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Home My Public Portal About4848 CLOVERLY AVE_Building__ I Ty cr T,4 .,4oc-,z e,, Ty 76A638A CE#'8035 6I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING 4848 8 4 p v 'DEPARTMENT OF COUNTY ENGINEER ADDRESS 'T v BUILDING AND SAFETY DMSION LOCALITYP-i-7,0L L' T JOHN A LAMBIE, COUNTY ENGINEER NEAREST' BB ^ WILLIAM A JENSEN SUP T OF BUILDING CROSS ST- O :(u DISTRICT NO I GROUP TYPE PROY -FOR APPLICANT TO FILL IN SI-0 ff _r CONSTg/ BUILDING O' /� ' STATISTICAL CLASSIFICATION —, WERMAP ADDRESS v C PG CLASS NO !RDWELL UNITS m O B� LOT NO BLOCK ' WATER NOT REQUIRED IJtI RECEIVED KLi CERTIFICATE IIILLL7TT\ TRACT _ MAP HIGHWAY STATE MAJOR SECON LOCAL NO OF BLDGS NO jt O (CIRCLE) SIZE OF LOT I NOW ON LOT USE ZONE SPECIAL USE OF /_ 4 \ CONDITIONS t EXISTING BLDG DST- G .1 TEL OWNER O BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH ADDRESS FRONT '' __`` ARCHITECT OR TEL P L !� - �C^O �B/P t ENGINEER NO SIDE IDE �� O ADDRESS TEL INSPECTION RECORD n A CONTRACTOR NO O ADDRESS DESCRIPTION OF WORE -- Ag-, A NEW ADD ALTER REPAIR DEMOLISH r i `/ yy SQ NO OF NO OF w./a�-1"d/� .. 1✓rte .�}�i1.R.'a'-'alfa" vn {�'?�'✓�+L4='lt „ecp. E D STORIES FAMILIES USEOF STRUCTRE 61 SIGNATURE OF j, /+ C"_.��xY-,•" ''�'s7. APPLICANT VALUATION$ P►L rj"o o �-- , APPROVALS DATE INSPECTOR S SIGNATURE P CPMT /' pO FOUNDATION LOCATION FEE $• FEE $ (9 FORMS MATERIALS FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION II ih� WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS AI IM1J ' BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH I'NT TION OF THE LABOR CODE OFF FALI FORN A RELAT ING TO WORKMEN S COMP ON I SUR LATH EXT SIGNATURE OF HOUSE NUMBER COR- PERMITTEE RECT AND POSTED ADDRESS y FINAL CLYDE N DIRLAM, PRINCIPAL STCTCT RAL ENGINEER PLAN CHECK VALIDATION CK MO CASH R PERMIT VALIDATION( cK`�� M o CASH 1 6 0 6 -01 APR ?Q 1 "D 6.0 0- TEMPLE CITY 688A CE#8081-61 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A. JENSEN SUPT OF BUILDING CROSS ST. i DISTRICT GROUP TYPE Pg ocE D�Y FOR APPLICANT TO FILL IN � ) S coNsr. C� BUILDING u ,/ //'� If bIATISTICALCLASSIFICATION SEWER MAP PG ADDRESS '�I 7 /S 4"'&';e'ALB !� `� CLASS. NO.1-DWELL. UNITS LOT NO. 1. BLOCK Wt-,TER NOT REQUIRED RECEIVED CERTIFICATE: / TRACT /1" S/s-v P y . oG, d/L� HIGHWAY STATE MAJOR SECOND, LOCAL NO.OF BLDGSNO SIZE OF LOT O O I NOW ON LOT + USE ZONE SPECIAI,,- USE OFCONDITIdDtS EXISTING BLDG. z)w-cc..c/�uG. h � TEL , / yL� L f OWNER 14 H113 t_14 L) NO.,pT s7 S BUILDINGEXIST. YARD STREET NAME WIDTH SETBACK ADDRESS `�S�/V CLG>:1Q/ez5/ FRONT ARCHITECT OR TEL. P. L. ENGINEER NO. SIDE P.L. ADDRESS TEL. INSPECTIOIj RECORD r CLO CONTRACTOR /�//L�f jtJL �c^/./fF'S NO.kO q'c-S ADDRESS 7/� �/ /��fP�� . /fZ S✓� J I 0 O DESCRIPTION OF WORK 42, IZ4 C %.L a NEW ADD ALTER REPAIR DEMOLISH to SQ.FT. NO.OF y NO.OF IZE 17311 STORIES 7 FAMILIES USE OF STRUCTURE SIGNATURE APPLICANT VALUATION$ APPROVALS DATE INSPECTOR'S SIGNATURE P.C. o-� PMT. v FOUNDATION: LOCATION FEE $ FEE' $ FORMS, MATERIALS FRAME: FIRE STOPS, IHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING, BOLTS AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORK N'S COM P/EN SAT INZNCE. [_ATH, EXT. SIGNATUR m HOUSE NUMBER COR- PERMITTE ,,� RECT AND POSTED ADDRESS": z /&D- � 's;-j- FINAL CLYDE N. DIRLAM, PRINCIPAL STRYCTPRAL ENGINEER PLAN CHECK VALIDATION cu M.O. CASH PERMIT VALIDATION CIC M.O. CASH t i. _ LI e `� r APPLICATION FOR BUILDING-,PERMIT r COUNTY OF LOS ANGELES BUILDING AND SAFETY 4 a ^ ING ADDRESS ` ,,WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILD ` 1 BUILDING ADDRESS t t 1 hereby affirm that I have a certificate of consent to self Insure or a certificate of,Workers Compensation Insurance or a certlfled LC v C? L _ copy thereof(Sec 3800 Lab-C) -- fir, CITY . ZIP LOCALITY �^ ' Policy N6 Company,6-si^-�' //�. t SIZE OF L,15T 40 OFVBLDGS NOW ON LOT ❑ Certified copy is hereby furnished , NEAREST CROSS ST fSCertltled copy Is flled,wdh the county budding Inspection TRACT BLOCKLOT NO ' department , - USE ZONE. MAP N, a a J A IICan /tee-.`� ASSESSOR MAP BOOK PAGE PARCEL 'r ' Date�� PP q + S^ 6' SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL'NO s. YES NO, COMPENSATION INSURANCE ��/� ��2 .zS WITHIN 1000 FT OFySCHOOL'? r (This'section need not be completed if the permit Is for one hundred /�/ Z/A1r-/f f !�e�� [DISTRICT GROUP TY CONST FIRE ZONE PROCESSED BY dollars($'100)or less j L i• ' " . i- CITY ZIP 41 I certify that in the performance of the work for which this,permit -d G 4 is Issued I shall not employ-any person in any manner so as to d become subject to the Workers Compensation Laws ARCHI CT OR ENGINE ` TEL NO 1 P STATISTICAL CLASSIFICATION APT CONDO Date p Applicant;' ADDRESS CLASS NO _L_ DWELL UNITS' J TO APPLICANT If after making this Certificate of 3 REQUIRED TOTAL SETBACK FROM `EXIST' Y ° Exemption you Should become subject t0 the WorkersTRACTOR �+ TEL NO 2 T SETBACK rYARD HWY' PROP LINE WIDTH Compensation provisions of-the Labor Code you must forthwith -Pe^ OB[—��^ -T-2—J14-4; FRONT comply with such provisions or this permit shall be deemed revoked ADDRESS Llg NO P L q SIDE LICENSED CONTRACTORS DECLARATION Y LIC CLAS$ �� P IL I hereby-affirm that I am licensed underp�rovisions of Chapter 9 SEWER+MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE I NO'OF STORIES NO OF FAMILIES Professions Code and'my license Is in full force and effect NEW ❑ BK PG License NumLer L LC Class "7 DE CRIPTION OF WORK' App ❑ $LUAnON - , _ p Contractor Date 3-' !�/JO+�7�' ALTER ❑ r� U , - _ ❑ 1 am exempt under SEC Y REPAIR ❑ B&PC+for this reason +� yy DEMOL F❑ LDMA P/C# d W Date ' ! ZG +�7e" USE OF E ISTING BLDG URM ❑ - s Y _ Signature �-- � APPLICANT(PRINT) TEL-NO., LDMA Perm# _ a - Z Epp T ❑ I'as owner of the property or my employees with wages as G �� -316 t� ZO �'-4 1 •g their sole compensation will do the work and the structure Is A DRESS rr 4= not Intended or offered for sale (Section 7044, Business and 'LL C4K+✓� FINAL DATE �y Q 'Professions,Code) 3 /3 y -_ _ I g j EM ,' WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ,0-1-as owner of the property am exclusively contracting 'With AMOUNTS'SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY licensed'contractors'to construct the project (Section 7044 f ,�/ TOTAL �O m�'— _' Business'and Professions Code).,' YES❑ NO L /Y C- {Ifi WILL THE INTENDED USE OF,THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING , .. �,H[,�_ r" 1V3.05 - ' r OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH - ~ L` CONSTRUCTION LENDING AGENCY COGUIDELINES n AST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR aANr oil _ I hereby affirm that there Is a construction lending agency for YES❑ , No the performance of the work for which this permit is Issued(Sec IHAVEREAD THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097 CIV C) - .,CHECKLIST I UNDERSTAND MY,REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE [11�I11�—Ll 1 '7 1'16/9,37 I TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS Lenders Name f MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD S 3 I,:,,r, i L` EL Lenders Address O „ I OWNER OR AGENT o I certify that I have read this application and state under penalty - o PC FEE PERMIT FEE , of perjury that the above Information Is correct I agree to comply , - o with all county ordinances and State laws relating to budding Gj Cry 1 a construction and hereby authorize representatives of ttns'County ISSUANCE FEE j I,O tq� r upon the above-menhone property for Inspection purposes �- t `oJ - INVESTIGATION FEE, TOTAL FEE /� r Sq.—a Ap Ac l or Agee Oeta , (/ ^ SEE REVERSE FOR EXPLANATORY LANGUAGE 3 s