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HomeMy Public PortalAbout9421 OLEMA ST_Building__ -''' WQRKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent self � L I CAT I N F p �'L D PERMIT insure, or a certificate of Workers'Compensation Insurance, ar or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS � Date Applicant CITY —1 -P ZIP 91780 LOCALITY I (.�ri� NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT i v NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT274 BLOCK LOT NO. d MAP BOOK 5382 PAGE 014 PARCELD hundred dollars ($100)or less.) TEL• USE ZONE OP y� OWNER `j N — I certify that in the performance of the work for which this SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS s3Iile 3S a bOVe CONDITIONS O CL so as to become subject to Jhe Workers'Compensation Laws. U CIN ZIP Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE G Exemption, you should become subject to the Workers' p w Compensation provisions of the Labor Code, you must forth- s ADDRESS •�0 `� j� a with comply with such provisions or this permit shall be TEL. _4.STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR owner NO. _ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 !•ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASSBK VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SiZE396 I STORIES IFAMILIES 1 ONE VALUATION DESCRIPTION OF WORK NEW ❑ Fi Contractor Date $ D DO•l`a ADD ❑ ;: ❑I am exempt under Sec. rer000f with pool ALTER ❑ B.BP.C. for this reason shingle & plywd. ] dAy ❑ '. $ Dote' USE OF EXISTING BLDG OL El APPLICANT �L• JEXIST. FINAL OWNER-BUILDER DECLARATION (PRINT) NiCK C.H. WANG NQ3 —I hereby affirm that I am exempt from the Contractor's LicenseDATELaw for the followin reason Section 7031.5, Business and ADDRESS 1815 AZALEA DR. ALHAMBFINALProessions Code): PRESENT By -I, as owner of the property, or my employees with ADDRIENSSG SS wages as their sole compensation,will do the work and _ - ( LOCALITY ' _.t the structure is not intended or offered for sale Section7044, Business and Professions Code.) MOVING TEL. i I,as owner of the property,am exclusively contractingCONTRACTOR NO.with licensed contractors to construct the project (Sec- ADDRESStion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE Ihereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. 25 ' ev ' (Sec. 3097, Civ. C.). SIDEl�lt P.L. 5. 5 ' 1015. 5 ' is"^ yl�t, Lender's Name �� 1_ i _ y) LDMA LRef. #P.C. Fee$ Permit Fee Lender's AddressI certify that I have read this application and state that the Issuance Fee �J LDMA above information is correct. I agree to comply with all County .Investigation Fee ordinances and State laws relating to building construction, Total Fee � 3. ` 'i LDMA and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. ,r 6 aTl4 Z SEE REVERSE FOR EXPLANATORY LANGUAGE p� i nature of licpnt or Agent Date C.0c` Lot #4i6A638A C$y. a03 3-69 • APPLICATION FOR DZILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS oZ ' BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. DISTRICT NO GROU TYPE CONST. PRO S Y FOR APPLICANT TO FILL IN DISRI ji (PRI OR Y E.0 ) r Q� BUILDING STATISTICAL CL�fSSIFICATION SEWER M ADDRESS - Temple t CLASS N0. `Z O DWELL.UNITS BK jrPG� LOT NO. �7 J BLOCK_ �� USE ZZJONE NOP TRACT G /r I SPECIAL SIZE OF LOT 60 x 112 NOWOON LOTS 0 999 1 CONDTIONS USE OF EXISTING BLDG. BLDG. SETBACK FROM TEL. �j Q^ FRONT PROP. LINE OF (STREET) OWNER John Marshall /r NO' 286— 822 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS 6 em le VitBlvd, HIGHWAY WIDTH FROM L.L. CITY_ _Temple,City, Calif . + 0 = O ,4RCHITECDOR TEL. p SIDE PROPS LINE OFM (STREET) ENGINEER R. Duff NO. 286-2102 TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS . Las Tunas Dr. T. C. HIGHWAY WIDTH FROM C.L. TEL. - CONTRACTOR John Marshall N0: 286-9822 ADDRESS 26 N. T.C. Blvd. NO 16 0] CORNER.CUTOFF YES ❑ NO ❑ CITY Temple _City _ CLASS BZ SEE REVERSE SIDE FOR SP CIAL APPROVALS NAME ANDTION BRANCH DER Self 3 t L ADDRESS lov SQ. FT NO OF NO. OF SIZE 11.00 STORIES 1 FAMILIES 1 NEW 11USE OF NJ' l D U STRUCTURE ADLTER ❑ yaa REPAIR ❑ ! Z. - \ SIGNATURE OFMOL ❑ APPLICANT VALUATIO �V'1 00 APPROVALS DATE 11 SP R'S SIGNATURE FEE$ �i� FEE$ / �-PMTFO FORMSO MATERIALSN Z_ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, / BRACING BOLTS /C L iCiCo /V- 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. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE LATH, INT. 1 OF THE STATE OF C FORNIA IN RELATING TO WOR EN'S COM- PENSATION INSUR I LATH, EXT. SIGNATURE OF HOUSE NUMBER CORRECT PERMITTEAND POSTED ADDRESS 6 N. Temple City Blvd. FINAL L. • JOHN F. LEWIS, PRINCIPT35- AL ENGINEER PLAN CHECK VALIDATION CK. M.O. cash - PERMIT VALIDATIOM.O. CASH 7 =, 7 N t SAY 1 2 3 D 8 5.9 5 d 4 Lt 60 7 0 5 7 JUL 19. 1 D 14Q APPLICATION FOR' EUILLDING'-PEF MIT FOR AF PLICANT-TO-'FILL IN (Print or type onlv)• BUkLTDINGCOUNTY OF LO, ANGELES. . ADDRESS 1 4LEeV-'9 -.DEPARTMENT OF COUNTY ENGINEER CITY' •/ �L Z P < ,, BUILDING AND SA Y DIVISION _ NO.OF BLDGS. BUILDING SIZE OF LOT� jjO/� - j_'2/NOW_ON'LOT- ADDRESS' TRACTS /"+•-FBLOCK' LOT NO. LOCALIT _ + TEL. NEAREST OWNER ��'7r'-�j -NO. CROSS ST. ASSESSOR. ADDRESS.: c � fE_ MAP BOOK PAGEPARCEL .. �r�y DISTRICTG P YPE FIRE SS BY CITY ZIP. - ON ZONE ARCHITEC`f i ENGINEER ,%Mo4r ® �j STATISTICAL CLASSIFICATION SEWE MA. ADDRESS �� `� ..� �Oode CLASS,NOy��DWELL,UNITS 46-- B ?-F-s CONTRACT U ZONE MAP 7 C ADDRESS �. ����Tp, SPECIAL LIC. , /n� �/ ` ONDITIONS &! i CITY • -.CLASS � . ROAD DEPARTMENT APPROVAL REQUIRED 1 YES'[:] NO❑ .CONSTRUCTION LENDER NAMEAND'BRANCH BLOG.S TBACKFROM FRONT' ROP.LI NE OF (STREET) c ADDRESS CITY HIGHWAY "+ YARD. = TOTAL SETBACK FROM TYPE OF EXISTING C SQ.'FT. NO. OF NO. OF - CHECK FRONT 'PROP: LINE HIGHWAY WIDTH p SIZ STORIES FAMILIES DESCRIPTION OF.WORK _ - NEW - co C ADD :❑ SIDEBLDG.SETBACK PROP.LINE OF ❑ FROM (STREET) 'Sea/ ,�:: -� �� ALTER HIGHWAY YARD YARD - TOTAL SETBACK FROM OF EXISTING •o.. Z R.-PA b.IDE PROP. LINE HIG Y -WIDTH USE OF EXISTING-BLDG. DEMOL ❑ APPLICA• ,/ ..-TEL -CORNER CUTOFF-. YES ❑ NO ❑ (PRI NT) i{- - _ .. NO.. ' I IN OPEN SPACE YES ❑ NO ❑ BY (SIGNATURE) ' ' AA IN COASTAL ZONE ..- YES ❑ ._ NO ❑ VALUATION 0 oV -, CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT I HAVE READ-THIS APPLICATION ENVIRONMENTAL . AND STATE THAT"THE ABOVE IS-CORRECT-AND;AGREE TO COMPLY- 'IMPACT - EXEMPTIO.N<DECLARATION SIGNED (DATE) WITH ALL .ORDINANCES" AND LAWS REGULATING BUILDING CON-' STRUCTION. -1 CERTIFY-THAT IN DOING HE' WORK AUTHORIZED - IMPACT REPORT-PROCESSED (DATE) HEREBY I WILL'NOT EMPLOY'ANY PERS IN VIOLATION OF THE LABOR: CODE OF THE TE OFCA RNIA IN RELATING TO- w-"!:'. ,n .WORKMEN'S COMPE NS I INSURANC - ''�� j��^' / ! 'f'1y: �^: {;,•:� ' f'f(�4- �`t t�1, OF " •'�'411 PERMITTEE 1 l�tl:.'i..r -41 ADDRESS - ,A l51 :e �' fG �f '. -.lLn>1L� e✓ .. FINAL �7_rl:. BY � CITY NOL. DATE��Ogu <rY:At+s � U MAKE CHECKS PAi'ABLE 'TO: FEE $ FEE HARVEY T. BRANDY,- COUNTY ENGINE%kR PLAN'CHECK VALIDATION c M.o. CASH '® PERMIT VALIDATION K. CASH 5 J. lJ 5 7 3 Juin 17 . 5.2 5.a98 76A636A CE_#603 12/72..' .::.: AP PL I CATION FOR COUNTY OF LOS ANGELES +� DEPARTMENT OF COUNTY ENGINEER B U I L D I N G PERMIT BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN -- ADDRESS BUILDIN g ADDRESS `•� LOCALITY G 1 c-�-C�� NEAREST CITY 1 Qy ZIP CROSS ST. S �` NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT I-G.ROUPJCOYNE FIRE PROCESSED BY ST.�! ZONETRACT BLOCK LOT N OWNER Vilek4 NSTATISTICAL ClASSIFICATI N SEWER MAP ADDRESS CLASS NO. DWELL.UNITS / BK PG ( USE ZONE MAP ej CITY ZIP NO. L ARCHITECT Q ©�` NEL SPECIAL ENGINEER `� CONDITIONS ADDRESS ' �,)�}`,FJ ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR TO OLJ BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS),%n O. �" HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. rr FRONT PROP. LINE HIGHWAY WIDTH CITY CLASS CONSTRUCTION LENDER + NAME AND BRANCH a BLDG.SETBACK FRO C ADDRESS CITY SIDE PROP.LINE OF (STREET) C. SQ. FT, NO. OF NO. OF CHECK HIGHWAY + YARD = TO $ETB FROM TYPE OF EXISTING CC SIZE STORIES'• FAMILIES ONE SID P LINE HIGHWAY WIDTH DESCRIPTION OF WORK NEW ❑ ❑ h O ADD CORNER CUTOFF YES NO z ALTER ❑ REPAIR❑ IN OPEN SPACE YES ❑ O ❑ USE OF �� IN COASTAL PERMIT ZONE YES ❑ NO EXISTING BLDG. - DEMOpL (❑ AP LZ T PRIN ANT NOL '{ ,y. ,,A� BY (SIGNATU ` .ter Ala 1v`� IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICkIttaN AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILP NO CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK T ORIZED HEREBY i WILL NOT EMPLOY AY PERS I VIOLA TI.N F THE LDRE OF THE STATE CALI 0 N IN R AT NG TO O _ S!1 N INSU CE. U FINAL BY/ 1O&j IV�"elaZ, (;TN DATE t(//33��cc ���� TEL. P.C. Fee$ Permit Fee NO. Issuance Fee Total Fee Q PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 8 2 9 NN1AY :-2 1 U 1 2°U 8 2 MAY 1;:& a•3 U U 7GA638A C:9*8038 12/75 - - -9^7 v 4 t y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0704300030 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I TR: 27410 LT: 4 I SQ. FT STORIES TYPE 1 9421 OLEMA ST 1 (STRUCTURE: I TEMP CA 917801342 1 IASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: OAK 15382-014-058 1 1 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl ITENANT: (EXIST BLDG USE: RESID USE ZONE: (ISSUED ON: PROCESSED BY: EXPIRES ON: 1 (EXIST OCC GRP. 104/30/07 JK 04/24/08 10WNER: TEL. NO: 1BLDGS. NOW ON IAT: VALUATION: In FI Y: CODE: ICHENG HAI CHENG;WAN JUI (626) 285-1816- 1 6,000 11 1 19421 OLEMA ST I 1 TEMP 917801342 I FEES PAID IDESCRIPTION OF WORK 1 IDEMOLISH SWIMMING POOL 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 I (APPLICANT: TEL. NO: I I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 1 1 1 102 DEMOLITION INSPECTN 163.50 ISPECIAL CONDITIONS: I I I TOTAL FEES 191.25 1 I ICONTRACTOR: TEL. NO: 1 [APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - I I I 1 LIC. NO I [PEDESTRIAN PROTECTION I 1 I 1 [SEWER DISCONNECTION 1 I I [ARCHITECT OR ENGINEER: TEL. NO: 1 (ABANDON PRIVATE DISPOSATI I I I LIC. NO: I IUNDERGRND STRUCT REMOVAL I I 1 I [AND SOIL RECOMPACTION 1 I 1 I I I FI I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1153H265 011 IgoI INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I I NO 24 I I I I I SCHOOL WITHIN HAZARDOUS [ 1 I I I (AIR QUALITY: 1000 FEET MATERIALS I 1 I I 1 NO NO NO I I I I I I I I I I I I I I I I I I I 1 I I I I I I 1 I I I 1 � 1 I I 1 I 1 I I 1 I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I I I I I 1 I WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self � T' F.-I& U I L®I N PERMIT 3krinsure, or a certificate of Workers' Compensation Insurance, S ON or a certified copy thereof(Sec. 3800,Lab. C.) CCAJNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified co is hereby furnished. FOR APPLICANT-TO FILL IN BUILDING PY Y :;ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING 9L 21 7L.EMA ST. tion department. ADDRESS Date Applicant CITY TEMPLE CITY zip 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 6 0 'x 1 1 2. 13 NOW ON LOT 1 NEAREST CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT 27410 BLOCK 8 18 LOT NO. 4 MAP BOOK 5382 PAGE 014 PARCEL 0 5 8 hundred dollars ($100)or less.) TEL, r OWNER nuan rlmmr. NO. _ d. USE ZONE MAP I certify that in the performance of the work for which this `' NO. permit is issued, I shall not employ any person in any manner ADDRESS Same as above a SPECIAL � so as to become subject to the Workers'Compensation Laws. CONDITIONS OU CITY ZIP Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY. M NOTICE TO APPLICANT: If, after making this Certificate-of ENGINEER NO. CONST. ZONE Exemption, you should become subject•to the Workers' t• "` p Compensation provisions of the Labor Code;you must forth- ADDRESS �QO V nw with comply with such provisions or this permit shall be TEL. ;s STATISTICAL CLASSIFICATION APT. CONDO. N deemed revoked. CONTRACTOR NO. Z LICENSED CONTRACTORS'DECLARATION LIC. ;' CLASS NO. `�/ DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY- CLASS BK PG ,9- VALIDATION SQ. FT. NO. OF NO.OF CHECK License Number Lic. Class' SIZE � F TORIES FAMILIES ONE '�; ' VALUATION Contractor Date DESCRIPTION OF WORK • NEW El ❑ ;' $ r� 2 ElI am exempt under Sec. family room, and f tont ADD • ALTER ❑ B.BP.C. for this reason �' ' . tUC1 REPAIR ❑ ;:; $ DateUSE O: EXISTING BLDO OL ElG ,.A Signature APPLICANT TEL, g OWNER-BUILDER DECLARATION (PRINT) N • _ FINAL DATE ` Z I hereby affirm that I exempt from the Contractor's License ADDRESS 1815 AZALEA DR. ALHAMBRA CA FINAL Law for the followingg r reason (Section 7031.5, Business and ,• Professions Code): PRESENT By ;BUILDINGI, as owner of the property, or my employees with ADDRESS J. wages as their sole compensation,will do the work and- "? the structure is not intended or offered I'or'sole(Section LOCALITY - 7044, Business and Profession's Code.) MOVING . TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR' NO. with licensed contractors to construct the project (Sec- ADDRESS N'�'-s x tion 7044, Business and Professions Code.) P P. REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK ;YARD. HWY PROP. LINE 'WIDTH I hereby affirm that there is a•construcfion lending agency for FRONT P.- the performance of the work for which this permit.is issued P.L.. + ' "-�' (sec. 3097, Civ. C.). SIDE L. A. 5 1 0' 15 . 5 ' ''�i Lender's Name r i LDMA Ref. # C -tl� P.C. Fee$ Permit Fee 7�' �� i''! it r Lender's Address I �1 -7,{� I7'-I+•'�C z ylil I certify that I have read this application and state that the i Issuance Fee �7• /✓ LDMA P/C# above information is correct. I agree-to comply with all.County Investigation Fee D i ordinances and State laws relatingto buildin uct constrion, Total Fee . LDMA Perm.# and hereby authorize representatives of this County to enter _ upon the above-mentioned property for inspection purposes. O 12 SEE REVERSE FOR EXPLANATORY LANGUAGE Sigyyature of ApppIicgg��I of Agent, Date