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HomeMy Public PortalAbout4804 CLOVERLY AVE_Building__ 7GA63SA C6#BOD6 sa APPLICATION FOR BUILDING PERMIT — • 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE,COUNTY ENGINEER NEARESTd CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST IZJ L L.-# " !J DISTRICT NO I GROUP ITYPEPROCp85Rb BY FOR APPLICANT TO FILL IN Is- Z CONST ' BUILDING SE ;MAP STATISTICAL CLASSIFICATION ADDRESS CLASS NO DWELL UNITS BK PG LOT NO BLOCK MAPSTATE YES NUMBER Z C3 � HWY _TRACT �� U�E7 ON SPECIAL {/ NO OF BLDGS CONDITIONS SIZE OF LOT �11 I NOW ON LOT USE OF 1 EXI TINO BLDG BUILDING Y EXIST SETBACK YARD HWY _STREET NAME -WIDTH. OWNER lO C C M T FRONT �tl MAIL ea�/ r ♦� /� P L ADDRESS t.[..y �J �/Y CCJ G-' SIDE CITY INSPECTION RECORD ` ARCHITECT OR /'� Q �`R TEL ENGINEER [ /� 4- NO ADDRESSa C 0 N T R A B FI d/9197�/�/10ER14 CNO z�^/7,4 i. ADDRESS DESCRIPTION OF WORK NEW (// IA ADD ALTER REPAIR DEMOLISH -- SQ FT y(�( SNO NO OOF FAMIOLIESZ SIZE u USE OF STRUCTURE SIGNAT,UREj'. APPROVALS _ AP ICAN C+G IE�"� —, JKA D T INSP S S1 NA'WRE AD FOUNDATION LOCATION � FORMS MATERIALS $ ` P C $ FRAME FIRE STOPS FEE BRACING BOLTS VALUATION /"2 00-oQ FURNACE LOCATION FEE GAS VENT DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE AD THIS AP LATH INT PLICATION AND STA HAT THE VE IS ORR-ECT AND AGREE TOC ALL CO E NO STATE LAW BUI LATH EXT l SIGNATURE OF HOUSE NUMBER COR- TU OR- / PERMITTE RECT AND POSTED .��f-/ //_ /7 ADDRESS FINAL CLYDE N DIRLAM PRINCIPAL ST C RAL ENGINEER I PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION cK mo CASH . 2 '6,4 7'S: FED 20,.,2 3-A , 19.50 A M s4's w FEB 27 1A 3 9.0 0 *. APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER a B U I L D I N G PERMIT BUILDING AND SAFETY DIVISION FOR APPLICANT TO FILL IN ADDRESS u BUILDING ADDRESS O LOCALITY CITY /rJ e 1�9 ZIP NEAREST CROSS ST. NO.OF BLOGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT UP YPE FIRE S�EO BY re S TRACT BLOCK LOT NO. 2 ~ TEL. y OWNER NO. / STATISTICAL CLASSIFICATION SEWER MAP ADDRESS Q - (J �'j9' (bj CLASS NO. DWELL,UNITS BK d7-PG �lONE MAP CITY �. ZIPTJ7 NO. ARCHITECT 0 TEL�y� gyp; SPECIAL ENGINEER 44-NO. 7(/ '7/�y� CONDITIONS T ADDRESS ef-t temr ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ TELBL G.SETBACK FROM CONTRACTORNO �r / FR*T PROP.LINE OF (STREET) ADDRESS 70 NO�l? NIGY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING LIC. H A FRONT PROP. LINE HIGHWAY WIDTH CITY A - CLASS _ CONSTRUCTION LE DER } NAME AND BRANCH BLDG. ACKFROM a ADDRESS CITY SIDEP P. LINE OF (STREET) C::) SQ. FT. NO. OF NO. OF CHECK HIGHWAY } YARD = TOTAL SETBACK FROM TYPE OF EXISTING O SIZE STORIES FAMILIES ONE OP. LIN HIGHWAY WIDTH DESCRIPTION OF WORK NEW } N r! O 60 el- ADD CORNER CUTOFF YES ❑ NO C] ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR❑ USE OF r IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLD �� �jDEMOL ❑ APPLICANT TEL - BY (SIGNATURE) A/4, 1 HEREBY ACKNOWLEDGE THAT I H E READ TN APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VI O ATI N OF TME LABOR CODE OF T E STATE OF CALIF IA I R ATING TO WORKMEN'S COMP NS TI NS IAANC E. SIGNATURE OF FINAL �^ ��� BY PERMITTEE ;� DATE 2_ ADDRESS TE L. P.C. Fee$ �� Permit Fee 21 7­5CITY NO. Issuance Fee VALUATION Q'� �J iF O v --� �C !! Total Fee PLAN CHECK VALIDATION CK,_ M.O. CASH _ PERMIT VALIDATION CCIC\ M.O. CASH 5 9 6r-"DEC 2 2.3 D 1 3.0 5 5 9 7 DEC 2 1 D ? ..7 5 76A638A CE#803B 12/75 '" _ �- COUNTY OF LOS ANGELES TEMPLE CITY #0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9709300049 PHONE: (818) 285-0488 EXT: LEGA ID NO. OF CONST BUILDING ADDRESS: TR: 11454 LT: 27 SQ. FT STORIES TYPE 4804 CLOVERLY AV STRUCTURE: 0 VN TEMP CA 917803808 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LOWER AZUSA 8590-020-011 THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY TENANT: TXIST BLDG USE: RESID USE ZONE: R- ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 09/30/97 UT 09/30/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY CODE: JONES EVAN S;MARGUERITE M (818) 287-4039- 1 1,500 Q 4804 CLOVERLY AVf i7-1"� TEMP 917803808 FEES PAID DESCRIPTION OF WORK CHANGE OUT 3 WINDOWS-RECOVER ROOF WITH GAF 20 YR. COMP. FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SHINGLES (HOUSING REHABILITATION) APPLICANT: TEL. N0: I R-ABLE II GENERAL CONTRACTORS (626) 357-9766- I,AA BLDG PERMIT ISSUANCE 27.75 'AC STRONG MOTION RESID 1500.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/0 EN-HC 1500.00 VAL 82.20 TOTAL FEES 110.45 CONTRACTOR: TEL. N0: „',-; APPROVALS DATE INSPECTOR SIGNATURE R-ABLE II GENERAL CONSTRUCTORS (818) 357-9766- 132 W. POMONA AVENUE LIC. NO LOCATION AND SETBACKS MONROVIA, CA 91016 469975/6 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 01I FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR DUALITY: 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 n j APPLICATION FOR BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY `• UILDIDDR WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS SS B �•� 0 - f I hereby affirm that I have a certificate of consent to self insure, � N3 or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY-.— /., j� zIP�/ C � LOCALITY Policy No. Company SIZE OF LOTNO.OF BLDG.NOW ON LOT r" ❑ Certified copy is hereby furnished. ld� .6. NEAREST CROSS ST. ❑ Certified c0 is filed with the county building inspection TRACT BLOCK LOT NO. Py 9 P � �Q a' USE ZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL Date Applicant JJ�/ SPECIAL CONDITIONS 0: , 7CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ' Tv ��1 TEL.NO. /� YES NO COMPENSATION INSURANCE �C�/�✓c7ADDRESS WITHIN 1000 FT.OF SCHOOL? <� (This section need not be completed if the permit is for one hundred �--�-�i�'/ DISTRICT GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) X ZIP I certify that in the performance of the work for which this permit �-e'C 1! 6Z 6 is issued, I Shall not employ any person in any manner so as to ARCHITECT 6R ENGINEE f TEL.NO. t� become subject to the Workers'Corr tion Laws. STATISTICAL CLASSIFICATION APT CONDO Date�` Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making t ertificate of CONTRACTOR TELNOREQUIRED TOTAL SETBACK FROM EXIST . . Exemption, you should become subject to the Workers' SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith ' FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL >- LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS PIL o U I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP SQ. SIZE NO.OF STORES NO.OF FAMILIES (commencing with Section 7000)of Division 3 of the Business and 4 NEW ❑ BK PG Professions Code,and my license is in full force and effect. v License Number Lic.Class DESCRIPTION OF WORK ADD VALUATION Lu Contractor Date ALTER ❑ $ c!> ❑ I am exempt under Sec. REPAIR ❑ $ B.BP.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF EXISTING BLDG. URM ❑ Signature APPLICADLT-fBRINT) �r TEL.NO. LDMA Perm# 4� ❑ I, as owner of the property, or my employees with wages as O An their sole compensation,will do the work and the structure is ADD Ess H .. not intended or offered for sale (Section 7044, Business and ©� /Q ( FINAL DAT Q _`t f ^. /professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE AHAZARDOUSMA ERIAL tffi I, as owner of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN 1 ` Y 9 THE AMOUNTS SPE IFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project.(Section 7044, YES❑ No Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ';-'�'^•'1 - - � CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINE ,i I•'-•i'�. I hereby affirm that there is a construction lending agency for YES C1 No — -the performance of the work for which this permit is issued(Sec. 14. 3097,CIV.C. . I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD ` ' ' •-"' """ PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES rn m. COUNTYCODE,TI , ,CHAPTER 220SECTIONS 220.100 THROUGH CONCERNING •_,•-,,,,, o Lender's Name RIALS REPORT ND FOR OBTAINING A PERMIT FROM THE SCAOMD. aLender's Address DR ncw� o I certify that I have read this application and state that the above FRC. E PERMIT FEEinformation is correct. I agree to comply with all county �f�' 7� / ordinances and State laws relating to building construction,and // / / o "`3-`t'3 F== '-` I ¢. hereby authorize representatives of this County to enter upon ISSUANCE FEE .,.� above- oned grope r inspection purposes. ���� '�•=�•.;. -• ••-•••- •• Q '3''6-92. INVESTIGATION FEE TOTAL FEE m _ necun n nngiwn a neem Dna SEE REVERSE FOR EXPLANATORY LANGUAGE 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 1101250013 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: 1 ITR: 11454 LT: 27 I SQ. FT STORIES TYPE 1 4804 CLOVERLY AV J I ISTRUCTURE: V-B TEMP CA 917803808 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LOWER AZUSA J 18590-020-011 J I THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: I (EXIST OCC GRP: 101/25/11 SR I I I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IF_]IN�AIf�J�1{DDSATE FIN CODE: J IWEN, IIN W (626) 614-8072- 1 3,000 14804 CLOVERLY AV I I ITEMP 917803808 1 FEES PAID IDESCRIPTION OF WORK 1 I I IBATHROOM REMODEL I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( I (APPLICANT: TEL. NO: I I I ISAME AS OWNER - JAA BLDG PERMIT ISSUANCE 27.80 1 J 1 JAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 1SPECIAL CONDITIONS: IAC STRONG MOTION RESID 3000.00 VAL 0.50 I I JB2 PERMIT W/ENERGY 3000.00 VAL 109.00 JFR INV WORK W/O PERMIT 257.00 DOL 257.00 I ICONTRACTOR: TEL. NO: I TOTAL FEES 395.30 (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I i I LIC. NO 1 JLOCATION AND SETBACKS I I I I I I I I ISOILS ENGINEER APPROVAL I I JARCHITECT OR ENGINEER: TEL. NO: J IFOUNDATION/TRENCH FORMS I I 1 LIC. NO: J JSLAB/UNDER FLOOR I I I I I I I I I I I IRAISED FLOOR FRAMING I I I I I I I I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: J (UNDERFLOOR INSULATION I I I 1144H269 3 001 1 11 1 I I IFLOOR SHEATHING I I I INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 21 1 IROOF SHEATHING I I I I I I I I I 1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I I JAIR QUALITY: 1000 FEET MATERIALS I I I I 1 NO NO NO 1 IFRAME INSPECTION I I I I I I I I I IFIRE SPRINKLER HANGERS I I I I I I I I I JINSULATION/WEATHER STRIPI I I I I I I (INTERIOR LATH/DRYWALL 1 I I I I I I I I JEXTERIOR LATH I I I I I I I IRATED FLOOR/CEIL ASSEM. I I I I I I I I I I IRATED WALL ASSEMBLIES I I I I I I I I IRATED SHAFTS/OPENINGS I I I I I I I I IT-BAR CEILINGS I I I I I I I I I I ILOT DRAINAGE I I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I