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HomeMy Public PortalAbout9471 OLEMA ST_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF -LOS ANGELES ADDRESS q DEPARTMENT OF COUNTY ENGINEER CITY yl`�Y �' zIP BUILDING AND SAFETY DIVISION . BUILDING SIZE OF LOT �% !�� ® NOW ONNO.OF LOTr ADDRESS I L% TRACT BLOCK LOT NO. LOCALITY ill Ll ,,te�t1 `` TEL. NEAREST OWNER e_ 3 N0. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRICT I GROUP TYPE FIRE PROCESSED BY1 `—CITY ZIP . CONSTZONE TEL. 0ARCHITECT O : ENGINEER STATISTICAL ION %rs SEWER MAP ADDRESS /d!! CLASS NO. DWELL,UNITS V BK.33 PG CONTRACTOR /7Cj( J6• tfA#A1r� NOL USE ZONE MAP . ` LIC. !; NO. .)10-0 •^ ADDRESS/I� A� cllm NO. ^I SPECIAL CONDITIONS CITY11 LA CSS �p� ' ROAD DEPARTMENT APPROVAL REQUIRED YES❑- NO❑ CONSTRUCTION LENDER itD yg NAME AND BRANCH BLDG.SETBACK FROM FRONT'PROP,LINE OF (STREET) 9 ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING HIGHWAY + YARD _ i SQ. FT. NO:OF NO. OF CHECK FRQ T PROP. LINE HIGHWAY WIDTH p SIZE 3100 STORIES FAMILIES ONE F + _ C. DESCRIPTION OF WORK NEW ❑ •` - v r ADD BLDG,SETBACKFROM LA SIDE PROP.LINE (STREET) ALTER ❑ HIGHWAY +• YARD TOTAL SETBACK FROM TYPE OF EXISTING Q REPAIR❑ SIDE PROP. LINE HIGHWAY WIDTH USE OF �t=A�tlk � + _ EXISTING BLDG, " DEMOL ❑ APPLICANT �f TEL �J$_ CORNER CUTOFF YES ❑ NO ❑ (PRINT) G.� 0. BY ISIGNATUR J iii, IN OPEN SPACE YES El :NO E]L r✓ IN COASTAL ZONE - YES ❑ NO ❑ VALUATION s Iso, 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 - EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- ' STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF TME STATE OF CALIFORNIA IN RELATING TO ' WORKMEN'S COMPENSATIO INSURANCE. SIGNATURE PERMI TTEE- ADDRESSffl Q CITY NO. / /B"�(i DIATE3�aa��/I - BY MAKE CH0._KS PAYABLE 7'U: FEE � `S FEE V' HARVEY T. BRANDY, COUNTY ENGINEER -��- PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALID ON CK. M.O. CASH 76A638A CE N803 'I2/72 9 o-JAN' yv �' •- 7 5.7 5 •98 APPLICATION FOR BUILDING PERMIT FOR ARPLICANT TO FILL IN (Print or type only) COUNTY OF LOS ANGELES ADDRIESS f Wil- /ary NG DEPARTMENT OF COUNTY ENGINEER C)ry f ZIP BUILDING AND SAFETY DIVISION /! NO.OF BLDGS. BUILDING SIZE OF LOT(',,iii 0,5N Q NOW ON LOT ADDRESS TRACT �, BLOCK LOT NO. LOCALITY ~ •TEL. NEAREST OWNER 6 NO. CROSS ST. ASSESSOR ADDRESS &M E MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRECESSED BY -CITY ZIP. L^ � CONST. ZONE ARCHITECT OR TEL. J. �J- �2 ENGINEER NO. STATISTICAL CLASSIFICATION SEWER MAP TEL ADDRESS CLASS NO. S` DWELL.UNITS BK 3_3PG Q CONTRACTOR A Fi � III` NO.. ) F' USE ZONE MAP Q �1 ! LIC. Q NO. ADDRESS1 f I /T,fI NO./. Q-�' CONDITIONS CITY A 4 (jµ CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH c BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF 0 CHECK HIGHWAY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES I FAMILIES / ONE } DESCRIPTION OF WORK �� NEW ❑ + CL O ADD ED, BLDG.SETBACK FROM Of 13A Pg!Wft-5' 732 ij11Fz,3 7- SIDE PROP.LINE OF (STREET) O ALTER LJ HIGHWAY SETBACK FROM TYPE OF EXISTING w �(/r HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH N USE OF REPAIR ❑ Z EXISTING BLDG. 7— �� DEMOL ❑ + APPLICANT TEL � CORNERCUTOFF YES ❑ NO ❑ (PRINT) p IV NO. j �/ IN OPEN SPACE YES ❑ NO err ❑ BY(SIGNATOR �c'J-• - 1' IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATIONQ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY THAT IN DOING THE Ay WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM. PENSATION INSURANCE. SIGNATURE O ✓ PERMITTEE / ADDRESS ( Z CITY 1 a— TEL r- t DATEFINAL7`.t7-- BY MAKE CHECKS PAYABLE TO: FEE FET HARVEY T.BRANDT,COUNTY ENGINEER_j tiJ• PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 8 6 1 rio-MRR 23 1 D 5 5.5 0 ©�'a ®f 76A63BA CE#603 3.75' _