HomeMy Public PortalAbout9819 GARIBALDI AVE_Building__ ot
76A688A CE#809-8-57 APPLICATION FOR BUILDING PERMIT Z
COUNTY OF LOS ANGELES ABUILDING
DDRESS , ' `
DEPARTMENT OF COUNTY ENGINEER ;
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE.COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST.
V7NE
CT NO. GROUP SEWER MAP
FOR APPLIC TO FILL IN TYPE' ER P�
CONST..
BUILDING >, �
ADDRESS TICAL CLASSIFICATION
NO. DWELL. UNITSLO7 NO. BLOCSTATE
R HWY YES OTRACT E SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT 63 30O NOW ON LOTUSE OF
EXISTING BLDG. G YARD HWY REET NAMEEXIST.
K WIDTH
OWNER Howard Raef ADDRESS 9817 GaribaldiMAIL
CITY T em le Citir TELAT 6-73 P L
ARCHITECT OR TEL, INSPECTIOU REpORD
ENGINEER NO.
ADDRESS
6ant a Anita AT 7-97
CONTRACTOR NO.
No:
Lpv %ju LL
ADDRESS871 as Tunas r. .SanGab_
DESCRIPTION OF WORK -
NEW R ADD ALTER REPAIR DEMOLISH
SIOZE 10941. 240 GoRIES 1 FAMOILIES Z
USE OF STRUCTURE
Dwelli
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRESS FOUNDATION: LOCATION
FORMS,MATERIALS Z.
P.C. $ FRAME: FIRE STOPS.
FEE BRACING, BOLTS
VALUATION S FURNACE: LOCATION.
FEE i GAS VENT,DUCTS 1
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND
STATE LAWS REGULATING BUIL G CONSTRUCTION. LATH,EXT. .`
SIGNATURE OFHOUSE NUMBER COR-
PERMITTER RECT AND POSTED 7+�'
ADDRESS FINAL - JJ-� rte•->-'
JOHN A. LAMBIE,COUNTY ENGINEER, CLYDE N.DIRLAM, PRINCIPAL STRUATURAL ENGINEER
PLAN CHECK VALIDATIONM.O. CASH PERMIT VALIDATION K M.O. CASH
,15740R FEB 271 6 A 16.75sov')�
®P
? 065N MAR 17 1 A 31 .00 n /;1
TAA638A c[�Bos.a-ea APPLICATION- FOR BUILD I G PERMI IJ
COUNTY OF LOS ANGELES 5UI.LDINO t
'r DEPARTMENTOF COUNTY ENGINEER ADDRESS t
BU[LDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER N AREST
COLEMAN W. JENKIKSAUP•T.OF BUILDING CROSS ST.
DISTYPE. PR BY
FOR APPLICANT TO FILL IN CONST.
SUI L'DI NO STATISTICAL 91FICATION 814 E/R MAP
ADDRESS /' CLASS-NO. D ELL UNITS BK/ P(3
LOT NO. BLOCK USE ZONE. NAP iiF�„rrr - -
NO.
TRACT. SPECIAL -
tONDITIONS
SIZE OF LOT 3^� NO. OF ■ .
X �J�—O MOW dN LOT .
USE OF
EXISTING 151-Da. BLDG. BET BACK FROM 1 1.
TEL. FRONT PROP. LIKE OF ([TR[tT)
OWNS NO. TYP[ OF EXISTING I./[TRACK. HIGHWAY YARD = TOTAL
ADDRESS 4'C;L -- '
+ _
CITY
ARCHITECT OR TEL. BLDG. SETBACK FROM
LI .
ENGINEER NO. SID[ PROP. K[ OF 8TR[[T
TYP[ OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS KIGHWAY WIDTH FROM C.L.
TEL. f f j, +
CONTRACTO NO (//�/l) O
ADDRESS CORNER CUTOFF YES NO U
CLAS IC �
SEERSE SID FOR SPECIAL APPROVALS
DESCRIPTION OF WORK
NEW ADD ALTER REP DEMOLISH /
SC FT. NO. O NO. OF /
SIZE STORIES FAMILIES
USE OF
STRUCTURE
•+ S�
SIGNATURE OF
APPLICANT
VALUATION APPROVALS DATE INSPECTOR'S SIGNATURE
IIIP.It. PMT. •FOUNDATION, LOCATION
FEE PEE zl-r FORMS, MATERIAL
FRAME, FIRE STOPS, .
I HrimY AC KNOWL[DG[ THAT I HAVE R[AD THIS APPLICATION BRACING BOLT
AHD STAT[ THAT THE ABOVE IR CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITH ALL COU HTY ORDINANCES AND STATS LAWS REGULATING OAS VENT'. DUCTS
GWLDI NG CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK
AUTHORIZm H[RABY I WILL HOT EMPLOY ANY P[RSON IN VIOLA-. LATH. INT.
TION OF THE LABOR CODA OF THE STATE OF CALIFORNIA "LAT.
ING TO WORKMEN-Q.COMPENSATION INSURANCE. LATH, EXT.
SIGNATURE OF f'yy)f HOUSENUMBER COR-
PE42MITTEE �l�l '( RE T ANE)
N P D
ADDRESS FI NA(_
JOHN F. LEWIS. PRINCIPAL STo
RAL ENGINEER
PLAN CHECK VALIDATION Cx. M.O: CASH _ PERMIT VALIDATIONM.O' CASH
,0 4 9 0�8 HAR15 1 D : 4.0Q�
. - APPLICATION .FOR BUILDING PERMIT
COUNT(- OF LOS ANGELES. BUILDING ANI?SAFETY
WORKER'S COMPENSATION DECLARATION T FOR APPLJCANf F111 IN Bu-DING ADDRESS Q ,
I hereby affinil that I have a oertfficate of consent to sell Inure, elm ottrc3 — o
Dr a cerf}flcabs of Vrbricsrs' Compensation trueu ,or a
copy C.) qTY 21P
11JCALiTY
Pd OF NO.OF BLDGa NOW ON LOT
'- C:ertlM1ed copy b hereby fumfahed. QST CRo89 ST.
❑ Certffied b flied with the bounty buliding TRACT BLOCK LOT NO.
I �20fiE. MAP
Dote {�{� ASSESSOR MAP BOOK E PARCEL
SPECUIL CONDITiO1J8
CERTIFICATE OF EXEMPTION FROM WOR ^C
COMPENSATION INSURANCE w wT Q+ loo-o Fr.OF ? YES N0
(fhb section need not be completed ff the Permit le for one hundred S �jy�,r /J�� Dir GFKXF' CONST. FFE 2DNE PROCI 93rd HY
dollars(S 100)or leas.) �'""�✓
I certtiy that In the perfa-merae d the work this permit- ClT1 �
b issued I shall not empty erry any mat,ruer so as toDO —
become aub)ad to the vkr*ars' tion LOWy CT EFA TEL No.
8-RTt3TIG4.. APT cormo
Date EWd ADDRESS CLASS NQ. �uWEl uNr-s
NODGE TO ff, after making -this Certifloate' of REQUIRED TOCAL SETBACK FROM EXIST
Exempn, shorid become subpet to the Nbrkera'" NO. SET BACK FhVY
tioPROP LINE WmTH
of the Labor Code; you must forthwith
FRONT
comply with provbbrm or.this peml-t shalle
be dearnd reMoked. LIC p
LICENSED CONTRACTORS DECLARATION SIDE
CITY - Lr— P L
I hereby affirm that I. am I beneed rnderpiwbbne of Chapter B SEWER=
(commencing with Section 7000)of DMaion 3 d the Bualrwm and sd FT.SpE Na OF STORIES N0.OF NEW Q ,
Profession Code, rrry rioense'Is In full force BK PO
uc-'W Nrmiber Lb.Class — DE OF worn( ADD ❑ vU1LqqQk OLD
Contractor Date, ALTER ❑ s
❑ 1 am exempt under Sec. RE RAJ
B,dP.C.for this reason DE MOL ❑
LDMA P/C•
bate: - USE OF F9 DG URM ❑ - - -
tuB TEL NQ LDIM Perm+ 1
❑ I, as Owrobr d the 01roperty, or my errployeee with wagag as Z ACCT■'ILr —
thatr sole corpensation, wm do the work and the etrtichue Is ADRRE
not kYonded or offered for aaie (Section 7044, Business and -MAL DATE a 3:7113 10$.90
Profeeabrra Coda.) ,tiu THE APPUCAKr OR ri, OCCUONT HANDLE A H64ZAiCOUS wa-ww l-Z?y FIs 1 ITats
❑ I, as ovupr of the property, am exduslvefy corltrac with
CRA wve�.L DFOR To OR LIRE? n uN n E
wzv�o«,e�urERuus rrFOErvsoN a�oE, MAL 13YTOTAL i _ 90
Licensed cbrrhadors to construct the pro)ect (Section 7044,'
Business and Code.) YEa El MO
NLL TFE NTQp®UENE of TFE aAXNG RY TFE h�.bR FUnRE RA-DING 4t1�7f1 11.IL1.74J
CO UCTFON LENDING AGENCY F�O�L�E A�r�Aaw eE PBGU��f��T� .00
..F .mss a�
I hereby aff6Tn there Is a construction lending agency for YES❑
n the performance d wont for which this perm R Is Issued(Sec. i Fore READ TFE FVZARDOU15 LWIT ALB lFCFW,-7 rr GLIDE AID TFE ecxPn PERMFFr O y-y-�_�yy� i , e
3087,Ctv.C.) a-ECKUST.i UNDERBIAND►tY uTDE7�THE Lge,INQELEs courrY cOoF-
IA.RJl.nJ�LR11 r 1p�9,�J
L.endef'9 Name 7 W TFRO"2.20. Fl�7AADOLrB /�y L.
LendWs Addraw c .h7471 1 AM 10:2b
Q I MtIfy that I have read this gpplloafion and state.under penatty
d perry that the atxxe Information Is correct I agree to oompty PC:FEE PER14T,FSE �/ D
with all county ordtuancea and State iewe reiatirp to bulking
00fatuctbn, and hereby reQreeemtetivee of u,ie Cou 0SL A 4CE FEE r� 3 0
. to the above property for. v`7
o PNESTK3ATION FEE TMAL FEE
O
dol
Ab-
SEE REVERSE FOR EXPLANATORY LANGUAGE
r ,