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Home My Public Portal About6003 CLOVERLY AVE_Building__ APPLICATION FO R`�`�rn �� COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT BUILDING AND SAFETY DIVISION BUILDING r� FOR APPLICANT TO FILL IN ADDRESS U6 rlt� BUILDING ADDRESS LOCALITY NEAREST CITY ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT v MAP BOOK IPAGIP PARC ./) � ��•7 DISTRICT 1GROUPITYPE FIRE P OC SSED BY TRACT ��3 BLOCK LOT NO. t„J U / CONST. Z f � OWNER S/C/Y NO. L Goi' STATISTICAL CLASSIFICATION j SEWERMA ADDRESS CLASS NO.�DWELL,UNITS Oc BKIAIG CITY• /L ZIP USE ONE NOP 00 AR HI O, r TE ,/ / SPECIAL ;! ENGINEE N (/- X 7�.t7U CONDITIONS {� 7 (t ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES NO❑ CONT N� BLDG.SETBACK FROM AD E - �'6'/y NO . ' 7Q�' FRONT PROP.LINE OFHIGHWAY + YARD. - TOTAL SETBACK FROM TYPETO FE EXISTING - C17Y LIC. FRONT PROP. LINE HIGHWAY WIDTH G CLASS CONSTRUCTION CLENDER^T + �-U - �'J � o NAME AND BRANCH LCIC0/A I S �r 1 LL�� BLDG.SETBACK FROM p ADD R IV �/_ :6--Y SIDE PROP, LINE OF (STREET) U SQ. F NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETBACK ROM TYPE OF EXISTING � SIZ STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH H DESCRIPTION OF WORK NEW ❑ + / v C O N LL �9 ADD CORNER CUTOFF YES ❑ NO Rev 3 '/ ?2 ALTER ❑ IN OPEN SPACE YES ❑ No v` ,� Ea'is PAIR❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO EXISTING BLDG. F�/YIlL� LD1' E OL APPiL�yfC NT �2(r, TE � N L/ OCA BY (S TU E) /1f= IFIE BY KNO ED E THAT I HAVE READ THIS APPLICATION AND AT HAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I L NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR ODE THE STATE OF CALIFORNIA RELATING TO WORK EN'S {OM ENSA TNS ANC E. .SIGNA R FINAL .� O h. �_ BYG2�'c PERMIT 6 DATE ADDR S d_— TE P.C. Fee$ �A �'� f Permit Fee CITY L'�'A�: N QQ Issuance Fee 411- VALUATION�V Total Fee 6 9 ®-B PLAN CHECK VALIDATIO CK. M.O. CASH _ PERMIT VALIDATION CK. ' M.O. CASH 3 8 ? JAN 1:11' 2 3 � 6 93.? 5 3r-FEES 23 U 76A638A CE#8038 12/75 76A888A CE#8098-68 APPLICATION FOR BUILDING PERMIT 1 COUNTY .OF LOS ANGELES BUILDINGA/ ADDRESS p! DEPARTMENT OF COUNTY ENGINEER — -BUILDING AND SAFETY DIVISION LOCALITY Jt 9 JOHN A.LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. DISTRICT NO. GROUPTYPE P ESS D Y FOR AP T TO FILL IN CONST. BUILDING ;' ATISTICAL CL SSIFICATION SEWER MAP ADDRESS BK LOT NO, 'La , LASS. NO.�DWELL. UNITS-1 �� MAP9061 ;,, STATE yES NO / J ti NUMBER 0 D HWY. TRACT �(:2 `(n_ USE ZONE SPECIAL SIZE OF LOT V I"o I NO.OF BLDGS. CONDITIONS NOW ON LOT USE OF EXISTINGB D . 7 Z' BUILDING EXIST. YARD HWY STREET NAME SETBACK WIDTH OWNER /._ _ -ly FRONT t I /L MAIL d P. L. dy ADDRESS 49 SIDE I TEL. P.L. CITY NO. INSPECTION RECORroj ARCHITECT OR TEL. ENGINEER NO. . ADDRESS aaTEL. CONTRACTOIJQA� /i NO '/� ✓� ' ADDRESS � DESCRIPTION OF WORK - NEW ADD ALTER REPAIR DEMOLISH SO.FT.' _ NO.OF rv/5 Pm,T vin p1j)c,, P.IN6 A�r SIZE STORIES FAMILIES /�• - '/ �T USAF, TRUCT P,DA A))AYC�fV A1E AD11TA �,Rfi)),7, - l� NPfi /))h Ali)7 /'ells SI ATURE OF APPROVALS /-7/V7- ,,ANT -7/V7ICANT DATE INSPECTOR'S SIGNATURE ADDRESS FOUNDATION: LOCATION FORMS,MATERIALS $ P.C. $ FRAME: FIRE STOPS, FEE BRACING, BOLTS VALUATION ® $ "� 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 COUNTY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. LATH, EXT. IGNATURE OF d HOUSE NUMBER COR. PERMITRECT AND POSTED ADDRESS FINAL -2-9-sq CLYDE N. DIRL.AM, PRINCIPAL STRUCTURAL EN91IMER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH L 2 6 2- 60%, F£8 2 0 1 A 300 M WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance,� or a certified copy thereof (Sec. 3800, Lab. C.) ❑ 639 _ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No C mpany BUILDING / Certified copy is hereby-furnished. FOR APPLICANT TO FILL IN ADDRESS e!:: � Certified copy is filed with the county building inspec- BUILDING tion de grim nt. ADDRESS f,2Q_7 Date f/ Applicant CITY ZIP LOCALITY CE TIFIC TE OF EXEMPTION FROM WORKERS' N OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT N WON 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 TEL. USE ZONE MAP 1 certify that in the performance of the work for which this OWNER permit is issued, I shall not employ any person in any manner /(ni SPECIALi so as to become subject to the Workers'Compensation Laws. ADDRESS /17 / , CONDITIONS U Date Applicant CITY ZIP NOTICE TO APPLICANT: If, after making'this Certificate of ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PR ESSED BY ENGINEER NO. CONST. ZONE F" Exemption, you should become subject to the Workers' r'6 2 U Compensation provisions of the Labor Code, you must forth- ADDRESS 3 J with comply with such provisions or this permit shall be /� TEL STATISTICAL CLASSIFICATION APT. CoNDO. N deemed revoked. CONTRACTOR Q o40� O. LICENSED CONTRACTORS DECLARATION , C_ CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS � E / O. SEWER MAPI (commencing with Section 7000)of Division 3 of the Business and LIC. ,�/� 7S-0 Professions Code, and my license is in full force and effect. CITY CLASS BK. Z-'PG.ll� VAg." A SO. FT NO. OF NO. OF CHECK License Numbe S�� L'c.Class SIZ O STORIES FAMILIES ONE VALUATION 052 # 7 DESCRIPTION OF WORK NEW ❑ $ 1�/J°� Contractor e ✓ ADD ❑ CS t./ o o 7 a Q Q ❑ I am exempt under Sec. r 6 ALTER ❑ $ , o a o 7 U.0 0� B.BP.C. for this reason T ? REPAIR ❑ 203-870 d 3`8 7 L Date: OF EXISTING BLDG. � M5 I DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE G I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FI Professions Code): PRESENT Y DBUILDING 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. O I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). RQEDCONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPREOTPAINEF WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. # 6P.C. Fee$ Permit Fee o ' Lender's Address 3 o I certify that I have read this application and state that the Issuance Fee � �O LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee t� LDMA Perm. #. R and hereby authorize re esentatives of this County to enter upo t bov entio d pe for inspection pur ase SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agentate a WORKERS�'COMPENSATION DECLARATION insurebor afcertif carte of Wo ke srlComtpensatoe of n Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof-(Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company XCertified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING a� 3 ADDRESS (12 Certified copy is filed with the county building inspec- BUILDING tion department. .ADDRESS C4,42 Date Applicant _�L�ACITY L. G ZIP 7 LOCALITY CERTIFICATE OF EXEMPTION M WORKERS' 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 TRACT BLOCK LOT NOASSESSOR . hundred dollars ($100)or less.) MAP BOOK PGE PARCEL TEL. USE NE MAP I certify that'in the performance of the work for which this OWNER /"1 ,Q NO. NO. permit is issued', I shall not employ any person in any manner i SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESS ds40 G^ LO ICL' iO✓CL ' CONDITIONS U CITY M�L"C ZIP Date ApplicanT ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE P CESSED BY F 'Exemption, you should become subject to the Workers' yy /) CONST. ZONE I"" P Y I ✓ � GLJ Compensation provisions of the Labor Code, you.must forth- ADDRESS r _ �, with comply with such provisions or this permit shall be ��p V��2 Ctl/�77Q ��TC, deemed revoked. V 1Y STATISTICAL CLASSIFICATION APT. CONDO. N C NTRACTO O.i� LICENSED CONTRACTORS DECLARATION LIC• CLASS NO.�DWELL. UNITS I hereby off irm that I am licensed under provisions of Chapter 9 ADDRESS43V/ Al, tt##;VG/N/ 7 /pONO.�1' SEWER MAP (commencing with Section 7000)of Division 3 of the Business and /� LIC. Professions Code, and my license is in full force and effect. CITY /✓Jj�G fl G! CLASS oO VALIDATION SQ. FT. NO. OF NO, OF CHECK BK, PG. License Number Lic.Class._ SIZE STORIES FAMILIES / ONE . 6 1�.iQv�OS/L Ce/vs�TiQr/G�'/e/� NEW VAL�/1TION Va Contractor Date !/• 4/-�7 DESCRIPTION OF WORK ADD L s.//�e 1 am exempt under Sec. , ALTER B.BP.C. for this reason REPAIR $ g828,7 USE OF o i o 0 0 0 Date: EXISTING BLDG. / DEMOL '0o i0o ,g APPLICANT �� TEL. v Signature PRINT ,a,g11C Jr�, NO.Z •7,tGL FINAL. OWNER-BUILDER DECLARATION DATE J 1,04-87 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS 4CC71�e' A6 taG/A//TiG iQr//� G FINAL Professions Code): PRESENI 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. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY IRED TOTALSETBACK WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name LDMA Ref. If Lender's Address P.C. Fee$ Permit Fee V- a /9 a I certify that I have read this application and state that the Issuance Fee V L J LDMA P/C fi above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee v LDMA Perm. ti R and hereby authorize representatives of this County to enter upon the above-mentioned pro rt inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE gnature of Applicant or Agent - to