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HomeMy Public PortalAbout9479 OLEMA ST_Building__ DEPARTMENT OF BUILDING AND SAF "JeLIL :A i LUM run rznml 1 COUNTY OF LOS ANGELES .I ' 1 WM. J. FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN • FOR OFFICE USE ONLY DISTRICT NO. PAN CK.NO. PERMIT NO. BUILDING ADDRESS I? /� i �`f:.'r 2 .P. M/0 Z 0047 _ RE IVED BY DATE OF APPL. DATE ISSUED LOCALITY Li i NEAREST (�1�i �� �� CROSS o BT. 0 OWNESU R -/':. i�'?�.t;, e��� .-/.±cwt-:'t/1!3''��"laD'Lo Nm ADDRESS tI^ f:• '� I 0? t + -iF - �"nI� LOCALITY H ^--./ 9� Yui/ 1�r A�✓ v'd NEAREST ' dX+' CITY .� s I"-:`'iraf s�•�;� / TEL. p. . . '"\ CROSS ST ARCHITECT OR / /^ / NO p ;;• ZONE '�" PLANSFIRE NO.or TYPE ^y.. ENGINEER / / f Le Be—PLDG. £ OR SD.NO. ADDRESSETBACK LINE ��. F ice ' l� L, YJ� r i APPROVED CONTRACTOR �Y �'�/°"'/� NO BY t~ DATt:� ,a � USE ��l AAPPROVED ADDRESS ZONE DATE LEGALDESCRIPTION p S3LOT NO. / BLOCK CORRECTIONS TRACT (-1{.ll . NO.OF SLOGS. SIZE OF LOT ,_j� ;� U� NOW ON LOT USE OF NO.OF NO.OF EXISTING BLDG. I FAMILIES`I ROOMS" DESCRIPTION OF WORD 2 NEW / ALTERATION ADDITION 3 r!//) s ////��v P/ REPAIR MOVING DEMOLISH 1s rl:f) ii°�• �! [L.:;• / /)ar �j e ?! Be;.FT. NO.OF ) - ,f' � t. Z SIZE /too ROOMS `` STORIEI=9�1 JG�e WALL ROOF COVERING S TQCCD I COVERING f PJr f ry USE OF NEW v c5rxL7p'� r'•:�5. y.�'j.i ..�o BUILDING %�. ' ' AI .`C ZZ 1 1-741./.0 kv �� � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS y �jc0 L vg vl +S APPLICATION AND STATE THAT THE ABOVE IS CORRECT F4 NDATIONC LOCATION NSPE'I±TOR D 'TE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATEFIALB� � 3/� AND STATE AWB REGULATING BUILDING CONSTRUCTION. f J• FRAME: FI S,Vt S, SIGNATURE OF BRACIN B. �B PERMITTElw' ..'7Jb't/Prj'�� � E LATH, 1 NT. Q AUTHORIZED AOT vLATH, EXT. mmm 7GA63RA-3 7145 T $ �•�/ () D, P.C,B PLASTER,INT. -r 7 g © FEE � � _ PLASTER.EXT. VALUATION FEE 0 0��`� FI NALi `�• WORKERS'COMPENSATION 4DECLARATION hereby ncertificate lfi�s•ireor acertifcae off Wokes'Compensaton Insurance, – P P L I CAT I N FOR BUILDING PERMIT at, certified copy thereof (Sec. 3800, Lob. C.) '� COUNTY OF LOS ANGELES BUILDING AND SAFETY P lity Company2tSum /s/ BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN (J ADDRESS Certified copy is filed with the county buildi inspec- BUILDING +— `ti�(on deeepartment. ADDRESS Date/V—S— r� gpplican CITY~' ZIP ® LOCALITY CERTIFICATE OF EXEMPTION FRO ORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS AT (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 I certify that in the performance of the work for which this OWNER NO NO. permit is issued, I shall not employ any person in any manner ,(� .4 f SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS % CONDITIONS Date Applicant CITY ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICTJROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to the Workers' ENGINEER NO. CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS �L9S � P 3 with comply with such provisions or this permit shall be TEL. j STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR NO LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 0,0NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY ' CLASS C BK VALIDATION a SQ. FT. NO.OF NO.OF CHECK LicenseNumber �� Lic.Class SIZE STORIES FAMILIES ONE VALUATION V Contractor l� �n` Date �// r�,5--�'b DESCRIPTION OF WORKig NEW ❑ADD $ ®®V n ❑ V I am exempt under Sec. s� " ALTER ❑ a B.BP.C, for this reason D PAIR $ Date: USE OF U44745 ,SNAG LF-9 � MMOLEXISTING BLDG. ❑ Si nature APPLICANT TEL FINAL g OWNE ILDER DECLARATION PRINT NO DATE ! ' —ell I hereby affirm that I W exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS �. FINAL ` 1 Professions Code): PRE EN By _ BUILDING J y ACCTA e 4 El I, as owner of the property, or my employees with '.ADDRESS �/� �J11 wages as their sole compensation,will do the work and LOCALITY f'}fl+�.f/1 K t"" 330717 140.22-1 the structure is not intended or offered for sale(Section J 7044, Business and Professions Code). MOVING TEL. / 1T4 CONTRACTOR NO. I, as owner of the property,am exclusively contracting r with licensed contractors to construct the project (Sec- TOT AL 140.22 DRESS tion 7044, Business and Professions Code). ADis C• 140.b REQUIRED YARD HWY TOTAL SETBACKFROM S-�I`� CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT CHNNGE = Itil the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE m P.L. Lender's Name . 12i 6 9I3 Ref. 0LD P.C.Fee$ Permit Fee /p � 4323 1 AM11I:+.- Lender's Address :3 1 certify that I have read this application and state that the Issuance Fee • 1 LDMA P/C# o above information is correct. I agree to comply with all County ` Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee �s�� <'. LDMA Perm. #R and hereby authorize representatives of this County to enter uponF above-m tioned property for inspection purposes. ce m / S SEE REVERSE FOR EXPLANATORY LANGUAGE Si re of Applicant or Agent Dote WORKERS'COMPENSATION DECLARATION _ erg / I hereby affirm that I have a certificate of count to pelf }�' :�, f D1 3 U H�] �� G IT insure, or a certificate of Workers'Compensation nsurance, LJ C G LLIIVV Pd�s or a certified copy thereof(Sec. 3800, Lob. C.) COUNTY OF LOS ANGELES BUOLDING ANDS ETY Policy No. Company �. ..•,. BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- [AD ILDING tion department. DRESS LOCALITY l e �� NEAREST Date Applicant Y / ZIP CROSS ST. 19 CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE E 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.) IACT BLOCK LOT NO. NO. d� TEL. SPECIAL I certify that in the performance of the work for which this iNER NO. — CONDITIONS DISTRICT .GROUP TYPE FIRE PRO ED BY permit is issued, I shall not employ any person in any manner CONST. ZONEas to become subject to t Workers'Compensation Laws. I DRESS i9 //� CITY ZIP Date Applic STATISTICAL CLASSIFICATION A JCONDO. a NOTICE TO APPLICANT: If, a r making this Certificate of ENGINEER'OR TEL. 'Exemption, you should bec a subject to the Workers' ENGINEER NO. CLASS NO.�DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER,MAP g with comply with such provisions or this permit shall be TEL. deemed revoked. CONTRACTOR &781 NO. BK• � VALIDATION LICENSED CONTRACTORS DECLARATION 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. Professions Code, and my license-is in full force and effect. CITY CLASS $ 00 .1 1110bSQ. / NO.OF � NO.OF CHECK License Number Lic.Class ®:; SIZE STORIES NO. ONE Contractor Date 1 y DESCRIPTION OF WOR — NEW ❑ $ t under Sec. f 60 ADD am exempt p i ;, s �' f!• ALTER FINAL' y = (3 7 9 5 E B.BP.C. for this reason REPAIR ❑ DATE 0 '��40 Date' i.USE OF ❑ FINAL EXISTING BLD DEMOL ` Signature APPLICANT TEL. By o 1 31L 25 OWNER-BUILDER DECLARATION PRINT. NO. J I hereby affirm that I am exempt from the Contractor's License D o o 3 4,25 Law for the following reason (Section 7031.5, Business and ADDRESS ) Professions Code): 1 PR E S BUILDING I, as owner of the property, or my employees with i ADDRESS wages as their sole compensation,will do the work and .the structure is not intended or offered for sale(Section I LOCALITY 7044, Business and Professions Code). MOVING TEL. i as owner of the property,am exclusively contracting CONTRACTOR NO. .,,ith 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. LIN WIDTH D tereby affirm that there is a construction lending agency for FRONT to performance of the work for which this permit is issued P.L. (Sec. 3097,Civ. C.). SIpE P.L. is ... .... .. .. ...::......s-':�. ��✓'/ v Lender's Name "'' ` P.C.Fee$ Permit Fee Lender's Address fO` ,Sa i s I certify that I have read this application and state that the Issuance Fee - above information is correct. I agree to comply with all County I Investigation Fee ordinances and State laws relating to building construction, Total Fee 43 f/i and hereby authorize representatives of this County to enter uporAe above-mentiorled propert for inspection purposes. `ni"h /I P�' 83 SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Applicant or Agent Date I ®s WORKERS'COMPE.NS�TIONfDECLARATION T I hereby affirm that S have a certificate of consent to selfo Insure, or a certificate of Workers'Compensation Insurance, APPI U CA �O I:i'til L4 �l�D 1 N*_,w PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGEL BUILDING AND SAFETY a Qolicy No. Company '© Certified copy is hereby furnished. ikADDRE' FOR APPLICANT TO FILL IN BUILDING 6 � L-p Aovt DL. ❑ Certified copy is filed with the county building inspec- tion department. �y p LOCALITY Ce NEAREDate Applicant l9 ZIP ��/ O CROSS ST. ®� / CERTIFICATE OF EXEMPTION FROM WORKERS' // NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE (� NOW ON LOT MAPBOOKAGEPARCEL (This section need not be completed if the permit is for one IUSE ZONE MAP hundred dollars($100)or less.) BLOCK LOT NO. NO.TEL. 6 SPECIAL I certify that in the performance of the work for which this iiL NO. tr 6 CONDITIONS permit is issued, I shall not employ any person in any manner j DISTRICT GROUP TYPE FIRE PROCESSED BY U ADDRESS © CONST. ZONE so as to become subject to the Workers'Compen tion Laws. - p � Date Applica t I ; CITY ZIP , STATISTICAL CLASSIFICATION APT. CONDO. NOTICE TO APPLICANT: If, aftLU o eking this Certificate of ARCHITECT OR TEL. Exemption, you.should beta _ subject tc the Workers'' -: ENGINEER NO. CLASS NO. _DWELL. UNITS Compensation provisions of the abor Code, you must forth- ADDRESS SEWER MAP with'comply with such provisions or this permit shall be TEL. 3 deemed revoked. ,'CONTRACTOR �(� NO. BK. PG, � VALIDATION , LICENSED CONTRACTORS DECLARATIONI LIC. I hereby affirm that I am licensed under provisions of Chapter I ADDRESS NO. �V�AL �UATION commencing with Section 7000)of Division 3 of the BJsiness and I LIC. rofessions Code,and my license is in full force and effect. ''CITY CLASS SQ. FT-el NO.OF / NO.OF CHECK nse Number Lic.Class SIZE D&, STORIES d FAMIU S ONE CastV aMW-r-1 4-'r e $ ^Actor Date DESCRIPTION OF WORK � o NEW ❑ xempt under Sec. (mac y�gr. - ADD R FINAL ` +this reason D Zu REPAIR ❑ DATE 4 �! IUSE OF FINAL �^ Date: j EXISTING BLDG. DEMOL ❑ By APPLICANT TEL. NER-BUILDER DECLARATION PRINT NO. at I am exempt from the Contractor's License lowIng reason (Section 7031.5, Business and ADDRESS . RESENT BUILDING , 'as owner of the property, or my employees with [ADDRE SS 'mages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section ITY r , 7044, Business and Professions Code). G TEL. I,as owner of the property,am exclusively contracting I ACTOR NO. with licensed contractors to construct the project (Sec- SS tion 7044, Business and Professions Code). IRED TOTAL SETBACK FROM EXIST. -CONSTRUCTION LENDING AGENCY ACK YARa; HWY PROP. LINE. WIDTH I hereby affirm that there is a construction lending agency for NT the performance of the work.for which this permit is issued tSec. 3097, Civ. C.). m , !Lender's Name ..e$ Permit Fee Lender's AddressI certify that I have read this application and state that the Issuance Fee [ 0,above Information is correct. I agree to comply with all County gation Fee �j ordinances and State laws relating to building construction, Total Fee / To and hereby authorize representatives of this County to enter upon a above-mentioned ape for inspection purposes. uad � SEE REVERSE FOR EXPLANATORY LANGUAGE ture of Applicant or Agent Date ®s ina