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HomeMy Public PortalAbout9148 OLEMA ST_Building__ 76A636A CE#6032-63 APPLICATION. FOR BUILDING-PERMIT. ` COUNTY OF LOS ANGELES BUILDING. Q DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING'AND SAFETY DIVISION LOCALITY ^� JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISF T p. GROUP TYPE ESSED BY FOR APPLICANT TO FILL IN } CONST. BUILDING STATISTICAL CLASSIFICATIONS WER MAP- ADDRESS / Q jCLASS. NO.-DWELL.UNITS-=] K G LOT NO. BLO K WATER CERTIFICATE: NOT REQUIRED ❑ RECEIVED - TRACT MAP HIGHWAY STATE MAJOR SECOND, CAL N OF B DGS. "NO. (CIRCLE) SIZE OF LOT W ON LOT USE ZONE SPECIAL EXIUSES. T NOF G BLDG. CONDITIONS TEL OWNER NO BUILDING 'YARD- HWY STRE T NAME EXIST. SETBACK WIDTH ADDRESS i QFRONT ARCHITECT OR TEL. P. L. ENGINEER NO. ,SIDE P ADDRESS- L ' ®!3A©IFII'a PERMIT REQUIHIEDa ' O CONTRACTOR TEOr 8J . r n V ADDRESS SS F ILL PAN JFINAI A O DESCRIPTION OF WORK : W A a NEW ADD • ALTER REPAIR DEMOLISH Iyy y�_ppIJ� t � Z SQ.FT. NO.OF NO.-OF SIZE STORIES FAMILIES I - USE OF STRUCTURE SIGNATURE OF APPLICANT " VALUATION $ °O APPROVALS - DATE INSPECTOR'S SIGNATURE P.C. PMT. / FOUNDATION: LOCATION FEE $ FEE $ {O FORMS, MATERIALS , FRAME: FIRE STOPS, -- 1 HEREBY ACKNOWLEDGE THAT I AVE READ THIS'APPLICATION 'BRACING. BOLTS AND STATE THAT THE ABOVE'IS C REGT AND E TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCE ND STAT A S REGULATING i GAS VENT. DUCTS ,.1.© f{�� .5� °� • BUILDING CONSTRUCTION.-1 C IF 'THA IN/ OI•NG THE, WORK AUTHORIZED HEREBY I WI EMPL ANY PERSON IN VIOLA- L•ATH. INT. TION OF THE LABOR G THE S TES OF.CALIFORNIA RELAT- � ° ING TO WORKMEN'S CO ATION RANCE. _ /� pr LATH, EXT. . + SIGNATURE OF HOUSE NUMBER COR- PERM ITTE_ _`c RECT OR-PERMITTEERECT AND POSTED Y ADORES Ti" �y FINAL JOHN F. LEWIS: PRINCIPAL ST URAL ENGINEER PLAN C K VALIDATION. '..cK: M.O. CASH _ PERMIT VALIDATION. cK. M.G. CASH. Lr;Lo 6.�+ G. 8 7 2 MIAR 2 3 � p . ' 76A638A SE 11803 1/71 d' ' APPLICATION FOR BUIL ING PERMIT COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK DS 2 PAGE PARCEL12—_ BUILDING AND SAFETY DIVISION BUILDING ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print ort a onl CROSS ST. _j Nt RARCHITECT S 9 I � �-/ D T O. GR CONST,��`TYPE- PRO SSED BY STATISTICAL CL $.IFICATION L SEWER MAP NO. BLOCK rr- CLASS NO. DWELL.UNITS BK A/P49 Tj S(�C�F L � -0;2U ONE MAP ® ^� NO.OF B OT / NO. �J LOT � �� NOW ON LOT •r( SPECIAL f7 /rCONDITIONS' G BLDG. ��CC LTJ'V� NOL?j E) II BLDG.SETBACK FROM � (STREET) S FRONT PROP.LINE OF TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL • C HIGHWAY WIDTH FROM C.L. ECT OR TEL. F _ ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACK HIGHWAY + YARD- = TOTAL C CONTRACTOR NO, HIGHWAY WIDTH FROM C.L. C..7 ADDRESS NO. + C LIC. Ct—r CITY CLASS CORNER CUTOFF YES ❑ NO ti CONSTRUCTION LENDER col NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS SQ. FT NO. OF NO, OF NEW SIZE STORIES FAMILIES USE OF ADD STRUCTURE 0 ALTER ❑ SIGN TUR REPAIR❑ APPL AN DEMOL ❑ Do VALUATIONS APPROVALS DATE INSPECTo 'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S. FEE S / C+-r F,O FORMS, MATERIALS FRAME: FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS RUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED E BY I WILL NOT OY ANY PE ON 'IN VIOLATION OF THE LATH, INT. AB C E 0 THE ST T 0 •C I ORNIA I RELATING TO ORK EN' ENSA ION N E LATH, EXT. SIG TUR HOUSE NUMBER COR- PERM RECT AND POSTED ADDRESS �) �QPJ OLEMP, FINAL JOHN F. LPM11s. PRINCIPAL ST R AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH _ PVALIDATION' cK. M.O. CASH r. •,�,+NO^.HERS'COMPENSATION DECLARATION 1• I hett�)Yj m thbt•I 504e a c4irlificate of consent to self insure, ar a certify ate of Workers'Compensation Insurance, APPLICATION FOR BUILDING PERMIT ora cerfified•copy thereof'(Sec. 3800, Lab. C.) Policy Ivo. Company COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ElCertified copy is filed with the county building inspec- BUILDING tion department. ADDRESS �� �� E; LOCALITY Date Applicant CITY L' t'!� NEAREST �' ?(fie G.t`�; ZIP I '�7 . � CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. //-- TEL. SPECIAL >- ' I certify that in the performance of the work for which this OWNER /V-C L ✓ NO. CONDITIONS IV permit is issued, 1 shall not employ any person in any manner DISTRICT GROUP TYPE FIRE P SED BY ADDRESS S 0 k-'e- S--'/((/ CONST. ZONE u so as to become subject to the Workers'Compensation Laws. 1/ 7910Vo Date Al- Z 46 Applicant t ✓�-�"D ITY 2 vv� Gly ZIP i STATISTICAL CLASSIFICATION APT. NDO. e NOTICE TO APPLICANT: If, after making t is Certificate of ARCHITECT OR TEE. Exemption, you should become subject to the Workers' ENGINEER O. CLASS NO.�DWELL.UNITS Compensation provisions of the Labor Code, you must forth- ADDRESSSEWER MAP with comply with such provisions or this permit shall be TEL. deemed revoked. CONTRACTOR NO. BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION U LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. 1 DDD o= Professions Code, and my license is in full force and effect. CITY CLASS $ , SQ. INC.OF NO,OF CHECK License Number Lic.Class SIZE ISTORIES j FAMILIES -7— 4 ONE t $ 4 5 2 0 A Contractor Date DESCRIPTION OF WORK (� ,�.11 C�! r�G :�' NEW E] ❑ I am exempt under Sec. Pja-, fir `��147:l 6 tlh�D ADD 0 .- # a o u o a I E / ALTER � FINAL a B.&P.C. for this reason ,c 1 h+I L130I S d� 4?S�1 REPAIR ®; DATE j 2�8,L.' ri Date: USE OF ` FINAL EXISTING BLDG. 0 DEMOL ❑ Signature' APPLICANT TEL. By o a OWNER-BUILDER DECLARATION PRINT NO. I hereby affirm that I am exempt from the Contractor's License ® Q 4,;' J—% 6 Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRE ENT IIIIIR UILDWG 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. ❑ 1, 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). REQUIRED TOTAL SETBACK FROM EXIST. 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. tSec. 3097, Civ. C.). SIDE o P.L. v Lender's Name a Lender's Address P.C.Fee$ Permit Fee �1 l v ` r I certify that I have read this application and state that the Issuance Fee ��•�D above information is correct. I agree to comply with all County Investigation Fee ¢ /� ordinances and State laws relating to building construction, Total Fee U ev D and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ®s Signatu of Applicant or Agent Date