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Home My Public Portal About9700 OLIVE ST_Building__ &jp1V.�SION OF BUILDING AND SAFETY � ' ® � NG Department of County Engineer County of Los Angeles ` . WM. J. FOX, COUNTY ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY � DISTRICT NO. PLAN CK.OR REO.No. PERMIT NO. BUILDING G,"i; r v� N�r e� S�e ADDRESS / �q4 . , q LODALITY�P•"iP IQJ G�[ /(� R�O�IVED Y DATE OF ADPL._ DATJ ISSUED CRO BBT. �i)14.h/ / � ® I1/ i BUILDING �o ADDRESS OO ` . OWNER (4 YA1 a,C ,J_ l/S MAIL LOCALITY y ADDREBB :F 7 v f� f� ,fl/I 1, a/ NEAREST �( CROBB BT. CI�elivi I,P.. (:'Il u NO. �' FIRE NCV OF ` IIN*E " I GROUP ARCHITECTOR, TEL // ZONE PLANS Y_ � ENGINEER Q i J� NO.th BLDG. 2 D SETBACK LINE ADDRESS `Ref mv) La- USE APPR13VED TEL ZONE 4-1 BY DATE CONTRACTOR (�/ d 1 .0 jAJ NO. HOUSE NUMBERING ADDRESS 'A ..n� MAP NUMBE46 t � NO. ASSIGNED BY LEGAL CORRECTIONS DESCRIPTION I LOT NO. BLOCK to yb_ OS ` TRACT �a�G/N.SPe�C�cd-p�, m° / NO. OF'SLDGS. SIZE OF LCT X 8 O.-Z._ I NOW ON LOT d USEOF /41-311w yyt N0.OF EXISTING BLDQ '.l A. !._ FAMILIES DESCRIPTION OF WORK m° NEW ALTERATION ADDITION d� Z D REPAIR DEMOLITION t r. BFT. NO.or ZE (A' ROOMS STORIES f EXT.WALL��yROOF ��//�� yf f COVEImNGJ.e(it.lrGrr�.f� COVERINGa�E,�/jo •Gr•( -USE OF STRUCTURE- AT/.r.1��.�LLf� .G/H. drJn /LJ B.�i IIC.. d - • INSPECTION FOR f APPROVALS OCCUPANCY A8 INSPECTOR'S SIGNATURE DATE FOUNDATION:LOCATION FORMS. MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FRAME: FIRE STOPS, CORRECT. BRACING,BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT,DUCTS SIGNATURE OF✓1�� I , LATH, INT. PERM1TTEe 311,-., 1, t -(.t 7 (.! 0Q 110"k l ,,,�7 LATH. EXT. ADDRESS n t�. a tri Q� i PLASTER, INT. AUTHORIZED AST. y PLASTER, EXT. 0L ®Q 1 cod FEE HOUSE NUMBER COR- RECT AND POSTED VALUATION a �.--- FEE h FINAL 9 Z/e3 75A52BA DOS 3 1-52 WORKERS'COMPENSATION DECLARATION lul hereby affirm that I have certificate of consent to self APPLICATION F OR PUILDING P E RM I T insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) 94841097 �am �ystern Employers COUNTY OF LOS ANGELES BUILDING AND SAFETY KfkpVn BUILDING L](J Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS LOCALITY NEAREST Date 11'419'4R4Applicant L,,ytle Roofing CITY Temple City zip 91780 CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE.ZONE MAP rl TRACT BLOCK LOT NO. l NO. 0� hundred dollars ($100)or less.) �� TEL. SPECIAL I certify that in the performance of the work for which this OWNER Merrit Davis NO.287-5551 CONDITIONS fi DISTRICT GROUPTYPEV FIRE PR OC ED BY 4 permit is issued, I shall not employ any person in any manner CONST. ZONE V so as to become subject to the Workers'Compensation Laws. ADDRESS r ^� 10 CITY Temle Cit zip 91780 S L(f �%� Date Applicant STATISTICAL CLASSIFICATION APT. JCOND0 # I— NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. Q U ENGINEER NO. CLASS NO. r DWELL. UNITS Exemption, you should become subject to the Workers' � Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be , TEL. deemed revoked. I CONTRACTOR fin 0.792-5171 BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION — LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 2948 E. Walnut NO.18 6 3 0 3 VALUATION (commencing with Section 7000)of Division 3 of the Business and i LIC. Professions Code,and my license is in full force and effect. I CITY CLASS 39 $ 400. 00 License Number 186303 Lic.Class 39 SI Ems' ' OF NO.OF CHECK '� IST �- FAMILIES 1 ONE �I I Contractor LV t1e Roof ina/Date 11/19/8 4 DESCRIPTION OF WORK 6 1/3 S . NEW ❑ $ I am exempt under Sec. I Class "An Shingles ADD El . # 0 3 A ALTER ❑ FINAL B.$P.C. for this reason I REPAIR ® 'DATE e: USE OF DEMOL ❑ ;FINA EXISTING BLDG. g o o 2 8,5 Signature APPLICANT TEL. Y + i PRINT NO. 792-5171 2&5 0 OWNER-BUILD RATIO i a o'o I hereby affirm that I am a mpt from the Contractor's License `ADDRESS y e Rooting O. 1 l 1, 'Q S S ( �,21 -84 Law for the following re son (Section 7031.5, Business and Professions Code): PRESENT I, as owner of the property, or my employees with i ADDRESS 9700 Olive l 2r 3 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. I, as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH I hereby affirm that there Is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. tSec. 3097, Civ. C.). SIDE 'a P.L. P Lender's Name Lender's Address P.C. Fee$ Permit Fee rI certify that I have read this application and state that the Issuance Fee 10. 5 z above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ®s