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Home My Public Portal About9312 OLIVE ST_Building__ . • APPLICATION FOR BUR. DING PERMIT • COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDIN D RES I hereby affirm that I have a certificate of consent to self insure, ILDING DDRESS (� or a certificate of Workers'Compensation Insurance,or a certified �L•l V A% kE copy thereof(Sec.3800,Lab.C.) CITYr�� 0Zl� \ C1'1 c-- 17' , LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDG&NOW ON LOT ❑ Certified copy is hereby furnished. (p NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. ..- Date Applicant ASSESSOR MAP J300K PAGE PARCEL 7 D Qr/ 6/9� "� SPECIAL CONDITIONS >1� O/ CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE QL,it/L Tr`-'•'« r • 6e;0% WITHIN 1000 FT.OF SCHOOL? YES NO /� / (This section need not be completed if the permit is for one hundred ADDRESS 1 i c��`-�'�� //� T1��)r DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) i IG !` 1 C I certify that in the performance of the work for which this permit �� C is issued, I shall not employ any rson in any manner so as to ARCHITECT OR ENGINEER TEL NO. beco subje�to the Workers pensatgp Laws. /• _ `� _ G J STATISTICAL CLASSIFICATION cam• APT CONDO Dat d Applicant ADDRELSS�ii CLASS I.C. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of 1-11115 P+ i . 50A I(., 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 comply with such provisions or this permit shall be deemed revoked. FRONT P Y P P ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER Mpp��ij (commencing with Section 7000)of Division 3 of the Business and QO.FT.SIZE NO.O RIES NO. F FAMILIES C - Professions Code,and my license is in full force and effect. ,7 STO I a � NEW I r� BK � PG fol a DE RIPTION�F WORK •� VALUATION ® - 0 License Number Lic.Class ! C n, ADD ❑ o U Contractor Date 7 `. /� ALTER ❑ ❑ 1 am exempt under Sec. 6'�2 L REPAIR d =0 goo. 11 � � 7/, � J BAP.C.for this reason Y DEMOL ❑ LDMA P/C# 23 W Date: Z T USE OF EXISTING BLDG. URM 11a- •' - [L Signature ' �� At•4T e.v '7 —z= ANT(PRINT) TEL NO. LDMA Perm# 0 ❑ I, as owner of the property, or my employees with wages as .s Telv ZGs 6a(.•' Z their sole compensation, will do the work and the structure is ADDRESS 0 _Ay O 1 not intended or offered for sale (Section 7044, Business and S-M, Lo'k— t%.- B'Z, ')Ei��G�a. il�c i " FINAL DATE F Professions Code.) o ACCT e v WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL I, e OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE '1 as owner of th —• property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 3303 2675.28 licensed contractors to construct the project (Section 7044, YES 11No 11 /Jim 2 ITEMS Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BU;LD:NG OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH (� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR TOTAL 2825.07 GUIDELINES (�,//��q '/ I hereby affirm that there is a construction lending agency for YES❑ NO❑ e'�KaC A �NfJ ow 916-1 a CHECK 2825.07 a the performance of the work for which this permit is issued(Sec. l { �1` p� I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING p A ?_/_ ��HA!'f�E .00 a 3097,CIV.C.) ^��/•/�� / / CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, (� `(U/ M V TITLE 2,CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20 140 CONCERN.NG HAZARDOUS 3 Lender's Name v MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOVD. y C3 Lender's AddressL _��I 10/2,/95 C OPnER OR AGEMT c I certify that I have read this application and state under penalty • '' 1 A� 1� of perjury that the above information is correct.I agree to comply P.C.FEE�r /) PERMIT FEE /t/9 2794 cm with all county ordinances and State laws relating to building �-�1 .4 (O7 m COnStrU tion and hereby authorize representative of this County ,/� �� ISSUANCE FEE , m to en tlu�gv� entioned propertv�(r In ctio p �osesr. 7 / V �J INVESTIGATION FEE TOTAL FEET / m �. (� OC ^ F wrwro m Mo'c�u a Aqt -' o SEE REVERSE FOR EXPLANATORY LANGUAGE ' , . , • APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDINOADDRESS 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 14 E. Olive Street copy thereof(Sec.3800,Lab.C.) gTC(pp 1 e Ci i ty ZIP 91780 LOCALITY f%i -- Policy No. Company SIZE OF LOT NO OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. 111,592 $ . Ft. One NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER COMPENSATION INSURANCE 01 iVe Trust (IR9?287-6092 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS dollars($100)or less.) 1613 Chelsea Road #201 DISTRICT GROUP CONST. FIRE ZONE PROCESSED BY YL I certify that in the performance of the work for which this permit 95n Ma r i.no, ZIP 911 O �0 is issued, I shall not employ any person in an manner so as to ARCHITECT OR ENGINEER O `•/ become subject to the Workers'Compensation Laws. I( K. K On & Associates 1(91'93-2881216 STATISTICAL CL SIF ATION APT CONDO Date 1/30 96 Applicant ADDRESS CLASS NO. - DWELL UNITS N0710E TO APPLICANT If, after making this Certificate of 2446 N. San Gabriel BIVd,#S, Rosemead 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 FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL > LICENSED CONTRACTORS DECLARATION SIDE a CITY LIC.CLASS PL C I hereby affirm that I am licensed underprovisions of Chapter 9C SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT Nq.OF STORIES NO q�FAMILIES a Professions Code,and my license is in full force and effect. 3 4�� 1 Wo Vne NEW ❑ BK PG C DESCRIPTION OF WORK VALUATI License Number Lic.Class ADD ❑ LL Contractor Date ALTER ❑ $ �.7?iP/ a gWtMM nq pOol. REPAIR ❑ $ z ❑ 1 am exempt under Sec. B.BP.C.for this reason DEMOL U LDMA P/C a j Date: USE OF EXISTING BLDG. URM ❑ IQnatue4rACCT.4 0�'�1 'T 7�t (MM-287-6092 LDMAPerm. 730 I, as owner of the property, or my employees with wages as Z 18MQ their sole compensation, will do the work and the structure is A RESS a 1 ITEMS not intended or offered for sale (Section 7044, Business and 1 r1 3 Chelsea Road #201 San Ma I n FINAL DATE Professions Code.) J'ZS TOTAL fiL o ,�j[(j WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE r AMOUNTS SPECT D ON THE HAZARDOUS MATERIALS INFORMATION GUIDES Q HEC O0 licensed contractors to construct the project (Section 7044, � FINAL BY > C 1880.K9 Business and Professions Code.) .YES❑ NOMM6� ��}}r WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING .00 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT ISCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES 11 Nod OI�GO-CIOU1 1/ 1/9c� the 7,Civ. C.) Of the Work for which this permit IS ISSUed(Sec. IHAVEREAD THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING { 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 623 1 F')112:22- U3TITLE 2.CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 NCERN;N Lender's Name MATERIALS REPORTING AN OR OBTAINING A PERM FROM THE SCAOMD.G HAZARDOUS FT Lender's Address OWNER OR AGENT 31 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 �p cc with all county ordinances and State laws relating to building /lle' m construction, and hereby authorize representatives of this County ISSUANCE FEE 3 to er upon $ab ve- tic d property for inspection Purposes. �7 �� V1 O ! J INVESTIGATION FEE TOTAL FEE """�� SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING P E RM I T insure, or o.qartificete of Workers' Compensation Insurance, or a certifidd copy thereof (Sec. 3800, Lab. C.) COUNTY 00 LOS ANGELES BUILDING AND SAFETY Policy No. Company ElBUILDING Certified copy is hereby furnished. G FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- ADDRIFSS 3 -F� tion department. Date Applicant CITY X77' p eP 2 ZIP �j LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT l /S NOW ON LOT / CROSS 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.. OWNER /'�'f + ,/�Et D N0 30 O/` USE ZONE OP I certify that in the performance of the work for which this SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS p• a CONDITIONS so as to become subject to the Workers'Compensation Laws. O CITY ! Qeo- [� t � ZIP / Date Applicant ARCHITECT OR TEL. D! NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY Q Exemption, you should become subject to the Workers' � J' - CONST ZOf V Compensation provisions of the Labor Code, you must forth- ADDRESS "ea. N with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR �i!/�7Lr/t,7 NO. CLASS NO./ DWELL. UNITS LICENSED CONTRACTORS DECLARATION LIC. 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 PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE I STORIES FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ $ r Oy U J � ADD ❑ ❑I am exempt under Sec. Tit- ! ALTER ❑ B.&P.C, for this reason REPAIR ❑ $ Date: USE O EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL• t FINAL . OWNER-BUILDER DECLARATION (PRINT) ` NO DATE I hereby affirm that I am exempt from the Contractor's License r� Law for the following reason (Section 7031.5, Business and ADDRESS SJ FINAL 1 Professions Code): PRESENT BY BUILDING ANT I, as owner of the property, or my employees with oa9 ADDRESS wages as their sole compensation,will do the work and 3304 92.25 the structure is not intended or.offered for sale(Section LOCALITY 1 ITEMS 7044, Business and Professions Code.) MOVING TEL. loop ElCONTRACTOR NO. I, as owner of the property,am exclusively contracting92.25 with licensed contractors to construct the project (Sec- TOTAL ADDRESS CHECK, 92.25 tion 7044, Business and Professions Code.) 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 CHANGE .00 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. 0000-0001 6/10/96 Lender's Name P.C. Fee$ Permit Fee (� /y LDMA Ref. # 6795 1 AM $:43 Lender's Address --}/ I certify that I have read this application and state that the Issuance Fee o! �0 LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee LL I ordinances and State laws relating to building construction, Total Fee �1 J LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-mentioned pro ey for inspection purposes. G + )r0 6 SEE REVERSE FOR EXPLANATORY LANGUAGE Signatur icant or Agent D COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1002160081 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I ITR: 11492 IT: 4 BL: .001 I SQ. FT STORIES TYPE [ 9312 OLIVE ST I I ISTRUCTURE: V-B I TEMP CA 917803127 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 18590-002-003 I I THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, Cl ITENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 IISSUED ON: PROCESSED BY: ] IEXIST OCC GRP: 102/16/10 SR 1 (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: I IKAO JIM Y;MENG-MEI (626) 309-0197- 1 3,800 1 O ] 19312 OLIVE ST I Iy ] ITEMP 917803127 I FEES PAID 10ESCRIPTION OF WORK I I IREPLACE ONE FRENCH DOOR AND 1 WINDOW I ]FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:1 I 1APPLICANT: TEL. NO: I I ] ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.75 1 I JAB STATE GREEN BLDG FEE 3800.00 VAL 1.00 SPECIAL CONDITIONS: I 1 JAC STRONG MOTION RESID 3800.00 VAL 0.50 1 I I ID2 PERMIT W/O EN-HC 3800.00 VAL 115.80 I 1 IFR INV WORK W/O PERMIT 257.00 DOL 257.00 I ] ICONTRACTOR: TEL. NO: I TOTAL FEES 402.05 (APPROVALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER I LIC. NO I 1LOCATION AND SETBACKS I I ] ] ISOILS ENGINEER APPROVAL I I [ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS 1 I LIC. NO: I (SLAB/UNDER FLOOR I I I 1RAI.SED FLOOR FRAMING I I [ IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I (UNDERFLOOR INSULATION I I I 1147H269 3 001 1 1-1 ] I I IFLOOR SHEATHING I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I NO 21 1 IROOF SHEATHING I I SCHOOL WITHIN HAZARDOUS1 ISHEAR PANELS I I I [AIR QUALITY: 1000 FEET MATERIALS I I ] NO NO NO 1 IFRAME INSPECTION I IREQUIRED TOTAL SETBACK FROM EXIST 1 IFIRE SPRINKLER HANGERS I I ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I [ I IFRONT PL- I IINSULATION/WEATHER STRIP] I 1 SIDE PL- I 1 ] 1 I I I IINTERIOR LATH/DRYWALL ] ] I [ 1EXTERIOR LATH ] I [ ] IRATED FLOOR/CEIL ASSEM. I I I ] I IRATED WALL ASSEMBLIES I I I I 1 IRATED SHAFTS/OPENINGS 1 I I I IT-BAR CEILINGS I I I I I I I I ILOT DRAINAGE I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I ] I I ]