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HomeMy Public PortalAbout5338 CLOVERLY AVE_Building__ • ' ��'ole, TEMPLE CITY .7CAl89A"#eo3?./eo APPLICATION FOR BUILDING PERMIT � _ COUNTY OF LOS ANGELES BUILDING CLOVE y ADDRESS DEPARTMENT OF COUNTY ENGINEER BUILDING AND SAFETY DIVISION LocALITY L_ Ci JOHN A LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRICT NO GROUP TYPE PROCESSED BY FOR APPLICANT TO FILL IN CONST - BUILDING �' elo vC r A ve T�I STATISTICAL CLASSIFICATION SEWER MAPP D S t y/�� �� CLASS NO WELL UNITS LMAP LOT NO T / r7,61F OSD� ,� t_ BLOCK /' NUMBER oL� �y STATE YES NO TRACT .I/ipdLA� AM/NP,i Pr/ Uu�E�EE SPECIAL � / // O OF BLDGS p,'��� CONDITIONS //', C� ` SIZE OF LOT k NOW ON LOT �OOO USE OF EXISTING BLDG Rk4 W,17 4-5 J?7'77 BUILDING EXIST TEL SETBACK YARD HWY STREET NAME WIDTH OWNER .t-L� S / 7-f p—A NO FRONT Tel ADDRESS �! OZ O1 Y ` SIDE (A t ARCHITECT OR TEL P L ENGINEER NO INSPECTION RECORD ADDRESS CONTRACTOR $S�/�iY.�A�vm OL - -0131 �0 ADDRESS DESCRIPTION OF WORK — ���i u_ ��1 U f_- 00 04f NEW ADD . ALTER REPAIR DEMOLISH SQ FT NO OF NO OF f - a SIZE �� V` STORIES / FAMILIES / / �D-` USE OF / C f� r n(6+! `f4! -I �f��S F .s.w.wdk.�"' STRUCTUR xe _ St NATURE OF V PPLIC 4NT { VA UATION O Q APPROVALS DATE/ INSPEC OR S SIGNATURE ,/' g� FOUNDATION LOCATION � ?3 3 3 a o FEE FC $O . (/ FORMS MATERIALS /] FRAME FIRE STOPS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- BRACING BOLTS PLICATION AND STATE THAT THE ABOVE IS CORRECT AND FURNACE LOCATION AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND GAS VENT DUCTS STATE LAWS REGULATING BUILDING CONSTRUCTION _ 1 CERTIFY THAT IN DOING THE, WORK AUTHORIZED I LATH INT WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE _ WORKMEN S COM ENSATION LAWS OF CALIFORNIA LATH`EXT ✓ HOUSE NUMBER COR- SIGNATURE SIGNAT E RECT AND POSTED __l v 1Ll ADDRESS FINAL Uf PLAN CHECK VALIDATION M O CASH CLYDE p REIMIT VALIDATIONM, PRINCIPALTR cK RALENGINEEREN�HER ��I _1915 - FEB 1 23 0 33Gvk WORKERS' COMPENSATION DECLARATION insure,oroafcertif cafirm tharte of Workers'CCompensation rtificate of Insuran ent to self APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy N{]ro 3CompanyStaj}a F LIJ BUILDIN Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING _ tion department. ADDRESS 0333 Clcverl. Ava. LOCALITY NEAREST Date Applicant CITY" 7 ZIP 1/y ©1 CROSS ST. ERTI ICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. ASSESSOR d COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK I PAGE PARCEL O (This section need not be completed if the permit is for ane USE ZONE MAP U hundred dollars ($100)or less.) TRACT BLOCK LOT NO. NO. LU TEL.. SPECIAL I certify that in the performance of the work for which this OWNER Vt3 NO JT—t}:3rJi CONDITIONS aL permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY } so as to become subject to the Workers'Compensation Laws. ADDRESS CONST. ZONE OC Q CITY "' ZIP `91730 W Date Applicant "- STATISTICAL CLASSIFICATION APT. CONDO. O NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. a Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. ( DWELL. UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP � with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR'' tF's � N©3�1w7167 BK. PG, VALIDATION LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS - '07 N0.15761.3 VALUATION (commencing with Section 7000)of Division 3 of the Businessond LIC Professions Code, and my license is in full force and effect. CITY '�Lb 91803 CLASsC-39 $ Poo, FT. NO. OF NO. OF CHECK License Number I C47f:7? Lic.Class SIZE STORIES (Me FAMILIES ONE Contractor F ' 611411- i Date DESCRIPTION OF WOR (" wdstjav, NEW ❑ ❑ I am exempt under Sec. iuny & r3"rwf Atli L-w-c' r ADD ❑ :]G�1;zw, pressum - . ALTER ❑ FINAL DATE B.BP.C. for this reason REPAIR • Date: USE OF DEMOL FINAL EXISTING BLDG. �31� BY Signature APPLICANT TEL. 21, OWNER-BUILDER DECLARATION PRINT NO. 71 1 hereby affirm that I am exempt from the Contractor's License , Law for the following reason (Section 7031.5, Business and ADDRESS rV^ " Professions Code): PRESENT ❑ BUILDING J' f I, as owner of the property, or my employees with ADDRESS j 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. ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO. \ with licensed contractors to construct the project (Sec- ADDRESS c tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. `} 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 m P.L. o Lender's Name _ Lender's Address P.C. Fee$ Permit Fee �•2 f I certify that I have read this application and state that the Issuance Fee ' above information is correct. I agree to comply with all County Investigation Fee y g ordinances and State laws relating to building construction, Total fee -- ItI and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. 0 a ^ SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of-Applicant or Agent Date es I ( %r WORKERS'COMPENSATION DECLARATIC;iO' I lit-_ hereby affirm that I h'a`ve a certificate of Wcin�self A P P L I CAT O N FOR BUILDING P E RM I T insure or a certificate of Workers tion Insurance,Compensaon nssurance, or a certified copy thereof (Sec 3800 lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy is hereby furnishedBUILDING FOR APPLICANT TO FILL IN 7114, DDRESS , A Certified copy is filed with the county building inspec- 'BUILDING �U� _ tion department ADDRESS (� / OCALITY ,t EAREST Date r Applicant CITY �•Q `/ ZIP ROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS / NO OF BLDGS SSESSOR COMPENSATION INSURANCE SIZE OF LOT /� NOW ON LOT AP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars ($100)+or less ) TRACT BLOCK LOT NO NO 2f L TEL /� SPECIAL I certify tat in the performance of the work for which this OWNER Q Q NO� %' CONDITIONS IL permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Workers Compensation Laws ADDRESS D CONST ZONE V _ . Date Applicant 2� {,..� CITY /-8 ZIP STATISTICAL CLA I ICATI - PT CONDO 0 NOTICE,TO-APPLICANT If, after making this Cer icate of ARCHITECT OR TEL V Exemption, you should become subject to the Workers ENGINEER NO CLASS NO DWELL UNITS CL Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP "0 with comply with such provisions or this permit shall be Z deemed revoked ?.F TEL �y BK PG VALIDATION CONTRACTOR (JLC ( NO LICENSED CONTRACTORS DECLARATION LIC I hereby_affirm that I am licensed under provisions of Chapter 9 ADDRESS /_ NO lOs7 ALUATION " (commencing with Section 7000)of Division 3 of the Business and LIC �' �� Professions Code, and my license is in full force and effect CITY i CLASS '/v $ � r SQ FT NO OF NO OF CHECK \�� Li cense Number3z�✓�/� Lic Class (1'.�'� SIZE �00 STORIES FAMILIES ONE Controctor�Gi14P.� ,(-�� , Date $ 2b —O DESCRIPTION OF WORK NEW 7 I am exempt under Sec ;W�l�yl ADD ALTER FINAL _ B&P C'for this reason DATE J , REPAIR � Date w EXISTING BLDG TTL'S�(� CP/ DEMOLUSE OF FIN Signature APPLICANT / TEL 7 By OWNER-BUILDER DECLARATION PRINT (J/ NOQ7j� �J I hereby affirm that I am exempt from the Contractor's License ADDRESSz( � N— d 6 Law for the following reason (Section 7031 5, Business and Professions Code) —9 1 3 1.2 A ❑ BUILDING 1,'as owner of the property, a, my employees with ADDRESS # 0 0 0 0 0 1 l wages as their sole compensation will do the work and , Z the structure is not intended or offered for sale(Section ~ LOCALITY 2 e o 8 7 3 ` 7044, Business and Professions Code) , MOVING TEL I, as owner of the property, am exclusively contracting CONTRACTOR NO 0 0 0 87 3 H u with,licensed contractors to construct the,project (Sec- ADDRESS tion 7044, Business and Professions Code) _ _ Q Q 20—Z3 REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LIN WIDTH _ .r 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 YARD- FO V PL Q Lender s Name $. r Lender s Address P C Fee$ Permit Fee •y , I certify that I have read this application and state that the Issuance Fee above information is correct I agree to comply with all County Investigation Feea . g ordinances and State laws relating to building construction, Total Fee ' kZ. 3,5,13 !j and hereby authorize representatives of this County to enter +' upon the above-mentioned property for inspection purposes t o yv SEE REVERSE FOR EXPLANATORY LANGUAGE $ ' Signature ofGkpp,ca or Agent Date 11 Y�, % • APPLICATION F®R� BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY APPLICANT WORKER'S COMPENSATION DECLARATION FOR TO FILL IN BUILDING ADDRESS I hereby affirm that I have a Certificate of consent to self insure AD BM Insure � ` or a certificate of Workers'Compensation Insuran or a certified CITYzIP IWULV copy the 3800 Lei C) LOCAL] Policy N Company SIZE OF LOT NO OF BLDGS NOW ON LOT $fQertifled copy is hereby furnish NEAREST CROSS ST ❑ Certified copy is filed wit the coun g Inspection TRACT BLOCK LOT NO USE ZONE MAP NO departm j � ASSESSOR MAP BOOK PAGE PARCEL Date a Applicant SPECIAL CONDITIONS CERTIFI ATE OF EXEMPTION ROM WORKERS' OWN TEL NO YES NO COMPENSATION INSURANCE WITHIN 1OD0 FT OF SCHOOL? ADD SS (This section need not be completed If the permit Is for one hundred, DISTRICT GROUP TYPE CONST' FIRE ZONE P CESS Y dollars that or less) z CITY — zl (�/ h(/ k-3 Z 2 I certify that In the performance of the work for which this permit Y1 / I Is issued, I shall not employ any person in any manner so as to ARCH ECT OR E INEER TEL NO become subject to the Workers'Compensation Laws STATISTICAL CLASSIFICATION APT DO Date Applicant ADDRESS CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption you should become subject to the Workers' CO R TE O SETBACK YARD HWY PROP LINE WIDTH Compensation-provisions of the Labor Code, you must forthwith Z FRONT — s comply with such provisions or this permit shall be deemed revoked ADD LINO P L SIDE >_ LICENSED CONTRACTORS DECLARATION CITY LIC C PL a I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (Commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORES NO OF FAMILIES O Professions Code,and my license is In full force and effect NEW ❑ BK PG � DESCRI NOF qpp VALUATION `, W Llcerise Number LIc Class Qv 13- Contractor Date ALTER ❑ Z ❑ • El am exempt under Secf REPAIR B&P C for this reason DEMOL ❑ LOMA P/C# Date USE OF EXISTING BLDG URM ❑ Signature APPLICANT PRINT) TEL NO WMA Perm# Z i ❑ i as owner of the property or my employees with wages as 6 .Z-6 p AT r T.'PT-- their ADDRE -s- their sole compensation, will do the work and the structure Is H � not Intended or offered for sale (Section 7044, Business and [FIZ)AINAL 011.'S_0�PfofesslonsCOde) WILLTHEAPPLICANTORFUTUREBUILDINGOCCUPANTHANDLEAHAZARDOUSMATERIAL J f I 83 owner of the r0 OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN a ]TEN jp perty, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FIY licensed contractors to construct the project (Section 7044 s + YES❑ NO❑ a -1�i E�L �� ®,0 0 Business and Professions Code) -- t WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING , - �L-t` �•'* '1 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST i- _ FOR GUIDELINES �'il^WSE _ uJI1 1 hereby affirm that there Is a construction lending agency for YES❑ NO❑ the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,Civ C) PERMITTING CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES j _- COUNTYCODE TITLE2 CHAPTER 220 SECTIONS 2 20 100 THROUGH 220140 CONCERNING Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING APERMIT FROM THE SCAQMD Lender's Address,CL OWNER '.4 0 1 certify that I have read this application and state that the above Q Information Is correct I agree to comply With all county PC FEE PERMIT FEE ' 00 Xz, ordinan State laws relating to building construction and v here auth r esentatives of this County to enter upon ISSUANCE FEE the bo ant property for Inspection purposes n 100 INVESTIGATION FEE TOTAL FEE m sgnwna om SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA SL 0508 9705280011 PHONE (818) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS TR. 17190 LT 1 BL .001 SQ FT STORIES TYPE 5338 CLOVERLY AV STRUCTURE 300 V TEMP CA 917803105 ASSESSOR T ' NEAREST CROSS STREET OLIVE 8590-005-003 THOMAS PAGE 596 GRID J4 LOCALITY TEMPLE CITY TENANT EXIST BLDG USE RESIDSE ZONE R-1 ISSUED ON PROCESSED 13Y EXPIRES ON EXIST OCC GRP 05/28/97 TC 05/2 %98 OWNER. TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE VESSEY THOMAS E,MARY B - 2 8,000 _/'-Q 5338 CLOVERLY AV // TEMP 917803105 FEES PAID D S I ON OF WURK ENCLOSE EXISTING ACCESSORY STORA BUILDING-NON HABITATION FEE DESCRIPTION QUANTITY UOM AMOUNT APPLICANT. TEL NO DONALD BOVINE (818) 287-4845- AA BLDG PERMIT ISSUANCE 27 75 IAC STRONG MOTION RESI,D80000 000 VAL 0 80 SPECIAl CONDITIONS AX BUILDING REVIEW,:�FEE 54 70 ID2 PERMIT W/O1ENsHC� 8000 00%VAL 183 90 �w TOTAL--FEESj) 267 15 CON�TR AORTEL NO \UUUv� AP RO . S DATE INSPECTOR SIGNATURE DONALD BOLINE (818) 287-4845- 951 MAYNARD DR LIC NOI OCL A MLW A SETBACKS DUARTE, CA 91010 643751 B ` O SOIL -ICR-5 I NEER APPROVAL ARATTECTbk-EAGTWnT-- O fOUM TRE REFFORFIr LIC NO I Mill SLAB/UNDER FL�R I RAISED NSWER MAP PAGE F ZONE ---C-FP-- WO" R FR UTNLOOR INSULATION 147H269 3 01 — ` - - — /�� FL55R .,HF NG 0 0 NO OF FAMILIES DWELI ING OND STAT CLASS O 0 NO 21 ( Q 0ROOF SHEAT I SCHOOL WITPINA DO O 0 o -SNEW-P NELS AIR QUALITY 1000 FEET MATERIALS � , 0 NO NO NO Dco `� FRAMs NS- P 0� N — �%-7 RE�YW � 0 S F i [ R SRI LER HANGERS— SET E SSET BACK YARD HWY. PROP LINE WIDTH: ��n FRONT PL- INSULATION/WEATHER STRIP SIDE PL- TwTffr(R LAT it A-1 EXTERIOPEA RATED F OO�R/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENI S T-BAR CEILINGS UO-7-DRAINAGE REPORT ID DPR261 ROUTE TO BS0508 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 0411020031 PHONE (626) 285-0488 EXT LEGAL ID 0 OF CONST BUILDING ADDRESS TR 17190 LT 1 BL: 001 SQ FT STORIES TYPE 5338 CLOVERLY AV STRUCTURE 2900 VN TEMP CA 917803105 S R N BER NEAREST CROSS STREET 8590-005-003 THOMAS PAGE 596 GRID J 4hQQAH TY TEMPLE CITY, C TENANT EXIST BLDG USERESID USE ZONE R-30 EXPIRES ON EXIST OCC GRP 11/02/04 JK 10/28/05 OWNER TEL N0: BLDGS NOW ON LOT VALUATION FI DATE FINAL BY CODE VESSEY THOMAS E,MARY B - 9,800 `/ 5338 CLOVERLY AV 7! '` s 7 TEMP 917803105 FEES PAID DESCRIPTION OF WORK TEAR OFF 1 LAYER SHAKE 29 SF APPPLY 1/2 CDX AND MONIER FEE DESCRIPTION QUANTITY UOM AMOUNT CEDARLITE #3783 1CBO #2656 APPLICANT HENRY (626) 207-0669- AA BLDG PERMIT ISSUANCE 27 75 4251 BALDWIN AVE AC STRONG MOTION RESID 9800 00 VAL 0 98 SPECIAL CONDITIONS EL MONTE 91731 D2 PERMIT W/O EN-HC 9800 00 VAL 216 60 TOTAL FEES 245 33 CONTRACTOR TEL NO- APPROVALS DA15 INSPECTOR SIGNATUR WEATHERGUARD ROOFING (626) 287-0669- 4251 BALDWIN AVE LIC NO LOCATION EL MONTE, CA 91731 808888 C39 SOILS ENGINEER APPROVAE- ARCHITECT OR ENGINEER. FOUNDATION/TRENCH FOR S LIC NO SLAB/UNDER FLOOR RAISED FLOOR FRAMING AP 0: SEWER MAP BOOK PAGE: FIRE ZONE CMP UNDERFLOOR INSULATION XX 3 01 FLOOR SHEATHING OF FAMILIES DWELLING UNITS. A /COD STAT L SS / NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE RI L R A S SET BACK YARD: HWY PROP LINE WIDTH FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT 1D DPR261 ROUTE TO BS0508