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HomeMy Public PortalAbout10407 OLIVE ST_Building__ DEPASTNZNT OF BUILDING AND SAFETY Jwr"L%on A avr r vu rr suv"A COUNTY OF LOS ANGELES WM. d. FOX. CHIEF ENGINEER El mum I L D IN" G FOR APPLICANT TO FU4LM FOR OFFICE USE ONLY �} A �� DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING ADDRESS i C�7'/_1F!/ " 24 p� �sI LOCALITY ` T DATE OP APPL. DATE u ur NEAREST �' CROBBBT. �Fi'�.d' � OWNERifi� a / '� y It BUILDING ADDRE69 MAIL � �r LOCALITY 1 99 r ADDREam, Af = �°!�F� � /�� NO. F-0 f:Fr' NEAREST et, _. CITY a�dTEL.` CROBB9T. lid_ FIRE ISO.OF ROUP ARCHITECT OR TEL. ZONE PLANE 6P F;- ENGINEER ND. `• BLDG. ORD.NO. ADDRESS �, BLOMOK LINE BYPROVED/�� r CONTRACTOR / ._ NO. fi?�/ G DATE r USE APPROVED ADDRESS ZONE �� BY DATE LEGAL .� CORRECTIONS DESCRIPTION LOT NO. BLOCK -09 C�%J TRACT 1 3?,— NO.OF BLTS. SIZE DF LOT. f) y NOW ON LOOT USE OF �- NO.OF NO.OF EXISTING BLDG. FAMILIB9 ROOMS DESCRIPTION OF WORD NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH O 9q.FT. NO.OF SIZE ROOMS STORIES WALL ROOF COVERING COVERING USE OF NEW BUILDING I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT. FOUNDATIOPO.LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION.' FRAME: FIRE STOPS. SIGNATURE OF rte ,- BRACING.BOLTS L� PERMITTEE s i�sT� 01-4 LATHr INT. AUTHORIZED AOT LATH, EXT. 7GA63BA-3 2-50 $ P.D,B PLASTER.INT. FEE .. �e PLASTER.EXT. VALUATION f 2�' FEE S� FINAL „�,/%,- -' 00n/w-) DIVISION OF BUILDING AND SAFETY Department of County Engineer I�-.� �D I G� County of Los Angeles WM. J. FOX, COUNTY ENGINEER F' APPLICATION FOR APPLICANT TO FILL /IN AADDRESS �d /✓ ��. //,l�G s BUILDING LOCALITY D �.✓ ADRESS �J `� J NEAREST LOCALITY [:�//(%�/ �r f CROSS ST. NEAREST �� �I" .. DISTRICT,NO. PUN CK.OR REC.No. PERMIT NO. CROSS ST. rx_"11 OWNER f)Ir._ a,/c �•`�y r�tit C/SG' /Ii, RECEI�(EEP By DATE OF APPL. 'yJDy/AVE ISSUEDU EZ AMAIL DDRESS /4/!G� ! tZf't.• /1 ��J / /1O' /7/�:J �' �o f�=t .a.- �+/ql NE I PLANS I1 NO. OF TYPE GROUP I FIRE ZONE CITY l.F lr'.�.�.,(:t l •t" Nott VIJ�`� e+ f J ARCHITECT O?R � - TEL. �/} ZONING DATED ENGINEER NO. APPROVED By. - BUILDING ADDRESS SETBACK LINE: W'• ' •' �ry TEL APPROVED DATE CONTRACTOR NO. ' BY: F HOUSE NUMBERING ADDRESS LEGAL ✓ " MAP NUMBER 'y� NO.-ASSIGNED BY—"N��? DESCRIPTION LOT NO BLOCK � DATE CORRECTIONS INSPECTOR TRACT r// S. SIZE OF LOT •�'-� ,�A'7 I NO. OF NOW ON LOT LOT :. USE OF NO. OF EXISTING BLDG. FAMILIES I I p DESCRIPTION OF WOE! o // NEW S ALTERATION ADDITION a I. REPAIR !� DEMOLITION SFT. NO. OF SIZE �if/� `� ROOMS STORIES I CCOVWALL ROOF ERING � � I COVERING USE OF STRUCTURE I APPROVALS INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT i HAVE READ THIS AP-' FRAME: FIRE STOPS, PLICATION'AND STATE THAT THE INFORMATION GIVEN IS CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, ' AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE OFX i� G� �'� LATH, INT. PERMITTEE LATH, EXT. ADDRESS PLASTER, INT. AUTHORIZED AGT. $ -� 11; HOUSE EXT. ;2J00 rr�� HOUSE NUMBER COR- FEE RECT AND POSTED �+yi VALUATION FEE FINAL 70AG313A DBS 3 2-58 J I DIVISION OF BUILD= AND SAFETY BUILDING D"arbnent of Conaty Slgiaeer Cocattyy��of Los Aageles WM. J. FOX, COUNTY ENGINEER APpLI(,'A'NQN BUILDING FOR APPLICANT TO FILL IN ADDRESS D L-_r BUILDING ADDRESS LOCALITY •�Ci 1, n NEAREST LOCALITY !�/Z9"' � � C.,..�o� CROSS ST. NEAREST B -.m DISTRICT NO. PLAN Cx.oR Rec.No. PERMIT NO.- CROSS ST. ,/% r S �FGIfi OWNER lJ _ � ��j RECEIVED DATE OF APPL. DATE ISSUED MAIL ONO 0 7` ` � e/ � 15 ADDRE/SS USE ZONE NO. OF YPE r02-0/up ROUP FIRE ZONE �t ` ! PLANS CITY: // ( t� NO.W 'd O �"'�_ 11 -T I � I ENGINEER iR . jQOd ZONING NO. ApPaoveD BY ADDRESS BUILDING /-- T RD o. SETBACK LINE: G �r TEL. APPROVED CONTRACTOR NO. By, HOASE NUMBERING ADDRESS LEGAL p MAP NUMBER —665 NO. ASSIGNED BY DESCRIPTION I LOT NO.T .s BLOCK 7 �� DATE I CORRECTIONS I INSPECTOR , TRACT / /, '7 2 �( � SO'i I NO. OF SLOGS. r— SIZE OF LOT ✓ /` ,O NOW ON LOT USEOF EX STING'BLDG. �s T /C'ULT Y I FAMILIES' I ' Q DESCRIPTION OF WORK Q NEW ALTERATION ADDITION REPAIR DEMOLITION SQ. FT. NO. OF I SIZE �WALL ,`T ROOMS STORIES / ROOF COVERING D/V G I COVERING USE OF STRUCTURE I I APPROVALS a INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FRAME: FIRE STOPS, PLICATION AND STATE THAT THE INFORMATION GIVEN 18 CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE OF �f' LATH, INT. PERMITTEE_ ,,¢¢yy' ,,,, LATH, EXT. ADDRESS ��y�7��'- ®,V1l�?i PLASTER. INT. AUTHORIZED AGT. S /-54, P. C.$ PLASTER. EXT. (/ FE6 HOUSE NUMBER COR- RECT AND POSTED VALUATION FEE FINAL 70AS38A DBS 3 •8-53 1 ' IBA898A DDS-3 9.BAPPLICATION FOR BUILDING PERMIT 1 . DIVISION OF BUILDING AND SAFETY BUILDING _ ADDRESS � Department of County Engineer County of Los Angeles LOCALITY A ° WM.J.FOX,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO.I GROUP , PE SEWEICR MAP PG FOR APPLICANT TO FILL IN 6: .� CONST. BUILDING fry' .1 %�' aLtMAP ADDRES8 NUMBER STATE YEStFO� USE ZONE SPECIAL LOT NO. .. BLOCK }i� CONDITIONS rZIJ % TRACTT. � ,r'8u /4, P n -MQNO.OF BLDG& .� BUILDING EXIST. SIZE OF LOT NOW ON LOT SETBACK YARD HWY STREET NAME WIDTH USEOFEX STING BLDG. /NF�� �RK.tI�-� / FRONT OWNER , I Ep yAflb-imeel!•44, i3v,ZrL SIDE MAILpL �°CCI� ., -1 5 INDUSTRIAL ADDRESS /V �i! O TRACT DWELL. 1 UNIT i TEL CITY,�-/lt6 NO." T�� "/' DWELL. I UNIT 6 PUBLIC BLDG. 2 DUPLEX 1 UNIT ARCHITECT OR -�.�,�yyTEL. P+�O1 7 ADDN..ALT.. ETC. ENGINEER a v /NO•�D/+ d 3 APT. UNITS ADDRESS �i�FFQ �t V,14;�O' 4 COMMERCIAL 8 M18CEL. CONTRACTOR� IES t'll OJ '`I�O //�E l INSPECTION RECORD A13DRES8 �r 1.41 L//i✓6� z,?6!,r7 / l `� s/F !/• �'/.•'n !?Y : DESCRIPTION OF WORSeA!/;nT�.Sjz LDi- G.,41. NEW ADD ALTER REPAIR DEMOLISH SQ.'Fr. J NO.OF NO.OF g ri— SIZE X11 Fi► STORIES FAMILIES I - US FSTR CURE SIGNATURE OF. - r/ - I/ APPLICANT h� �1I7V-f kl t.C/(f1 APPROVALS6�/.( �/{, to 117"se lod"' , ADDRESS . aI Y p 16. (,�)/(� 1 DATE INSPECTOR'S SIGNATURE FOUNDATION:LOCATION � P.C. S O� FORMS.MATERIALS Af FEE FRAME: FIRE STOPS. VALUATION / BRACING,BOLTS �•i'%I �%�� .:� •'.�"�✓�. `� FEE ���fO' FURNACE:LOCATION, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT.DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. // q LATH.EXT. SIGNATURE TTEE /I�1� •�yJ, HOUSE NUMBER COR- /9d�.�el1fA✓� �' RECT AND POSTED ADDRESS FINAL �� L WM.J.FOX,COUNTY ENGINEER VALIDATION C.N.DIRLAM,CHIEF BLDG. INSPECTOR -Aco4 3 8 4 JAM 22 1 6 1 8.0 O A m 4 6 5 The Easterly 103 feet of the f esterly 527 feet of Lot 35 of 2.J.Bal&Tln' s Addition No.l• of Santa finita Colony Tract, in ti-!e County- of Los fin;;eles, Stat9 o� Cali ornia$ as Der map recorded in Book 52 page 60 of I.1iscellaneous Records, in the office of the county recorder of said county. 21{CEPT tae norLl.erly 351 feeti thereof. L SPS-3 25M SETS 8-4S DEPgRgME1;vT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES BUILDING ® WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. NO. PERMIT NO. BUILDING ADDRESS i v - ,��(�r_.�-�. .`l --e,7 LOCALITY e . >f.ri RECEIVED BY •yDATE OF APPL. DATE ISSUED NEAREST I '}��y .� 8..t_ L.a.:• /�- /-4,1t!. / CROSS ST. ` BUILDING - OWNER I t�I, ADDRESS ar MAIL /`f1J •1rY'.S 1 I/il J LOCALITY .-t.,....... „� tf ADDRESS NEAREST TEL. CROSST. CITY I /f/i�l ii' [.�// fJ NO. FIRE I NO.OF TYPE I GROUP, ! ARCHITECT OR TEL. ZONE PLANE �- ENGINEER NO. VVV BLDG. ORD. NO. ADDRESS SETBACK LINE APPROVED TEL. BY DATE CONTRACTOR NO. `., USE APPROVED ADDRESS ZONE BY DATE LEGALI - CORRECTIONS DESCRIPTION LOT N Q ��{ I BLOCK TRACT /�l NO. OF BLDGS. SIZE OF LOT/ 2 I NOW ON LOT USE OF NO.OF NO. OF. EXISTING BLDG. FAMILIES ROOMS DESCRIPTION OF WORK NEW Y., ALTERATION ADDITION O REPAIR M_OVINO DEMOLISH L7 Sq. FT. NO.OF SIZE ROOMS �. STORIES _ > WALL ROOF COVERING LGL« COVERING USE OF NEW BUILDING APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS INSPECTOR DATE APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION: LOCATION, AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FRAME: FIRE STOPS, BRACING, BOLTS SIGNATURE OF i OWNER �Jj�� LATH, INT.: �Y,{� AUTHORIZED AOT-`�' T"' • • �d' �? `, LATH, EXT.: y"7 ;1 P L,.' PLASTER, INT. FEE PLASTER, EXT. �n �f� VALUATION FEE ��'"-.-.---. FINAL DEPARTMENT OF BUILDING AND SAFETY riiiAPPLICATION FOR PERMIT .> MUNTY OF LOS ANGELES - WM. J. FOX, CHIEF ENGINEER BUILDING FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING , DISTRICT NO. PLAN CK.NO. PERMIT NO. _ADDRESS / jJ•/ ( i.2+�L / i ��ae''lC are LOCALITY fi e- �:L:Z RE CF�1•V B DATE OF APPL. DATE ISSUED NEAREST CROBB ST. BUILDl OWNER 1�'. 1 'rai n ADD ESB .3 �/yrs ADDRESS, ®O GtJ° O� /UdI 0 MAIL LOCALITY NEAREST �� TEL CROSS 8T. �✓1 ��,� CITY L4-24-L.[C.srG+�'y NO. FIRE PLANS TYPE GROLI ARCHITECT OR J TEL ZONE PLANS — '�� ENGINEER NO. BLDG, ADDRESS SETBACK LINE APPROVED TEL. BY ,DATE CONTRACTOR NO. USE APPROVED ADDRESS - ZON11 BY DATE LEGAL CORRECTIONS DESCRIPTION LOT NO. BLOCK 2 TRACT 4zw SIZE OF LOT lb- -af� I NO.OF BLOBS. NOW ON LOQ �! U 8 E OF ' i.c i;�f,e L I NO.OF / I NO.OF EXISTINGSLDG. &.Arf-www... FAMILIES ROOMS ■ DESCRIPTION OF WORE: NEW ALTERATION ADDITION O R REPAIR MOVING DEMOLISH SD.FT. NO.OF Z SIZE G/ ROOM® STORIES D WALL a ROOF ■ f' COVERING ae_a I COVERING 'C-5'& USE OF NEW p l?4 C� BUILDING Y//bL��Iy� jZ.��•L 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE 18 CORRECT FOUNDATIONeLOCATION INSPECTOREDATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION. �� JJ ) FRAMES FIRE STOPS, -SIGNATURE OF ,�4�/6</ c e [�ir � BRACING,BOLTSCPERMITTEF (� LATH,INT.7 / L ORIZED AGT � � X � � � % LATH,EXT.: SOM SETS 7-47 $ d0 P.C.10 PLASTER,INT. FEE PLASTER,EXT. r ATION FEE 4;.ate FINAL r / 7M°eeA APPLICATION FOR BUILDING. PERMIT ], rl-ss DMSION OF BUILDING AND SAFETY BUILDING' Deportment of County Engineer ADDRESS. f County. of Los Angeles LOCALITY , JOHN A.LAMBIE' COUNTY ENGINEER NEAREST CASSATT D'.GRIFFIN,SUPT OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROUP TYPE SEWER MAP PQ CONST _ BUILDING //� r` /� /' ADDRESS / 0 Gq ® ' / � (7([Cie NUMBER '" �MAP SjTjyAyTyE YES O LOT ROS 3 N r'�• B ' USE ZONE SPECIAL CONDITIONS- TRACT NOFOFBLDGSZ;Z SIZEOF LOT�D }( ''�i/ NOLOT BUILDING YARD HWY STREET NAME EXIST. SETBACK. WIDTH USE OF S � EXISTING BLDG. / FRONT P. L. OWNER -f G� hJ �/••� SIDE. MAIL J P.L.ADDRESS / U YO Z "( �` �l�Cl'P� O TRACT DWELL. 1 UNIT IS INDUSTRIAL CITY �/ ���Vfi��Q� NO. 1 DWELL. y,/ i UNIT 6 PUBLIC BLDG. ARCHITECT OR TEL. 2 DUPLEX 2 UNITS' 7 ADDN.,ALT..ETC. . ENGINEER NO. 3 APT. UNITS t3 MISCEL. ADDRESS �]_3 d /i�p��.� 4 COMMERCIAL CONTRACTOR Ca/ NOL .' INSPECTION RECORD• ADDRESS �j DESCRIPTION OF WORK NE ADD ALTER REPAIR , DEMOLISH FT. NO.OF NO.OF SIZE STORIES ,FAMILIES USE OF STRUCTURE pp J SIGNATURE OF APPLICANT �S JJ APPROVALS ADDRESS DATE INSPECTORS SIGNATURE, TFEE S �'� FOUNDATION:LOCATION FRAME: FIRE STOPS. - VALUATION $ da BRACING, BOLTS ����� FURNACE: LOCATION.. 1 HEREBY ACKNOWLEDGE. THAT I HAVE READ THIS GAS VENTti Q. APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY.ORDINANCES LATH.INT. AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH. EXT. SIGNATURE OF � ) ) HOUSE NUMBER COR- ; PERMITTEE W f C RECT AND POSTED ADDRESS__ FINAL IOHN A.LAMBIE.COUNTY ENGINEER V41MATION CLYDE N.DIRLAM. CHIEF BLDG. INSPECTOR K' MO CASH ' LACor 9 .2 5 3D; JUM 14. 1 6 . .2.5 U •• : 0 i���o 9 2 5 4—U- .'J u m 14- `� APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) B:DDRE �yo7 /vim COUNTY OF LOS ANGELES A ,1 DEPARTMENT OF COUNTY ENGINEER AIM CIeVp l 4 %n zIP BUILDING AND SAFETY DIVISION O.OF BLDGS. BUILDING D�107 t SNOW ON LOT ADDRESS*bl T - LOCKLO O. LOCALITY� NO. NEAREST Otel,/ �J ,�Jl ?NO. CRASSESSOR OSS ST. ADDRESS /�/�/"©/ ag5 Q/ MAP BOOK PAIdE RCEL G7 � r DISTRICT GROUP TYPE FIRE PRO ESSED BY CITY //� C..! ZIP �y��/g ONST ZON ARCHITECT OR TEL. 6167 ENGINEER NO. . STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO DWELL•UNITS B41.�PG CONTRACTOR p E ZONE NOSPEC AL MA P O ADDRESS �3IC ^.) CITY �� / �a,I_LASS��/L CONDITIONS CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ NAME AND BRANCH BLDG.SETBACK FROM V F FRONT PROP.LINE OF (324� (STREET) C ADDRESS CITY - TOTAL SETBACK FROM TYPE OF EXISTING SQ, F NO. OF NO. OF CHECK HIGH AY + YARD - HIGHWAY WIDTH SIZE ` RIES FAMILIES ONE FRONT PROP. LINE F + = L DESCRIPTION OF WORK NEW ` ADD ❑ BLDG, ETBACK FROM SIDE P1kqP.LINE OF (STREET) ALTER ❑ _ TOTAL SETBACK,FRQM TYPE OF EXISTING HIGHWAY YARD - E REPAIR USE OF + PROP. LINE HIGHWAY WIDTH ❑ _ • EXISTING BLDG. DEMOL ❑ APPLICAN / /4 �/� NEOL ` CORNER CUTOFF YES ❑ NO (PR T) f'j�jL BY (SIGNATUREdj�V IN OPEN SPACE ' YES ❑ NO ❑ IN COASTAL ZONE YES ❑ NO ❑ VALUATION� �V v CATEGORICAL EXEMPTION YES❑ NO ❑ 1 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. IC THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE , LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMPE NSA ON SUflANC E. !" r / ( ..� SIGNATURE PERMITTEE L 1 ADDRESS , / / 1 FINAL BY � Ju TEL. / DAT CITY NO. 1 11 MAKE CHECKS PAYABLE- TO: FEE $ �If/ FEE HARVEY T. BRANDT, COUNTY ENQINEER V PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH 9 9 2 JUL 12 1 D Q AZIO 76A638A CENS03 7/73 1 1 Apffl-LICATION FOR BUILDINGIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION2) f FOR APPLICANT TO FILL IN BUILDINGBBUILDING � RESS,,V G I I hereby affirm that I have a certificate of consent to self insure, � or a certificate of Workers'Compensation Insurance,or a certified UILDI ST copy thereof(Sec.3800,Lab.C.) CITY---— �� 17), ZIP OA O LOCALITY Policy No. Company SIZE OF LO ` NO.OF BLDGS.NOW O LOT ❑ Certified copy Is hereby furnished. /�( 3 NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZO MAP NO. Date Applicant ASS P BOOK PAGE PARCEL 1014 � SPECIAL CONDITIONS tp &CERTIFICATE OF EXEMPTION FROM WORKERS' ER 1� �� il/ WTEL No. J f WITHIN loon FT OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS (This section need not be completed if the permit is for one hundred . 04 a— 9T DISTRI GROUP TYPE QPNST.' FIRE ZONE PROCESSIEDBYrN dollars($100)or less.) I ZIP I certify that in the performance of the work for which this permit l� C! r �Jv/ OA 1 is Issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation Laws. STATISTICALGI�MIF CATIO ^ CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS 5� 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 PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith A FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PIL CL I hereby affirm that I am licensed under provisions of Chapter 9 SEWER E (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES m Professions Code,and my license is in full force and effect. 1 ❑ BK 21 PG License Number Lia.Class DESCRIPTION OF WORK ADD ❑ VALUATION r,l Contractor Date ALTER ❑ $ t r a CO3 ❑ I am exempt under Sec. REPAIR B.BP.C.for this reason 9 f DEMOL ❑ LDMA PIC li Date: U E OF EXISTING BLDG. •URM ❑ 1 �Signature APPLICANT(PRINT) TEL NO. 1.as owner of the property, or my employees with wages as LDMA Perm M 0 �.�T e s their sole compensation,will do the work and the structure is ADDRESS 331307 82.011 not Intended or offered for sale (Section 7044, Business and ��D Professions Code.) OR A MIXTURECANTO NTNG A HAZARDOUS BUILDING MATERIAL QUAL T AZARGREATER THAN U 1 ITEMS ❑ 1, as owner of the ro e OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN p p rty, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL SY > TOTAL 92.1310 licensed contractors to construct the project (Section 7044, YES❑ NO❑ Business and Professions Code.) CHECK 82.00 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING _ CONSTRUCTION LENDING AGENCY COAST REQQUA IREAPER IT FOR GEMENT DISTRICT CHANGE 01.1 COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST CHANGE G e FOR GUIDELINES. 1 hereby affirm that there is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit is Issued(Sec. z I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCOMD IJI�•I�(�—j [j(3 j ' / (� 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND My REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,TITLE Z CHAPTER Z20 SECTIONS 2.20.100THROUGH 220.140 CONCERNING Lender's Name HAZARDOUS MATERIALSREPORTINGANDFOROBTAININGA MR 6 FROM THESCAOMD. 74'22 f 1 AM 8o41 x46,o Lendel'sAddress �� 0 1 certify that I have read this application and state that the above O information is correct. I agree to comply with all county RC.IFEE PERMIT FEE ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon I ISSUANCE FEE �i the above-mentioned property for i spection purposes. 0 E _ L INVESTIGATION FEE TOTAL FEE egnmumawoppra,naApalt Dao Y SEE REVERSE FOR EXPLANATORY LANGUAGE 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 0302030008 PHONE: (626) 285-0488 EXT: LEGAL . OF CONSTBUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 10407 OLIVE ST STRUCTURE: TEMP CA 917802863 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BALDWIN 8586-028-025 THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: IS L • USE IS D PROCESSEDEXPIRES ON: EXIST OCC GRP: 02/03/03 JK 01/29/04 OWNER: TEL. 0: BLDGS. NOW ON OT: VALUATION: FINAL DATE FINA BYt:-.4 CODE: C0EN EOLIVEANG ST MEI MEI (626) 444-1093- 0 3 TEMP 917802863 F ES PAID DESCRIPTION OF WORK DEMO SWIMMING POOL FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 02 DEMOLITION INSPECTN 163.50 SPECIAL CONDITIONS: :== _'TOTAL FEES 191.25 CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO � PROT 0 NX SEWER DISCONNECTION A C I C 0R ENGINEER: TEL. 0: I r- - FJ_ j, I i' �� _� \� ABANDON PRrV TE DISPOSAL - L I iLl LIC. NO•I, UNDERGRND STRUCT REMOVAL i �, y AND SOIL RECOMPACTION MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: X •,, 0. OF AMILIES: DWELLING UNIT : A CO D: STAT CLASS.:. NO 23 • SCHOOL WITHIN HAZARDOUS _� I l /,'•'� AIR QUALITY: 1000 FEET MATERIALSNO NO NO VICC ,sr bE�jo E,�c 'z A., C� icy s k,o CCoo.j REPORT ID: DPR261 ROUTE TO: BS0508