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HomeMy Public PortalAbout5426 CLOVERLY AVE_Building__ APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BU!LCI NGCOUNTY OF LOS ANGELES A DDR ESS �.�_. r• 1.'.. <'•'G'�t'`k'� in .I'- DEPARTMENT OF COUNTY ENGINEER CITY {� "•'%r.+_tri ' : ZIP ,'' a-> BUILDING AND SAFETY DIVISION NO.OF BLOGS. BUILDING •��,.. r. 6 t SIZE OF LOT NOW ON LOT ADDRESS �.., } I" -' e',� TRAC-; '- A'L IRI OCK LOT NO LOCALITY TEL_/,. NEAREST GWNERi ;' �� � ,i_�/l� C NO. 1 ,,/ /•jf CROSS ST. ASSESSOR ADDRESS �,- yf^�/�/e" MAP BOOK PAGE PARCEL 7 ,v DISTRICT GROUP ITYPE FIRE PROCESSED BY CITY y:';O/``% ZIP , CONST, ZONE ARCHITEC,.T GSR,r TEL ENGINE.,.'-,_:xv'� ,!`�G'' �''� C.� .� 0 r` `��%{ STATISTICAL CLASSIFICATION SEWER M A P ADDRESS '�'-� ,af• /�"+! :,f `/:IG'! CLASS NO.-..'/---.-DWELL.UNITS BK r,'1 G CONTRACT >�/%�;'.A:,�f / ELw i it USE ZONE MAP , NO. ADDRESS u•� �� ,i f- /,� -T1V0 '� SPECIAL LIC. CONDITIONS CITY ..�; o CLASS •,�' "'? ROAD DEPARTMENT APPROVAL REQUIRED YES NO CONSTR�U TION LENDER �p NAME AND BRANCH BLDG.SETBACK FROM U FRONT PROP.LINE OF (STREET) Lu J ADDRESS CITY HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING la. SQ. FT�;�.' / NO. OF NO. OF CHECK FRONT PROP. LINE HIGHWAY WIDTH r SIZE STORIES FAMILIES ON EF^. } _ DESCRIPTION OF WORK NEW p E] BLDG.SETBACK FROM a' ADD SIDE PROP. LINEOF )STREET') ALTER TOTAL SETBACK FROM TYPE OFEXISTING _ HIGHWAY } YARD - HIGHWAY WIDTH REPA4�❑ SIDE PROP. LINE USE OF DEMOL ❑ + EXISTING BLDG. APPLICANT TEL CORNER CUTOFF YES NO E] (PRINT) NO. BY (SIGNATURE) IN OPEN SPACE YES El NO Q IN COASTAL ZONE YES 1:1 NO 0 VALUATION$ 'kr. 't �+ ` CATEGORICAL EXEMPTION YES NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CER TIF.Y" AT IN DOI NQ THE WORK AUTHORIZED IMPACT REPORT PROCESSED iDATE) HEREBY I WILL NOV EM OY AN7: AjiFORNIA SON IN VIOLATION OF THE LABOR CODE OF, E TATE OIN RELATING TO WORKMEN'S COM ( TION INS USIGNATURE. .•' rr+,� �' /. .-_ - i,,,:, PERMIT--E I ADDRESS FINAL BY TEL. DATE CITY NO. MA KF. CHECKS PAYABLE TO: P. E $ [FE CFEE D HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION I M O CASH _ PERMIT VALIDATION CK . MO I ASH 1 rya sI � 76A638A CE#803 7/73 F APPLICATION FOR BUILDING PERMIT C� FOR APPLICANT TO FILL IN (Print or type only) BUILCING COUNTY OF LOS ANGELES ADDRESS DEPARTMENT OF COUNTY ENGINEER CITY TeMpj e Pity ZIPBUILDING AND SAFETY DIVISION NO.OF BLD S BUILDING S''LE OF LONOW ON LOT ADDRESS Mission ViM; TRACT LOCK 4ti0 o LOCALITY - TEL. NEAREST OWNER NO. 1 ROSS ST. ASSESSOR ADDRESS ' MAP BOOK PAGE ,PARCEL _ DISTRICT GROUP TYPE FIRE PROC SED BY If CITY ZIP CONST. ZONE ,,." �! ARCHITECT OR EL. •-� ENGINEER NO. -' STATISTICAL CLASSIFICATION SKEWER MA'P ADDRESS CLASS NO.__„-�2./__DWELL,UNITS ) Blj%J'fPG ig PrC q -% Con rs no TEL USS ZONE MA0. P LIC. ADDRESS "1 - SPECIAL CITY LIC. CONDITIONS CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ r CONSTRUCTION LENDER ^Y O U NAME AND BRANCH BLDG.SETBACK FROM FRONT PROP.LINE OF (STREETI J ADDRESS CITY _ TOTAL SETBACK FROM TYPE OF EXISTING 4. F CHECK HIGHWAY } YARD = HIGHWAY SQ. FT. WIDTH NO. OF �. NO. FRONT PROP. LINE } SIZE u,' STORIES F-AMILIES ONE + _ G DESCRIPTION OF WORK NEW. '- - d ADD QBLDG,SETBACK FROM Frame and stunno P SIDE PROP. LINE OF 1-� TREETI w «, ALTER L�Jj _ TOTAL SETBACK FROM TYPE 0 XISTING ~ HIGHWAY } YARD HIGHWAY IDTH REPAIR❑ SIDE PROP. LINE USE OF �(.,P�e �. + _ EXISTING BLDG, DEMOL E - APPLICANT TEL CORNER CUTOFF YES ❑ NO (P R NT) NO. BY (SIGNATURE) IN OPEN SPACE YES ❑ NO ❑ i "' �*• � IN COASTAL ZONE YES ❑ NO VALUATION0 Do CATEGORICAL EXEMPTION YES NO I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION ENVIRONMENTAL AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY IMPACT EXEMPTION DECLARATION SIGNED (DATE) WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED IMPACT REPORT PROCESSED (DATE) HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKM E N'S COMPENS N INSURANCE.'"""! SIGNATURE OF d^ PERMITTEE ADDRESS FINAL BY TE L. CITY NO. DATE MA KI: CHECKS PFEE AYABLE TO: PMT.Q FEE FEE $ HARVEY T. BRANDT. COUNTY ENGINEER PLAN CHECK VALIDATION CK M.O. CASH PERMIT VALIDATION CK M0 CASH Y 76A638A CE#803 7/73 `i 78we.a H�D68 a e ea ' APPLICATION FOR BUILDING PERMIT 1 DIVISION OF BUILDING AND SAFETY BUILDINGADDRESS �j 6 A/4 Cletie v /o Deportment of County Engineer Esse W County of LOS Angeles LOCALITY r �� WM J FOX, COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST _ i�'l�G• DISTIiI�T NO G�UP I TYPE 19EWER /ZAP FOR APPLICANT TO FILL IN VL� �Lj SS G PG 2--00 CONST _/ BUILDING NUMBER 61 0© HWY ADDRESS to e v E �L+ MAP q, STATE YES NO LOT NO POl- 50 �Ai1,� �I`4.. BLOCK USE ZONE 'SPECIAL Ca,^ CV_�te USE CONDITIONS , \ a y/. TRACT 7I�1 16 : .� � O I ®� i�1 (5�e1 I NO OF BLOG SIZE OF LOT O O 0 NOW ON LOTS BUILDING YARD HWY STREET NAME EXIST SETBACK WIDTH USE OF g� EXISTING BLDG FRONTP LDE OWNER 1 d.11sw d V P LMAIL _ ADDRESS CL aLleff O TRACT DWELL 1 UNIT T p _ 5 INDUSTRIAL -01 CITY /,�' T�N ) fIT 6 o 39! DWELL 1 UNIT `�ALETC ARCHITECT OR TEL 2 DUPLEX 1 U T ENGINEER d + II NO b -1 A 3 APT UNITS _ $ MISCEL ' ADDRESS 4 COMMERCIAL CONTRACTOR TEL A-r6o79_1 INSPECTIONRECORD ADDRESS IC CVZ ZRIm ((� � . Y �tT 1.KGs '��c.L� � -4 r••'•• DESCRIPTION OF WORK NEWADD ALTER REPAIR _ DEMOLISH SO FT NO OF NO OF SIZE G 0 STORIES FAMILIES ,� uaq � c _ o m�,� USE OF ST UCTUR ?�."'7 ((''�� ([ �/4 .,Z ®/i o v M S oT 1=1 wdL t mg',,A. SIGNATURE OF «.c -i�ey� APPLICANT APPROVALS ADDRESS [1G, f DATE INSPECTOR S SIGNATURE ® 0 P C S � FOUNDATION LOCATION $ A � D� FORMS MATERIALS VALUATION �F FEE FBRACING BOLTS AME FIRE S ld -�1 ^ o- �!'�d.1" .,..�' FEE � FURNACE LOCATION I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS GAS VENT, DUCTS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT AND STATE LAWS REGULATING BUILDING CONSTRUC- TION LATH, EXT SIGNATURE OF HOUSE NUMBER COR- PERMITTEERECT AND POSTED �I ems A ADDRESS I T�L 1 FINAL WM J FOX,COUNTY ENGINEER VALIDATION C N DIRLAM,CHIEF BLDG INSPECTOR LAC04725—ul APR 3 16 �` 6.0 0 w 2 0 0 1 7eeeeee e46e>� G O APPLICATION FOR BU LDIN ) PERMIT C Y OF LOS ANGELES BUILDING / DEPAR Mg OF COUNTY ENGINEER ADDRESS BUILD AND SAFETY DIVISION LOCALITY JOHN A `LAMBIE, COUNTY ENGINEER NEAREST ' WILLIAM A JENSEN SUP T OF BUILDING CROSS ST DISTRIC;.N I GROUP TYPE CESSED BY FOR APPLICANT TO FILL IN !�� CONST BUILDING STATISTICAL CLASSIFICATION I EWER MAP ADDRESS •S G L p L T�� ' BK - P y�� CLASS NO DWELL�UNITS ! /7 L T NO S O LOCK - MAPSTATE YES NO t/y NUMBER HWY TRACT 2- .7 V USE ZONE SPECIAL ./ NO OF SLOGS t CONDITIONS SIZE OF LOT O/� I NOW ON LOT ..3TrA USE OF � ,��M�� "+ EXISTING BLDG BUILDING YARD HWY TREET NAME - EXIST /1 C n T L/J SETBACK WIDTH OWNER PTIL,C3E,QT<, B0!/Oo,944 6 AZ 4-039, FRONT P L ADDRESS SIDE ARCHITECT OR I TEL P L v ENGINEER NO 1 INSPECTION RECORD ADDRESS a O OCONTR4CTOR'fNyV 7-ly ADDRESS S Wg4N1 DESCRIPTION OF WORE t I? _ /•?69R VfQ!lam= /—h!//I) 0 NEW ADD ALTER) REPAIR DEMOLISH n ,/ , / �/ Q�I1� ,�/ SQ FT �! NO OF NO OF { 7-//,,c VRll� -- IA11,9 ,L19,0�TA ? SIZE STORIES FAMILIES -7-/y SUSE OF' l TRUCTURE ,�' -X S { Y/G/_ .9,6 -y/- / h 400 � 6ATf/ /N g1CtsT D�, � D�yl��7i-cTfi�n,E/�_Ft.J/�iCt'.f�0 ,S� D/✓ SIGNATURE OF R e 1 ! /TC J /T/7 ✓� �i APPLICANT f VALUATION v vv APPROVALS DATE INSPECTOR.S SSIIGNATTURE PC PMT �9 FOFORMSI MATERIIALS N t? FEE $ FEE $ FRAME FIRE STOPS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS If A/ A AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS !I BUILDING CONSTRUCTION I CERTIFY THAT.IN THE PERFORMANCE e OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATH INT ..CW RV• �'- EMPLOY ANY PERSON IN ANY MANNER O AS T BECOME SU BU ECT '�`�"^"�'�• TO THE WORKMEN S COMPENSATIO WS O ALIFORNIA LATH EXT h SIGNATURE OFOWCefl HOUSE NUMBER COR- PERMITTEE OR- , PERMITTE RECT AND POSTED , � ADDRESS �+� FINAL �i�/hQdL PLAN CHECK VALIDATION CK MO CASH CLYDE PERMIT VALIDATION T RmAL0 ENGINEER ER 1 LAC,3763 " 111n10 1 D 1500' TO DEPARTMENT OF BUILDING AND SAFETY,, �� APPL'1eATION FOR PERMIT COUNTY OF LOS ANGELES ® � WM. J FOX. CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY 1 D16TRICT NO i PLAN CK NO PERMIT NO BUILDING i) v k ` S-7J v ADDRESS 4 LOCALITY ( RECEIVED BY DATE OF APPL�/ DATE ISSUED NEAREST //��� '/ /o � 2 CROSS ST C/ V BUILDING /, �• // �� %7�' / ,! OWNER Y 1 0 VLx ..ADDRESS CL nC _ /././8�"l".C�/I_�( ♦ li( MAIL � 'C` n I/ LOCALITY ,tom X Q�l " xv� C ADDRESS TEL NEAREST CITY / NO �(J��J CROSS ST Q FIRE I NO OF GROUP ARCHITECT OR TEL ZONE PLANS ENGINEER NO BLDG R O ADDRESS SETBACK LINE - APPROVED TEL BY i DATE CONTRACTOR NO USE A APPROVED � ZONE BY' DATE ADDRESS LEGAL14VCORRECTIONS DESCRIPTION LOT NO X71oT BLOCK TRACT dj / S O �1A�✓ NO OF�.' SIZE OF LOT 1 mac+ v NOW ON LOTS / USE OF NO OF EXISTITI NG BLDG FA FAMILIES/ ROOMS DESCRIPTION OF WORK r� V NEW ALTERATION ADDITION + ftiri�i�f{"' O A REPAIR MOVING DEMOLISH 9q FT NO OF c Z SIZE Ci ROOMS STORIES D WALL I ROOF r COVERING V, � U , USE OF NEW,,;; �, BUILDING _Q�l I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION j C'TOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS AND STATE LAWS REGULAT NG BUILDING CONSTRUCTION / ! -L..,�r 3/L/rte FRAME FIRESTOPS, SIGNATURE OF BRACING,BOLTS PERMITTE - LATH, INT AUT 43RIZE AG LATH, EXT 76A638A 9-48 �i V DBS-3 6OM SETS $ P C $ PLASTER, INT _ FEE _ PLASTER,EXT VALUATION FEE FINAL SETS 6-46 �ARTN ENT OF BUILDING.,AND SAFETY APPLICATION FOR PERMIT ,COUNTY OF LOS ANGELES - tJ WM. J.,, IL'® I ^ G OX, CHIEF'ENGINEER_ , FOR APPLICANT TO FILL IN' FOR OFFICE-USE ONLY DISTRICT' O PLAN CK NO PERMIT NO'J r5, BUILDING /U _ +,('I - " ' - r't .g� ADDRESS r V.. ; ,13: 7, �,,a a �,� � �EIVED' BY DATE OF APPL DATE ISSUED ' LOCALITY NEAREST 4} CROSS ST �• i - _ _ , , BUILDING ^OWNER- ...///WWW r s ADDRESS . { MAILt ' `y 4 �, ' c; ADDRESS E!y 4 �, Q<O&+1- LOCALITY , / NEAREST -� +�L -fi j'►/'�i.+` ,p�� � � f��_�a, _ -TEL. ,CROSS 9T �y/{�-� Y-'+A�.� 6^„"y'T"'�ma+�'V NO CITil FIRE NO OF h7tl TYP I GR^Lj$oi ' r�J ARCHITECT OR - 4r-+� _ � ry TELA,` M... 5 ZONE IOPLANS ENGINEER NO "' II' BLDG ` _ (�RD NO ADDRESS SETBACK LINE" 'APPROVED'1� ir}r '�'e ►�•�JL. BY iixrr r 1 DATE CONTRACTOR NO, _ l _ B + USE APPROVED �f ADDRESS �� ZONEAN 1'1Y i ` ,r9 �" �,( DATE LTJ - t LEGAL + ' i CORRECTIONS r ` DESCRIPTION I LOT NO d�I I BLOCK ., I +yr TRACT I'( t f '1 -r V s+9< -AI/19 zi-1 jJ NO OF SLOGS T r } SIZE OF LOT 400 NOW ON.LOT USE OF I NOOF I NO OF 7 i EXISTING BLDG FAM ILIKS ROOMS ' DESCRIPTION OF WORK ' /NEWn- i`xALTERATION', ADDITION- O C +, REPAIR - MOVING DEMOLISH ` r BWa`q NO OF SIZE'FT >� ROOMS �' ;TORIES ' ' ' WALL ROOF`, i r N COVERING COVERI'NG' ' ,USE OF NffW BUILDING "p" >• - ry APPROVALS - I HEREBY ACKNOWLEDGE THAT.'I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION, INSPECTORV DATE AND AGREE TO COMPLY WITH,ALL COUNTY ORDINANCES I FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION FRAME' FIRE STOPS, SIGNATURE OF - ;"�l� BRACING, BOLTS ' OWNER I' LATH, INT' AUTHORIZED'AGT • " "' LATHr EXT' } ,ti P C, PLASTER, INT FEE , PLASTER, EXT VALUATION J" �i FFE -� 2—v FINAL _ w