Loading...
HomeMy Public PortalAbout10539 OLIVE ST_Building__ 76A838A CE#803 8-83 APPLICATION FOR BUILDING PER-MIT LJ COUNTY OF LOS ANGELES° BUILDING s/ O ,S'�3 9' 0/� DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALITY 1—M-le- r _ C� JOHN A. LAMBIE, COUNTY ENGINEER NEAREST / JI/Jg7 . WILLIAM A.JENSEN, SUPT OF BUiLDiNG CROSS ST. DISTRICT NO. I GROUP I TYPE PROCESSED BY FOR APPLICANT TO FILL IN 457,0 9 7 CONST. BUILDINGp STATISTICAL CLASSIFICATION SEWER MAP ADDRESS ��� / ©li V e CLASS.NO. ZDWELL.UNITS #41k P;� LOT NO. BLOCKWATER NOT REQUIRED.inj RECEIVED ❑ 7010 �/p/y CERTIFICATE: TRACT /h!V MAP NO. Z o O (IGHWA NO.OF SLOGS. STATE MAJOR SECOND,LOCAL SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF / CONDITIONS EXISTING BLDG. nn ,,__// a r/G4A;ct� OWNER i /7• !�E/[l TEL I� �/ NOG7� ![✓ BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS f,� FRROL T oo/ /S/ /_O/ ARCHITECT OR TEL. C/ �O ENGINEER NO. SIDE ADDRESS yO CONTRACTOR L/� J 1' NO, O 3I7 4� U ADDRESS f, Z olR , L' a DESCRIPTION OF WORK J1N W NEW ADD ALTER REPAIR DEMOLISH ` H . l Z SQ.FT. NO.OF NO. OF SIZE vO STORIES FAMILIES --[USE OF STRUCTURE pLw C i SIGNATURE OF � �b APPLICANT VALUATION $ )g�' APPROVALS DATE Ll PECTOR'S SIGNATURE PC FOUNDATION: LOCATION FEE $ h13 FEE $ FORMS, MATERIALS FRAME: FIRE STOPS, �/ /I A I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS n AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. 0� WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS •BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMMPPENSATION INSURANCE. LATH,EXT. SIGNATURE OF HOUSE NUMBER COR. PERMITTEE ,/ RECT AND POSTED _ ADDRESS .7 2 FINAL i JOHN F. LEWIS. PRINCIPAL ST / AL ENGINEER PLAN CHECK VALIDATION. CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH. Li-WFAP-' 0-0 o s �� 15 1 0 11.50- foe'. 1.50-f®c'. APPLICATION FOR "�3�lILDING PERMIT � COUNTY-617 LOS ANGELES I BUILDING AND SAFETY ^� WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN Sol BUJLDING ADDRE S ///�� BUILDING ADD E ! �'w �. IL�.J J ` LCA I hereby affirm that I have a certificate of consent to self insure, DG ./ j or a cert�ate of Workers'Compensation Insurance,or a certified CITY V , ti copy thereof(Sec.3800,Lab.C.) Policy No. Company Y ��� /- LOCAiLITYr/ SIZE OF LOT NO.OF BLD S.NOW ON LOT ❑ Certified copy is hereby furnished. 174 X t NEAREST CROSS S.T. Lsf ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. l department. USE ZONE MAP N0 Date Applicant t ASSESSOR MAP 9OK PAGE PARCEL A / SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL N RCOMPENSATION INSURANCE D 114 '� WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS ^�� T`7"A _ZCt dollars•($100)or less.) ,i ' / DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY ZIP I certify that.in the performance of the work for which this permit ���� !,�4f is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. m�� J become subject to the Workers'Compensation Laws. STATISTICAL CLASS FICATION APT +CONDO Date Applicant ADDRESS CLASS NU DWELL UNITS ' NOTICE TO APPLICANT.• If, after making this Certificate of REQUIRED' TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' ONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith0� FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE r`t•!•i ° t�1 CRY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 \ SEWER MAP -= " C. (commencing with Section 7000)of Division 3 of the Business and `\_� SO.Fr.SIZE NO.OF STORIES NO.OF FAMILIES _ _ Professions Code,and my license is in full force and effect. Y NEW ❑ BK PG p1r�` 1 t;;`..,�'3� � v License Number Lia.Class DESCRIPTION OF WORK ADD W ,VVALUATION ® I j�� a ', - a ''--9 C Contractor Date ALTER ❑ '7 w T.'1` 4.-7•u� ❑ IC161AI 66--,Al I am exempt under Sec. IREPAIR $ ;_ i s;Yt BAP.C.for this reason k �' EMOL ❑ LDMA P/C Date: USE OF EXISTING BLDG. /` URM ❑ Q jFJ ) -/Signature APP ICA (FT) T L NO. /�2 LDMA Perm '. 1-!-.� :f° 17_N' V - �C1.7.�'r 1 I'•lI�•lyd!.7 I,.as owner of the property, or my employees with wages as O `I1 their sole compensation, will do the work and•the structure is ADDRESS / ��/ �t not intended or offered for sale (Section 7044, Business and �� [/� `T"r �q-o p FINAL DATE a �; _; Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL I ^� �{ }- - OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE j•I�1 HL. 82 ,r c 2' 7 ❑ I, as owner of the property, am exclusively contracting 44, AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY O' ' licensed contractors to construct the project (Section 7044, CHECK + ' YES❑ NO Business and Professions Code.) 11JI A I/ WILL THE INTENDED USE'OP THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING CHANGE OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH �! trH 1NGE a I jI CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES , I hereby affirm that there is a construction lending agency for 'YES❑ NO❑ N the performance of the work for which this permit is issued(Sec. ll�nj—[ICIr: