�E < D ` 1PTtibN( Contractor Date ADD L1 �' �--f l qm-exempt dnder:Sec B,BP.C;. for this reason f�AIR UA LZE OF ,. DAte• E—lNG BLDG. DCAbL Y Slpoature /1PFtiG11J1 NO... r OWNER BUILDER 1A� T"' ,. - _k. I hereby afflr that I am exempt from he 4,ntr d s LlceAl� ► . Idw for the following reason (Sedlon•7CQI,.3, Business and. n Rr$feislorp Code); BPRESENT UILDING I, q* owner of the property, or my employees with ADDRESS W0900,cis thilr sole compensgtlon,will do thRwork and A, fhe structgre Isnot Intended or offefetf.for.sale(Section ` 7041, BoslWM1 and froferslon4 Coded (rVOVt►1Q tEL NO. f 'Q o a 0 Q;. n I, as-owner of tbe.prOpeFt_y,am-bkcfusfvely conteo�ting N with Ike prod ( :S rued controGfor4to oorlstmtct the bat Sec= ADDt�� .° ° J� 9, 2 4 -tion 7041,Busibesi and-Professloip Cc4e) p�7 CONSrRI) tK*LENDING AGENCY BI. YARD FIV✓Y PROP. U MCIMYVIO?Fi , o;o o'�. C) r v I heref.Ty:afffrm'that therg:la a conrtrvctloR lendlttg ag*dcy.ft�r CONT .. ' e performance of the work.for which this permit la Issued P: 0•Q 0 6 ,Sec. 3097, Clv. C.) DE Lends s Name R.L. Genders Address P.C. Fee Permit Feed �[ I cWlify.that l ha4e read this applloBHon bnd stab that the .{may �• above Irrforrrwttorl b correct.J agree to comply with all County Investlpatlon Fee - ordlrwttces and $tate laws rprating to..�julWing coratFuttl9n, I Tool F« ' hereby authorize representatives of this." unty to enter ' Theaboveentlo for Iron pu I y a 1�S _ f� V11111IMi POR WGIA"TOlry J HOCL& g pf Imnt or Agent Date _ . 71r WORKERS'COMPENSATION DECLARATION hereby a acrd that I have a certl mpe of ;incur to self APPLICATION FOR BUILDING. P E R11A I T Insure, or a certicate of Worker'Compensflo Insurance, or a cerilfled copy thereof(Sec. 3800, Lab. C,) COUNTY OF LOS ANGELES BUILDING AND SAFETY El Policy N� _Company�+i�m�a,,T Certlfled copy is hereby furnished. BUILaNc FOR APPLICANT TO FILL IN ADDS Certlfied'copy Is filed with the county ullding Inspec BUILDING e �J Ilan department. ADDRESS I LOCALITY l Date ��i�TJ I Appllcgn CfTY QST ZIP CRO55 ST. CERTIFICATE OF EXEM FROM WORKERS' •OF BLDGS. ASSESSOR COMPENSATIONINSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be com leted If the paFmIt Is for one USE ZONE hundred dollars ($100)or less. TRAR BLOCK LOT NO. NO. d } CL I certify that In the performance of the work for Which this r NO. CONDITIONS O DISTRICT GROUP TYPE FIRE BY permit Is Issued, I shall not employ any person In any manner V so as to become subject to the Workers'Compensation Laws. ADDRESS 0 CONST. ONE O Date Applicant ARCHITECT OR AR ZIP STATISTICAL ION AFT. CONDO. NOTICE TO APPLICANT: If, after making this Certificate of NO." pA55 NO DwEil- UNffS Wd OR -Ekemption, you should become subject to the WorkerN Compensatlon provlslons of the Labor Code, you must-forth- ADDRESS SEWER P CA with comply with•such provisions or this permit shall be deemed revoked. COtJTRACiOR NO _ BK PG tO VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter-9. A.RESSp 7 l� Z �1�- L NO V ALUAMN (commencing with Section 7ODD)of Dlvlslon 3 of the&rslnam and f / Professlom Code, and my license Is In full force and effect. CITY CJ+t r� LQ 455 i G�c OL SGL. NO.OF NO. OF CHEOC License Number Llc.CI.,G SIZE STORIES FAMILIES ONE Contracto Date -7—20-8J DESCRIPTION OF WORK NEIN 0 I am exempt from the licensing requirements as I am a ADD licensed architect or a registered profeaslonal engineer ALTER FINAL acting In my professlonal capacity (Section 7051, kDATE Business and Professions Code). yg-W ❑ DEMOL PINAL9 Llc.or Reg.No. Date APPUCANT TEL. r OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License S Law for the following reason (Section 7031.5, Business and ADDRESS / Professions Code): ElBUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work arld - Q Jr 4 A the structure Is not Intended or offered for sale(Section" LOCAM 7044, Business and Profesalons Code). MOVING TEL # o a o o o 1 ElI, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS o2200 - tion 7044, Bwlness and Professions Code). REQU ADDRESS2 CONSTRUCTION LENDING AGENCY BACK H) OP. Ll NNE NY HY TOT PRS FROM WIDTH o'o -2 2 0 0 6 I hereby affirm that there Is a construction lending agency for FRONT the performance of the work for which this permit Is Issued P.L0.7.2 8—8 1 (Sec. 3097, Civ. C.). SIDE Y P.L Lender's Name Lenders Address P.C. Fee i Permit Fee 15, I certify that I have read this application and state that the Issuance Fee above Information Is correct. I agree to comply with all County Inv«tl on Fee nn ordlnances and State laws relating to building construction, Tofal Fee and hereby authorize rap r ntotives of this County to enter upon the veJ/-p�ention operty r Inspection purposes. {r�/ SEE REVERSE FOR EXPLANATORY LANGUAGE ^ Os Slpnature of Apolkant or Agent Doh _