HomeMy Public PortalAbout6053 CLOVERLY AVE_Building__ 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 1205220099
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 6561 LT: 308 UN: .002 SQ. FT STORIES TYPE 6053 CLOVERLY AV
I STRUCTURE: V-B TEMP CA 917802026
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
15385-006-002 I THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY, Cl
TENANT: JEXIST BLDG USE: RESID USE ZONE: R-1 JISSUED ON: PROCESSED BY: I
(EXIST OCC GRP: 105/22/12 SR
OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: FINAL DATE INAI BY: CODE:
1HUANG HSU-HUANG;MEI-CHUEN (626) 378-5510- 1 18,000 I �J
16053 CLOVERLY AV 1 �_✓ /B' CID
(TEMP 917802026 FEES PAID (DESCRIPTION OF WORK ��••ff"
I (COMPLETE WINDOWS CHANGE TO VINYL WINDOWS & REPLACE ALL
I _!FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: IEXTERIOR WOOD SIDING TO STUCCO (21 WINDOWS & 2 FRENCH DOORS)
(APPLICANT: TEL. NO: I
IWU, BRYAN (714) 990-9988- IAA BLDG PERMIT ISSUANCE 27.80 1 1
1545 W LAMBERT RD #E jAB STATE GREEN BLDG FEE 18000.00 VAL 1.00 (SPECIAL CONDITIONS: 1
IBREA, CA 92821 1AC STRONG MOTION RESID 18000.00 VAL 1.80 1 1
ID2 PERMIT W/O EN-HC 18000.00 VAL 351.00 1 � I
TOTAL FEES 381.60 _ -m 9y\'Dy �
i
(CONTRACTOR: TEL. NO: IAPPR VAL- DATE INSPECTOR SIGNATURE 1
IWU, BRYAN (714) 990-9988- 1 1_...
1545 W. LAMBERT RD., #E LIC. NO I ILOCATION AND SETBACKS 1 1
IBREA, CA 92521 899265B I I-
I I
(SOILS ENGINEER APPROVAL I I
1ARCHITECT OR ENGINEER: TEL. NO: (FOUNDATION/TRENCH FORMS I I I
LIC. NO: i ISLAi/UNDER FLOOR I 1
(RAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: j (UNDERFLOOR INSULATION I I I
1150H265 3 00; 1_ 11 1
I _1 (FLOOR SHEATHING 1
INC. Or FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
0 NO 21 (ROOF SHEATHING 1
1 SCHOOL WITHIN HAZARDOUS I (SHEAR PANELS 1 I I
(AIR QUALITY: 1000 FEET MATERIALS I 1 1 I
1 NO NO NO 1 1FRAME INSPECTION
I I I
1 I (FIRE SPRINKLER HANGERS I 1
I I I
1 11NS17LATION/WEATHER STRIPI I
I 11NTERIOR LATH/DRYWALL I I
I I I
I IEXTFRIOR LATH 1 1
I
I IRATED FLOOR/CEIL ASSEM. 1
1 (RATED WALL ASSEMBLIES I I I
1 1 (RAT D SHAFTS/OPENINGS 1 1 I
1 1 IT-BAR CEILINGS
I I I
I 1 ILOT DRAINAGE 1 I I
I I I
1 (REPORT ID: DPR261 ROUTE TO: BS0508
}
WORKERS' COMPENSATION DECLARATION
.,
insure, or a certificate of Worke s' Compensation Insuran e, APPLICATION FOR- UILDING PERMIT
or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
et
Policy No. Company BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO•FILL IN ADDRESS
vin` E
❑ Certified copy-is filed with the county building inspec- BUILDING L A�7�
tion department. ADDRESS t:� r�� T&rye L'E C,(
Date Applicant CITY `ice e ZIP 17 E) LOCALITY
NO. OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE'OF LOT X 1440 NOW ON LOT / CROSS ST.
COMPENSATION INSURANCE' / ASSESSOR Q
(This section need not be completed if the permit is for one TRACT VSb BLOCK LOT NO. 308 MAP BOOK S3 ZJ S PAGE OQ p PARCEL �)
hundred dollars ($100).or.less.) TEL. Q �+
OWNER Nsu Cff NO. 30!' USE ZONE MAP
�7Z /6-P
I certify that in the performance of the work for which this
NO.
SPECIAL
permit is issued, I shall not employ any.person in any manner ADDRESS IJ C,Lo J �- CONDITIONS
so as to become subject to the Workers'Compensation Laws. 1 0
CITY C-,v" CJ-C ZIP 'T 1 7 9
Date ApplicantARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY 0
NOTICE TO APPLICANT: If,' after makingthis Certificate of ENGINEER 1NJ NO.
CONST. ZONE F_
Exemption, you should become subject to the Workers' p w
Compensation provisions of the Labor Code, you must forth- ADDRESS �QO 3 0-
with
with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. to
deemed revoked. CONTRACTOR NO. Z
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. --:%/ DWELL. UNITS
-
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC.
and Professions Code,and my license is in full force and effect. CITY CLASS BK PG VALIDATION
SQ. FT. NO. OF NO. OF / CHECK
License Number Lic. Class SIZI I STORIES FAMILIES / ONE
VALUATION
DESCRIPTION OF WORK D 5 n •� OO•
Contractor Dare NEW $ LG. �
,+ DOo2 LL a ADD ►
❑I am exempt under Sec: ❑
ALTER
B.&P.C. for this reason Pf• LA•N m 6r. ❑ $
REPAIR
Date: USE OF DEMO' ❑
EXISTING BLDG. RL I
Signature APPLICANT TEL. FINAL
OWNER-BUILDER DECLARATION (PRINT). $14- / AN NO. ;05-0-75
DATE �
I hereby affirm that I am exempt from the Contractor's LicenseADDRESS S�n�E �S
Law for the following reason (Section 7031.5, Business and FINAL
Pssions Code): PRESENT j A By
BUILDING (QOS7 Nr �C�(/�iJ2r+ fT��•
i
rI, as owner of the property, or my.employees with ADDRESS
wages as their sole compensation,will do the work and LOCALITY
Tom+ 7 (� (Z `?
the structure is not intended or offered for sale(Section
7044, Business and Professions Code.) MOVING TEL. I #
❑ I, as owner of the property, am exclusively:contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- '•.:'
ADDRESS ri i•.-•:
tion 7044, Business and Professions Code.)
REQUIRED TOTAL SETBACK FROM EXIST. ;•" -
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH t'• ,._.
I hereby affirm that there is a construction lending agency for FRONT T- i
the performance of the work for which this permit.is issued P.L. " Ltd •4 -•-• -
(Sec. 3097, Civ. C.). SIDE. /
z
Lender's Name. r';°G
m L.._..
LDMA Ref. #
Lender's Address P.C. Fee$ =f75- Permit Fee 4 ••f•;�!!-.!t;4,
1 certify that I have read this application and state that the Issuance Fee c� LDMA P/C# ,
above information is correct. I agree to comply with all County Investigation Fee /
8 ordinances and State laws relating to building construction, Total Fee lO ✓ LDMA Perm. # ___._ t„t
a and hereby authorize repr sentatives of this County to enter
a upon th bove-mention property for inspection purposes. f.4::•+:�:•t
o L- 41it/A. �t G 1j_ �j � 1, SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date