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Home My Public Portal About6217 CLOVERLY AVE_Building__ —DEPARTMENT OFUB�ILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES WM. J. FOX. CHIEF ENGINEER B U 1 L 1 FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY / ZDISTRICT NO. PLANCK NO PERMIT NO BUILDING ADDRESS 6 � Cloverl Ave. -� . 37069 6o z�- LOCALITY RECEIVED BY ' DATE OF APPL DATE ISSUED oRoHeBT Flaherty St. , Temple City ups a BUILDING / �� OWNER Meeker Land Company ADDRESS (O (/ ADDREBB 11236 E. Live Oak Ave. LOCALITY C- NEAREST CITY Arcadia TEo DO-72151 CROSS ST. FIRE O.OF TYPEGROUP J� ARCHITECT Q�q o• q.Bi s s e11 NO FL-74420 ZONE PLANS ENGINEER Z - 1 IITTEE BLDG ..,.7 " � � ORD NO / ADDRESS SETBACK LINE ICJ i l APPROVED TEL BY DATE CONTRACTOR NO. USE APPROVED ADDREB ZONE BY DATE LEGAL DESCRIPTION LOT`NO. 17 BLOCK �n� CORRECTIONS TRACT 17179 54x108 NO OF BLDGS none �j SIZE OF LOT NOW ON LOT / / USE OF NO OFNO OF 6 EXISTING BLDG none FAMILIES ROOMS DESCRIPTION OF WORK NEW x ALTERATION ADDITION O A_ REPAIR MOVING DEMOLISH Gl SO FT 1113 NO OF 6 1 D SIZE ROOMS STORIES r WALL COVERING Plaster I COVERING ROOF Compo USE OF NEW BUILDING Residence Plan 2-B Garage 18 x 20 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPROVALS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION. LOCATION INSPECTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS, MATERIALS AND STATE LAWS REGULATING BUILDING CONSTRUCTION py. FRAME FIRE STOPS, SIGNATURE OF LAND BRACING,BOLTS �v lll]]] CC77 PERMITTEE lVyD LATH, INT. AUTHORIZED A LATH, EXT. (� o 76A63BA-3 7-49 s T3 Q P C s �, o��t PLASTER, INT. SEE PLASTER,EXT. 941-5- $ � VALUATION ` � O FEEto FINAL APPLICATIONf^EOR BUILDING PERMIT COUNTY OF LO ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT•,TO FILL IN BUILDING ADDRESS," I hereby'affirm that I have a certificate of consent to self Insure,• or a certificate of Workers Compensation Insurance,or a certified �y copy there f Sec 3 'y� "/ , /` ,./ CIT�I�� /� j / `. ZIP LOCALIT Policy No GompaCv SIZ OF LOT G!✓ O OF BLDGS NOW ON LOT ertlfied copy Is hereby furnished INEAREST CROS ST TRACT BLOCK LOT NO O ❑ Certified copy Is filed with t- c my building nspechon , e tme t USE ZONE MAP NO d , DatepllcanASA �": ASSESSOR MAP BOOK PAGE- PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNERJ� T N COMPENSATION INSURANCE v/� f d WITHIN 1000 FT OF SCHOOL'S YES No This section need not be completed If the permit Is for one hundred ADDRE ( P C�v6z L\-1 4 DISTRICT GROUP TYPE CONST FIRE'ZONE PROCESSED BY dollars ($100)or less) �1�� ,� r ZIP C � I certify that In tFie performance of.the work for which this permit �„ s Issued, I shall not employ any persor In any manner so as to !A;CHITECT OR ENGINEER TEL NO become Subject to the Workers Compensation Laws STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO DWELL UNITS NOTICE TO APPLICANT If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CQAJeACTR T N —7 SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the.Labor Code, you must forthwith Jv b✓ FRONT comply with such provisions or this permit shall be deemed revoked ADDR A LI � PL LICENSED CONTRACTORS DECLARATION �" SIDE CITYn,/J� LIC CLASS P L I hereby'affirm that I am licensed underprovisions of Chapter 9 /Y�(/ SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ FT SIZE NO STORIES NO OAMILIES Professionibe od yl Is In full force a e NEW El BK PG d License N Lic Class DES NOF ORK ADD E] VALUATION ' polo. Q ContractoDate 1 ALTER ❑ cc ❑ I am exempt under Sec L REPAIR ❑ $ s 08 BBPC for this reason DEMOL ❑ LDMA P/C# W Date USE OF EXISTING BLDG c URM ' ❑ 1 Signature APPLICANT(PRINT) _ TEL NO r LDMA Perm# AUToT Z ❑ I, as owner of the property, or my employees with wages as ZO3303 175;65 their sole compensation, will do the work and the structure Is ADDRESS not Intended or offered for sale (Section 7044 Business and 'FINAL DATE - G 1 ITEMS Professions Code) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of the property, am eXCIUSIVeI contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE v a TOTAL ` 175- 65 Y Y g AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS,INFORMATION GUIDE? FINAL BY" L licensed contractors to construct the project (Section 7044, YES No 1:1CHECK 175-05 Business and Professions Code) WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING (�EJAME .04 _ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH - 1.Ill'7�Y�7C CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR y GUIDELINES I hereby affirm that there Is a construction lending agency for YES 1:1 NO El �{� a the performance of the work for which this permit Is Issued(Sec I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING """�T�� ,��,�� 3097 CIV C) A CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE i �I+I1 p N TITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20,140 CONCERNING HAZARDOUS, 3407' 1 ,+O°+6 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD o Lender's Address OWNER AGENT O , o I certify that I have read this application and state under penalty PC FEE PERMIT FEE O of perjury that the above Information Is correct I agree to comply ' N with all county ordinances and State laws relating to building ^ter < constru d hereby authorize representatives of this County ISSUANCE FEEOD to to'ent upon e -mentlo ed pr p rt for Insp ctlo po ro it K INVESTIGATION FEE , TOTAL FEE S�pnawre Agant Gaye n SEE REVERSE FOR EXPLANATORY LANGUAGE ` 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 1205210098 PHONE (626) 285-0488 EXT ILEGAL ID NO OF CONST BUILDING ADDRESS ITR 17179 LT 17 SQ FT STORIES TYPE I 6217 CLOVERLY AV I STRUCTURE V-B TEMP CA 917801602 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET WENDON 15385-010-017 J THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY, Cl TENANT 1EXIST BLDG USE RESID USE ZONE R 1 JISSIED ON PROCESSED BY J IEXIST OCC GRP 105/21/12 SR I OWNER TEL NO IBLDGS NOW ON LOT VALUATION IFINAL DATE FIN Y CODE ILEE, HUANLING (626) 456-0716- 1 5,500 19615 GARIBALDI AVE ( J TEMP 917801602 FEES PAID ICT-SCPIPTION OF WORK I CONVERT EXISTING CLOSET INTO BATHROOM IN BEDROOM #2, REMODELI IFEE DESCRIPTION QUANTITY UOM AMOUNT I (F) BATT-IROOM ADD SHOWER AND REMODEL KITCHEN I (APPLICANT TEL NO I I ISAME AS OWNER - IAA BLDG PERMIT ISSUANCE 27 80 I IAB STATE GREEN BLDG FEE 5500 00 VAL 1 00 ISPECIAL CONDITIONS I J -IAC STRONG MOTION RESID 5500 00 VAL 0 60 I IAX BUILDING REVIEW FEE 54 70 I JB2 PERMIT W/ENERGY 5500 00 VAL 164 30 J ICONTRACTOR TEL NO IFR INV WORK W/O PERMIT 342 60 DOL 342 60 JAPT`:.vALS DATE INSPECTOR SIGNATURE I ISAME AS OWNER - TO AL FEES 591 00 I_<' I LIC NO ILOCATION AND SETBACKS I I I I I �SO:LS ENGINEER APPROVAL I J 1 -.___ I I J JARCHITECT OR ENGINEER TEL NO I IFOUVF',TION/TRENCH FORMS I I LIC NO i ISLAR/UNDER FLOOR I I I I J I IRA-SED FLOOR FRAMING J J I I JMAP NO SEWER MAP BOOK PAGE FIRE ZONE CMD JUNDRPFLOOR INSULATION I I I I153H265 3 00 J—�— I I IFI 00' SHEATHING INO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 0 NO 21 J JROCF StiEATHING I SCHOOL WITHIN HAZARDOUS J ISHEAR PANELS I J I J I (AIR QUALITY 1000 FEET MATERIALS I I_, J J NO NO NO e I J FRA:AE INSPECTION I I I IFIRE SPRINKLER HANGERS I J I I I JINSULATION/WEATHER STRIPI I JINTEPIOR LATH/DRYWALL J I I �I I I I EXTERIOR LATH I I J I J JRATFJ FLOOR/CEIL ASSEm J I I J I IRATED WALL ASSEMBLIES I I J J J I J IRATED SHAFTS/OPENINGS J J I J IT BAR CEILINGS I J I ILOT DRAINAGE J J I I IREPORT ID DPR261 ROUTE TO BS0508 I J I J