HomeMy Public PortalAbout8904 GARIBALDI AVE_Building__ ,[.,U IIIA a#.GO-o APPLICATION FOR BUILDING P MI
COUNTY OF LOS ANGELES BUILDING 1 i.
DEPARTMENT OF COUNTY ENGINES& a- ��V'
wDDRE88
BUILDING AND SAFETY DIVISION LOCAL ITM
JOHN A. LAMBIE, COUNTY FrNaINKKR NEAREST
IAM of lluiLoimcs CROSS ST.
DISTRICT NO GROUP rpLr P ED BY
FOR APPLICANT TO FILL IN a CONST.
STATISTICAL CLASSIFICATION 8 ER MAP'
BUILDING I1 Krh
ADDRESS 7
91/1
[� CLASS.NO WELL.UNI
LOT NO. 9+I T BLOCK MAP STATE YES
NUMBER HWY"
TRACT D q USE ZONE SPECIAL
QQ NO.OP BLDGS. CONDITIONS
SIZE OF LOT 77' NOW ON LOT '
USE OP
EXISTING BLDG. G BUILDING YARD HWY RE NAME EXIST'
TEL SETBACK WIDTH
pyy}gER V NO. FRONT [
P.L
ADDRESS SIDE
ARCHITECT OR TEL P. ~
ENGINEER 4� NO. INSPECTION RECORD
ADDRE89 O
E
CONTRACTOR T
6 xi NO. V
'ADDRHS$ A- O
DESCREMON OF WORK
_ a
NEW ADD ALTER REPAIR DEMOLISH Z
sq. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF r� �
STRUCTURE _ge "C
616N.�TUR�p F
A1'IILICAN7
VAL TIONS }}
APPROVALS DATH IXS CTOA'6 3IGXITURE
12 4TP FOUNDATION: LOCATION
'FEE FEg• FORMS. MATERIALS
FRAMH: PIRH STOPS.
ILI HERESY ACKNOWLEDGE THAT I HAVE R[AD THIO API LIGATION BRACING BOLTS
AND STAT[ THAT THE ABOVE IR CORRECT AND AGREG TO COMPLY FURNACE: LOCATION, /
WITH ALL COUNTY ORDINANCES AND STAT[ LAWS REGULATING GAS VENT DUCTS lip 'A
BUILDING CONITRUCTI ON. I CERH
CERTIFY THAT IN THE FERFORMAr(C[
OF THE WORK FOR WHICH THIS PERMIT IB ISiUFD I SHALL.NOT LATH, INT.
[MI'LOY ANY FFRDO NY MANNER SO AS TO BECOME SU DU FCT
TO THE WORKM CO ENSATION LAWQ OF CALIFORNIA.
. LATH,EXT..,.
HOU
COR-
SIGNATURE OF SE AND
COR-
SIGN TT RECT ND POST
PHRM / /
ADDRESSFINAL
CLYDE N. DIRLAM, PRINCIPALRAL EGINUM
PLAN C = VALIDATION �Mo. CASH PERMIT VALIDATIONN
wo. cmw
_Lcop 9 '_9 5 X 21 2 3- D 12.0 0
LJ'Z 9 2 3 6 o ,RA 27 i D 24-00
I_
APPLICATION FOR BUILDING PERMIT
COUNTY O, -LOS.;ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN QLD
I hereby affli n that I hwe a o&rfficate of consent to ,eed kmzl Bu d
or a certtkate of Vubrkem' Corrpenaat n Ineuranoe,or a certffled'
copy
Policy fJo,. Canpen}JSCt��+ d�.0 �
LOT N0.OFBMG&NOW ON LOT
fled copy Is hereby fumlehed. NEAREST GAOSS ST.
�7 Certtfled Copy is filed wtth the ty.bulldl TATBLOck LOT NO.
TL USE mtJE MAP N0.
Dets Icarlt ASSESSOR MAP BOCK PACE PARCEL
SPECIAL COto(T10N8
RTIFICATE OF EXEMPTI FROM WORKERS' �� vEe
COMPENSATION 1 SURA CE %M-1111114 1000 FT.OF SCHOOL
NO
0-h1e section heed not be compieted ff the permit is for one hundred pp T � FIRE IDNE PROCESSEDBY
dollars ($100)or leen) ;4��
I certify that 1n the performance of the work for which this permft
Is Issued, I shall not errpby arty person In any manner eo es toC J
C
become sA*d to the"Criersapen9anaws. ATm
'C ti LTE T OR EN NEFA L W.e— 30013T1GAL aa�,�q��r//( APT COtIDO
DatApplicant ADDRESS aAss N0. �� DWELL UN"
NOTKE TO A*Lr-ANT ff, after making this Certfficate d REpLV:ED
TQ-1AL
E�Riptl« o
1. you shd becon-ba subject m the "brkro
e ' CONTRACTOR .� TEL d�6 8ET BAG )ARD RD HW P o-UW YAM-
Compermabon provWons of the Labor Code, you midst fothwtth EFlDNT
comply with suoh provbbrts or this pwmft shall be deemed revoked. 88NO. P L
16
LICENSED CONTRACTORS DECLARATION L� P L
CLAB� o P L
I hereby atflrm that I em Ifceneed rurderprovbbns of Chapter 8 C.._� BFrypR KW
(commendnp with Section 7000).of DNiabn 3 of the Buiahees and Na OF STORES NO.OF FAAig8 NEW ❑ BK P(3 ,
PPofeeabne bcens�s In full face and effect.
Lberlee fJumber / Lo,Ciaea of ADD ❑ l S
Contractor Date L TER ❑ $ 'a
❑ I am exempt under Sec REPAIR
FYVI
BAP.C,for this reason DEMOL ❑ LDWA P/C•
USE of E GSTING BLDG. URM ❑
5 APPUCA T(PANT) TEL Na LDMA Perm 0 1 Z
❑ 4 as owner of the M-, -- my employees with wegee as z ACCT.L
their sole will do the work and the etixtire Is ADDRESS3303 .2
not Intended a for Bale (Section 7044, Buahnees and FINAL DA E 1 ITEMS
Profeesiorle Code.) waL TFE APRXMT OR FUTURE c,■DM OCaF4HNrr DLE A RAZA.DOM rMvsani ••
❑ I, as owner of the property, am exduahely oontactirq wfth CR A►smut carPwxa A NAZARCoue MAaeWL EQUAL To OR GREaaa THAN n-e
lceneed o«mac�ors m corletrrx t the project (section 7044, AASXKM 8PECF�ON TM FrAZAFo MA7r�S�FCFMQ1 N OUOET FDtAL HY � TOTAL 209.25
Business and Professions code.) `YE°❑ "°El ( {( ( 209.2
wu. Tri MiEfom ueE OF n1-e auor,ro ar of AaP,Uc,H r OR wTta M•D••0
oCo"ZI FA
REQ E A P9T FOR COr6al TRUCrON MOCFG4a
pN FROM THE 8mi
CONSTRUCTION LENDING AGENCY r ASA QUALMY MWaE1err ortrlT�cr MACW eEE PERSAFTM rralEOUST roR � { .00
I hereby afflrm that there Is a corv5b'uotlon lead ng agw-cy for y�❑ No❑
a the performance of the work for which this permit Is Issued(Sec i P^E READ THE HAZARCOUS MQBiALa nN GUIDE Aro THE SCAQLID PEP' MO 1 9�2b/9�
3087,Civ.C.) a�aarac i uoaravuo Mr RECu�rrs UNDER n-e LOS AHoELm Caxrr cox
d �✓ S�a9 �SLMH Z"A°°"
Lenrs Ikune W ERIAL8 FF °o �AA CM THE 2489 1 Ali 11%02
Landau's Address '!f '
0 CWAM a+AWDiT
I certify that I have reed this application and state under penalty
of perjury that the above information b correct.I agree to oon#y P.C.FEE PEF T FEE
with all oounty ordinances and State lave relating to twld rig
and hereby represeritatteas d thle County BBL A 4CE FEE
m the
o NVESTIK)ATICN FEE TOIL FEE
Q�
SEE REVERSE FOR EXPLANATORY LANGUAGE