HomeMy Public PortalAbout9651 OLIVE ST_Building__ JUN .6f-'-1958
7BASSSA CE#80811-87 APPUtATI0N _FFR.. BUIL.DlNG PERMIT -1
COUNTY.-OF•LO§ ANGELES BUILDING d9
C
•.DEPARTNIENT OF COUNTY' ENGIM11 AD°REss
BUII ING ,AND SAFETY DIVISION LOCALITY l
JOHN A..LAMBIE.,-COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN,SUr.T OF BUILDING CROSS ST.
DISTRICT NO. GROICP TYPE 3E ER MAP
FOR APPLICAN TO FILL IN — BK. P
CONST.
'BUILDING C - I
ADDRESS &66 ' STATISTICAL CLASSIFICATION
CLASS.NO. DWELL.UNIT dcA
LOT NO. BLOCK
MAP STATE YES O
I NUMBER HWY.
TRACT US Z NE SPECIAL
y•� NO.OF BLDGS. CONDITIONS
SIZE OF.-LOT s p■o+ NOW ON LOT
USE OF
EXISTING BLDG. 'r UILDING EXIST.
• SETBACK YARD HWY STREET NAME WIDTH
OWN • T FRONT. C
MAIL P.L:
ADDRESS a_ - 0 SIDE
CITY N
ARCHITECT INSPECTION RECORD
O
ENGINEER TEL O
ADDRESS12
TEC
S • " �_:..
CONTRACTORNO.
ADDRESS
DESCRIPTION OF WORK
NEW ALT,E ".REPAIR DEMOLISH
SQ.pp NO.OF NO.OF' \
SlZ __ STORIES _ FAMILIES
-VSE OF STRlJCTURE
SIGNATURE 0 ",p APPROVAL I'PfL.
APPLICANT
i- DATE . IlY9. 'S S NATURE
ADDRES FOUNDATION: LOCATION
pl FORMS,MATERIALS / J.'
—P•C. '.$ y FRAME: FIRE STOPS,
/JJ. FEE 1 BRACING,BOLTS Cry sc - .11"Go ter.
VALUATION $_�J FURNACE: LOCATION,
FEE �f GAS VEWT,.DUCTS
' HE
HERE)Y A LEDGE THAT I HAVE READ THIS AP- LATH,INT.
PLICATION AN STA E THAT THE ABOVE IS CORRECT AND
AGREE TO COM L LL COUNTY ORDIN CES AND ;•
STATE LAWS HUl •DI 6 CONST TION. LATH,EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED
ADDRES FINAL
Y! • CLYDE-N.DIRLAM, PRINCIPAL STR RAL ENGINEER '
PLSN CR�CS VALIDATION K, M.O. CASH PERMIT VALIDATION. c M.O. CASH.
,1 5.9;6FR,,::tUN .6.1 6 A 2 0$-o A•n
_ M3 18 50R JUL 24 1 41 .00 M :`
EOMPENSATION DECLARATION •�
ti,ure,.,or 4 e rpt f cote of Worke s'tificate Compen of on Insurance, APPLICATION FOR BUILDING P E RM I T
or a certi�ied copy thereof(Sec. 3800, Lab. C.)
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company
❑' Certified copy is hereby furnished. BUILDING
FOR APPLICANT TO FILL IN
ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS r05 /i- LOCALITY
NEAREST
Date Applicant CITY ZIP CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT til YV 5 X 3 Z NOW ON LOT Z MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one L USE ZONE MAP
BLOCK NO.
hundred dollars($100)or less.) TRACT LOT NO. �
TEL. 10 SPECIAL �-
I certify that in the performance of the work for which this OWNER % NO. '� CONDITIONS
permit is issued, I shall not employ any person in any manner DISTRICT GROUP I TYPE FIRE PROCESSED BY UADDRESS (p 6 • CONST. ZONE
so as to become subject to the Workers'Compensation Laws. V�t
Date Applicant CITY ZIP STATISTICAL CLASSIFICATION APT. C DO.
--]
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.
Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. - DWELL.UNITS EULa
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or this permit shall be —
deemed revoked. CONTRACTOR TEL.NO. BK. Ill PG, VALIDATION
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.
Professions Code, and my license is in full force and effect. CITY CLASS S_50 coo,,O ,
SQ-FT• NO.OF NO.OF CHECK 12 1 1 2 4 A
License Number Lic.Class SIZE 600 ISTORIES IFAMIIIES ONE # o a o 0 0 1
DESCRIPTION OF WORK GLA-1 NEW ❑ $
Contractor Date ADD ❑ 1 - 306,75
Elam exempt under Sec. -
ALTER ❑ FINAL ,p o 0 7j(? &7 F=
B.BP.C. for this reason REPAIR ❑ DATE / —L
USE OF DEMOL ❑ 1 1,27-84
Date: EXISTING BLDG. ? - �' r FEIN /n
Signature APPLICANT Y i I/ ��i
OWNER-BUILDER DECLARATION 3
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS764 •vlll, L.l� t___q_NJD.
Professions Code): PRESENT
13BUILDING
I, as owner of the property, ormy employees with ADDRESS
wages as their sole compensation,will do the work and �`� 1 1 7.3 A
the structure is not intended or offered for sale(Section [ADDR
ITY -
�7044, Business and Professions Code). NG TEL. o.�aG c
I,as owner of the property,am exclusively contracting RACTOR NO. # C�
with licensed contractors to construct the project (Sec- ADDRESS 1 ° 251.82
tion 7044, Business and Professions Code).
UIRED TOTAL SETBACK FROM EXIST.
CONSTRUCTION LENDING AGENCY BACK YARD HWY PROP. LIN WIDTH ° 0 2 5 1.a 2
I hereby affirm that there is a construction lending agency for NT ®
the performance of the work for which this permit is issued A. 1 2.05-24
tSec. 3097, Civ. C.).. '
n
Lender's Nameiee$ Permit Fee 2Lender's Address �`/�I certify that I have read this application and state that the Issuance Fee �/t/above information is correct. I agree to comply with all County gation Fee 1
3 ordinances and State laws relating to building construction, Total Fee
and hereby authorize representatives of this County to enter i t
upon the above-mentioned property for inspection purposes. I '"
L d;?-7, SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date as