Loading...
HomeMy Public PortalAbout10410 OLIVE ST_Building__ 76A638A CE-#809 6-62 APPLICATION FOR BUILDING PERMIT . 11 .'COUNTY OF LOS ANGELES nop DI..N DEPARTMENT OF COUNTY ENGINEER BUILDING AND, SAFETY DIVISION =LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / WILLIAM A.JENSEN,SUP'T OF BUILDING _ CROSS'ST. DI§_TB'IC N P] TYP E B FOR APPLICANT TO FILL IN _. I . ( c sr. BUILDING /� e• STATISTICAL.,CLASSIFICATION S WER MAP . ADDRESS 1 t� yl� K' 3 CLASS.NO." DWELL.UNITS LOT NO. 7 BLOCK WATER'. . CERTIFICATE: REQUIRED RECEIVED TRACT U S MAP HIGHWAY, LLLJ Q ,L NO.OF SLOGS, r NO. ICIRCLEI STATE MAJOR SECON LOCAL' SIZE OF LOT /D. T 7 NOW ON LOT 1 USE ZONE SPECIAL'' USE OF }� CONDITIONS EXISTING BLDG. `J OWNER TEL.C V - Q.n.ry�NO. Zb s BUILDING ­EXIST.. SETBACK YARD . WY STREET NAME WIDTH ADDRESS R ^ W Gr+� FRONT ARCHITECT OR _ TEL. P. L. .' ENGINEER NO. SIRE ADDRESS TEL. to f ,�• �♦ � ) 4 'fi;�t 1]i;fir? ,I1I+'I.:/h't :'9, .'•:4G..� f{:eL'' •�.e�i�".:Z�i �='.0 CONTRACTOR NO. �' .! - t ' +may yj t {`,fir ADDRESS ( I 1 t ✓Jff' '�{ /ri�,b' /u, DESCRIPTION OF WORK 1, _ �. Lam- • + LL NEW ADD ALTER REPAIR DEMOLISH SQ.FT. NO.-OF ( NO.OF J a SIZE �/ STORIE �+ S FAMILIES USE OF O STRUCTURE SIGNATURE OF .✓ r .�/Ir�� APPLICANT VALUATION APPROVALS (y )DATE INSPECTORS SIGNATURE P.C. PMT. S` FOUNDATION: LOCATI N f' FEE $ ♦ FEE.$ FORMS, MATERIALS ;t$ f_.a•^_.�;7�•"€ /d la FRAME: FIRE STOPS, �r� I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS .(� •n !/ '� ./.s.``� AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ' FURNACE: LOCATION. +4) ✓ �977 WITH ALL COUNTY, ORDINANCES-AND STATE LAWS REGULATING GAS-VENT.-DUCTS ,� d BUILDING CONSTRUCTION.;I CERTIFY THAT IN DOING THE WORK �j� AUTHORIZED HEREBY I-WILL NOT. EMPLOY ANY PERSON IN VIOLA- TION OF THE LABOR CODE OF-TWsTATE OF CALIFORNIA RELAT- ' LATH, INT. p�',��f„,n° y N`-•:�.+I, *%p ° ING TO WORKMEN'S COMPENSATION,INSURANCE. S` l f •>✓� LATH,EXT. !/ /� '. ♦. SIGNATURE OF I HOUSE NUMBER COR - PERMITTEE� RECT AND POSTED i ADDRESS1 92 �ID ify�. J�r �• �,'� FINALt t, fftsl°rs'}` lJr JOHN F. LEWIS, PRINCIPAL ST RAL ENGINEER Y PLAN CHECK VALIDATION cK. M.0. CASH PERMIT VALIDATION KK. M.P. CASH UAC 2'7 7 4 A R 1 2 3. D6.7'5 ,.f ,o3342w APR 15 . 1D 53.50, AP PL I CATION FOR COUNTY OF LOS ANGELES � •; DEPARTMENT-OF COUNTY ENGINEER BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS / [ 4 ��-/ S�OE BUILDING _ ADDRESS /7L /(.t- LOCALITY NEAREST CITY ��•; %I, ' / ZIP CROSS ST. LL 'F NO.OF BLDGS: ASSESSOR 'SIZE OF LOT 791 •_ NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE. FIRE OCESSEC) BY TRACT BLOCK LOT NO. CST = ZONE OWNER (Jf�// "� '' TOL STATISTICAL CLASSIFICATION' SEWER MAP .. ADDRESS j ♦ = CLASS NO.2;j DWELL.UNITS BKAf PCCQ CITY ZIP 'USE ZONE MAPt NO. 'ARCHITECT OR TEL. 1 SPECIAL ENGINEER NO. CONDITIONS ADDRESS ROAD DEPARTM,ENT.APPROVAL REQUIRED YES❑ ':NO❑ CONTRACTOR NEOL� BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS 8 �6T NO. �� HIGHWAY {• YARD TOTAL SETBACK FROM TYPE.OF EXISTING LIC. FRONT PROP. LINE HIGHWAY WIDTH CITYnn�-ImzcCLASS /3/ _ r _ CONSTRUCTION LENDER , + NAME AND BRANCH th Ar. a BLDG.SETBACK FROM ADDRESSCITY SIDE PROP.LINE OF (STREET)e'r SQ• FT p NO. OF NO. OF / CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF. EXISTING SIZES STORIES / FAMILIES '/ ONE SIDE PROP. LINE HIGHWAY 'WIDTH DESCRIPTION OF WORK NEW ❑ + CA i1 ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z /T ALTER ❑ . IN OPEN SPACE YES ❑- NO E]REPAIRREPAIR[:] USE OO NG BLDG.. DEMOL ❑ IN COASTAL PERMIT ZONE YES ❑ 'NO-❑ �C�/DC.ricr 'APPLICANT TEL �/// ij r• t. - , (PRINT) E BY (SIGNATURE) f Ag LANDAREBY ACKNOWLEDGE THAT I HAVE READ S APPLICATION ATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY ALL ORDINANCES AND LAWS REGULATING BUILDING CON- ION. I CERTIFY -THAT IN DOING THE WORK AUTHORIZED - 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THECODE OF THE STATE OF CALIFORNIA IN RELATING.TOEN'S COMPENSATION INSURANCE. 7�• FINAL '% ��/� BYURE OF TEE DATE&01 110VO-001— SSTEL. © - p,C:FeePermit Fee NO. Issuance Fee TIbN 67670. Total Fee c��'• s� ;:PLAN CHECK VALIDATION - ck M.'O. CASH PERMIT VALIDATION CK. M.O. CASH c , ? .11�1l+ 5 3.5 5 eye 76AGSO C6"#605EI 12/7S - - _,S. WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self I APPLICATION.- FO or a certified cop thereof(Sec. 3800, Lab. C.) R ,.BUILDING PERMIT lul insure, or a certificate of Workers'Compensation Insurance, .• 3C81732 �rloyal' Indemnity Policy No. COUNTY OF LOS ANGELES BUILDING AND SAFETY ' mpany BUILDING FOR APPLICANT TO FILL IN Certified copy is hereby furnished. ADDRESS 10410 Olive Street Certified copy is filed with the county building inspec- `' BUILDING tion department. I ADDRESS 10410, Olive Street LOCALITY Temple City Date 4-28-87 Applic n I cITY Temple City ZIP 91780 >CNRosssr. fr♦ } CERTIFICATE OF EXEMPTION FROM WORKER NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT 1 MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one '' s USE NE MAP hundred dollars.($100)or less.) TRACT BLOCK LOT NO. / NO. Walker Parmenter TEL' , SPECIAL > I certify that in the performance of the work for which this I OWNER NO. CONDITIONS 13. permit is issued, (shall not employ any person in any manner DISTRICT G UP TYPE FIRE PROC ED BY 0 ADDRESS same " CONST. ZONE so as to become subject to the Workers'Compensation Laws. I `o 3 � � Im r ✓ v Date Applicant CIN ZIP STATISTICAL CLASSIFICATION AFT.. CO d NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. U 'Exemption, you should become subject to the Workers' j' ENGINEER NO. CLASS NO. DWELL.UNITS Compensation provisions of the-Labor Code, you must forth- I ADDRESS SEWER MAP, with comply with such provisions or this permit shall be I 5E deemed revoked. CONTRACTORWestern Sierra TEL BK. PG,23 VALIDATION LICENSED'CONTRACTORS DECLARATION I hereby.offirm that I am licensed under provisions of Chapter 9 I ADDRESS 450 Apollo Stre(& #D '1•{•925 . VALUATION. (commencing with Section 7000)of Division 3 of the Business and 1 Brea L,a. LIC. Professions Code,.and my license is-in full force and effect. CITY s CLASS C-39 ' $ 5,364.00 49'2599 c-39 NO.OF NO. CHECK ► License Number Lic.Class p p I SIZE . STORIES FAMILIES ONE Western SieY'r �i-28-87 DESCRIPTION OFWORKerOOf- Sierra NEW 0: $ Contractor to I am exempt under Sec. tile over Shake 29. sqs ADD 1 ICBO O ALTER FINAL B.BP.C.'for this reason I REPAIR I DATE Date: USE OF residence DEMOL FI EXISTING BLDG. O„ r Signature APPLICANT TEL. OWNER-BUILDER-DECLARATION i PRINT NO.. 9 6 9 a J5 A I hereby affirm that I am exempt from the Contractor's License #;o,0 0 0 0-1 Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): TRESENT J o 0 8 Z 3 8 BUILDING 10410 olive Street I, as owner of the property, or my employees with ADDRESS _ wages as their sole compensation,will do the work-and Temple City o 0 0 8 7.3 8 c5 the structure is not intended or offered for sale Section LOCALITY i 7044, Business and Professions Code). (• MOVING TEL. + O O 7'i$7 I,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- 1 ADDRESS 'tion 7044, Business and Professions Code). j ' REQUIRED TOTAL SETBACK FROM' EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD• HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for i FRONT ' the performance of the work for which this permit is issued I P.L. Sec. 3097, Civ. C.). i SIDE P.L. o Lender's Name P.C.Fee$ Permit Fee Lender's Address xI certify that I have read this application and state that the. Issuance Fee ' a above information is correct. I agree to comply with.all County Investigation Fee } ordinances and State laws relating to building construction, Total Fee and hereby,authorize representatives of this County to enter upon tho above-mentioned property for inspection.purposes. o927 7) : ' SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of ApC or Agent' Date ®s