HomeMy Public PortalAbout5734 CLOVERLY AVE_Building__ L
76A898A CE#809, 1056 APPLICATION FOR BUILDING - PERMIT �.
BUILDING AND SAFETY DIVISION BUILDING
Department of County Engineer - ADDRESS `
County of'Los Angeles LOCALITY
JOHN A LAMBIE COUNTY ENGINEER NEAREST
CASSATT D GRIFFIN SUP 7 OF BUILDING CROSS ST
DISTRICT NO- GROUP TYPE t�SEWER MAP
FOR APPLICANT TO FILL IN CONST I BK
ADDRESS 57 Cl V STATISTICAL CLASSIFICATION
/ CLASS NO--(L—DWELL UNITS ~I
LOT N ,T .. -BLOCK - MAP �y � STATE
NUMBER CCP HWY YES
TRACT (�/ - USE ZONE SPECIAL
_ NO OF BLDGS �-� CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
EXISTING BLDG BUILDING EXIST
SETBACK YARD HWY STREET NAME WIDTH
OWNER S. R., Lanier FRONT
ADDRESS 5734 Cloverly St. SIDE _
CITY Temple City TEL P LNO
-
ARCHITECT OR TEL 1 INSPECTION RECORD
ENGINEER NO ,
ADDRESS Sr
CONTRACTOR Vr� in Roof Com; AT705 7 ,
ADDRESS 600 S.San Gabriel B1. S G
DESCRIPTION OF WORK
NEW _ ADD ALTER REPAIR DEMOLISH
SQ FTO OF NO OF
SIZE STORIES FAMILIES
USE OF STRUCTURE
Re-roof House; Garaize
& Flat Deck
APPROVALS
SIGNATURE OF -
APPLICANT DATE INSPECTOR S SIGNATURE
ADDRESS 600 S. San. Gabriel B1. S.G. FOUNDATION LOCATION `
FORMS MATERIALS
11 500.00 P C S FRAME FIRE STOPS
FEE BRACING BOLTS
+ 3 FURNACE LOCATION `
VALUATIONGAS VENT DUCTS
FEE 5
1 HEREBY ACKNOWLEDGE TH 1 HAVE READ THIS AP- LATH INT '
PLICATION AND STAT T T T ABOVE IS CORRECT ANp -
AGREE TO COMPLY TH'A OUNTY ORDINANCES AND LATH EXT '
STATE LAWS RE UILDING/CONSTRUCTION
SIGNATURE OF HOUSE NUMBER COR-
PERMITTE RECT AND POSTED r
P ADDRESS FINAL !_�"
JOHN'P. LAMBIE. COUNTY ENGINEER CLYDE N DIRLAM PRINCIPAL ST CT RAL ENGINEER
PLAN CHECK VALIDATION CK m o CASH PERMIT VALIDATION cK M o cwsH
"
/(E)S 76A638A
CE#803 IREV 6/78) g
A'?PLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES r BUILDING AND SAFETY
FOR APPA
LICANT TO FILL IN BUILDING _
DDRESS
BUILDING
ADDRESS `73 v2 r Ei LOCALITY
NEAREST
CITY l ZIP ? CROSS ST
N OF BLDGS ASSESSOR
SIZE OF LOT j NOW ON LOT, �Q MAP BOOK PAGE PARCEL
TRACT OWNER 6k5- / BLOCK I LO'I'l Gam}`
TEL DISTRICT GR) TYPE M F CES E BY
_..� CONT E
S /( STATISTICAL CLASSIFICATION Ej2 MAP
ADDRESS 1 l O O V CLASSNO _L DWELL UNITS BK' P�
CITY' ( ZIP
ARCHITECT OR I TEL VALUATION $
ENGINEER NO
ADDRESS BLDG SETBACK FROM
TEL FRONT PROP LINE OF (STREET)
CONTRACTOR NO HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING
LIC FRONT PROP LINE HIGHWAY WIDTH
ADDRESS' NO
LIC + ti
CITY' CLASS _
BLDG SETBACK FROM
CONSTRUCTION LENDER
NAME AND BRANCH _ SIDE PROP LINE OF (STREET)
HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING '
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH G
SO FT NO OF NO OF CHECK + = V
SIZE STORIES FAMILIES ONE w
DESCRIPTION OF WORK tj elell NEW ❑ P C Fee$ Permit Fee O
r0 Q VLl ADD ;
ElIssuance Fee g
_ < ALTER _ _
R �IR ❑ Total Fee
USE OF EMOL
EXISTING BLDG �� ❑ Z
APPLICANT—S, TE C r
(PRINT)
BY ISIGNATU CE / Q ~
IHEREBY CKN WLEDGE THAT I HA I APPLICATION AN ATE Y _�
THAT THE AB VE I CORRECT AND AGREE C MPLY WITH ALL O ANCES
AND LAWS RE UL ING BUILDING CONSTR I I CERTIFY THAT I NG THE S `
WORK AUTHOR E HEREBY I WILL NOT-EM Y ANY P I TION OF U z 2 6 1 1 A
THE LABOR COD HE ST OF CALIFORNI IN RELA G K EN S COM Z L' _
00000
PENSATION IN AN E �-
# `
LN-�
SIGNATURE 2 0 - 97,00
PERMITTEE
ADDRESS Z o 0 0 9 7, Q Q c�
TEL
s�,�y^ O !1
CITY NO;�ab QG 0206_79
USE ZONE MAP " Q
NO C/ V
/ SPECIAL r
C TIONS
FINAL r / I�t/ BY e..� Sall
v
1