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HomeMy Public PortalAbout9506 OLEMA ST_Building__ o 0RKERS_COMPENSATION DECLARATION I+hsurm- r}#il'm,tF�f I have r certificate of consent to self LIC U N C N �� �I I I I�K I PERMIT insuitl,'or�i•ertifi�ate of Workers'Compensation Insurance, E�`ti ESU [[��JJ� LL�� or a certified copy thereof(Sec. 3800, Lab. C.) ccLL / / COUNTY OF LAS ANGELES BUILDING APB®SAFETY Policy 2�,,��//Fb.t�dmpany- 0"'e 6+C-4 —iC.G Pv v FOR APPLICANT TO FILL IN ADDRESS Certified co is hereby furnished. �L ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS ® 0 Q��Cs LOCALITY Date �C—Applicant CC c�a may+ NEAREST ' J• 1 �t,G,r+ CITY / ZIP CROSS ST. CE TI KATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK AGE PARCEL hThis section need not be completed if the permit is for one // US71,40C)[LSPEtIAL undred dollars($100)or less.) . TRACT d BLOCK LOT NO. l TEL 9 I certi that in the erformance of the work for which this OWNER /� NO. CONDITIONS EL certify P DISTRICT G OUP TYPE FIRE P CESSED BY O permit is issued, I shall not employ any person in any manner ADDRESS Sob ® C r,�( CONST. / Z3E so as to become subject to the Workers'Compensation Laws. J rV(� B/ 109 Date �j� l'S/�;Applicant L/° GLM,_^ ' CIN .� ZIP STATISTICAL CLASSIFICATION APT. NDO. F_ ARCHITECT OR j TEL. ul NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER •+1`s✓NO. CLASS NO. 211 DWELL.UNITS Exemption, you should become subject to the Workers' ;,.. H Compensation provisions of the Labor Code, you must forth- ADDRESS yS �" �d.S� �� SEWER MAP with comply with such provisions or this permit shall be TEL deemed revoked. CONTRACTOR T. NO. �' BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC. ` I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �/� NO. OB / VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. pp /� Professions Code,and my license is in full force and effect. CITY CLASS " $ V ov 'SQ.FT. NO.OF NO.OF CHECK ' PoI License Number Lic.Class LJ SIZE STORIES Z FAMILIES ( ONE Contractor ���+� Date //r. " DESC IPTION OF WORK NEW ❑ $ ADD 9.9 ❑ I am exempt under Sec. Co RyA ALTER FINAL 222 2 9,9 A+ • DATE B.B,P.C. for this reason a^+ REPAIR ❑ # o 0 o 0 2.5 USE OF Date: EXISTING BLDG. DEMOL ❑ By /� I o J [j 9 Signature APPLICANT TEL. y OWNER-BUILDER DECLARATION PRINT NO. - 31 Q.93,, I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 0 —85 Professions Code): PR T ❑ •BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. with 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 Hwv PROP. LINE WIDTH 2 4 9.6 A I hereby affirm that there is a construction lending agency for FRONT D the performance of the work for which this permit is issued P.L. # a o 0 o 0'1 tSec. 3097, Civ. C.). SIDE a 381.00 1 d Lender's Name o a 3 8 1, Q OZ Permit Fee P.C. Fee$ l �U Lender's Address :; n p I certify that I have read this application and state that the IIssuance Fee `� �/ 07, 1 9-85 above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee Y and y u orize representatives of this County to enter - _,•. up th 7�Z7rtyntativfor inspection purposes, u SEE REVERSE FOR EXPLANATORY LANGUAGE i ature of Applicant or Agent D to ®s t V RKERS'COMPENSATION DECLARATION hdteby affirm that I have a certificate of consent to self APPLICATION F®R B U I L®I N G PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDINGII � tion department. ADDRESS ©lac I. Date Applicant CITY + ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' / NO.OF BLDGS. 2 (� COMPENSATION INSURANCE SIZE OF LOT ( NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one r ASSESSOR hundred dollars($100)or less.) TRACE J BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. ���n USE ZONE NO ��s I certify that in the performance of the work for which this OWNER L. I i NO. C. permit is issued, I shall not employ any person i ny mannerSPECIAL a so as to become subject to the Workers' om sotion Laws. ADDRESS r.—, CONDITIONS U 5�82CITY ZIP IX Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE SED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONS. ZONE Exemption, you should become subject to the Workers' (� Compensation provisions of the Labor Code, you must forth- ADDRESS ' q i a with comply with such provisions or this permit shall be TEL. 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 and LIC. Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. F NO.OF CHECK License Number Lic.Class SIZE 'L STORIES FAMILIES ONE VA TION DESCRIPTION OF WORK NEW Contractor Date $ / ADD ❑ I am exempt under Sec. Ayp 17AT IO 60\169ALTER B.BP.C. for this reason REPAIR ❑. $ Date: USE OF DEMOL EXISTING BLDG. Signature APPLICANT .�t, TEL. FINAL / g PRINT Q (���: ITH NO Q (5/0 OWNER-BUILDER DECLARATION / �j DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS `/�� DQ V/1 ��{�/1�I.�1 �) J FIN Law for the following reason (Section 7031.5, Business and Professions Code): PRESENTBy BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ,. z n A 7044, Business and Professions Code). MOVING TEL. 7 3 9 I, as owner of the property, am exclusively contracting CONTRACTOR NO. # 0 0 0 0 0 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). / I ° - 59.25 REQUIREDTOTAL SETBACK ROMA FxIs CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTHri _ I hereby affirm that there is a construction lending agency for FRONT ° ° ° 5 9 2 5 the performance of the work for which this permit is issued P.L. 0 626-87 (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name I.M. w ' LDMA Ref. # Lender's Address P.C. Fee$ Permit Fee 767 //�� ys I certify that I have read this application and state that the Issuance Fee L'i �� LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. # and hereby gut�e representatives of this County to enter upon the /akfo e-rgentioneil property for inspection purposes. Y . � /. �f'/✓• '/ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicunt or Agent to WORKERS'COMPEIMEtT101V DECLARATION hereby affirm that I have a certificate of-consent to self (/ APPLICATION .FOR �6'ILDING PERMIT insure,or a certificate of Workers'Compenstion Insurance,or a certi,fi,e�dry cop th�e�reof(Sec. 3800, ab. C.) Policy l�6 ccOL Company (� .� COUNTY OF LOS ANGELES BUILDING.AND SAFETY oo Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING S U to ADDRESS 1,0 JL4 4 ' Certified copy is filed with thuilding inspec- BUILDING �/�/ tion department. DDRESS IJV(> LOCALITY Te�M jO C Cd. NEAREST Date PQ0JAn ApplicantCITY ZIP CROSS ST. Al CERTIFICATE-OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE 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.) TRACT .� e,6 BLOCK LOT NO. NO. t/ • J TEL � � O SPECIAL - n.I certify that in.the performance of the work for which this OWNER NO. CONDITIONS O --permit is issued, I shall not employ any person in any manner C`; ( DIST ICT GROUh TYPE FIRE PROCESSED BY V ADDRESS .50 \! CONST. ZONE r so as(to become subject to the War Co pensation Laws. iV LLC �� CITY ZIP Date Applicant STATISTICAL CLASSIF CATION APT. CONDO. ARCHITECT TEL. N&YfICE TO•APPL'ICAIVT:• If, after m king this Certificat f - y til Exemption, you'`4hQuld become subject to the Wor ENGINEER 1.�•�.l.e�l NO. a S CLASS NO-9 I DWELL. UNITS 8, Compensation provisions of the Labor Code, you must forth- z ADDRESS _ SEWER MAP with comply with such..' visions or this permit shall be _deemed revoked. � TEL.C`_ BK.f�PG, VALIDATION; �. CONTRACT NO, 1I�CJ r LICENSED CONTRACTORS DECLARATION �A LIC. ^ ((,,�/ I-herebyaffirm that I am licensed under provisions of Chapter 9 ADDRESS 0,SVe l- VALUATION (commencing with Sectio 7000)of Division 3 of the Business and _ LIC. �� $ /1 `V Uu - Professions Code and m lice se is in full force and effect. CITY (JL/L CLASS `'L �/J�"��� SQ.FTS. NO.OF NO.OF CHECK License Numb 7GJ Lic.CIa9s SIZE Lj STORIES FAMILIES ONE Contracto �QJC� DESCRIPTION OF WORK $ ' NEW l�t�+�� Date ❑ ❑ `, (� C— ADD I am exempt from the licensing requirements as I am a ,�,t,.>L•�G� Vl.9�C- ��JJ licensed architect ora registered professional engineer ALTER " FINAL -7 t acting in my professional capacity (Section 7051, /� 6 33 REPAIR DATE Business and Professions Code). USE OF EXISTING BLDG. DE OL FINAL Lic.or Reg.No. Date APPLICANT TEL.' rr By OWNER-BUILDER DECLARATION (PRINT) NO. Qfv� 7 8•`7 A I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and AD6RESSCR-4,L Profess!ons;Code): PRESENT 2 0 0 5 Q [�- EJ BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and o o c 5 0,LL 0<<� the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 0 s 1 8-80 1,-as owner of the property, am exclusively contracting -CONTRACTOR NO. With licensed contractors to construct the project (Sec- ADDRESS J 1 7 8•g n• tion 7044, Business.and Professions Code). REQUIREDTOTAL SETBACK FROM' EXIST. c o 0 0 0 H" I hereby affirm that there is a construction lending agency.for FRONT the performance of the work for which this permit is issued _ P.L. d ,� 5-0 Zoo 9:7,0 0 (Sec'. 3097,-Civ:C..)." SIDE SIDE tri P.L. .0 o c 97005 Lender's NamhtJ�-+��+ 0 � 1 B-80_�0 Lender's Address P.C. Fee$ l� (, Permit Fee 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 Investigation Fee p ordinances nd St aws relating to building construction, and here y a t rite presentatives of this Count to enter Total Fee upon the abov - enti ned property for inspect!o 'purpN s. t SEE REVERSE FOR EXPLANATORY LANGUAGE o, Sig ature of Applicant ent Date ®s• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 ! BL 0508 9810020058 PHONE: (818) 285-0488{EXT? .� -LEGAL ID: NO. OF CO ST ;BUILDING ADDRESS: TR: 14533 LT: 18 SQ. FT STORIES TYPE 9506 OLEMA ST STRUCTURE: 0 VN TEMP CA 917801343 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5382-020-038 THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY TENANT: XIST BLDG USE: RESID USE ZONE: R-1 1SS ED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 10/02/98 UT 10/02/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL, DATE FINAL BY: CODE: SMITH WAYNE L;GUADALUPE - 1 2,800 / 9506 OLEMA ST i0 " TEMP 917801343 FEES PAID DESCRIPTIO OF WORK SINGLE STORY PORTION ONLY-TEAR OF XISTING HEAVY SHAKE APPLICANT: T0• FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: AND APPLY FIRE RETED HEAVY SHAKES OVER EXISTING PLYWOOD AZUSA ROOFING (626) 334-2201- AA BLDG PERMIT ISSUANCE 27.75 938 GALATEA ST AC STRONG MOTION RESA 2800.00 VAL 0.50 SPECIAL CONDITIONS: AZUSA, CA D2 PERMIT W/0 ENS 809410 VAL 99.00 EL.ETG DoE 127.25 CONTRACTOFING EL. N334-2201- o� ��Ay APPROVALS DATE INSPECTOR SIGNATURE AZUSA RO938 GALATEA ST LIC. NO SETBACKS AZUSA CA 91702 189244 C39 SOILS ENGINEER APPROVAL tj ARCHITECT OR ENGINEER: TEL. N0: FOUNDA ON/TR C FORMS I LIC. N0: 1111111 SLAB-UNDER FLOOR RAISED FLOOR FRAMING 1MAP NO: 53H265 SEWER MAP BOOK: PAGE: FIRE ZON3: CMPO6 pDUC n�]� FLOORS UNDERFLOOR INSULATION v v ATH G 0. OF FAMILIES: DWELLING ITS: P /GOND: STAT CLASS: P u NO 21 p 0 ROOF SHEATHING ig SCHOOL WITHIN HAZARDOUS `4' Y'r«, SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS 46, ❑ .; NO NO NO �, ©�� FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE'SPRINK ER HANGERS SET BACK FRONT PL- YARD: HWY: PROP LINE: WIDTH: '�C `fie rVYC a.alb INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH I RA ED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS i -BAR CEILINGS OT DRAI A E REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BU!LO:rju F-b(MI T DEPARTMENT ut PUBLIC WORKS 9701 LAS TUNAS AL's:'"r!0!:,RCPAIR BUILDING AND SAFETY i LAND DEVELOPMENT TEMPLE CITY CA 91780 BL ijoul 0410140044 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONSTBUILDING ADDREC:,. TR: 14533 LT: 18 S0. FT STORIES TYPE 9506 OLEMA ST ".; ��SUR INFORMATION NUMBER: STRUCTURE: 1500 VN TEMP CA 91780134'= NEAREST CROSS STR._FT: OAK D382-020-038 THOMAS PAGE: 55c. GRID: J2 LOCALITY: TE--;P'LE CITY, C TENANT: —EX IS u L—DU USE: R S D USE ZONE: R— .SUED 0 N T PROCESSED Y: EXPIRES 0k: EXIST OCC GRP: 10/14/04 JK 10/09/05 OWNER: TEL. NO: NOW ON LOT: VALUATION: MLCRIPT10- DAT' FINAL SY: CODE: LIAO, DAVID (626) 278-1809— 3,000 s 9506 OLEMA ST TEMP 9/7807343 FEES ID DPAOFW RK TEAR OFF COMPOSITION SIUNGLES HOUSE AND GARAGE APPLICANT: —r TEL. N0: EE DESCRIPTION: QUANTITY: UOM: AFOUHT: SAME AS OWNER — IAA BLDG PERMIT ISSUANCE 27---F- AC 7-%54C STRUNG MOTION RESID 3000.00 VAL 0.50 SPECIAL CONDITIONS: - J2 PERMIT W/O EN—HC 3000.00 VAL 90.00 I 7O-R- FEES 1 . TOTAL .G7 � CON i %-TOR: T- -NO: A�PRC.VALS ----^y TE I -SPECTOR -_.a�yn•U. SAME AS OWNER - j LIC. NO ! iILOCATION AND SET8ACK5 — i SOILS Et GINEER APPRO +'I, i TEL. N0: - :iDrii'IOlI.RENC _ i LIC.—NO: I i. 44Vi. --- _ _ _ -_ - - 1 I�gl_'1- Ii.4P NC:SEWER h�IiP BCO�. —nG'c: FIRE ZONE: CMP: 1'uirT^7cRFL00R INSULATIO?i i XX 3 01T FLOOR SHEATHING . OF FAMILIES: DWELLING UWITS: AP COND: STAT CLASS: SCHOOL WITHI NO 21 ROOF SHEATHING "- HAZARDOUS AIR 3UALITY: 1000 FEET MATERIALS SHEAR PEL5 NO NO NO F(IA!dE NSPECTION —i RE3lIREO TORT ESETgACK FROM EXIST —f rk—E S R NKL R HANGEI:S -- SET BACK YARD: HWY: PROP LINE: WIDTH: i FRONT PL— INSULATION/WEATHER STRIP SIDE PL— IN ERIOR LATH/DRY A L EXTERIOR LATH I� RATED LOOR/CE L AS EM.— RATED WALL ASSEMBLIES RATED S TS OP ING T=BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS05O8 _ LOUNTY OF LOS ANGELES FmPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAY OUIL'DING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 041018003; PHONE: (626) 285-0488 EXT: LEGAL ID: _ — NO. OF Cult C::�,IWG RDDRESS: TR: 14533 LT: 18 S4. F1 STORIES TYP-- 9rC6 OLEMA ST STRUCTURE: VN TFt4P rA 917801343 ASSESSOR INFORM TON NUMBER: NEARSST CROSS STREET: OAK 5382-020-038 THOAAS PACE: 596 GRID: J2 LOCALITY: TEMPLE CITY, C� T X S B SE: RESID U TO-iTE R- SSU D ON: PROCESSED B : EXPIRES 0 : EXIST OCC GRP: 10/18/01 JK 10/13/05 OWNER: TEL. NO: BLDGS. NOW ON LOI: VALUAIION: FINAL D TE INAL BY: CODE: LIAO,ODAVILEMA ST (626) 278-1809- 2,0009506 ��` f 0 �J TEMP 917801343 FE S PAID DESCRIPTION OF -WORK REPLACE 3 DOORS, 3 WINDOWS SAME SIZE FEE DESCRIPTION: QUANTITY: Lin!+: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG Pcni-'-i' ISSUANCE 27.75 AC STRONG MOTION RESID 2000.00 VAL 0.50 SPECIAL ONDITIONS: D2 PERMIT ::. E"-HC 2000.00 `;^L 82.20 TOTAL FEES 110.45 CONTRACTOR: SAME AS OWNER TEL. :40: APPROVALS DATE :NS;EC;OR SIGNATURE - LIC. NO IOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCH-ITE-CT OR E0 N•ER: TEL. OUID TION/TRE CH FORMS LIC. NO: SLAB/UNDER FLOOR MAP NO: SENOR MA? BOOK: PAGE: FIRE LONE: Ct9P: URDERFLOOR INSULATION XX S 01 0. OF FAMILIES: DWELLING NI S: PT/GOND: STAT CLASS: FLOOR SHEATHING NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME IMbf-EL51UN j REQUIRED TOTAL-SETBACK FROM R21 ST— FIRE SPP.?NKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LA R W LL EXTERIOR LATH ! RATED L OR/C IL ASSEM. I RATED WALL ASSEMBLIES FA—TED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508