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Home My Public Portal About10412 OLIVE ST_Building__ 76AG38A CF#B03 6-6P APPLICATION FOR BUILDING PEl.aRMIT COUNTY OF LOS ANGELES BUILDING. DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTRICT_NQ G P • TYPE P $ Y FOR APPLICANT TO FILL IN (//)CJy .co T. BUILDING t`��D STATISTICAL CLASSFICATION S. MAP ADDRESS D 7 _ K CLASS.NO. DWELL.UNITS LOT NO. 4f 7 BLOCK WATER r _ CERTIFICATE• NOT REQUIRED RECEIVED ' TRACT (� S f^ MAP NO.OF BLDGS. _NO. (CIRCLEHIGHWAY), STATE MAJOR SECOND LOCAL �. SIZE OF LOT Q /2 NOW ON LOT -USE_ZONE SPECIAL: / USEOF CONDITIONS EXISTING BLDG. TEL.5.0 OWNER-I& NO. yd.J''_fZ BUILDING YARD Y STREET NAME EXIST. SETBACK WIDTH ADDRESS y177 P A^,C ~ /N. FRONT -� ARCHITECT OR TEL. P. L. D ENGINEER NO. SIDE P: L. 4 A > ADDRESS - - 'n CONTRACTOR Qo TE -1-PR ✓ lSx�] �IV - C ADDRESS y A�' y iris _ t✓ DESCRIPTION OF WORK ' •°'stt� .ray . ' t� l� z '�'1 F • .. �'` NEW ADD ALTER REPAIR. DEMOLISH SO.FT. / NO.OF. NO.OF .s- !'f J:#--z SIZE / ~� STORIES 'I FAMILIES f+ �',yf USE OF ^ /� *�I �7i: >✓G! di e• .o'?�" P%"�:�'� s�V�? . STRUCTURE FJ /� ` ` (' rrd �c+ SIGNATURE OF �f APPLICANT VALUATION$ /3 I &D APPROVALS QATIF INSPECTOR'S SIGN tglI E FOUNDATION: LOCATION FEE $ FEE $ FORMS, MATERIALS . FRAME: FIRE STOPS, ` 1 HEREBY ACKNOWLEDGE.THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS" AND STATE THAT THE ABOVE IS .CORRECT AND AGREE-TO COMPLY FURNACE: LOCATION. ^,}I WITH ALL COUNTY ORDINANCES AND.STATE LAWS REGULATING GAS VENT, DUCTSvi BUILDING CONSTRUCTION. 1 CERTIFY THAT"IN DOING THE WORK `j � AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- TION i•✓! / TION OF THE LABOR CODE OF THE'STATE OF CALIFORNIA RELAT. LATH..INT. //. ING TO WORKMEN'S C MPENSATION INSURANG LATH,EXT. w> q� p�-y• r/� SIGNATURE O HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS 94,7 d _ FfNAL. -I y JOHN F. LEWIS, PRINCIPAL STID.K 'URAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDATION M.O. CASH. LiZo 277 "1 APER. 1 23 D 26.75 l.�.[,o 3 3 4 3 G. APR'15 � � . 5.3.50- n'' WORKERS' COMPENSATION DECLARATION rebo affirm that I have certificate of consent to Self APPLICATION FOR BUILDING PERMIT • •insjrg or a certificate of Workers'Compensation Insurance, • ur-Q•certifia'd copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company '1 BUILDING i ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING '� 1•Z �t,1ly� ST. tion department. ADDRESS l •y Date Applicant CITY 1 VA PLL C zip �/4itO LOCALITY ,t NO.OF BLDG5. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT Crib *7"f•S NOW ON LOT CROSS ST, 901 . 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.) OWNER �EV{Gl via TEL'NO, 448'7193 USE ZONE MAP r �ry 1 certify that in the performance of the work for which this NC* [ 7 ` J permit is issued, I shall not employ any person in any manner ADDRESS 10 4 Z OL%V a SPECIALCL so as to become subject to the rs' mpensation cos. T `� C ' / CONDITIONS O CITY l �-+^� 1 ZIP 7 �Date�Appl ican ARCHITECT OR L, M NOTICE TO APPLICANT: If, after mak e o ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you, should become lett to the Workers' O� - CONST. ZONE Compensation'provisions of the Labor Code, you must forth- ADDRESS 3 a with-comply with such proYtsions or this permit shall be z TEL. STATISTICAL CLASSIFICATION APT.- CONDO. Z deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION %orLIC. CLASS NOzS2 DWELL. UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER • (commencing with Section 7000)of Division 3 of the Business , and Professions Code,and my license is in full force and effect. CITY LIC.CLASS BK. PPG. . 3 VALIDATION SQ. FT. �+" NO. OF N_0.0 F CHECK License Number tic. Class SIZE '7' STORI IFAMILIES -ONE DESCRIPTION OF WORK, �� NEW EJ VALUATION Contractor Date n-� � AA b L� $ OAA• T4i� ADD• X4 ❑I am exempt under Sec. , �k % , y�•L�� ALTER , B.BP.C. for this reason AA7kJw %ha � $ Date: USE OF EXISTING BLDG. SA-4 DEMOL Signature ' APPLICANT 1�e A TEL, g OWNER-BUILDER DECLARATION (PRINT) &VaIIbR/4''ik}1•I O. 4 '7 FINAL �� I hereby affirm that I am exempt from the Contractor's License ADDRESS .0 Z V�+ S I • ' Law for the following reason (Section 7031.5, Business and FINAL 9 r fessions Code): PRESENT 1 BY• I, as owner of the property, or my employees with ADDRIIII �� 1 � OLl V E S7"' A Tns wages as their sole compensation,will do the work and -C the structure is not intended or offered for sale(Section LOCALITY , 3M7 171.75 7044, Business and Professions Code.) MOVING TEL. ITEMS ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. vw1 ^� with licensed contractors to construct the project (Sec- ADDRESS TOTAL 17 1. ar 5 tion.7044, Business and Professions Code.) �+t�t�•/+��/ REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. CHECK 1710 f CONSTRUCTION LENDING AGENCY SEi BACK PROP. LINE WIDTH uA�� I hereby affirm that there is a construction lending agency•for FRONT Cf7AKE .00 the performance-of the work for which this permit is issued P•L• (Sec. 3097, Civ. C.). SIDE. P.L. Lender's Name Q� -�Q1 ��u $ '1 LDMA Ref:# P.C. Fee$ Permit Fee �Spo � Lender's Address �tlrt72 1, AN v•177 0 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# o above information is correct.I agree to comply with all County Irivestigation Fee i ordinances and State laws relating to building construction, Total Fee 17 •7 LDMA Perm. It and herebyi uthorize representatives of this County to enter t on t a e-mention�d property for inspection ur ose . `1 SEE REVERSE FOR EXPLANATORY LANGUAGE Sig .lure pplieant or Agent ate