HomeMy Public PortalAbout9422 GARIBALDI AVE_Building__ ms Z" tRal�enel � I -rte
APPLICATION O UILDI P wM.IT
COUNTY OF LOS ANGaU BUILDING AND SAFETY
FOR APPLICANT TO FILL IN BUILDING
ADDRESS
BUILDING
ADDRESS LOCALITY
N EA REST
ZIP CROSS ST.
1 AN(5.OF BLDGS. ASSESSOR
SIZE OF L NOW ON LOT MAP BOOK PAGE . PARCa
DISTRICT GROUP TYPE FI EO B
TRACT BLOCK LOT NO. CONST.
OWNERNe
U
STATtSTiCA1 CL,ASSFQICQ,TION SEWER MAP
ADDRESS O ASS NO.(/,( / DWELL UNITS BK PG
CI
ZIP 1 ///L,�/���
ARa-IIT YALUATION.�
ENGINE
ADD
fRONT PROP.LINE OF (ST REED
CONTRALTO TOTAL SET- ACK FROM TYPE OF EXISTING
LI HIGHWAY + YARp FRONT PROP,LINE HIGHWAY WIDTH
LIC +
aASS BLDG.SETBACK FROM
CON7RUCTiON L 1 SIDE PROP.LINE OF (STREET) .
NAME AND B
HIGHWAY + YARD TOTAL SETBACK FROM I TYPE OF EXISTING
ADDRESS CITY SIDE PROP.UNE HIGHWAY WIDTH
50.FT NO.OF NO.OF (( CHECK + .
SIZE STORIES FAMILIES l ONE
DESCRIPTION OF WORK NEW P.C. Fee$ Permit Fee
r' ADD Issuance Fee
ALTER � /p
REPAIR Total Fee
USE OF DEMOL
EXISTING BL
A PPU
fPR `
BY CE%lj4A
YC�
I H I HAVE READ IS TK3N AND STATE
THAT THE is CORRL{T -
TAGREE TO Y WITH All ORDINANCE f
AND LA TING OONSTRUCTK)N-I CERTIFY THAT RJ DOING THE
WORK EREBY LL NOT EMPLOY ANY PERSON IN VOLATION OF
THE CAUFC%U7LA IN RELATING TO WNDWMEN'S OA
>3� '
PA 714 a 0 A
SIGMA F
P pa o-o 0 0,1
ARESS 2 1 '5 1 0.0
TEL
NO. 1 :51,006
MAP D 3 1 a'Uo -79 '
NO.
SPECIAL
OGN DTT I ONS
BY
BUILDING F
BUILDING
ADDRESS
O
APPLICATION LOCALITY .�.<- , ;�> ./:;: i✓�
NEAREST
DIVISION OF BUILDING AND SAFETY CROSS ST.
Department of County Engineer DISTRICT NO.' RECEIPT PERMIT NO.
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED L DATE ISSUED
CAS9ATT D. GRIFFIN, SUPT of BUILDING
FOR APPLICANT TO FILL IN TYPE ONST. RECEIVED BY ISSUED BY
9/
FCITY
ER MAP i, ., . STATE YESr NO
L ��7_ NUMBER c>.
RESS °'�r�- USE ZO E SPECIAL
J TEL / / CONDITIONS
/ .. . / f NOM k!T/ f ��� '•
ARCHITECT OR TEL.
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
SETBACK WIDTH
ADDRESS /� / a FRONT c-
CONTRACTORi{'Y .a ,lam" (//1 /JVNOH. T(Qi/D�OoZ 5 pE -P. `
ADDRESS J[ D�� , .►` A AYe, . C.. . P.L.
n
BUILDING DATE CORRECTIONS INSPECTOR
/� --- —
ADDRESS ,
LOT NO. `� V BLOCK
TRACT
NO.OF SLOGS.
SIZE OF LOT - t ij Q J CJ I NOW ON LOT
USE OF
F.XIRTING BLDG.
DESCRIPTION OF WORK a°
NEW ADD )kl ALTER REPAIR DEMOLISH Z
Sq. FT. NO. OF NO.OF
SIZE STORIES FAMILIES r
USE OF STRUCTURE
L,
n� <I
may, � � /�►{_/'Y"fiYY d'�. ��,.�G �"i.GL✓..�'
c
N O.O F
EMPLOYEES
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN IS APPROVALS INSPECTO 'S SIGNATURE DATE
CORRECT. 1`
IAGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION / � / ✓.
AND STATE LAWS RE ULATING BUILDING CONSTRUCTION. FORMS,MATERIALS Y
FRAME: FIRE STOPS,
SIGNATURE OF BRACING,BOLTS
PERMITTE } '•fir
FURNACE: LOCATION,
GAS VENT,DUCTS -
ADORES S YL /
LATH, INT.
AUTHORIZED AST.
LATH, EXT.
$ /�O 0.6 P. C. $ HOUSE NUMBER COR-
FEE _RECT AND POSTED
VALUATION $ /
-EE FINAL �.
76A638A DSS 3 (Bb 5-54
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D E P A R T M E N T O F B U I L D I N G A N D S A F E T Y A P P L I C A T I O N F O R P E R M I T
C O U N T Y O F L O S A N G E L E S
W M . J . F O X , C H I E F E N G I N E E R
F O R A P P L I C A N T T O F I L L I N F O R O F F I C E U S E O N L Y
B U I L D I N G - D I S T R I C T N O . P L A N C K . N O . P E R M I T N O .
A D D R E S S
L O C A L I T Y ( J / _ . Y - t R E C E I V E D B Y D A T E O F A P P L . D A T E I S S U E D
N E A R E S T
_ C R O S S S T .
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F I R E N O . O F T Y G R O U P t
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I H E R E B Y A C K N O W L E D G E T H A T 1 H A V E R E A D T H I S A P P R O V A L S
A P P L I C A T I O N A N D S T A T E T H A T T H E A B O V E 1 5 C O R R E C T F O U N D A T I O N : L O C A T I O N " N O E C T O R D A T E
A N D A G R E E T O C O M P L Y W I T H A L L C O U N T Y O R D I N A N C E S F O R M S , M A T E R I A L S
A N D S T A T E L A W S R E G U L A T I N G B U I L D I N G C O N S T R U C T I O N . 4 i �� 1 4
F R A M E : F I R E S T O P S ,
S I G N A T U R E O F B R A C I N G , B O L T S
O W N E R M �� L A T H , I N T . :
A U T H O R I Z E D A G T . I L A T H , E X T . :
J M a P . C , P L A S T E R . I N T .
F E E P L A S T E R , E X T .
V A L U A T I O N 1 a F I N A L /
F E E - - - - - - ) - Y ,
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4 APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BULDW a
I hereby aHtrm that I have a m-ttfioete of consent to setf Ineure, BUILDNO
or a oertlflcate of Vrbrhera' Compensation Insuranoe,or a cerUTied
copy thereat Sec. .C.) CrTY mwir + Zip -
Comperry//� �L�/ � Y8¢E OF LAT N0.OF BLDOS NOW ON LOT
Z=1
oopy le hereby furnished I NEAMST CF1089 ST.
❑ Certlffed copy le mod with colrtty bul TRACT BLOCK LOT NO.
USE ZONE MAP Na
t r ASSESSOR VLV BOOK PAGE Fl1A(',E1
Date Appk r t
SPECIAL COf•DrTI0N8
CERTIFICATE OF EXEMPTION FROM WORKERS' CER TLL YES
COMPENSATION INSURANCE ADDRESS LINE YATHIN 1000 FT.OF SCHOOLS
NO
(Tt,la section need not be correlated n the pefmn b for one twrcJred
ya DOTPJGT GnouP CONST. FRE ZONE PROCESSED BY
dollars($100)or lase)
I oerttfy mat In the pwbrmanoe of the work for which this permit CrrY !ra _
In Issued, I shell not errXpioy any peraon bn any manner as as to
become aub)ect to the Workm'C n-qm atbn Law& AACIMOR ENOANFE TEL NO.
8-oo-lsT1c1,L APT CONoo
Date Appalcant ADDRESS asss No. DwEI MFM
ACTK:E TO APPGrANT.. n, after makhp alis Certfflcate .of FECLN ED TOTAL SETBACK FROM oOST
Exemption, you ehoAd become subJecit to the ftrker.' CONTWTOR SET BACK YPJ7dD HWY PROP DIE WDTH
Compensation prwtelone of the Labor Code, you must torthwv
comply with arch provisions or thm
le permit shell be deemed reyoked. AD RE FRONT
m
PL
LICENSED CONTRACTORS DECLARATION 5 Sam
Crr y I LIO P L
I hereby afflrrn that I am Ilcenaed undertxwbUbna of Chapter 8 gEyYEp
(oomrnencirV wRh Section 7000)of DNkblon 3 of the Business and 8a Fr.Sag NO.OP STORES NO OF FANCIES MAP
Professions Code,end rry Ilcense b tri fuA force end NEW ❑ BK P(t
Ucarse Lio Ctess DE , ADD ❑ �!�o ,
Contractor Det. � L j� ALTER ❑ $ �� ' 1-10
❑ I am Wmmpt irxw Seo. �tJ REPAIR ❑ .
R P.C.for this reason 1 DEMOL El LATA P/ • 23
DAte- 1 4 f 113E of �'� URM ❑ ACGT.'#
Sl 1,re P f , Na LDHA Pwm+ 3303 50.50 ??
❑ 1,'as oww of the property, or my en oyeee with wagm ee PAV a9WA9 Z
their sole compensation, w01 do the work and the structure b• . 1r FAL / T 1
not Interded or offered for sale (Seodon 7044, BLrairmm and /r ■r
Professions Code.) V LL THE ADPL r.Vff OR FUTLFE BUI OM CCCLFWT KA DLE A HAZ MCUB MAT� L'
Iloereed ca,traobre to construct the pnoJect (Section 7044, S ,03 14 .20
El I as owner of the property, am wxkms My contraottnp with oR A MDc W Caraiaxa A FWAFDOUe HATEFUL EQUAL To OR GFilyM THAN THE
AAIXKM.PEGN TFE FVZA;C0L1S MATEWlR.ra10
s rFON GLIDE? F"L.BY BuslneyEs E] No El k 2 ITE]�S
as and Profeesbrs Code.)
NLL THE M@D®Use OF THE B I ■G e1' THE APPLKJNr OR FUTLFE BILO!!e �y
OCCUMT REOIIt-E A PffW FOR GON.TRJCTON OR MOCrr.A10N FROM TI-E SOUTH TOTAL 192 - 70
CONSTRUCTION LENDING AGENCY COAU ATR UMLrTM A WQUIE+T DUFFICT MCAQ16 f BEE PBifMO TTCFIEMrar FOR
a rice era
I hereby affirm met there Is a mvdruob n lendlnp apenvy for vm❑ mo❑ CWCIV, 192.70
N the performance of the work for winch this permit le leeued(Seo.
u .00
I FWE WAD TFE FMMaCHAWE
ZMDOUS 9aALe WORAIGI N GLIDE AND THE SCAQW PST"F D
a 3097,CN.C.) CI-EC70_rei I UrDERS[AFD MY WaAW ENM LMTHE LOS A QB-He O"i-FY CODE.
TTLC 2,CWTER 220 SECTCW 220.100 TWOD"220.140 CCNCEFiMe HAZARDOUe
Lenders Nam WCE M"rEPOFFM AND POR COW040 A PS:&U FF10M TFE aCAC AQ
0 Cardene Address 0000-0001 12/ 4/95
CNOW a,3
5Q� 1 cermy mat I have read th>e appucabon and state adar penalty
y of per)u y met the above lnlormafbn is correct 1 aRee to cor#y P.C.FEF7T PERA1r Ftp � O 7 1 PM 2:04
R with e0 county ordlin ncee and State lase rslathlp to buAdlnp
cormtucbm,, and hereby authortze repromybffiives of oris Casty IssLuwCE FEE 3
u b1�,� �A for ln:spe<lro pu ossa
P1V
m.
�i1tti4A"� 1l E9Tr(3ATION FEETo�1L FEF / � 7 Q
.A~ or / �
�T
SEE REVERSE FOR EXPLANATORY LANGUAGE
L
APPLICATION FOR BUILDING PERMIT �]
�* COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLAMATION FOR APPLICANT TO FR1 IN BON-DM ADDRESS
I heetflrm that I have a cerdfpcabe of ooneerl to sotf Irmum euor►c3 ADDRESS
reby
or a cert fladegooff YOor�kaa�rs''eC�onipeneetlon durance,or a cerf W 9422 GARIBALDI AVE.
onY�
(1U4b14U �) ry STATE FUND TEMPLE CITY CA 91780
srg OF LOT 40.Of BLD08.NOW ON LOT
❑ Certffled copy Is hereby furnWe ed
J�kCerfffW copy Is flbd wlth the county buAdlnp UTapeciion TRACT BLOCX LOT Na
USE ZONE APAP NO.
depertrlTent.
Date 11-1-9 5Appcant RANDOL ROOFING ASSESSOR MAP BOOR( RADE RA
saAa_cornmoNs � O/
CERTIFICATE OF EXEMPTION FROM WORKERS' owNER TEL Na
vEe
COMPENSATION INSURANCE LAWRENCE LM28ACaSPECIAL5-508& WM-W 1000 Fr: DRONOOL?
RO ?
dollars
seclJon need not be oorrpleted ff the prarmft b for one hundred 22 C�ARIBAT, I AVE.
DtBTHCf OFlOIJP FIRE 3�NE PROCESSED BY
I owti ($10-0)D<bas, CITY MP
-3
I cartery that In the perbrmenan d t-PBm worts for mwhichann r s as I:o TEN= CITY 9178G
Is issued, I shell not employ, erry person b any manner to as m
become&A*ct to the Workers'Cort�naation Lew&. AAgffEGT OR QJONEER TEL?4a
SATt3T1(',AL APT CONDO
Dade ApptloarTt ADDRESS CL,-M NO.-=DWELL LITS
NOT)CF TO APRJC4 N.. M, after makfnp this CwM%cats d REOLIFED' TO-VL SETBACK FROM EIQBT
Ery tption, you should become tubW to the Workers' CONTRACTOR TEL Na BET BACK )Ikm FWY PROP LTE VODTH
Corrpeneailon prwfelorn of the Labor Code, you must forllrMth OOFT-NG 288-4040 FRONT
comply with mich provbforTe or this permlt then be deemed revolted. ADDRESS LIC.NO. PL
529 F, VALL BLVD, 451'937 BADE
LICENSED CONTRACTORS DECLARATION CITYuC P L
I hereby affirm that I am IlCerred Lrderprovbbrn of Chapter B —
(commencfnp wlth Seodon 7000)of Dlvleton 3 of the Buslinow and 8Q FT.Sag 40.OF STORES I W.OF 8 SEWER LW r
Pmfeaelom Code,and my§cense is In full force and effect NEW BK PO 8
License Number 451937 Llo.ctaas .C-39 DEecRFT1ON OF vx>RK ADD ❑ YUIMT�O+ ,
Contractor RANDOL ROO ALTER ❑ $ 3,000.00 •
W
❑ I am exempt undar Sec. 2.5—YEAR CLASS A FIBERGLAS REPAIR Q z
R P.C.for We reenon SHINGLES. REROOF OVER ESI.ST OEMOL ❑ LDMA PAC+
Deter L"%RDE tSTWO BLDG. URM ❑
❑ L,as owner of the property, or my enproyom with wages as RA L ROOFING 2W-4040 LOMA Pry,+ z ITE��I
their sole oompenaation, *d do the work and the structure Is ADDR ESS
root ir� or offered code for tale (Section 7044, matt end BLVD SAN GABRIEL FURL DMERdemkm �a
YALL THE APPLICANT CR PUTUFE BUQLDM OCCUPANT HANDLE A HAZARDOUS W[T RIAL
❑ 4 as owner of the property, am exduelvely con"dinp wRh OR A►DCn RE CONTA!!IG A HW.AMOUS 6WEFMAL E01AL TO OR OFEAMR THAN THE
§Canted contractors bo conWuict thepro}ect (Section 7044, MAOU�%3ECFH.1 CN THE HAZARDOUS LWEALus GUI
DET OET FRIAL BY
ran El No Elaltl7TeeE and PROfeeti0rle Code.) Y&L THE rfre4)m um OF THC BLmxm 6Y THE APPLIGKr OR FUTTFE BuuJNo
OCCU WT REQUIRE A PEFMT FOR CCHdTRUCT10N OR MOOFlCADN FROM THE SOUTH
CONSTRUCTION LENDING AGENCY Cesar AIR QUALITY uvxoOWETrT DWRICT(SCACW tee PB44 TNM a-ECI .W FOR
�rw.pS
I hereby afArm Umd there is a cormftnx m lerdhTp aperxy for rEe❑ No❑ /
the perlomTaroe of the work for which this pwnft Is ls&u (Sec. i HIVE READ THE HAZZARCCUUe NA7FFlALS WORN)UION OLDE Aro THE ecran PE]4KFn4Q
3007,Ctv.a) cHEC1QIST.I U1D6ATIAM MY RE(LWVaAE Ta UNDER THE LOB ANGELES COUNTY COOS /Q
TRLE 2 CRAFTER 220 SECTCM 22Q 100 THROUGH 270-140 CCNCEFil10 HAZARDOUS -
Landers Name LWERALB REPORTMO AHD'FOR 06W1i0 A PEJ%JT F00M THE SC/rYQ
LerTdees Address
O OAAAW OR AdOW
I pertly that I have reed this applicid n and state ruder penalty PC FEE FE77)AT FEE
of penury the the above hmratbbrr
don correct I awes ID oon#y 96.60
*Iff1 all couanty orally ee and Stabs Yews relating d bull
=mtuctiorI, and a or F�E .
to for 26.85
SnGAnON FEE TO-V L FEE 123.45
SEE REVERSE FOR EXPLANAMW LANGUAGE