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HomeMy Public PortalAbout5439 CLOVERLY AVE_Building__ C��803�(REV 11/78) - . APPLICATIO FO U ILD I IE RM IT ' COUNTY-OF LOS ANGELES BUILDING AND SAFETY-BUILDING r - FOR APPLICANT TO FILL IN_, __ ADDRESS ADIDRESGAO/�_�/�� LOCA LITY NEAREST CITY f1 %� ZIP �'��� CROSS ST NO OF BLDGS T ASSESSOR ` SIZE OF LOT �CJ ,Y �� NOW ON LOT Off/ MAP BOOK �r PAGEv PARCEL DISTRICTGROUP -TYPE FIRE P SED BY TRACT BLOCK I 0 LOT NO -� CONST a TEL � OWNER . ­ ✓ ' O ` /� �NO c7` g$ r ` STATISTICAL CLASS (CATION SEWER MA ADDRESS �C i�LP - f CLASS NO�/ DWELL UNITS � ,. B ''G CITY%��j'i,f�// �%T = ZIP ARCHITECT OEL R T $�� ENGINEER ��/�U iZ® IJ�� NO VALUATION �j ' ADDRESS G�[7 V �`f_f7 �� r BLDG SETBACK LINE OF- (STREET) `"- STREET( ^ T _ CONTRACTOR O HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING y ' LIC FRONT PROP LINE HIGHWAY WIDTH ADDRESS NO -- ' LIC` +` _ h' CITY CLASS CONSTRUCTION LE DER - _ BLDG SETBACK FROM SIDE PROP LINE OF (STREET) NAME AND BRANCH HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING d ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH Q SO FT nn NO OF / NO OF CHECK SIZE V STORIES ! FAMILIES ONE O E ZO E MAP fJj DESCRIPTION OF WORK r - - - NEW SPECIAL ADD CONDITIONS '. ABY' g ALTER FIN L REPAIR '❑ DATE USE OF 3^ - DEMOL EXISTING BLDG _ ❑ -Z APPLICANT I / TEL'+1 �r (PRINT)�r/J .L ,E'(J���/ NO _ BY(SIGNATUREr � �.1 s.. +_. > IHEREBY ACKNOWLEDGE THAT I HAVE READ IS PPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TOC P U WITH ALL ORDINANCES �. ., �. � °y AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE ~ ' ..y x __ 81 5 �3'A , WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF V THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO,WORKMEN 5 COM ' Z #,»o'O o o a 1 PENSATION INSURANCE - g iY O SIGNATUREC�j y 4 - l 4 3 CSG PERMITTEE E ADDRESS t• It TEL CITY__�/�2 � r✓ / NO1� G ! Q 7— a PC Fee$ Permit Fee i `� w > T Issuance Fee Total_Fee_ l✓i ' w , ©s 76A638A` + , ,._a.,., .a _ ' a CE 803{REV 11178)_'v i- LQ , M ' v - + Yn r J APPLLC'ATI,ON 'FOR BU_ILDING'PE�RM IT COUNTYnOF,LOS ANGELES'_ . ' ' __BUILDING•AND-SAFETYµ 4 f BUILDING T t ' EOR APPLICANT TO FILL IN ADDRESS _..S BUILDING ` t ADDRESS l n l0 s� �r LOCALITYt NEAREST'k +1 CITY > f�V y S �f Ll A- .,ZIP 9 / , CI, CROSS ST NO OF BLDGS r ASSESSOR v SIZE OF LOT O NOW ON LOT O/�G MAP BOOK, PAGE PARCEL ' '' ` " ' DISTRICT'+' OUP TYPE +'�+ FIRE ESSED BY TRACT /1-7 �'/ BLOCK S� LOT NO F. - CONST^ ZONE OWNER . /t/l NO 9. STATISTICAL CLASSIFICATION -, SEWER MAP ' ADDRESS s G'/O V t'f �''� _ _ .Y ! J. CLASSNO DWELL UNITS - BK �Z a CITY ARCHITECT OR sn- TELVALUATION $ �tL�� ENGINEERy✓LINO L4 \J 4~ 3 ADDRESS T G BLDG SETBACK FROM TEL FRONT PROP LINE OF (STREET) Y CONTRACTOR NO 5 - TOTAL SETBACK FROM TYPE OF EXISTING a LIC L HIGHWAY t YARD = FRONT PROP LINE, HIGHWAY¢,WIDTH' 1 ADDRESS NO - -- LIC"' CITY VV vCLASS CONSTRUCTION LENDER w BLDG SETBACK FROM — SIDE PROP LINE OF ; (STREET) NAME AND BRANCH n HIGHWAY y + YARD = TOTAL SETBACKIFROM TYPE OF EXISTING t i + ADDRESS � � ? CITY SIDE PROP LNE HIGHWAY WIDTH O SO FT NO OF NO OF CHECK - + _ " "` U' (SIZE O STORIES` FAMILIES— ONE ` `�r Cl U ZONE MAP Q �? DESCRIPTION OF1,WORK - a -- NEW-- l�K) NO G/ SPECIAL ADD ❑ CONDITIONS y�f ALTER INAL REPAIR `BY ' X+ ` + 1:1DATE ' op/ 9 .� USE EXSTTIINGBLDG _ DEMOL L1I, ^`O APPLICANT TEL ` IPRINTI_ ',.. NO `° _ ..� ', . • a,. Q ..;'...� , + ti J.. �: , BY(SIGNATURE) r _ r vt, _+•_� , Y d I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATIONw AND STATE UU + THAT„THE,ABOVE IS CORRECT,AND AGREE TO COMPLY WITH ALL„ORDINANCES„ AND LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE V ~ .+YT WORK AUTHORIZED HEREBY I'WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WO/ENM „�, .,J`J..._ ti_...,_ ,2 8 4 73 A-,:-, 'PENSATION INSURANCE PERMITTEE 2 o 1 e r x24 OQ ADDRESS /U e y - i TEL -O o o 1 2A,0 0 CITY G l� NO rt p1 b4-80 ' .. s ... �a P C Fee$ Permit Fee 4 a F Issuance Fee d Total Fee„ oF BUILDING AND SAFETY APPLICATION FOR PERMIT OUNTY OF LOS ANGELES F E B%5 1946'� LD ,® � ®� Ili WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY �'""�' / n � DISTRICTN0 P� .613_�Cµ�IO ' PERMIT NO. BUILDING, G/ T 7 'J ADDRESS �� / 5 // GI LOCALITY a v / 'IB / � RECEIVED BY DATE OF APPL DATE IBSUE,D/L_ NEAREST + .. L �.pG r. 2,.— 11-6 I o- CROSS ST s �..6..f �q BUILDING OWNER ADDRESS r „4tei.{,c MAIL 'ADDRESS /") LOCALITY .1) NEAREST TEL CROSS ST CITY _ NO FIRE I NO OF TYPE I GROUP ARCHITECT OR TEL .ZONE— PLANS I Pq ENGINEER NO VVVV _ BLDG ' ORD NO ADDRESS SETBACK LINE TEL APPROVED ,w CONTRACTOR NO BY - DATE e _ USEAPPROVED, ADDRESS J ZONE// BY �. DATE LEGAL I 0 y9VIF I BLOCK - CORRECTIONS DESCRIPTION LOT NO J TRACT SIZE OF LOT 6 d X'I S� I NO OF BLDGS moo, x 1 NOW ON LOT USE OF - - I NO OF �-I NO OF EXISTING BLDG FAMILIEH ROOMS i DESCRIPTION OF WORK NEW ALTERATION I ADDITION 1 O A REPAIR ss,. MOVING DEMOLISH p SIZESQ f3CO RO13OFOMS STORIES / D r WALL ROOF COVERING COVERING fg.(3 USE OF NEW// �/ IF �r BUILDING (� Y �► 3 t APPROVALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION, INSPEC R DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION „1 FRAME FIRE STOPS, � .,r� 'T SIGNATURE OF BRACING, BOLTS " Y" OWNER LATH, INT 25 r ' AUTHORIZED AOT 77 LATH, EXT ' P C ela 9�p PLASTER, INT / FEE (/`! `9 PLASTER, EXT O•00 VALUATION FINAL �: wFr$ ��—/�f /� ` FEE D _ 76A638ACE#6> 8-64 APPLICATION FOR BU LDING PE MIT GUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS '4y BUILDING AND SAFETY DIVISION LOCALITY JOHN A LAMBIE COUNTY ENGINEER NEAREST COLEMAN W JENKINS SUP T OF BUILDING CROSS ST DIST GROUP TYPE P SSED BY FOR APPLICANT TO FILL IN y CONS BUILDING ;—C/37 R �// STATISTICAL LASSIFICATION S ER MAP ADDRESS � ) ( CLASS NO DWELL UNITS BK PG 1 LOT NO T OCK _USE ZONE MAP NO TRACT I 1 SPECIAL c ' NO OF SLOGS F CONDITIONS SIZE OF LOT NOW ON LOT i USE OF EXISTINA( BLDG SETBACK FROM TELyi. FRONT PROP LINE OF (STREET) CII OWNER 1 c./ O tl TYPE OF EXISTING SETBACK HIGHWAY + &ARD = -TOTAL heADDRESS e r o H HWAY I F M C L CIT N\ i + 6 BLDG SETBACK FROM — ARCHITECT OR^ TEL SIDE PROP LINE OF (STREET) ENGINEER NO TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS )) ,,!! HIGHWAY WIDTH FROM C L d C N ACT R� //Y� _ L L + AD O �-- 21"1/ AWV al CORNER CUTOFF YES 0 1 NO E O clr �M l�� �°/l7 cIc �` O SEE REVERSE SIDE FOR SPECIAL Lu DESCRIPTIO OF WORK U Z_ NEW AD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF SIZE STORIES FAMILIES USE O F STRUCTURE z kCr N SF CA SIG �/ APP NT )L - VALUATION$ + �1 APPROVALS DATE _INSPECTOR'S SIGNATURE P C PMT G FOUNDATION, LOCATION FEE$ �"^ FEE$ FORMS,-MATERIALS FRAME, FIRE STOPS, I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLT AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE LOCATION WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT DUCTS 9UILDING CONSTRUCTION I CERTIFY THAT IN DOING THE WORK , AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA LATH INT TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT _ ING TO WORKMEN S C/O�'1��E , NSA N INSU RAN/O LATH EXT SIGNATURE OF / i/ / HOUSE NUMBER COR- PERMITTEE V� �V/ /// REQT AND POSTED ADDRESS FINAL gr '� ✓ JOHN F LEWIS PRINCIPAL ST CT R�,l ENGINEER PLAN CHECK VA ATION CK M O C SH _ PERMIT VALIDATION, cK M o CASH �r'It c 63 �i I D q (D o—