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Home My Public Portal About9160 OLIVE ST_Building__ -TEMPLE -PITY' . ►iA68eA CB#669.1-61 APPLICATION FOR BUILDING .PERMIT COUNTY OF LOS ANGELES BUILDING ' DEPARTMENT OF'COUNTY ENGI NM ADDRESS el BUILDING AND SAFETY DIdISION LOCAL JOHN A. LAMBIE. COUNTY ENC#INEER NEAREST ~ WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUP TYPE PR ESSED BY FOR APPLICANT TO FILL IN coNsr. BUILDING q, STATISTICAL CLASSIFICATION SEWER MAP - ADDRESS /MBK PG W q,0 -17- .10� o�d4• �N+�e T y0 CLASS.NO.�DWELL.UNIT LOT NO: LOCK - WATER 'NOT.REQUIRED RECEIVED G� CERTIFICATE: TRACT /G MAP HIGHWAY' NO.OF BLEIGS. NO ccIRCLEI STATE MAJOR SECOND, LOCAL SIZE-OF LOT. yJr 8 I NOW ON LOT USE ZONE SPECIAL USE OF p CONDITIONS EXISTING BLDG. OWNER h4P4VP sti 0 / df-jbptNO. BUILDING EXIST. r /�` • SETBACK YARD HWY STREET NAME WIDTH ADDRESS �'I6d " e /i/ie_- FRONT ARCHITECT OR TEL. P.L. ENGINEER NO. SIDE ADDRESS �mfTELINSPECTION RECORD• 0 - . �`' CONTRACTOR thl.�. �J �rg wle NO.. /F—y5p u ADDRESS. f/d .4 AS '/ts as K DESCRIPTION OF- WORK . G W NEW D LTE REPAIR DEMOLISH h SQFT.. q,, NO.OF NO.OF ,S 6 STORIES FAMILIES USE OF STRUCTURE x'1 / ow 's 1. /SSS SIGNATURE OF APPLICANT VALUATIO APPROVALS DATE INSPECTOR'S SIGNATURE FOUNDA'T'ION:LOCATION f F E $ - FEE $ • FORMS,MATERIALS FRAME:FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLTS `te l V.tri J1 .0�. 4��° A AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE:LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING 'GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH,INT. ' TION OF THE LABOR-CODE.OF THE STATE OF CALIFORNIA RELAT. , ING TO WORKMEN'S COM E TION INSURAN LATH,EXT. - e SIGNATURE OF 'HOUSE NUMBER COR- PERMITTE -RECT AND POSTED -e ' ADDRESS FINAL a.! In/ C`>�_t'.t�.--- _ • CLYDE N. DIRLAM, PRINCIPAL STRycre�RAL ENGINEER' PLAN CHECK VALIDATION cr. M.o. cAsR PERMIT VALIDATION CK.J•M.O. CASH LACo0-2 9 4 JUL 21 1 D 3.00 K I � C::>L IOA600A CE#003-9-60 APPLICATION FO I3LJILDI.I\IG PERMIT COUNTY OF LOS ANGELES BUILDING ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LOCALI JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST- DISTRICT NO. GROUP I TYPEPR ESSED BY FOR APPLICANT TO FILL IN ,Q 2 77 CONST. BUILDING • STATISTICAL CLASSIFICATION SEWER MAP ADDRESS 6� / CLASS.NO.- —DWELL.UNITS s�_I Rt LOT NO. -24f Imp-, fL BLOCK MAP /� STATE YES NO NUMBERm.0 o HWY. TRACT Zk 94 USE ZONE SPECIAL NO.OF BLDGS. r CONDITIONS SIZE OF LOT L)L/-X LTP] I NOW ON LOT USE OF EXISTING BLDG. s�r BUILDING YARD HWY STREET NAME EXIST. TEL. SETBACK WIDTH OWNER&W�-�"� t(dt/SO'7L NO. FRROLNT ADDRESS /JGR D dr 40/1 SA SIDE ARCHITECT OR TEL. P.L. ENGINEER NO. INSPECTION RECORD ADDRESS TEL. CONTRACTOR :KO• .- t ADDRESS§t/, 47 4ZIU' 2t=C Ar a � o DESCRIPTION OF WORK G NEWADD ALTER REPAIR DEMOLISH a' h Z SC.FT. G NO.OF NO.OF STORIES FAMILIES USE OF STRUCTURE BP jor SIGNA'T`URE.917 VALUATI O I APPROVALS DATE INSPECTOR`$ SIGNATURE P C PMTO-� FOUNDATION: LOCATION FEE $ FEE FORMS.MATERIALS r FRAME:FIRE STOPS, I 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 COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH,INT. ' EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT TO THE WORKMEN'S CO E ATION LAWS OF C RNIA. LATH,EXT. SIGNATURE O HOUSE NUMBER COR- SIGN TU RECT AND POSTED ADDRES FINAL �r/(li/' +�.1 Sn 1 A� CLYDE N. DIRLAM, PRINCIPAL STR RAL ENGINEER PLAN CK VALIDATION CK. M.O. CASH PERMIT VALIDATION cK. N.C. . CASH LACo B 4 4 2 m JGMd 12 1 D 5.0 0to APPLICATION FOR- BUILDING PERMIT . FOR APPLICANT-TO FILL IN: (Print or type on IV) BUI;L-DING 4/ O. % �` COUNTY OF LOS ANGELES [ADDRESS 7 DEPARTMENT OF COUNTY ENGINEER ITY�EM%LSE L'( ZIP . BUILDING AND SAFETY DIVISION + JNO.OF BLDGS. - BUILDING . t SIZE OF LOT/08 'x 9y NOW ON L / V✓ ADDRESS TRACT '7 BLOCK LOT N40y [y+,2L'OCALIT .. TEL. NEAREST~� OWNER + -/V E NO. T.5A16 CROSS ST..ASSESSOR " if �cjC� ADDRESS J6O E , '=- SE MAP BOOK PAGE PARCEL DISTRICTGROUP TYPE FIRE2,z, GESSED BY CITY /� `17y ZIP _ CONST. ZO EARCHITECT OR TEL, ENGINEER NO. . . _ STATISTICAL CLASSIFICATION SEWER AP ADDRESS' CLASS NO. DWELL•UNITS BK �'`PG' +`x-j S TEL. CONTRACTOR NO USE ZONE MAP � LIC. NO. O / ...A . ADDRESS. NO, S PE C I A L LIC. ti CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES[] NO❑ , CONSTRUCTION LENDER NAME AND-BRANCH BLDG.SrETBACK FROM FRONT IPROR.LINE OF (STREET) ADDRESS CITY HIGHWAY + YARD —_ {TOTAL SETBACK'FROM TYPE OF EXISTING SO• FT -- NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH SIZE 5 j-31 STORIES FAMILIES ONE ' } DESCRIPTION 'W OFOR' .yyr, NEW ❑ O BLDG.SETBAC ROM C.) x-3 _ ADD SIDE'PROP.LINE (STREET) lb:: ALTERCD ❑ TA SET K FROM TYPE OF EXISTING HIGHWAY + YARD = C� REPAIR[E] �'�) NE HIGHWAY WIDTH - W CL EXISTING BLDG. DEMOL ❑ } Z_ APPLICANT. M C�/�I¢�� TEL [jAf Jr CORNER CUTOFF YES ❑ NO (PRINT)AM IN-OPEN SPACE YES ❑ NO ❑ B-Y (SIGNATURE) IN COASTAL PERMIT ZONE_ ' YES ❑ NO ❑ VALUATION;$ /1/ S �5 ,or= I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND'AGREE TO COMPLY - �' •�.� WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- - - t� �1L�.� STRUCTION. I CERTIFY-THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE t LABOR CODE OF THE ST)1TE OF -CALIFORNIA IN RELATING TO i •: t, — Pz ...- ;WJE ��y�,:,,;-.F= WORKMEN'S COMPENSATION INSURANCE. SIGNATURE OF �r rti!"f! �{/f �I.-c.-►,Lr'~�'� PERMITTEE ADDRESSFINAL� ��yy�7i/Ei —7 � CITY � ��/ NO. DATE / ./r-�'•7/' BY. ��".J�"'`•` MAKE CHECKS PAYABLE TO: F E' FEE'$ HARVEY T. BRANDT, COUNTY ENGINEER jy E � PLAN'CHECK VALIDATION CK. M.O. CASH o PERMIT VALIDATION' .CK. M.O. CASH . JUN 26 •1.:D 0 ',&W 7GA638A CE*.803 574 (,• — "" WORKERS'COMPENSATION DECLARATION / Z I ,hereby affirm that I hove a certificate of consent to self I 'APPLICATION FOR- BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance,or "a certified copy thereof(Sec. 3800, Lab. C.) ; PblicyNo. Company COUNTY OF LOS ANGELES BUILDINGAND SAFETY Certified copy is hereby furnished. ADDRESS F] FOR APPLICANT TO FILL IN BUILDING ❑ Certified copy is filed with"the county building inspec- BUILDING tion department. ADDRESS -�- LOCALITY C Date Applicant CITY, g-1/E: ZIP CI 1 NEAREST f' NO.OF BLDGS. j CROSS ST. -.•r�C�C CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT /CFl,7( yS� 'NOW ON LOT 1 C& MAP BOOK PAGE PARCEL- COMPENSATION INSURANCE (This section need not be cbmpleted if the permit Is for one USE ZONE MAP LOT'NO. hundred dollars($100)or less.) TRACT BLOCK ` NO. TEL. p�C [�G) / SPECIAL d I certify that in the performance of the work for which this OWNER Q-�� Iz��uDez NO,.29 Ic��`' 1 CONDITIONS ' o permit is issued, I shall not employ any person in any manner / G, DISTRICT GROUP TYPE FIRE PRO ED BY U so as to become sCu-bjoct'to the Workers'Compensation Laws. IA) ADDRESS/� G d �. (�: (� S�t CONST.// ZONE ! 0 �Z-�� -d� V� Y ( CITY tl�i I� Q-f ZIP �. Date Applicant �U1 STATISTICAL CLASSIFICATION APT. CONDO. U r ARCHITECT OR TEL. UJ NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER .Cil)A_'G NO. CLASS NO. DWELL..UN ITS IL Exemption, you should become subject to the Workers' u7 Compensation provisions of the Labor Code, you must forth- I' ADDRESS �� SEWER A&A 2:, with.comply with such provisions or this permit•shall be 'deemed revoked. TEL' q 'VALIDATION CONTRACTOR. e r fr'I . C I NO. -3 BK• PG, LICENSED CONTRACTORS DECLARATION I hereby affirm that I am licensed under provisions of Chapter V ADDRESS X2-6 u l f LIC. 01.7 ?D VALUA lON (commencing with Section 7000)of Division 3 of the Business and I( r LIC. p(� Professions Code, and my license is in full force and effect. CITY LAN 1.1 L 12v - CLASS �1'� $ U V ? V SQ. FT. NO.OF NO.OF CHECK I License Number 7 1 V Lic.Class �'-� : I SIZE STORIES FAMILIES ONE N' ,f NEW 3 $ ontractor_(c v r /YLQ Vl�}'s Date - - DESCRIPTION OF WORK471 U I am exempt from the licensing requirements as I am a ADD ❑ ; licensed architect or a registered professional engineer i ALTER FINAL EJ acting in my/professional capacity (Section 7051, DATE Z REPAIR ❑ Business and Professions Code). 1 USE OF FINAL j EXISTING BLDG. 'Z,F_� DEMOL ❑ _By r �� Lic.or Reg.No. _Date - I APPLICANT TEL d OWNER-BUILDER DECLARATION I (PRINT) L (�Qtt/ 6'Q y YS,3 Jai I hereby affirm that I am exempt from the Contractor's License ( vl` Law for the following reason (Section 7031.5, Business and ADDRESS 8(}'F-/� (�$r l9 diC i ffi-e`� Professions Code):` ' PRESENTr l '3 3 q, 1 A ❑ BUILDING " I, as owner of the property, or my employees with, ADDRESS •wages.as their sole compensation,will do the'work and o 0 0 0.0 1. the structure is not intended or offered for sale(Section LOCALITY 7044, Business,and Professions Code). MOVING TEL. 2 e o 340 0 ❑ _ I, as owner of the property, am:exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- kADDRE O n o 3� 0 G~ tion 7044, Business and Professions Code). • ' TOTAL SETBACK FROM - EXIST. 12 -H O CONSTRUCTION LENDING AGENCY YARD HWY PROP.LINE WIDTH ,I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued 1 \ (Sec. 3097, Civ. C.). I L'ender's Name I Lender's Address PermitFee I certify that I have read this application and state that the Issuance Feeabove information incorrect;I agree.to comply with all County on Fee ' ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter Total Fee � upo above-mentioned property for inspection purpases.� � ' SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature.of Applicant or Agent ' Dote I . _ Os T. WORWERS'COMPENSATION DECLARATION II I, hereby affirm that I have a certificate of consent to self APPLICATION F O� U I L D I N G PERMIT insure,or a certificate of Workers'Compenstion Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) /� Policy No. Company COUNTY OF LOS ANG LES L . BUILDING AND SAFETY JF ❑ J ING j/ Certified copy is hereby furnished. FOR APPLICANT TO FILL INESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS L.I V L SLITY ST r Date Applicant CITY E ZIP -CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' G / NO.OF BLDGS. SOR COMPENSATION INSURANCE SIZE OF LOT / / NOW ON LOT OOK PAGE PARCEL (This section need not be completed if the permit is for one ONE MAP hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. 0 OWNER s j TEL. �` SPECIAL I certify that in the performance of the work for which this ssc CONDITIONS O permit is issued, I shall not employ any person in any manner _ RICT GROUP TYPE FIRE. ED BYso as to become subject to the Workers'Compensation Laws. ADDRESS 6Q E !(/G S/" �� CONST. M I/?—A CITY (� 1s� 7- ZIPDate Applicant TICAL CLASSIFICATION APTCONDO. u NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. �Ql W Exemption, you should become subject to the Workers' ENGINEER NO. SS NO. L-1`1 UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be TEL. VALIDATION deemed revoked. CONTRACTOR ✓ NO. BK. PG, LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS _ NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC. O Professions Code, and my license is in full force and effect. CITY CLASS $ 5_00 SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE NEW $ Contractor Date DESCRIPTION OF WORK ❑ ElADD I am exempt from the licensing requirements as I am a �(� (� I C licensed architect or a registered professional engineer ALTER �: FINAL ►9 / acting in my professional capacity (Section 7051, r REPAIR DATE Business and Professions Code). FINAL DEMOL USE OF ' EXISTING BLDG. �/ ❑. By Lic.or Reg.No. Date APPLICANT)CANT ' No. yk6 OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS S Prof sions Code): PRESENT BUILDING 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 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- ADDRESS tion 7044, Business and Professions Code). 7_56,10 O�'�l n 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 FRONT o a a 0 0 J the performance of the work for which this permit is issued P L. (Sec. 3097, Civ. C.). SIDE a a 23 5 C. P.L. Lender's Name �� } o o ' -_- Lender's Address P.C. Fee$ Permit Fee rJ v y I certify that I have read this application and state that the Issuance Fee x above information is correct. I agree to comply with all County Investigation Fee `0 ordinances and State laws relating to building construction, ° and hereby authorize representatives of this County to enter ITotal Fee --yJr� upon th bove-mentioned prop;rtfar inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Signature of Applicant or g t Date as