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HomeMy Public PortalAbout9409 OLEMA ST_Building__ ���•• Lot #2 76A¢j8A CE,11803 3-69 APPLICA ION FO BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING �/ DEPARTMENT OF COUNTY ENGINEER ADDRESS, `f0 BUILDING AND SAFETY DIVISION LOCALITY Temple Crit JOHN A. LAMBIE, COUNTY ENGINEER O COLEMAN W. JENKINS, SUP'T OF BUILDING ROSS S CT. FOR APPLICANT TO FILL IN DISTRICT NO GROUR TY5C .tP4,,� (PRI NT OR TYPE ONLY) 1TRr © iBUILDING STATISTICAL CFICATION P ADDRESS6 42 N•Cak Tem le Cit CLASS NO. � DWELL.UNITS BK PG3.Y ' LOT NO. - BLOCK J USE ZONE MA ® I N0. L' TRAC7-S-afkt,ar.n.-.^.e-., r ^"`a-d.. rPr^n1- 10 SPECIAL NO. BLDGSIZE OF LOT 60 X 112 NOWOON LOTS 0 CONDITIONS USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL. FRONT PROP:LINE OF (STREET) OWNER John Marshall N0. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 26. N•Tem le City Blvd. HIGHWAY WIDTH FROM C.L. CITY Temple Cit Calif . - -�' + O = ENGH ECjl OR R Du NO�' 86� l0 SI INE OF (STREET) DG.SETBACK FROM O SIDE PROP. L TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 41Las Tunas Dr• T.Q. HIGHWAY WIDTH FROM C.L. TE CONTRACTOR John Marshall NOL286-90722 + c ADDRESS 5926 N• T•Ci•Blvd. NO 165015 CORNER CUTOFF YES ❑ NO E] CITY Temple Cit LIG. L SS B1 SEE REVERSE SIDE FOR SPECIAL APPROVALS C CONSTRUCTION LENDER ~ L NAME AND BRANCH Self � LL CL ADDRESS v L SO. FT. NO OF NO OF - SIZE 1 .00 STORIES 1 FAMILIES 1 NEWUSE OF �f STRUCTURE Single Family ADD ❑ ALTER ❑ REPAIR ❑ SIGNATURE OF OL ❑ APPLICANT VALUATI. $ 19 S 00 PMTz APPROVALS DATE? IHsa oR's sl A UPE FEE $ ° �✓ FEE$ ✓ 5 FO FORMS;MATERIALSN l / t- I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECTAND AGREE TO COMPLY FURNACE: LOCATION, ?� WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- GAS VENT DUCTS TION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PER,59N IN VIOLATION OF THE LABOR CODE LATH, INT. /' r �%", 7 -1 OF THE STATE �LIFOIN RELATING TO WORKMEN'S COM- PENSATION INSUpw_COM- PENSATION OF LATH, EXT. jf�- �-�• _ 'SIGN PERMITTEE HOUSE NUMBER CORRECT AND POSTED ozl ADDRES 26 N. Tem le. Cl1 .1t Blvd• FINAL ' JOHN F. LEWIS, PRINCIPA ' URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH - PERMIT VALID TIO - c M.O. CASH L&o F 77 5 3 N Mi 1 '2 3 D 8 5-95A Q �t�a 7 0 5.9 N- JUL.19 1 :D '14 -32 N APPLICATION.,FOR B-V.ILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY BUILD NG ADDRESS WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS — or a certificate of Workers'Compensation Insurance,or a certified "' L • copy thereo f(Sec.3800,Lab.C.) � CITY ZIP LOCALITY / Policy Nom! CompaSIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. 1-1-157-el NEAREST CROSS 6T. ❑ Certified copy is filed with the cou ding inspection TRACT BLOCK LOT NO. departure t. P. IUSE ZONE MAP No. ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS XDat App Icant CERT ICATE OF EXEMPTION FROM WORKERS' OWNERTEL NO. YES NO COMPENSATION INSURANCE G J WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS �.'. DISTRICT GROUP TYP CONST. FIRE ZONE PROCESSED BY dollars($1.00)or less.) CITY ZIP �0,of .—3 I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ARCHITECT E GI TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTR RTEL NO�r 9" SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith `'f Ii `L L FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS C.NO. P L LICENSED CONTRACTORS DECLARATION C ` y SIDE 1C, h u .CLAS / PL I hereby affirm that I am licensed underprovisions of Chapter 9 .� Q i�ft SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.W.SI7�E NO.OF STORIES NO,OF FAMILIES Professions Code, d license is in full force an eff g < NEW BK PG a License Nu r Lic.Class DESCRIPT OF WORK ADD ❑ VALUATION �� , O Contr �02`a��—�S ALTER ❑ $ ❑ I am exempt under Sec. REPAIR ❑ $ 0 BAP.C.for this reason . DEMOL ❑ LDMA P/C# U W Date: USE OF E NG BLDG. URM ❑ i CL Signature APPLICANT PRINT) TEL NO. LDMA Perm# 1 g Z ❑ I, as owner of the property, or my employees with wages as '� ���� �� �? r ZO + `r' 192.45 their sole compensation, will do the work and the structure is AD ES \ t n �p)' 0) F not intended or offered for sale (Section 7044, Business and FINAL TE Q00. Professions Code. 1 ITEMS ) LL THE PLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERVIL J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE TOTAL .p,. a"'@'�_ ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY5 licensed contractors to construct the project (Section 7044, VES❑ No❑ Business and Professions Code.) CHECK 192,45 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR n�0 i CHANGE GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ W the performance of the work for which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) 4.-Q001 q/int/9 CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. CM TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. '�3i� AM 09 0 Lender's Address 0 OWNER OR AGENT cI certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE r with all county ordinances and State laws relating to building CO construction, and hereby authorize representatives of this County ISSUANCE FEE co to enter on=mentioned property for inspection purposes.a / INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE