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Home My Public Portal About4929 PERSIMMON AVE_Building__ DEPARTMENT COUNTY OF LOS ANGE ESAFETY BUILDING UILDING WM. J. FOX, CHIEF ENGINEER APPLICATION FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY DIST RI T NO. PLAN CK. OR REc.No. PERMIT NO. BUILDING !� ,s Sys [j� 'J ADDRESS -�'t 7 / / 0. � F/C''SI/�I/y�/1r 7 / �O RjrCEIVED BY DATE OF APPL. DAT' IBSUED y LOCALITY l r-M.�.c C-" c.i �.'.Y NEAREST f'' ; G�,v N Q CROSS ST. �! BUILDING j� ADDRESS J Y NLJ /OJ I /H0I(/ OWNER_ MAIL LOCALITY ��jj �� (('' �(' ADDRESS 7A.2 lS, �'+O� 4+V�JIF J NEAREST t� _ TEL CROSS ST. r! Zo CITY -" �� r�" FIRE I NO. OF ORQUP ARCHITECT OR TEL ZONE PLANS ENGINEER NO. nRp� NN SETBACK LINE ADDRESS USE 7 USE APPROVED TEL ZONE BY DATE CONTRACTOR NO. HOUSE NUMBERING ADDRESS MAP NUMBER NO. ASSIGNED BY_-_–' LEGALs1eM Re, 14147,) 2jjcCORRECTIONS DESCRIPTION I LOT NO. _BLOCK i TRACT _. .. .y.� I NO. OF BLDGS. SIZEOF LOT NOW ON LOT USE OF NO. OF EXISTIN BLDG. ( FAMILIES r DESCRIPTION OF WORK n NEW '� ALTERATION ADDITION I Z D r REPAIR DEMOLITION Bq. FT. N O. O F SIZE _7(op ROOMS STORIES EXT.WALLROOF �a COVERING .�T'y000 I COVERING �D/V0,=", USE OF STRUCTURE , C i9 P e�f-V 0. S77/IC,V e=-0. INSPECTION FOR APPROVALS OCCUPANCY AS _ INSPECTOR'S SIGNATURE DATE FOUNDATION: LOCATION _ FORMS, MATERIALS i 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- PLICATION AND STATE THAT THE INFORMATION GIVEN IS FRAME: FIRE STOPS, CORRECT. BRACING, BOLTS I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FURNACE: LOCATION, AND STATE LAWS REGULATING BUILDING CONSTRUCTION. GAS VENT, DUCTS SIGNATURE OF 7�,. LATH, INT. PERMITTEE �L ,f �. _ ( � r,�o LATH, EXT. ADDRESS �•7 PLASTER, INT. AUTHORIZED AOT. If f / PLASTER, EXT. $ P.C.S r. FEE _ HOUSE NUMBER COR- RECT AND POSTED VALUATION �i/ C� FEE �v FINAL 76A63RA DBS 3 7-51 APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES + ° '`'�kr t" buill-DING AND SAFETY ''WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUIL I ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUIL ING ADDRES +%� or a certificate of Workers'Compensation Insurance,or a certified �^ copy thereof(Sec.3800,Lab.C.) ITY ZIP Co LO LR � Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. z) - % NEAREST CROSS T. ❑ Certified copy is filed with the county building inspection TRACr BLOCK LOT NO. department. I I USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER ` t 2�- TEL NO. YES NO COMPENSATION INSURANCE '9�}— WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit CITY C`� ZIP `�� Q Ye-5 �«9 is issued, I shall not employ any person in any manner so as to t\ become subject to the Workers'Compensation Laws. \V ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLWIFICATION 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' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith ! & FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. PL LICENSED CONTRACTORS DECLARATIONSIDE CITY LIC.CLASS PL I hereby affirm that I am licensed underprovisions of Chapter 9 SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES SEWER MAP (commencing with Section 7000)of Division 3 of the Business and p Professions Code,and.my license is in full force and effect. NEW ❑ BK PG v DE CRIPTION OF WORK VALUATION License Number Lic.Class ADD VALUgg p Contractor Date �I ALTER $ 6 , O W ❑ 1 am exempt under Sec. �T REPAIR 11 $ BAP.C.for this reason DEMOL ❑ LDMA P/C# ' Date: USE OF EXISTING BLDG. URM ❑ J$Ignature APPLICANT(PRINT) TEL NO. LDMA Perm# 0 I;as owner of the property, or my employees with wages as Y ZFLA,; o their sole compensation, will do the work and the structure is ADDRESS O not intended or offered for sale (Section 7044, Business and FINAL DATE a uzl •° _If!,:�I�' Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL .7 ❑ 1, as Owner of theOR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J 'E property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY licensed contractors to construct the project (Section 7044, A " YES❑ NO❑ ':9 ':I a 3 Business and Professions Code.) _" LL THE INTENDED USE'OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING -•j�f i' '?`_:I�j CUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST,AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDEDNES i L1't I hereby affirm that there is a construction lending agency for YES❑ No❑ s T: 22 " 1i ; C11 the performance of the work for which this permit is issued(Sec. I L ® �-- rn\ 3097CIVCI HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING n a , . .) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE. +I' r";.;: TITLE 2.CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. a.o Lender's Address vy( -'L C OWNER OR AGENT o I certify that I have read this application and state under penalty o P.C.FEE 51� PERMIT FEE of perjury that the above information is correct.I agree to comply /� ((JJ / ,L N with all county ordinances and State laws relating to'building // V`7' loll: 'firytj const uction, and hereby authorize representatives of this County ISSUANCE FEE / --855 , a to en n&1a ove-mentioned property for inspection purposes. G, ` INVESTIGATION FEE TOTAL FEE s'a�nn...a AppliCanl u Bale e SEE REVERSE FOR EXPLANATORY LANGUAGE —�� COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9902170064 PHONE: (626) 285-0488 EXT: DUPLICATE LEGA ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 4902 LT: 5 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 4932 PERSIMMON AV STRUCTURE: 1114 1 VN R3 TEMP CA 917804114 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: GRAND 8574-024-008 OTHER: THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY TENANT: E IST BLDG USE: USE ZONE: ISSED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 03/30/00 UT 09/26/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: CLARK;RUSSELL (626) 401-0603- 1 82,440 �(j�/� /l 4932 PERSIMMON AV ��YY''//��L TEMP 917804114 FEES PAID DESCRIPTION OF-WORK ADDITION TO EXISTING RESIDENCE-2 BEDROOMS/2 FULL BATHS AND FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: FAMILY ROOM APPLICANT• TEL. NO: SAME AS OWNER - B1 PLANCHECK W/ENERGY 82440.00 VAL 1,049.62 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AC STRONG MO ON-_RES�D�82440.00 VAL 8.24 T� B2 PERMIT,, p s 440�Q0 VAL 1,234.86 D8 PER ,,Fr •XTEN$ F S 8 OL 308.72 CONTRACTOR: TEL. NO: TO 2,629.19 APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: - FO ATIO /TRE C FORMS LIC. NOs lllllll SLAB/UNDER FLOOR ' RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: �Mp�1 n n D n �} n //� K 3 USDELEVELRFLOORLATIOff— SHEATH 0. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLAS }— U IIIA \`v�J\\v�/ lu^us NO 21 V 7N—D LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS `\ ii' t*r ' ROOF S EATNING AIR QUALITY:LITY: 10000 FEET MATTEERIALS \ Q i �, El - FIRE DEPT. FRAME INSPEC REQUIRED- TOTAL S T CK FROM XIST 4 n1 t� BLDG PT. RAM INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: 6�% 11 0 FRONT PL- C aServic 113 SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EX ERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT 1D: DPR261 ROUTE TO: BS05O8 COUNTY OF LOS ANGELES TEMPLE CITY 4 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0405200039 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 4902 LT: 5 BL: .001 SQ. FT STORIES TYPE OCCUP GROUP 4932 PERSIMMON AV STRUCTURE: 1114 1 VN R3 TEMP CA 917804114 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: GRAND 8574-024-008 OTHER: THOMAS PAGE: 597 GRID: D4 LOCALITY: TEMPLE CITY TENANT: EXIST BDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 05/20/04 VG 05/15/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL D FINAL CODE: CLARK;RUSSELL (626) 401-0603- 82,500 4932 PERSIMMON AV TEMP 917804114 FEES PAID DES I ION 0 WORK AD TION TO EXISTING RESIDENCE-2 BEDROOMS/2 FULL BATHS AND FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ILY ROOM APPLICANT: TEL. NO: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 82500.00 VAL 8.25 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 B2 PERMIT W/ENERGY 82500.00 VAL 1,240.31 TOTAL FEES 1,331.01 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. O: FOUNDATION/TRENCH--FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CHIP: UNDERFLOOR INSULATION 3 01 ST LCVEL FLOOR SHEATH NO. OFFAMILIES: DWELLING UNITS: AP /COND: STAT CLASS: NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAISE INSPECT a REQUIRED TOTAL SETBACK FROM EX-1-ST- BLDG DEP RA E INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS • SIDE PL- INSULATION/WEATHER STRIP l��r INTERIOR LATH/DRYWALL-- EXTERIOR ATH/DRYWALLEXT RIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508