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HomeMy Public PortalAbout9909 OLIVE ST_Building__ M .'75 638A CE #803 1/71 APPLICATION FOR BUILDING PERM � COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DMSION BUILDING ADDRESS COLEMAN W. JENKINS. SUIP'T OF BUILDING LOCALITYf' C FOR APPLICANT TO FILL IN NEAREST Print or tvDe onl CROSS ST. Al'C CA M A VA BUILDING DISTRICT NO. GROUP YPE WOCESSED BY ADDRESS Q y /U �f �' �' CONST, STATISTICAL C ASSIFICATION SEWER✓�MAP LOT NO. —72_ BLOCK CLASS NO. DWELL,UNITS BK EPG Z- TRACT USEZONE MAP NO.OF BLDGS. NO. V SIZE OF T NOW ON LOT awc SPECIAL USE OF NG BLDGG/ I "0Ar///" �, CONDITIONS EXISTING OWNER ,IATI�/= �'2 TEL NO. Z�� 787 SETBACK ADDRESS FRONT PROP.LINE OF (STREET) 9 �9 Dr�vr- S7� TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY HIGHWAY WIDTH FROM C.L. ARCHITECT/OR TEL. + ENGINEER NO. BLDG.SETBAC ADDRESS SIDE PROP.LINE OF _ (STREET) TEL. LI TYPE OF EXISTING SETBACK HIGHW YARD = TOTAL O CONTRACTOR - C'//�' NO. HIGHWAY WIDTH FROM C.L. zC: ADDRESS2 � Tlam/= NO. XIST5pp 7 + - 1C. CITY p �� /Vf(�✓ s CLASS ��/ CORNER e0T.OFF YES 'G NO ❑ Lj CONSTRUCTION LENDER C- NAME AND BRANCH SEE REVERSE SID FOR SPECI APPROVALS ADDRESS SQ. FT. NO. OF NO. OF NEW ❑ //r/7Z '07 ) SIZE STORIES FAMILIES USE OF ADD ❑ �' i� G►� / "^-^ STRUCTURE i ALTER ❑ �' f ' REPAIR SI NATURE OF APPLICANT DEMOL ❑ VALUATIONS APPROVALS DATE INSPECTOR'S SIGNATURE PMT. FOUNDATION: LOCATION FEE S FEE$ FORMS, MATERIALS FRAME: FIRE STOPS, ?L 1 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. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT (yj LABOR CODE OF THE STATE OF •C LIFOR NIA IN RELATING TO WORKMEN'S COMPENSATION I RA E. LATH, EXT. ,L, SIG PERMITTEE OF HOUSE NUMB R CO f RECT AND POSTIED 114 i ADDRESS FINAL JOHN F. LEWIS. PRINCIPAL SncK. RAL ENGINEER PLAN CHECK VALIDATION Cl. M.o. CASH _ PERMIT VALIDATIONM.O. CASH LA Co.4 4 1 01 FEB 15 1 D 28.50, IBA888A CE#808 B-63APPLICATION FOR BUILDING PERMIT-.. COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY 1017 JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTRICT NTYPE B FOR APPLICANT TO FILL IN CONST. BUILDING STATISTICAL CLASS ICATION E E P ADDRESS Q BKPG CLASS. NO. DWELL.UNITS ii-- LOT NO. BLOCK WATER CERTIFICATE: NOT REQUIRED ❑ RECEIVED TRACT£'� MAP NO. H NO.OF BLDGS. CGRCVLE) STATE MAJOR SECOND,LOCAL SIZE OF LOT NOW ON LOT USE ZONE —SPECIAL USE OFr CONDITIONS EXISTING BLDG. TEL. OWNERNO. U L INC EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS Q 7 64ivE lg--wAsC FRONT ARCHITECT OR TEL. P. L• ENGINEER _ �`I0 SIDE P. L. ADDRESS O� -- TEL. 0 CONTRACTOR 4 NO.47A/p ADDRESS G/j6AA0 DESCRIPTION OF WORK �` �`/ _ v Lu z 916 tn NEW ADD ALTER REPAIR DEMOLISH SQ.F NO.OF NO.OF SIZE �- STORIES FAMILIES 7 USE OF / .... n - STRUCTURE L. SIGNATURE OF APPLICANT VALUATION $ I/ V APPROVALS DATE INSPEC RIS SIGNATURE P.C. PMT. FOUNDATION: LOCATION ��f FEE $ FEE $ d FORMS, MATERIALS FRAME: FIRE STOPS, f 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE 18 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, �,7` , WITH ALL COUNTY ORDINANCES AND STATE LAWS REGU /LATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT., O AG TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMPENSATION INSURANCE. LATH,EXT. v SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS1� + 2wi�'JSO G�TQ FINAL ��! om —' A--A-1 7-,,!F JOHN F. LEWIS. P INCI�AL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH LAL;o 8 6 0 0MAY 17 1 a 2 2.0.ON r ",WORKERS'COMPENSATION DECLARATION r affcer that I have certificate of consent self APPLICATION FOR BUILDING PERMIT insure' or a certificate of Workers'Compensation Insurance, or o'certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company F-1Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRBUILDESS ADDRESS . ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS Date Applicant ,F Y ZIP LOCALITY, CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLD NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. J (This section need not be completed if the permit is for one TRACTBLOCK LOT NO. _ MAP BOOK PAGE PARCEL hundred dollars($100)or less.) I certify that in the performance of wo for which this OWNER q (.• �� r�6f�, USE NE NOP permit is issu d,1 shall not emplo ny per n in an nn e$ �I SPECIAL so as to be m s jet to the rkers' m e s S. ADDRESS ����""'"' CONDITIONS V Date ,1 Applicant CITY ZIP NOTI TO APPLICANT: If, a r aki s Certificate f ARCHITECT OR TEL. DISTRICT G UP TYPE FIRE PROCESSED BY O ENGINEER NO. / CONST ZONE I-^ Exemption, you should b o 3W to the Work rs' Compensation provisions t Labor Code, you must forth- ADDRESS VVV o 1 LL( with comply with such pr isions or this permit shall be 0- TEL. STATISTICAL CLASSIFI TION APT. NDO. N deemed revoked. CONTRACTOR 1. NO. Z LICENSED C NTRACTORS DECLARATION LIC. CLASS NO. � DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK P15.* VALIDATION SQ. FT. NO.OF NO.OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE • ❑ VALUATION DESCRIPTION OF RK NEW Contractor Date ADD ❑ s �V ❑1 am exempt under Sec. ALTER ❑ , B.&P.C. fort re on ^ REPAIR ❑ $ USE OF ❑ •ate' EXISTING BLDG. DEMOL . APPLICANT TEL. Signature FINAL NE�- W RATVntractor's PRINT NO. DA I hereby off' hat Wm exempt from the License or Law for t 9 allowing reason (Section 70 , Business and ADDRESS Profess! ode): PRESENT Y X 9 2 9.0 A [01nBUILDING as ower of the property, or my employees with ADDRESS #;a 0'a 0 10 ;.1 wages as their sole compensation,'will do the work and ' the structure is not intended or offered for sale(Section LOCALITY 1. - - 49.88 7044, Business and Professions Code). MOVING TEL. ❑ I,as owner of the property, am exclusively contracting CONTRACTOR NO. o 0 0 [j.q,$$;� with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). �0 1 `8 8 REQUIRED YARD HWY TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK 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.). SIDE P.L. Lender's Name W P.C.Fee$ Permit Fee L LDMA Ref. p Lender's Address �) �) I certify that I have read this application and state that the Issuance Fee V. — LDMA P/C H 9 above information Is correct. I agree to comply with all County Investigation Fee �( q or s and State laws rg�lating to building construction, Total Fee E J LDMA Perm.N R an er y authorize r presbniptives of this County to enter on t above-m d' dro arty for inspection purposes. m SEE REVERSE FOR EXPLANATORY LANGUAGE n Si a of Applicant or ant Date Wa�cqrtified ERS'COMPENSATION DECLARATION that L.oave r certificate of consent to self APPLICATION � FOR BUILDING PERMIT tificate of Workers'Compensation Insurance, 'py thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING r ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN. ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS A p Date Applicant CITY /1-X1 ZIP ITy 2tnak / / NEAREST I'f '/ CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. / V COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. Ro (This section need not be completed if the permit is for one - ASSESSOR hundred dollars($100)or less.) TRACT BLOCK LOT NO.'• MAP BOOK PAGE PARCEL TE pp f7 US�ZONE MAP OWNER 0 I certify that in the performance of the work for which this © N IS ZX� 6 I NO permit is issued,I shall not employ any person in any manner ADDRESS . O� '� + ' ��1� , so as to comes bject to the Workers'Compensation Laws. CONDITIONS 0 A n CI ZIP �� V Date 7 Applicant ARCHITECT OR ^ $� � NOTI TO PLI NT: If, of making*this Certificay of ENGINEER ��-2 DISTRICT GROUP TYPE FIRE PROCESSED BY O Exe ption, fou should become subject to the Wdrkers' ADDRESS /� 0 NST./ ZONE w Compensation provisions of the Labor Code, you must forth- (� with comply with such provisions or this permit shall be deemed revoked. TEL STATISTICAL C CAT ON APr. DO. Z CONTRAC70Re. NO. LICENSED CONTRACTORS DECLARATION CLASS NO. DWELL UNITS— I v Z LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code,and my license is in full force and effect. CITY CLASS BK PGVALIDATION SQ.FT. NO.OF NO.OF r CHECK License Number Lic.Class SIZE STORIES V FAMILIES / ONE � VALUATION Contractor Date DESCRIPTibN OF WORK , l 42 D O $ I am exempt under Sec. TER ❑ o .20a79:05 B.BP.C. for this reason U OF G REPAIR ❑ $ 1 .1,30-87 Date EXIST)NG BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL ,Proessions Code): PRESER BY I, as owner of the roe y employees BUILDING 8 8 7 9 A property,rty, or m em to ees with ADDRESS wages as their sole compensation,will do the work and• ® # o e o a,all the structure is not intended or offered fbr sale(Section LOCALITY 7044, Business and-Professions Code). MOVING TEL ;1 - 256,13 ❑ I,as owner of the property;am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS a a 2 5 6, 1 3 5 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FR CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH o.1.29.-88 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.). SIDE P.L. Lender's Name / C S (� 3 LAMA Ref. # m P.C.Fee$ i Permit Fee Lender's Address 0 1 certify that I have read this application and state that the Issuance Fee V (/ LDMA F/C# o above information is correct. I agree to comply with all County Investigation Fee q ordtnan nd State laws relating Ip building construction, Total Fee S TDMA Perm.if I R and reby authorize yr s ntatives of this Coun toe ter 2 u�the ove-ment• roe inspection urpo es. a— SEE REVERSE FOR EXPLANATORY LANGUAGE Sign o p licanr or Agent