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Home My Public Portal About5440 CLOVERLY AVE_Building__ L 78A898A CE 9$09 J857 APPLICATION FOR BUILDING PERMIT 1 COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS O BUILDING AND SAFETY DMSION LOCALITY JOHN A LAMBIE,COUNTY ENGINEER NEAREST CASSATT D GRIFFIN SUP T OF BUILDING CROSS ST DISTRICT NO GROUP TYPE WER MAP PG FOR APPLICANT TO F71N y� pCONADDEAcr BUILD ISS �11 STATISTICAL CLASSIFICATION J CLASS NO DWELL U ITS LOT NO MAPvj�FO HWY D E YE5 d TRACT V', J / Z NUMBER Oi- _ USE ZONE SPECIAL // NO OF BLDG S CONDITIONS SIZE OF LOT L� NOW ON LOT USE OF EXISTING BLDG BUILDING EXIST /J SETBACK YARD HWY STREET NAME WIDTH OWNER /f -sC� FRONT / MAIL •��e (� P L ADDRESS Ole, SIDE CITY C— - LL' �l•� TEL P L - ARCHITECTOR ,�pp INSPECTION RECORD TEL ENGINEER JI,�/�../ NO d ADDRESS /f TEL CONTRACTOR 1J NO ADDRESS DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ NO OF NO OF i STORIES FAMILIES USE OF STRUCTURE Al SIGNATURE OF APPLICANT - ® �•1' iT DATE INSPECTOR S SIGNATURE ADDRES /• w ��J�1 ..Q'�� FOUNDATION LOCATION $ ®O O P C S FRAME MATERIALS RAME FIRE STOPS FEE BRACING BOLTS VALUATION S / 0 V� FURNACE LOCATION FEE ` GAS VENT DUCTS 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LATH INT PLICATION AND STATE THAT THE ABOVE IS CO RECT AND AGREE TO COMPLY ITH ALI, COUNTY QRDINCES AND STATE LAWS TIN ILDIN �O TRUCTION LATH EXT SIGNATURE O HOUSE NUMBER COR- PERMITTE G RECT AND POSTED ADDRESS FINAL JOHN A LAMBIE COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CKM o CASH PERMIT VALIDATION CK M o -CASH 2 6 6 7 APR 7, 2 A 1 .0 0 M ®o IGA638A CE#809-8-S7l 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 QL"" - �! CASSATT D GRIFFIN,SUP T OF BUILDING CROSS ST _ DISTRICT NO I GROU PE EWER MAP FOR APPLICANT TO FILL IN J%- - BK PG CONST BUILDING Jj e / 1 ADDRESS d/ C.. 8. STATISTICAL CLASSIFICATION CLASS NO"- DWELL UNITS LOT NO BLOCK MAP STATE YES NO NUMBER HWY TRACT USE ZONE SPECIAL NO OF BLDGS CONDITIONS SIZE OF LOT o62 LO NOW ON LOT USE OF EXISTING BLDG BUILDING EXIST OWNER l �D l`cf0� SETBACK YARD HWY STREET NAME WIDTH. FR MAIL /�(� � P L -`y ADDRESS �ifr `-« SIDE TEL P L CITY � G l�� NO ARCHITECTOR A�J� TEL INSPECTION RECORD ENGINEER lye Al NO ADDRESS TEL CONTRACTOR NO ADDRESS DESCRIPTION OF WORE Y v NEWI DD ALTER REPAIR DEMOLISH SQ FT NO OF NO OF SIZE �( STORIES FAMILIES USE OF STRUCTURE 70) SIGNATURE OF APPROVALS , APPLICANT 'A DATE INSPECTOR S-SIGNATURE ADDRESS iF'•dtj FOUNDATION LOCATION $ P C $ FORMS MATERIALS FRAME FIRE STOPS FEE BRACING BOLTS VALUATION 00 FURNACE LOCATION FEE GAS VENT DUCTS \ I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP LATH INT - PLICATION AND STATE THAT THE ABOVE I COR CT AND AGREE TO COMPLY WIT ALL OUNTY O IN CES AND STATE LAWS REG ING IN CON RU TION I LATH EXT SIGNATU' OF�h HOUSE RECTAND POSTED PERM]' ADDRESS FINAL JOHN A LAMBIE COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL STRUCTURAL EN PLAN CHECK VALIDATION CK mo CASH PERMIT VALIDATION CK m o ` sH {,AC,p 2 6 3 8 APR 7 1 A 2.0 0 6f OF DIVISION OF BUILDING AND SAFETY Department of County Engmeer BUBO 1 County of Los Angeles - WM J. FOX, COUNTY ENGINEER M; APPLICATION - -- - - r FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY J DISTRICT NO PLAN CK OR REC NO PERMIT NO BUILDING ADDRESS 4 4 7110 (p a dam- t "D� j J j LOCALITY RECEI Y DATE OFAPPL-- AT�BUED I KEAREBT + _ CROHB BT BUILDING ADDRESS `� V OWNER MAIL LOCALITY ADDRESS cK 4 Q `�,() , �,(}�(/.�} y I NEAREST TEL. ({ CROSS ST CITY I lk NO. t FIRE I NO OF TYPE GROUP ARCHITECT OR TEL ZONE PLANS ENGINEER NO I BLDG ORD NO I SETBACK LINE ADDRESS/ USE APPROVED TEL / �f + ZONE BY !DATE CONTRAOTOR „�QyII tr j♦yyyyw NO (D l I?, ! HOUSE NUMBERING / ADDREB13 ' 1 MAP NUMBER NO ASSIGNED BY LEGALS� /is- CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT NO DF BLDQB SIZE OF LOT NOW ON LOT ' USE OF NO OF EXISTING BLDG FAMILICH DESCRIPTION OF WORE: IT NsFO / l A 0 NEW ALTERATION ADDITION / Z D REPAIR DEMOLITION f' Bq FT NO OF ' SIZE ROOMS STORIES EXT WALL I ROOF COVERING COVERING USE OF STRUCTURE i �l�ovo PaTu r f INSPECTION FOR j APPRQVALS OCCUPANCY AS IN PETOR'S SIGNATURE DATE FOUNDATION LOCATION FORME, MATERIALS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- FRAME FIRE STOPS, F PLICATION AND STATE THAT THE INFORMATION GIVEN 19 CORRECT BRACING, BOLTS + I A13REE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE LOCATION, ' AND STATE LAWS REGULATING BUILDING CONSTRUCTION A OAS VENT, DUCTS rr r SIGNATURE OFOF��-Ir LATH, INT PERMITTEE y 1 LATH, EXT ADDRESS _ + ru A. . PLASTER, INT AUTHORIZED AGT ..P.F.X� + PLASTER, EXT. FEE HOUSE NUMBER COR- VALUATION I� //,, RECT AND POSTED FEE 1 V FINAL '.' ,��l� 76A636A DBS 3 1-52 , - DBS-3 25M SETS B-45 — c DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES - ® � ' r,` SWM. J. FOX, CHIEF 'ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY �f gDIST�R.I(CT NO PLAN CK. NO PERMIT NO. ADDRBUILDESS // !s. I� �'f�/�" LJ — LOCALITY �" �+"/�syss C,eY�.�� RECEIVED BY DATE♦OF APPLDATE ISSUED NEAREST CROSS ST. BUILDING/j� 1 ADDRESS "� (� f - OWNER' � l �ADDREHB j r 4 LOCALITY,MAIL NEAREST CITY CROSS ST t FIRE I NO OFA TYPE i GROUP' j' ARCHITECT OR TEL - ZONE-- PLANS ENGINEER NO BLDG ° " , ORD NO t /',NYt Y SETBACK LINE ' 1 ADDRESS � APPROVED TEL s BY c DATE CONTRACTOR NO USE APPROVED x ADDRESS ' �"SrS"'�et`+i'e� P ' ZONE+:Z/,By DATE LEGAL / - �♦ ,DESCRIPTION I LOT N.t,OI/D_ Vy� I�ByLOCK '"� t �? f� F+ rrCORRECTIONS,` TRACT �ry gI�NO OF SLOGS SIZE.OF LOT L.� I NOW ON LOT USE OF ,,gy�pQ O OF NO OF G .. EXISTINBLDG ..Ffa AMIL1[B ROOMS DESCRIPTION OF,WORK NEW ALTERATION ADDITION O REPAIR MOVING DEMOLISH ° 12% ` Sq FTNO OF _ 1 D SIZEROOMS _ SF.TORIES WALL ROOF , COVERING I COVERING — — USE OF NEW r s 13UIL'DING 4 ♦ 1 + F ' APPROVALSt j1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE"THAT THE ABOVE IS CORRECT FOUNDATION LOCATION, INSPECTOR DATE — AND 'AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS W _ A r' AND STATE LAWS REGULATING BUILDING CONSTRUCTION FRAME FIRE STOPS, 1 r I - BRACING, BOLTS ' SIGNATURE OF OWNER LATH, INT 4/' AUTHORIZED AGT d ' LATH, EXT $ P C„>a PLASTER, INT ° n a r ♦ / v' FEE PLASTER, EXT VALUATION FEE /ZZ O 6 FINAL I `f4 APPLIOAPON FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS �S I hereby affirm that I have a certificate of consent to self Insure BUILD DRESSAVn or,a certificate of Workers Compensation Insurance or a certified CITY�j r zIP ^C/a v� copy thereof(Sec 3800 Lab C) b `J LOCALITY Policy No Company 'SIZE�O OT /� NO OF BLDGS NOW ON LOT ElCertified copy is hereby furnished sZ V ZI NEAREST CROSS ST ❑•Certified copy is filed with the county building inspection TRACT BLOCK LOT NO ' _ USE ZONE MAP NO department ' ASSESSOR MAP BOOK " PAGE PARCEL - DateApplicant SPECIAL CONDITIONS v r CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER,( T NO ` YES NO COMPENSATION INSURANCE ///��ll 1 WITHIN 1000 FT OF SCHOOL (This section need not be completed if the permit is for one hundred ADDRESi I � �� t V � DISTRICT GROUP TYPE CON FIRE ZONE PROCESSED BY dollars s($100)or less) CITYZIP p w� I certify that In the performance of the work for which this permit 'T 9 1 Is issued"I shall not employ any person in any manner SQ as t0 ARCHITECT OR ENGINEER TEL NO * ' become subject t0 the Workers Compensation Laws STATISTICAL CLASSIFICATION APT CONDO '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 CONTRACTOR TEL NO SET BACK YARD HWY PROP LINE WIDTH Compensation provisions'of the Labor Code, you must forthwith FRONT COmply'with such provisions Or this permit shall be deemed revoked ADDRESS LIC NO P L a SIDE LICENSED CONTRACTORS DECLARATION CITY LIC CLASS P L I hereby affirm that i am licensed underprovisions of Chapter�9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO OF STORIES NO OF FAMILIES Professions Code and my license is in full_f0rce and effect NEW VA PG , a License Number LIC Class DES TION OF WORK /ADD ❑ VALUATION Q Contractor Date _ ALTER ❑ $ ❑ I am exempt under Sec REPAIR ❑ $ 0 'B&PC"for this reasonyDEMOL 1:1V r LDMA P/C# W m Date I USE OF EXISTING BLDG _ URM ❑ CO r Signature �- APPLICANT(PRINT) TEL NO LDMA Perm# Z L - _ 1 r �j,_/I las owner of the property or my'employees with wages as 1 Z tT•v their sole compensation will do the,work and the structure is ADDRESS O n.� not intended or offered for sale (Section 7044 Business and FINAL DATE Q 0.3 3,07 102.30 Professions Code) �� 0 r WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 1-ITEMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE El as owner of the property am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL § licensed contractors to construct the project (Section 7044 _ TOTk -102. 30 , Business and Professions Code) VES El No t r WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING - �— LSC('S! 102•30 ,OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH ,�'�! f�1E K svi r CONSTRUCTION LENDING AGENCY r COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR , �V V a 1 GUIDELINES _ CHANGE GE .00 I hereby affirm that there Is a construction lending agency for YES❑ NO i rn the performance of the work for which this permit Is issued(Sec [HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING a 3097 CIV C) s CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE � �—I �1 3/25/93 / / TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20 140 CONCERNING HAZARDOUS I 2 Cr ,Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o Lenders AddressONNER OR AGENT 88.+66 L AM11'-08 Q 4 ' a T o I certify that I have read this application and state under penalty C of perjury that the above information Is correct I agree to comply PC FEE PERMIT FEE o 'with all county ordinances and State laws relating to building a construction and hereby authorize representatives of this County ISSUANCE FEE CD 10 to er p the abov ned property for inspection urpo es INVESTIGATION FEE TOTAL FEE SEE REVERSE FOR EXPLANATORY LANGUAGE