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Home My Public Portal About4840 CLOVERLY AVE_Building__ 76ABBOA C6#903,0-e8 " APPLICATION FOR BUILDING PERMIT - 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER- ` ADDRESS r' BUILDING AND SAFETY DMSION 'LOCALITY > JOHN A LAMBIE, COUNTY ENGINEER NEAREST / CASSATT D GRIFFIN,SUP T OF BUILDING i r .CROSS ST G DIST ro GRO P TYPE TOCESSED Y' FOR APPLICANTIO FILL IN s CONST r BUILDING + STATISTICAL CLASSIFICATION I SEWER MAP ADDRESS f, - -_ , BK PG Q' CLASS NO WELL UNITS ' MAP STATE LOT NO J » BLOCK NUMBER "v HWY YES NO -0 TRACT lvv�` } SE ZONE SPECIAL j NO OF BLDGS CONDITIONS -� _ SIZE OF LOT)FD g I N ON L T USE OF EXISTING LDG UILDING ' EXIST SETBACK YARD= HWY STREET NAME r WIDTH OWNE v J `l FRONT MAIL ADDRESS SIDE TEL - P L `- CITY • No INSPECTION RECORD ` ARCHITECT OR - TELA r _ ENGINEER NO ADDRESS TEL' CONTRACTOR NO ADDRESS DESCRIPTION OF WORK� r - - NEW -NEW ADD ALTER REPAIR DEMOLISH [ SQ FT -if- ` NO OF ` SIZE 00 STORIES FAMILIESQ USE OF STRUCTURE S SIGNATURE OF -� - APPLICAN((�� APPROVALS .r DATE INSPECTOR S SIGNATURE , ADDRES (f ltO : FOUNDATION LOCATION FORMS,MATERIALS VALUATION S FRAME FIRESTOPS, BRACING,BOLTS < PC PMT Q _ FURNACE LOCATION, FEE `$ I FEE $ �� I GAS VENT,DUCTS w I HEREBY ACKNOWLEDGE THAT 1 HAVE READJHIS AP- PLICATION AND STATE THAT THE ABOVE IS CORRECT AND LATH INT AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND _ STATE LAWS REGUL NG BUILD I NS RUCTION LATH EXT SIGNATUREOF HOUSE,NUMBER COR- _Z4 REC T AND POSTED ADDRESS FINAL' 1 CLYDE.N DIRLAM, PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION cK M O CASH 0 5 9 W)l h1OV ?-4 ` WORKERS COMPENSATION DECLARATION ` Y 1 hereby affirm that I have certificate,of consent to self APPLICATION FOR BUILDING PERMIT `ti insure or certificate of Workers' Compensation Insurance, ` a oP a cer#died copy thereof (Sec 3800, Lab C )1. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No" Company Certified copy is hereby furnished -FOR APPLICANT TO FILL IN _ BUILDING y, ADDRESS Certified copy is filed with the county building inspec BUILDINGo yo `tion department ADDRESS �C� IU-IHV Q L a e Date Applicant CITY TE l e / 1 ZIP 9 7 so LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS NEAREST , COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST (This section need notbe completed if the permit is for one TRACT BLOCK LOT NO ASSESSOR hundred dollars ($100)or less ) MAP BOOK PAGE PARCEL /� TEL USE ZQ NE MAP ` 'I certify that in the performance of the work for which this OWNER i ( 4 fcv 1 Zu NO 2 87 yS permits issued I shall not employ any person in any manner ADDRESS /`CJI SPECIAL so as to become subject to the Wo ers'Compensation Laws J CONDITIONS O 6 6 cLl� CITY _ ZIP y Date Applicant ARCHITECT OR TEL NOTICE TO APPLICANT If, after making this Certificate of DISTRICT GROUP TYPE FIRE PRO SSED BY O Exemption, you should become subject to the Workers' ENGINEER NO S1 J /► CONST ZO E U Compensation provisions of the Labor Code, you must forth- ADDRESS r 6 !n/ L� W with comply with such provisions or this permit shall be - Ej STATISTICAL CLASSIFI TION APT100NDO, N deemed revoked CONTRACTOR NO Z LICENSED CONTRACTORS DECLARATION , - LIC - CLASS NO DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO SEWER P (commencing with Section 7000)of Division 3 of the Business and - LIC Professions Code, and my license is in full force and effect CITYCLASS BK VALIDATION PG SQ FT NO OF NO OF CHECK License Number Lic Class SIZE 3S(o TORIES FAMILIES ONE " VALUATION 0 Contractor Date DESCRIPTION OF-WORK n NEW ❑ s do�." ILOO WI. KOO ADD ® VV ®, I am exempt under Sec C:]ALTER B&P C for this reason ` ��"` REPAIR ❑ :29779A Date USE OF A. EXISTING BLDG DEMOL ❑ # 0 0 0 0 0 Signature _ APPLICANT TEL FINAL OWNER-BUILDER DECLARATION PRINT NO DATE 1 hereby affirm that I am exempt from the Contractor's License ADDRESS FINAL °'° 8,�, 1 3= Law for the following reason (Section 7031 5, Business and 5 Professions Code) FRMNI =BT s BUILDING 0 6 O6 z 8 8 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and f 1' the structure is not Intended or offered for sale(Section LOCALITY 7044, Business and Professions Code) - MOVING TEL _ 1, 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) " t - A REQUIRED TOTAL SET ti, 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 ) SIDE PL + Lender s Name &,3 LDMA Ref # m P C Fee$ Permit Fee ® ^ Lender s Address I certify that I have read this application and state that the Issuance Fee LDMA P/C# o above information is correct I agree to comply with all CountyInvestigation Fee o ordinances and State laws relating to building construction Total Fee LDMA Perm # $ and hereby authorize representatives of this County to enter 9 u n the above-mentioned property for inspection purposes 7 +s M e " a � , SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date � WORKERS.COMPENSATION DECLARATION ^A=bby alt�rm that I hove a certificate of consent to self g ina race ted copy thereof of�(S rke s C Lab nssation Insurance, A P PL i CATION FOR BUILDING, PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company 4 F Certified copy is hereby furnished FOR APPLICANT TO FILL IN D�RESS DU 7:'--/`48lfo CloU EA1- Y ❑ Certified copy is filed with`the county building inspec- BUILDING k tion department . e ADDRESS , /8 b C r/0 u c2C- e� LOCALITY � _i,Evt1 jLQ C,tl / ZIP /�9�O CROSS Upw EtL uZuS A t� 1 _ Date Applicant CITY T9M e- CG T CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLD13f ASSESSOR COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT' MAP BOOK PAGE r PARCEL t US ZON ESPECIAL (This section need not be completed if the permit is for one _ � 4 ' _ r � ` - hundred dollars ($100)or less ) TRACT BLOCK LOT NO/ n TEL �,'I certify=that in'the performance of the'work for which this OWNER &J////Fl m r`F R:V Z ^ NO `G8 7 y� ONS d permit is issued, I shall not employ any person'in any manner - [1 / - DISTRICT GROUP TYPE -FIRE PROCESSED BY 0 so as to become subject to the Wor ers'Compensation Laws ADDRESS r� '0e 8ufl y� CONST ZONE Date 3 �`s Applicant Im CIN TEi�/ Y G°�f C�/4 Y ZIP �/78 0 6dY PPicantSTATISTICAL CLASSIFICATION APT 11CONDO 1 NOTICE TO APPLICANT If, after making this Certificate of s ARCHITECT OR TEL ENGINEER NO CLASS NO _�L_DWELL UNITS LU Exemption, you should become subject to the Workers' IL Compensation provisions of the Labor Code, you'must forth- ADDRESS SEWER MAP Z N r' with comply with such provisions or this permit-shall be deemed revoked CONTRACTOR _ TEL NO BK PG w VALIDATION LICENSED CONTRACTORS DECLARATION '^ - LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC - ' Professions Code, and my license is in full force and effect CITY CLASS $ 00. 0 0 <' SQ FT NO OF NO OF CHECK License Number Lic Class SIZE ISTORIES FAMILIES ONE ,.a DE $ 1 4 + t a3 t SCRIPTION OF WORK %Ar-r%y1 V Wc� O NEW S Contractor - Date ❑ , „1 eW ❑ I am exempt under Sec YV +q ADD �� f e ALTER ❑ FINAL B &P Cfor this reason €Y{� T t V1 O0 - DATE ' y , REPAIR ❑ USE OF FIN Date f r r EXISTING BLDG L SL�� DEMOL_ ❑ BY Y APPLICANT TEL Signature ' OWNER-BUILDER DECLARATION PRINT NO r I hereby affirm that I am exempt from the Contractor's License ADDRESS #;y Law for the following reason (Section 7031 5, Business and t '_ i' ono' ��'�ti, < Pr fessions Code) " PRN 3 0 0 0 BUILDING -I, as owner,of the property,-or`my employees with ADDRESSp (�_8`5', -� wages 4s their sole compensation,will do the work an`d ! 0 the structure is not mtended'or offered for sale(Section .. LOCALITY 7044, Business and Professions Code) MOVING TELA+*� 1, as owner,of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to con"tructI the project (Sec- r r t ADDRESS tion 7044, Business and Professions Code) REQUIRED TOTAL SETBACK FROM EXIST 1 V,. A CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN , WIDTH I,hereby affirm that there is a construction,lending agency for rFR w1 the performance of the work for which this permit is issued K M ' IT (Sec 3097, Civ�C ) t d Lender s Name b Permit Fee Lender s Address I certify thai I have read this application and state that the Issuance Fee (/ J Vabove information is correct I agree to comply with all County tion Fee xx �^J�j g ordinances and State laws relating to building construction, Total Fee V .J 10 - and hereby authorize representatives of this County to enter upon ih above-mentioned property for inspection purposes 9 o ✓ I - Q S SEE REVERSE FOR EXPLANATORY LANGUAGE ®s Signature of ApplicontRor A nt - Date ` " g f 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 0801230041 PHONE (626) 285-0488 EXT ILEGAL ID I NO OF CONST I BUILDING ADDRESS I ITR 11454 LT 24 BL 001 I SQ FT STORIES TYPE 4840 CLOVERLY AV I I ISTRUCTURE V-B TEMP CA 917803808 I (ASSESSOR INFORMATION NUMBER I NEAREST CROSS STREET LOWER AZUSA I 18590-020-025 I I THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY Cl ITENANT SEXIST BLDG USE RESID USE ZONE R-1 (ISSUED ON PROCESSED BY EXPIRES ON 1 I (EXIST OCC GRP 101/23/08 SR 07/21/08 (OWNER TEL NO 1BLDGS NOW ON LOT VALUATION IFINAL DATE FIN Y CODE I (WANG, YUKI (626) 353-8899- 1 350 1 I 14840 CLOVERLY AV I I ~� TEMP 917803808 1 FEES PAID 1JESCRIPTION OF WORK I I (CHANGE TWO WINDOWS IN BEDROOM AND BATHROOM 1 I FEE DESCRIPTION QUANTITY UOM AMOUNT I I (APPLICANT TEL NO I 1 I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 75 I I 1 IAC STRONG MOTION RESID 350 00 VAL 0 50 ISPECIAL CONDITIONS I ID2 PERMIT W/O EN-HC 350 00 VAL 43 65 1 I TOTAL FEES 71 90 I I ICONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER LIC NO ILOCATION AND SETBACKS I I I (SOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER TEL NO 1 (FOUNDATION/TRENCH'FORMS I I 1 LIC NO 1 (SLAB/UNDER FLOOR I I I I I I IRAISED FLOOR FRAMING+, I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I (UNDERFLOOR INSULATION I I I I I I144H269 3 Ol 1FLOOR SHEATHING I I I INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I - NO 21 IROOF SHEATHING I I I SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I I (AIR QUALITY 1000 FEET MATERIALS NO NO NO 1 (FRAME INSPECTION I I IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS 1 I I ISET BACK YARD HWY PROP LINE WIDTH 1 I- I I IFRONT PL- I (INSULATION/WEATHER STRIPI I I I SIDE PL- 1 1 I 1 (INTERIOR LATH/DRYWALL I 1 I 1EXTERIOR LATH IRATED FLOOR/CEIL ASSEM I I I I I I IRATED WALL ASSEMBLIES IRATED SHAFTS/OPENINGS I I I I I I IT-BAR CEILINGS ILOT DRAINAGE I I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 _ - BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR _-i3UILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9704230008 PHONE (818) 285-0488 EXT LEGAL ID NO or CONST BUILDING ADDRESS TR 11454 LT 24 BL 001 SQ FT STORIES TYPE 4840 CLOVERLY AV STRUCTURE 1600 V TEMP CA 917803808 ASSESSOR I BER NEAREST CROSS STREET 8590-020-025 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY TENANT EXIST BLDGD USE ZONE R-1 ISSUED ON PROCESSEDEXPIRES ON EXIST OCC GRP 04/23/97 TC 04/23/98 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL 8 CODE ARVIZU WILLIAM,CARMEN (818) 287-4591- 1 1,000 4840 CLOVERLY AV TEMP 917803808 FEES PAID D P 0 VOK CONVERTED EXISTING FAMILY ROOM T STER BEDROOM AND INSTALL FEE DESCRIPTION QUANTITY UOM AMOUNT BATHTUB IN EXISTING LAUNDRY ROOM MAKE FULL BATHROOM- APPLICANT TEL NO SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27 75 IAC STRONG MOTION RESID 1000 00 VAL 0 50 SPECIAL CONDITIONS AX BUILDING REVIEW=FEE54 70 D2 PERMIT W104 -HCL E R,1000-00 VAL 65 25 TOTAL FEES'�� 148 20 CONTRACTOR TEL 0 �� APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER \uuuv� U L I C NO I � � L6CATTU AND SETBACKS — SOILS LNGINEER APPROVAL ARCH I !` p G� NDA' N/TRENC ORMS LIC NOlllllt 1 SLAB/UNDER FLOOR WAT-S 6 FLOOR FRAMING MAP NO SEWER MAP BOOK PAGER ONE CMP O C �n O""� U D RFIOOR INSULATION 144H269 3 Oil V V U a FLOOR SHEATHIWG NO OF FAMILIES DWELLING UNITSPT COND STAT CLASS O o NO 21 OO QO ROOF SHEATHING SCHOOL WITHIN HAZARDOUS (� O o cr SRR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO �° ❑ FRAME INSPECTION REQUIRED — TOTAL SETBACK FROM EXISTR RI GERS SET BACK YARD HWY PROP LINE. WIDTH FRONT PL- �/�}� INSULATION/WEATHER ATH STRIP SIDE PL- 1l 11 TRTERTUR LATH/DRYWALL EXTERIOR LATH RATS SSEM RATED WALL ASSEMBLIES RA SH TS 0 E GS T-BAR C ILIN S * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 t' COUNTY OF LOS ANGELES TEMPLE CIFY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1310250004 PHONE (626) 285-0488 EXT ILEGAL ID I NO OF CONST BUILDING ADDRESS 1 ITR 11454 LT 24 BL 001 1 SQ FT STORIES TYPE 4840 CLOVERLY AV I ISTRUCTURE 1390 V-B TEMP CA 917803808 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 18590-020-025 I THOMAS PAGE 596 GRID JS LOCALITY TEMPLE CITY CAI ITENANT IEXIST BLDG USE RESID USE ZONE R1 (ISSUED ON PROCESSED BY 1 EXIST OCC GRP 110/25/13 SR (OWNER TEL NO IBLDGS NOW ON LOT VALUATION JFIW DATE FINAL BY CODE IJUNG, DENISE (818) 287-4591- I 1 2 000 IZN 14840 CLOVERLY AV I _I ITEMP 917803808 1 FEES PAID ID CRIPTION OF WORK v1 IREPLACE TWO EXISTING DOORS, FRONT AND SLIDING GLASS DOOR _IFEE DESCRIPTION QUANTITY UOM AMOUNT I (APPLICANT TEL NO 1SAME AS OWNER a - IAA BLDG PERMIT ISSUANCE 27 80 I I IAB STATE GREEN BLDG FEE 2000 00 VAL 1 00 ISPECIAL CONDITIONS 1 IAC STRONG MOTION RESID 2000 00 VAL 0 50 ID2 PERMIT W/0 EN-HC 2000 00 VAL 82 20 TOTAL FEES 111 50 ICONTRACTOR TEL NO I IAPPROVALS DATE INSPECTOR SIGNATURE ISAME AS OWNER - I LIC NO 1 1LOCATION AND SETBACKS ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER TEL NO IFOUNDATION/TRENCH FORMS I I LIC NO I (SLAB/UNDER FLOOR I I I I IRAISED FLOOR FRAMING I I I IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP IUNDFRFLOOR INSULATION I I I 3 Oo IFLOOR SHEATHING I INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I 1 NO 21 1 (ROOF SHEATHING I 1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS I (AIR QUALITY 1000 FEET MATERIALS NO NO NO I IFRAME INSPECTION I FIRE SPRINKLER HANGERS I I (INSULATION/WEATHER STRIPI I _I IINTLRIOR LATH/DRYWALL I I I (EXTERIOR LATH lowiI RATED FLOOR/CEIL ASSEM I I I (RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS I I I I IT-BAR CEILINGS - I I I (LOT DRAINAGE I I i IREPORT ID DPR261 y ROUTE TO BS0508 I I I I I I