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HomeMy Public PortalAbout9665 OLIVE ST_Building__ DEPARTMENT OF BUILDING AND SAFETY ArrL.lLrtl a avr Jr WSL Zlx& a"a COUNTY OF .LOSLmGELES 3 N ® � �- WM. J. FOX. CHIEF ENGINEER +� 1 • FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY / DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING �{/ ADDRESS Z Air c S 373 g,g g / 6 LOCALITY �J.9�., oai C4C/�„ ECE D B / DA�/TE OF APP4 DAITE ISSUED NEAREST IF n ! - 2- �° �� -7! / e-,1'19 CROS -(��, ,n DDREBB OWNER �lJ Ls jll U?l ,o �� BUILDING ! (� e A -+ U� MAIL � )-l-0 f yQ, LOCALITY C ADDRESS �-EBS _ L /J NEAREST e G Ae NC CROON ST. C ird FIRE NO.or V TYPE flROUP 1 ARCHITECT OR TEL. ZONE PLANO ENGINEER NO. BLD2. , ORD.ND. ADDRESS SETBACK LINE .C/S APPROVED JJ TEL v. 7 g �BY DATE CONTRACTOR,LrJ �O� NO. I Sty USEAPPROVED ADDRESS ZONE /ZONE 1 BY DATE LEGADESCRIPTION LOT NO. S BLOCK " CD ONS -'^" Oati Z 1 N / 1 TRACT 'J NO.OF BLDBB. SIZE OF LOT TS d NOW ON LOT USE OF NO.OF NO.OF EXISTING ELDfl FAMILIEIt ROOMS DESCRIPTION OF WORK NEW CO's' ALTERATION ADDITION REPAIR MOVING DEMOLISH p 84FT. No.or ✓ Z M.E /-•I�!� ROOMB STORIES / JZ" r/ WALL Roar COVERING t� ./�[+ I COV BINS /p7- PpA,147 044x4'usEarmcw Y s BUILDING strJaQ� 1. G rn.1 t6�/J? a !4`� IJL� 1 HEREBY ACKNOWLEDGE THAT I HAVE READ TH19: v APPROVALS APPLICATION AND STATE THAT THE ABOVE IB CORRECT EOTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FOUNDATION;*AT LOCATION ` FORME.MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION:. FRAME.'FIRE STOPS, p �� SIGNATURE OF BRACING.BOLTS PERMITTEc v v, NAj LATH. INT. - AUTHORIZED AOT - LATH. EXT. 74M63BA-3 3-50 per , / .r�, PLASTER.INT. 7 ® FEE' �f PLASTER.EXT. D� :� FINAL G "`� 7-L VALUATION FEE WORKERS'COMPENSATION DECLARATION � % I hereby affirm that I have certificate of consent ti, self; • ®L I T� FOR L I N P E RM I T insure, or a certificate of Workers'Compensation Insurance, , ® j or a certified copy thereof(Sec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES BUILDING AND SAFETY 1:1Certified copy is hereby furnished. FGR�APPLICANT TQ FILL IN ADDRESS C((/ Slit U r S Certified copy is filed with the county building inspec- BUILDING Tion department. ADDRESS LOCALITY G 0,1 CITY (� . 4' }. I NEAREST Date Applicant_ �L I / ZIP 'CROSS ST. t V CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF.BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT `1 NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one ,� USE ZONE [LSpp7E hundred dollars($100)or less.) TRACT BLOCK I LOT NO. Q CIAL y. 1 certify that in the performance of the work for which this, OWNER - CONDITIONS 4. permit is issued, I shall not employ any person in any manner -y DISTRICT GROUP TYPE FIRE P?C? SSED BY O so as to become subject to the Workers'Co ensation Laws. ADDRE ,- 7' i �t /I(( �_ CONS,? ONE U CITY /�' ZIQ �— V 0 (� O Date Applicant %` STATISTICAL CLASSIFI�jATION APT. CON . b NOTICE TO APPLICANT: If, after making this Certificate of .ARCHITECT OR TEL. Z� U Exemption, you should become subject to the Workers' s. ENGINEER NO. CLASS NO. DWELL UNITS Compensation provisions of the Labor Code, you must forth- ADDRESSr SEWER MAP H with comply with such provisions or this permit shall be TEL. r 4V CONTRACTOR NO. deemed revoked. L BK. It PG, D VALIDATION 9. LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ,n= NO. «VALUATION (commencing with Section 7000)of Division 3 of the Business and, LIC 10 r). o o Professions Code, and my license is in full force and effect. CITY CT CLASS $ /� V SQ.FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE 1111110. I.,����//ry $ �225i4A Contractor Date DESCRIPTION OF WORK &)A) , NEW ❑ I am exempt under Sec. ADD ❑ # 0 0 0 0 0 ALTER ❑ FINAL /� A, I a 0 4 B.BP.C. for this reason REPAIR ❑ DATE ,(^� - 40,50 Date: USE OF DEMOL ❑I EXISTING BLDG. B FIN 000 4 Q 5 0 H Signature � �. / / APPLICANT TEL.(�'� , , OWNER-BUMiiILDER DECLARATION PRINT NO, 1 hereby affirm that I am exempt from the Contractor's License o613-85 Law for the following reason (Section 7031.5, Business and, ADDRESS Professions Code): PRESENT BUILDING I, as owner of the property, ormy 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 FROM EXIST. 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. JSec. 3097, Civ. C.). SIDE 0 P.L. `v Lender's Name - ` - - _ a Lender's Address P.C.Fee$ Permit Fee 30, u I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County, Investigation Fee 6Q S ordinances and State laws relating to building constructioni. Total Fee r J and hereby authorize representatives of this County to enter upon the ab e-mnenttioned property fo inspection purposes u ( ---Signature SEE REVERSE FOR EXPLANATORY LANGUAGE 6 13 {Signature of Applicant or Agent Date / ®s I WORKERS'COMPENSATION DECLARATION • i' r '� �' l I �i hereby affirm that I have a certificate of consent to self , cnce, BUILDING., P E.RM I Tinsure, or a.certificate of Workers'Compensation PLICATION FOR or a certified copy thereof(Sec. 3800lab. C) AP COUNTY OF LOS ANGELES BUILDING AND SAFETY ' Policy No: .Company Certified copy is hereby.furnished. FOR APPLICANT TO FILL IN qpp ESS � GJ & DCertified copy is filed.with the county building inspec- BUILDING / tion department. ADDRESSs V is LOCALITY NEAREST .O Date Applicant. CITY -7r ''L `' ZIP �� CROSS ST. /. G CERTIFICATE.OF EXEMPTION FROM WORKERS' i O.OF BLD ASSESSOR '.COMPENSATION INSURANCE • SIZE OF LOT. S- Z0NOW ON LOT Zr MAP BOOK . PAGE PARCEL - (This section'need.•no}be.completed,if.the permit is for one• �j����pN:V/�'�"� ' USE ZONE, MAP cy hundred dollars'($100)or less:).. 7RACI'.• • BLOCK LOT NO. �, ' IVO.. :. TEL t+ r < SPECIAL } 'I certify that in'the performance o_f'the'work'for which thi's OWNER `r/Y/,� IS'i J Jy •,' .iCONDITIONS IL permit is-issued,I;shall not emplo ny person in any anri / DISTRICr!' ;.GROUP•.TYPE FIRE PROCESSED BY O'. 9 ADDRESS (. 5. �VLI V '• }' CONST.. ZO E U so'as}o become'subject to the.W rk rr ti o p r'�r��, �y �( i p jN �'!I �'/ - ZIP ///•wr v ••'" �•D `' /'� - . f' � - O Date Applicant STATISTICAL CLASSIFICATION APT. CONDO. V NOTICE TO APPLICANT: If, after' makin this Certificatb of ARCHITECT OR TEL. rg ENGINEER �` NO. ' CLASS NO. DWELL. UNITS LN Exemption,' you should, become ,subject to the Workers' Compensation provisions.of the Lobor'Code,-you must forth- ADDRESS SEWER MAP with comply with such provisions or,this•permitshall be TEL. deemed revoked. CONTRACTOR NO. BK. +PG, � VALIDATION LICENSED CONTRACTORS DECLARATION' /r LIC. I hereby affirm that I am licensed-under provisions of Chapter 9 ADDRESS G,V OL/.!f s VALUATION (commencing with Section 7000)of Division 3 of the Business andLIC• Professions Code, and my license is in full force and'effect. CITY r �t�"L,l� 4 7• CLA55;. F mss" SQ.Fq ' NO.OF 'n' NO.OF CHECK , License Number U6.Class SIZE /���Q STORIES. 2' FAMILIES ONE 'J DESCRIPTION OF WORK L J1s✓ NEW Contractor Date 1. , ADD, 7. I am exempt under Sec. `0 r FINAL 41. A - ALTER: � ' ' B.&P.C. for this reason t a DATE ° °''° ° REPAIR Ir �) Date: USE OF FIN I _ ' EXISTING BLDG. bEMOL ❑ B j °' �: �? Signature APPLICANT TEL. .r� bb Y ' PRINT NOrG,OS-� • •OWNER-BUILDER DECLARATION I hergby offiPm that I am exempt from the Contractor's License - ADDRESS �Z i ✓� 1;7 Law for the following reason;(Section 7031.5, Business and j 2'2 0—8 L i Professions Code): PRESENT-. . + BUILDING PL V "j�. I,-as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and thstructure is not intended or offered for sale(Section LOCALITY !G/b e- 74 �L✓ (� 4, Business.and Professions Code). MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR NO. �D 1 7 8 L1,,7.2 A with lieensedepontractois to construct the project (Sec- ADDRESS tion 7044, Business and'Professions Code). } o o v f REQUIRED TOTAL SETBACKYROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LIN • WIDTH ® 1 hereby affirm.that there is a.constructiori lending agency.for FRONT • the performance of.the work'•for which this permit is issued P.L. = ° ° v ;1 �,� tSec.;3097, Civ. C.). SIDE o ��. 'P.L. 7' 'Lender's Name ;/��"�` ( • 2.0 -8 Lender's Address P.C. Fee$ .I ' Permit Fee "%, 71, i rI certify that 1,have read this application and state that the �^ Issuance Fee o 0 above information is correct: I agree to comply with.all County Investigation Fee p•© .` r ordinances'and State laws relating to building construction, Total Fee, cnd'hereby authoriie representatives of this County to enter2 t. u on the above-ment' nedgoperty for inspection purposes. ��� SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Age t Date •: as WORKERS'COMPENSATION DECLARATIQN I hereby affirm that I have certificate of consent to self Insure, or a certificate of Workers'Compensation Insurance, r� L�CAT I D N FOR S UA I N PERMIT E MIT or a certified copy thereof(Sec. 3800, Lab. G.) " Policy No. Company COUNTY OF LOS AhI�IGSLSS ELBI9.DjR�G AND SAFETY r., y_.,.. .. f Certified copy is hereby furnished. ` FOR-APPLICANT MIA IN ADDRESS Certified copy is filed with the county building inspec- FADDRE 7 tion department. 1,) V r S'/. LOCALITY -jP ,, NEAREST Date Applicant ZIP O CROSS ST.CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE �' O Q• NOW ON LOT MAPBOOK PAGE PARCEL(This section need not be completed if the permit is for one A/ !1�/� ,�S . USE ZONE MAP hundred dollars($100)or less.) QC LOT NO. S�-3 NO. 7� TEL. SPECIAL I certify that in the performance of the work for which this ,`%C r9 O. CONDITIONS 13.DISTRICT GROUP TYPE FIRE PROCESSED BY O permit is issued, I shall not employ any person in any m nor o !� �� M �JCONST.�y�f� ZE �1so as to become subject to the W Com s nd yl/6y ,,po U Date Applicant i CITY ZIP STATISTICAL CLASSIFICATION APT. CONDO. ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of 0 — {ed Rif Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS WrIm Compensation provisions of the Labor Code, you must forth- tf1 ADDRESS -- SEWER MAP with comply with such provisions or this permit shall be deemed revoked. 2 N S y(� BK. .� PG, r3 VALIDATION CONTRACTOR In+ LICENSED CONTRACTORS DECLARATION _ I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS %/ L ✓� CT NO. �� VALUATION p.P (commencing with Section 7000)of Division 3 of the Business and r LIC. Professions Code, and my license is in full force and effect. CITY PSG C// CLASS $ SQ NO.OF NO.OF CHECK License Number Lic.Class t,SI STORIES FAMILIES ONE r� = NEW $ Contractor Date DESCRIPTION.OF WORK E .( 9' A c_ i 0 ADD I am exempt under Sec. A/ k ! Q r 06 i✓t ALTER FINA r�J B.$P.C. for this reason =e_A PAIR ❑ DAT Date: USE O �o EMOL FINAL EXISTING BLDG. 6�!t^F1 By Signature APPLICANT EL. L OWNER-BUILDER DECLARATION PRINT /fl,� ,z . O. S I hereby affirm that I am exempt from the Contractor's License S��6 G� 1�i� / L'MPL& C , Law for the following reason (Section 7031.5, Business and ADDRESS _ Professions Code): PRESENT p BUILDING GS V VC, j fi I, as owner of the property, or my employees with ADDRESS a wages as their sole compensation,will do the work and LOCALITY �f V l� C %I�f►1 1 L j%y (3 L the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR / NO. with licensed contractors to construct the project (Sec- ADDRESS _ tion 7044, Business and Professions Code). , REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this per is is d P.L. tSec. 3097, Civ. C.). J ; SIDE P.L. ? Lender's Name Lender's Address ��'� P.C. Fee$ Permit Fee e I certify that I have read this application and state that the Issuance Fee v above information is correct. I agree to comply with all County ;Investigation Fee ordinances and State laws relating to building construction, Total Fee 7 i and hereby authorize repro tatives of this County to enter u on the above me ioned rty for ir`spection purposes. 30— SEE REVERSE FOR EXPLANATORY LANGUAGE Signature ofp icant or Agent Date