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HomeMy Public PortalAbout5628 CLOVERLY AVE_Building__ 76A638A CE#803 f.-,, 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 /►- CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. (� DISTRICT NO. ROUP TYPE P SSED BY FOR APPLICANT TO FILL IN CONS BUILDING /' % ER MAP ADDRESS �t0 2-e CLO f/&/PL STATISTICAL CLASSIFICATION ,SK PG / CLASS.N DWELL. I UNITS�'�"' LOT NO�4 v OCK MAP STATE �J� ( NUMBER HWY. YES TRACT (� / JV�GJlis� USE ZONE SPECIAL NO.OF SIZE OF LOTr 7 JS L- OV I NOW ON LOTS -f,/ CONDITIONS . U S E OF EXISTING BLDG. qtr S BUILDING EXIST. T SETBACK YARD HWY STREET NAME WIDTH OWNER (�I� R1ZI1_+_ F-! �TZ.✓ O HA FRONT MAIL P. L. gl ADDRESS 'SIDE - - TEL. P. L. CITY hLi %i NO. INSPECTION RECO ARCHITECTOR TEL. ENGINEER e©�G la.J,� NO. - ADDRESS CONTRACTOR - 14KS7_AL 76V4 NO. 4- 17Z11d,f7- ADDRESS .SGO�O M /C a.SG'HGAD r DESCRIPTION OF WORE NEW>r ADD ALTER REPAIR DEMOLISH SQ.FT. NO.OF NO.OF �1 � Z de 2W SIZE STORIES FAMILIES ' USE OF STRUCTURE c 7 p /3LAN rQsj 3 J L 1'_> �/ a Mil �zzl1 Y�i9,r.5' G/ ""/A/G c :3 5 ; SIGNATURE OF APPROVALS APPLICANT �' L DATE INSPECTOR'S SIGNATURE ADDRESS — FOUNDATION: LOCATION 7 4-a) FORMS,MATERIALS U /fG• ?�rY'' $ P.C. t Q (jl FRAME: FIRE STOPS. FEE BRACING, BOLTS VALUATION $�a FURNACE: LOCATION, FEE �� GAS VENT,DUCTS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL OUNTY P 1- kUCES AND LATH,EXT. ' STATE LAWS REGULATING/ I RUCTION. SIGNATURE OF HOUSE NUMBER COR. PERMITTEV RECT AND POSTED ADDRESS FINAL ��'�I ��' �' `✓ .. CLYDE N. DIRLAM, PRINCIPAL STR9MEAL ENGINEER PLAN CHECK VALIDATION cK. M.O. CASH 'PEOUT VALIDATION CK. M.O. CASH r L o 5 4 7 0 'APR 21 2 3 A 3.0 0 -•M Of, 05471 APR ? 1 1 A 1.2.00. - i6ay7A DBS-3 12•54 - 4 APPLICATION FOR. BUILDING PERMIT DIVISION OF BUILDING AND SAFETY BUILDING Jr—(�02 _--p � Department of County Engineer ADDRESS County of Loa Angeles LOCALITY W&I. J. FOX, COUNTY ENGINEER NEAREST CASSATT D. GRIFFIN, SUPT OF BuILDuiG CROSS ST.5028MMIR 0119= DISTRICT NO. GROUP SEWER MAP BUILDING FOR APPLICANT TO FILL IN �{')TYPE :711 n BK_ PG yy�/�, a� /1 MAP /� �f '-' I CONST. ADDRESS f:6 i'./ !i• �.J�`•',� `"�`y� � I'n� NUMBER �QV / STAT YES ` N LOT NO. /tS '{./ /�/ �1 7S ( BLOCK USE ZONE SPECIAL CONDITIONS TRACT NO. OF BLDGS. SIZE OF LOT NOW ON LOT BUILDING SETBACK YARD I HWY STREET NAME WIDTH EXIST. USE OF - EXISTING BLDG. FPROL T q T I ,/ �� !vt/l/"yl/ !!�l/ J . a 0 / X OWNER / 4!�`�`'Q a SIDE MAIL h ,q P. L. 11 ADDRESS_TA'/-/ p - . ,V/✓i1 TEL 1 DWELL. I UNIT 5 INDUSTRIAL CITY 2 DUPLEX_UNIT 6 PUBLIC BLDG. ARCHITECT TEL. - ENGINEER NO. 3 APT. UNITS 7 ADDN.,ALT., ETC. ADDRESS �i4 COMMERCIAL 8 MISCEL. ��9 ..TEL. CONTRACT b:_ NO. INSPECTION yRECORD ADDRESS DESCRIPTION OF WORK / NEW HADD ALTER REPAIR. DEMOLISH SQ FT.0�O NO.-OF NO. OF SIjE STORIES FAMILIES USE OF STRUC TURE Q SIGNATURE OF/" � AO F �d APPLICANT " - 1"-T APPROVALS ADDRESS DATE INSP CTOR'S SIGNATURE - FOUNDATION:.LOCATION p FEE SZ��-' FORMS, MATERIALS FBRACING BOLTSRAME: FIRE VALUATION t: -- FEE (3� FURNACE: LOCATION, - 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT, DUCTS `1 APPLICATION AND STATE THAT THE ABOVE IS CORRECT - AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LATH, INT. � 1� AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. LATH, EXT. - SIGNATURE OF HOUSE NUMBER COR- PERMITTEE, RECT AND POSTED ADDRESS ell FINAL t wm. J. FOX. CouNTY EN6[Nzm VALIDATION gD2 51' MAR 14 1 6 1 �55!.�jO/ '0 . � ',ACO 1B"6 2 .6 MAR 14 1 3 2.0.0 +� ..���tin/EPUTY . _ .. .__. .._. . DEPUTY g C� BY BY DEPUTY DEPUTY COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS DEMOLITION BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0803140003 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 5628 CLOVERLY AV STRUCTURE: TEMP CA 917802550 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 18588-006-007 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, Cl TENANT: 1EXIST BLDG USE: SWIMM USE ZONE: JISSUED ON: PROCESSED BY: EXPIRES ON: - EXIST OCC GRP: 103/14/08 SR 09/10/08 OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1FIPAL DATE FIN BY: CODE: 1WU ANDY C;VUONG KELLY (626) 975-1490- 3,800 15628 CLOVERLY AV TEMP 917802550 FEES PAID 1DE CRIPTION OF WORK I SWIMMING POOL FILL UP REMOVE CONCRETE CEMENT I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 (APPLICANT: TEL. NO: I I 1WU (626) 975-1490- IAA BLDG PERMIT ISSUANCE 27.75 1 15628 CLOVERLY AVE 102 DEMOLITION INSPECTN 163.50 (SPECIAL CONDITIONS: (TEMPLE CITY CA 91780 TOTAL FEES 191.25 1 I I � (CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE ISHIPING SONG (626) 246-8384- 1 1506 N. LINCOLN AVE #A LIC. NO 1 1PEDESTRIAN PROTECTION I I (MONTEREY PARK, CA 91755 889656 B 1 I I I I 1 ISEWER DISCONNECTION I I (ARCHITECT OR ENGINEER: TEL. NO: 1 IABANDON PRIVATE DISPOSALI I LIC. NO: 1 1UNDERGRND STRUCT REMOVALI I I I AND SOIL RECOMPACTION I 1 I I I I- 1 I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 I <' 1147H265 Oil I T INC. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 24 I SCHOOL WITHIN HAZARDOUS 1 1 I 1 (AIR QUALITY: 1000 FEET MATERIALS 1 I I I NO NO NO L I I I (REPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I 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 0506290045 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 5628 CLOVERLY AV STRUCTURE: 3600 VN TEMP CA 917802550 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8588-006-007 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 06/29/05 VG 06/24/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: WU ANDY C;VUONG KELLY - 7,000S 5628 CLOVERLY AV TEMP 917802550 FEES PAID DESCRIPTION OF WORK T/O EXIST ROOF AND INSTALL ELK COMP SHINGLES ON SLOPED AREA FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: AND MODIFIED BITUMEN ON FLAT AREAS APPLICANT: TEL. NO: - GARVEY ROOFING (626) 358-9208- PA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 7000.00 VAL 0.70 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 7000.00 VAL 166.20 TOTAL FEES 194.65 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE GARVEY ROOFING (626) 358-9208- 174 W. FOOTHILL BL. LIC. NO LOCATION AND SETBACKS MONROVIA, CA 91016 692839-C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION XX 3 01 FLOOR. SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 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 SPRINKLER HANGERS 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 ID: DPR261 ROUTE TO: BS0508 WOWKERVCOI`APENSATION DECLARATION insure, or�,ifcertif cane ofirm thataWorkr�rt i_mpensa ioi"fate of n Insurancnt to e` APPLICATION FOR BUILDING PERMIT *' or a certified.copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ;❑ Certified copy is hereby furnished. FOR,APPLICANT TO FILL IN BUILDING v ADDRESS (� Certified copy is filed with the county building inspec- BUILDING L�L tion department. ADDRESS ' 2-12 i bate Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROMWORKERS' 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 OWNER NO. USE ZONE [NO. -2- 1 certify that in the performance of the work for which this �'permit is issued, Lsholl not employ any person in any manner ADDRESS �(, –� IALso as to become subject to the Workers'Compensation Laws. DITIONS O Date Applicant CITY cG_ C� ZIP NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE ESSEDBY O Exemption, you should become subject to the Workers' ENGINEER NO. Q CONST. ZONE , {— Compensation provisions of the Labor Code, you must forth- ADDRESS �6• with comply with such provisions or this permit shall be deemed revoked. CONTRACTOR �j C�S�~ 07/ 6 STATISTICAL CLASSIFICATION APT. CONDO. fA Z LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ® ®CiL-.�J•zrr NO. J6 90 1 (commencing with Section 7000)of Division 3 of the Business and LIC ,yam— SEWER MAP Professions Code, and my license is in full force and effect. CITY L/9" CLASS 6 BK PGVALIDATION •� SQ. FT. NO. OF NO. OF CHECK License NumbTr -7w�2Let� Lic.Class� SIZE STORIES FAMILIES ONE VALUAT N Contractor,A e ��lK.�iwO Date �L� / DESCRIPTION OF WORK ` NEW ❑ ❑ $I am exempt under Sec. / /L ycL C rGtJ b� �j� ADD , G ALTER B.BP.C. for this reasR ❑ $ r` ote: USE OF y EXISTING BLDG. Signature APPLICANT' TEL. FINAL OW ER-B ILDER DECLARATION PRINT N0.7� � ��IF DATE I hereby affirm that I am exempt fro m,the•Contractor's License ADDRESS ����stll ` Law for the following reason (Section 7031.5, Business and FINA Professions Code): BY ❑ BUILDING I, as owner of the property, or my employees with ADDRESS 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. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. 7 3 U ,O A with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). # • • • • •.1 REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE, WIDTH I •;1 4 3 6 3 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. • •'1 G 7J.6.3 c�i (Sec. 3097, Civ. C.). SIDE P.L. 0,6,26`.87 Lender's Name ' ?? LDMA Ref. # m Lender's Address P.C. Fee$ Permit Fee 3lop' o I certify that I have read'this application and state that the Issuance Fee �� �� kLDA P/C# o above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and S to laws relating to building construction, Total Fee •�a� LDMA Perm. # and hereby t rize representatives of this County to enter upon the c m tioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signatu of Applicant or Agent VV Date - . APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AUD SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN QUILDIN q.DR I hereby affirm that I have a certificate of consent to self insure, BUIL AQQ S or a certificate of Workers' Compensation Insurance,or a certifiedd]� copy thereof (Sec.3800,Lab.C.) J A� IP �rL LO Policy NO. Company SI OF.LOT NO.OF BLDGS.NOW ON LOT 11 Certified copy is hereby furnished. NEZST.QROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. (r tflzte department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWN C TEL NO. r COMPENSATION INSURANCE ITHIN 1000 FT.OF SCHOOL? ves No (This section need not be completed if the permit is for one hundred ADDRE dollars($100)or less.) DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY CITY ZIP I certify that in the performance of the work for which this permi p �J is issued, I shall not employ any person in any manner t �a dt 5 , become sub'e t e Workers' om ensati t a1Ms. ARCHITECT OR ENGINEER TEL NO. f j�'�� / STATISTICAL CLASSIFICATION APT CONDO Date '�J OnAppplicant %ioj & RESS CLASS NO-0---7 DWELL UNITS NOTICE TO APPLICANT If, after making this Ce REQUIRED' TOTAL SETBACK FROM EXIST Exemption, you should become subject to the WO ers' 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 LICENSED CONTRACTORS DECLARATION PILE CITY LIC.CLASS PL 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 CL Professions Code,and my license is in full force and effect. NEW ❑ BK PG ® OC.�, License Number Lic.Class DESCRIPTION OF ORK ADD ❑ VALUATI N Cr- C) Contractor Date ALTER ® C-) W ❑ I am exempt under Sec. REPAIR 1:1 $ z BAP.C.for this reason DEMOL ❑ LDMA P/C# Date: U 4 Ve DFT71ING 131-9G. " L . 6URM El Signature P ANT�(PRIN > f NO. LDMA Perm# ' ❑ 1,-as owner of the property, or my employees with wages as Z 7 �- their sole compensation, will do the work and the structure is A DRESS � not intended or offered for sale (Section 7044, Business and FINAL D�E G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J El 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > i licensed contractors to construct the project (Section 7044, YES❑ NO❑ -- Business and Professions Code.) ;; I i[�sL 9 a -•-5-� WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING � OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH • CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR t_• _•-_.( _ _n GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ No❑ t-ids EiI'3= _U m the performance Of the Work for which this permit is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS - Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. Of I Ii 1—I 191 1 4! i Lender's Address - T_ 0 OWNER OR AGENT .• i.F 1 Hi F N F„ o I certify that I have read this application and state underpenalty 0 of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE Ga• 0 N with all county ordinances and State laws relating to building m construction, and hereby authorize representatives of this County I�SUANCE FEE / t enter up9nn the above-mentioned property for inspe tionon pu �,/7 1 INVESTIGATION FEE TOTAL FEE r OI ARpli It Date � o' SEE REVERSE FOR EXPLANATORY LANGUAGE