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Home My Public Portal About4540 CLOVERLY AVE_Building__ -VtVISION OF BUILDING AND SAFETY U ' ` - Aepgrtment of CountAyA,,vngineer OC 1 l — �Q�� ' WM. J. FOX, COUNTY ENGINEER ,�+`- APPLICATION FOR APPLICANT TO FILL INFOR OFFICE USE ONLY /-r DISTRICT NO. PLANCK OR REC NO PERMIT NO BUILDING ;L ADDRESS q-D LOCALITY RECEIVED �BnY� DATE OFAPPL. DATE ISSUED 1 G! �l�n/7/YVG/l� - �Q - S �" T b IO NEAREST r-16 7 CRO BT U Z✓Z 9UILDING LL F._// O /J ADDRESS T .J 4 {,.'1 i OWNER G/` r ~ _ , LOCALITY /d.xr� � V / MAIL // ADDRESS fo G v i NEAREST CWOf9 ST. CITY E `I �+i T No O FIRE NO.OF I TYPE GROUP �'� ARCHITECT OR TEL ZONE PLANS ENGINEER NO. BLDG -).. o ORD NO SETBACK LINE 49./) ADDRESS USE ^ � APPROVED J.-' TEL ZONE BY DATE CONTRACTOR NO HOUSE NUMBERING ADDRESS MAP NUMBER l y NO ASSIGNED Y LEGAL DESCRIPTION LO�TrNO BLOCK /�/�CORRECTION3 TRACT pG 9 O A ND. DF BLOGB. X SIZE OF LOT &3 O NOW ON LOT USE OF NO OF EXISTING BLDG I FAMILIES N-, DESCRIPTION OF WORK 00 - NEW ALTERATION ADDITION o Z ' D `REPAIR DEMOLITION r 89 FT. NO or SIZE 11,V ROOMS STORIES EXT WALLr I ROOF tolqDp/ COVEMNG / ✓ G Q C- COVERING /,✓ ICE S USE OF STRUCTURE INSPECTION FOR J APPROVALS OCCUPANCYAS G" INSPECTgR S SIGNATURE DATE FOUNDATION LOCATION FORMS. MATERIALS / J� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME1 FIRE STOPS, CORRECT BRACING, BOLTS �/I AGREE TO COMPLY WITH ALL ` 1 AND STATE LAWS REGULATING BUI DOING CONSTRUCTIOUNTY N FURNACE LOCATION, ` ` OAS VENT, DUCTS SIGNATURE OF�7 LATH, INT PERMITTE 1 ,1 LATH, EXT. ADDREBB� T�M F G r �x L5 � � � — // PLASTER, INT. AUTHORIZED AOT. d C ! 1 PLASTER, EXT. P y FEE l� '�' HOUSE NUMBER COR- RECT AND POSTED v VALUATION / FEE Q FINAL i 76A63aA D65 3 1-52 ""APPLICATION:FO-R " fi !bIJIL®1NG ,PERMIT' -- ` ' FOR APPLICANT TO FILL IN ADDRESS BUILDING �� CI BUILDINGr ` - - -' ADDRESS r C'/OLS edZ l LOCALITY7w ti NEAREST „ CITY_ 1Z Cl/ f ZIP CROSSST' NO OF BLDGS �J ASSESSOR t SIZE OF LOT ° NOW ON LOT MAP BOOK 'S PAGE "' " PARCEL n DISTRICT, GROUP TYPE FIRE ' PROCESSED BY TRAC-T "--/-? G( BLOCK LOT NO U7 p" " CONST)//''. ZO OWNER �YV Il1 t. 1 l NO «u(� -/! 5� Y ✓': l G fiJ p�- �p ST ATISTICALCLASSIFICATION'1 h Y ( - SEWER MAP ADDRESS J 14'D cl'o v ep CLASS NO DWELL UNITS r �BK,Z-PG' CITY C T ZIP v USE ZONE,g +NOP S/' %�n ry ARCHIT CT OR -TEL i z , ENGINEER �"` NOCONDITIONS' tet' _ - + ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED ,YES ❑ NO ❑✓ �J TEL ` CONTRACTOR C Jfl✓)t #20 /wtNO %N�3/3 BLDG SETBACK FROM ,• " Q Q LIC ��o FRONVPROP LINEOF 'L ''(STREET) ti ADDRESSq ` oe(/_S Z570/�NO ...JJ HIGHWAY t YARD _ = TOTAL SETBACK FROM TYPE OF EXISTING �j'� LIC - • —FRONT PROP LINE' HIGHWAY WIDTH CITY /'�/ 1/�OJII-� (� CLASS ` + „ _ , U CONSTRUCTION LENDER } NAME AND BRANCH.— +.Y� / r U "` � BLDG SETBACK FROM �„ {-� .a -t - - �"- �. U SIDE PROP LINE OF (STREET) r ADDRESS CITY «' O SQ FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK FROM TYPE'OF EXISTING U SIZE ` STORIES FAMILIES ONE SIDE PROP LINE. HIGHWAY WIDTH a _ - - DE RIPTION OF WORK NEW iCl "o �U u _°n ADD , '❑ CORNER CUTOFF YES ❑ NO '❑ r ALTER .❑ IN'OPEN SPACE YES ❑ NO ❑ " T �p Az 0 REPAIR ❑ USE OF, BLDG 1 T l `�+� �o DEMOL ❑ AS -IN'COTAL PERMIT ZONE #-YESN EXIEl ❑ APPLICANT ' TEL �J�j p Q 3 w� IFRINT)�►V 9r /�jvm%VJ NO WY3`` J r BY(SIGNATURE) IHEREBY ACKNOWLEDGE THAVI HAVE-READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO'COMPLY WITH ALL ORDINANCES AND,LAWS REGULATING BUILDING CONSTRUCTION I'CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM t r PENSATION INSURANCE SIGNATURE OF FINAL 'PERMITTEE DATE ADDRESS j � TEL � P C Fee$ �4' � � Permit Fee CITY - NO Issuance Fee VALUATION$ CJ(/ Total Fee PLAN CHECK VALIDATION cK M O CASH PERMIT VALIDATION CK M o` CASH ), (QCT 5 3�@ 9,0 ® �7 _ K ; ®S'76A63813 CE'N80313 6/78 WORKERS' COMPENSATION DECLARATION y insure,oraafcertif cafirm tharte of Wo ke sr Compensation eInsuran of APPLICATION FOR BUILDING PERMIT or a certified copy� t��he��reof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 1101812 BUILDING ❑ Certified copy is hereby furnished. FOV, APPLICANT TO FILL IN ADDRESS O4,6 vext- L+K Certified copy is filed with the county building inspec- BUILDING J, tion ADDRESS '� I VE (� department. 11 Date rtrtment. r 13�v Applicant ISI] Is gr&o><— CITY ( ZIP LOCALITY Li NO. OF BLDGS. CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT .5f NOW ON LOT NEAREST ROSS ST. AbWE12 COMPENSATION INSURANCE C ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK I LOT NO. MAP'BOOK PAGE PARCEL hundred dollars ($100) or less.)_ TEL. OWNER NO. USE ZONE MAP NO. I certify that in the performance of the work for which this _ /l � permit is issued, I shall not employ any person in any manner ADDRESS � {� ! CSPECIAL ONDITIONS 4 so as to become subject to the Workers' Compensation Laws. CITY � � ZIP Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE . FIRE PR ESSED BY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. ®� CONST ZONE Exemption,. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS / with comply with such provisions or this permit shall beTEL. STATISTICAL CLASSIFICATION APT, CONDO. Z deemed revoked. CONTRACTOR NO. — — LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS S NO. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY CLASS BK LPG VALIDATION SQ. FT. Ih I NO. OF NO, OF CHECK License Number 3 3 gq q 2 Lic. Class SIZE TI STORIES FAMILIES ONE VALUATION DESCRIPTION . NEW El Contractor �J Date 8 DESCRIPTION OF WORK ADD $ ❑I am exempt under Sec. ► ALTER ❑ B.&P.C. for this reason REPAIR ❑ E USE OF Date: EXISTING BLDG. r C e_V DEMOL ❑ Si nature APPLICANT TEL. g OWNER-BUILDER DECLARATION (PRINT). FINA\ U N0.5 DATEL I hereby affirm that I am exempt from the Contractor's License ADDRESS r W FINAL Law for the following reason (Section 7031.5; Business and Professions Code): PRESENT BY , BUILDING El 1, as owner of the property, or my.employees with ADDRESS wages as their sole compensation,will do the work and •' to " — ' 9 P 1 +t t. t y 41 2 _• r 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 exclusive) contracting CONTRACTOR NO. _ P P Y� Y 9 "f•'� with licensed contractors to construct:the project (Sec- �`'' ` '` tion 7044, Business and Professions Code.) ADDRESS _ CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP. LISETBACNE WIDTH WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work fogy which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE. P.L. .. m Lender's Name •'7 LDMA Ref. # P.C. Fee$ Permit Fee / Lender's Address �_ ^ , I certify that I have read this application and state that the Issuance Fee < U LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee 6 ordinances and State laws relating to building construction, Total Fee i LDMA Perm. # a and hereby authorize represeqtatives of this County to enter upon the abo -mentioned pert for inspection purposes. • SEE REVERSE FOR EXPLANATORY LANGUAGE S' nature f Applicant or Agent Date I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0506140030 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS TR 12998 LT 10 SQ FT STORIES TYPE 4540 CLOVERLY AV STRUCTURE VN TEMP CA 917804203 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8592-002-025 THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY C TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 06/14/05 JK 06/09/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE KIRIN DENNIS J,CONNIE L (626) 444-7988- 4,300 4540 CLOVERLY AV TEMP 917804203 FEES PAID DESCRIPTION OF WORK REPLACE (9) WINDOWS SAME SIZE ,.- FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT TEL NO SEARS HOME IMP (800) 807-9889- AA BLDG PERMIT ISSUANCE 27 75 10395 SLUSHER DR AC STRONG MOTION RESID 4300 00 VAL 0 50 SPECIAL CONDITIONS SANTA FE SPRINGS D2 PERMIT W/O EN-HC 4300 00 VAL 132 60 TOTAL FEES 160 85 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SEARS HOME IMP (800) 807-9889- 10395 SLUSHER DR LIC NO LOCATION AND SETBACKS SANTA FE SPRINGS CA 90670 721379 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS LIC NO SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION 144H269 3 OL 'In FLOOR SHEATHING NO OF FAMILIES DWELLING UNITS APT/GOND STAT CLASS �,�-/�/f/�wX— NO 21 DLI(� 'Y'�v I ROOF SHEATHING SCHOOL WITHIN HAZARDOUS 14� SHEAR PANELS o AIR QUALITY 1000 FEET MATERIALS LLL NO NO NO J� FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST // FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE WIDTH FRONT PL- \('�"O�� e/ INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS ' T-BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0506 BUILDING PERMIT n DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR (� BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0509070080 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS TR 12998 LT 10 SQ FT STORIES TYPE 4540 CLOVERLY AV STRUCTURE 2500 VN TEMP CA 917804203 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8592-002-025 THOMAS PAGE 597 GRID AS LOCALITY TEMPLE CITY C TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 09/07/05 JK 09/02/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINA CODE KIRIN DENNIS J CONNIE L (626) 444-7988- 5,200 4540 CLOVERLY AV 1 TEMP 917804203 FEES PAID D S RIP ION OF WORK TEAR OFF AND RE-ROOF WITH 30 YR COMPOSITION SHINGLES AND FEE DESCRIPTION QUANTITY UOM AMOUNT TORCH HOUSE AND GARAGE APPLICANT TEL NO JAY RHEE (323) 864-7388- AA BLDG PERMIT ISSUANCE 27 75 3100 S MAIN ST AC STRONG MOTION RESID 5200 00 VAL 0 52 SPECIAL CONDITIONS LOS ANGELES 90007 D2 PERMIT W/O EN-HC 5200 00 VAL 149 40 TOTAL FEES 177 67 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE JAY FREE (323) 864-7388- 3100 S MAIN STREET LIC NO LOCACION AND SETBACKS LOS ANGELES CA 90007 829737B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMS LIC NO SLAB/UNDER FLOOR i RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDERFLOOR INSULATION 144H269 3 01 FLOOR SHEATHING NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS NO 21 ROOF, SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION T i REQUIRED TOTAL 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/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0506060002 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS TR 12998 LT 10 SQ FT STORIES TYPE 4540 CLOVERLY AV STRUCTURE VN TEMP CA 917804203 _ ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 8592-002-025 THOMAS PAGE 597 GRID A5 LOCALITY TEMPLE CITY C TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 06/06/05 JK 06/01/06 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL, FI L'BY CODE KIRIN DENNIS J,CONNIE L (626) 444-7988- 6 980 S/o'— 4540 CLOVERLY AV TEMP 917804203 FEES PAID DESCRIPTION OF WORK` REPLACE 14 WINDOWS (SAME SIZE) FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT TEL NO SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 AC STRONG MOTION RESID 6980 00 VAL 0 70 SPECIAL CONDITIONS D2 PERMIT W/O EN-HC 6980 00 VAL 166 20 TOTAL FEES 194 65 CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER TEL NO FOUNDATION TRENCH FORMS LIC NO SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP UNDFRFLOOR INSULATION XX 3 01 FLOOR SHEATHING NO OF FAMILIES DWELLING UNITS APT COND STAT CLASS NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL 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/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508