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HomeMy Public PortalAbout9625 OLIVE ST_Building__ e 'BA898A GE#'808.10.88 APPLICATION FOR BUILDING PERMIT 1 BUILDING AND SAFETY DIVISIONB U 1 LD I NG r Department of County Engineer ADDRESS yt County of Los Angeles LOCALITY ✓ JOHN A.LAMBIE. COUNTY ENGINEER NEAREST rp CASSATT D.GRIFFIN. SUP'T OF BUILDING CROSS ST. FOR APPLICANT TO FILL IN DISTRICT G uP TYPE ER MAP 1 m0 G B /l CONST. ADDRESS �y2� ,r�'i- ,GLIA C, S\/� STATISTICAL CLASSIFICATION I LOT NO. 1/(0,6;t°nr C.+ O /��BLSCI(• 7* CLASS. NO. DWELL. UNITS MAP STATE YES O •� ®]� ,�_ NUMBER If O HWY TRACT —/4` �U' USE ZONE SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT NOW ON LOT �� USE OF EXISTING BLDG. BUILDINGYARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER�ljC/• ��1•L'L✓ l�1.� -f(I.!U" X FRONT �ry D MAI P. L. V ADDRESS %� �] r. SIDE n TEL. P. L. CITYAI"'LL'C!�" 0 i rr NO• INSPECTION RECORD ARCHITECT GR I / TEL. ENGINEER /I ej It1 . /f/7l 11 ,; 1_N0. r ' ADDRESS r �y CONTRACTOR _.. x PiJ .�C-C NO. 9 Fj ?re�Z l -G7 '- - �'1^F••4'_L �.pp ��!,�G�.1 e.•. ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO.OF NO.OF SIZE STORIES FAMILIES USE OF STRUCTURE, APPROVALS SIGNATURE OF APPLICANT -�I '^" , ' � V v�tl DATE INSPECTOR'S SIGNATURE - J � / r �V(�(( j'a�C I�'•I!.�cl• � DF'<<:yll FOUNDATION:LOCATION ADDRESS FORMS, MATERIALS P.C. S FRAME: FIRE STOPS. FEE Q BRACING,BOLTS $ VALUATION FURNACE: LOCATION, FEE c GAS VENT. DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH. INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH. EXT. STATE LAWS REGULA;'YING BUILDING CONSTRUCTION. O SIGNATURE F L (�.� G�" ��•✓ C� �' HOUSE NUMBER COR- PERMITTEE 1 ��1 •- 7ii1_w �,.�7( RECT AND POSTED /1 ADDRESS C/ 5 V(/ V//.�d�. ei ,-411rtic3n7+ FINAL OHN A.LAMBIE.COUNTY ENGINEER, CLYDE N.DIRLAM. RINCI AL STRUCTL_it__,_S,al ER PLAN CHECK VALIDATION cK. M.o As PERMIT V DATION CK. W.0 H Q 1 1 0 91; AUG 14 -r 6 2.7 5 C01 1 1 O s AUG 14 1 1 1.0 0 S. 76A638A CE 6032-63 APPLICATION FOR BUILDING PERMIT - . a COUNTY OF LOS ANGELES' BUILDING' g 6.2 5 01 i v e Temple•e C i't DEPARTMENT OF COUNTY'ENGINEER BUILDING AND SAFETY DIVISION •LOCALITY JOHN A. LAMBIE, COUNTY ENGIN' EER. NEAREST - WILLIAM A.JENSEN, SUPT OF BUILDING CROSS ST.- DI TRICT NO G PYPE P 97 B FOR APPLICANT TO FILL IN ,' D' �sTr o o f BUILDING .STATISTICAL CLASS [CATION SEWER P ADDRESS 9.625 -Olive ,- Tem,• 1 e City BKPG CLASS. NO. DWELL.UNITS- LOT NITS LOT NO. BLOCK WATER NOT REQUIRED ❑ RECEIVED CERTIFICATE: TRACT MAP IGH WAY STATE MAJOR SECOND,LOCAL NO.OF BLDGS. NO. O (CIRCLE). SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OF CONDITIONS ' EXISTING BLDG. OWNER e. McDona dNo' 287-46 /BUILDING EXIST. .SETBACK YARD HWY STREET NAME WIDTH ADDRESS 9625 E. O 1 ' a ' Tem l e C i"ty FRONT - ARCHITECT OR TEL. P. L. ENGINEER NO.• SIDE ADDRESS - P L C CONTRACTOR Howard L . RandeTV288-404u ADDRESS §29 E . V41ley B .y d . w!• r�/ f �l� t. j •l�r:ll �P /' .r/ a 0 � NEW ADD ALTER REXAIR DEMOLISH Z SQ..FT. NO.OF NO. OF fs SIZE STORIESAMILIES USE OF STRUCTURE SIGNATURE OF APPLICANT /� VALUATION $ 5 9 9•. O 0 ' APPROVALS DATE INSPECTOR'S SIGNATURE _ FOUNDATION:-LOCATION FEE'$ /- . 1'-FEE FORMS. MATERIALS- FEE FRAME: FIRE STOPS, - - I HEREBY ACKNOWLEDGE THAT'l 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 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 TOWORKMEN'S C�OMJyEN!AT ON INS ANCE.. LATH,EXT. _ SI.GNA7URE HOUSE NUNIBEWCOR- PERM ITTEE `.ice RECT AND POSTED z ADDRESS FINAL '?�'`+'r°p7 i•.y3i::;d'.a. JOHN F. LEWIS, PRINCIPAL STR URAL­ENGINEER PLAN CHECK VALIDATION CK. M.?".. CASH _ :PERMIT, VALIDATION cic. M.O. CASH ; SA WORKERS'COMPENSATION DECLARATION hereby affirm that ! hovecertificate consent to self APPLICATION FOR BUILDING PER I T IL1� insure, or a certificate of Workers'Compensation ation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT O FILL IN ADDRESS L ` ❑ Certified copy is filed with the county building inspec- BUILDING cW tion department. ADDRESS p� /+� Date Applicant CITY �� (.r ZIP /Q/7?V LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. / NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT / CROSS ST. / (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT L07 NO. MAP BOOK PAGE PARCEL OWNER ANDA /VG k174- NO.TEL USE NE MAP I certify that in the performance of the work for which this O permit is issued,I shall not employ any person in any manner qq SPECIAL ' so as to b co a subject to the Workers'Compensation La ADDRESS 96 d �U•e S CONDITIONS U Dote 7 �+ Applicant �� CITY 7"�H r My- zip 174P a �: NOTICE O APPLICANT: If, a r mrb' g fh' erfificate of ARCHITECT O TEL DISTRICT GROUP TYPE FIRE PROCESSED BY Q ENGINEER NO. CONST. ZONE W Exemption, you should ome ct the Workers'Compensation provisions of the Labo e,you must forth- ADDS -511 with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR STATISTICAL CLASS IFI TION APT. DO. N , � LICENSED CONTRACTORS DECLARATION LIC CLASS NO. DWELL. UNITS U) 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP ,.1.h,.­.J (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FF L#7 INC.OF NO.OF CHECK License Number Lic.Class SIZE STORIESS h, FAMILIES ONE Contractor Date DESCRIPTION OF WORK /`O0 vL I T10 6� NEW ® VAL 81/�d ❑I am exempt under Sec. Aq4 r.-F— 'S&Z P-00of �6J ALTER ❑ B.BP.C.for this reason REPAIR ❑ $ USE OF Date: EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE I hereby affirm that I am exempt from the Contractors License Law for the following reason (Section 7031.5, Business and ADDS FINAL Professions Code): PR 8y 8 1 A ® BUILDING 1, as owner of the property, or my employees with ADDRESS # 0 0 0 0 0 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCJLLITY 7044, Business and Professions Code). MOVING TEL I o o 5 9.2 5 ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. 0 0 0 5 9.2 5 with licensed contractors to construct the project(Sec- ADDRESS tion 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY STET UB comic YARD HWY T��P LIM WIDTH 0 7.Q 6-88 1 hereby affirm that there is a construction lending agency for FROM the performance of the work for which this permit is issued P.L. (Sec.3097,Civ.C.)_ SIDE P.L. Lenders Name LDMA Ref.# P.C. ee$ Permit Fee Z Lenders Address 2 1 certify that I have read this application and state that the Issuance Fee It P/C# g above information is correct.I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm.# n and hereby authorize representativ of this County to enter upon the above-mentioned pr a for inspection P)Irp,7es. Y6 � SEE REVERSE FOR EXPLANATORY LANGUAGE nature of licant or Agent Date r• WORKERS'COMPENSATION DECLARATION ,,L hereby'affirm that I have certificate of consent to self A P P L I C ®T N F BUILDING p U I L®I N G PERMIT E I T ` insure%r a certificate of Workers'Compensation Insurance, /�'i Y 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 APP CANT TO FI L IN BUILDING l / S , ADDRESS W ❑ Certified copy is filed with the county building inspec- BUILDING �! !/J� O v Sr- tion department. ADDRESS (�OLV � 47/ Q +. Date Applicant CITY "// d // ZIP /I�Gl LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST to COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (Win"V (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT /J 'n BLOCK n �LJO�TjNO. MAP BOOK PAGE PARCEL OWNER K lfl74�� /��/J4b. USE ONE MAP I certify that in the performance of the work for which this NO. permit is issued,I shall not employ any person in any�Ls. /qq P S SPECIAL O so as to b ome ubject to the Workers'CompensatiADDRESS - Ooc �p `�p n CONDITIONS Date Applicant �O" CITY /e�/� e G ZIP g L 0 V it Date O A PLICANT: If, of r m mg/thi ertificate of ARCHITECTTEL• DISTRICT G UP TYPE FIRE PR SED BY O ENGINEER NO. �Exemption, you should b me subjecthe Workers' CONST. Z ECompensation provisions of The Labor Coou must forth- ADDRESS r Ow. with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFI ATON APT. I QbNDO. CA deemed revoked. CONTRACTOR ,V NO. CLASS NO. _DWELL. UNITS LICENSED CONTRACTORS DECLARATION LIC. 21 I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWERNP (commencing with Section 7000)of Division 3 of the Business and LIC. 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 STORIES FAMILIES ONE /� VALUATION Contractor Date DESCRIPTION OF WORK O �l F CF NEW E] ; roo ❑ [D� QK R� PIZS o ADD ❑ V I am exempt under Sec. ALTER ❑ B.BP.C. for this reason REPAIR ❑ $ Date: USE OF DEMOL ❑ EXISTING BLDG. ;292 1.8 A Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE # o o a o o 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FIN a o 2 a 5 0 Professions Code): 1PRESENTB . BUILDING o o o 28.5 0 v 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 -0,2o-88 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). CONSTRUCTION LENDING AGENCY SET BACK YARD HWY TOTAL SETBACK LIINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. # m P.C.Fee$ Permit Fee i Lender's Address I certify that I have read this application and state that the Issuance Fee G v LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee `^ oo, ordinances and State laws relating to building construction, Total Fee (J LD"Perm.# 6 and hereby authorize represent tiv s of this County to enter u on the above-mentioned er for insP ection urpo es.P SEE REVERSE FOR EXPLANATORY LANGUAGE m ignafure 9 pplicant or Agent Ddle _WORKERS COMPENSATION DECLARATION �u e I%sure, to cer that I have r certificate of consent to self P P L I C A �j I WILDING PERMIT insure, or a certifiSate of W6rkers'Compensation Insurance, u 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 APPLI ANT TO FILL I BUILDING �� ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING 9/'g_( - /VF / tion department. ADDRESS ((�1 �SFF�^ l Date Applicant CITY e� ` et,77ZIP 9` 7 c) LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. J NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT r CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT //���F BLO/C�K ,r }-�/�L,OT NO. MAP BOOK GE PARCEL OWNER IW AW /Two m G//T NO.certify that in the performance of the work for which this LITE/16/C`/ NO. permit is issued, I shall not employ any person in any manner �f SPECIAL pr+ ADDRESS / {� CONDITIONS so as to b71;7i; ect to the Workers'Compensation La n ��M �l ZIP 4 �a U 3 CITY W Date Appiican ARCHITECT OR TEL. NOTICE O APPLICANT: If, er m ing thi ertificate of ENGINEER NO. DISTRICT GR UP TYPE FIRE PROCESSED BY O Exemption, you should become subject o the Workers' CONST. ZON f) 9) V Compensation provisions of the Labor Code, you must forth- ADDRESS J` a with comply with such provisions or this permit shall be EL. STATISTICAL CLASSIFICAA TION APT. I 4NDO. N deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER ,,,'p REEIRE (commencing with Section 7000)of Division 3 of the Business and LIC. R�} Professions Code, and my license is in full force and effect. CITY / CLASS BK �� VALIDATION G. SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE /° y1 VALUATION Contractor Date DESCRIPTION F WORK U /�R�� �� NEW D ❑ $ Z1)0 ;291 6 7 A ❑I am exempt under Sec. 0 1 �'� ALTER ❑ Pilo. # o 0 0 0 0 1 B.BP.C. for this reason $ REPAIR $ ) o - 2R50 Date' USE OF EXISTING BLDG. DEMOL ❑ o 0 0 28505 Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE '/ �/� 03, 15-88 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code): PRESENT BY rGG BUILDING 1, 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). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAL SETBACK LINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. fi Lender's Address P.C.Fee$ Permit Fee c 1 certifythat I have read this application and state that the pp' Issuance Fee G LDMlop, A P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm.# + and hereby authorize repress t es of this County to enter $ upon the above-mentioned, y for inspection,purp ses. y 3/IC/t� SEE REVERSE FOR EXPLANATORY LANGUAGE n �gnoture pplicant or Agent Date a i —*WORKERS'COMPENSATION DECLARATION hereb+rlpffirm that I have a certificate of consent to self `�C ,��I®� ® ®' PERMIT insure, ora 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 APPLI ANT TO Fly IN .BUILDING 6)1 ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING j/,0/"9 ( D �U� 12 tion department. ADDRESSSSr u �/`-e Date Applicant CITY I F'/ �^ 67Y ZIP - if 7V v LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT I CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars($100)or less.) TRACT BLOCK'f p -�+ LOT NO. MAP BOOK PAGE PARCEL OWNER AJ4 NG/�RlT6� NO. USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any mann r CjGa�' �`ULC` i SPECIAL p„ so as to/begg me ppubject to the Workers'Compensation ADDRESS CONDITIONS s. / /700 7p V (� o�� 7� .✓. CITY (.� ZIP 1? `Q V Date Applicant � NOTICE TO APPLICANT: If, a r ing t ' Certificate of ARCHITECT OR TEL. DISTRICT GRpppUUUP TYPE FIRE P ESSED BY O Exemption, you should be me subject to the Workers' ENGINEER NO. CONST. 1 ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS s �V/ —5 W with comply with such provisions or this permit shall be 0- deemed revoked. TEL. STATISTICAL CLASSIFIC TION A CONDO. N CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Clrofessions Code, and my license is in full force and effect. CITY CLASS BK Cl PG$ VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE ��� ORIES I FAMILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK 06py Aa TtB Al NEW ® $ 10 d j I am exempt under Sec. ��/20DH ��� 110. ;29 9 4 7 A ALTER ❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF # o 0 0 0 0 1 DEMOL EXISTING BLDG. ❑ Signature APPLICANT TEL. FINAL ° 4 3 b 3 OWNER-BUILDER DECLARATION PRINT /wa vo f�AIG' Q 1T NO. Q DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 9Gd�'o�are +Pytf ♦ri FIN / ° ° 143,635 Law for the following reason (Section 7031.5, Business and Professions Code): PRESENT By � Q 621 $ ® 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). REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name c / -3-3,13 LDAAA Ref. a Lender's Address P.C.Fee$ Permit Fee ii �,) I certify that I have read this application and state that the Issuance Fee l OJ-V LDMA P/C N above information is correct. I agree to comply with all County Investigation Fee / ordinances and State laws relating to building construction, Total Fee 3 .v3 LD and hereby authorize representatives f this County to enter MA Perm.q $ upon the above-mentioned pr art inspection p p pos s. n /•� a SEE REVERSE FOR EXPLANATORY LANGUAGE gnwur Applicant or Agent Date he 4WORKERS'COMPENSATION DECLARATION , e ' affirm ctrtificate of selfeL acertifate of WorkersCompensatonInsuranceAPPLICATION ®R BUILDING PERMIT ~ or-a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company / ElCertified copy is hereby furnished. FOR APPLICANTTO FILL IN ADDRESS (Op� ❑ Certified copy is filed with the county building inspec- BUILDING f 01a, S tion department. ADDRESS (, Date Applicant CITY �EE4 �� ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' +t �/!� NO.OF BLDGS. >.NEAREST COMPENSATION INSURANCE SIZE OF LOT oC 1` NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars($100)or less.) TEL. OWNER NDO 6,, TW NO. USE ZQNE MAP I certify that in the performance of the work for which this Q/ r Y J NO. }� permit is issued, I shall not employ any person in any manner ADDRESS {I72�1 0�� D►C__ SPECIAL so as to be om subject to the Workers'Compensation L CONDITIONS UO Date 6 Applicant rs� �f'r CITY /�� € LI ZIP tjS ARCHITECT Oft /EL. DISTRICT GROUP TYPE FIRE PR CE ED BY NOTICE'I70 you should If, er m je of ertiWork of S� ` r� n CONST. / ZO� / Exemption, you should b ome subject o the Workers' ENGINEER NO. /v1]( '/(`•' V � Compensation provisions of the Labor Code, you must forth- ADDRESS V with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. C NDO. g deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION CLASS NO.LIC. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. t' SEWER MAP (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code,and my license is in full force and effect. CITY CLASS BK � VALIDATION SQ.FT. NO.OF NO,OF CHECK License Number Lic.Class SIZE 910 STORIES FAMILIES ONE Q L/a VALUATIO Contractor Date DESCRIPTION OF WORK IL�Q � ���^N� ADD NEW ❑ $ � 0✓ ❑I am exempt under Sec. N� ab6Tl0� ALTER B..BP.C. for this reason REPAIR ❑.` $ USE OF Date: EXISTING BLDG. DEMOL Signature `. APPLICANT t TEL. FINAL PRINT w m N9. OWNER-BUILDER DECLARATION /q p- ` ,d DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 6aC�l 0/C 1(j�c� 4 pl —4 4 8 Q..7 A Law for the following reason (Section 7031.5, Business and Professions Code): PRE ENT # 0 0 0 0 0 �v�I BUILDING I, as owner of the property, or my employees with ADDRESS !C wages as their sole compensation,will do the work and LOCALITY ° 1 2 a,8 8 the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. 0 0 12 4,8 8 5 ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS 0 6 1 9—8 6 tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK PROP.LINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE a3 P.L. e Lender's Name QQ LDMA Ref. # P.C.Fee$ Permit Fee Lender's Address x I certify that I have read this application and state that the Issuance Fee ,O .�V LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee Q 9 ordinances.and State laws relating to building construction, Total Fee 0 LDMA Perm. # v and hereby authorize representatives of this County to enter upon the above-mentioned prg e y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Si atureof S plicont or Agent Date t WORKERS' COMPENSATION DECLARATION dn iter- , o Affirm that I have certificate of consent self i APPLICATION FOR BUILDING P E RM I T in e, 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 BUILDING ❑ Certified copy is hereby furnished. FOR APPL CANT TQ FILL IN ADDRESS GA ❑ Certified copy is filed with the county building inspec- BUILDING 01/p— tion department. ADDRESS P /� Date Applicant CITY �� � 4' Y ZIP ��� v LOCALITY NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK I LOT NO. MAP BOOK PAGE I PARCEL hundred dollars ($100)or less.) uy� �J T ��^ / OWNER /rrl I P T1 W,4 1 T' EL NO. O USE ZONE MAP I certify that in the performance of the work for which this C�1G 4 D 1 S �� SPECIAL a permit is issued, I shall not employ any person in any manner ADDRESS 19 CONDITIONS so as to be me bject to the Workers'Compensation O 'Law /+ y z(�b U �y1G' CITY / /� � (.p� 7 zip �` �L Date Applicant ARCHITECT O TEL t DI TRICT GROUP TYPE FIRE PRO ESS BY tO- /\ NOTICE TO APPLICANT: If, a r mqq6 mg thi ertificate of ENGINEER NO. 'n CONST. Z NE Exemption, you should become gubject o the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. STATISTICAL CLASS FICATION APT. CONDO. N deemed revoked. CONTRACTOR Z LICENSED CONTRACTORS DECLARATION IC. CLASS NO.� DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS f N, NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP WSJ and Professions Code,and my license is in full force and effect. CITY CLASS BK �i VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Uc. Class SIZE STORIES FAMILIES ONE ' VALUATION Contractor Date DESCRIPTION OF WORK /Q — u1/N aQ NEW ❑ $ �D©, d b ❑I am exempt under Sec. ADD ❑ pop.ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL�j OWNER-BUILDER DECLARATION (PRINT) NO. CYJx I hereby affirm that I am exempt from the Contractor's License DAT Law for the following reason (Section 7031.5, Business and ADDRESS F rofessions Code): PRESENT J Aye Awvl 7d BUILDING M&4 a- I, as owner of the property, or my employees with ADDRESS A'tCUL wages as their sole compensation,will do the work and LOCALITY ? ° I the structure is not intended or offered for sale(Section 7044, Business and Professions Code.) MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR NO. n w�1 ITEF'!a S with licensed contractors to construct the project (Sec- ADDRESS TOTAL 23 o 50 tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. OK 28.50 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT °OG the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name _-LDMA Ref.# IM—OOQ1 6/19/89 Lenders Address $ P.C. Fee S Permit Fee /910 O 4043 f M-188109 � I certify that I have read this application and state that the Issuance Fee LDMA PSC# 3 above information is correct. I agree to comply with all County Investigation Fee / ordinances and State laws relating to building construction, Total Fee �,J V c LDMA Perm. # and hereby authorize repress t' es of this County to enter upon the above-mentions r y for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignatur Applicant or Agent Date WORKERS' COMPENSATION DECLARATION ` to self insure bo s certificatffIrm e I have a certificate of coof Workers' C mpensat on eInsurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company r BUILDING / ❑ Certified copy is hereby furnished. FOR APPLIC NT TO FILY IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING / f–' ,v� S tion department. ADDRESS U V Date Applicant CITY T H At ezip 9/7F0 LOCALITY 1 F BLDG . CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT ea X 1117 NOW ON OT NEAREST .� CROSS ST. � � _ COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACE BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL' USE ZONE MAP > OWNER P.rI/�'JIl 0 0 Al.��'�,2/7�rlo. 073'6 3�G No. / .- I certify that in the performance of the work for which this fit%? 1(16' s �� permit is issued, I shall not employ any person in any manner ADDRESS SPECIAL a CONDITIONS so as to became s}ibject to the Workers'Compensation Law CITY�E� �, y/ Zip 9l 71e V OU Date 3!/0�Applicant ARCHITECT R C• TEL. ; DI TRICI' GROUP TYPE FIRE PROCESSED BY 0 NOTICE TO APPLICANT: If, ter aking thi K ertificate of ENGINEER NO. O Exemption, you should ecome subject Y the Workers' n CONST. r / ZONE n 13 Compensation provisions of the Labor Code, you must forth- ' ADDRESS a }f`� V _ /f/�'�y with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z deemed revoked. CONTRACTOR NO. CLASS NO. DWELL. UNITS LICENSED CONTRACTORS DECLARATION ADDRESS NO I hereby affirm that I am licensed under provisions of Chapter 9 . 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 NO. OF CLASS CHECBK PG VALIDATION S". ,T. 2-29STORIES I FAMILOIES / ONE License Number Lic. Class SIZE VALUATION C7"' Contractor Date DESCRIPTION OF WOKC4.0 NEW ❑ $ yam+0 0 0 ElI am exempt under Sec. �00 D V— AD ALTS B.&P.C. for this reason REPAIR $ Date: USE OF EXISTING BLDG. N // DEMOL ❑ Signature APPLICANT T)x )yq IAo d4a I*/TNO.dy e-3a FINAL OWNER-BUILDER DECLARATION �v DAT p,`ADDRESS !U � I hereby affirm that I am exempt from the Contractor's License a � SUP s G! Law for the following reason (Section 7031.5, Business and yFINA 1 Professions Code): BUILDING PRESENT By I, as ` A/�1/+�h owner of the property, or my employees with ADDRESS ACCT°V wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 3307 78°00 7044, Business and Professions Code.) MOVING TEL.❑ TT�1' 1,as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS TOTAL 78.00 tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY SE°BACK YARD HWY TOTAL SETBACK LINEFROM EXIST. C EOK 78°00 1 hereby affirm that there is a construction lending agency for FRONT CHANGE �(y the performance of the work for which this permit is issued P.L. CHANGE .00 (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name 5`r4j9 Lender's Address P.C. Fee$ Permit Fee 7 i'^ LDMA Ref. # 3483 1 AN $ ng ® Y[r PS7 L 67°V I certify that I have read this application and state that the Issuance Fee d °' LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee ���� LDMA Perm. # and hereby authorize represent Ives of this County o ent r 17 upon the above-mentioned p for inspection rpos S. o SEE REVERSE FOR EXPLANATORY LANGUAGE ignatu1; ppIkant or Agent Date ;.WORKERS'COMPENSATION DECLARATION pe .1 CAT . :tV '�FO�,: [WILDING PERMIT I hereby.affirm thci I have'a certificate''of consent to self' insure, or a certificate of Workers' Compensation•Insurance',. lY „ or,,a certified copy thereof(Sec. 3800, Lob. C.) COUNTY'OF.,:L'+�S"ANGELES BUILDING AN SAFETY s Policy No.- Company BUILDING El- -Certified copy is hereby furnished:•.:' FOR APP CANT TO ILL IN ADDREss q Ar ' ❑ Certified copy is filed with the county,building inspec- BUILDING .tion department. p ADDRESS 4G � � «e � . ��/� �. � ��- VIM>, >, CITY'/ E. e `e zip �! 7 l/ LOCALITY Date• '` -Applicant - NO.OF BLDGS., CERTIFICATE-OF:EXEMPTION-FROM WORKERS.',':'• .• SIZE -LOT- NOW ON-LOT, • ' ' NEAREST. .� e. . L .:. , gl.7c�;b CROSS ST. COMPENSA ION INSURANCE. ASSESSOR (This'sectlon''need not'be compleiec!41he permit"is,for one TRACT'. BLOCK r LOT IVO. MAp BOOK jJO O PAGE 7 PARCEL hundrd&clollais($100)of less.) • . ' • ,#TEL. 9elf /� OWNER'�'//CIYRN�U �NGi¢ T/¢NO: USE'ZONE MAP• ` :i certify:that.16,.the performance of-the.work for-which this' IVO. A. ermit is issued,•1 shall not em to 'an erson-in an �(�pZ r� .� ,� SPECIi4l'. CL p p y. y P y manner ' ' i4DDREss f; 'j� J CONDITIONS so.as to become subject,to'the Workers'Compensation'Laws. p y� 7pp/y+� _ . . O""::, 3 CITY G! `ZIP"�17Q.•v U'.. Date ` Applicant` :'' ARCHITECT R _ TEL. NOTICE•TO APPLICANT: If; aftermakin � this:.Certiflcate of ENGINEER NO. DISTRICT GROUP TYPE' ' FIRE'. PROCESSED BY' O. 9 N ZONE F- . Exem tion,, CO ST. p you -should •become; subject to..,the. Workers' : V ,.Cornipensatiori provisions of the.Labor Code,.you'must forth= ' 'ADDRESS '. ,��Q� �3 a.' ' with comply with such.provisions,or•thdR.-permit shall be: TEL. STATISTICAL CLASSIFICATION. APT. CONDO.. to 'deemed revoked. CONTRACTOR NO.._ Z LICENSED CONTRA ORS=DCCL`A AT LIC.' , .. CLASS NO. a'� DWELL:'UNITS I bee's' ffifm that I om'license �" �' AbDRESS 'NO. y ii d under provisions of Chapter9 LIC. SEWER'MAP ;;•, (commencing with Section 7000.)6f.'Divisfbn 3:bf,fhe'Business. ' and Professions.Code;and my'license is in full force and effect. CITY CLASS BIC C VALIDATION. ' S.Q. FT, NO.OF N0.OF a CHECK Licen'se'Number 'Lice"Class IZE ``�' • STORIES ® FAMILIES f ONE VALUATION " :Contractor -Date DESCRI F N'OF WO �q NEW - : Q / IL�N[ ADD .❑ Sj V A ❑I•am.exempt under$ec: _. } ALTER B.BP.C„for'this;reason :$ y REPAIR ❑ ( O.O(/.. Date USE OF' EXISTING.BLDG., DEMOL. Signature APPLICANT- TEL.: FINAL • _ ' .',OWNER-BUILDER DECLARATION.' (PRINT).-;' NO. .DATE ' I hereby"affirm fh6t I am exempt from the,Cbntractor's License• ''�• • - Law.fdr:the;•following reason (Section 7031:5,`Business and' ADDRESS FINAL'-' .. Professions:Code): " PRESENT .. BY• i : _tii: ' . BUILDING .. _6s'owner of the Property,-or my employees with ADDRESS gym- ,: '•' : �.€.E ' •- wages as their sole compensation,will do the work and - �/f/ :,'•' '' the structure is riot intended or offered for sale(Section..` LOCALITY 7044, Business and Professions,Code:) MOVING"•. ; • - TEL.- CONTRACTOR NO. bl-}.1,.as owner of the property;am exclusively contracting.' ;.with.licensed contractors to constru"ct the prdjecf'.(Sec-' ADDRESS i tion 7044,''Busines's. and Professions Code..) , ,',� «. REQUIRED' TOTAL SETBACK.FROM EXIST. . '-- 'CONSTRUCTION LENDING AGENCY. SETBACK PROP. LINE WIDTH ,�••°I:I YARD FIWY I hereby affirm'that there is a construction.lending agency for• FRONT• ' ,f '` u the performance of the work:fbr':which.this'Permit:is issued:. 'P.L. "`" "f w <<`< .SIDE, f-Ir. _I" 19. HL (Sec.'3097, Civ: c.).'.- 3. LDMA Ref.# whi~•�(< }(Ir} P C.`Fee$ Permit Fee Lender's Address. . _ m� .•= I certify that I.have read this application and state that the• ,. . ' Issuance Fee o� LDMA P/.0# ,. above information is correct:I agree to comply with oil County Investigation:Fee. "ordinances and"State.laws"relating to Building cbnstruction, Total Fee �J s TDMA Perm. # 'f•')j i=s` "r;'E"i r -y-;• and hereby authorize representatives of s unty.to enter. g� upon,the ab ve-mentioned property ns ion p po S. All SEE REVERSE FOR EXPLANATORY LANGUAGE Dat : Si. ure of�Ap . .nt or.A ent: a ::