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HomeMy Public PortalAbout9126 OLEMA ST_Building__ PMS-3 MW SETS '9-43. `' '- - _`•-�'"_:+._.i :-.: -'- _ - ` DEPAR%T- ENT OF BUILDING AND SAFETY PLICATION FOR PERMIT X.OUNTY OF 'LOS ANGELES J A �1 �� �: BU_ tL ® ING • WM. J. FOX, CHIEF ENGINEER i/� / I FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY _ DISTRICT NO. . PLAN. CK..NO. PERMIT NO. BUILDINGADDRESS /7�D LOCALITY '/-L° ,O/`t lr 7-y RECEIVED BY DATE OF APPL. DATE�pISSUED NEAREST �/ � CROSS 9T. 1'7 C �f7!/GI / r �e _1 / M BUILDING OWNER --L).,�7 ��1, IJY GII�'YI• :ADDRESS �f I • c_.2 �t r. MAIL ADDRESS LOCALITYF iNEAREST TEL. CROSS ST. cITY � No. _ . FIRE TYPE..^r^�--'• GROUP -, ARCHITECT OR TEL. - _ ZONE. I P-LANBI 'T. ENGINEER NO. 'BLDG. ORD. NO. ADDRESS f pp SETBACK.LINE CONTRACTOR l, j-o / �F gale, Iti�NO./ APPROVED. BY DATE `USE APPROVED �c� ADDREBB �!/ /Y �A` �!l 'a�� �vi/. ZONE,'-.,t/ BY- DATE LEGALN �JI,yya IBLOCK CORRECTIONSDESCRIPTION LOT NO. .77 TRACTJU%VIY (/dPt \)IFJeYAYfS140/IViS✓DY2 � / „G •J /1 NOW ON-LOTS_NO h Q SIZE OF LOT USE OF �J/ NO.OF NO. DF EXISTING BLDG. /Yp 4 t I FAMILICS I I ROOMB.7 DESCRIPTION OF WORK NEW !< ALTERATION I ADDITION 1. O A REPAIR I MOVING L DEMOLISH P. � p SIZE � //Q ROOMS 5r i STORIES WALLC�rj" I ROOF SI � PI ' COVERING J,/OC c O COVERING USE OF NEW ✓ - _ , BUILDING 1 HEREBY• ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT -FOUNDATION: LOCATION, i SPE 'TOR D,�j7E.<I/ AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS �� AND STATE LAWS REGULATING BUILDING CONSTRUCTION. LI• [ar •'FRAME? FIRE STOPS, o /� BRACING, BOLTS ] SIGNATURE .OF •1 13 op- f\' a� CYrls / OWNER /'(� , .'LATH, INT.: �7• 'J' ,`•� AUTHORIZED AGT - LATH, EXT.: - .SJ-,I.i-`•F"t:Y r .'1 sC•!•c•' - P. C.Is J•`;1 'IPLASTER, INT. I- f FEE p PLASTER, EXT.. FEE VALUATION R�414 FINAL �,�: g� l l�t.rAliTM1;1V1 vt BUILDING AND SAFETY aYYL1CiAl1V1V Y'Vtt l'l;luvll-K COUNTY OF LOS ANGELES i �w , J". J. FOX, CHIEF ENGINEER 'dam ` ,FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 11 BUILDING /� �` L DISTRICT NO. PLAN CK.NO. PERMIT NCr ADDRESS .I wK Q L lw' 61 -..�� Q'�) C LOCALITY' —E L f +C17)" RE EIVED•BY DATE OF APPLE/ DAATE ISSUEDNEAREST `J CROSS 8 /�'�f V Al F �' I !L(- ( / `'1-7 B ILDING l7 t� OWNER }R' � � L(' `••� � ADDRESS / © A �1� /q MAIL ` LOCALITY �/ c I ADDRESS 0 Q L,,.E:A TEL. t NEAREST J/I ` /. ! / CITY ��p L NO. r �fl� CROSS 5T. ✓Y lr- V FIRE NO.Or TYPE GROUP ARCHITECT OR TEL. ZONE PLANS (/ ENGINEER NO. BLDG. .( _ Y- i�rD.e. ADDRESS ,._•�'` SETBACK LINE �-(/ �"1 APPROVED TEL. BY DATE CONTRACTOR NO. " USE APPROVED ADDRESS ^� ZONE BY DATE LEGAL DESCRIPTION( i LOT NO. f BLOC • � J7 SECTIONS TRACT A) SIZE OF LOT NO.OF BLDGS. cwe I NOW ON LOTUSE or / NO.OF up EXISTING BLDG. ���.? F MIL ES RO MS DESCRIPTION OF WORK NEW B"-- ALTERATION ADDITION - O REPAIR 1_' MOH S VING DEMOLISLa :11. ZE ^{ ROOMS or ' STORIE'S Y WALLQ y I , #/it/(- USE COVERING 5 I u G(-® I DOOMING 1 ,� S//# it BUILDI NEW r-,C f V_ ' 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 18'CORRECT FOUNDATION: LOCATION }NBPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS"" 1 AND STATE LAWS REGULATING BUILDING CONSTRUCTION. 1• n ./1 FRAME: FIRE STOPS, SIGNATURE OF C�w�iL.�v BRACING,BOLTS OWNER / _ 'LATH,INT.: AUTHORIZED LATH,EXT.: DBS-3 2SM_s¢Ts 4-47 $ P.C.Il PLASTER,INT. 'PLASTER,EXT. VALUATION FEE FEE !E{ _ 1 FINAL J76AAlfi'A CE;p#809 1/7�PPLICATION FOR BUILDING PER(d�� � G� COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS �j G COLEMAN W. JENKINS, SUPT OF BUILDINGa LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvDe only). CROSS ST. BUILDING DISTFUQT N GRO TYPE P O BY ADDRESS 9 "JA of CONST. ooa STATISTICAL CLASSIFICATION SEWEMAP LOT NO. BLOCK /' ! CLASS NO, '2= DWELL.UNITS BK PG Or 04 TRACT t USE ZONE MAP �0 03 NO.OF DGS. NO. SIZE OF LOT-71ZAlQa NOW O OT !r SPECIAL USE OFo CONDITIONS EXISTING BLDG. TEL. OWNER �^ NO. BLDG.SETBACK FROM ADDRESS 2FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITYq2le ✓ • HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEL. Afme + _ .a�7 ENGINEER NO. BLDG..SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TE TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL C CONTRACTOR NO. HIGHWAY WIDTH FROM C.L. C: LIC. ADDRESPO NO,., + = C LIC. H CITY CLASS CORNER CUTOFF YES ❑ NO ❑ LL CONSTRUCTION LENDER a NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS z ADDRESS . SQ. FT. NO. OF NO, OF NEW ❑ SIZE -� STORIES FAMILIES USE OF ADD STRUCTURE ALTER ❑ SIGNATURE OF REPAIR[] APPLICANT DEMOL ❑ G C^ VALUATION.$• c ��� APPROVALS DATE INSPEC R'S SIGNATURE P.C. PMT. O FOUNDATION: LOCATION ` ) FEE$ FEE$ FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS a / AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. I CERTIFY THAT IN DOING THE. WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPE! INSURA! E� A LATH, EXT. � SIGNATURE OF�I4 e t HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS 6 Owl FINAL t� JOHN F. LEWIS. PRI CIPAL STR RAL ENGINEER PLAN CHECK•VALIDATION CK. M.D. CASH _ PERMIT VALIDATIO CK. M.D. CASH I Arr 0 8 6 5ZF` JUN 1 1 D 2 2.5 0 N I WORKERS'COMPENSATION DECLARATION • insure, oraafcertif carte of Worke s'tnt Compensation ificate eInsuran of A'93—"P L�CAT 10 N F 0 R BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ';ADDRESS F . Certified copy is filed with the county building inspec- BUILDING 5 tion department. ADDRESS p Q Q / A Date Applicant CITY L.c+ ZIP ^/7ard .LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST //` COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS Sl/-O v eje ¢ (— (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL // �-- TEL USE ZONE FscpoENDITIONS I certify that in the performance of the work for which this OWNER C i rL/UNO %_ «permit is issued, I shall not employ any person in any manner IAL so as to become subject to the Workers'Compensation Laws. ADDRESS GG / /t_ 7 CITY t° ZIP /-7 Date / r Applican ARCHITECT R TEL. NOTICE TO APPLICANT: If, after maki this ertificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to a Workers' �� n CONST. Z�E Compensation provisions of the Labor Code, you must forth- ADDRESS 6,0t t� V/ with comply with such provisions or this permit shall be /� TEL. STATISTICAL CLASSIFICATON APT. CONDO. deemed revoked. CONTRACTOR ► ' 1 NO. el LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC, SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO.OF NO.OF CHECK L1. License Number Lic.Class SIZE STORIES FAMILIES ONE VALUATION �, V Contractor Date DESCRIPTION OF WORK NEW $ 9`56 L J O I am exempt under Sec. ADD ALTER pill. B.BP.C. for this reason I REPAIR ® $ d Date: USEEXISTIING BLDG. DEMOL ❑ a0 1 0 a 5 A Z Signature APPLICANT TEL. FINALy (PRINT) NO. v G # 0 0 0 0 0 OWNER-BUILDER DECLARATION DATE =C ( a o 4 05 I hereby offirrrf that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESSFI t:.. �/y o 0 0 40505 Professions Code): PRE EN B BUILDING I, as owner of the property, or my employees with ADDRESS 1 1. 07 -88 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section "LOCALITY 7044, Business and Professions Code). MOVING TEL. j, as owner of the property, am exclusively contracting CONTRACTOR NO. 1 F_ with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Namen I LDMA Ref. N Lender's Address P.C. Fee$ Permit Fee I certify that I have read this application and state that the Issuance Fee r LDMA P/C R above information is correct. I agree to comply with all County Investigation Feej�(/ ordinances and State laws relating to building construction, Total Fee , LDMA Perm. a and hereby authorize representatives of this County to enter 7177757 I upon the above-mentioned property for inspection purposes. �/2 SEE REVERSE FOR EXPLANATORY LANGUAGE nature of plimnt or Agent Date WORKERS'COMPENSATION DECLARATION insure,or a certif cane of Workers'Compensat on Insuran elf APPLICATION F BUILDING PERM'T or a certified copy thereof(Sec. 3800,/Up Cj}) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company �o d = BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS �� � Dat Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTI FRO WORKERS' NO.OF BLDGS. NEAREST COMPENSATIO NSURANCE 1OWNER SIZE OF LOT NOW ON LOT CROSS OR (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE I certify that in the performance of the work for which this NO. SPE V permit is issued, I shall not employ any person in any manner Yn�1 SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS r CONDITIONS V CITY ZIP Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCE ED BY } Exemption, you should become subject to the Workers' 3 CONST. / Z�E V 5.06 Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be EL. q� c� STATISTICAL CLASSIFIC TION APT. CO O. g deemed revoked. CONTRACTOR NO.p�t7 d��/ LICENSED CONTRACTORS DECLARATION �` LIC. CLASS NO. Z DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS��� ( NO. 7�7 / SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY a pq CLASSBK VALIDATION I i� SQ.FT. NO.OF NO.OF CHECK License Number 413/ /h Lic.Class e 3� SIZE STORIES FAMILIES ONE VALUATION ;02 1 21 A DESCRIPTION OF WORK NEW ❑ , �� Contracto Date °�/g ❑ , $ , ADD # o 0 0 0 0 1 ❑I am exempt under Se CVL ALTER ❑ 1a - 5925 B.BP.C. for this reason REPAIR ❑•a. $ USE OF - - a 59,255 Date: EXISTING G. DEMOL ❑ Signature s,�� APPLICANT TEL. FINAL 0529-85 g (PRINT) NO. DATE `� "lam LDER DECLARATION I hereby aft txempt from the Contractor's License Law for th allowing reason (Section 7031.5, Business and ADDRESS FINA Professions Code): PRESENT BY ❑ BUILDING . I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY T. SETT BACK YARD HWY TOTAPRROTPLINEFROM WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE 0 P.L. Q Lender's Name IJ re,U LDMA Ref. # P. 75 C.Fee$ Permit Fee Lender's Address (— r I certify that I have read this application and state that the Issuance Fee v a LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee J I a LDMA Perm. # and hereby authorize representatives of this County to enter upo he above-m ttfi ed property for inspection .urposes. OZ�/ SEE REVERSE FOR EXPLANATORY LANGUAGE o ' Signa a of Applicant or Agent Date , ©t