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Home My Public Portal About9863 OLIVE ST_Building__ :DICERS'COMPENSATION DECLARATION �•::: affirm ir(bf'Ihlf W r certificate.,-of consent to self APPLICATION. FOR BUILDING PERMIT' ' or,f certificate of Workers'Compensation Insurance, -i ot',a certified copy thereof(Sec. 3800, Lob'.C.) �p� COUNTY OF LOS.ANGELES BUILDING.AND SAFETY Policy No/053"99-ompony I'01f ' Certified copy is hereby furnished. ! j FOR APPLICANT TO FILL IN BUILDINGU:b: QADDRESS .J Certified copy is filed with the county building inspec- rADDRESSING tion department. __11 Date Z~ Applicant 'AA. f/• CITY C, - ZIP q�76 f� LOCALITY CERTIFICATE OF EXEMPTION FROM ORKERS' 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 BLOCK LOT NO. MAP BOOK E PARCEL TEL. USE NE MAP -1 certify that'in the performance of the work for which this OWNER p/. O. Z - �3 NO. permit is issued,-1 shall not employ any person in any mariner SPECIAL ADDRESS / 8 O i� CONDITIONS , so cs to become subject to the Workers'Compensation Laws. V. CITYZIP 9/786 Date ApplicaW NOTICE TO APPLICANT: If, after making'this Certificate of ARCHITECT OR �.• TEL DISTRICT GROUP TYPE FIRE PROCESSED BY O ENGINEER NO. ` CONST. ZONE (-- Exemption, you should become subject to the. Workers' V Compensafion provisions of the'Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be .. TEL. STATISTICAL CLASSIFICATION APT. NPO. Cl) deemed revoked.- 1 CONTRACTOR N z13. 3 3 :l LICENSED CONTRACTORS DECLARATION LIC• CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS , raja NO.a Z L (commencing with'Section.7000)of Division 3 of the Business and p LIC 'SEWER MAP Professions'Code,,and my license is in full force and effect. I CITY O 0-)W-3 CLASS .; BK PGVALIDATION SQ.FT. NO.OF NO.OF CHECK License Number Z 3 /Lic.Class 7 SIZE STORIES FAMILIES ONE Contractor. �PJ C/AfJnC/I Vi ire Z-G 2-0 6 , �I' DESCRIPTION OF WORK .= ADD O VALUATION ❑1 am exempt under Sec. ALTER• 13 B:&P.C. for this reason G° - t� REPAIR s', USE OF / �� Date' I - EXISTING BLDG. - Cii4 DEMOL ' •Signature �,�T�'• :I APPLICANT TE fj FINAL OWNER-BUILDER DECLARATION t PRINT dr N ) DATE I hereby affirm that'l am exempt from the Contractor's License " Law for the following reason (Section.7031.5, Business and' } ADDRESS 3 s 4* AN 9 1•5 A Professions,Code): R MIT BY ,.. I' BUILDING #pm a o o.o.1 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 t LOCALITY (•o 0 59.25 .7044; Business and Professions Code). MOVING TEL. I, as owner of the property,am exclusively contracting CONTRACTOR NO. o o'0 5 9.2 5 with licensed•contractors to'•construct the project (Sec- I ADDRESS tion 7044, Business and Professions Code). 02 2 2'r6 8'8 REQUIRED TOTAL SETBACK F 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.). I SIDE Lender's Name P.L. 1 ` `�(N LDMA Ref.# P.C. Fee$ Permit Fee J Lender's Address I certify that I have read this application and state that the• .• Issuance Fee L l/Z J 6 LDIMA P/C# g above information.is correct. I agree to comply with all County '. ' Investigation Fee t �. q ordinances and State laws relating to building construction, Total Fee (DMA Perm.'# R and hereby authorize representatives of this County to enter j $ upon the abo -menti ne operty f r inspection purposes. m .111/ A SEE REVERSE FOR EXPLANATORY LANGUAGE r Signal a of pplicant or gent --Data"- , S a I ; COUNTY OF LOS ANGELES j TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT fT•EMk''E CITY CA BL 0508 9712150045 PHONE: (818) 285-0488 EXT: EG NO. OF CONST BUILDING A DR SS: ON FILE SQ. FT STORIES TYPE 9863 OLIVE ST STRUCTURE: 0 VN TEMP CA 917803256 ASSESSOR FOR I ER: NEAREST CROSS STREET: 8588-020-011 THOMAS PAGE: 597 GRID: A4 LOCALITY: TEMPLE CITY TENANT: EXIST-BLDG USE: RESID USE ZONE: R-1 ISSUE ON: PROCESSED 8Y: EXPIR S ON: EXIST OCC GRP: 12/15/97 UT 2/15/98 OWNER: TEL. NO: BLOGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY'. CODE: KURPAKUS DOROTHY S 000 - 1 2,290 9863 OLIVE ST t -g !b! TEMP 917803256 FEES PAID DESCRIPTION OF WORK TEAR OFF EXISTING AND RECOVER WITH GENSTAR CAP SHEET FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: PLICA TE O: SUPREME ROOFING (213) 469-2981- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 2290.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 2290.00 VAL 99:15 TOTAL FEES 127.40 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SUPREME ROOFING CO., INC. (213) 469-2981- 1015 N. GOWER ST. LIC. NO LOCATION AND SETBACKS LOS ANGELES, CA 90038 386172 C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: L. 0: FOUNDATION/TRENCH FORMS ' LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 147H269 3 01 _ _ NO. 0 FAMILIES: DWELLING S: AP CO D: S CLASS: FLOOR SHEATHING NO 21 ROOF SHEATHING SCHOOL WITHIN - HAZARDOUS SHEAR PANELS ►��i�� AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TO SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- _ INTERIOR LATH/DRYWALL EXTERIOR LATH RATED-FLOOR/CML S . RATED WALL ASSEMBLIES RATEDS 0 N S T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 t/ h� IVY s COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDfNG-PERMI•I1 DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS .a v —RESIDENTIAL.`ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 Z qL-0508-9901-070042 PHONE: (626) 285-04118 EXT: LEGAL 0. OFO S E B I DI G-ADDRES.: - ON FILE SQ. FT STORIES TYPE OCCUP GROUP �8li3_OLIVE ST STRUCTURE: 506 1 VN U1 ', TEMP--CA 9178032567 - ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: . y% 8588-020-011 OTHER: THOMAS PAGE: 597 GR 15 �A44 LOCALITY:"TEMPLE CITY TENANT: EXIS T CONG 5 USE 0 ISSUED PROCESSED-BY: E P S ON: EXIST OCC GRP: 01/07/99 UT 01/07/00 OWNER: TEL. 0: BLDGS. NOW ON LOT: VALUATION: FINAL DA FINAL FINAL BY CODE: KURPAKUS DOROTHY S (626) 286-8903- 1 12,14 9863 OLIVE ST TEMP 917803256 FEES PAID DESCR PTION OF WORK _ BUILD_NEW-RESIDENT-IAL-GARAGE:, FEE DESCRIPTION: QUANTITY: UOM: AMOON•L• APPLICANT: E-r. WO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION 7A 12140.00 VAL 1.21 SPECIAL CONDITIONS: AX BUILDING E N-F 54.70 D2 PERMI ��E '�f tE��QO VAL 3267.00 50.66 CONTRACTOR: TEL. NO: ��5 ,, APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: -M.—Nu: 0 TIO RENC OR S �Q! LIC. N 1111111 SLAB/UNDER FLOOR RARREW FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: M_ NDERFLOOR ISULATION3j: Lo NO. OFFAMILIES: DWELLING TS: APT CO : STA C ASv �� s) IST LEVELFLOOR SHEATH • NO 21®\\ O 0 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS \ � � �'risme ROOF S EATH G AIR QUALITY: 1000 FEET MATERIALS NO NO NOEl ®y IRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST 46�• El 0th BLDG DEPT. FR INSPECT FRONBACK PL- YARD: FRONT PL- PROP LINE: WIDTH: Service•That SHEAR PANELSSIDE ` INSULATION/WEATHERSTRIP INTERIOR LTT—H/DRYWALL-- EXTERIOR LATH LOT DRAINAGE SMO DETECTIOff-DIVC S FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508