The URL can be used to link to this page

Home My Public Portal About5022 CLOVERLY AVE_Building__ 76A638A CE#80311_57 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 NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GR UPTYPE SEWER MAP FOR APPLICANT TO FILL INI /_BK CONS �( BUILDING STATISTICAL CLASSIFICATION ADDRESS �y ' CLASS. NO. DWELL.UNITS LOT NO. `J OCK NUMAP MBER / STATE YES 3 HWY. TRACT USEZONE SPECIAL NO.OF BLDGS. �I f CONDITIONS SIZE OF LOT . NOW ON LOT 14 J USE OF ` Q 1� EXISTING BLDG. �� BUILDING YARD HWY STREET NAME EXIST. SETBACK WIDTH OWNER - - ` !' FRONTMAIL. � �y r _ P.I ADDRESS L} E/ ® 4 V SIDE (L. P.L. CITY NO. INSPECTION RECORD ARCHITECT OR �s TEL. ENGINEER /C!j'��C�/= �^� NO. ADDRESS C ;�y 0 �! CONTRACTOR 1/.� Al ^ NO. � — TEL. ADDRESS -- J10 � DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH yy �- SQ. FT. NO.OF NO.OF SIZE STORIES FAMILIES r- USE OF STRUCTURE ' eS'9 /.(A Iv SIGNATURE OF APPROVALS APPLICANT DATE INSPECTOR'S SIGNATURE ADDRESS20- p�il" FOUNDATION: LOCATION - FORMS,MATERIALS $ P.C. $ FRAME: FIRE STOPS. FEE BRACING, BOLTS � ^Y v VALUATION a $ � FURNACE: LOCATION. / FEE GAS VENT.DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE-REA THIS AP- LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND l AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS REGU TI B-m CONSTRUCTION. LATH.EXT. ►i SIGNATURE OF HOUSE NUMBER COR. PERMITTE - RECT AND POSTED ADDRESS FINAL CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL EN5lAlW§AR FLAN CHECK VALIDATION CK. M.o. ASH PERMIT VALIDATION CK. M.O. AS s .3 -7c JW302 3 A. 2 75 A F L 2-3-7 8 V .JUN 30 1 A 1X1 :0.0 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 1206220016 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 13329 LT: 46 SQ. FT STORIES TYPE 5022 CLOVERLY AV I I TEMP CA 917803812 STRUCTURE: 2000 V-B (ASSESSOR INFORMATION NUMBER: i NEAREST CROSS STREET: I 18590-019-004 I THOMAS PAGE: 596 GRID: J5 LOCALITY: TEMPLE CITY CAI I I I I (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-1 (ISSUED ON: PROCESSED BY: 1 IEXIST OCC GRP: 106/22/12 SR I 1 I I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: - VALUATION: IFINAL DATE FINAL BY: CODE: I IWU ERIC JENNCHANG - 1 1 5,000 15022 CLOVERLY AV I / l ITEMP 917803812 I FEES PAID ID SCRIPTION OF WORK 1 IT/O, EXISTING ASPHALT SHINGLE, INSTALL 7/16 PLYWOOD OR OSB __(FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IPER CITY REQUEST., INSTALL 15 LB PAPER FELT, INSTALL 55 YR (APPLICANT: TEL. NO: I 13D ASPHALT SHINGLE ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27.80 1 I 1 IAB STATE GREEN BLDG FEE 5000.00 VAL 1.00 ISPECIAL CONDITIONS: I 1 IAC STRONG MOTION RESID 5000.00 VAL 0.50 1 1 ID2 PERMIT W/O EN-HC 5000.00 VAL 132.60 I 1 - TOTAL FEES 161.90 (CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1 ISAME AS OWNER - I I I LIC. NO I (LOCATION AND SETBACKS I I I I I I I' ISOILS ENGINEER APPROVAL (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I LIC. NO: I 1SLAB/UNDER FLOOR (RAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP-: J (UNDERFLOOR INSULATION I I 1144H269 3 001 1_ -1-1 1 I _I IFLOOR SHEATHING I 1 INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I_ I 0 NO 21 IROOF SHEATHING ( SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I (AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION I I I I I I I IFIRE SPRINKLER HANGERS i IIN:ULATION/WEATHER STRIPI I (INTERIOR LATH/DRYWALL 1 I I I I I (EXTERIOR LATH I IRATED FLOOR/CEIL ASSEM. I I I IRA7ED WALL ASSEMBLIES I I I IRATED SHAFTS/OPENINGS I 1 . IT-BAR CEILINGS I I ILOT DRAINAGE 1 I 4 I I I I 1 (REPORT ID: DPR261 ROUTE TO: BS0508 e f� WORKERS'COMPENSATION DECLARATION a certificate of coent to insure, or afirm certif certificate of that I Worke s' Compen at on Insuran elf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ®"�� C ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS 220/1 76 D Date Applicant CITY ZIP ql7eO LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' �/ XI ! NO. OF BLDGS. NEAREST 6(6 COMPENSATION INSURANCE SIZE OF LOT 170 NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one /t. ASSESSOR hundred dollars ($100)or less.) TRACT -3 I_BLOCK LOT NO..Q�vv MAP BOOK PAGE PARCEL OWNE >° h C NO. J� — Z USE ONE MAP 1 certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner SPECIAL so as to become subject to the Workers'Compensation ws. ADDRESS 2 �/ 1 CONDITIONS 0 Date Applicant CITY c-tZIP l NOTICE TO APPLICANT: If, after making this ertificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0 ENGINEER NO. CONST ZONE U Exemption, you should become subject to the Workers' NE Compensation provisions of the Labor Code,you must forth- ADDRESS �f W. with comply with such provisions or this permit shall be 0..' deemed revoked. TEL. STATISTICAL CLASSIFIC TION APT. NDO. U)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 MAP (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 BK PG O VALIDATION 'SQ. FT; NO. OF NO. OF CHECK License Number Lic.Class SIZE 2 STORIES FAMILIES ONE NEW ❑ VALUAT N �to Contractor Date DESCRIPTION OF WORK s �� DD � 0( , ❑ I am exempt under Sec. �mAu,—&i-00y/ )ALT ❑ 1 �`l ❑ $ 8.8P.C. for this reason REPAIR USE OF DEMOL ❑ 0 0 0.5 A Date: EXISTING BLDG. 1 t Signature APPLICANT ` TEL �p , FINAL OWNER-BUILDER DECLARATION PRINT- C RNO. /1^2O X3 DATE �j�/� # ®-a'o a e 11 I hereby affirm that I am exempt from the Contractor's License gDDRESS 22 ("[� DA; ( - 26550 Law for the following reason (Section 7031.5, Business andFIN2!1 Professions Code): By ❑ BUILDING 0 ° 265,505 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ® () 6,28-8 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). CONSTRUCTION LENDING AGENCY SET REQBACK YARD HWY TOTAPROP.LIINE 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. 17 (Sec. 3097, Civ. C.). SIDE P.L ~g11'ender's Namevf� LDMA Ref.'# m P.C. Fee$ Permit Fee v Leader's Address _ 3 I ce.. _if that I have read this application and state that the o Y PP Issuance Fee .J v LDMA P/C# o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee S ASO LDMA Perm. # R and hereby authorize representatives of this County to enter upon the abov -mentioned propert for inspections purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ° Signalure of Applic&Ti<or Agent �-�- Ddie