HomeMy Public PortalAbout9815 GARIBALDI AVE_Building__ 7GA638A CE#803-10.56 APPLI TION FOR BUILDING PJERMIT, 1
BUILDING AND SAFETY DIVISION BUILDING j
AGDRESS
Department of County Engineer y r
County of Los Angeles LOCALITY p
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
CASSATT D. GRIFFIN, SUPT OF BUILDING CROSS ST, v('
DISTRICT NO. FGROUP I TYPE SEWER MAP
FOR APPLICANT TO FILL IN BK PG
CONST.
BUILDING i i I
ADDRESS STATISTICAL CLASSIFICATION
BLOCK CLASS. NO. DWELL. UNITS
LOT NO. MAP STATE
NUMBER Q--3 HWY YES
TRACT USFE SPECCONDITIONS
ONS
63 x 300 I NOW ON LOTAL
NO.OF S
SIZE OF LOT '
USE OF nn
EXISTING BLDG. Dwelling BUILDING EXIST.
SETBACK YARD HWY S REET NAME WIDTH
OWNER Howard Raaf FRONT i
MAIL P. L.
ADDRESS 9817 Garibaldi VIDE
TELAT 6-730 I'. L.
ARC Temple Cite NO. INSPECTIO RECORD
ARCHITECT OR TEL _a
ENGINEER NO.
01
ADDRESS
CONTRACTO n a NoAT 7-974
ADDRESS 8717 Las Tunas nr0 aQ� _nt2h.
DESCRIPTION OF WORK
NEWyX,,QnA�DDe�,c� ALTER REPAIR DEMOLISH
S ZE ZS 82* 220 Ga_V DRIES 1 FAMILIES 1
USE OF STRUCTURE
Dwelling APPROVALS
SIGNATURE OF
APPLICANT DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION .
FORMS. MATERIALS
P, C, S _ FRAME: FIRE STOPS. -
V FEE BRACING. BOLTS
S FURNACE: LOCATION. -
VALUATION GAS VENT. DUCTS
FEE
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT.
STATE LAWS RE!UMTIN B UCTDINGCO ION.` HOUSE NUMBER COR-
SIGNATURE OF S% EJ/ RECT AND POSTED )•-. �to t .
PERMITTEE � v
ADDRESS FINAL /� ✓6 //F/// ,
(JOHN A.LAMBIE, COUNTY ENGINEER, do CLYDE N. DIRLAM. PRINCIPAL STRUFnTURAL ENGINEER
PLAN CHECK VALIDATION 6.K") M.O. CASH PERMIT VALIDATION CK. M.O. CASH
5 7 5°° FEB 27 1 6 A 1 3.0 0 M
! f02066,? MAR 17 1 A 26.00 P
gav- 4_�r��
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION r FOR APPL1 TO FlIN ADDRESS
I hereby affhm ttlat I have a oerNM1cate of coneent to self haUre, BU
or a oertfifco of VVbrfaem' Compen¢atfon Insurance,or.a
copy thereof( 3 C.) CITY
d LOCALITY
�� lag OF LOT Na OF BLD68.•NOW ON LOT
r-Err*Gfied copy b hereby hunbhed.
NEAREST C408a ST.
❑ Certified copy b flied with the Gwty bu ung TRACT BLOCK LOT NO.
USE DOPE MAP NO.
Date ksr tr ASSESSOR MAP BOOK PAOE PARCEL
SPEC'-IAL COrDfT10N8
CERTIFICATE OF EXO-MPT10N FROM WORKER - YES No
COMPENSATION INSURANCE WHEN 10010 FT.OF sC4-�oL?
Chfs section F
need not be completed tf theperrtilt b for one hundred nDDi
DtHTPoG'r GROUP TYPE CODt3-r. RE DOBE PROCESSED 13Y- dollars ($10-0) or�, � � � 3 ,
CITY ZP
I owttfy that to the perfor naof the worts for which t** pKmft
me 910PQ
Ie laa , I shall not empiay arty person In arry nWhner 8b_as to ARCFfrECT OR ENOAEEA TF1 NO.
becom>a eubjec t0 the Workers'Compeneatfon Laws.' 8AT19TICA1 CL pN - APT CONDO
Date., Applksnt ADDRESS CUSS Na DWELL U1J r8
NOT7CE- TO APPLCANT.. If, after' making tt1la CwHcatB of REOUfFED TO-VL SETBACK FROM EMST
Exemption, you should 'become subject to the Vkckera' SET BACK. `kRD 1 WY PROP LINE WIDTH
Compensation prwbbne.of the Labor Code, you mUi
must iorwfth FRONT
comply wtth,such prwbbus or thle pwmtt shall be deemed revoked. PL
LICENSED CONTRACTORS DECLARATIONSDE
CITY LK:. PL .
I hereby affirm that I am Ifceneedu xWprovlalom of Chapter 9 ' SEWER MAP
(cq-n--Clnp with Section 7000)of DKialcn 3 of the BUeh'1am and 3a FT,SIZE OF BToFE8 No.OF FAMIIEs .
Rb,l abase Code, b In full force NEW ❑ Bx Pa
LJcenee Nu Lb.Claw DE OF WORK ADD - S
Contractor be ALTER ❑ $
❑ I amt exempt under Sec. RE MR ❑ $ .
BAP.C.for dila reason DEMOL ❑
LDMA P/C f
Date: 118E OF oae-rW N-Da URM ❑ r
APPLICANT( TEL NO. . LDµA Pem,r 3303 108.90 —
❑ 1, as owner or.the property, or � employees with wages as NT z 1 ITM
U*r sole cornpensadco, will do the work and the sbucture.fs ADDRESS Q.
not Intended or offered for aala (Section 70", Buerrreao and F&L Do" 7 � /T+V�T{AJL 10�r IMM
OR
Pm(as �co(�) M\1 TFE APPL%a&W OR FUTIFE BLLDM OCQRWr WMDLe A WZA lDCLtB W9FFVL "42–g� CASH 108.7U
❑ I, as owner of the em comtraotinp with oR ALAOnLFE COI MING A HAA FCCOO wxrmn EDLL&L To oR GRE rEA T-�N n-E
Property, Y AMOlrm8 ePECFH 'n-E R-zmcOUC uaszmLs PvoAm "GLIDE? FDiAL BY
6ceneed oontractDm tD construct the project (Section 7044, YES El �
Bualnees and Professions Code.)
Ma.L Tre Werri® uae of Ti E BY TFE OR Ami BUILBM
LrrH
CONSTRUCTIOI�LENDING AGENCY Coffin All A l OteTRr,7 c1) ��n FOR 1 1 rf J
rY IDE ►FA
1 hereby affirm that there le a consttuctfon lending agency for
tea❑ 39M 1 W110:2b
a the performance of the work for which tt>b permit Is baled(Seo. i P�r�TFE t �e rorl GLIDE AND THE a,�o PE]:&�
3097, Ctv.C.) .i uoeapvo uv umDER THE Lce
Lenders Name r awK8 A Parr F 2-m
rind
LQnder's Addreee a ACHKT
0
5Q2 I cerfffy that I have read thio appllcatial and state under penetty
of perjtry that the above hrormatbn Is correct I agree to comply P.C.FEF PEFiA rr FEE
wfth all omnly ortfrencee and Stake fawn relatln0 to briIdn, V
a repreaentativee 6f thio Courrty ISSUANCE FEE -
ythweby
STK3A,TK)N FEE TOTAL FEE O p.
SEE REVERSE FOR EXPLANATORY LANGUAGE