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Home My Public Portal About10643 OLIVE ST_Building__ :IEF)P I_.I CATION FOR COUNTY OF LOS ANGELES OF COUNTY ;• b ING PERMIT DEPARTMENT BUILD NG AND SAFETY DIV SINN -t U ILR ` FOR APPLICANT TO FILL IN ADIDRESS BUILDING / ADDRESS 3 0i_-A)-e_ 2% LOCALITY NEAREST CITY ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIREESSED BY TRACT26& BLOCK LOT NO. CONST. ZONE TEL. OWNER NO. STATISTICAL CLASSIFICATION SEN P ADDRESS � CLASS NO.=x4__DWELL.UNITS ft-7 CITY ZIP' TO US NE NAP• ARCHITECT R TEL. SPECIAL ENGINEER NO. CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ TEL. CONTRACTOR ((/(Vrc NO. BLDG.SETBACK FROM LIC. FRONT PROP.LINE OF (STREET) ADDRESS '- NO. HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP.LINE HIGHWAY WIDTH CITY CLASS _ CONSTRUCTION LENDER '' - + r NAME AND BRANCH C 0 BLDG.SETBACK FROM ADDRESS' CITY ` IL SIDE PROP.LINE OF (STREET) 0 SQ.FT. NO.OF NO. CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING SIZE L STORIES FAMILIES ONE SIDE PROP.LINE HIGHWAY WIDTH O DESCRIPTION OF WORK EM rA)L NEW + U ADD ❑ CORNERCUTOFF YES ❑ NO ❑ a ALTER ❑ REPAIR ❑ IN OPEN SPACE YES ❑ NO ❑ Z USEOF BLDG. DEMOL ❑ IN COASTAL PERMIT ZONE YES C] NOEXI ❑ APPLICANT TEL (PRINT) No. .> 1 r d /9j-jp OAJ re--A'Z_C_.,'-T.'•%,S-e BY(SIGNATURE) I HEREBY ACKNOVRECT GE THAT I HAVE READ THI APPLICATION AND STATE THAT THE ABOVE IS AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATIILDING CONSTRUCTION.1 CERTIFY THAT IN DOING THE _ WORK AUTHORIZED HEREBY I WILL NOT-EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. SIGNATUREOn �Qk� FINAL /---77 BY PERMITTEEDATE .r ADDRESS ' TEL. P P.C.Fee$ Permit Fee CITY ~� NO. •� 1 7-- - ' • • Issuance Fed ' VALUATION� �D •• Total Fee PLAN CHECK VALIDATION• CK, M.O. CASH _ PERMIT VALIDATION, �\•CK. M.O.• 'CASH ;- ;. 2 g03^iAY D 14 2.0 D e 76AG38A CE/803A 6/76 ' r-41 QJ ✓' 76A688ACE#SA-64 APPLICATION FOR BUILDI G PERMI COUNTY OF LOS ANGELES BUILDING ` DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION i LOCALITY JOHN A. LAMBIE'. COUNTY ENGINEER NEAREST �' COLEMAN W. JENKINS.SUP'T OF BUILDING CROSS ST. . ' 6 DISTJLLCT NTYPE. PR FOR APPLICANT TO FILL IN x 0 O GR CONST. Ct BUILDING /l/ STATISTICALXC�L rFICATION SEWER MAP ADDRESS CLASS NO.�DWELL UNITS BK PG LOT NO./p, �` BLOCK USE ZONE MAP �}/� 0/1 NO. LSC I/ TRACT SPECIAL N0. OF BLDGS. CONDITIONS SIZE OF LOT / NOW ON LOT USE OF IS G BLDG. SETBACK FROM TEL. FRONT PROP. LINE OF (STREET) OWNE O. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADORES - HIGHWAY 'F M C.L. CITY + �= BLDG. S BACK FROM ARCHITECT OR TEL SIDE PROP. LINE OF (STREET) ENGINEER NO. TYPE OF— EXISTING SETBACK HIGHWAY + YARD = TOTAL } ADDRESS HIGHWAY WIDTH FROM C.L. d CONTRACTOR NOL + u LIC ADDRESS NO CORNER CUTOFF YES NO 0 V CITY cic SEE REVERSE SIDE FOR SPECIAL APPROVALS W DESCRIPTION OF WORK5Q� D- 2-1 fo -(o S4?ar- ba G V 6 Q L V I'2. ' Z NEW ADD ALTER REPAIR -'DEMOLISH SF FT. NO. OF NO. OF `J Y l. AS s�(oui A) 6 Aj ?4 SIZE D STORIES FAMILIES �I C1Y 4 t USE OF T/ Ii7. n4.42• R,�ntx mi-A r.. _D e-I . ext:.ca b STRUCTURE I '� [�� Ta 'fin<t r� �e�:t� n_f<n.e Co.Ci:..c..•s G , F SIGNATURE OF 4-rk-Cpj . M6 09S_ `nOKt APPLICANT , r VALUATION r _ LL -rOe l�`aP, _- `� -APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMTFOUNDATION, LOCATION FEE$ FEE$ C '� `� FORMS, MATERIALS e.te1.;:31d', !Fc?A.b FRAME, FIRE STOPS, (J I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT 1i AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION gg WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS SUILDINO CONSTRUCTION. 1 CERTIFY THAT. IN DOING THE WORK ./k/ r V AUTHORIZED HEREBY I WILL NOT EMPLOYANY PERSON IN VIOLA- LATH. INT. _ ,� I � jy V j' TION OF THE LABOR CODE OFA'lNj TATE OF CALIFORNIA RELAT- E INC TO WORKMEN'S COUPS RANGE. LATH. EXT. PERMITTEE O , HOUSE T ANDEPOSTED ADDRESS FINAL ( 1 U JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGI R PLAN CHECK VALIDATION CK. M.G. CASH _ PERMIT VALIDATION CK. M.O. CASH L:1l,;J 8 5 7 4 FFS 15 1 D 6.00- L' 76A63BA CE 41803 1/71 ., !//1 APPLICATION F A?6(1�D......1��-N"`��G �PE�AIT F ' COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDINGr-W If ADDRESS ` COLEMAN W. JENKINS, SUPT OF BUILDING LOCALITY FOR APPLICANT TO FILL IN NEAREST Print or tvoe only) CROSS ST. BUILDING DISTaLQT NO. GROUP TYPE PROC SED BY ADDRESS �` 0.0 CONST _ STATISTICAL -CLASSIFICATION SEWER-MAP LOT NO. BLOCK CLASS NO. DWELL.UNITS BK PG TRACT SE O E MAP NO.OF BLDGS. NO. SIZE OF LOT NOW ON LOT C= SPECIAL USE OF CONDITIONS EXISTING BLDG. TEL. OWNER NO. BLDG.SETBACK FROM ADDRESS ` FRONT PROP.LINE OF (STREET) A TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CIT ..ti HIGHWAY WIDTH FROM C.L. ARCHITECT O TEL. + � =2_61 ENGINEER NO. BLDG.SETBACK FROM ADDRESS SIDE PROP.LINE OF (STREET) TEL. TYPE OF EXISTING SETBACKHIGHWAY + YARD = TOTAL d CONTRACTOR NO, HIGHWAY WIDTH FROM C.L. C C: ADDRESS NL 0.t C LIC. H CITY CLASS CORNER CUTOFF YES ❑ NO y� CONSTRUCTION LENDER v NAME AND BRANCH SEE REVERSE SIDE FOR SPECI PP VALS ? ADDRESS7z- SQ. FT.j �y NO. OF NO. OF NEW ❑ SIZE �J(J STORIES OF USE OF STRUCTURE ;e) ADLTER ❑ SIGNATURE OF REPAIR❑' APPLICANT DEMOL ❑ VALUATION S �� APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEES FEES Op FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION INSURAN E. LATH, EXT, SIGNATURE F A HOUSE NUMBER COR- PERMITTEE-la2c RECT AND POSTED ADDRESS AL JOHN F. LEWIS. PRI CIPAL T C U_ AL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH LICo 4 5 2'()"' FEB 2 3 1 D 9. N Q i APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI G 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 CITY O ZIP copy thereof(Sec.3800,Lab.C.) 910 LOCALITY Policy No. Company SIZE 09 LO N .OF BLDGS.NOW OOT —G • ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK L NO USE ZONE MAP NO. department. Date Applicant ASSES R O ®E PARCEL v 0015— 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 DISTRICT GROUP TYPE CONST FIRE ZONE PROCE§FEIZBY dollars($100)or less.) 1064R. CLWeAl CITY Z I certify that in the performance of the work for which this permit Q l V is issued, I shall not employ any person in any manner so as to ARCHIT O N EER TEL N become subject to the Workers'Compensation Laws. STATISTICAL CLA IFICATION APT CONDO Date \ Applicant 1' ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of ,1 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 i' FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing.with Section 7000)of Division 3 of the Business and SQ.FT 9ZE NO,OF STORIES NO,OF FAMILIES ACC g O Professions Code,and my license is in full force and effebt. NEW ❑ BK PG t-� tt �- License Number LiC.Class I, DESCRIPTION OF WORK- ADD ❑ VALUATION , 3303 135.30 Q Contractor Date �'• ALTER AP $ —D !'ITEMScc U ❑ I am exempt under Sec. ,q_-.<t-61—r OJ REPAIR` El $ TOTAL AL :135 m 30 p B.BP.C.for this reason 1 DEMOL ❑ TDMA P/C s CHECK �'`5.30 8 LU Date: USE OF EXISTINGIBLDG. URM ❑ CHANGE .000- Signature 00 0- Signature APPLICA NT TEL NO. LDMA Perm Z as owner of the property, or my employees with wages as ZO e their sole compensation, will do the work and the structure is ADDRES 0000-0001 7/1.0/95 not intended or offered for sale (Section 7044, Business and 0 (W 7 FINAL DATE a ,,��c 1 AM V Professions Code. n` FJ ��-- WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL F J OR A MIXTURE CONDONING 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 BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE.SOUTH 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❑ CM the performance Of the work for Which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING C4 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 MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. v Lender's Address 0 Mw W OR AGEW c I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE / N with all coun finances and State laws relating to building [OOR. g construct' and reby authori representatives of this County ISSUANCE FEE .ry,�•3O m to en on t b ,TOenytyl roperty for insp pio�urpe8 �/ INVESTIGATION FEE tom TOTAL FEE ?D ,oa ,t Agent {.7 SEE REVERSE FOR EXPLANATORY LANGUAGE . j�WORKERS' COMPENSATION DECLARATION ` I'hereby affirm f I have certificate of consent to self A P f.I CATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRI ElESS Or/o� ❑ Certified copy is filed with the county building inspec- BUILDING .Dto w tion department. DRESS DateApplicant CITY a ZIP LOCALITY O. OF BLDG . NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 7'Z. NOW ON LOT 'zCROSS 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. USE ZONE MAP J�y L/ q73 OWNER I NO. NO. / / / o� I certify that in the performance of the work for which this /1 permit is issued, I shall not employ any person in any manner ADDRESS �(/�•� SPECIAL a so as to become subject to the Workers'Compensation Laws. /� CONDITIONS O CITY ZIP / P V Date Applicant ARCHITECT OR TEL. 0 NOTICE TO APPLICANT: If, after making this.Certificate of ENGINEER NO. DIS7RICi GROUP TYPE FIRE PROCESSED BY Q CONST ZONE 0 Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS 3 —4 a with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR 1.10L VOL NO. n — LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK.ff PG.y VALIDATION SQ. FT NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES ' FAMILIES ONE VALUA71ON [� ContractorDate DESCRIPTION OF WORK o NEW ❑ $ - q JJ , ElI am exempt under Sec. ADD /� ALTER Ll B.&P.C. for this reason REPAIR ❑ $ Date: USE OF ; EXISTING BLDG. DEMOL ❑ SignatureAPPLICANT TEL FINAL OWNER-BUILDER DECLARATION (PRINT) L. I hereby affirm that I am exempt from the Contractor's License / DATE Law for the following reason (Section 7031.5, Business and ADDRESS 06 FINAL Professions Code): PRESENT By C[t�� BUILDINGS( :F I, as owner of the property, or my employees with ADDRESS ` wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY ® +=•„I!} 7044, Business and Professions Code.) MOVING TEL. ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code.) ADDRESS r 11 `•:;,; REQUIRED TOTAL SETBACK FROM EXIST. t ti, �l t ,;• CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT i E Cl the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE �. P.L. !t:;A� •'�_e 3 a ��•*`-;:. Lender's Name 'NECK: d LDMA Ref. # P. Fee$ 7 PZZ, ermit Fee - LI.-- Lender's Address '/ �J i•�iHlitii= I certify that I have read this application and state that the Issuance Fee 2 • ` LDMA P/C# above information is correct.I agree to comply with all County Investigation Fee 5 ordinances and State laws relating to building construction, Total Fee 0�• LDMA Perm. It IwIJ#J>_!—IJI;(J1 ;-f and hereby a thorize represe tatives of this County to enter - ° upon a or' pre petty for'inspection pu po `i� = r - g 7 SEE REVERSE FOR EXPLANATORY LANGUAGE 'ITgnature of App i o Agen Date