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Home My Public Portal About4914 PERSIMMON AVE_Building__ DEPARTMENTCOUNTY OF LOS ANGE ESAFETY BUILDING ® U ' LDING WM. J. FOX, CHIEF ENGINEER APPLICATION 1jk7R APPLICANT TO FILL IN FOR OFFICE USE ONLY DISTRICT NO. PLAN CK. OR RECC..`No. PERMIT NO. BUILD NG ADD EISS �gidQ/✓ .,�s `"�'1 /U F� QDifted REPXI VED BY DATE OF APPL. DATEISSUED LOCALITY NEAREST C" ��xj�do BUILDING CROSS ST. C �.�.y� ADDRESS u � /L s� �L� L OWNER /C OB Lam. k T ` 1 / �C� �C/NC T MAIL -+ (� LOCALITY / -ADDRESS ��.� :d , LJ G�/�` '�'r �• NEAREST TEL CROSS ST. _ CITY tT NO. FIRE NO. OF ` I TYP GgQJ7-012e." ARCHITECT OR TEL ZONE PLANS ENGINEER NO. BLDG. SETBACK LINE ADDRESS USEAPPROVED TEL ZONE BY DATE CONTRACTOR NO. HOUSE NUMBERING ADDRESS MAP NUMBER S�ZNO. ASSIGNED BY LEGAL CORRECTIONS _DESCRIPTION LOT NO. BLOCK .... -- �o - CO E- 7 �T O TRACT �i ` NO. OF SLOGS. S� A SIZE OF LOT i r' I NOW ON LOT USE OF I NO. OF EXISTIN BLDG. FAMILIES DESCRIPTION OF WORK 00 0 NEW ALTERATION ADDITION Z D r REPAIR DEMOLITION Sq. FT. NO. OF SIZE "7G O ROOMS STORIES EXT.WALL I ROOF COVERINGC. 71 COVERING USE OF STRUCTURE INSPECTION FOR APPROVALS OCCUPANCY AS -. INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION FORMS, MATERIALS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRESTOPS, ' CORRECT. BRACING, BOLTS 1 AGREE TO COMPLY WITH ALL COUNTY ORDINANCES LOCATION , AND STATE LAWS REGULATING BUILDING CONSTRUCTION. FUGRNACE:RNACE:AS , DUCTS SIGNATURE OF LATH, INT. PERMITTEE >. �..:' ADDRESS �' ��• V G• �'-�C/N.1�I_"`. T LATH, EXT. PLASTER, INT. AUTHORIZED AGT. � - PLASTER, EXT. FEE P. E s 7� HOUSE NUMBER COR- l" �� RECT AND POSTED \ I L VALUATION ✓�"' F[[ S 3 �-- FINAL PI y , 76A636A 005 3 7-51 WORKERS' COMPENSATION DECLARATION hereby affirm that I havecertificate of consent to self 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 BUILDING Pol Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS t Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM 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 ASSESSOR a hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL USE ZONE MAP 0 1 certify that in the performance of the work for which this OWNER NO. NO U permit is issued, I shall not employ any person in any manner SPECIAL J so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS CITY ZIP Dole—' "' Applicant IY ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO PPLICANT: If, after making this ertifictite of CONST. ZONE ENGINEER NO. Exemption, you should become subject to e Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS 0- with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR NO. Lil LICENSED CONTRACTORS DECLARATION LIC CLASS NO. DWELL. UNITS f 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 CLASSBK �! ? u,,. VALIDATION �{ SQ. FT, NO. OF NO OF CHECK F1 License Number Lic.Class SIZE STORIES % FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW ❑ Contractor Date ADD 0 $ 011111" +, 4 I am exempt under Sec. 4. • ,, 0 ALTER ❑ ' t B.BP.C. for this reason I REPAIR ❑ ^"�" J DaterUSE OF r c t • .� �E ❑ EXISTING BLDG. ',f, =-- APPLICANT TE j, fi r :V, Signature /` L+ �tCtL FINAL OWNER-BUILDER DECLARATION PRINT : NO. ) DATE a I hereby affirm that I am exempt from the Contractor's License ,, r,' Law for the following reason (Section 7031.5, Business and ADDRESS "yT FINAL Professions Code): PRE EN 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. 1, 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). FROM ExibT. CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK SET BACK YARD HWY 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. _ (Sec. 3097, Civ. C.). SIDE P.L. a I. Lender's Name t LDMA Ref. # _ m P.C. Fee$ F f Permit Fee �` ! Lender's Address I I certify that I have read this application and state that the Issuance Fee LDMA P C# o above information is correct. I agree to comply with all County Investigation Feef 0 ordinances and State laws relating to building construction, - Total Fee LDMA perm. # and hereby authorize representatives of this County to enter m upon the above-mentioned.property for inspection purposes. a ! / SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS' COMPENSATION DECLARATION I hereby to insure, orairm afcertif cane of Worke s' Comtpennsat on of coent Insuran elf APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS Date Applicant CITY , ZIP - LOCALITY CERTIFICATE OF EXEMPTION FROM 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 ASSESSOR >_ hundred dollars ($100)or less.) TRACT i BLOCK LOT NO. MAP BOOK PAGE PARCEL 0- TEL, TEL. USE ZONE MAP O I certify that in the performance of the work for which this OWNER NO. NO U permit is issued, I shall not employ any person in any manner SPECIAL J so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS LL CITY ZIP }. Date ' Applicant ARCHITECT ORTEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO.t 4. DISTRICT GROUP TYPE FIRE PROCESSED BY Q Exemption, you should become subject to the Workers' CONST. ZONE X Compensation provisions of the Labor Code, you must forth- ADDRESS d with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. 2 deemed revoked. CONTRACTORNO. LLJ LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS 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 PG VALIDATION SQ. FT. NO. OF NO OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE ❑ VALUATION . DESCRIPTION OF WORK NEW Contractor Date ADD Q $ , F-1I am exempt under Sec. ALTER B.BP.C. for this reason I REPAIR ❑ $ Date: USE OF ❑ EXISTING BLDG. DEMOL Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO DATE ` + I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT By BUILDING S I, as owner of the property, or my employees with ADDRESS wages as their sole compensation, will do the work and LOCALITY ' the structure is not intended or offered for sale(Section 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 REQUIRED YARD HWY TOTAL SETBACK FROM 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. (Sec. 3097, Civ. C.). f SIDE - {..:�✓�f Lender's Name LDMA Ref. N t� P.C. Fee$ Permit fee ' Lender's Address I certify that I have read this application and state that the Issuance Fee LDMA P/C N ° above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. N y and hereby authorize representatives of this County to enter `m upon the above-mentioned property for inspection purposes. m a SEE REVERSE FOR EXPLANATORY LANGUAGE n Signature of Applicant or Agent Date hereby affirm that I have certificate`of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, �. or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. Company COUNTY OF LOS ANGELES BUILDING AND SAFETY ❑ BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS "ef Fly,G 1 l /;Vv copy is filed with the county building inspec- BUILDING / 11 /I - tion department. ADDRESS IC t i, � .` -V,41 Date Applicant CITY �4 } ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLryiS. INEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. , (This section need not be completed if the permit is for oneASSESSORIb hundred dollars($100)or less.) TRACT BLOCK LOT NO. PARCE MAP BOOK PAGE L t N L USE ONE MAP I certify that in the performance of the work for whisk this OWNER NO permit is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ADDRESS lt.K' SPECIAL1�>y "`•"�` CONDITIONS Date �TO Applicant l4 �' CITY ZIP 0 NOTIC APPLICANT: If, after maki g thi ertific to of ARCHITECT OR TEL: DISTRICT GROUP TYPE FIRE PROCESSED BY W Exemption, you should become subject t the Workers' ENGINEER NO• �y TYPE ZONE W Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be deemed revoked. TEL. STATISTICAL CLASSIFICATION APT. NDO CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC CLASS NO. DWELL. UNITS W 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 tic. SEWER MAP Professions Code, and my license is in full force and effect., CITY CLASS VALIDATION SQ. FT. NO.OF NO.OF CHECK BK. PG. License Number Lic.Class SIZE STORIES FAMILIES ONE Contractor pate DE IPTION OF WORIc � NEW VALUATION ❑ I am exempt upder Sec. • ADD ❑ $ I B.&P.C. for this reason ALTER REPAIR REPAIR ❑ $ Date: USE-OF EXISTING BLDG.: l DEMOL ❑ Signature APPLICANT, T C \ FINAL OWNER-BUILDER DECLARATION PRINT �Lj '(y`''' itr� N I hereby affirm that I am exempt from the Contractor's License G+. DATE. 4 Law for the following reason (Section 7031.5, Business and ADDRESS ; Professions Code): PRE ENT \ By , n^. BUILDIN '�' v - ❑ I, as owner of the property, or my employees with ADDRES wages as their sole compensation,will do the work and dr *{ • • • • r `i the structure is not intended or offered for sale(Section LOCALITY ' 7044, Business and Professions Code). MOVING TEL. SPECIAL l • • `�'+� ❑ 1, as owner of the property, am exclusively contracting CONTRACTOR NO. INFORMATION with licensed contractors to construct the project (Sec- • • •4 05?,G 7 tion 7044, Business and Professions Code). ADDRESS ON REVERSE CONSTRUCTION (ENDING AGENCYREQUIRED YARD HWY TOTAL SETBACK FROM SIDE SET BACK PROPLINE WIDTH . 1 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 m P.C. Fee / LDMA Ref. # Dr Lender's Address $ Permit Fee if t C/ ' 0 1 certify that I have read this application and state that the Issuance Fee / '✓= LDMA P/C# o above information is correct. I agree to comply with all County esn9ar Fee 9 ordinances and State laws relating to building construction, -' R and hereby authorize representatives of this County to enter Total Fee LDMA Perm. # upon the above-mention d property for inspection purposes. ro ` SEE REVERSE FOR EXPLANATORY LANGUAGE Signal a of Appli Vint or Agent Dat WORKERS' COMPENSATION DECLARATION hereby affirm that I havecertificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or o certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS OCertified copy is filed with the county building inspec- BUILDING tion department. ADDRESS - Date Applicant CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO, OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. ASSESSOR >_ (This section need not be completed if the permit is for one hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL t1. TEL. USE ZONE MAP O I certify that in the performance of the work for which this OWNER NO. NO V permit is issued, I shall not employ any person in any manner SPECIAL J so as to become subject to the Workers'Compensation Laws. ADDRESS CONDITIONS Date Applicant CITY ZIP >_ ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate of Q Exemption, you should become subject to the Workers' ENGINEER NO. CONST. ZONE Of Compensation provisions of the Labor Code, you must forth- ADDRESS CL 0 with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. :�F deemed revoked. CONTRACTOR NO. Lij 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 and LIC. 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 SIZE ISTORIES FAMILIES ONE Cl VALUATION Contractor Date DESCRIPTION OF WORK NEW ADD ❑ $ , ❑ I am exempt under Sec. ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF ❑ EXISTING BLDG, DEMO' Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESINT ByI ❑ BUILDING I, as owner of the property, or my employees with ADDRESS r r r o 1 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. 3 r K with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQROM SETT BACKK YARD HWY IRED TOTAPROP.SETBpLINE CK F 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 w; LDMA Ref. p P.C. Fee$ Permit Fee ��' •'� L'' ' Lender's Address I certify that I have read this application and state that the Issuance Fee LDMA P/C N ? above information is correct. I agree to comply with all County Investigation Fee i ordinances and State laws relating to building construction, Total Fee LDMA Perm. $ 3 and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent i Date ' Y COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT ,. DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS j ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0309240050 PHONE: (626) 285-0488 EXT: " LEGAL D: NO. OF CONST R S: TR: 4902 LT: 7 BL: E SQ. FT STORIES TYPE 4914 PERSIMMON AV STRUCTURE: VN TEMP CA 917804114 ASSESSOR 0 0 R: NEAREST CROSS STREET: LOWER AZUSA 8574-024-011 THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY TENANT: EXIST SLOG : RESID USE 0 R- ISSUED ROC ED B --EXPIRES 0 : EXIST OCC GRP: 09/24/03 JK 09/18/04 OWNER: TE 0: BLDGS. NOW ON LOT: A UATIO • FIN A FINAL BY: CODE: KAREN BAO DIEP (626) 453-3539- 3,000 4914 PERSIMMON AV TEMPLE CITY 91780 FEES PAID DESCRIPTlON OF WORK INSTALL 2SYR COMP SHINGLE OVER EXISTING SHEATING(HSE&GARAGE) FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: REPLACE DRYWALL IN KITCHEN, DINING RM & 1BATH AP O: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG NOTION RESID 3000.00 VAL 0.50 SPEC AL CONDITIONS: D2 PERMIT Wj0-EN3HC X3000.00 VAL 99.00 �NGEO-ES L+ L-FEES 127.25 CONTRACTOR: TEL. NO: Cj APPROVALS DATE INSPECTOR SIGNATURE SAME AS .OWNER - VG Ty LIC. NO j 0 T' 0 SETBACKS X/ I SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: J 0 NDA 0 TRENC NNW LIC. 1111111 SLAB UNDER FLOOR ED FLOOR FRAMING •a MAP N0: SEWER MAP B00 PAGE: FIRE ZONE: CMP: Fl ��F��r� Ey UNDERFLOOR INSULATION 144H277 3 X01U Bo ILIA ((��..�J►E{J�l{1 lllK� OUR SHEATHING 0. OF F S: D E ING S: AP CO D: STAT C ASS- NO 21 ROOF -SHEATHING SCHOOL WITHIN \ S EA PANELS AIR QUALITY: 1000 FEET MATERIALS ] NO NO NO �'r FRAME INSPECTION REQUIRED TOA SETBACK RO EXIST' (f Se-ry ,(� RE S RIN R HA G RS SET RACK FRONT PL- YARD: NWY: PROP LINE: WIDTH: b�i� Ce That�� INSU A TION/ EAT ER STRIP SIDE PL- INTE.RIOR LATHMMFL—L EXTERIOR-LATH RATEDJLOOR/CEILSSE . l RATED' ALL ASSEMBLIES F S OPE I GS T-HAR CEILINGS lLOT ORA G I REPORT ID: DPR261 ROUTE TO: BS0508 I