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HomeMy Public PortalAbout9409 GARIBALDI AVE_Building__ I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING� I �D I WM. J. FOX. CHIEF ENGINEER FOR APP NT TO VLL INFOR OFFICE USE ONLY BGCJ DISTRICT NO. PLAN CK. NO. PERMIT NO. UILDIN ADDRESS LOCALITY RECEIVED BY DATE OF APPL. DATE ISSUED NEAREST CROSS ST. BUILDING ADDRESS - OWNER MAIL LOCALITY ADDRESS NEAREST C TE CROSS ST. CITY ry FIRE NO. OF I TYPE GROUP ARCHIT CT OR T ZONE I PLANS _ ENGINEER ry , BLDG. - ORD. NO. " SETBACK LINE ADDRESS L' �/h.�.. APPROVED T BY DATE CONTRACTOR "' USE APPROVED ��yy ZONE BY DATE ADDRESS `-� '4•s. HOUSE NUMBERING LEGAC DESCRIPTION I LOT NO. / BLOCK MAP NUMBER FIELD CHECK BY TRACT - NO. ASSIGNED BY DATE � NO. OF BLDGS. CORRECTIONS SIZE OF LOT`V O �� I NOW ON LOT USE OF y NO. OF EXISTING BLDG, V �(,�� I FAMILIBS / - DESCRIPTION OF WORK NEW I I ALTERATION I I ADDITION REPAIR I DEMOLITION I I I p $0. FT. NO. OF SIZE ROOMS 8 IES ` Z EXT. WALL ROOFeD r COVERING �CCO�V�ER�IN�G V USE OF STRUCTURE rJ ✓" APPROVALS INSPECTOR'S SIGNATURE DATE I HERESY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION: LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT. I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME: FIRE STOPS, HEREON AND WITH ALL COUNTDINANCES AND STATE BRACING, BOLTS LAWS REGULAT BUILDI G ON RUCTION. FURNACE: LOCATION, SIGNATURE OF GAS VENT, DUCTS PERMITT _ LATH, INT. ADDRESS LATH, EXT. AUTHORIZED AGT. C� PLASTER, INT. 7ewe3ew• DHsi fano �0 P. C. $ FEE PLASTER, EXT. VALUATION $ FEE FINAL I DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES S ' ® ' WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DIBTRI5�NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS ` LOCALITY / RECEIVED BY DATE OF ADPL. DATE IBBUED NEAREST CROSS ST. g2 _ BUILDING " OWNER ADDRESS ✓ 'J MAILLOCALITY C- ADDRESS a 2 � NEAREST TEL CROSS ST. CITY ZIP 24 O. FIRE NO.OF T PE. GROUP ARCHITECTOR TEL ZONE PLANS ,f' ENGINEER NO. BLDG. ORD.NO. ADDRESS - SETBACK LINE APPROVED TEL BY DATE CONTRACTOR Z NO. USE APPROVED ADDRESS ZONE BY DATE LEGAL CORRECTIONS DESCRIPTION'S LOT NO. BLOCK TRACTT ' 1 NO.OF BLOBS. SIZE OF LOT � I NOW ON LOT USE OF I NO.OF f I NO.OF� EXISTING BLDG..& 't�'. FAMILIES ! ROOM DESCRIPTION OF WORK NEW ALTERATION ADDITION O A REPAIR MOVING DEMOLISH p S4•FT. NO.OF Z SIZE ROOMS STORIES /t r WALL I ROOF COVERING i n cry COVERINGUSE o BUILDING W a a I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, SIGNATURE OF BRACING,BOLTS PERMITTEE -, LATH,INT.: AUTHORIZED AOT LATH,EXT.: OBS-3 50M SETS rae $ _ _ - FFEE PLASTER,INT. PLASTER,EXT. VALUATION - ' FINAL APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDINGS �� COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CIT ZIP '7 C� BUILDING AND SAFETY DIVISION NO.OF BLDGS. BUILDING �--/�/ •� �� SIZE OF LOT-S.0 XJ6 0 NOW ON LOT ADDRESS TRACT BLOCK LOT NO. 'LOCALITY Gr OWN NO NEAREST CROSS ST, A ASSESSOR ADDRES MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE PROSS CEED BY CITY ZIP d CONST le ZO ARCHITECT O TEL �� ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NOA_�__DWELL.UNITS BK PG CONTRACTOR TEL. _ �S�Z MAP LIC. ADDRESS f tjNO, SPECIAL LIC. CONDITIONS CITY CLASS _ ROAD DEPARTMENT A PPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LffNDER NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP,LINE OF (STREET) ADDRESS CITY HIGHWAY } YARD TOTAL SETBACK FROM TYPE OF EXISTING SQ.SIZE STORIES FAMILIES ! FT. NO. OF NO. OF / E CHECK FRONT PROP. LINE HIGHWAY WIDTH ZON + _ DE4C RIPTION OF WORK NEW 1:1 DD ❑ BLDG.SETBACKF SIDE PROP.LINEOF (STREET) LTER HIGHWAY } YARD = TBACK FROM TYPE OF EXISTING EPAIR❑ E�Rgil LINE HIGHWAY WIDTH USE OF } _ EXISTINP BLDG. nEMOL ❑ APPLIC T / TE CORNER CUTOFF YES NO ❑ (PRINT) F4Q N0� � Iti IN OPEN SPACE YE3 ❑ O ElBY (SIGNATURE) t �] IN COASTAL ZONE YES ❑ NO VALUATION�Y CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIIED IMPACT REPORT PROCESSED ( TE) HERESY I WILL NOT EMPLOY ANY PERSON IN -VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURA NCE. N 31GNATUR r PERMITTE ADbR ESS FINAL BY TEL. DATE CITY NO. t MAKE CHECKS PAYABLE TO: FEE FEE F HARVEY T. BRANDT. COUNTY ENGINEER 0 -6 f� PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION(CK. CASH U 3 SJ G=MAT b 1 U J -9.0 0 76AO38A CE#a03 7/73 es 76A63BA CE#QM(REV.11/78) APPLIC.A . 10 OR BU I PERMIT . COUNTY OF. LOS ANGELES_ BUILDING AND SAFETY,-_, FOR APPLICANT TO FILL IN ADDRar C-14 BUILDING (I Ltoq ADDRESS LO(rALTTY NEAREST d ZIP 1 CROSS ST. NO.OF BLDGS, ASSESSOR 51ZE OF LOT O NOW ON LOT MAP BOOK PAGE P " DISTRICT ' GROUP TYPE FIRE E55 BY TRACT BLOCK LOT NO. OWNER C T�b�U - r — STAT15T1CAL CLPSS CATION } S MAP ADD - - - CLASS NO.�PWELL UN T5 BK.. PG crrY - Zip ARCHITECT OR TEL VALUATIONQ QQ OG EN GI N EER NO ADDRESS BL FPOM TEL FRONT PROP.UNEOF ISTREETI CONTRACTOR NO. TOTAL SETBACK FROM TYPE OF EXISTING LIC HIGHWAY + Y FRONT PRQ?.LINE HIGHWAY 'WIDTH ADDRESS NO. - Uc } CITY CLASS - CCXJSTRUCTI BLDG.SETBACK FROM NAME AND BRANCH SIDE PROP.L1N� TI OF ISTREE }}}... HIGHWAY + YARD TOTALSETBACK FROM TYPE OF EXISTING O� ADDRESS CITY SIDE PROP..LINE HIGHWAY WIDTH O SO.FT. NO.OF NO.OF CHECK -+ cm SIZE STORIES I' FAMIUB - "-CNJE - C) IISE E MAP D DESCRIPTION Or-WORK - - NEW . . / SPE .. � SPECIAL •'r , ADD CONDMONS y� BY JCV .. FDATE USE OF DEMOL EXISTING BL ]REPAIR - APK(MN T I t.A-hK D C Uj( T BY ISIGNATU I HEREBY gOAVCV40V-EDGE THAT I HAVE f�,�D U D STATE �O 3 Q 3 A _THAT LAWS REGl1LATINall 1=13 Tb QO/�1PL All ORDINANCQ .- LbifiG G fTdICTION. CEiTI THAT IN DOING THE WORT(AUTHORIZED HERBY I WILL NOT EMPLOY ANY PERSON IN VFOLAT}ON OF '# O O 0.0 O.1 TFIE 4A80R CODE OF THE STATE OF CAU FQRN IA IN RE.ATI NG TO WOWMEYS CQA� - -. ) PENSATION 1NSU WX:E.• ' `G O O 4 J,0 O'. SIGNATURE O 40_ _ 4 3 Q Q iS PERMITTEE ADDRESS 0613-80 to CITY I.C. Fee$ PermR Faq - Issuance Foe Total Fee C/ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CIT ZIP OT11 ,zo BUILDING AND 14 SAFETY DIVLSION QA NO.OF BLDGS. BUILDINGJ SIZE OF LOT d NOW ON LOT I ADDRESS Q (! ` TRACT BLOCK I LOT NO. LOCALITY T NEAREST OWNE -� CROSS ST. ASSESSOR ADDRESS MAP,BOOK PAGE RCEL Q- DISTRICT TYPE FIR PR ESSED BY CITY Zip 0 0 /� T. z E ARCHITECT R TEL. ,0 ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO L—DWELL•UNITS BK PG CONTRACTORS TEL. ZONE NO. 6 LIC. ADDRESS NO. SPECIAL CITY LIC. CONDITIONS CLASS RO D PARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLD .SETBACK FROM FRO T PROP.LINE OF (STREET) ADDRESS CITY = TOTAL SETBACK FROM TYPE OF EXISTIRG L� SQ. FT NO. OF NO. OF CHECK HIG}IW } YARD - FRONT PROP. LINE -HIGHWAY WIDTH SIZE D ISTORIES FAMILIES ONE } DESC RIPTI F WORK NEW El d7 DD BLDG•SETBACK FROM ZL SIDE PROP.LINE OF (STREET) LTER HIGHWAY } YARD TOTAL SETBACK FROM YPE OF EXISTING = USE OF E }PA SIDE PROP. LINE HWAY WIDTH _ EXISTING BLDG. EMOL ❑ P T NE rI CORNER CUTOFF YES ❑ NO IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE) IN COASTAL ZONE YES ❑ NO ❑ VALUATION$ 4aLo - CATEOORICAL EXEMPTION YES[] NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I C[RTI FY THAT IN DOING THE WORN AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL MOT [M PLOY ANY PERSON IN VIOLATION OF THE LABOR C DE OF THE )TAT[ .C' CALIFORNIA IN R[LA TI NG TO WORKMEN' CO MPENSATIO IMS RAN SIGNATU F PERMITT ADDRESS FINAL BY CITY 7p DATE MAKE CHECKS A YABLE TO: FEE PMT,Q FEE FEE $ HARVEY T. BRANDT, COUNTY ENGINEER 7,-;t--o f PLAN CHECK VALIDA'T'ION CK. M.O. CASH _ PERMIT VALIDATIO C M.O. CASH 8 1 Z JUN 13 3 D 7.2 0 A98v 4'8 28. 1 13 1 .D 1 2.0 0 • 7BA630A CEGBOS 7/79' I t WORKERS'COMPENSATION DECLARATION.., 1 I hereby affirm that I have a certlflcate of con"nt to sA f Insure, or a certlflcate of VN a'rs Compensation Insurance, APPLICATION FOR BUILDING P E RM I T or a ceritfled copy thereof(Sec 380Q, Lab. C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING / . Certified copy Is hereby furnished. -fa FOR APPLICANT TO FILL IN ADDRESS ❑ Certtfled copy Is filed with the county building Inspec- BUILDING tion department.. ADDRESS. V 1✓ LOCALfTY L fti NEAREST Date Applicant QTY ZIP CROSS ST. CERTIFIQATE OF EXEMPTION FROM WORKERS' NO.OF BLDG& ASSESSOR COMPENSATION INSURANCE Sig OF LOT 410 NOW ON L I MAP BOOK PAGE PARC`$ USE ZOt�. (This se cloll:need fioi be cam 'leted.ff.the petmlt Is for one-` ,. �T. BLOCK LOT �TEL ES:PEC�LAL MokP hundred dol4ars (;100}or less.� .I certffy that In the performance of the work for which thlf OWNER ftOtZ d permit Is issued, I shall not employ any Peron In any manner D ILT. GROUP TYPE Y f. Z RE PROCESSED BY 0 asWTAPICA asubject tot Worker Compensatl ��ITECT OR CITY ZIP �' 3TATUrAL Fr_ATION AFT. CO1D0.nNT: If, making thl: ofd Exemption, you should become subject to the Worker' NE R �' CLA55 No.=�`DWa1- uNfTs IL Compensation provlslons of the Labor Code, you must forth- ADDRESS SEW Z , with comply with such provisions or this permit shall be _ deemed tevoked. TEL CONTRACTOR NO. BK PG, A-T VALIDATION LICENSED CONTRACTORS DECLARATfON LC_ I hereby affirm that I am Ilcensbd under provisions of Chapter 9 ADDRESS NO. VALUATION (ommencingwith Section 7000)of DlvWoA 3 of the Buslnew and UC 0fesslom Code, and my license Is In full force and effect. CITY CLASS Ilk ti SQ. Fr YW I NO.OF NO:OF / CHEO ► License Number LIE Claes Sig STORIES FAMILIES ONE Contractor pie DESCRIPTK>N OF WORK NEW ❑ ADD ElI am exempt under Sec- ALTER FlIiA1 B.dP.C. for this reason ❑ DATE REPAIR Date' USE OFFINAL EnTnNG BLDG. / t DEMOL ❑ � > Signature APPLICANT — TEL OWNER-BUILDER DECLARATION NO. I hereby affirm that I am exempt from the Contractors License Low for the following reason (Section 7031,5, Bushes and . Professions Code): F] 1, as.owner-of the property, or my employees with AAp REST'S w09e6 as their sole compensation,will do the work 9nd 1'9 Q$7J A the structure Is not Intended or offered for sale(Section .710a,.Business•and Professions Code} MOVING TEL 1, as owner of the'property, am exclusively coniracting RACTOR NO. #? 0 0 0 0 0 1 with licensed contractors to construct theproject (Set= ADDS 2'� 2.6550 .tion 7044, Bull and Professions ode . _ i I RED TOTAL SETBACK FROM E(ST. 2 6'5-5 0 CONSTRU ON LENDING SE7 an YARD FW' PROP. U WIDTH ► 0 0 iSac.hereby affirm that there con on lending agency for FRGNT �, —f33 he performance of the w Ich this permit Is Issued P.L 3097, Civ. C.} SIDE s Lenders Name' C enders Address P.C.Prm Fee; PeIt F. I certify that I hav read this appllcatlon and wte that the I....Fee above Information Is correct. I agree to comply With all County ImeulQatlon Fes ordinances and State laws relating to bullding construction, Total Fie and hereby authorize representatives of this County to enter u n the abov meRt n Inspectlon purposes. to Revow POR EUMIAP ATORY LANGUAGE _ Slgra of Applicant or Agent .