HomeMy Public PortalAbout10104 OLIVE ST_Building__ COU_NTX OF IAS ANGELES � tl
WM..J. FOX,-CHIEF ENGINEER..
FOR OFFICE USE ONLY.
. FOR �1PPI,IC�TT-TO FILL`IN . ' ` - ' `
BUILDING � 171 DISTRICT_.NO,'• PLANCK.-NO. /PEE1RMMIT NO.
-ADDRESS- c?
LOCALITY d J I '3 ft F� $ -`yWda RE EI ED'BY ®ATE OF ADPL. ®ATE'IH9l3E°J
.NEAREST i"Ja g 1,
CRASH 9T. sA s i✓ f--?_iC�P
BUILDING r l
n
A ��_ ADDRESS !�.��
OWNER
MAIL" �? -
'ADDRESS,,,, K -I LOCALITY-
NEAREST-
all,
OCALITY-..
} r. - NEAREST-
.� F TEI�r CROHSST.
CITY !' "'' r "? I', I _. °•J`y
No., rr.1 ;dam r
w FIRE - NO.OF TYPE:
"GROUP
ARCHITECT OR TEL. ZONE I PLANE (-
ENGINEER. NO. -
///�
ADDRESS - _ SETBACK LINE
APPROVED: V
TEL
CONTRACTDR-'.:_r:K _;.YS'`t._:i NO. BY DATE .
USE —_APPROVED f ..
ADDRESS i �:t. ZONE HY', - A( DATE ° J�' •1'_
LEGAL. - �� ! CORRECTIONS
DESCRIPTION I `LOT NO. ;'- 't_y I: BLOCK
TRACT -/ -�
SIZE OF LOT';'.
NOW ON LAT A
USE OF .?..,�,I.�. tia. NA.OF ai NO.OF '.r'
'EXISTING BLD Q. jr9- FAMILIES ROOMS -
DESCRIPTION:OF WORD
NEW ALTERATION ADDITIOI�9 - -
REPAIR MOVING DEWIALIHH ®_ _
JIZq Z
E - :� •-• . -% ROOMS r STORIES - - --- -
r ID'
:WALL - rr, ^"-; - .- ROOF.
COVERINQ .: P.:f�,_s-I±:�`•�.; `�, I,: COVEING _% i•'•%` � - - - - - - _ -_
t .
USE OF NEWJ-�
BUILDING ti.. Al
I 'HEREBY ACKNOWLEDGE THAT I HAVE- READ THIS•- d��PR®ViflaS'
APPLICATION-AND STATE THAT THE ABOVE-IB`OORRECK FOUNDATION: LOCATION
INSPECTOR DATE•
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS-
;AND STATE-LAWS REGULATING BUILDING CONSTRUCTION.
_ FRAME? FIRE STAPH, -
SIGNATURE OF - r - BRACING,BOLTS _
OWNER
1 LATH,INT..,
�✓erA'
AUTHORIZED'AST.
LATH,EXT..'
DBS-3 25M SETS 1-47' _ _ .P.C_C.�_' _ - •PLASTER.-'INT.
o'c _:FEE - PLASTER, EXT. .-
III -
VALUATION
FEE_ FINAL
'"�'
>'DB9-8 2SM SETS 6-46
DEPARTMENT OF BUILDING AND SAFETY 1 T30N FOR PERMIT
COUNTY OF LOS ANGELES pm ® �
WM. J. FOX. CHIEF ENGINEER
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING 7,
DIBTRI 0. PLAN CK. NO. PERMIT NO.
/+, f/
ADDRESS � ✓� I
LOCALITY S.'� /��(lf �}��O ('-,{ r.G� REED ED BY DAT CF APPL. DATE ISSUED
NEAREST
CROSS 9T. YI -i
p BUILDING 6?
I p
ADDRESS VV //
OWNER
MAIL
ADDRE68 P�_� LOCALITY V'j
1( %5- E
N EAREBT r �
CITY d: TC-r^iR ' . � NO' •e�[o3jq CRCSa 8T.
FIRE NO.OF TYPE G OUP
ARCHITECT OR TEL ZONEI I PLANE
ENGINEER NO. .y
n BLDG. ^7 / j� ORD. OO!
ADDRE99 7 SETBACK LINE
TEL. APPROVED
CONTRACTORNO. BY DATE
USE APPROVED
ADDRESSLEGAL 4/ a ZONE BY DATE
DE CRIPTION I LOT NO. a�� I BLOCK l�/Q /p CORRECTIONS
/ �` �r � � r
TRACT r
rz`,� l etC
NO. OF BL �)��f � o
SIZE OF LOT {,� � ' NOW ON LOT13T �/•/.
USE CF �� NO.OF -NO.
EXISTING BLDG. FAMILIES I ROOMS
DESCRIPTION OF WORK nim. H 09 r Q c:c•I'V -t n r i 1 4 I-? o
NEW 4d ALTERATION ADDITION c �i r.�f,/G �" /JA/ Fd FI 1^,-4- /.'I//IJ G/GC/✓ O
_ >0
REPAIR MOVING DEMOLISH U t h c"!? -j Oj YP lJC_Ii - S y'a /9 Cr1Y1 S�p;0
Sq. FT. °- NO.OF •F ' / Z
SIZE r.((, s•' ROOMB `ej!STORIEB T/7//l/r PC Ifo/M i T F.
WALLR
1(�4•. ;5 �I OOF I A-'a T.n 4 G7afi �/aS'C
G " /`.+ ✓[i�^!Z:!
COVERIN _ ; . _ COVERING c C/
USE OF NEW
BUILDING , is - ,,;,•t7n � /
,Ir f
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE I8 CORRECT FOUNDATION: LOCATION, INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPB,
SIGNATURE OF
BRACING, BOLTS
.�
OWNER LATH, INT.:
AUTHORIZED AST '' ` ' x `itA
• .` LATH, EXT.:
P. C.
PLASTER, INT.
c FEE A~' PLASTER, EXT.
,; s
VALUATION,, FEE /y FINAL
DEPARTMENT-OF`BUILDING AND SAFETY _ t�tv: r va► rrratiaaa a
COUNTY OF LOS ANGELES s 1
j WM. J. FOX, CHIEF ENGINEER • '�
NG
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY '
q
UILDING DISTRICT NO. PLAN CK.NO. PERMIT NO.
B .�fx" k1 r °�� l .r.-• ..u�'-'
ADDRESS s1 /r ..'/..{��r
LOCALITY RECOEIVD BY
! DATE OF,AP/PL. DATE ISSUED
NEAREST.CROSS ST. sri� c1�!v� V
A
OWNER UILESS ew'.= / �(! c •�
MAILF DDRESS•-
ADDRESS �� , LOCALITY "`/�J7 P/ 3L L'- /T'1I
7NEAREST /
ITY t .C le"1'S s�-"' r, TE 8 CROBB 9T. /w I-
NO. �J /e
FIRE . NO. I TYPE.� GROUP S
ARCHITECT OR TEL. c ZONE. PLANE
ENGINEER NO. r
BLDG. �j / ORD.NO.
ADDRESS r,� SETBACK LINE � /�".L /7 7
r
f ' APPROVED
CONTRACTORi NO.EL. BY DATE
�,F
USE APPROVED
ADDRESS ZONE//�.t BY DATE
LEGAL Tt` CORRECTIONS
i DESCRIPTION I LOT NO.
I BLOCK /}/0 ZKZ/f,3
J TRACT •L.
r �G!S1 I NO.OF BLDG9.�i 7 �lrs i ' •�� !> L �
SIZE OF LOT ,fir NOW ON LOT �(.�• du ����
USE OF ND.O rNO.OF -. _
EXISTING BLDG. FAMILIE O 5•
0"'�`'ra t/its- r 4 c:m ria r,r=r c=e
DESCRIPTION OF WORK
" C r�lf l//G e: I•Sr err�YIIYG /� JY C9 �►./l!'C /V
NEW < ALTERATION ADDITION ' C R -7-0 ���O� _�3•`a. � '
REPAIR -MOVING DEMOLISH •T , �'/ L'F-rR1A/.t /� "IP/Y!/7 -
G-Q.FT. . �j NO.OF f - ,
SIZE 1 sQ .,ROOMS,%--, nI-�STORIE9 /�y I�"
f r �, L 7 ai i 4 e—A L/=J G./!SC' r/ i
WALL 4r1 1._ /,^,:_�ROOF i'/ ,!
COVERING,_ {�/r.� a� °'' . ' COVERINGas�e�
USE OF NEW
BUILDING �°�_:�)=�i!�,= -.•��A� f� �I s /l� C , /f .5 7-/-I O' T
• l�c:�'�^U��r� �=/�3-x . Jac.:�,�.r
1 HEREBY ACKNOWLEDGE THAT I HAVE 'READ THIS APPROVALS
APPLICATION AND STATE THAT THE ABOVE IB CORRECT FOUNDATION:LOCATION' INSPECTOR DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS
AND STATE LAWS REGULATING BUILDING CONSTRUCTION..
FRAME: FIRE STOPS,
BRACING,BOLTS
BIGNATURE OF
OWNER LATH,INT.: '
AUTHORIZED AOT. ~ _ LATH,EXT.-
SETS 1-47 $ P.C.6 PLASTER.INT: -
FEE. ` PLASTER,EXT.
N i FEE / ~� FINAL
DEPARTMENT OF. BUILDING'AND- SAFETY. tarra.i�.is a avis moi.+-++±
COUNTY OF LOS_ANGELES ; - -
WM. J.' FOX;-CHIEF ENGINEER IgUILDIN
FOR. APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILDING •� , 1 DISTRI�rNO. PLAN CK.NO.f / PERMIT NO.
ADDRESS , ! tp lt!_ n .c+ � .f �' �°" � (•7
LOCALITYti;w�sLi 1• a., 4—�. Y�r _ RECE ED BY DATE OFAPPLI. DATE ISSUED
NEAREST _ � -
CR089 9T. BUILDfNB-
:'Z�77' -2.-• / v
ADDRESSGSC I U
OWNER .��,,tfl� ��.r�s•�a-s.�f+'--��s�_..+F"
MAIL
ADDRESS V•Y ��.1-E" "t;1� � s- M � LOCALITY
l•-�!•" _} � � -•• .
J } NEAREST. _
ITY r4 !,x'•�-C '"r1 y�� _.".ii•� NOTE �g CROSS ST. L�
FIRE NO.OF TYPE GROUP-"
ARCHITECT OR TEL_ y,, -ZONE' PLANS
. ENGINEER NO.
fti�.. BLDG. 2 p ' /
ADDRESS s,V d'`� SETBACK LINE
APPROVED
:CONTRACTOR �'S�_�=c!�;,�'"' NO. BY DATE
USE APPROVED
._ADDRESS I" ZONEF/ BY DATE
LEGAL PT I f I CORRECTIONS
DESCRIPTION LOT NO. BLOCK
TRACT g -No.OF SLOGS,
f7�.ICl
SIZE OF LOT so ,: ee I NOW ON LOT / �•
USE DF ; � NO.OFA�-..-NO.OF
EXISTING BLDG.
FAMILIES I ROOMS
DESCRIPTION OF WOAK-
()ujN&Iz keli /ate G/Y t/vdTfl=f(- to r=
NEW r Ap ALTERATION ADDITION' CX���L. (�(2QlYi/ICG, fin( G/�jL/✓
REPAIR MOVING DEMOLISH OI�12C'fl? Z•'C) If, 7-V!Afc- O_
SQSt4 1 /f NO.13 / !
SIZE �� ~i ROO
OMS L STRIES � i'
c�TZ
WALL .Y 6. 1 s �. L!t /rrr � �./lac:il T di
COV RING, I {I•,,«' COVERIND 't/ `K
i'tC�C:i� .'L 1?M/i"S M/D• '�v� 2; d C/-C•^/f
eu
ILODI o ' C�S G'+ i f
.h1r-cam'e, s n�X` 3° �}'�Ci.•'/I 7 l Y ���cFJ�.lz'.�'�.
czc
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS�-
APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION �INSPECTOR "DATE
AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS l,.
AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
. - % FRAME: FIRE STOPS,
SIGNATURE OF BRACING,'BOLTS
OWNER ; LATH,INT.: /7111
AUTHORIZED AGT.l" ✓ •'� '� ` /Ids //S/
LATH,EXT.:
DBS-3 25M SETS I-47, P.C.41 00 PLASTER.INT. ,.��
7 FEE PLASTER,EXT.
VALUATION
FEE FINAL - +-
/�] -
BUILD
BUILDING ADD EISS
APPLICATION LOCALITY 6
-4
P-dDIVISION OF BUILDING AND SAFETY NEAREST 1 7
CROSS ST. V
Department of County Engineer DISTRICT NO. RECEIPT NO. PERMIT NO.
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED DATE 189UED
CABSATT D. GRIFFIN, 9UP•T OF BUILDING S Y/
FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY
V
OWNER /��el/LI/' Tlt/Os6/�dri/�
MAIL NUMBER d O MAP SHOE = YES NO
ADDRESS
U8EZONE SPECIAL
CITY [ds?A�+/, f•7///iA/��
TEL A _ r CONDITIONS
ARCHITECT OR TEL. Si �'�'lG I
ENGINEER NO. BUILDING ys� EXIST.
SETBACK YARD H Y STREET NAME / WIDTH
ADDRESS �j�Y FRONT
CONTRACTOR�/,•R4O�f�a N/�r� pJ NOI.� -®"g SIDE /J
ADDRESS /®1Oc! (04.e rrr S7. T&"yaaC C//7' y P.L.
BUILDING A DATE CORRECTIONS INSPECTOR
ADDRESS �0/� Vg..'va- 7 I r
LOT NO. �d BLOCK
TRACT
NO.OF SLOGS.
SIZE OF LOT Io OX)l I NOW ON LOT
USE OFIPf//f/IQAq, Tom,Sme-10
EXISTING BLDGAQJ349S COQ
DESCRIPTION OF WORK
• o
NE ADD ALTER REPAIR DEMOLISH Z
B1).FT. .•1 NO.OF NO.OF D
SIZE �'/ STORIES FAMILIES ® P
118E OF STRUCTURE
2® dip,•�d� a GSD i�o.v/�Fs ��✓
NO.OF
EMPLOYEES
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 19 APPROVALS INSPECTOR'8SIGNATURE DATE
CORRECT.
1AGREE TO .COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION: LOCATION
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS f
FRAME: STOPS,
SIGNATURE OFBRACING,,SO
PERMITTE `�Gf Mr7'"
�C• �„ /' FURNACE: LOCATION, �
ADDRESS- /t/�d•!'9� + 9PliG Gs GAS VENT,DUCTS `—
LATH, INT.
AUTHORIZED AST.
d d LATH, EXT.
�_ FEE-
!� HOUSE NUMBER COR- ,1
•-�— - LMLO d FEE v RECT AND POSTED ,,r
VALUATION S FEE FINAL d !moo
76AS38A DBS 3 12.53 a��
BUILD
BUILDING
ADD RE
!/
APPLICATION LOCALITY ~ //—1
DIVISION OF BUILDING AND SAFETY NEAREST
CROSS BT. r �✓ rrr+! l
Department of An mr DISTRICTRECEIPT NO. t/ PERMIT ),
WM. J. FOX, COUNTY ENGINEER GROUP DATE RECEIVED G/jDATE ISSUED
CASBATT D. GRIFFIN, BUP•T OF BUILDING I
i /
FOR APPLICANT TO FILL IN TYPE CONST. RECEIVED BY ISSUED BY'
OWNERMAP
1�}��iP ��MO /-09 � - •/ `/'�r/✓L'CT�
MAIL ? p da� ����,Q' + UMBER D D SHWY NO
TATE
ADDRESS d /�/
CITY r/.j�J/ / N L E ZONE CONDITIONS
ARCHITECT OR T
ENGINEER NO.
BUILDING YARD HWY STREET NAME EXIST.
ADDRESS SETBACK WIDTH
4 /� ^ FRONT
CONTRACTOR 7/�'�./ a�+�r rf`/k24rTe'J� ND. I'�jq'� P.L. / � ��' riz?, .
DE
ADDRESS i pa:/®6: d'7�- 1�. C• P.L 1 a/
® � DATE CORRECTIONS INSPECTOR
BUILDING 7
ADDRESS ��� �`/teal•
LOT NO, b 1�/ BLOCK
TRACT (�M`
SIZE OF LOT 410 X X� 0 I NOW ON LOTB.
`
USE OF
EXISTING SLOG.
DESCRIPTION OF WORI{ a
• o
NEW ADD ALTER REPAIR DEMOLISH Z
Sq.FT. �3 -/ NO.OF / NO.OF r
81ZE STORIES FAMILIES
USE or STRUCTURE
Cr o e,a a� </.d A le //+• - d Jit! �
NO.OF
EMPLOYEES
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 16 APPROVALS INSPECTOR'S SIGNATURE DATE
CORRECT. t
1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATIONI LOCATION �:7- r a A
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FORMS,MATERIALS �!/jf l<G/ffLd L? e d ei I'
FRAME: FIRE STOPS,
SIGNATURE OF BRACING.DOLTS !�7/5��1. �., _,•.' ���= li
PERMITTED FURNACE: LOCATION,
�� �
ADDRESS � BAB VENT,DUCTS
LATH. INT. /
AUTHORIZED AGT.
LATH, EXT.
a. 9 a/" P.C•S HOUSE NUMBER COR-
FEE RECT AND POSTED q'
VALUATION / IB G FINAL
FEE
76AG313A DB8 3 4-54 / n ��.•�
DMSION OF BUILDngG-AND SAFETY
DepwinIent of County Engineer
county of Los Angeles
WM. J. FOX, .COUNTY ENGINEER_ APPLIC
ATION.,
FOR APPLICANT TO FILL IN ADDRESS '1049
g -
BUILDING LOCALITY ! r
ADDRESS (/ 'Q ' ' o
- �..� {! • NEAREST •
LOCALITY _ CROSS ST.
NEAREST DISTRICT NO. PLAN CK..OR'RSc.No. - PERMIT-NO.
CROSS E . a � 3
"OWNER RECEIVED BY DATE OF APPL. DATE'1SSUED.
MAIL 7 /— _g O
ADDRESS- USE ZONE NO.NS OF TYPE GROUP F1RE,ZONE•1
� PLA
CITY .�/!Aa (�!(PV •NO1. 'v`ar' //
ARCHITECT OR TEL. ZONING -DAT=
ENGINEER NO. APPROVED BY=
ADDRESS BUILDING ORD.No.
SETBACK LINE:
o09 TEL. APPROVED DAT6-
CONTRACTOR rI /iGONO. �Vf BY,
HOUSE NUMBERING ;
ADDRESS ` (�(X/^✓/P�i o� •^ � •
LEGAL MAP NUMBER _J �J D No. ASSIGNED BY
DESCRIPTION LOT NO BLOCK
DATE I CORRECTIONS INSPECTOR
TRACT y/
SIZE OF LOT /l/A I NOW ON LOT BLDGS
USE EX STOING BLDG. I FAMILTE8 I 0
DESCRIPTION OF WCM
z
NEW ALTERATION ADDITION
REPAIR DEMOLITION
Sq. FT. NO. OF I
SIZE ROOMS STORIES
EXT. WALL ROOF
COVERING I COVERING I
USE OF ST URE
' � + ,�• APPROVALS.p
INSPECTOR'S SIGAATURE DATE f{
y�yyU �P FOUNDATION: LOCATION y� !
FORMS, MATERIALS
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP-
PLICATION AND STATE THAT THE INFORMATION GIVEN 18. FRAME: FIRE STOPS,
CORRECT. BRACING, BOLTS �J {
I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, f
AND STATE LAWS REGULATING BUILDING.CONSTRUCTION. GAS VENT, DUCTS � �
P.— . � �
SIGNATURE OF 1 LATH, INT. A.d"'"
c` PERMIT M
} LATH. EXT. Nif
ADDREB 1 F t
AUTHORIZED AGT PLASTER, INT.
$ PLASTER, EXT. ti
,HOUSE.NUMBER COR- 1
FEE RECT AND POSTED
VALUATION FEE ffi pG FINAL :.y/ A ," !"
.7.6A888A 'DBB.B .8-88 _ ...-. A f� r
/L 49
WORKERS' COMPENSATION DECLARATION i
1 hereby 001.i�n that I have a certificate of consent to self APPLICATION FOR- BUILDING P E RM I T
insure, or a certificate of Workers' Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF.LOS ANGELES I BUILDING AND SAFETY
Pol icy No: Company r•.rti
BUILDING ) ,,��qq
ElCertifiedcopy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS { 0� V` I V S T
❑ Certified copy is filed with the county building inspec- ADDRESS O(O �
tion department.
CIN �(__1W ZIP � v LOCALITY
Date Applicant . NO.OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST.
COMPENSATION INSURANCE ASSESSOR
(This section need not be completed if the permit Is for one TRACT BLOCK LOT NO MAP BOOK PAGE PARCEL
hundred dollars ($100)or less.) TEL.
,OWNER S'N ' NO•� 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 (� (i C SPECIAL
CONDITIONS
so as to become subject to the Workers'Compensation Lbws. � (� O
CITY ZIP9110t• 0f/ O
De
Date Applicant ARCHITECT O NO. � �02
NOTICE TO APPLICANT: If, after makingthis.Certificate of ENGINEER. DISTRICT, GROUP TYPE FIRE PROCESSED BY O
CONSP�' ZONE
Exemption, you should become subject to. the'Workers' �) OV L)
Compensation•provisions of the Labor Code, you must forth- ADDRESS �c'aai 3' a
with comply with such provisions or this permit.shall be f_ 1 TEL, STATISTICAL CLASSIFICATION APT. CONDO. Z
deemed revoked. ' CONTRACTOR UJ S NO. Z _
LICENSED CONTRACTORS DECLARATION IC. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ID&Z4 t �9��NO.
LIC. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business r7rj„�, ����.�/ C��
and Professions.Code,and my license is in full force and effect. CITY l2?KL I BK PG VALIDATION
License Number<_26 q
SQ. FT. STONO.RIES
IE FA OF CHECK
(� � Lit. Class SIZE STORIES FAMILIES ONE
' VALUATION
Contractor �lILC7�s 1 11� DESCRIPTION OF WORK A4.4 eq-19 NEW ❑ $
0 ADD ❑ 10❑I am exempt under Sec. t�-
❑
B.&P.C. for this reaALTER son REPAIR ❑ $
Date: USE OF
EXISTING BLDG. DEMOL'
Signature' APPLICANT TEL. NAL
OWNER-BUILDER DECLARATION (PRINT) NO. FIA
I hereby affirm that I am exempt from the Contractor's License DATE
Law for the following reason (Section 7031.5, Business and ADDRESS FINAL ` -307 �� ��
rr .5F
Professions Code): PRESENT B / -i 1)GI�� -
❑ I, as owner of the proper or-my employees with BUILDING Y C
P P, Y� YADDRESS T
wages as their sole compensation,will do the work and LOCALITY ' fi�- V
0 50
the structure is not intended or'offered for sale(Sectionpool
7044, Business and Professions•Code. MOVING TEL. C'• r' r
CONTRACTOR NO. 'CHECK t3U a r-�LI
I,as owner of the property,am exclusively contracting - �.
with licensed contractors to construct the project (Sec- CHANGE
ADDRESS'
tion.7044,. Business and Professions Code.) '
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAL SETBACK
FROM WIDTH r
I hereby affirm that there is a construction lending agency for .FRONT O� -17k) 1/ u
the performance of.the work for,which this permit is issued P.L. •�i
(Sec. 3097, Civ. C.).' SIDE 7127
1 S t fl
p_ P:L.
Lender's Name /C/f'f LDMA Ref. #
. P.C.Fee$ Permit Fee ,
Lender's Address
I certify that I have read this application and state that the Issuance Fee LDMA P/C#
above information is correct. I agree to comply with all County Investigation Fee
ordinances and Stat laws r ting to building construction, Total Fee LDM&Perm. #
= an hereby a hori a repr tatives of this County.to enter
o the ab - nt- n' "s action purpose .
1 SEE REVERSE FOR EXPLANATORY LANGUAGE
ig at re of Applicant or Ag nt Date
APPLICATION FOR BUILDING PERMIT �1
.1144•
COUNTY OF LOS ANGELES. I BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS
BUILDING ADDRESS _
I I hereby affirm-that I.have a certificate of consent to self Insure, G Q�� +� /04 ��
or a certificate of Workers'Compensation Insurance,or a certified I
copy thereof(Sec.3800,Lab.C.) /
CITY ZIP
Policy No. Company T
LOCALITY
SIZE OF LOT NO.OF BLDGS.NOW ON LOT
r' ❑ Certified copy is hereby furnished. NEAREST CROSS ST
❑ Certified copy is filed With the county building inspection TRACT p BLOCK LOT NO. USE ZONE EMANdepartment. Dss-O � 73
pate Applicant ASSESSOR MAP BOOK PAGE PARCEL
/7 / �•� sl '�OZi-(jlI CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' °WN� TEL NO.
COMPENSATION INSURANCE �7fiwbs-a WITHIN 1000 FT.OF SCHOOL?J ,' YES No
ADDRESS
(This section need not be completed if the permit is for one hundred /0/0-'/ /---. C)`! DISTRICT GROUP TYPE CONST.' FIRE ZONE $01CFESSED BY
dollars($100)or less.) CITY 5
ZIP ✓
I certify that in the performance of the work for which this permit TeAAPR �CJOff3
Is issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO. 2'
become subject to the Workers'Compensation Laws. . --. /3 U.Ss-e- Yp3 j—f f C3J— STATISTICAL CLASSIFICATION A CONDO
Date Applicant ADDRESS CLASS NO. DWELL UNITS
OL
7d.y S �e/r(.�QS'e
NOTICE TO APPLICANT. If, after making this Certificate of REQUIREDTOTAL SETBACK FROM EXIST
Exemption, you should become Subject to the Workers' CONTRACTOR TEL NO. SETBACK YARD HWY PROP LINE WIDTH
Compensation proilsions of the Labor Code,you must forthwith A/-,4 e-lo OS a /e-OV6 PyOJ, FRONT'
comply with such provisions or this permit shall be deemed•revoked. ADDRESS — LIC.NO. �+ PL
/6® Art- OTZA 0 4-1r 7 SIDE >`
LICENSED CONTRACTORS DECLARATION CITrYLIC.CLASS PL I c
I hereby affirm that I am licensed under provisions of Chapter 9 P`'-f4'A Q SEWER M&Ptc a
(commencing with Section 7000)of Division 3 of the Business and FT.SI NO.OF STORES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. NEW IS BK PG
S
9 1
DESCRIPTION OF WORK C7
License Number � 3 LIC.Class � . r ADD ❑ VALUATION , �.
Contractor SSe v pate 3~ 'g® AV 1/�7'" C'ti✓ e7/ X d! ALTER ❑ V I D
R VA e- REPAIR ❑ �
131 am exempt under Sec.
BARC.for this reason DEMOL ❑ LDMA P%C N
Date. USE OF EXISTING BLDG. URM ❑'
Signature '��� APPLICANT(PRINT) TEL NO. LOMA Perm 0 j _
Or
11I,as owner of the property, or my employees with wages as
C ACCT.
their sole compensation,will do the work and the structure is ADDRESS. F
not intended or offered for sale (Section 7044, Business and FINAL DATE C 3;307 128.50
Professions Code.) WILLTHEAPPUCANTORFUTURE BUILDING OCCUPANT HANDLEAHAZARDOUS MATERIAL I �� �, J 1roltJ
❑ I, as owner of the • am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN
P PertX THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY '}' •�-�
licensed contractors to construct the project.(Section 7044, YES 11 NO❑ (, TOTAL 128 @ 2_50
Business and Professions Code.) Uhf{ 128.50 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING 1
OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH -
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST
FOR GUIDELINES. CHANGE 1 .00
I hereby affirm that there Is a construction lending agency for YES❑ NO❑
the performance of the work for which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD ((''�1��jj (�yyff ff��'j'+ `
3097,CIV.C.). PERMrMNG CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES 0000-0001 i/ 9/90
COUNTY CODE,TITLE 2.CHAPTER 220 SECTIONS 220.100THROUGH 220.140 CONCERNING
3Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAGMD. p/42+•I M O°
' 7 s
IL Lender's AddressOWNM� � u,�
o' I certify that I have read this application and state that the above
Information is correct. I agree to comply With all county RC.FEE' PERMIT FEE f �• I.
ordinances and State laws relating to building construction,and r +-Jn
hereby authorize representatives of this County to enter upon ISSUANCE FEE
the above-m R o d property for Inspection purposes. 0,0
I e
A 7-9-170 INVESTIGATION FEE TOTAL FEE
8Wft-WAPPKWWAPffl DW
SEE REVERSE FOR EXPLANATORY LANGUAGE,
• : APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES ®' a BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION
FOR APPLICANT TO FILL IN BUILDING ADDRESS? _
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS 9
or a certificate of Workers'Compensation Insurance,or a certified (J �i
ST
copy thereof(Sec.3800,Lab.C.) CITY Z ZIP
Policy No. Company L v G/TLOCALITY T
SIZE OF LOT NO.OF BLOGS.NOW ON LOT 1 TJ° C6- ciTV
❑ Certified copy is hereby furnished. NEAREST CROSS ST.
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
USE ZONE MAP NO.
department.
Date Applicant ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS -
CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ♦ TEL NO. [�
COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred ADDRESS 2
dollars($100)or less.) Q V(T DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
CIT T ZIP
I certify that the performance of the work for which this permit O� fJ
is issued, I shall not employ any person aany manner so as to ARCHITECT OR NGINEER TEL NO. /� — «✓-
become subject to the Workers'Compensattion Laws. STATISTICAL CLASSIFICATION APT' CONDO
Date Applicant ADDRESS CLASS NO.--2/ DWELL UNITS
NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PR - s WIDTH
Compensation provisions of the Labor Code, you must forthwith FRONT .0
comply with such provisions or this permit shall be deemed revoked. ADDRESS UC.NO. PL a 1n.1 L .60
LICENSED CONTRACTORS DECLARATION SIDE
CITY LIC.CLASS PL IIT1-i 1
;
I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES NEW 11BK PG t OTAL 69 = 60
Professions Code,and my license is in full force and effect. a
License Number Lic.Class DESCRIPTION OF WORK App ❑ VALUATION CHECK 69.U60 C
c '51Y Contractor Date
i✓b®U1! ALTER 11 $ C��• CHANGE oDOC
a
❑ I am exempt under Sec. REPAIR ❑ F
$
6.8 P.C.for this reason DEMOL ❑ 1000-0001 5/ 2/950LDMA P/C#
USE OF EXISTING BLDG. I 1 a
Date: URM ❑ � i ! AN 8:440
f Signature APPLICANT(PRINTI�y, 1 TEL NO. pLDMA Perm#
I, as owner of the property, or my employees with wages as C(" � ZV, z
f kheir sole compensation, will do the work and the structure is ADDRESS
not intended or offered for sale (Section 7044, Business and 0 L 19 2r CJ zk
FINAL DATE Q
Professions Code.)
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT H4NDLE A HAZARn6uS MATERIAL J
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE
❑ I, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY
licensed contractors to construct the project (Section 7044, YES❑ No❑
Business and Professions Code.)
WILL THE INTENDED USE OF THE BUIDUNG BY THE APPUCANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH
CONSTRUCTION LENDING AGENCY COAST NR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR
GUMEUNES
I hereby affirm that there is a construction lending agency for YES❑ NO❑
CM the performance Of the work for which this permit IS ISSUed($eC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
°' 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE.
TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS
Lender's Name MATERMLS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD.
o Lender's Address
� OWNER OR AGENT
o I certify that I have read this application and state under penalty
of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE /�,
CCM with all county ordinances and State laws relating to building
construction, and hereby authorize representatives of this County ISSUANCE FEE
ro to enter upc b esti ed property for inspection purposes. Q
INVESTIGATION FEE TOTAL FEE
(rj ft
/ SEE REVERSE FOR EXPLANATORY LANGUAGE
' n
APPLICATION FOR BUILDING PERMIT
- COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL INBUILDING ADDRESS
I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS
or a certificate of Workers'Compensation Insurance,or a certified 6pL"117
copy thereof(Sec.3800,Lab.C.) CITY ZIP
LOCALITY
Policy No. Company SIZE CJF LOT NO.OF BLDGS.NOW O7LOT
❑ Certified copy is hereby furnished. NEAREST CROSS ST. 47
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
USE ZONE MAP NO.
department.
Date Applicant ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS � Q/
CERTIFICATE
COMPENSATION EXEMPTION
INSURANCE WORKERS' OWNER GHw-G 517*m TEL NO.
YES NO
WITHIN 1000 FT.OF SCHOOL?
(This section need not be completed if the permit is for one hundred ADDRESS /
O OU,�'� DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY
dollars($100)or less.)
I certify that in the performance of the work for which this permit CITY ZIP
u ��ff
is issued, I shall not employ any person in any manner so as to ARCHI E' OR ENGIN TEL NO. 101 P/ -3
become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NO.0-2/ DWELL UNITS
NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject t0 the Workers' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS UC.NO. PL
LICENSED CONTRACTORS DECLARATION SIDE
CITY LIC.CLASS PL
I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and 80.FT.SIZE NO.OF STORIES NO.OF FAMILIES
Professions Code,and my license is in full force and effect. NEW E3 BK PG ® a
License Number Lic.Class DESCRIPTION OF WORKppp ❑ VALUATION
Op10 GV/A�WNT 7
Contractor Date D ALTER El $ 0�' Of
Ix
ElI am exempt under Sec. REPAIR 11 $
B.BP.C.for this reason DEMOL ❑ LL
LDMA P/C#
Date: USE OF EXISTING BLDG. URM 11 - D,
Signature Cr
APPLICANT(PRINT TEL NO. LDMA Perm# :+_ ' :r Z
1, as owner of the property, or my employees with wages as Z -7
their sole compensation, will do the work and the structure is ADDREAlcoa.
O - --
not intended or offered for sale (Section 7044, Business and a O L FINAL DATE a '
Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HAADLE A HAZARD S MATERIAL
C i �lrl.
OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GRENrER THAN THE J
El 1, o 60
I, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY > '•7 tk
licensed contractors to construct the project (Section 7044, YES❑ NO❑ -
Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING -
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �,i��
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR
GUIDELINES.
I hereby affirm that there is a construction lending agency for YES❑ NO❑
a the performance Of the Work for which this permit IS ISSUed(Sec. IHAVEREADTHE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
W 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,
N TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERNING HAZARDOUS
Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. + j "i!: • ' -'
o Lender's Address
O OWNER OR AGENT
c I certify that I have read this application and state under penalty
of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE .
N with all county ordinances and State laws relating to building !J
construction, and uthorize representatives of this County ISSUANCE FEECO
ato enter upom tinned property for inspection urposes. !O O
INVESTIGATION FEE TOTAL FEE /O
m (p
SEE REVERSE FOR EXPLANATORY LANGUAGE
r • �.• COUNTY OF LOS ANGELES TEMPLE CITY # 0508BUILDING PERMI - �
DEPARTMENT OFt'P4ELIC WORKS 9701 LAS TUNAS �� —
RESI�DENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9904290002
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS:
TR: 10558 LT: 20 SQ. FT STORIES TYPE OCCUP GROUP 10104 OLIVE ST
STRUCTURE: 0 1 VN R3 TEMP CA 917803344
ASSESSOR INFORMATION NUMB R: GARAGE: 651 1 NEAREST CROSS STREET: BALDWIN
8585-002-020 OTHER: 273 1 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY
TENANT: 5 G SE: USESS ED 0 : PROCESSED--BY: EXPIRES ON:
EXIST OCC GRP: 05/21/99 UT 11/17/99
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FI L DATE FINAL BY: CODE:
SHUI MICHAEL (626) 582-8235- 1 22,180 rr��
10104 OLIVE ST i --w,
TEMP 917803344 FEES P IDSCRI TION OF WORK
RESIDENTIAL GARAGE AND WORKSHOP- NOT FOR HABITATION
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
SAME AS OWNER - D1 PLANCHECK W/O EN-HC 22180.00 VAL 369.75
AA BLDG PERMIT ISSUANCE, 27.75 SPECIAL CONDITIONS:-----
AC
O DI IO S:AC STRONG MOyI-UN---j .D�22:1$0.00 VAL 2.22
D2 PERMIT W.O'EN �V L�C 221 O�OU VAL 435.00
�+ �Tfl# L7ES 834.72
CONTRACTOR: TEL. NO: - y05 n/ APPROVALS DATE INSPECTOR SIGNATOR
SASLit. NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVA
C ECT OR G R: EL. 0: - 0 D TIO TRENCH FORMS
LIC. N0: r 1111111 SLAB/UNDER FLOOR
L RAISEDILOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: Cm D D ��` O�P//' 3 UNDERFLOOR INSULATION
u �I uls—T LEVEL FLOOR S TH
0. 0 ILIES: DWELLrNG TS: A /CO D: STAT CLASS'•
NO 21 2ND LEVEL FLOOR SHEATH
SCHOOL I IN HAZARDOUS Q ff T�, ROOF SHEATHING
AIR QUALITY: 1000 FEET MATERIALS
NO NO NOEl — I y FIRE DEPT. FRAME INSPECT
REQUIR D TOA SETBACK FROM IST 4 "t DG DEPT. F I S C
SET BACKT P.- YARD: HWY: PROP LINE: WIDTH:FROB��C aS@pV����a+L�C SHEAR PANELS
SIDE PL- �j c
0 RIP
INTERIOR LATH/DRYWALL
EXTERIORAT /O
LOT DRAINAGE JJ
SMO KKETECTION DEVICES
FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508