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Home My Public Portal About5202 PERSIMMON AVE_Building__ 78A888A Ce9808 8.88 APPLICATION FOR BUILDING PERMIT. _ LI COUNTY OF LOS ANGELES. • BUILDING— � DEPARTMENT OF COUNTY ENGINEER ADDRESS • BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,Sup'T OF BUILDING CROSS ST. DISTRICT NO. I GROUP ITYPE PROCESSED BY FOR APPLICANT TO FILL IN coNsr. BUILDING X) �y • STATISTICAL CLASSIFI'CATI'ON R MA ADDRESS �0 /v jaL 1 8" ��1 �" BF��P CLASS.NO.�DWELL.UNITS LOT NO. 7 BLOCK WATER NOT-REQUIRED RECEIVED �+4 7 CERTIFICATE: TRACT (I MAP NO. xHIGHWAY _57 (CIRCLE) STATE MAJOR SECON ,LOCAL NO.OF BLDGI .0 SIZE OF LOT �� 0� NOW ON LOTS USE ZONE SPECIAL USE OFCONDITIONS EXISTING BLDG.IIJsp." OWNER � NO. BUILDING EXIST. r� ,p SETBACK YARD HWY STREET NAME WIDTH ADDRESS /� f>Oji �i�2S mVyV1d FRONT �y ENGARCINEER ffeITECT R J�GI Fit r NO'.! Q__1-7 SIDE i/ ADDRESS -31-7,N- N, g ft e6aAr7' AV& ` 4.At P. L. CONTRACTOR I�k a L -40.0 NO, iJ' Sal 607. ADDRESS jqap S a ATLAA1TCC. N rAr J ! A1' 0 DESCRIPTION OF WORK v NEW ADD ALTER REPAIR DEMOLISH W SQ.FT. ; NO.OF ia NO. OF ] z SIZE STORIES 1 FAMILIES 1 USE OF STRUCTURE SIGNATURE OF GPs�+I ''1�i+a� �'�►�"CA APPL IC CANT VALUATION $ Q p APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE $ FEE $ / FORMS, MATERIALS. FRAME: FIRE STOPS, 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS AND STATE THAT THE ABOVE_IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. ' WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. TION,OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT. ING TO WORKMEN'S COMPENSATION INSURANCE. LATH.EXT. ' SIGNATURE O :HOUSE NUMBER COR- PERMITTEE ) •'-d•�s- RECT AND POSTED ADDRESS,as&- Sr 1��'�J9JVTtt�j�/i! �o l� • FINAL . Ju lo I JOHN F. LEWIS. PRINCIPAL STRUCTjtJRAL EmGTRtss PLAN CHECK VALIDATION CK. M.O. 'CASH PERMIT VALIDATION CK. M; GASH LAL,02 4 9 9% AUG12 1 D 1 i.54- V DEPARTMENT OF COUNTY ENGINEER r1VISION OF BUILDING AND SAFETY BUILDING COUNTY OF LOS ANGELES 1 WILLIAM J. FOX, COUNTY ENGINEER APPLICATION CASSATT D.-GRIFFIN, SUPT of BUILDING FOR APPLICANT TO FILL IN FOR OFFICE..,USE ONLY BUI „, DISTRICT NO. PLAN CK.OR RUC:No. PERMIT NO L'oADDR LNG 2 ''`/�' .4/. ../ > W I �� "�. LOCALITY /,a /• I/ RECEIVE BY DATE OF APPL. DATE ISSUED NEAREST . / Z, CROSS.ST / -' C S ADDRESS h IL OWNER L�.:. ADDRESS MAIL " LOCALITY- C(1 F NEAREST �� .TO S� CROSS ST. ;Z4 . h CITY _ ARCHITECT OR TEL. % 'r FIRE No. OF TYPE.�� GROU ENGINEER N ZONE I PLANS m I V ADDRESS BLDG. / O D. NO. / SETBACK LINE Q CONUSE TRACTO ✓” •' NO. �0 ZONB BYPROVED AT ADDRESS Je pl HOUSE NUMBERING LEGAL. MAP NUMBER v V ` NO. ASSIGNED BY -DESCRIPTION LOT NO. I BLOCK CORRECTIONS TRACT JD q 21 NO. OF BL"DGS.• SIZE OF LOT 1 0 i NO ON LOT e! USE OF �� NO. OF EXISTING BLDG. NO. d DESCRIPTION OF WORK — O RE ITION• AIR DEMOLITION ADD _ z ,�gypp r SZ FT. �. NO. OF O h Ls" SIZE 'ROOMS STORIES O 6R ALL ,,t e C l3 I COVERINGROOFr US6 OF STRUCTURE ' - APPROVALS INSPECTOR'S'SIGNATURE- DATE FOUNDATION:LOCATION FORMS, MATERIALS 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP=' FRAME: FIRE STOPS, PLICATION AND-STATE THAT THE INFORMATION GIVEN IS BRACING, BOLTS • r CORRECT. FURNACE:LOCATION, 1 AGREE TO'COMPLY WITH ALL,COUNTY ORDINANCES- AND VENT, DUCTS ' AND STATE LAWS REGULATING BUILDING CONSTRUCTION.. 2- Mils, LATH..INT. ® .3 SIGNATURE OF r PERMITTEy�d' ' LATH.•EXT: ADDREIM ""�' �G - `• PLASTER,'INT. , AUTHORIZED AG i D d PLASTER, EXT. / $ Q O P.C. 8 HOUSE NUMBER COR-' FEE 1p RECT AND POSTED VALUATION -7 u7 69D6,FEE �L !^ FINAL `^¢ ^ -3 L 7BAS88A 01183 9-88 �✓ CS A ROAD DEPT. PERMIT IS REOU!REd FOR ANY MATER-IAL STORAGE 0.2 WORK DONE IN THE ROAD RIGHT OF'WAYa. reneaeAeshoaa-ea APPLICATION FOk. BUILDING PERMIT COUNTY OF LOS ANGELES- BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS }. BUILDING AND SAFETY-DMSION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST ,( CASSATT D. GRIFFIN SUPT OF BUILDING CROSS ST. �7 DISTRICT NO. GROUP TYPE PR ED BY • FOR-APPLICANT-TO FILL IN coNsr. ti r�L BUILDING STATISTICAL CLASSIFICATION SEW4R MAP ADDRESS D . . _.8K G CLASS:NO.ccyy ELL.UNITE LOT NO. BLOCK MAPSTATE-- -.ER pli�J HWY. YES NO TRACT / USE ZONE SPECIAL �g NO.OF BLDGS. CONDITIONS SIZE OF LOT u 7 I NOW ON LOT USE OF EXISTING BLDG.. LU BUILDING YARD- HWY STREET:NAME EXIST. SETBACK WIDTH OWNERI-q Ill FRONT - j/ MAILP.L. ADDRESS 02 SIDE � e � '! NO. P.L. CITY l INSPECTION RECORD ` ARCHITECT OR TEL. ENGINEER NO. ADDRESS CONTRACTORfi?(10ttip TO. S. ADDRESS O � � If °�`� F DESCRIPTION OF WORK NEW ADD gLTER REPAIR DEMOLISH r SQ. FT. NO. OF _ NO. OF SIZE t STORIES FAMILI USE OF STRUCTURE .p C-- SIGNATURE OF APPLICANT APPROVALS DATE• INSPECTOR'S SIGNATURE ADDRESS FOUNDATION:LOCATION FORMS,MATERIALS VALUATION $ G9 r!J FBRACING,BOLTS S FURNACE:LOCATION, . F E $� FEE $J? GAS VENT,DUCTS 1•HEREBY ACKNOWLEDGE THAT I HAVE READ THIS AP- LATH,INT. r.5 PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ' STATE •LAWS GULATI BUI I �COSTRUCTION: LATH,EXT. •� 1 SIGNATURE � HOUSE NUMBER COR- PERMITTE RECT AND POSTED ADDRESS— FINAL .. .�" ��.,G u CLYDE N. DIRLAM, PRINCIPAL SSR URAL ENGINEER PLAN CHECK VALIDATION CK•• M D• CASH PERMIT VALIDATION aK, M.o. cwsN .1ACo5 8•..g-WE FEB'._ 1 1 A 3.00 - JAPPLICATION FOR BUILDING PERMIT COUNTY OF LOS 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, BUILD DD SS A� �/c/ O� or a certificate of Workers'Compensation Insurance,or a certified Toe -W AA y ` '�� copy thereof(Sec.3800,Lab.C.) f C ZIP Policy No. Company �i 1--/L LOCALITY e SIZE OF L NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OW ER ^ A� L NO. (�/ Y COMPENSATION INSURANCE !`f- g.Q P(KJ WITHIN 1000 FT OF SCHOOL? YES No (This section need not be completed if the permit is for one hundred RCHITCCT / . DISTRICT GROUP TYP CONST. FlRE ZONE PROCESSED BY dollars($100)or less.) 91 J ZIP I certify that in the performance of the work for which this permit !/ is issued, I shall not employ any person in any manner so as to O NGINEER TEL NO. /C + 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' 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 P L I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG ® } IZ License Number Lic.Class DESC ION OF RK ADD ❑ VALUATION O Contractor Date ZZeALTER ❑ � ,5 U ❑ I am exempt under Sec. 0 REPAIR 11 $ O BAP.C.for this reason Z� DEMOL ❑ LDMA P/C# 1 �u,�� LLI Date: SE OF EXISTING G. URM ❑ 1 ITEMS 0- Signature Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 125 -M CD ner Z ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS 0 r'In not intended or offered for sale (Section 7044, Business and FINAL DATEg% Q lttl I � GE r"FutJV rofessions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J I, as owner of the property, am exclusively contracting with FINAL BY AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATON GUIDES licensed contractors to construct the project (Section 7044, Business and Professions Code.) YES 11 NO 11 Z. ama-0631 8/14/95 WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING qQ+]L i AH 6e�� OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 1824 1 PSJ� B CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for YES❑ NO❑ athe performance of the Work for which this permit is issued(Sec. IHAVE READ THE HAZARDOUS MATERIALS INFORMATON GUIDE AND THE SCAQMD PERMITTING °' 3087,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 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 C3 Lender's Address O OWNER OR AGENT o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE �t N with all county ordina sand State laws relating to building �( < cons ruction, and her y Authorize representatives of this County ISSUANCE FEE • m toe er upon the ab - entioned property f inspect1 n purposes. AA KUINVESTIGATION FEE TOTAL FEE 6/7 m A —k--L _ /� n V SEE REVERSE FOR EXPLANATORY LANGUAGE I APPLICATION FOR BUILDING PERMIT COUNTY OF LOS 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, BUIL or a certificate of Workers'Compensation Insurance,or a certified ( ' copy the e f3 0 ab r` CITY-- 1 ZIP lewdc (J LOCAL TV Policy NO Ompany SIZE OF LOT NO. F S. OW ON LOT Certified copy is hereby furnished. v NEAREST CROSS Sf ❑ Certified copy is filed with the county building' specti n TRACT BLOCK LOT NO. dep tm ?\"— • USE ZONE MAP NO. Date�v Applicant / ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM W RKERS' WNER TE N COMPENSATION INSURANCE e- ► -WW2 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred AD S , �/ � DISTRICT GROUP TYP CONST FIRE ZONE PROCESSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit CI ' ,O i ZIP 1�7eO �01 is issued, I shall not employ any person in any manner so as to ARCHITECT O ENGINEER TEL NO. v Mom-ge become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION 0 APT CONDO Date Applicant ADDRESS CLASS NO. a I DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' Cf NCo SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith TC �J FRONT comply with such provisions or this permit shall be deemed revoked. cpJ�1�� u , PL SIDE LICENSED CONTRACTORS DECLARATION CIT LIC. s PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,$ 1'c�Qs is in full force d effect. NEW ❑ BK PG ® a License Nu er L� C� Lic.Class D CRIPIf"TION OF R ADD ❑ VALUATION 0 Contractor Date ALTER ❑ $ S ❑ I am exempt under Sec. REPAIR $ 0 BAP.C.for this reason DEMOL ❑ 10 LDMA P/C# OF EXISTING V)G. URM ❑ i- Date: 1 q co Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 3303 1`6.i5 Z ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS O 1 ITEMS EMS not intended or offered for sale (Section 7044, Business and FINAL DATE a Professions Code.) _I dl G .UPC -1156 WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the y y g OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J v�ir�'1 property, am exclusive) contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 0 licensed contractors to construct the project (Section 7044, YES❑ NO❑ CHANG,E =GO Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES t� I hereby affirm that there is a construction lending agency for YES❑ NO❑ i�fJ�J�— I f 3 611 6/95 a the performance of the work for which this permit is issued(Sec. 0I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 4 a 3097 ,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LAS ANGELES COUNTY CODE, 0751 i 1 1 Art ,9 0 a 11 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. o Lender's Address C OWN:R OR ACENT o I certify that I have read this application and state under penalty O of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building m construction, and here y authorize representatives of this County ISSUANCE FEE / &� atom t upon the abc� menti �1ed property for inspe do p (O Q J G ! �AZ1�� INVESTIGATION FEE TOTAL FEE / /yo/ n o App'Gnl«AFnl 0o (!/ SEE REVERSE FOR EXPLANATORY LANGUAGE