HomeMy Public PortalAbout9167 GARIBALDI AVE_Building__ AEPPLBTMENT OF BUII.DINGEI FSrY SRBUILDING COUNTY OF LOS 1�iNGII.FS
WM. J. FOX, CHIEF ENGINEER
FOE APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING DISTRICT NO. PLAN CK. NO. (PSRNIT NO.
ADDRESS Sll
LOCALITY RE�CAEIIVED DY DATE OF APPL. DATE IBB QED
NEAREST Y `3 —S1 q J
CROSS DTA BUILDING D /�
AD REDS Syr
OWNER 1 1 G
MAIL
LOCALITY
ADDRESStiff( EL a Ln NEAREST
QQ CROeS WT. q,
CITY � NO_ "D7o7 FIRE NO. OF / TYPE J GROUP
ARCHITIkCT OR TEL, ZONE PLANS l/
ENGINEER NO. BLDG, ORD. NO.
_ SETBACK LINE
ADDRESS APPROVED
�L eY DATE
CONTRACTOR , NO. USE APFROVED
ZONE DY DATE
ADDRESS 9 wtv HOUSE NUMBERING
' ms ESD F RIELD CHECK eY
DESCRIPTION LOT NO. BLOCK MAP NUMBER
AS RIr
-!p No. ASSIGNED Y-------DAT
.R
N.O. OF DLDGB. CiORR=cNB
SIZE OF LOT 13 Q1 ' {F NOW ON LOT ll
USKOFO
EXISTING DLDQ., FALIuxs I
DESCB=ON OF WORK
NEW ALTZRATION ADDITION IIX
o
REPAIR DIEM OLITION - - - Z
SO. FT. 1 O NO. OF Q
SIZE 1 ROOMS STORIEDKx-r // Z
COVERING CING �1�luU
USE-OF STRUCTURE
5 trr S RL P `(R00 Ltil
- APPROVALS
INSPECTOR'S SIGNATURE DATE
1 HERiSY ACKNOWLEDGE THAT 1 HAVE READ THIS Ar- FOUNDATION, LOCATION
PLICATION AND.STATA THAT THE INFORMATION GIVEN ID FORMS, MATERIALS / I
CORRECT,
1 AGREE TO COMFLY WITH T}�E CORRECTIONB LISTED FRAME] FIRE STOPS, .�1
HQRSION AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, DOLTS
I-AWS REGULA b, 1 I G CONST UCTION.
T � � FURNACSi LOCATION,
SIGNATURE OF
GAD VENT, DUCTS
KRMI
LATH, INT.
ADD I I V
LATH. EXT. �
v vu
AUTHORIZED AGT.
PLASTER, INT.
74LAOV.• DSO f0-90 ✓f P. I j
m a FEE PLATER, EXT.
vALuwnoN {{�� FEE j FINAL
an-3 uM rrn iO-4* i
DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT
COUNTY OF LOS ANGELESg U I L D I N
WM. J. FOX, ONIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
DISTRICT Na PLAN OK.NC. PERMIT NO.
BUILDIN
AD D R[SS 182-1 Garibaldi d 3/
LOCALITY Temple City, Calif. L.A.Co. RECEIVED IFY DATE OFAFPL DATE ISNUED
N[Aye ESTe,1q11v5 r-,o�����,,/�+ O—�� — �} {ted
DWN[R James Mar�t:i nek ADORN ] +�( r �+6�e,4
MAIL
ADDRiN 182-1 Garibaldi LOCALITY 6 7
NEAREST
prTY Temple City, Calif oI- CRDNN ST.
ARCHITECT OR TEL ZONE PLANA TMP ORDUr '
ENEINK" NO. f/
■LDC. ORD.NO.
ADDRESS ■ETRAOK LIN[
A-PRDV[D
Down AoTORBenedict & BenediW Sy 32158 ■Y DATE
USE A"ROV[D
ADPRUM 1433 E. Colorado St. Paaa.4 ZONE ■Y DAT[
LEMAL
DESCRIPTION OT NO- BLOCK '�,�--d "5 CORRECTIONS
L
TRACT.
NO.OF■LDOS.
■IZE air LbT NOW ON LOT
USE DIF NO.OF NC.OF
e LD
DESCRIPTION OF.WORK
NEW ALTERArt113141 ADDITION
O
REPAIR MOVING D[NOLIMH RG
Sq.FT. NO. OF
SIZE ROOMS ETORIEN
WALL ROOF
ODVERIND OOVERINO
UmE OF NEW
■UILDINO
Install one #45 Holly Dual furnace .
I HERESY ADKNOWLEDDE THAT 1 HAVE READ THIN APPROVALS
APPLICATION AND STATE THAT THE ABOVE 12 CORRECT F•CUNDATIONI LOCATION IN19PECTOR DAT[
AND AOR[[ TD COMPLY WITH ALL COUNTY CRDINANDIM FORMS, MATERIALS
AND RATE LAWS REOULATINO ■UILDINO OONSTRUOTION.
FRAM[I FIR[STOPS,
■IDNATUR BRAD,
SD4Tla
OWN[
! � TH,INT.e
AUTHOR LATH,EXT.I
R O,*yam PLASTER. IMT.
FEI —�+vv PLASTER, EXT.
VALUATIONFR Z�' FINAL
WO dkS'COMPENSAf16N'DECIARATiON. R r `
I hergby afftrm that I ,,aye a.certIflcnte of 4orw0t to self. I
Irnure, o<a ceritflcat• of Workers' (_'ompensWIon�Iruurance, � ii ►T1 ON TOR
rLH Ei
or d cerftfied Copy'thersof (Sec: 3800;Ldb 'C.) _ - _ . .. .._.. _- __ - - -
j . Q COUNTY OF LOS ANGELES BUILbING AND SAFETY
Ilcy No. Compbpy /' -
.Certlfled copy:,. hereby futnlshed.' FOR APPLICANT TO FILL IN BUILDING
Certified copy R fljep with'the' qunty'b Iding Ihsp' _ BUllpl / - / i
tlbrildepartment: ( C
Q - ,
Date "" Appll 6h - ra - - --cny ZIP Y
i A OF' FROM' KERS' _ SIZE OF LAT . '- -_.. . _. ..NO; OF
COMPRZATION INSURANCE
(This sbctlon need not fie completed If the permit is for one s - ' 81 00( LOT NO. _. ; - - 17•
hVvdred dollars,(i100)or Ids. ) MAP tiootc PACE PARCH
TEL._227
I.certNy that In"the.perfwrhance.of the'woirk foi'W' h thh � - �- - � NO.
pirmlt Is,lssued, I shall clot employ any person Ih any manneS ADDRESS 7TE- / SPEG14 - ,- •- - --- -_. I�
}o as to become subject to the Worker?'Compdnswlon LaWi, r - 4-. �- _ � ,
I , .'��1;�.• '{;,..: „ .. CJTY _ _.\- _ _ ..ZIP_ -
bat•.... . • .' 74ppllcant •. '-- r . '
H ITECT OR
NOTICE TO APP.LJC ANT: If; bfter'makln� this C"ertlflcote. of. ENGIrJE�2 NCO. -.DISTRICT P TYPE_- __J FRE-. BY .
Exem�tlonj your�shbuld beco'me' subject tb the Wot-kerf'- - ` �T Z
Com pensatiorr-piovhloru of'the Labor,Codi,•you-must,forth- ADDRESS
V r
with,comply with suds•prov,slons or•thlsl-permit. shall be - _. - STATI OASSIF1C4TtOtN APF. . . ODfDO
themed rpyoked. ti COfJTR 4C T �((�(J. - �- L,f- -
UC'ENSED CONTRACTORS DEC1ARATION, 4455 h10. DWEIL ';UNITS
I hereby affirm that I am Ilcensed under provislom of Coapter 9' 0
(commend wtthSgdlorl7000)of,Dlv'on 3 of the Buslriess and _ - s SEWER MAP
ProfbssI"Code, bnd my license Ii)'rl full force'and effaSr. c�Ty CJ �C I�-/ X55 C- -/ -- - - V/11DATFWi
� -.
r / - 3Q_ FT.` __ NO,OF. y C]ECK
.l �n .rQf
LJ N w Llc CI 7 (�. SIZE sl E FAMI ES 04 -.
DESQt1PTK)f�OF WORK - -- - NEW - - VALLIA"ON .
Contrad ' ADD _ i
�.
am exempt udder Sec - - - -
ALT
13 P.C. for thiseaso
rn _ _.. AR -
USE 6F
_ Date; - EJQST1NCi BLDG. DEAD
SIghaturo - -' 191i/11
OWNER-BUILDER DECLARATION
1•hereby affirm flwi-13nl exempt.froai Jhe Contractor's License
Lo* for the folleklnq'f*qwn'(Sbctlbh.7031.5, Business and ADDRESS
Profewlo'nf Cotte):_. _�,.... - - = - 6 7,IRA-A
I, as owner of the BUILDING ;
property, or my'.em ,oyes.with ADDRESS _'' -... _ .. - - -- -'- -. ... - - ' -- - °•.° ! ! 0 1 -
`wv9es as+r4fr soli compensation,wlfl'dote work'and pp
the structure Isnot Intended a offered for sole(Section LOCALITY "
._ ) o-° b,q 6
-7044, Bualness-and Profpslons Coc:6 - _. -MOVING y_- _. _ __ TEU_-- �. : _. -- _ .�
Y� f, as owner of the property, am exclusively controcting' QQNTRACTOR40. 6 d • (�g 3
wttfr Ilcerued contractors to construct the project-(Sec_ - -1 _._ ._ _ —.• -- -. _ _�_
tion 7044, Business and Profe•slons Code).
"CCNNSTRUCrION-LENDING AC,EtJ('Y ._ _ _ __-' O 2 3 �II
I h*aby affirm that there-I■o'aonstrtictlon lending agency Tor Fir YARD FIVVY PROP. Ute WIDTFI i l
-the performance of-the work:for which-this permit is_issued Pt' _ `_ _ -. _ - _ _ a_K j •
(Sic•3097, Ov. C)_ SIDE
Lender Name' .-
$ 'f•r l LDMA R•f.
P.0 Fe"- Permit
Lindri Ade
- CCom] -
_I rarttfy.that J.have read this.application and state-thaf Jhe -- _ -' -- = luuonc•Fee t� V C/ LDMA P/C 1- - poll
.-
above Information Is correct. I agree to comply with all County. Lnvalgatlon Fee
Y- -
ordlriances and Slate laws rolcrting to.building conwruct,on, Two 1-Fed - LDMA-P" # '
duthorlfe roe•
prentative•of this County to enter
the boned pr, for Inspection
. ✓.f M MV f I M KM AlIATORY L.AP000AW
- AppllcmtorA ._..