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HomeMy Public PortalAbout5725 CLOVERLY AVE_Building__ " 155Deb . 9- i APLiCATiON FOR BUILDING P" ,RMIT ],z e ' DIVISION OF BUILDING AND SAFETY B U I LD 1 NG Deportment of County Engineer ADDRESS County of Los Angeles LOCALITY Ce JOHN A' LAMBIE. COUNTY ENGINEER NEAREST CASSATT D GRIFFIN, SUP T OF BUILDING CROSS ST- FOR APPLICANT TO FILL IN DISTRICT NO G1� TYPE SEWER,r MA PG v� ..Y CONST BUILDING _j o V / NUMBER ' O D STAT YES O ADDRESSHWY LOT NO r�4 LOCK USE ONE SPE IAL - 6 _ CONDITIONS TRACT SIZE OF LOT O /flya I h10 OF BLDGS OT BUILDING EXIST NOW ON L YARD HWY STREET NAME USE OF 9 p ' �/ �( SETBACK WIDTH EXISTING BLDG vv l -',v & 6/T 0 FRONT I �Lol/� /6 /tl QQ P L Y YY� OWNER C Q N G SIDE - P L MAIL ADDRESS / O TRACT DWELL I UNIT TEL 5 INDUSTRIAL CITY NO 1 DWELL I UNIT 6 PUBLIC BLDG ARCHITECT ORTEL 2 DUPLEX 2 UNITS ,7 ADDN,ALT, ETC ENGINEER NO 3 APT UNIT 8 ADDNMISC ` ADDRESS t 4l COMMERCIAL CONTRACTs/ jf4 CONTRACTORAA A �ZJ`/M&A0/N, /�,�a?s' INSPECTION RECORD _ ADDRESS/�V zG/�y 2w �y.Q6 DESCRIPTION OfF WORD A NEW ' AD ALTER REPAIR I DEMOLISH I SO FT NO OF NO OF SIZE STORIES FAMILIES USE OF STTtUCTU6E U hJ1 "ZZ% -A C. +� P ar SIGNATURE OF APPLICANT APPROVALS ADDRESS _ DATE ' INSPEC OR S SIGNATURE © � B'� P C $ - FFORMSTION MATERIALSION -21411:5e, FEE FRAME FIRE STOPS / L ' / f// / VALUATIO $ �' BRACING BOLTS �/�]q ' � /)J.1.- -•^�"'� FEE FURNACE LOCATION E / I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS GAS VENT'DUCTS APPLICATION AND STATE THAT THE ABOVE IS COR C AND AGREE TO COMPLY WITH ALL COUNTY OR INA y(j TH. INT q AND STATE STATE LAWS RE ULATING BUILDING- N T !J TION LATH EXT Fl SIGNATURE OF HOUSE NUMBER COR- �+ r PERMITTEE RECT AND POSTED ADDRESS FINAL I JOHN A LAMBIE. COUNTY ENGINEER AgAWATION CLYDE N /DIRLAM, CHIEF BLDG INSPECTOR OK MO CASH ` �t� X 5 8 6 2 I'lAY, '9 1 1 2.0 0 �' ' CO UNTY OFOF LLOS ABTGELES�£�T� ) �� APPLICATION FOR PERMIT ' WM. J. FOX. CHIEF ENGINEER - 5S UILDING FOR APPLICANT TO FILL IN ' FOR OFFICE USE ONLY BUILDINM / _»+A DISTRICT N6 PLAN CKK/NO PERMIT NO ADDRESS ,.CQ/ .1.� I I_ ,� LOCALITY /��J� � ��J���t� j RECEIVED BY DATE �.00FFAPPPL � DATE ISSUED CRARBB T /Ys9JV.a�'//" / II Gi / i V 27 i BUILDING �^ OWNER X.f,��i� ADDRESS d MAIL / /J ADDRESS ��,„(p / J LOCALITY i -'e— ✓ NEAREST �1 CITY ! Gyj Na i CROBB 9T P /!/�- ®/4?I L. FIRE NO OF TYPE OROU� .ARCHITECT RTOR ., NOL(.�r(� /.�� ZONE PLANS �LlP'� r I BLDG ORD NO ADDRESS /OC/U �1�-P/Yh � SETBACK LINE � � APPROVED TEL BY DATE CONTRACTOR NO - USE APPROVED ADDRESS 11 ZZONNEE BY DATE DESCRIPTION LOT Nb / vT BLOCK ifTV LEGAL CORRECTIONS / 1 ' TRACT .t-1'l , NO 13F SIZE OF LOT -. C y(� I NOW ON LOTS y - 7/ --� ' UBE OF / NO OF NO OF EXISTING BL FAMILI6e ROOMS DESCRIPTION OFA WORK NEW / ALTERATION ADDITION0 REPAIR MOVING DEMOLISH _ �/YBG � / I� ��� ' Lm p_ .... FT / NO OF / ,g Z SIZE ROOMS qS STORIES / SU/'"//P.FM .� ��(/yv�_ ��w� r WALL „-7�-- I ROOF I t COVERING f•LC.L6 'C COVERING f N UBE NEW BUILDIDI NG , , I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND BTATE THAT THE ABOVE IB CORRECT ' FOUNDATION, LOCATION ,,?INS!,-ROTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS.MATERIALS i AND STATE LAWS REGULATING BUILDING CONSTRUCTION FRAME , a SIGNATUREOBRACINGBOLTS PERMITTEE A � LATH. INT. AUTHORIZED AGT LATH, EXT. I 76A636A-3 a SU $ 5-7/4//► P C B 70' Q PLASTER,INT. �$. 7 df�-Q FEE / PLASTER.EXT. VALUATION-7-i FINAL V APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES ' . BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION 1; `` '��FOR APPLICANT TO FILL IN _" y- , BUILDING ADDRESS BUILDI G DR SS I hereby affirm that I have a certificate of consent to self insure y or a certificate of Workers Compensation Insurance or a certified copy thereo� � b C) �+�, �''` CITY � ZIP �/ Policy NO C04.TYA 1�+1`, LOCALRY L fff SIZE OF L NO�OF BLDGS N W ON LOT .Certified copy Is hereby furnished NEAREST CROSS ST ` ❑,Certified copy Is flied with the county budding m ectl n TRACT BLOCK LOT NO epartment �2 i USE ZONE MAP NO D /�� ,7 licant ASSESSOR APB OK PAGE PARCEL - �� r--T— APp O SPECIAL CONDITIONS CERTIFICATE OF EX MPTION FRO KERS' OWNER T NO COMPENSATION INSUR CE r 7�v WITHIN 1000 FT OF SCHOOLS YES NO (This section need not be completed If the permit is for one hundred ADDRE - ) DISTRICT GROUP TYPE CONST FIRE ZONE PROCESSED BY dollars ($100)or less CITY ZIP - f I certify that In the performance of the work for w this permit /1O Is Issued i shall not employ any person In a anner so as oto ARCHITEC ORE INE T L� Ov —0 become subject to the Workers Compens n Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRES J�1 CLASS IN � DWELL UNITS NOTICE TO APPLICANT If fter making this Certificate Of 0 O Y REQUIRED TOTAL SETBACK FROM EXIST Exemption you should .come Subject to the Workers CONTRACTOR TEL NO SET BACK YARD HWY,, PROP LINE - WIDTH Compensation provisl of the Labor Code you must forthwith, 4WAIdIVO FRONT ` comply with such provisions or this permit shall be deemed revoked AD LIC NO P L LICENSED CONTRACTORS DECLARATION SIDE CITY J` LIC C C- / f P L I hereby affirm that I am licensed underprowsions of Chapter 9 (� G.� b1 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and S E NO OF S RI NO OF FAMILIES } Professions Code nd my Ice se i In full force and Offe 7 NEW ❑ BK, PG , d License Number LIC Class +� �G D S RIPTION OF WORKADD ❑ VALUATION " Q (,�DiJ�•r U Contractor��J..( Date , . �1 _9� � ALTER $ '2 � � ElI am exempt under Sec REPAIR ❑ $ e&PC for this reason DEMOL ❑ LDMA P/C# W Date USE OF EXISTING BLDG URM ❑ `_ � Signature APPLICANT(PRINT S O ' LDMA Perm# �{r r' y a S Z J _ I Z f'I.- T ❑ I as owner of the pro erty my employees with wages as _ their sole compensate do the work and the structure is ADDRESS O .i1ilf �1lI,�(I not,Intended or offered for sale (Section 7044 Business and FINAL DATE Q Professions Code) 1�-� Q` WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL J. OR A MIXTURE CONTAINING-A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE 'AUT.'� � ❑ I as owner of the property am exclusively contracting with � - J Q yyjf// a AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDES FINAL BY / y , C1i�l a T licensed contractors to construct the project (Section 7044 , ❑ Business and Professions Code) VES 1:1 NO 3307 10 -0 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING , OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTHp CI.� CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR �1"�6 12 ,` y �'y ITEM f1 GUIDEUNES �;_t I hereby affirm that there Is a construction lending agency for d'`�° i TC IfALL „, 0 YES❑ NO❑ N the performance of the work for which this permit Is issued(Sec , - "HEC , rn I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING t 3097 CIV C) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE - {l N TITLE 2 CHAPTER 2 20 SECTIONS 2 20 700 THROUGH 2 20 140 CONCERNING HAZARDOUS - „� 'Lenders Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD CHANGE .1311 C) Lenders Address 0 p4NER DA AGENT o I certify that'I have read this application and state under penalty tti�nn ''Y f' 0 of perjury that the above information is correct I agree to comply PC FEE PERMIT FEE 0099-0001 4i 5/9 bN with all county ordinances and State laws relating to budding a 5 AM construction and hereby authorize re resentativea of this County ISSUANCE FEE i,`r� 7iJ�Fi 1 - t1j1 '��.0 ro to enter Upon the abcv rop y fOrin r inspection purposes INVESTIGATION FEE TOTAL FEE Alp h Q - - m !/ s���,a of Ap Aaam om SEE REVERSE FOR EXPLANATORY LANGUAGE