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HomeMy Public PortalAbout9461 OLIVE ST_Building__ TEMPLE CITY 76A638A CE #803 3-69 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS K BUILDING AND SAFETY DIVISION LOCALITY , s JOHN A. LAMBIE, COUNTY ENGINEER COLEMAN W. JENKINS, SUPT OF BUILDING NEAREST CROSS ST. FOR APPLICANT TO FILL IN DISTRICT NO. GROIT:?r PRo (PRINT OR TYPE ONLY) (/.� i BUILDING STATISTICAL CLASSIFICATION SE ER MAP ADDRESS 9461 E . Olive , Temple Cit CLASS N0. DWELL.UNITS BK PG LOT NO. BLOCK USE ZONE MAPel '/) N0. TRACT SPECIAL NO. OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT USE OF EXISTING BLDG. PBDTBACK FROM OWNER Aldridge TEL'AT 6-92OP. LINE OF -(STREET) EXISTING SETBACK HIGHWAY + YARD - TOTAL ADDRESS 'WIDTH FROM C.L. CITY Temple City , Calif. _ ARCHITECT OR TEL. P AOM (STREET) ENGINEER NO. P. LINEEXISTINGSETBACK HIG + YARD = TOTAL ADDRESS �+ WIDTH FROM L.L. CONTRACTOR H . L . RANDOL CO. NO.288-4040 TEL + LIC. ADDRESS NO. CORNER CUTOFF YES [3NO El LIC. CITY San Gabriel , Calif. CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS CONSTRUCTION LENDER NAME AND BRANCH ADDRESS SQ. FT. NO. OF NO. OF ❑ SIZE STORIES FAMILIES NEW USE OF STRUCTURE re-roof Dw1 . &Gar ADD ❑ ALTER ❑ with Celo. Comp . REPAIR SIGNATURE OF DEMOL APPLICANT VALUATION S 576 . 00 APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE$ FEES 9 . 00 FORMS MATERIALS IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FRAME: FIRE STOPS, AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY BRACING BOLTS WITH ALL ORDINANCES AND LAWS REGULAU G BUILDING CONSTRUC- FURNACE: LOCATION, TION. I CERTIFY THAT IN DOING THEW K UTHORIZED HEREBY I GAS VENT DUCTS WILL NOT EMPLOY ANY P SON V LATI N OF THE LABOR CODE LATH, INT. OF THE STATE OF C IF NI I LAT TO ORKMEN'S COM- PENSATION INSURA LATH, EXT. SIGNATOR OF HOUSE NUMBER CORRECT PERMITT AND POSTED ADDRESS 529 Val l y Blvd. , SanGab 'FINAL Z / tld JOHN F. LEWIS, PRINCIPAL ST TURAL ENGINEER PLAN CHECK VALIDATION CK. M.G. CASH - PERMIT VALIDATION CK. M.O. CASH I Ar.,4 8 5 9 C t-AY 11 1 D 9.00- a I 76A698ACE#6 3 6-62 A6 PLICA Y IO t FOR. BUILDING PERMIT t <� 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.NO G P TYPE - GF�3�Fb H FOR APPLICANT TO FILL IN j, CONST. BUILDING ` STATISTICAL CLA CATION S ER MAP ADDRESS K CLASS. NC DWELL.UNITS LOT NO. ��,� ` 1 ,�•a• B OC WATER NOT REQUIRED RECEIVED I( d CERTIFICATE: J !! TRACT ]1�, MAP HIGHWAY • N_O.OF BLDGS. NO.c::; (CIRCLE) STATE MAJOR SECOND, OCAL SIZE OF LOT ( ` OW ON LOT USE ZONE SPECIAL USE OF / ,/J ^ CONDITIONS EXISTING BLDG. + TEL. �^q OWNER :Lj. t/ NO.11r --�/7 p(� BUILDING EXIST. G-Q �L SETBACK YARD HWY STREET NAME WIDTH ADDRESS �p /" FRONT �D' ARCHITECT OR TEL. P. L. (G7 ENGINEER NO. SIDE P. L. ADDRESS O TEL. C CONTRACTOR' jQ...yl,�,�_, NO. L ADDRESS V O DESCRIPTION OF WORK F L . u NEWe�ADD ALTER REPAIR DEMOLISH O SQ.FT. NO.OF NO. OF A� SIZE STORIES FAMILIES USE OF STRUCTURE 1+ r o A_aL__ SIGNATURE OF APPLICANT VALUATION $ ov.. / ) APPROVALS /DATE INSPECTO 'S SIGMA- �E F E $ FEE.$ I V '� FOFORMSDAT!OMATER ALSON / FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 1 .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 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- •`1 ING TO WORKMEN'S COMPENSAT 114;SU CE. LATH,EXT. S'• SIGNATUR `/J////�' ) HOUSE NUMBER COR- PERMITTE RECT AND POSTED J / ADDRESS FfNAL //IVB Id„4=jmss+ ,- JOHN F. LEWIS, PRINCIPAL STRUCTURAL EN R PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH WORKERS'COMPENSATION®ECLARATION I { I affirm that I have r certificate of consent to self P I�L l ATI®I� F R j B U I L®I N G PERMIT a certificate of Workers'Compensation Insurance, I certified copy thereof (Sec. 3800:Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY No. Company BUILDING L tified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 1 Il(� T Certified copy is filed-with the county building inspec- BUILDING UU tion department. ADDRESS Date Applicant CITY -'II74610n P I 1 'I ZIP 90AO LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST �r COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT I CROSS ST. d V`C/• (This section need not be completed if the permit is for one .ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. e121 NE MAP I certify that in the performance of the work for which this OWNER TJ��h 'f•LthZ 0. sES111IJ NO, 0 E-Z , NO. permit is issued, I shall not employ any person in any manner PECIAL ADDRESS ��� �(' 5��. �— Y CONDITIONS so as to become subject to the Workers'Compensation Laws. by�s� V Date Applicant CITY e C � ZIP `��Ov 0 NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. �/ DISTRICT GROUP TYPE FIRE PROCESSEDBY -O ENGINEER lG6'1 i itl NO. CONST ZONE / I— Exemption, you should become subject to the Workers' _ 4 ,�i,[/''� U Compensation provisions of the Labor Code, you must forth- ADDRESS (rIZ,S- WL%ee1 Gr SLA i T< 'r V 3 5 1"V a with comply with such provisions or this permit shall be cL r I Cc%-, 9 • TEL. STATISTICAL CLASSIFICATION APT. CONDO. t7) deemed revoked. CONTRACTO t&• P NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. k (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY c,�y CLASS BK. VALIDATION ECK License Number Lic.Class SIEFi `i C S ORIIES FAMILLIIES I CONE DESCRIPTION OF WORK Actniy,I NEW ❑, VALUATION Contractor Date $ 56, / 15((L 6 r'''••" 'x 01 ADD I am exempt under Sec. 3vt �t� :�.� • ALTER ❑V. • B.BP.C. for this reason ��-vi+�t' REPAIR $ _ L I Gi*' Dote: USE OF I s r-y r p 3 EXISTING BLDG. 1640^.;( • DEMOL ❑. r H 1-+s = Si nature APPLICANT TEL. 8' 4 r'•: , 9 FINAL r i� r. = +� +' OWNER-BUILDER DECLARATION PRINT k a{1e5"r`w NO. .LTS /32 DATE — 3 reby affirm that I am exempt from the Contractor's License ADDRESS �� �'/ "r S% ��: i FINAL (•t~.I �r'�= c It( R. I.wesslons for the following reason (Section 7031.5, Business and Code): PRESENT BY ❑ BUILDING , -••- i• 7�:;r3 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 ,' {{j�I�' ; r (-r` i;['e 12 7044, Business and Professions Code). MOVING TEL. d " ❑ 1, as owner of the property,am exclusively contracting CONTRACTOR NO. ACCT.4 with licensed contractors to construct the project (Sec- 1P66��rr44GG tion 7044, Business and Professions Code). ADDRESS 3M7 519oI[M REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH I ITIS I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. TOTAL 519 o IMIC11 (Sec. 3097, Civ. C.). SIDE P.L. CECK 1qu 001 o Lender's Name LDMA Ref. # NAME AM a Lender's Address P.C.Fee$ `)�• 3 Permit Fee- 0 g�� 0 � I certify that I have read this application and state that the Issuance Fee / �.J � LDMA P/C# R above information is correct. I agree to comply with all County Investigation Fee \ f / MMI-MI 5n � 9 0 ordinances and State laws relating to building construction, Total Fee J / .�' lJ LDMA Perm. # R�11°a47 N and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. g SEE REVERSE FOR EXPLANATORY LANGUAGE m Signature of Applicant or Agent Date tceJ ORKERS'COMPENSATION [DECLARATION �a It ffirm.that I have r cerrCom a of consent to self f 1", P P.L K C .T I®N I`®R BUILDING PERMIT d certificate of Workers'Compensation Insurance, LT'�l� E ed copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY i _— Company fie&copy is hereby furnished. - FOR APPLICANT TO FILL IN "BUILDING (,, i ✓� Lf J' ADDRESS I Certified copy is filed with the county building inspec- BUILDING tion department. ADV1',-S y 61 d 1 i d s j. '7 r eIN� L ZIP I /�d LOCALITY NO.OF BLDGS.-"�aete Applicant gg NEAREa CERTIFICATE OF EXEMPTION FROM WORKERS' 'SIZE OF LOT &y_)9-2,0e NOW ON OT 1 CROSS SST. "' I L COMPENSATION INSURANCE (This Ssection need not be completed if the permit is for one ASSESSOR TRACT hu�edrdto dollars ($100)or less.) BLOCK LOT NO. MAP BOOK PAGE PARCEL USE ZONE MAP I certify fhc i the performancP•nt the work-sor_..�liih ihls OWNER BAN 1' L—i 0. l� l° 14K)NO.Z $= 3Ze NO. permit is issued shall not,,..Vioy any person in any manner / � �..� SPECIAL so as to become suolect to the Workers'Co pen 'on Laws. ADDRESS 6 I, o r u e ST Q CONDITIONS �} CITY . ZIP -117J06 f�• Date , Applicant NOTICE TO APPLICANT: If, aft akin this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should beco a subject to the Workers' ENGINEER p."afp2111 c+�c1v. NO. Z7 CONST. / ZONE /�� Compensation provisions of the Labor Code, you must forth- ADDRESS L�i�r\IP ��� Gtl t e �� e vV�I 'S V D 91(v S with comply with such provisions or this permit shall be A MCXOL if 'cam r TEL O STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR — �0 0. s NO. LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Tr NO. (commencing with Section 7000)of Division 3 of the Business and / LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY T-i C i CLASS BK PG VALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class . SIZE STORIES FAMILIES ONE O VALUATION SCC - -VT- 0 Contractor Date DESCRIPTION OF WORK NEW ❑ IY -+—--+ ❑ 1 am exempt under Sec. G'r fOirL 1� ��.s G� .e ADD ❑ / LJIJf C� 7ro f ALTER ❑ / .. L�C 0 .�l .L 1 I G3 E 1 W' B.BP.C. for this reason REPAIR ❑ $ �(' 1 Y OAL 96 f a Date: USE OF DEMO ❑ EXISTING BLDG. r3 96.7`77 Z r. Signature APPLICANT TEL. FINAL CHECK •.!7r•.t PRINT NO. 3ZO j- -BUILDER DECLARATION DATE (AN t :OWNER I hereby affirm that I am exempt from the Contractor's License y� Law for the following reason (Section 7031.5, Business and ADDRESS MESE B 6 Q Ive / FINAL rr^., Professions Code): NT Y f rVIBUILDING t0 01 r I(_ILi� 1, as owner of the property, or my employees with ADDRESS ,,--•; fi I wages as their sole compensation,will do the work and ® i t)�i•t 1 Fit 1 a 12 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. 1, 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). REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 4hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. / i (Sec. 3097, Civ. C.). SIDE Le+ P.L. I nder's Name "` w � LDMA Ref. # P.C. Fee$ Permit Fee 7, Lender's Address e I certify that I have read this application and state that the Issuance Fee LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, $ and herebyauthorize representatives of this Count to enter Total Fee LDMA Perm.# Py r... _,.._.. .,:.... .: $ up=thbment'i dpro rty for inspection purposes. a „`� -7•�q SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of pplicant or Agent Date