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Home My Public Portal About6038 CLOVERLY AVE_Building__ APPLICATION FOR BUILDING PERMIT FO -,;�PP[ICANT TO FILL IN (Print or type only( COUNTY OF LOS ANGELES BUILDING ADDRESS Q (� DEPARTMENT OF COUNTY ENGINEER CITY ZIP p BUILDING AND SAFETY DIVISION NO OF BLDGS BUILDING l SIZE OF LOT �j� X NOW ON LOT o� ADDRESS /� TRACT / BLOCK LQ/6b3,-,; LOCALITY y ' TEL- NEAREST OWNER CLni` NO y 66 1 CROSSST ASSESSOR ADDRESS MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE ESSED BY CITY �IY1 ZIP D �� CONST �. ZON ARCHITECT OR TEL ENGINEER NO STATISTICAL CLASSIFICATION f SEW MAP 1 ADDRESS TEL CLASS NO 2� DWELL UNITS `_ BK/S.:tiG CONTRACTOR NO ZONE MAI LIC �C ADDRESSNO SPECIAL , LIC * CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF ISTREETI ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ FT NO OF NO OF CHECK HIGHWAY + YARD = FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } DESCRIPTION OF WORK NEW ❑ + p ADD � BLDG SETBACK FROM � SIDE PROP LINE OF (STREET) O r ALTER El TOTAL SETBACK FROM TYPE OF I EXISTING w N0 , REPAIR HIGHWAY + YARD = • SIDE PROP LINE HIGHWAY WIDTH N ❑ USE OF __ _ EXISTING BLDG DEMOL ❑ + Z APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (FIR NT) NO IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) r IN COASTAL PERMIT ZONE YES ❑ NO Q ❑ VALUATION Q dU 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICAJINGHE ATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH CES AND LAWS REGULATING BUILDING CONSTRUCTION CERTIFY THTHE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO OM PENSATION INSURANCE SIGNATURE OF ✓ PERMITTEE ADDRESS FINAL 'BY CITY C NO TEL DATEMAKE CHECKS PAYABLE TOFEE $ FEETHARVEYT BRANDY,COUNTY ENGI PLAN CHECK VALIDATION CK M o CASH PERMIT VALIDATION CK M o <CASH 4 2 7 EMAP 1 1 U - 3.00 ASS OS 76A638A CE#803 3 75 F"-OBS-3 SSM BETE 8-46 t �j DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR,PERMIT COUNTY OF LOS ANGELES � A® - WM. J FOX, CHIEF ENG `>�INEER .9 L DI Nr �I FOR APPLICANT TO FILL IN , FOR OFFICE'USE ONLY - DISTRICT NO PLAN CK NO f PERMIT NO. BUILDING n (/$ f/ �• w { ' / ADDRESS �/ L/ / !/ LOCALITY t RE EI�/EL'i� D ®Y DATE OF APP ' I DATE ISSUED, -NEAREST CROSS ST BUILDING OWNER 1 r 1 �A 4��,p rDy�A,• ADDRESS %�%C MAIL //�� ADDRESS LOCALITY r'j / `��y,� / rye{ NEAREST C I TY i/,r(/1'l�t CiL./r�./ -NO Gj tel^�/ G� // FIRECRO8T f+' FIRE NO OF TYPE / ' GROUP_ _ ARCHITECT TEL tlZONE I PLANS` ENGINEER NO BLDG , .�`�/', '/.� ORD. NO ADDRESS- - SETBACK LINE APPROVED T_EL r CONTRACTOR NO " r BY - >> DATE LUBE APPROVED ADDRESSj ~ „ ZONE BY .y DATE " LEGAL q0,5 I c r CORRECTIONS DESCRIPTION' I LOT NOrl ,3BLOCK- ' TRACT 1 (.� NO OF SLOGS K SIZE OF LOT ch b I NOW ON LOTUSE OF EXISTING BLDG k (i S (r/q,�I NO OF I I NO OF FAMILI[H / ROOMS J DESCRIPTION OF WORK r NEW ALTERATION ADDITION , REPAIR MOVING DEMOLISH f A t ' '' p 1- , Lz Fm`dt O S NO orBZEA ' $„(�/ ROOMS / STORIES `I -�_ r- WALL ROOv COVERING S1�(;//1/f IF COVERING 0.0jLA�M , USE OF NEW, BUILDING ' APPROVALS"' - I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS 'APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION LOCATION, BPE R DATE�II AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS I 11 AND STATE LAWS REGULATING 13UILDIN13 CONSTRUCTION FRAME FIRE STOPS, SIGNATURE OF , BRACING, BOLTS _ ��// ` ��//jj LATH, INT I 1" • OWNER � i!/[/rvF �. f�`.(.N'�I�,S1�L�� `AUTHORIZED AOT- _ _ LATH, EXT• Li $ P C PLASTER, INT Y � FEE' /� � PLASTER,-EXT VALUATION ,m,,,L_ FEE tJ FINAL r— WORKERS—COMPENSATION-DECLARATION 4 r APPLICATION FORBUILDING PERMIT I hereby affirm that I ho�a fa cPrtificate,of consent to self ' insure or a certifia`ote of Workers' Compensation Insurance c ci ertified copy thereof (Sec 3800; Lab C ) r COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company ❑, Certified copy is hereby furnished FOR APPLICANT TO FILL IN BUILDING �( ADDRESS El Certified copy is filed with the'county building mspec BUILDING r O /� T '- 1 " tion department ADDRESS . O l� V V l Q Date Applicant CITY l(6 4J44 �'ZIP l J(—7 l� LOCALITY OUM CERTIFICATE OF EXEMPTION FROM WORKERS' C/ O OF BLDGS- � NEAREST — COMPENSATION INSURANCE SIZE OF LOT 'J NOW ON LOT CROSS ST (This section need not be completed if the permit is for one , ASSESSOR hundred dollars ($100)or less ) ti TRACT BLOCK LOT NTEL `O'11(� MAP BOOK ' PAGE PARCEL I OWNER GLY�dee *� NO "1 USE NE MAP 1 certify that in the performance of the work for which thisNO _ permit is issued, I shall not employ any person in any manner /� '` SPECIAL so as to become subject to the W rs'Compensation La s ADDRESS C D 2'( (QO2 CONDITIONS O CITY CJ ZIP Date a� Applicant LL' ARCHITECT OR TEL NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO DISTRICT G UP TYPE FIRE PROCESSED BY Exemption you should,become subject to .the Worker's, CONST ZONE V Compensation provisions of the Labor Code you must forth- I / with comply` with such provisions or this permit shall be ADDRESS deemed revoked ' ^ CONTRACTOR NO STATISTICAL CLASSIFI ATION APT LICENSED CONTRACTORS DECLARATIONLIC CLASS NO DWELL UNITS Z I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO (commencing with Section 7000)of Division 3 of the Business and LIC SEWER MAP Professions Code and my license is in full force and effect CITY �'� CLASS BK VALIDATION ' SQ FT((�� PG ( !l NO OF NO OF CHECK License Number Lic Class SIZE f�7 STORIES FAMILIES ONE NEW ClVALUATION d Q DESCRIPTION OF WORK N Contractor Date ADD $ ❑ I am exempt under Sec ALTER ' 9 2 6 a B&P C for this reason REPAIR ❑ $ _ Date qJ EXISTING BLDG �r� DEMOL E] # 0 0 0 •1• Signature APPLICANT TEL g OWNER-BUILDER DECLARATION PRINT �� NO 14 —7 FINAL �✓ ) ° ° 9 b 7 5 I hereby affirm that I am exempt from the Contractor's License DATE = Law for the following reason (Section 7031 5, Business and ADDRESS c v� FINAL` l �I o e ° 9 6 7 5 Professions Code) ` ' By �/ 5 � BUILDING ; I as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and i�� `u the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code) MOVING TEL ❑ CONTRACTOR NO `£ \ Q Z ,Z 5 �8 8 I, as owner of the property, am exclusively contracting ' }`i � �V U with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code) CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBA I a SET BACK PROP LINE WIDTH �t 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 T ' (Sec 3097, Civ C ) SIDE 4 Lender s Name ° LDMA Ref # ` -0 Lender's Address P C Fee$ Permit Fee I certify that I have read this application and state that the _ Issuance Fee - t P/C# above information is correct I agree to comply with all County Investigation Fee S ordinances and State jaws relating to building construction, Total Fee r LDMA Perm # �0 and hereby authorize representatives of this County to enter uR!n4he above-mentioned pro arty for inspection purposes t SEE REVERSE FOR EXPLANATORY LANGUAGE t - Signature of Applicant or Agent Date �WORKERS' COMPENSATION DECLARATION hereby o certificate that I havecertificate of consent to bel ` APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance,, or a certified copy thereof (Sec 3800, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company I BUILDING Certified copy is hereby furnished FOR APPLICANT TO FILL IN ADDRESS �.. Certified copy is filed with the county building inspec- BUILDING Q (�v tion department ADDRESS O C� QAJe LOCALITY NEAREST p Date Applicant CITY 1 C� //�� 1pr NOW ZIP ` CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS' I O JMO F BLDGS ASSESSOR SIZE OF LOT (J COMPENSATION INSURANCE MAP BOOK PAGE PARCEL t (This section need not be completed if the permit is for oneUSE ZONE MAP hundred dollars ($100)or less ) TRACT BLOCK LOT NO ' NO T �)/��j�77 / SPECIAL I certify that in the performance of the work for which this OWNER ee. � C i$ '�7"`IC) CONDITIONS` d permit is issued, I shall not employ any person in any manner (� DISTRICT GROUP TYPE FIRE - PR SSED BY O so as to become subject to the Workers'Compensation Laws ADDRESS (0O3O C DYev- CONST ZONE U Date Applicant CITY e 'µ IP 9 /" � STATIST 1.2 L CLASSIFICATI CONDO O NOTICE TO APPLICANT If, after making this Certificate of ARJ1qGINEER O Joff NO CLASS NO DWELL UNITS TEL LU Exemption, you should become subject to the Workers ` 1 CL Compensation provisions of the Labor Code, you must forth- / ADDRESS v SEWER MAP W with comply with such provisions or this permit shall be 1., Z deemed revoked CONTRACTOR UJ�� NO BK PG VALIDATION LICENSED CONTRACTORS DECLARATION LIC I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO _ LUATION (commencing with Section 7000)of Division 3 of the Business and LIC Professions Code, and my license is in full force and effect CITY CLASS SQFT NO OF NO OF CHECK 5 2 8 6 3 A License Number Lic Class SIZE STORIES FAMILIES ' ONE �� O b $ ' # 0 0 0 0 Contractor Date DESCRIPTION OF WORK � NEW ❑ 23 I am exempt under Sec ADD ❑ 0 4 4 Q d 8 ALTER FINAL B 8P C for this reason ❑ DATE �° ° 4 4 9,4 8 c= REPAIR Date USEQQ EXIStING BLDG i e DEMOL ❑ B N 14�] 8� Z 3 Signature APPLICANT �� c Y # 0-1 -7 `�(-� OWNER-BUILDER DECLARATION PRINT J NO 0 0 0 ` 1 hereby affirm that I am exempt from the Contractor's License ADDRESS 3 C� 2'-,° 5'7 317 Law for the following reason (Section 7031 5, Business and v Professions Code) P E o - 5711371: BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and 0 8 2 4—$3 the structure is not intended or offered for sale(Section [ADDR LITY 7044, Business and Professions Code) NG TEL 1, as owner of the property, am exclusively contracting CONTRACTOR NO with licensed contractors to construct the project (Sec- 4 7 6 9 A tion 7044, Business and Professions Code) ESS UIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SETBACK YARD HWY PROP LIN WIDTH # o'o o'e o I hereby affirm that there is a construction lending agency for NT the performance of the work for which this permit is issued 2 - 60675 (Sec 3097, Civ C ) E FD ° - 606756o Lender's Name rLender's Address ee5 Permit Fee '�`J � 24 -83 I certify that I have read this application and state that the 3,�� Issuance Feeabove information is correct I agree to comply with all County igation Fee i ordinances and State laws relating to building construction, Total Fee Y/ and hereby authorize representatives of this County to enter Upon the above-mentioned property for inspection purposes i a SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Applicant or Agent Date ®s _a 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 1002040040 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ITR 6561 LT 305 UN 002 SQ FT STORIES TYPE 6038 CLOVERLY AV STRUCTURE 1900 V-B I 1 TEMP CA 917802025 (ASSESSOR INFORMATION NUMBER I I NEAREST CROSS STREET 1 15385-007-021 I I THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY Cl ITENANT JEXIST BLDG USE RESID USE ZONE R-1 JISSUED ON PROCESSED BY I 1 1EXIST OCC GRP 102/04/10 SR I I I I I JOWNER TEL NO JBLDGS NOW ON LOT c VALUATION IFINAL DATE FINAL BY « CODE - I IKIDD, CHRIS (626) 359-9306- 1 6,990 I 1 16038 CLOVERLY AV 1 1 ITEMP 917802025 1 FEES PAID IDESCRIPTION OF WORK J J J IREMOVE EXISTING COMP & WOOD SHINGLES INSTALL 7/16" OSB I I IFEE DESCRIPTION QUANTITY UOM AMOUNT (INSTALL 30 YR CLASS (A) COMP SHINGLES I (APPLICANT TEL NO I I I IDOWD ROOFING (626) 857-1010- IAA BLDG PERMIT ISSUANCE 27 75 1 1 1540 S GLENWOOD JAB STATE GREEN BLDG FEE 6990 00 VAL 1 00 ISPECIAL CONDITIONS 1GLENDORA, CA 91741 JAC STRONG MOTION RESID 6990 00 VAL 0 70 I 1 ID2 PERMIT W/O EN-HC 6990 00 VAI, 166 20 I I 1 1 TOTAL FEES 195 65 1 ICONTRACTOR TEL NO I JAPPROVALS DATE INSPECTOR SIGNATURE 1 IDOWD ROOFING CO (626) 857-1070- 1 1 1 1540 S GLENWOOD AVE LIC NO I ILOCATION AND SETBACKS 1 IGLENDORA CA 91741 ( 380611 C39 I I 1 1 I I ISOILS ENGINEER APPROVAL I 1 I I I I I I (ARCHITECT OR ENGINEER TEL NO I IFOUNDATION/TRENCH FORMS I I I LIC NO I „ ISLAB/UNDER FLOOR I I I I I 1 I I I IRAISED FLOOR FRAMING 1 1 1 IMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I _ JUNDERFLOOR INSULATION I I I 1150H265 3 001 1 11 1 I I IFLOOR SHEATHING I I I INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS I I I I NO 21 i iROOF SHEATHING � C�/� J SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS JAIR QUALITY 1000 FEET MATERIALS I I 1 NO NO NO I IFRAME INSPECTION 1 I I I I I I IREQUIRED TOTAL SETBACK FROM EXIST I IFIRE SPRINKLER HANGERS I I I ISET BACK YARD HWY PROP LINE WIDTH I I I I IFRONT PL- I IINSULATION/WEATHER STRIPI I I I SIDE PL- I 1 1-1 1 1 I IINTERIOR LATH/DRYWALL 1 1 1 J I I I I I 1EXTERIOR LATH I 1 J I J IRATED FLOOR/CEIL ASSEM I I I I I I I I I I I (RATED WALL ASSEMBLIES I I I I I I I I IRATED SHAFTS/OPENINGS I 1 I I I I I I J IT-BAR CEILINGS I 1 I I I I I I 1 I ILOT DRAINAGE J 1 I I I J J I 1 IREPORT ID DPR261 ROUTE TO BS0508 1 1 1 1 I I I I 1 WORKERS COMPENSATION DECLARATION H.;eby-affirm that I hove-aw,ce of tate of consent to self APP L I C ATI O N FOR BUILDING PERMIT insure, or a certificate of Workers C.-Pen Insurance, or a certified copy thereof (Sec 3800, Lab C ) _ COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company BUILDING Certified copy is hereby furnished - FOR APPLICANT TO FILL'IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department ADDRESS` f> } 1 'el4,1 ✓ LOCALITY NEAREST Date Applicant CITY ZIP r CROSS ST CERTIFICATE OF EXEMPTION FROM WORKERS NO OF BLDGS ASSESSOR -COMPENSATION INSURANCE I SIZE OF LOT i131) NOW ON LOT, MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one U }O�IE MAP hundred dollars ($100) or less ) TRACT BLOCK LOT NO �// NO TEL 1� SPECIAL I certify that in the performance of the work for which this OWNER NO ( —7 _ CONDI S 0 permit is issued I shall not employ any person in any manner ADDRESS DISTRICT P T FIREE PR E D BY V 'so as to become subject to the Workers Compensation Lows- Dote-.L— aws-Date ° Applicant CITY ZIP-cant IP STATISTICAILel?PASSgICATI07 APT CONDO NOTICE TO APPLICANT If after making this Certificate of ARCHITECT OR TELNO r d Exemption you should become subject to the Workers CLASS NO DWELL UNITS / Compensation provisions of the Labor Code you must forth- ADDRESS SEWER MAP 4A ! with comply with such provisions or this permit shall be TEL deemed revoked CONTRACTORNO BK PG VALIDATION LICENSED CONTRACTORS DECLARATION , r LIC I hereby affirm that I am licensed under provisions of,Chapter 9- ADDRESS NO VALUATION (commencing with Section 7000)of Division 3 of the Business and LIC 4, a Professions Code and my license is in full force and effect CITY CLASS $ SQ FT �' NO OF NO OF CHECK Cicense Number Lic Class SIZE ZQ STORIES FAMILIES ONE -Contractor I — Date DESCRIPTION OF WORK ( NEW ❑ I am exempt from ALTER FINAL the licensing requirements as I am a _ ADD licensed architect or a registered professional engineer ❑ '' , acting in my professional capacity (Section 7051 ❑ DATE (Z�� Business and Professions Code) USE OF REPAIR EXISTING BLDG r DEMOL ❑ FINALBI Lic or Reg No Date APPLICANT TEL = OWNER-BUILDER DECLARATION (PRINT) NO I hereby affirm that I am exempt from the Contractor s License Low for the following reason (Section 7031 5, Business and ADDRESS Professions Code) , PRESENT BUILDING m - / I, as owner of the property, or y employees with ADDRESS wages as their sole compensation will do the work and -24 4 h 8 A the structure is not intended or offered for sale(Section LOCALITY 7044 Business and Professions Code) - MOVING TEL # 0 0 0 0 0 1 I, as owner of the property am exclusively contracting ` CONTRACTOR ' NO with licensed contractors to construct the project (Sec- ADDRESS / 2 0 ° 5 2 0 0 tion 7044, Business and Professions Code) REQUIRED YARD HWY TOTAL SETBACK FROM EXIST o 0 0 5-2, 0 0 CONSTRUCTION LENDING AGENCY SET BACK PROP LINE 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 2 0"' (Sec 3097 Civ C ) SIDE - - PL Lender s Name _ r P C Fee$ Permit Fee Lenders Address I certify that I have read this application and state that the Issuance Fee ' above information is correct I agree to comply with all County_ Investigation Fee ordinances and State laws relating to building construction Total Fee— and hereby authorize representatives of this County to enter upon th above-mentioned property for inspection purposes Lit a � 7r� SEE REVERSE FOR EXPLANATORY LANGUAGE ISK Signature of Applicant or Agent, Date ,