HomeMy Public PortalAbout9163 GARIBALDI AVE_Building__ J
7.Ae3.AC:1.03II_V7 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING 6
DEPARTMENT OF COUNTY KNGMM ADDRESS
$IIII.DINC� `AND SA= DIVMON LOCALITY r
JOHN A SIE,COUNTY ENaINmupt N4"EST
CASSATT D GRIFFIN 'SUrT OF]BUILDING CROSS ST
_ DISTRICT NO. GROUP ,,ypE EWHR MAP
FOR APPLICANT TO FILL IN CO SK PG
BUILDING J� D
ADDREliA „ V, STATISTICAL IFICATION
CLASS.NO EL UNI
LOT NO. D OClC MAP STATE
NUMBER 7-00 3 HWY. Ygz O
TRACT U8 ZONE SPECIAL
L"9r)x/ �) j G NO.flPBLDGS. -CONDITIONS '
SRH OR LOT �' /� NOW ON LOT
USE OF /O
r �V BUILDING HX 8T.~
,y FRONT
SETBACK YARD HWY BTREETf1AN6 WIDTH
OWNER 070//,&AILbVi /HA J I� f�
ADDRE" I /1 /FJ77�^ 4Yi P.L �V
SIDE
ciTy T-Am 12,L It= C TEL P.L
NO IIdSPEC'rION RECORD
ARCHITECT OR � TEL
ENGINEER NO.
ADDRRM
F a !K• �-
C'TO Rt-
4wpRwQs,!r6(g,9 ye
Y�
DON OF WORK
'-
4
NEW ADD ALTER REPAIR DEMOLISH f
SCI.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
` USE OF STRUCTUFM
69 72//Al 49K
SIGNATURE OF APPROVALS
APPLICANT
DATE I"PECTOR'S SIGNATURE
ADDRESS 4S olg0FO NDATIONI LOCATION
FORMS.MATERIALS 4
O D rO
P.C. 4 FRAME, FIRE STOPS,
FEE I BRACING.BOLTS
VALUATION s Q FURNACE: LOCATION,
Er ` �. GAS VENTDUCTS
I HERESY ACKNOWLEDGE THAT 1 HAVE READ THIS_AP-
I•LICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH IM'
AGREE TO COMPLY WITH COUNTY ORDINANCES AND
STATE LAW B RE 1 UILDIN6 CON RUCTION. LA'T'H EXT.
SIGNATURE OF HOUSE NUMBER(;.OR-
PHRlII RECT AND POSTED
A.DD-RE, D, -2 -v?-
FTNAL
CLYDE N.DIRLAM, RI CIPAL STRUCTURAL ENGINEER
PLAN CSEGT VALU)JMON CK. hLOL., CASH PEHJGT VALIDATION cK. M.O. cASH
L ,54 9 N' M .rj- 1 k
4PPLICATION FOR
BUILDING PERMIT
FOR APPLICANT TO FIIN AM�
LA \ <_
BUILDING
ADDRESS LOCALITY
NEAREST
CTTY C Ity ZIP CROSS ST.
NO.OF BLDGS. ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
DISTRICT GROUP TYPE FIRE ED B
TRACT BLOCK fr4o. CONST ZONE
TEL. �� ,L
OWNER NO 66
STATISTICAL YO
CLASS Fl SEWER
ADDRESS C_ CLASS NO. —DWWaL UNITS BK PG
OTY ZIPS NO.
A ICH I T ECTT Ei SPEC.A L
ENGINEER CONDITIONS
ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
OW RACTOR Z2,-a bL BLDG.SETBACK FROM
LIC. ` F PROP.LINE OF (STREET(
ADDRESS NO. H AY t YARD TOTAL SETBACK FROM TYPE OF EXISTING
LI
FRONT PROP.LINE HIGHWAY WIDTH
CITY � N CLASS C�
CONSTRUCT'lON LENDER t L
NAME AND BRANCH SETBACK FROM O
ADDRESS GTY SIDE UNE OF (STREET) 0C
SQ.FT NO.OF 1 NO.OF CH ECIC Hr4iWAY + YARDIOIAT M TYPEOF EXISTING
SI STORIES ! FAMILIES ONE SIDE PROP.UN HIGHWAY WIDTH N
+ � Z
DESCRIPTION OF WORK NEW
ADD CORNER CUTOFF YES ❑ NO ❑
LS "TER IN OPEN SPACE YES ❑ NO El
REPAIR
USE OF
DEMOL IN COASTAL PERMIT ZONE YES ❑ NO El
$LDC'.
APPLICANT TEL
(PRINT) NO I Ilk,�i I.
BY(SIGNATUR
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATKXJ AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH All ORD(
AND LAWS REGULATING BULDING CXt6TRIJCTYON.I CITIFY THAT IN DOING
WORK AUTHORIZED H8ZEBY I WILL NOT EMPLOY ANY PERSON IN V
THE LABOR CODE OF THE STATE OF GAJ FORN IA IN RELATING TO
PENSATION INSURANCE
SIGNATURE OF Tl / ���� BY
PERMITTEE V TE ((//
ADDRESS
TEL. P.C. Fee$ 5 Permit Fee c,2
CITY NO,
Issuance Fee
VALUATION$ oo O —7 Total Fee / 1
P � T PERNUT VALIDATION. CK_ Y.O. CA#H
��4 23 V _- I J.0 b t
POLICY HOLDER: 1 D 9 r-NOV 14 1 D 2 1.'7 5 A`b
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