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Home My Public Portal About4901 CLOVERLY AVE_Building__ r A ROAD DEPT PERMIT IS REQUIRED FOR ANY MA i ERIAL STORAGE OR WORK r DONE IN THE ROAD RIGHT OF WAY. ti APPLICATION FOR BUILDING PERMIT COUNTY_OF LOS ANGELES BUILDING �. DEPARTMENT' OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCALI JOHN A LAMSIE, COUNTY ENGINEER - NEAREST p ' CASSATT D GRIFFIN SUP T OF BUILDING' CROSS ST DISTRICT GRO TYPE PRO ESSED BY FOR APPLICANT TO FILL IN X�D- CONST y R BUILDING C- STATISTICAL CLASSIFICATION SEWER MAP ADDRESS _.' BK ,+PG CLASS NO DWELL UNITS - LOT NO BLOCK MAPF Lp M1 - e STATE yES NO NUMBER HWY TRACT USE,Z NE ' SPECIAL NO OF BLDGS 117/ _ CONDITIONS SIZE OF LOT / I NOW ON LOT `1 - USE OF 7 EXISTING BLDG Lam/ BUILDING EXIST J SETBACK /AFYD HWY , STREET,NAME,- WI TH OWNER �- /e - FRONT r9`✓ iC • F • - MAIL' A ADI RESSS D ,pG ✓Pl✓/ At.,cn— SIDTEL PE • "` ' ` CITY / �/9'J Csl� NO - - INSPECTION REC ARCHITECT R TEL - O _ ENGINEER NO ADDRESS .y{ TEL •� t_ � iCki-/ Cf� �G'<c� CONTRACTOR O ADDRESS (?049,6 .�2nY, .dilt p. E� - •,'� '- t�.c�C9 �r DESCRIPTION OF WORK NE*' ADD ALTER REPAIR DEMOLISH �- SQ FT ��yy�� NO OF NO OF SIZE J�/ STORIES FAMILIES USE OF /;xo ^ /:'/�[/!^[--t O I� 1''.°LXr�•!� STRUCTURE GS C - ' 9304 SIGNATURE OF APPLICANT // APPROVALS, DATE ,NSPECT0,A'SIGNATURE ADDRESS FOUNDATION LOCATION r FORMS MATERIALS VALUATION $/' ..=.�.0, `� FRAME FIRE STOPS v V BRACING BOLTS FPCPMT EE �• de I FEE I FURNACE , VENT DUCTS LOCATION I HEREBY ACKNOWLED E THAT 1 HAVE READ THIS AP- LATH INT r PLICATION AND STATE THAT THE ABOVE IS CORRECT AND e AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND LATH EXT STATE LAWS REG TI G BUI DING C STRUCTION SIGNATURE OF � HOUSE NUMBER COR- PERMITTEE RECT AND POSTED 'I _ ADDRESS-- ji8=nl M FINAL 4AA., y CLYDE N DIRLAM, P INCIPAL$ T UCRAL ENGINEER PLAN CHECK VALIDATION CK ' M o CASH PERMIT VALIDATIO i CK IM O CASH -10 0 -9 .5 2 FA 2 3 lj 2 4 0 ,D O� 2 4 �� I41 1 4 1 D I r r y 4 C8 C, L IT, y WORKERS COMPENSATION DECLARATION APPLICATION FOR BUILDING PERMIT I hereby affirm that I have a certificate of consent to self ; nsure, or a certificate of Workers'Compenstion Ins rance, or a certified copy thereof (Sec 3800, Lab C ) -� COUNTY OF LOS ANGELES BUILDING AND SAFETY Pol rl3l�/�7 Campan BUILDING ' 'Certified copy is hereby furnished FOR'APPLICANT TO FILL IN ADDRESS �r(-��eert'fied copy is filed with the county buildin inspec- BUILDING tion dep rtment ADDRESS �� LOCALITY ' NEAREST ,Date Appli ' CITY �/ ZIP CROSS ST ERT FICATE OF EXEMPTION ROA WO I RS N OF BLDGS ASSESSOR COMPENSATION INSURA� CE SIZE OF LOT WON LOT MAP BOOK _ PAGE PARCEL (This section need not be completed if the rmit is for one USE ZONE MAP hundred dollars ($100)or less ) a OWNE BLOCK LOT NO / /1� SOCIAL O I certify that in the performance of the work for which this CONDITIONS - I Q permit is issued I shall not employ an person in an manner DISTRICT GROUP TYPE FIRE PRO SSED BY U p P Y Y P Y R CONST ZONE so as to become subject to the Workers Compensation Laws ADDRESS /�� IM Date Applicant CITY+ / / IF STATISTICAL CLASSIFICATION y - PT CONDO W NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TE ENGINEER !�I n> O Z CLASS NO DWELL UNITS d Exemption you should become subject to the Workers V! Compensation provisions of the Labor.Code you must forth ADDRESS ; SEWER MAP Z with comply with such provisions or this permit shall be ? deemed revoked CONTRACTOR / / /��/ BK � PG��J VALIDATION LICENSED CONTRACTORS DECLARATION ':>t�c�Z/'! C �� I hereby affirm that I am licensed under provisions of,Chapter 9 ADDRESS �/ 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 /V CLASS SQ FT NO OF NO OF / CHECK ^ License Number Lic Class SIZE STORIES FAMILIES l ONE - $ - i NEW DESCRIPTION OF WORK ) Contractor Dote ADD I am exempt f the licensing require ents as I am a �� ` ALTER- FINAL j - licensed archit ct or a registered professional engineer p DATE o —a 7 - acting in my professional capacity (Section 7051, C REPAIR Q 'Business and Professions Code) USE OF ^ - DEOL "Ell FINAL EXISTING BLDG Gt/ ' Lic or Reg No Date ! APPLICANT TE OWNER-BUILDER DECLARATION (PRINT) v 2 8 8 A I hereby affirm that I am exemjit from the Contractor's License / ,U, of 1 Law for the following reason (Section 7031 5, Business and ADDRESS e� —LC/ I # o o o ° 23 Professions Code) PRIED NG , 2"- ° 27.60 t j' as owner of the property or my employees with ADDRESS wages as their sole compensation, will do the work and ( o'° a 2'7 6 Q= the structure is not intended or offered for sale(Section LOCALITY- . v 7044, Business and Professions Code) MOVING - TEL 02 O 1 ' 8 2 I 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) ; 9 2 8 9 A" REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH I herebyaffirm that there is a construction lending a en'c for - - 9 9 Y FRONT ,, # 0 0 0 0 0 the performance of the work for which this permit is issued P L (Sec 3097 Civ C ) _ SIDE-, _r 2 0 0 4 3 0 0 PL / Lender s Name �7 fA9 0 ° °'4 3 0 0 5 $ r PC Fee$ /� �� Permit Fee Lender s Address _ 2 t� 1 r=8 2 W I certify that I have read this application and state that the _ - Issuance Fee /�o above information is correct I agree to comply with all County _ ^ Investigation Fee _ • - 0 ordinances and State laws r5.firves ing to build ' construction and hereby authorize repre o thi County to enter Total Fee t U upon th ve noon ef n ection purposes ' Y a rU SEE REVERSE FOR EXPLANATORY LANGUAGE D ignalure_/p Mc a n)r Ag t Date - t.. 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 0009180071 PHONE (626) 285-0488 EXT -I-9—GAI ID NO OF CONST BUILDING ADDRESS TR 11454 LT 8 SQ FT STORIES TYPE 4901 CLOVERLY AV STRUCTURE VN TEMP CA 917803811 ASSESSOR IN 0 0 NEAREST CROSS STREET LA ROSA 8590-021-009 THOMAS PAGE 596 GRID J5 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESID USE ZONE R-1 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 09/18/00 UT 03/18/01 OWNER TEL NO BLDGS NOW ON LOT VALUATION FIjL'DATE FI BY CODE TINSLEY RICHARD P (626) 286-2434- 2 3,000 (/�f 4901 CLOVERLY AV TEMP 917803811 FEES PAID DESCRIPTION OF WORK REMOVE EXISTING ROOF AND INSTALL 25YR GAF SHINGLES FEE DESCRIPTION QUANTITY UOM AMOUNT APPLrCAT TEL—VO — BRIAN KEEFER (626) 279-1224- AA BLDG PERMIT ISSUANCE 27 75 5654 WILLARD AC STRONG MOTION RESID 3000 00 VAL 0 50 SPECIAL CONDITIONS SAN GABRIEL, CA D2 PERMIT W/O EN=HC-----!----�3000 00 VAL 99 00 O�AOFEES 127 25 CONTRACTOR TEL NO �O�j � APPROVALS DATE INSPECTOR SIGNATURE TEMPLE CITY ROOFING CO (626) 279-1224 5456 WILLARD AVE LIC NO LOCATION AND SETBACKS SAN GABRIEL, CA HIC SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEERTELFOUNDATION/TRENCH FORMS LIC NO / 1111111 SLAB/UNDER FLOOR 1L RAISED OOR FRAMING MAP NO SEWER MAP BOOK PAGE FIRE ZONE C P � UNDERFLOOR INSULATION 144H269 3 �06 �0 V V (U 11 K3 t OOR SHEATHING NO OF FAMILIES DWELLING UNITSAPT/E59U--§TTT-T[TSS'- NO 21 d ROOF SHEATHING WITHINSCHOOL e 49 D HES AIR QUALITY 10000 FEET MATERIALS Q Q NO NO NOO ® ®y FRAME INSPECTION REQUIRED 0 AL SETBACK FROM EXIST ZIg� IDt� FIRE SPRINKLER HANGERS SET BACK YARD HWY PROP LINE WIDTH IL+ V' FRONT PL- `NepVICe Thai INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CE L ASSE RATED WALL ASSEMBLIES RATED AFTS z T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID DPR261 ROUTE TO BS0508