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Home My Public Portal About9244 GARIBALDI AVE_Building__ APPLICATION FOR BUILDING PERMIT -FOR APPLI ANT TO FILL IN (Print or type on1v) BUILDING COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY o� �y ZIP B=ING AND SAFETY fDIVISIO/NNo.OF T D f D NOI4 ON LOTS ADDRESS BUILDING _2'y4 ` SIZE OF LO Dl TRACT BLOCK LOT NO. LOCALITY /�,yy)/ f- TE NEAREST OW NE S O. ROSS ST. /� ASSESSOR ADDRESS � (/ MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY CITY %7YIP CONST ZO ARCH TECT OR T ( QAW 211-0� ENGINEER7E9STATISTICAL CLASSIFICA ION I.� )6C� t+1 LL SEWER MAP ADORES CLASS NO�DWELL,UNITS BK PG CONTRACTOR E ZQNE MAP LIC +`r NO. .2 007 ADDRES L+A IX��NO SPECIAL eAV �1 LIC. e CONDITIONS C,I TY Q (f/v� CLA ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER Q NAME AND BRANCH a�iti� • BLDG.SETBACK FROM FRONT PROP.LINEOF (STREET) ADDRESS 60O CITY _ TOTAL .SETBACK FROM TYPE OF EXISTING SQ. FNO. OF NO, OF ` CHECK HIOHW } YARD _ / FRONT PROP. LINE HIGHWAY WIDTH � SIZE—Q5701STORIES FAMILIES ONE _ O� DESCRIPTION OF WORKNEW EllW DD BLDG.SETBACK y M SIDEPROP,LINE OF (STREET) Z LTER ❑ HIGHWAY } YARD = TAL SETBACK FROM TYPE OF EXIBTING EPAIR❑ DE PROP. LINE HIGHWAY WIDTH USE OF } _ EXISTING BLDG. ENOL ❑ APPLICANT TEL /)/ CORNER CUTOFF YE NO ❑ (PRINT) e/ 7a BY (SIGNATURE IN OPEN SPACE YES ❑ NO ❑ 4 IN COASTAL ZONE YES 0I ❑ VALUATION$ D CATEGORICAL U(¢MPTION YES NO ❑ I HEREBY ACKNOWLEDGE THAT I HAV[ READ THIS APPLICATION ENV IRONM[NTAL AND STAT[ THAT THE ABOVE IS CORRECT AND AGR[[ TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS RL-GULATING BUILDING CON- STRUCTION, I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT R RT PR(N:[11[D (DATE) HERESY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR COO[ OF THE STAT[ OF CALIFORNIA I RELATING TO WORKM[NIS COMPENSATION INIURA ( CC11 SIGNATURE O PERMITTE / ADDRESSSA C L FINAL BY ,p TE DATE t CITY NO. %JAKE CHECKS PAYABLE TO: FEE � REQ HARVEY T. BRANDT, COUNTY ENGINEER 1611111 1 PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATIONCK. .o. CASH 309373 SEP 6 1 D 48 ,75 TBA638A CE&803 12/71 WKERS'COMPENSAT10t4 DECLARATION OR s raffirm Wires �m' tinn � �f 'PERMIT RM I T�nt&�orker 'CopennsaoInsurance, APPLICATION FOROUILDING or a cerleag co lthereof (Sec. 38M, Lab. C.) _ COUNTY OF.LOS ANGELES ]BUILDING AND'SAFETY . Pollcy No.' Company Cert Hled.copy,ls hereby furntshed. _ FOR APPLLCANT TO FILL IN Certified oopy It filed'wlth the county building Inspec- . DUILpING / ' - t(on depgrtment. ADDRESS Date Appllcar,t CITY LP O LOCALITY CERTIF#CAt�OF f)(fJ1APTIbN FROM WORKERS',... : �E BLDGS COMpENSATK)t4 INSUWANCE Sia OF LCR sv . ON LCR St. ' (Thls,wdron•hegg not be completed I£-ho.permit Is for one ASSE=R S Hundred 6611grs ($,I W)(?r{gsa) TRACT B1CR]C LOT NO. MAp flOpK p�,E p i cert y that 1n,the �e4arrhonce of-thb work'for which this WE � ^ N . Tr NO. permit I,:Issued, I shdll hot employ any�erson In any nner I SlC ti .� so arta �itr,ubl t6 the Wolk �ompensgtlonADDRESS +TI . CITY TJP Datcan- e N Ma'TO AMJCAAR if, II after'making ARCHITECT Ok this Cerfificate, Qf �y a` DISTR1 CT CONST. AREj,� BY O t I Fxemptlon, you ,should bicomi. sobtect to the Worke ' � �j I .. Cornneatloh provisions of the Labor Code,-you must.forth- �J�V {yaTj with.comply with such provlsfons or.,this pefmlt sbdll be. ... Ta- STATISTICALCIASSIFKJI AFT. . deemed revoked. . , CONTRACTOR NO. ' LKX+4SED CONTRACTORS DECLARATION. _ CLASS NO.. _ _PWELL UNTTS `. T hereby affirm tbat f am licensed under provltlom of Chapter- AWRfStIVO. (comrnencJr�rn q with Sectlpn 7000)of Div*ori 3 of the&nlness and �'�AAAP Prgfeft[oCode; and my license is In.full force and effic(... - CITY' CLASS ` FT. NO.OF OF BK. PG.' V/1CD�1Tli)k License Number Llc.CFrer STORES F LIES ' OSE 4 r- VALUATION CbnttSctor Date. ; 0.1 am exempt yrkler3ec_ e I`�f/ll�uV e f ? 8 3 a,9 A car B.3P.C. for thla tpson REPAIR .. - Dale: USE O.• •; 11 EXISTING BLDG. r p .�y:.: h Signature _. ice. APPLiCAt{1 �.�C'�LcFRUU .o,c L a 5.0 ; 4OWNER-BUILDER OKLARATFON I NO. RA i I hereby affirm that_l artrrexempt from.the ro ntracto VlJonse Law'for Tkq fol,lgwing IV.—p (Segtlon 709x.5, ,Business and . ADDRESS -.e. e .4 a,u�Q loris Code) �. .� I, as owner of theoes property, or9y,employee4{wltli; ADDRESS BUILDING 8,-87 was thelr'iblem copensatlgn,will¢o-+*work-a0d t*sbvcturels not Intended or.offsrs for sale(Secfldrr LQCALrrY 7044, Buslnese dnctProfesslon�rCode)' MOVING TELt4o - _ owner of the property,ram gxGluslvely conh*Oing ` TRACTOR with.licensed cohtractan tq-ct rkWuct the'pmI_gct (Sec- . tion 7044,"Ineis obd "aw ons Code). E £ONSTRUCTIOrF Lt44DING AGENCY YARD . PtVi(Y TOTA.LPROP. LM WIDTH , I hereby affirm that then It 0 construction lording agency for FRONT "t" performance of the,work'fo-whltb-this permlt is Issued (Sec 3047, CI c C-). Lender,Name Y ' LDAAA i ' $ _ P.C. Fee f '. - Permit fee- z {enders Address _ . I cprt fy that t have reqd.thl4 pppllcatlon and slate that the• Iowa"Tie LDMA P/C/ ADDRESS above infbrnwNon is corned. I ogee to,comply with all County Invest4patlon F« ordlnances qnd Slate flaws relating to bullding construction, Tolai Fee: / iDNA Rertn. t and'hrl ereby autf1oxe representatives of this Courity,to inter upon above-mentioned for In,pecHon purposes., up Rwiiiiiitsiii POR EgtmtATOfY b wGuAW Si --6 VApplkpnt or Agent Dgle WORKERS'COMPENSATION DECLARATION rrae-o�-.p'cettfccattea Weorrk certificate 'C mtpensationn Insurance, APPLICATION FOR BUILDING PERMIT 04 a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company I 01 Certified copy Is hereby furnished. FOR APPLICANT TO FILL INS Certified copy Is filed with the county building Irspec- BUILDING !j ' tion department. ADDRESS 7 I LOCALI-Y NEARESTj� ST Date Applicant CITY Z1P `�V Q CROSS ST. CERTIFICATE OF EXEMPTION EMPTN FROM WORKERS' NO OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON AMP BOOK PAGE PARCB (This section need not be comleted If the permit Is for one �/ 3S USE ZC),E Z(r hundred dollars (;100)or leis-� TR'OT `J� BIO�� 1 T I SPECIAL OWNER S /`l JCONDITIONS DITIONS IL IL I certify that in the performancA of the work for which this 0 permit Is Issued,I shall not employ any Person In any manner ADDRESS j ' DlSTR1Ci GROiJP TYPE ZOFIRNE LB 0 so as to become subject to the Workers Com rtaatlon CONST ZONE i �'iV .3ce Dat Applicant Crn , �P ARCNfTECT 1� /� � STATISTICAL a,ss1 rloN APT. O NO CE TO CAM: If, after making this Certificate of PONEER NO SSS NO=DWELL UNITS W Exempiton, you should become subject to the Workers'.. IL Compensation provisions of the Labor Code, you must forth ADDRESS gy,R MAP with compty, with such provisions or thh permit.shall be Z deemed revoked. CONTRACTOR NO. BK. PG, VALDATION -UCENSED CONTRACTORS DECLARATION LFC 1 hereby affirm that I am licensed under provisions of Chapter 9 NO. VALUAMN — (commencing with Section 7000)of Dtvhlon 3 of the Buslnew and L� Professions Code, and my Ilcgnse Is In full force and effect. CITY CLASS $ SQ. FT. NO.OF NO.OF C}fECK License Number Lic.Class SIZE STORFES F LUES OtIE 3 Contractor Die DESCRIP1lbN WORK NEW ADD FJ I am exempt under Sec ALTER � FINAL B.BP.C, for this reason- REPAIR DATE Date: — USE OF S E] FI F7uSTING BLDG. DFBY Slgrwture APPUCANT TEL OWNER-BUILDER DECLARATION PRINT NO. r I hereby affirm that I am exempt from the Contractors License , Law for the following reason (Section 7031.5, Business and ��aewaqm Ions Code): ` BUILDING I, as owner of the property, or mfr employees'wlth,.- as their sole compensation,will do the work and !' the structure Is not Intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL I, as owner of the property, am exclusively contractlag CQNTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 5 6 P,6 A tion 7044, Business and Profa=Ions Code}. CONSTRUCTION LENDING AGENCY VU I YARD H Y TOTAL�SE�TBAC7U C FROM dWTH `� �'# e o • 0 0 1 1 hereby affirm that there Is a construction lending agency for CONT . ,T ' `}� A "1 o 0 4 Q O 0 L. the performance of the work for which this permit Is Issued P Sec. 3097, Cly. C.). PDE \ Q 0 0 _ 'o 0 0 Lender's Name Q 3-86 C Lenders Address P.C..Fee$ Pa..it Fee I certify that I have road this application and state that the lsutance Fee / S above Inforrtwtlon Is correct. I agree to comply with.all County Investigation Fs• �8{ ordlnancee.and ,State laws relating to bul4ding construction, TotalFe• and hereby authorize represen Ives of this County to enter u the above-mentlo for InspecH n pu 0 SE REVOM FOR DPLIINATORY LANGUAGE Sip of ApPltoont or Agent Date -