8 iyoed, RE: Request to Refund $55, from the Los Angeles Department of Building and Safety (LADBS) Fund 48R to Los Angeles LGBT Center

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1 BOARD OF BUILDING AND SAFETY COMMISSIONERS VAN AMBATIELOS PRESIDENT E. FELICIA BRANNON VICE PRESIDENT JOSELYN GEAGA-ROSENTHAL GEORGE HOVAGUIMIAN JAVIER NUNEZ City of Los Angeles CALIFORNIA :1 mm ' 8 iyoed, 10 ERIC GARCETTI MAYOR DEPARTMENT OF BUILDING AND SAFETY 201 NORTH FIGUEROA STREET LOS ANGELES, CAS0012 FRANK M. BUSH GENERAL MANAGER SUPERINTENDENT OF BUILDING OSAMA YOUNAN, P.E. EXECUTIVE OFFICER April 20, 2017 Honorable Members of Budget and Finance Committee City of Los Angeles 200 N Spring Street Los Angeles, CA Attention: Lisa Hughes RE: Request to Refund $55, from the Los Angeles Department of Building and Safety (LADBS) Fund 48R to Los Angeles LGBT Center In accordance with LAMC Sections and 22.13, the Department requests your approval of refund claim number LADBS received payment for building permit number from Los Angeles LGBT Center in the amount of $55, The customer is requesting a full refund due to double payment resulting from the Department s error. The error was corrected through a new permit application (number ) which resulted in a duplicate charge to the customer. As such refund in the full amount of $55, is recommended to fully correct the transaction error. Attached are copies of the customer s permit and other supporting documents. Frank M. Bush General Manager Department of Building & Safety W:\RMBDATA\FINANCIAL_SERVICES\REFUNDS\Refunds for Council Approval\Claim # final.docx LADBS G-5(Rev ) AN EQUAL EMPLOYMENT OPPORTUNITY - AFFIRMATIVE ACTION EMPLOYER

2 \*>V2 ccmt^ct h&ge: CLAIM # v\tsirr^^ V J o DEPARTMENT OF BUILDING AND SAFETY (3'd2**S xtt V -< O m m I cn Received Date StaSp no AlWl4^ 5S*-6'- va kv ci 3! PRINT NAME OF Claimant (.Last) cn (First) Vuor-l&i Mailing.Address 33- x RAYrH»f4 > (KFA (City) (Sireel) QW1P11 &LV0 5ArtTA (StateZip) UA (AreaCode) (Phone Mumber) folqyyn-'mg REFUND INFORMATION v- JOB LOCATION: _[ 1115 NoRffl M(:LADDerl PLACE. Amount Claimed $_ 55,^64.65 V los k\mny Date Fees Paid:_ sg.-agmx's ^ RECEIPT #PERMIT SREFERENCE #: MioioOQZOiHeg STATE REASON FOR REQUESTING A REFUND - (Details): of A5 a Af CAT10 1*4 <ufpl( :r]gr^l 0 5CfU ftttm Of APPrT\or4. NOTE: A Claimant may be required to submit to examination under oath. (Charter Section 63.) Presentation of a false claim is a felony. (California Penal Code Section 72.) I HEREBY CERTIFY THAT THE ABOVE STATEMENTS ARE TRUE. v Yzh^Jll I SIGNATURE A^pTITLE OF CLAIMANT rc-wri DATE FOR DEPARTMENT OF BUILDING & SAFETY USE ONL Y r RFAUBEM I 0 sl&j.im'od' VNTAPPROVED aoioun : FOB REFUNDS 1, 4 v\ ON 1^upaC jl"vyu^' VJfy«>nV*Jrty L:>n d^u 4 f(vr>tdr {jits Zrer Jrp?rr) lxv^> >, vwosvv't ' r>pztau-^approved by: l LADBS-Finan. Frm 1 (42003) (X - Dale: Date: fuejn, l+ul>*\, 1

3 s&4iplfis$ 'V.w+iKHS o: ') s an 11 v n -t* City of Los Angelas Department of Building and Safety REPORT ON CLAIM FOR REFUND CLAfi.i NO.: 131?69 OPEiUATiON DIVISIOMS REPORT AND!i % Sent to: : :T>i1 f- Location Date:. COM&SNDATiOKS i o f g 1. Did Building and Safety perform any work for which the permit or receipt was issued? t io 2. Are reasons given by claimant correct? IO N.A. If "NO, please explain 3. Of the gross amount claimed, Is the portion of the amount claimed pertaining to {these) particular item(s) correct? V NO Should be pus arate shaft z r 5, Did Department initiate action resulting in an error? if "," please explain 8, Is claim over one year from date of expiration? If ",'* was permit extended? NO i NO V O un -4» n me; - -j(tnr -CO">r- 7. Is a refund recommended? NO* a, Explain under item 1C S. is this a duplicate permit or receipt of the same job or item? if ", indicate other permit or receipt nurnberfs) NO V 0, Enter this claim for refund number on your office copy of the receipt andor permit, or other records. Date entered URTHER COMMENT OR CLARIFICATION OF TH J2i ^ t> i -y. j g' xr-v «E ABOVE ITEMS (use back of form If more space required): trl Ql.C^ C^A V-* ' r7r~ kfegai jkl. h* 1. if _z Uz " J Z a as aw 30 CO o Date: Signature of Reaomrnencfei: Division: MISCForm 03(6V2015) " Approved: _ 7 f - I f i''" Of. "hl Ext, www. fad bs.org

4 1118 N Mccadden PI RF Application #: m Plan Check #: B16LA19783 Printed: :36 AM Event Code: Bldg-Addition GREEN - MANDATORY Apartment Regular Plan Check Plan Check City of Los Angeles - Department of Building and Safety APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Last Status: Submitted Status Date: TRACT BLOCK LQTQl ARB COUWTV MAP RFP# PARCEL IP <t (TIN IB STRONG AND DICKINSON'S IIO B B B B B B B Z. ASSESSOR PARCEL # Area Planning Commission - Central LADBS Branch Office - LA Council District - 4 Certified Neighborhood Council - Central Hollywood Community Plan Area - Hollywood zones(s): [QJM1-1VL-SN Census Tract District Map - 144B185 Energy Zone - 9 Fire District - 2 Near Source Zone Distance - l.6 Thomas Brothers Map Grid E5 4. PQCUM WS ZI - ZI-2330 Hollywood ZA - ZA-7266 ZI - ZI-2374 LOS ANGELES STATE ENTER PKLY - PKG-2673 ZI - ZI-2433 Revised Hollywood Injunction ORD - ORD SA19 ZI - ZI-2452 Transit Priority Area in the Cit QRD - ORD CHECKLIST ITEMS ORD-ORD ORD - ORD SA17:3 ORD-ORD CPC-CPC HD CPC - CPC GPC CPC - CPC CPU CPC - CPC SUD CPC - CPC CPU <i, PROPERTY OWNER. TENANT. APPLICANT INFORMATION Owner(s): MCCADDEN PLAZA LP 1625 SCHRADER BLVD, LOS ANGELES CA Tenant: For Cashier's Use Only WO#: Applicant. (Relationship: Architect) LEE COOPER OLYMPIC BL, - (310) EXISTING USE PfiPRQSKP USE 8. DESCRIPTION OF WORK SUPPLEMENTAL ADD 82 UNITS FOR APT FI I tigs»n Site & Use: SUPPLEMENTAL Ifl. APPLICATION PROCESSING INFORMATION BLDG. PC By: OR for Cashier: Signature: DAS PC By: Coord. OK: Date: 1L PROJECT VALUATION Permit Valuation: Sewer Cap ID: 12- ATTACHMENTS Submittal Fee Period $13,250,000 PC Valuation: Total Bond(s) Due: For inspection requests, call toll-free (888) LA4BUILD ( ). Outside LA County, call (213) or request inspections via To speak to a Call Center agent, call 311. Outside LA County, cal! (213) P SN *P SN* LA SELV :36:56 AM BUILDING PLAN CHECK DEV SERV CENTER SURCH SYSTEMS DEVT FEE CITY PLANNING SURCH MISCELLANEOUS PLANNING GEN PLAN MAINT SURCH Sub Total: Permit #: Receipt #: $46, $1, $10.00 $2, $55,364.65

5 13. STRUCTURE INVENTORY (Note: Numeric measuremenl data in the format "number number" implies "change in numeric value total resulting numeric value") , APPLICATION COMMENTS: ** Approved Seismic Gas Shut-Off Valve may be required jg. BUILDING RELOCATED FROM: 16. CONTRACTOR, ARC15ITECT & ENGINEER NAME CLASS UcEN&fc *» PHONE U pl.\n CHECK EXPIRATION; Unless a shorter period of time has beer established by an official action, plan check approval expires one and a half years after the plan check fee has been paid N MCCADDEN PL Courier? ( Yes or No) O PC- O d.a.s. (JN.P. o G.p.l. O s.p.i. G D.P.I. USE: Plan Check Number - Regular PC 30 B16LA19783 Submittal Date: Notes: PC Engr: ( ) Ready for Pick-up

CLAIM FOR REFUND - PAYMENTS CLAIM# 131269 FEE FUND FUND AMOUNT TYPE TYPE PAID RETENTION 20% NET REFUND B-PC 48R0841563896 AP10 46128.89' 0.00 7 46128.89 OSS 58V084659465901 AP10 1383.87 0.00 1383.

6 CLAIM FOR REFUND - PAYMENTS CLAIM# FEE FUND FUND AMOUNT TYPE TYPE PAID RETENTION 20% NET REFUND B-PC 48R AP ' OSS 58V AP SYS 48R AP CPLS AP T MISC 48R AP & GPMS 52F AP TOTAL , r

7 Km LAI m. «S5 DBS DEPARTMENT OF BUILDING AND SAFETY LA Department of Building and Safety LA SELV :36:56 AM BUILDING PLAN CHECK DEV SERV CENTER SURCH SYSTEMS DEVT FEE CITY PLANNING SURCH MISCELLANEOUS PLANNING GEN DLAN MAINT SURCH $46, $1, $10.00 $2, *7 DBS department of building and safety LA Department of Building and Safety LA SELV :36:57 AM Sub Total: $55, Permit #; Receipt #: $55, $0.01 Pern - #: Reaeir #: Total: $55, Check $55, ii 22 c. r-vv rjrb '! DBS DEPARTMENT OF BUILDING AND SAFETY LA Department of Building and Safety LA SELV 10 ^ '- ' :37:09 * AM OVERUNDER PAYMENTS $0.01 Receipt #: Sub Total: $ Olympic Boulevard Santa Monica, California kfalosangeles.com

City of Los Angeles REPORT OF RESIDENTIAL PROPERTY RECORDS

RPR: C10191331 Status: Completed Date Issued: 10/09/2018 Receipt: 0102950035100218 I. MAIL-TO AND CONTACT INFORMATION City of Los Angeles REPORT OF RESIDENTIAL PROPERTY RECORDS Company COLDWELL BANKER