Loading...
HomeMy Public PortalAbout9655 OLIVE ST_Building__ 2 7 76A63BA`-CEpB09a"APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES 'ASSESSOR ' DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ���• MAKE CHECKS PAYABLE TO: ADDRESS �J HARVEY T. BRANDT, COUNTY ENGINEER LOCALIT FOR APPLICANT TO FILL IN NEAREST Print or tvDe onl CROSS ST.BU L _ DISTRICT NO. GROOP TYPE OC SSED BY ILDING ADDRESS S S OLIVE s- � C O Z7CONST. STATISTICAL CLASSIFICATION SEWER M LOT NO. +73 BLOCK / CLASS NO. �/ DWELL.UNITS BK PG/ TRACT' a-4, Z /J� SE ZONE MAP Q NO.OF BLDGS. f I NO. c G SIZE OF LOT ;$:OLS NOW ON LOT G-• SPECIAL USE OF ` CONDITIONS EXISTING BLDG. OWNER D- �' NOLE�r .OGb((t7�l/pf BLDG.SETBACK FROM ADDRESS S � V FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY HIG WAY WIDTH FROM C.L. ARCHITECT OR TEL. 60 } �� _ 'O ENGINEER NO. BLDG,SETBACK FROM a ADDRESS SIDE PROP.LINE OF (STREET) C TEL. HIGHWAY WIDTH FROM C.L. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL C: CONTRACTOR NO. C ADDRESS NO. } LIC, a CITY CLASS CORNER CUTOFF' YES ❑ NO ❑ Z CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SID_ E FOR SPECIAL APPROVALS ADDRESS SQ. FT NO. OF NO. OF / NEW 17 ❑ ONr'L.e7 I7�30� SIZE STORIES FAMILIES USE OF ADD STRUCTUR i �IDY30 REPAIR❑ siGNAxFURE OF APPLICANT,r. DEMOL ❑ VALUATION S` �, 0 d APPROVA DATE INSPECTOR'S!f GNATURE /�/ f © FOUNDATION: LOCATION �/ FEE S �.%,�7 FEE'S •""7 FORMS, MATERIALS S/l?/7 3 ?P4zcM� 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 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED ry HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. - LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMP NSATION INSURANCE. LATH, EXT. SIGNATURE _-E � �� � PERMITTEE HOUSE NUMBER COR- RECT AND POSTED a /Q " ADDRESS FI N AL IC • PLAN CHECK VALIDATION cK. M.O. CASH _ PERMIT VALIDAT M.O. CASH �?.7 3'G �1lti� 2 3 D 8 5.95A SLA Go 1,340 InaA 3' G3 %�� X28• APPLICATION FOR BUILDING PERMIT FOR APWCA-1;6T TO FILL IN (Print or type only) RDDRESS G q/ — Jr^ COUNTY OF LOS ANGELES I S `'l ( DEPARTMENT OF COUNTY ENGINEER - ZIP 7 BUILDING AND SAFET 7 DIVISION NO. F BLDGS. BUILDINGLOT 4S_XAOONOW ON LOT ADDRESS /{/`�f�/IL 15-9 BLQCK NO � LOCALIT �RL. NEAREST O. '� �r CROSS ST. ASSESSO MAP BOOK PAGE PARCEL ZIPC !79b DISTRICT GROTUPITYPE CONSTZONERO SSE�YCT OR TEL./ /O 6,D / ENGINEER NO. STATISTICAL CLASSIFICATION S WER MAP ADDRESS I CLASS NO�OWELL,UNITS BK CONTRACTOR NOL• USE ZONE MAP, NOO ADDRESS NO. �.. I SPE AL CITY LIC. CO,NDITI ONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES NO❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG.SETBACK FROM FRONT ROP.LINE OF (STREET) ADDRESS CITY HIGHWY . LINE} YARD = TOTAL SETBACK FROM TYPE OF EXISTING C SQ, FT NO. OF NO. OF CHECK FRONT PROPHIGHWAY WIDTH C SIZE 5 STORIES FAMILIES ONE _ CCCF DESCRIPTION OF WORK NEW ❑ + i BLDG\,S ADD ETBACK FROM (STREET) ,y SIDE!ROP.LINE OF ALTER ❑ _ TOTAL SETBACK FROM TYPE OF EXISTING USE OF REPAIR❑ HIGHWAY - ROP. LINE HIGHWAY WIDTH EXISTING BLDG. �C� DEMOL [:] t APCANT• T �O�r/(O CORNER CUTOFF YES ❑ NO PR (� IN OPEN SPACE YES ❑ NO BY (SIGNATURE) ❑ $ IN COASTAL ZONE YES ❑ NO ❑ VALUATION W ' � O. -- CATEGORICAL EXEMPTION YES❑ NO ❑ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION ENVIRONMENTAL , AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT'' EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S OF INSURANCE. SIGNATURE OF PERMITTEE ADDRESS TEL. S ' FINAL BY CITY NO. DATE •� ....ham •� rr�-j la ��,/L/L �-J MAKE CHECKS PAYABLE TO: FE FEE / HARVEY T. BRANDT. COUNTY ENGINEER r, PLAN CHECK VALIDATION CK. M.O. CASH PERMIT V TION CK. M.O. CASH 3 6 7 OCT 16 �, D 4 2.0 0 a5o 76A638A CENS03 7/73 •- r' 78 41803 4/72 ' APPLICATION FOR BUILDING PERMIT/ fl COUNTY OF LOS ANGELES ASSESSOR . DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING MAKE CHECKS PAYABLE TO: ADDRESS HARVEY T. BRANDT, COUNTY ENGINEER LOCALITY 1,; e-£ FOR APPLICANT TO FILL IN NEAREST La / Print or We only) CROSS ST. BUILDING ,n t L DIST�RIICT NO. GROUP TYPE PROCESSED Y ADDRESS YC � 1 j v7 L O� �� CONST�� kg�l Q � STATISTICAL CLASSIFICATION SEWER MAP LOT NO. B2 _3Z3 BLOCK CLASS NO, ( DWELL.UNITS BK PG TRACT 2 USE ZONE MAP a �7 NO.OF BLDGS. / NO. •� SIZE OF LOT- ,Os- )( 2-0 NOW ON LOT SPECIAL USE OF CONDITIONS EXISTING BLDG, s� OWNERMw T -' L d`�$ �. Gi BLDG,SETBACK FROM V ADDRESS I—(Ve •T' FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITYl t L HIGHWAY WIDTH FROM C.L. ARCHITECT OR T �dL` In } ENGINEER O. BLDG.SETBACK FROM - ADDRESS SIDE PROP.LINE OF (STREET) v TEL. TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CONTRACTOR r NO. HIGHWAY WIDTH FROM C.L. C7 ADDRESS NO t CITY CLASS_ CORNER CUTOFF YES ❑ NO ❑ Z CONSTRUCTION LENDER NAME AND BRANCH SEE REVERSE SIDE FOR SPECI APPROVALS ADDRESS SQ. FT. NO. OF NO. OF 441- SIZE STORIES FAMILIES NEW ❑ e USE OF ADD ❑ .J 6 3 6K e&4 STRUCTURE oe �yv47/0` ALTER ❑ /� REPAIR[-]SIGNATURE OF 2 / 11 �_• APPLICANT IDEMOL ❑ 1 .7 7 Cifit IC.C.a VALUATION S ©� APPROVALS- DATE IN P CTOR'S VI.ATURE eg 0 FOUNDATION: LOCATION FEE SFEES 2 2P, FORMS, MATERIALS FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING -BOLTS AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, fes. WITH ALL � /1 ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTI ON. I CERTIFY THAT IN DOING THE WORK AUTHORIZED �} y HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. Ir ,{�•!� �' �'.� '� , LABOR CODE OF THE STATE OF -CALIFORNIA IN RELATING TO WORKMEN'S COMPENSATION IN URANCE. LATH, EXT, s, SIGNATURE OpAkzHOUSE NUMBER COR- PERMITTEE- RECT AND POSTED ADDRESS FINAL A f-43 ° PLAN CHECK VALIDATION CK. M.O. CASH _ PERMIT�Y, LI TION CK M.O. CASH .LA co �- APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUI IN AD : q or a certificate of Workers' Compensation Insurance,or a certified CITY,., _ , r. ZIP copy thereof(Sec.3800,Lab.C.) 6, & , LOCALITY Policy No. Company SIZE F LOT NO.OF BLD S.N O LOT ❑ Certified copy is hereby furnished. O NEAREST CROSS SV' ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. USE ZONE MAP NO. department. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' R /� TEL NO. a / COMPENSATION INSURANCE r iy ^� WITHIN 1000 FT OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred dollars($100)or less.) DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY I certify that in the performance of the work for which this permit C016-2 is issued, I shall not employ any person in any manner so as t0 ARCHITECT,(OR ENGINEER TEL NO. �J become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of 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 forthwithFRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATION SIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG ® } License Number Lie.Class DE IPTION OF WORK C ADD ❑ VALUATIIgDL97 o�j 0. Contractor Date ALTER ❑ ri • O ❑ I am exempt under Sec. REPAIR ❑ $ Q BAP.C.for this reason DEMOL ❑ LDMA PIC# W Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICANT(PRINT) TEL NO. LDMA Perm# Z Ift I, as owner of the property, or my employees with wages as Z 1 their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE Q ACCT.4 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL303 69.6C OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL B licensed contractors to construct the project (Section 7044, I ITEMS Business and Professions Code.) YES 11 NO❑ WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING TOTAL 69 r 6IL" OCCUPANT REOURE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR �C�:�C •j GUIDELINES CHECK K 69_6,, I hereby affirm that there is a construction lending agency for YES❑ NO❑ m the performance of the work for which this permit is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING AN GE 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REOU:REMENTS UNDER THE LOS ANGELES COUNTY CODE, C11 TITLE 2,CHAPTER 2.20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. a Lender's Address td�1�-I]�itl �' .n +7.1 01NNER OR AGENT o I certify that I have read this application and state under penalty 1081 1 ACl 1114-ti• of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE a with all county ordinances and State laws relating to building m c struction, and hereby authorize representatives of this County ISSUANCE FEE to Tter upo a rove-mentioned propert r r insp�cti— `1 !� d �^ J INVESTIGATION FEE TOTAL FEE ' n o IDS •Sgnauro of App'Csl a AQnI Oyu (sof SEE REVERSE FOR EXPLANATORY LANGUAGE