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Home My Public Portal About9012 GARIBALDI AVE_Building__ 76AS38A CE$803.7.56 APPLICATION FOR BUILDING PERMIT BUILDING AND SAFETY DIVISION BUI R ING Department of County Engineer ADDRESS County of Los Angeles LOCALITY G JOHN A. LAMBIE, COUNTY ENGINEER NEAREST r CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST. goC DISTRICT NO. GROUP SEWER MAP FOR APPLICANT TO FILL IN TYPE �` BK PG CONST. ADDRESS BUILDING � / L STATISTICAL CLASSIFICATION V _ f LOT NO. 3 4 CLASS. NO. DWELL. UNITS TRACT ��_ O NUMBER (�6 HWY STATE �' NO USE ZONE SPECIALh � NO. OF BLDGS. � CONDITIONS %�LL +l— l 2 -�Y41 SIZE OF LOT, NOW ON LOT USE OF rl V.rK,.c1 i"� EXISTING BLDG J BU',LDING EXIST. SE`fBACK YARD HWY STREET NAME WIDTH OWNER FRONT MAIL 11. L. ADDRESS ;;IDE zZa TEL P. L. CITY No INSPECTION RECORD ARC ITEC OR TEL. ENGINEER NO. -71 ADDRESS CONTRACT R TE I - I ADDRESSM ON • G DESC TION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ. FT. �J R p� NO. OF NO. OF SIZE /(i�/ STORIES / FAMILIES !/ USE OF T TURE APPROVALS S SIGNATURE OF APPLICAN 3, DATE INSPECTOR'S SIGNATURE ADDRESS a FOUNDATION: LOCATION FORMS. MATERIALS $ P. C. S FR4.ME: FIRE STOPS. , �7 � FEE BRACING, BOLTS r ��O, g 7 FURNACE: LOCATION. VALUATION / FEE v GAS VENT, DUCTS HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. ��' ' PLICATION AND STATE THATT E ABOVE IS CORRECT AND AGREE TO COMPLY AND LATH. EXT. STATE LAWS RE IV5zff_L_ TION. — SIGNATURE OFHOUSE NUMBER COR- / PERMITTEE ( RECT AND POSTED ADDRESS a FINAL JOHN A. LAMBIE, COUNT GINEER, CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. ASH PERMIT VALIDATION CK M.O. CASH 177 �,�0 1 :.3 J- L JUL WORK RS'COMPENSATION DECARATON hereby tr that I hwa certificate opnsent self Insure, or a c&rtflxrte of Workeri Compensatlon Insurgtrce;. ° APPLICATION FOR BUILDING P E RM I T or a certified copy thereof(Sec 3900,.Lob. C) COUNTY OF LOS ANGELES . BUILDING AND SAFETY Policy No. Cgmpany aLJrLDM _Z '4L. ❑ Certtfied copy is hereby furnished. FOR APPLICANT TO 1`I14 ADDRM DCertified copy Is filed with the county building Intoes- BUILMNG tion department. ADDRESS / LOCJJrTY NEAREST Date Applicant.. CTTY ! LP CROSS ST. CERTIFICATE OF DM%UMON FROM WORKERS' NO.OF KDG& ASSESSOR C.QM ENSATION INSURANCE Sig OF LOT S NOW oN MAP BOOK PAGE PAH (Thls taction reed not be cam'leted if the permft 14 for one USE ZOtE hundred dollars (;100)or less. Ta�T BLOCK LOT NO. TEL SPEC AL I cer fy that In the performance-of the work for which this NO. permlT Is lowed, I shall net employ arty n In any manner • DISTRICT GROUP TYPE RRE PROCESS®BY 0 .so as to become subject Jo the Workers pensation Daws• ADOt55 % CONSi. . Z .,ol 'Q' CITY vyt C!' ZIP O o Applicant '�'� � fTECT OR TEL STA ¢A-S� TION �j NOTICE TO APPILCANT: after making this CertNicate of a12/ Exemption, you should become subject to the Warkert' CLASS NO. -DWELL UNITS a Compensation,provisions of the. Wbor Code,.yo4.must forth- ADDRESS _ 5 WER MAp with comply wtth such provisioeu.or.thlr permit Miall be ? deemed revoked. a CONTRACT t O: W PG; VALIDATION LKENS®CONTRACTORS.DECLARATION LIC 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. ATFON (comrnerxing with Sect1w 7000)of DfvWw 3 of the Business and UC Plofeeslgra Code,and my IIoensp K In full force and effed. CITY `CLASS �(, • Sq. FT.• .OFNd.OF C1fOC UcenselJkTmber Lk.Chas S� STORIES UES ONE ntrador DESCRIPTION OF WORK �V ❑ . -r ( Datq . ADD F--+ I am exempt under.sec 61 l ALTER Q FlNAL IN B.B,P.C. foe this reason REPAIR ❑ DATL' Dat.: USE oEMOL El U .of OF BLDG. Signature APPLICANT UETEL owNER-BuiLDER DEC-ARAT1oN 40' PL Lher%by affirm that I am exempt from the Controctors License , 1• _4,9 A �Lggww for the following reason (Section 7031.5, Business and Profeeslons Code): # c I e o or-o I, as own*- of the propbrry, or my employees with ING AADS ESS 2`';° 54,,2.5 wages as chair sole compernation,will do the work and the structure Is not Intended or offerod for sale(Section VXA1JTY �o-'-`5 4,2 5Z' 7044, Business and Profeglons Coded MOVING. TELr I, as owner of the-prop", am exclusively controcllnp QDNTRACTOR NO', 0 5 4e-$L► with licensed contfock" to anWryct•the project (Sec- ADDRESS tion 7044, Bovines and Professrons Code) phi BACK CONSTRUCnON LENDING AGENCY ED g7 I U YARD HNT PRTOTAL OP. WITH I hereby affirm tfwt ther6 is acorutrix-fion lend) for , {he performance of th4'work for.which this permit is Issued P�T Sec 3097, Cly. C. SIDE P.L - Lenders Name - P. Fee Per.It F6e Lenders Address; .. k I certtN that I'have rea4.this appllcatlgn and-state that the Fee 110 , above Infornwtlon Is correct. I agreeto comply**K all County Invedlpatim Fee ordlmMcm and ,State Laws relating to i>uIIdIng construction, and hereby authorize represenf rtive4 of.this County to enter Taal Fee upon above-mentl for Inspection purposes. e>fvMI11 K*EGIANATo[Y LA"GUACR /I signoture of ApplI o=T or Agent Dale I �+ r COLlliTY OF LOS ANGELES TEMPLE CITY D508 BUILDING PERMIT DEPARTMENT OF AIR BUILDING AND SAFETY PUBLIC LLAND .DEVELOPME)[T TEMPLLAS CITYCAS 91780 BLT0508I035020038 7f PHONE: (626) 285-04M EXT: LEGAL ID: NO. OF CONSI BUILDING ADDRESS: TR: 5904 LT: 160 BL: .001 SQ. FT STORIES TYPE 9012 GARIBALDI AV STRUCTURE: VN TEMP CA 917801545 ASSESSOR INFORKArTION NLMER: -7—5384-016-001 NEAREST CROSS STREET: ROSEMEAD THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: - EXIST BLDG I : REBID USE ZONE: - EXIST DCC GRP: 05/02/03 JK 04/26/04 OWNER: TEL. *0: BLDG$. NiOW ON LOT: VALUATION: FINAL DATE FIKkL B Z MOUEE—: CUM MICHAEL P (626) 2B7-8117- 3,000 9012 GARIBALDI AV TEMP 917801545FEES PAID C/0 IN 19 E t STUCCO FRONT OF HOUSE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: No: SAME AS (AMER - AA BLDG PERMIT ISSLWiCE 27.75 AC STRONG MOTION REBID 3000.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HG- 3000.00 VAL 99.00 - -TOTAL--FEES- - ---TOTAL-FEES 127.25 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS 06MEat LIC. NOLOCATION AND SETBACKS ENGINEER: .95TUFENGINEER WWI- ARCHITECT OR LIC. � '� - RAISED FLOOR MAP X 3� UNDERFLOOR INSULATION 01' I' ` ' _ FI = L' �� 90. OF FAMILIES: DWELLING LIMITS: APT/COMD: sTAT CIA No 21 V, ROOF SHEAtHING AIR QILILITY: 1000 FEET MATERIALSIto No No F REgAJIRED TOTAL SETBACK FROM EXIST ,, .. �� r TIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LIME: WIDTH: -I FRONT PL- 'I _ - f,F SIDE PL- INTERIOR LATH/DRYWALLEXTERIOR LATH 1-7 7'-L- RATED WALL A99BtBLIE9 RATED Swrr7mnffffm—r= T-W CEILINGS LOT IMAGE s � a� REPORT ID: DPR261 ROUTE TO: BSO508