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Home My Public Portal About9415 OLEMA ST_Building__ �,.. Lot �#3 76A63 E 9863 3-68 APPLICATION FO BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING �'I"' N. J'�'- DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY Temple Cit JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING CROSS NEAREST -o-^� FOR APPLICANT TO FILL IN DISTRICT 0. GRO P TYPE I'Y �FTR I %R.T.Y L Y) t / i D BUILDING STATISTICAL CL/5SIIEIICATION SEWER MAP ADDRESS .. Temple Cit CLASS NO. =WELL.UNITS BK 97 OG-32 . LOT N0. pOCK_ USE ZONE I MAP TRACTSanta Anita Land Co. Tract J ISPECAL -7 NO. OF BLDGS. CONDTIONS SIZE OF LOT 60 X 1 NOW ON LOT 0 USE OF EXISTING BLDG. BLDG. SETBACK FROM OWNER TE`286- 822 FRONT PROP. LINE OF -(STREET) TYPE OF EXISTING FROM C.L. SETBACK HIGHWAY + YARD - TOTAL HIGHWAY WIDTH ADDRESS5 26 N. Temple CityBlvd• v CITY Temple Cit Calif. + OR TEL BLCK DG.SETBAFROM GINEER R NO.286-2102 SIDE PROP. LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS -9417 Las Tunas D HIGHWAY WIDTH FROM C.L. CONTRACTOR John Marshall • o Th TEL + 822 ADDRESS 6 NO L'c. CORNER CUTOFF YES C] NO ❑ l CITY Temple City CLASS Bl SEE REVERSE SIDE FOR SPECIAL APPROVALS CONSTRUI: F NAME AND TBRANCH ION NDER Self u n v ADDRESS L SQ. NO. OF NO. OF SIZE FT 1400 STORIES 1 FAMILIES NEW T USE OF ADD ❑ STRUCTURE ER//�� C]ALT `F®6, REPAIR ❑ SIGNATURE OF EMOL ❑ APPLICANT VALUATI Z OO APPROVALS DATE INSP TOR'S SIGNATURE P.C. G: s, PMT. j '2� FOUNDATION: LOCATION FEE$ �� ✓ FEE$ / xt MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME- FIRE STOPS, BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND 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 PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. I 7 OF THE STATE OF LIFO A IN RELATING TO WORK 'S COM- PENSATION INSUR C LATH, EXT. SIGNATURE OF HOUSE NUMBER CORRECT PERMITTEE AND POSTED, ADDRES 6 FINAL JOHN F. LEWIS, PRINCI AL STRUCTURAL ENGINEER PLAN � CHECK VALIDATION CK. M.O. CASH - PERMIT VALIDATIOJ. CK M.O. CASH i,AUO 7 7 5 51-3 Iidilf 1 2 3 D 8 5.9 5A L&O—r .0 5 '8N JUL 19 1 D 14 .25N c c APPLICATION FOR BUILDING PERMIT COUNTY OF.LOS .ANGietES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION BUILDING ADDRESS FOR APPLICANT T FILL IN I hereby affirm that I have a certificate of consent to self insure, BUIL D Ole 1 or a certificate of Workers'Compensation Insurance,or a certified /IP70 sr copy thereof(Sec.3800,Lab.C.) CI Gy�� ZIP e m C' LOCALITY Policy No. Company SIZE OF LOT F NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST, ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OVNER ; I�lo� S�� JJ y� t`J WITHIN 1000 FT.OF SCHOOL? YES No COMPENSATION INSURANCE ( This section need not be completed if the permit is for one hundred ADDRESS, ( P P �'1 _!J DISTRICT GROUP ONST. FIRE ZONE PROCESSED BY dollars($100)or less.) C CITY ZIP I certify that h the performance of the work for which this permit 0z J is issued, I shall not employ any person in any manner so as to vv become ubje t to the Workers' ompensat on Laws. ARCHITECT OR ENGINEER TEL NO. ,�` N. STATISTICAL CWSIFICATION APT CONDO Dated Applicant `Q 1 C ADDRESS CLASS NO.,C--'- DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CPIVrRACTOR • g SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith ✓e ®d I h ` �� FRONT comply with such provisions or this permit shall be deemed revoked. %1JO PM C;G 1;s 7— LICENSED /� p L CONTRACTORS DECLARATION /� �f SIDE C -e -er Irl , PL I hereby affirm that I am licensed underprovisions of Chapter 9 EWER MAP (commencing with Section 7000)of Division 3 of the Business and so.FT.SIZ NO.OF STORIES NO.OF FAMILIES ��! } Professions Code, n �^my lic n e is in full force and effect, NEW a BK P OC License Nu er / LID.Class D IPTION OF� ` a ADD ❑ VALUATI , C Contractorr-rrow�(VT lk� Z Z Q I�Q r D \' S. a 9° w� ALTER ❑ $ �0 2 (q Cc 7 r C ❑ 1 am exempt under Sec. Cc V-' ` REPAIR BAP.C.for this reason �,: .,TING ' e� f�1 EMOL ❑ LDMA P/CDate: USBLDG. URM ❑ U Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z ❑ I, as owner of the property, or my employees with wages as ZA;,s 1'. their sole compensation, will do the work and the structure is ADDRESS O __.1_ ,a. :c not intended or offered for sale (Section 7044, Business and FINAL DATE -R''-' Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A•HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ I, as owner of the property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 0 L 3 licensed contractors to construct the project (Section 7044, YES❑ NO❑ TOTAL i F� �.-9,� -45 Business and Professions Code.) .all 117"`•• tt WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING -° OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH Sy'wn-p )) �• CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR �+`'1`V K�, S ;i;-j( {i�p y l!I; GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO 11 /� a the performance of the work for which this permit is issued(Sec. t .HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING a 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, L7 L J TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20.140 CONCERNING HAZARDOUS ° 4 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. iii'_=v .L t L•M �._!a ti4, o Lender's Address G OWNER OR AGENT o I certify that I have read this application and state under penalty I of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE ^ 7. �� N with all county ordinances and State laws relating to building i Oc m construction,and ihegby authorize representatives of this County ISSUANCE FEE �,mto nter up a aticoP<d property for inspecti pur ses. i 1O -T INVESTIGATION FEE TOTAL ga11- FEE n r� y b M G �. SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS'COMPENSATION DECLARATION I herebyaffirm that I have.a certificate of consent to self insure,� r a certificate of Workers'Compensation- Insurance, APPLICATION F OR BUILDING PERMIT orla yfied copy thereof(Se . n00 La C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY PiomO � BUILDING i ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS /5 D Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS /} Date ��7 Applicant17 CITY ZIP % LOCALITY CERTIFICATE OF EZPTIO FRO WORK NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS.ST. (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 MAP 00l I certify,that in the"-performance of the work for which this OWNER N /(A/ I . NO. permit permit is issued, I shall not employ any person in any manner /\ A CIAL 1IL so assubject to become subjeto the Workers'CompensationADDRESS CONDITIONS O Laws. ' 0 CITY ZIP Date Applicant ARCHITECT.OR J TEL. DISTRICT GROUP TYPE FIRE PROC SSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER- 'V NO. �L f'� CONST. E Exemption,'you should become subject-to' the•Workers' (J Im Compensation provisions of the Labor Code,-you must forth- ADDRESS �� —� H with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT, I CPNDO.: Z deemed;revoked. CONTRACTOR NO. i LICENSED CONTRACTORS DECLARATION / LIC. CLASS NO. �/r DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS CQ NO363 (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 VALIDATION �. SQ.FT. OF NO.OF CHECK License Number, � Lic.Class SIZE J DRIES FAMILIES ONE .. ,/� ,-• . VALUATION Contractor,: 7 4 pate ✓ DESCRIPTION OF WORK -/ 'may? NEW ❑ $.• _J ❑ ADD oil,I am exempt under Se ❑ ALTER �4.1 S-1 A B.&P.C. for this reason REPAIR ❑ $ Date: USE OF D ❑ # 0,0 0 02 1 EXISTING BLDG. ,F. APPLICANT TEL. r o o37.50 Signature .j�Q FINAL �� v J OWNER-BUILDER DECLARATION PRINT)' NO. DATE 4� •1, • _ I hereby affirm that I am exempt from the Contractor's License , . ° ° ° 3. 7 5 0 v Law for the following reason (Section 7031.5, Business and ADDRESS FIN z 'Profess!ans'Code): PRESENT `� `�—8 6 ❑ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY jp the structure is not intended or offered for sale.(Section 415,2 A- 7044, Business and Professions Code). MOVING TEL. y ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. ARA # 0.0 ° o o''1 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). I ° o40,50 REQUIRED TOTAL SETBACK FRO ST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for •FRONT o 0 0 4 M-5 0 v.. the performance of the work for which this-permit is issued P.L. Q 3'0 3'.-"8 6 (Sec. 3097, Civ. C.). SIDE P.L. Q Lender's Name 2 LDMA Ref. # .� P.C.Fee$ L37L�O Permit Fee Lender's Address `///�� 1 certify that I have read thls application and state that the Issuance Fee LV�� -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 r LDMA Perm.# u and hereby authorize representatives of this County to enter upon a above-mentioned property for i spection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant oilAgetl Date O