Unpermitted Dwelling Unit (UDU) Inter-Agency Referral Form

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Unpermitted Dwelling Unit (UDU) Inter-Agency Referral Form Los Angeles (DCP), Department of Building and Safety (DBS), and Housing and Community Investment Department (HCIDLA) This form is to serve as an inter-agency referral for applications for legalization of pre-existing unpermitted dwelling units pursuant to Public Benefit Project procedures in LAMC Section 14.00 A.10. This form shall be completed and signed by staff from the relevant Department(s) prior to issuance of the final building permit. I. Project Information - To be completed by applicant 1. PROJECT LOCATION/ ZONING Project Address: Existing Number of Units: Permitted: Unpermitted: Applicant Name and Phone/Email: Assessor Parcel Number(s): Community Plan: Number of Lots: Lot Size: s.f. Current Zone: Land Use Designation: Specific Plan HPOZ DRB Enterprise Zone CRA CPIO Q-condition/ D-limitation/ T-classification (please specify): Other pertinent zoning information (please specify): Is lot(s) located within ½ mile of a Major Transit Stop 1? (yes/no): II. Project Eligibility - To be completed by applicant and determined by DCP Housing Services Unit Eligibility Criteria (To be Determined by DSC Housing Services) Please Write: Yes or No (a) Structure has a non-permitted dwelling unit or guest room. (b) Structure is located in a zone that allows multiple-family uses (R2 or less restrictive) (c) Units to be legalized were built and occupied as residential units between December 11, 2010 and December 10, 2015. Please provide acceptable evidence such as a lease, utility bill, Order to Comply, Rent Stabilization Certificate, photographs, or other evidence. (d) At least one additional Restricted Affordable Unit will be provided on-site. (Covenant and Agreement will be required by HCIDLA) DCP Staff Name and Title DCP Staff Signature Date 1 Per AB 744, a Major Transit Stop means a site containing an existing rail transit station or the intersection of two or more major bus routes with a frequency of service interval of 15 minutes or less during the morning and afternoon peak commute periods. It also includes major transit stops that are included in the applicable regional transportation plan.

III. Zoning Compliance - To be completed by DBS Staff 2. NUMBER OF PERMITTED AND UNPERMITTED UNITS A. Number of permitted units on-site: units (a) B. Number of unpermitted units on-site: units (b) C. Total number of units proposed: units (c) [c = a+b] 3. PARKING A. Number of parking spaces currently provided on property: spaces B. Description of current parking provided on property: (include description of number of compact spaces, number of covered spaces, number of tandem spaces, etc. as applicable) Is the existing parking compliant with the LAMC? Yes No 4. PARKING COMPLIANCE A. Requested parking compliance: (Please choose only one of the following options) Parking Option 1: Recalculate parking for all units in the project based on # of bedrooms for all units in the project (not just the restricted units), inclusive of Disabled and Guest parking. # of Units Spaces/Unit Parking Required Parking Provided 0-1 Bedroom 1 2-3 Bedrooms 2 4 or more Bedrooms 2.5 TOTALS Parking Option 2: Parking may be calculated by maintaining all existing parking and providing additional parking only for newly legalized unit(s) in accordance with Parking Option 2 in LAMC Section 12.22 A.25(d). Up to 40% of required parking for Restricted Affordable Units may be compact stalls. One Restricted Affordable Unit or dwelling unit for Low Income individuals must be provided for each legalized unit. # of Units Spaces/ Unit Additional Parking Required Parking Provided Permitted units n/a 0 Restricted Affordable 1 Very Low/ Low Income Senior or Disabled 0.5 Residential Hotel 0.25 TOTALS [from Section 3A] CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 2 of 7

Parking Option 3: Parking may be calculated by maintaining all existing parking and providing additional parking at a ratio of 0.5 parking spaces per bedroom only for the newly legalized unit(s) for a project located within one half mile of a Major Transit Stop 1. The maximum ½ mile distance to a major transit stop is measured in a straight line ( as the crow flies ). Tandem or uncovered parking is permitted. Permitted units # of Bedrooms Spaces/ Bedroom Unpermitted units 0.5 TOTALS Additional Parking Required n/a 0 Parking Provided [from Section 3A] 5. PASSAGEWAY Does project meet the passageway provisions of LAMC Sections 12.21 C.2(b) through (e). Yes No 6. ADDITIONAL PROJECT ZONING COMPLIANCE (if applicable) Zoning Standard Required per applicable Code Section Description of conditions currently provided on property Zoning Relief Required (Y/N) Parking Open Space Yard/Setback: Front Side Rear Lot Coverage Lot Width Floor Area Ratio Other (please specify) DBS Staff Name and Title DBS Staff Signature Date CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 3 of 7

IV. Verification of Zoning Compliance and Affordable Housing Referral - To be completed by DCP Housing Services Unit Staff 7. DENSITY COMPLIANCE A. Maximum density allowable per zoning: Lot size: s.f. (d) Density allowable by zone: units/s.f. of lot area (e) Units allowed by right (Base Density): units (f); [f = d/e, Including fraction and round up to the next whole number] or if applicable, Permitted Units by Certificate of Occupancy of units. B. Total Number of Units Proposed: units (g) [from Section 2C] C. Total Increase in Density Requested: percent (h) [h = ((g-f)/f)*100] D. Total Increase in Density Approved: (check code section below) Check One Code Section LAMC 14.00 A.10(d)(1) LAMC 14.00 A.10(d)(2) LAMC 14.00 A.10(d)(3) Description Less than 35% increase in density 8. ADDITIONAL INCENTIVES Greater than 35% increase in density when the number of legal units exceeds allowable density Legalizing a third unit on a property when an existing permitted twounit building already exists A. Total Number of Incentives/Zoning Relief Requested: [from Section 6 above] List of Incentives Requested and Approved by DCP [from Section 6] One: Two: Three: Additional Waivers of Development Standards Required: If not waived, these development standards would physically preclude the legalization of an eligible UDU project with the densities and incentives permitted by Section 14.00 A.10. Development standards include, but are not limited to, a site condition, a height limitation, a setback requirement, a floor area ratio, an onsite open space requirement, or a parking ratio that applies to a residential development pursuant to any ordinance, general plan element, specific plan, charter, or other local condition, law, policy, resolution, or regulation. Development standards do not include conditions imposed through discretionary approvals. Incentives and additional waivers shall not be used to exempt compliance with performance standards. DCP Staff initials CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 4 of 7

B. Qualification for Incentives: (Please check only one) Eligible Number of Incentives Percent of Total Units Restricted to Very Low Income Households Percent of Total Units Restricted to Low Income Households Percent of Total Units Restricted to Moderate Income Households One 5% to <10% 10% to <20% 10% to <20% Two 10% to <15% 20% to <30% 20% to <30% Three 15% or greater 30% or greater 30% or greater 9. NUMBER OF AFFORDABLE UNITS REQUIRED Type Percent Required [per Sections 7 and 8] Number of Units Required Number of Bedrooms per Restricted Unit(s) Extremely Low Income Very Low Income Low Income Moderate Income Total DCP Staff Name and Title DCP Staff Signature Date CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 5 of 7

V. Affordable Housing Covenant - To be completed by HCIDLA Staff 10. AFFORDABILITY COVENANT An Affordability Covenant has been executed and/or recorded to the satisfaction of the Los Angeles Housing Department s Occupancy Monitoring Unit. Type Number of Units Recorded Extremely Low Income Very Low Income Low Income Moderate Income HCIDLA Staff Name and Title HCIDLA Staff Signature Date CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 6 of 7

INSTRUCTIONS: Unpermitted Dwelling Unit Inter-Agency Referrals 1. Appointments: Individual agencies may require appointments to require completion of individual portions of this referral form. Please inquire with individual agency staff to determine this. For the, an appointment with the DSC Housing Services Staff is recommended to complete this referral form. After the Unpermitted Dwelling Unit Inter-Agency Referral Form is completed, an appointment to file your Public Benefit application at the Development Services Centers is also required and must be made via the City Planning website: http://planning.lacity.org. 2. Review Materials: Review of the referral form by staff is intended to identify and determine compliance with City requirements necessary to achieve the proposed project. Materials submitted for Eligibility Criteria and Zoning Compliance must comply with the respective agency s criteria for submittal. Please consult the respective agency for specific submittal requirements. a. Eligibility Criteria: The Unpermitted Dwelling Unit (Ordinance No. 184,907) requires specific evidence to establish occupancy including an apartment lease, utility bill, Rent Stabilization Ordinance (RSO) Rent Registration Certificate, code enforcement case documentation (i.e. Orders to Comply), all between the period of December 11, 2010 to December 10, 2015. Insufficient materials or lack of materials will delay processing of your project. b. Zoning Compliance: Applicants will need to submit for Plan Check with the Los Angeles Department of Building and Safety (LADBS) to ascertain if there are any other issues or necessary approvals associated with the project/site which should be resolved. 3. Contact Information: DOWNTOWN OFFICES: Housing + Community Investment Department 1200 W. 7th Street, 8th floor Los Angeles, CA 90017 Phone: (213)808-8843 Website:http://www.hcidla.lacity.org Department of Building and Safety, Metro Office 201 N. Figueroa St., 4 th Floor Los Angeles, CA 90012 Phone: (213) 473-3231 Website: http://www.ladbs.org DSC Housing Services Unit Figueroa Plaza 201 N. Figueroa St., 5 th Floor Los Angeles, CA 90012 Phone: (213) 202-5464 Email: dcpphp@lacity.org DSC Metro Counter Figueroa Plaza 201 N. Figueroa St., 4 th Floor Los Angeles, CA 90012 http://planning.lacity.org VALLEY OFFICES: Department of Building and Safety, Van Nuys Office 6262 Van Nuys Blvd., Suite 251 Van Nuys, CA 91401 DSC Valley Counter Marvin Braude Building 6262 Van Nuys Blvd., Suite 251 Van Nuys, CA 91401 Phone: (818) 374-5050 WEST LA OFFICES: Department of Building and Safety, West Los Angeles Office 1828 Sawtelle Blvd. Los Angeles, CA 90025 DSC West Los Angeles Counter 1828 Sawtelle Blvd., 2nd Floor West Los Angeles, CA 90025 Phone: (310) 231-2598 CP-7835 [08.01.2017] Unpermitted Dwelling Unit Inter-Agency Referral Form Page 7 of 7