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HomeMy Public PortalAbout5328 CLOVERLY AVE_Building__ . lk- I DEPARTMENT OF BUILDING AND SAFETY APPLICATI@ON FOR PERMIT COUNTY OF LOS ANGELES I L mullmoG WM J FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING y�p DISTRICT NO PLANCK NO PERMIT NO ADDRESS '� 4 �-� 4e d RECEIVED BY DATE OF APPL_ DATE ISSUED LOCALITYit ' NEAREST CROSS ST _� BUILDING ADDRESS 3 �� OWNER .�,. 1 w l G MAIL LOCALITY ADDRESS ��S ft,4" NEAREST CITY � ,�� `' CROSS ST 1 /IJ�r NO �/ /fi Off/4, FIRE IANO OF I TYPE I GROUP ARCHITECT OR 'TEL �F ZONE PLANS ENGINEER NO BLDG., F ORD TTO f SETBACK LINE ADDRESS - APPROVED TEL BY J DATE CONTRACTOR s NO USE APPROVED ZONE BY DATE ADDRESS ./' HOUSE NUMBERING LEGAL DESCRIPTION I LOT NO I BLOCK MAP NUMBEp___,______________FIELD CHECK BY 1 � TRACT -' C NO ASSIGNED 16Y DATE NO OF BLDGS ., CORRECTIONS _ SIZE OF LOT NOW ON LOT I USE OF I NO OF EXISTING BLDG FAMILIES , - DESCRIPTION OF WOM NEW I ALTERATION I I ADDITION REPAIR I I DEMOLITION SQ FT NO OF 'n SIZE ROOMS STORIES Z ~ EXT WALL I ROOF r r COVERING COVERING USE OF STRUCTURE a ' APPROVALS INSPECTOR'S SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FOUNDATION LOCATION PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS CORRECT I AGREE TO COMPLY WITH THE CORRECTIONS LISTED FRAME FIRE STOPS, HEREON AND WITH ALL COUNTY 0,RDIN'ANCES AND STA E BRACING, BOLTS ` LAWS REGULATING I1!9-LD7XI, RIJC'�ION FURNACE LOCATION, a SIGNATURE OF .4 LATH, ddd•�"`q �f/J , GAS VENT, DUCTS PERMITTE / v LATH, INT ADDRESS ' LATH, EXT _ AUTHORIZED AGT PLASTER, INT 76A638A OBS3 10-80 $ P C >$ ® �O FEE PLASTER, EXT VALUATION V V FEE $ FINAL .� s " I e 4 EPARTMENT OF BUII�DIIIG AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES SWEp 5 1951 U 6 L_® I _ WM J FOX, CHIEF ENGINEER FNG OR/APPLICANT TO FILL IN FOR OFFIC�IE USE ONLY BUILDIN ADDRES 9t-3 / / .ice e�, DISTRICT NO PLANCK N� PERMIT O� RECEIVED BY DATE OF APPL DATE ISSUED LOCALITY NEAREST CROSS ST /1���r� BUILDING {� , ,j! / ADDRESS J p C/O j:"4'.O /c- / OWNER ��� � I. MAIL -'� 1 s �..A LOCALITY-7� , , r666 ADDRESS NEAREST 0 � , TEL / CROSS ST b ✓-I CITY ,� NO /4� �j A J FIRE I NO OF I TYPE I GROUP ARCHITECT OR .- TEL ZONE PLANS ENGINEER ' NO BLDGCJD / 9RD NO SETBACK LINE O y• /? �y )'"" ADDRESS '�` APPROVED -R , BY CONTRACTOR f� I TE / �� a USE _ APPROVED ADDRESS `j'CJ ZONE BY � HOUNUMBER.NGLEGAL � E1 DESCRIPTION I LOT NO ly BLOCK MAP NUMBER -FIELD CHECK BY l / O } TRACT NO ASSIGNED BY � AT NO OF BLDGS / CORRECTIONS_ SIZE OF LOTlji ® I NOW ON LOTUSE OF NO F EX SITING BLDG ,�/,�/l I FAMILIES '4 1 C_ /J / >p ^ DESCRIPTION OF WORK M1 NEW I k ALTERATION I I ADDITION I / O n REPAIR DEMOLITION SQ FT s NO OF / In SIZE ROOMS STORIES / D EXT WALL ROOF0_4I COVERING WO d,, /qf¢�+ ` f' COVERING � USE.OF STRUCTURE ' �a� 67 APPROVALS INSPECTORSS SIGNATURE DATE I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- FOUNDATION LOCATION ��/_�,.J / PLICATION AND STATE THAT THE INFORMATION GIVEN IS FORMS, MATERIALS /C'75���i'� q /.e,a(fd CORRECT 1 AGREE TO COMPLY WITH THE CORRECTIONS LISTED` FRAME FIRE STOPS, HEREON AND WITH ALL COUNTY ORDINANCES AND STATE BRACING, BOLTS LAWS REGULATING BUILDING COIV,STR ON I 11////////JJ �`�A\\((,..//t�t� FURNACE LOCATION, SIGNATURE OF GAS VENT, DUCTS PERMITTE �'_ I �I V LATH, INT ADDRESS �� ""_� LATH, EXT AUTHORIZED AGT �qmmaPLASTER, INT 76A638A DBS3 10-80 $ t-O V P C $ /� ® J d O FEE PLASTER, EXT $ VALUATION FEE FINAL � r 76 P,838A CE J803 9-67APPLICATION "IFOR BUILDING PERMIT COUNT i'.OF-LOS ANGELES BUILDING (✓�j DEPARTMENT OF COUNTY ENGINEER ADDRESS BUILDING AND SAFETY DIVISION LOCA LI TY / JOHN A LAMBIE, COUNTY ENGINEER COLEMAN W JENKINS, SUP T OF BUILDING NEAREST CROSS ST DISTRICT NO GROUP TYPE P ESSED BY F'3'� OR APPLICANT TO FILL IN CONST (Print ort pe only) tG STATISTICAL CLASSIFICATION ySEWER MA � - �� CLASS NO._�DWELL UNITS +' BK PG 1� J BLOCK USE ZONE MAPNO © / TRACT (,� SPECIAL /t NO OFBLDGS 72-d CONDITIONS SIZE OF LOT �+ x NOW ON LOT ` USE OF EXISTING BLDG BLDG SETBACK FROM TEL FRONT PROP LINE OF (STREET) OWNER }r�✓ ZUNO � _ TYPE OF EXISTING SETBACK HIGHWAY YARD - TOTAL ADDRESS `S t /-',n HIGHWAY WIDTH FROM C L CITY (' L C 14.1 LcaL C�� 0 + ARCHITECT O TEL BLDG SETBACK FROM ENGINEER NO SIDE PROP LINE OF _ TYPE OF EXISTING SETBACK HI YARD - TOTAL ADDRESS HIGHWAY WIDTH I FR TEL + = r CONTRACTOR NO a_ LICc:) ADDRESS NO CORNER CUTOFF YES ❑ NO ❑ U CITY CLASS SEE REVERSE SIDE FOR SPECIAL APPROVALS DESCRIPTION OF WORK a NEW ADD ALTER REPAIR DEMOLISH , SQ FT NO OF NOOF SIZE STORIES FAMILIES r , USE OF STRUCTURE SIGNATURE-OF Y Old- APPLICANT ` VALUATION $ i APPROVAL P C PMT FOUNDATION LOCA ION FEE$ FEE $ „� 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 ) WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS BUILDING CONSTRUCTION Iy CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I W LL-NOT EMPLOY ANY PERSON IN VIOLA TION OF THE LABOR CODE Of--;THE STATE OF CALIFORNIA RELAT LATH INT _ ING TO WORKMEN S COMP SATION INSURANCE LATH EX SIGNATURE O n� Zt HOUSE NU ER COR- f PERMITTEE RECT AND POSTED ADDRESS FINAL JOHN F LEVVl RINCIPALTRUCTURAL ENGINEER PLAN CHECK VALIDATION CK D CASH _ PERMIT VALIDATION I CK M O ' CASH t 13+1,0 6 GGT L{ d 27.7t~ `� v 1~ t I J. 78A 638A CE 9803 12/89 1111) - APPLICATIONFO UIL ING PERM COUNTY OF LOS ANGELES ASSESSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING JOHN A LAMBIE, COUNTY ENGINEER ADDRESS COLEMAN W JENKINS, SUP T OF BUILDING LOCALITY fliyfj FOR APPLICANT TO FILL IN NEAREST f i Print ort a only) CROSS ST V DISTRICT NO GRO P TYPE PR ED`BY BUILDING ADDRESS v ��'` Q� CONST STATISTICAL CLASSIFICATION J� SEWEtR MAP LOT NO BLOCK CLASS NO DWELL UNITS BK 14 PG�� TRACT USE ZONEMAP NO OF BLDGS NO SIZE OF LOT _ NOW ON LOT / SPECIAL USE OF CONDITIONS EXISTING BLDG Id JO Fs M TEL OWNER VNO LB / BLDG SETBACK FROM ADDRESS DU .( U FRONTPROP LINEOF (STREET) TYPE OF EXISTING SETBACK HIGHWAY } YARD = TOTAL CITY /�L HIGHWAY WIDTH FROM C L ARCHITECT OR TEL t ENGINEER NO BLDG SETBACK FROM ADDRESS SIDE PROP LINE OF (STREET) TEL TYPE OF EXIS = TOTAL CONTRACTOR NO HI IDTH FROM C L LIC ADDRESSNO + = a LIC O CITE' CLASS CORNER CUTOFF YES ❑ � NO �� V CONSTRUCTION LENDER p NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS 1 W ADDRESS 9 Z SQ FT NO OF NO OF NEW f7' SIZE STORIES FAMILIES USE OF ADD 1 STRUCTURE 41/' n (� aY� „I ALTER Q� x REPAIR❑ SIGNATURE O -a YX APPLICANT DEMOL ❑ i, VALUATIONS APPROVALS , DATE INSPECTOR 5 SIGNATURE P C PMT FOUNDATION LOCATION i FEE S FEE + 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 WITHALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT DUCTS, STRUC TION I CERTIFY THAT IN DOING THE WORK AUTHORIZED , HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH INT LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COMP�N INSURANCE LATH EXT 6 l SIGNATURE OF I HOUSE NUMBER COR- PERMITTEE RECT AND POSTED i ADDRESS FINAL I PLAN CHECH-VALIDATION cH M o cnsH _ JOHN F LEWIS PRI CIPAL STRUCTURAL ENGINEER PERMIT VALIDATION�CK M O CASH 4 [Kn6 9 8 8� SEP3 0 1 D 11.25- i 'Ilk CE#803(REV 11/78) -� 11 t -• = LLLSSS APPLICA 1 _ R EB PERMIT COUNTY OF LOS A ELES _. BUILDING AND SAFETY, - FOR APPLICANT TO FILL IN BUILDING - ADDRESS, BUILDING n /j DDRESS S'3 C . fe VFie t LOCALITY TNEAR EST CITY : i� / ZIP CROSS ST / 7NO OF BLDGS ASSESSOR (� SIZE OF LOT 9.0 D NOW ON LOT MAP BOOK PAGE PARCEL, - DISTRICT GROUP TYPE FIRE SED BY TRACT BLOCK LOT NOTEL 7 CONS Zia OWNER */0/S=ot D NO o�p i T/�/ �i ,,` / STATISTICAL CLAASSSI�FIC'ATION SEWER MAP ADDRESS ap /1/ L./O✓'��L� CLASS NO CDWELL UNITS BK CITY �, e �/T ZIP ARCHITECT OR TEL VALUATION$ ' 'J,�qa ENGINEER - NO - X,, ADDRESS BLDG SETBACK FROM !L G FRONT PROP LINE OF (STREETI CONTRACTORIZ /fLD D6f�'1 NO TOTAL SETBACK TYPE OF EXISTING [ LIC j� HIGHWAY + YARD = FRONT PROP L E HIGHWAY WIDTH ADDRESS .EIPS/l� S� LIC + - CITY S.LtiVf.Ei¢Q CLASS CONSTRUCTION LENDER BLDG SETBACK FROM NAME AND BRANCH L- SIDE PROP LINE OF (STREET) _ HIGHWAY t YARD = TOTAL SETBACK FROM TYPE OF EXISTING - IL ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH C SO FT/ Q NO OF NO OF CHECK + = V as SIZE:� STORIES FAMILIES ONE USE ONE MAP �f DESCRIPTION OF WORK EW NO C, 4 SPECIAL )a,144, adl A D CONDITIONS Vf �Q R ❑❑ FINAL ¢/� B Z �i'0� �i0� Ir/t0'D/✓� DATE �_ .. AIR USE OF n EXISTING BLDG JAN✓/� � �/��V DEMDL ❑ _ APPLICANT TEL (PRINT)gaxvw-� el'.G/f NO;La-,'-V&3 Q BY(SIGNATURE) I HAVEAND STATE x THAT THEBABOVErOWLEDGE ISS CORRECTTHAT AND(AGREE OACOMPLY WITTHISIH ALL ORDINANCES ,- 9 030 A AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE _ WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF U '# 0 0 0 0 0 1 ' THE LABOR CODE OF THE ST F CALIFORNIA IN RELATIN WORKMEN S COM Z t P SATION INSURANCE O 0 { O O SIGNATURE OF 0 0 0 8 a 0 0 V ERMITTEE _ ADDRESS' fief %� - y� c 0215-80 CITY—/!/�/�/.iV NEL PC Fee$ Permit Fee �J Issuance Fee ' W . Total Fee WORKERS' COMPENSATION DECLARATION insure, or afirm certif carte of Worke s' Comtpensat onsens ran to elf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C. �taLe COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. 1 0461 6()Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 1,5-5'-2, X❑ Certified copy is filed withthecounty building inspec- BUILDING tion department. ADDRESS 5328 Cloverly Date 1 j:-1-88_Applicant Randol Roofing_ CITY Temple City zip 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed,if the permit is for one ASSESSOR hundred dollars.($100)or less.) TRACT BLOCK LOT NO, MAP BOOK PAGE PARCEL TEL-OWNER ZO MAP I certify that in the performance of the work for which this OWNER Tom Ml1a NO. — NO. permit is issued, I shall not employ any person in any manner Same as above SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS O 8-1-88 Randol Roofing CITY ZIP U Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate of O ENGINEER NO. CONS ZONE V Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS n with comply with such provisions or this permit shall be deemed revoked. TEL. STATISTICAL CLASSIFI (n C TION APT. CONDO. N CONTRACTOR Randol Roofing NO288-4040 Z LICENSED CONTRACTORS DECLARATIONLIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 529 E Valle Bl. N 51 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 (,—qQ BK PG VALIDATION SO. FT. NO.OF NO. OF CHECK License Number 451937 Lic.Class C-39 SIZE STORIES FAMILIES ONE VALUATION Contractor Randol Roofing Date 1-31-89 DESCRIPTION OF WORK house NEW ❑ ; 2388.00 with GAF 300# Fiberglas shing 69P C3 1 am exempt under Sec. ❑ , ALTER B.BP.C. for this reason REPAIR ❑ $ Dote: USE OF DEMOL EXISTING BLDG. ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT Randol Roofin NO. 288-4040 DATE I hereby affirm that I am exempt from the Contractor's License ✓ Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): By BUILDING I, as owner of the property, or my employees with ADDRESS ;2 04 3.8 A .wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. # a o o • o`� 1, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS ,®`0 4 9.2 5 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK o 0 0 (�9, rj v SET BACK YARD HWY PROP. LINE WIDTH O�!� 6,--8 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 P.L. Lender's Name m - P.C. Fee$ Permit fee 48.75 LDMA Ref. # Lender's Address 3 I certify that I have read this application and state that the 10.50 LDMA P/C# o Y PP Issuance Fee g above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee 49.25. LDMA Perm. # 6 and hereby authorize representatives of this County to enter � upon the ov R ned p bpe 'for inspect' p_ . a tJ r SEE REVERSE FOR EXPLANATORY LANGUAGE I Signature of Applicant 46 Agent Date