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HomeMy Public PortalAbout5410 PERSIMMON AVE_Building__ D P RTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES ' ® ' WM. J. FOX, CHIEF ENGINEER FOR APPLICANT T77t FOR OFFICE USE ONLY DISTRICT NO. PLAN CK.NO. PERMIT NO. BUILDING 3r4, Persimmon 7� 0 ADDRESS �i•J LOCALITY Temple City CEIVED BY DATE F APDL. D E ISS ED NEAREST �gip�a Dri�9 �� '7 CROSS ST. ,/ / DDESSBUILDING OWNE QBZ>#ll 92L,�CZ MAIL SALOU FALMM DRIVE - L® ES$1,CpLtP OCALITY ADDRESS NEAREST /- E�f�js6► � 1 TE CROSS ST. ✓v CITY NO. N . N ZONE PLANE 'FIRE PE�,y�e}�� GROUP ARCHITECT OR O�®Eo EO. ENGINEER BLDG. / ORD.NO. ADDRESS {� SETBACK LINE By DATE DATE CONTRA&Rg- (� LOLTQ�Z� USE APPROVED Saab PALmpft GRIME - LStS ANGtLtB 41,CALIF. ZONE BY DATE ADDRESS LEGAL �� CORRECTIONS DESCRIPTION LOT NO. BLOCK TRACT No. 13613 � NO.OF BLDGS. ( SIZE OF LOT `�0 x 130 NOW ON LOT None USE OF I NO.OF I NO.OF EXISTING BLDG. FAMILIES ROOMS DESCRIPTION OF WORK NEW X ALTERATION ADDITION O REPAIR MOVING DEMOLISH p Sq.FT. NO.OF Z SIZE 1306 RN{OOMS 6 STORIES 1 r WALL uece and I ROOF Wood COVERING RdW°d S3.d1131Z COVERING Ghinglom USE OF NEW Single Fami4 Residence BUILDING V� I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPE VA11A APPLICATION AND STATE THAT THE ABOVE 19 CORRECT FOUNDATION: LOCATION IN FE TOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORMS,MATERIALS �' AND STATE LAWS REGULATING BUILDING CONSTRUCTION. r�.-• O^ arxe rA�J FRAME: FIRE STOPS, SIGNA e BRACING.BOLTS alta CO ° �L LATH,INT.: AUTHORIZED AGTI f LATH,EXT.: �� f DBS-3 5OM BETS 7-47 $ j� P.0.S PLASTER,INT. (� FEE ccJ 9� PLASTER,EXT..070 VALUATION FEE4 FINAL (U�'�61 16A6rA CE 3-B ,. . s - 4V APPLICATION FOR �uiLDIN PERMI �I COUNTY-OP LOS ANGELES LDING r ` DEPARTMENT OF COUNTY ENGINEER AD RESS tel` Gr BUILDING AND SAFETY DIVISION AALITY JOHN A. LAMBIE, COUNTY ENGINEER HE REST COLEMAN W. JENKINS, SUPT OF BUILDING CRASS ST. FOR APPLICANT TO FILL IN DI§TR CTNO. GR TYPE CO ST. PRP Y (PRINT OR TYPE ONLY) b o BUILDING / STATISTICAL CLAS 1CATION SE ER MAP ADDRESS ]D • CLASS NO. DWELL.UNITS BK PG LOT N0. � BLOCK US'E ZONE MAPi1 /1 N0. (/(J TRACT SPECIAL • /�., N0. OF BLDGS. CONDITIONS Z OF LOT(0/k`/A10 NOW ON LOT 'USE OF i EXISTING BLDG. // N 9L G. SETBACK FROM TEL JJ FRONT PROP. LINE OF (STREET) OWNERNO. 26�dP TYPE OF EXISTING SETBACK HIGHWAY + YARD' = TOTAL ADDRESSJV/� B HIGHWAY WIDTH FROM C.L. CITY ARCHITECT ORTEL. BLDG.SETBACK FROM STREET) ENGINEER N0. SIDE PROP. LINE OF TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL ADDRESS HIGHWAY WIDTH FROM C.L. TEL. CONTRACTOR NO. + LIC. 3' ADDRESS N0. ..CORNER CUTOFF YES ❑ NO ❑ LIC. k' CITY CLASS SEE�REVERSE SIDE FRA,SPEC IAL-APPROVALS', i CONSTRUCTION LENDER j' NAME AND BRANCH I,. D d i ADDRESS G © ) SQ: FTNO. OF NO. OF . SIZE O STO.RIES / FAMILIES NEW ❑USE OF STRUCTURE f�/l//i✓ ADD ALTER ❑ REPAIR ❑ ,, SIGNATURE OF DEMOL ❑ APPLICANT VALUATION$ VU� 0-d s i. APPROVALS DATE INSP TORS'SIGNATURE - P.C. PMT. S� FOUNDATION:WORMS, M TERIALSN 7� FEE $ FEE$ r I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION FR� ME:.F•IRE STOPS, ? �f AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY SBRACING BOLTS ,fir WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUC- FURNACE: LOCATION, TION. I'CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I .GAS VENT DUCTS WILL NOT EMPLOY ANY PERSON IN VIOLA TIO OF THE LABOR CODE OF THE STATE%F CALIFORNIA IN RELAT 0 WORKMEN'S LATH, INT. r / -.�y�. _} , ,�•`. �/'' 'v ✓ COM- PENSATION INSU�Ej �• LATH, EXT. SIGNATURE HOUSE NUMBER CORRECT PERMITT AND POSTED - 14, at ADDRE FIIAL JOHN F. LEWIS, PRINCIPAL STRUCIURAL ENGINEER"' PLAN CHECK VALIDATION Cu. M.O. CASH _ I PERMIT VALIDATION M.O. CASH ARI 31 1 7 DEC 2 2 1 •D 2 2.5 0 4 APPLICATION FOR BUILDING PERMIT FORAPPLICANT TO FILL IN '(Print or type only) B LDING COUNTY OF LOS ANGELES ADDRESS L A A Allo1v DEPARTMENT OF COUNTY ENGINEER IL CITY r" J-� eI'T zIP BUILDING AND DIVISION 10.OF BLDGS. BUILDING I SIZE OF LOT,5 NOW ON LOT / ADDRESS U TRACT BLOCK LOT NO. LOCALITY L ` �+ TEL. NEAREST OWNER .. NO4w-e� CROSS ST. � � ASSESSOR ADDRESS 541tg `/�/� MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE !IRE p ESSED BY -CITY � ZIP �, CONST. ARCHITECT OR TEL. ENGINEER NO. STATISTICAL CLASSIFICATION SEWER ADDRESS /� �-^ z CLASS NO. DWELL.UNITS BK PG CONTRACTOR V. E N L, J - J USE ZONE MAP o ADDRESS ,� LIC.NO./ _. SPECIAL CONDITIONS CIT4YLS/ 4-4 CLASS � � / ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLD .SETBACK FROM FRO T PROP.LINE OF (STREET) ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIG AY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE' STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ O BLDG.SETBACK FROM ADD O SIDE PROP.LINE OF TOTALS.B K FROM (STREET) S REETEXISTING G USE OF V17h DN j REPAIR ❑ HIGHWAY + YARD = SIDE PROP.LINE HIGH WIDTH Z EXISTING BLDG. I)k)V I DEMOL ❑ + APPLICANT �Q,�Rr� ��+� EOL CORNER CUTOFF YES ❑ NO ❑ �� 3,` IN OPEN SPACE YES ❑ NO ❑ BY O IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALLUATIUATI ONN$ I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CONSTRUCTION.I CERTIFY HAT IN DOING THE WORK AUTHORIZED HEREBY I W T EMPLOY ANY PE N IN VIO TION OF THE LABOR CODE OF THE ST F RNI ELATIN O W RK S COM- PENSATION INSURANC SIGNATURE PERMITTEE _ ADDRESS FINAL ,r BY TEL. DATE / j- r'�f�j / �.r.- CIT N 6 ( �. - L`@c'- MAKE CHECKS PAYABLE TO: P.C.E $ FET HARVEY T.BRANDT.COUNTY ENGINEER I �J PLAN CHECK VALIDATION CK. M.O. CASH a PERMIT VALIDATION cK. M.O. CASH .5 7 0 ci ti�anR 15 1 D 8 20 Av IDS 76A63BA CE 11803 3.75' WORKERS' COMPENSATION DECLARATION I' hereby-ahereby-aff r that I have certificate of consent to self insure, ora certificate of Workers' Compensation Insurance, ORLICATION FOR BUILDING P E RM I T or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. C FOR APPLICANT TO FILL IN ADDRESS 5410 p e�Si,witi...a ❑ Certified copy is filed with the county building inspec- ADDRESS S ��rS'1 � Cts T La 1111, 11b-6 tion department. Date 1 3JOLI.- Applican+ ^^- G CITY p� r1211c, CA IP LOCALITY Te,, pct, l_ CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT D�C� NOW ON LOT NEAREST COMPENSATION INSURANCE CROSS ST.hh nn 2-0 ASSESSOR ac E.`p (This section need not be completed if the permit is for one TRACT B�106 BLOCK LOT NO. MAP BOOK Cl 7�3 PAGE PARCEL hundred dollars ($100)or less.) TEL. ffBe� OWNER o4. a CQ �PV NO.glp�bD�T,6 USE ZONE MAP 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 ie- / CONDITIONS d so as to become subject to the Workers'Compensation Laws. r� Q CITY �• ZIP g 0 ll a V Date Applicant ARCHITECT OR Vp r, TEL. ix i1 S �.� �, ai•2 DISTRICT GROUP TYPE FIRE PROCESSED BY Q NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER 'ti`9 d NO. �� CONST. ZONE t— Exemption, you should become subject to the Workers' `, V Compensation provisions of the Labor Code, you must forth- ADDRESS S t[d C-f=6�"�GiO Q� _ ,3 LU with comply with such provisions or this permit shall be S TEL. �� ( STATISTICAL CLASSIFICATION APT. CONDO. to deemed revoked. CONTRACTOR NO.Li �2 '14 f Z LICENSED CONTRACTORS DECLARATIONLIC. pp�e CLASS NO. x i DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 4�t�d'6'""U"I'NO. 34'01 4 ^� (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP CITY � 11�r CLASS �� and Professions Code,and my license is in full force and effect. ® LIIES BK. PG VALIDATION SFT. RIFAMILIESO IEA ONE License Number. -'[ '�� Lic. Class l SIZE STORIES pryer., VALUATION Contractor- e �� Date � DESCRIPTION OF WORK �. NEW $ LU T© ADD ► ❑I am exempt under Sec. N ALTER B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature_ ii I! \Jh APPLICANT TEL. (PRINT) NO. FINAL O NER-BUILDER DECLARATION DATE --6 q 7 r� I hereby affirm that I am exempt from the Contractor's License 26" Law for the following reason (Section 7031.5, Business and ADDRESS FINAL s Professions Code): PRESENT By ACCTo4 BUILDING ❑ I, as owner of the property, or my employees with ADDRESS 33507 48.71 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. s ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. RCCTu4 with licensed contractors to construct the project (Sec- ADDRESS 3307 X21 �.. o 3- tion 7044, Business and Professions Code.) ITEM CONSTRUCTION LENDING AGENCY REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. , SET BACK PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT T�I'f �o 59 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDEi'E4'�/; 270.F P.L. Lender's Name, t;}�ANGE ,CIO S Cf LDMA Ref. # P.C. Fee$ • / Permit Fee 7 Lender's Address I certify that I have read this application and state that the Issuance Fee LDMA P/C# 000 0000-0001 ii/ I :: above information is correct.1 agree to comply with all County Investigation Fee t,� ordinances and State laws relating to building construction, Total Fee �j LDMA Perm. # 6448 1 AM 9046 and hereby authorize representatives of this County to enter (�on the abo e- ntioned property for inspection purposes. I \ !B A� ,,-Li �-�� l�— SEE REVERSE FOR EXPLANATORY LANGUAGE �� Signature f Applicant or Agent Date -�` APPLICATION FOP ` VILDING PERMIT k COUNTY OF LOS ANGELES BUILDING AND SAFETY -,WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN ,;, BUILDINGUADDRESS BUILDING ADDRESS �'YIo IJV I hereby affirm that I have a certificate of consent to self insure, or a certificate of Workers'Compensation Insurance,or a certified CITY ✓G/' z17P copy thereof(Sec.3800,Lab.C.) i .� �� E i 1 LOCALITY 6.Policy No. CQIT1PanY SIZE'O•F'LOT 7 ` NO.OF BLDGS.NO ON LOT ❑ Certified copy is hereby furnished. 6 NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. departmeht. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE COMPENSA COMPENSATIONEXEMPTION INSURANCEWORKERS' i OWNER �,/f� T�No. oO YES No Y O WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred 1 ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) � ��A-1141-1 "r I certify that in the performance of the work for which,this permit CITY '��` - ��� ZIP l��O �D� .is issued, I shall not employ any person in any manner so as to LE become ubj ct t�a Workers'Comp nsaIf Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT 'CONDO Date ApplicanV-_'] ADDRESS CLASS NO. DWELL UNITS i NOTICE TO APPLICANT If, making ofREQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTRACTOR EL 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 DECLARATION SIDE 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 SOS IZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. + NEW IJ PG 0}. DESCRIPTION OF WORK 10 VALUATION • 'License Number LID.Class � ADD ' ' 'U Contractor Date _ ALTER ❑ $ ' �p Km ❑ I am exempt under Sec. REPAIR 13 $ O BAP.C.for this reason P-.--6t>P_eC,9A -GI DEMOL ❑ LDMw Pica Lll Date: USE OF EXISTING BLDG. URM ❑ 0- 23 Signature APPLICANT(PRINT) TEL NO. LDMA Perm a,~ s ? - I�as owner of the property, or my employees'with wages as i• ZO 3M3 50.50 their sole compensation, will do the work and the structure is ADDRESS not intended or offered for sale (Section 7044, Business and FINAL DATE a Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL' 10- OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE //��//''''�//�� ❑ I, as owner Of the property, am exclusively contracting with it AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 0 .• ACCUr r A licensed contractors to construct the project (Section 7044, ' Business and Professions Code.) I YES❑ No El 330.3 . 668-" WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING , I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH •7;' `''` -''i TT�FAG� CONSTRUCTION LENDING AGENCY ( COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR 1 t Lf k7 GUIDELINES ' I hereby affirm that there is a construction lending agency for YES❑ NO❑ TOTAL +7 19 14 N the performance of the work for which this permit is issued(Sec. ,, 719 e i 1 01 IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMDPERMRnNG -3097,Civ.C.) 1UiUt 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. aLender's Address ..� •( OWNER OR AWJfr . c I dertify that I have read.this application and state under penalty n a yQ( '(o 0 of perjury that the above information is correct.I agree to comply I P.C.FEE t--,J7•� PERMIT FEE / /2 �raV 1 1 Fl !U CM with all ty ordinances and State laws relating to building �% consIon, nd Fheby authorize representatives of this County ISSUANCE FEEter upon the ve-mentioned property for in`s9eotion urpos S. q� `IJ(ro //�� INVESTIGATION FEE TOTAL FEE � M ApplCBnt w Agent re I .. •.' � 1/ SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0703270032 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST NEW I BUILDING ADDRESS: I ITR: 13613 IT: 20 I SQ. FT STORIES TYPE OCCUP GROUPI 5410 PERSIMMON AV I I (STRUCTURE: 216 1 VN R3 I TEMP CA 917802803 1 [ASSESSOR INFORMATION NUMBER: GARAGE: I NEAREST CROSS STREET: FREER 18573-005-008 1 OTHER: 1 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, C� ITENANT: EXIST BLDG USE: USE ZONE: (ISSUED ON: PROCESSED BY: EXPIRES ON: I I (EXIST OCC GRP: 103/30/07 JK 03/24/08 1 1OWNER: TEL. NO: [BLDGS. NOW ON LOT: VALUATION: FIT DA FI CODE: 1 ITANG, MINH (626) 665-9199— 1 17,840 1 r A / 15410 PERSIMMON AV [ 1 ITEMP 917802803 1 FEES PAID 1DESCRIPTION F WORK I I [ACCESSORY STRUCTURE GAME ROOM NOT FOR HUMAN HABITATION 216 I I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IS.F. (APPLICANT: TEL. NO: I ITANG (626) 665-9199— IDI PLANCHECK W/O EN—HC 8900.00 VAL 169.83 1 LD1 I5410 PERSIMMON AVE. IAA BG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: TEMPLE CITY CA 91780 AC STRONG MOTION RESID 23200.00 VAL 2.32 I 1D1 PLANCHECK W/O EN—HC 17840.00 VAL 128.52 1 1 ID2 PERMIT W/O EN—HC 17840.00 VAL 351.00 1 I [CONTRACTOR: TEL. NO: 1 TOTAL FEES 679.42 (APPROVALS DATE INSPECTOR SIGNATURE 1 ITHOI, KATHY (626) 279-5145- 1 I 1 15410 PERSIMMON AVE. LIC. NO 1 [LOCATION AND SETBACKS �� I ITEMPLE CITY, CA 91780 NONE I I I [ ISOILS ENGINEER APPROVAL [ 1oc 4 I 1ARCHITECT OR ENGINEER: TEL. NO: — 1 iFOUNDATION/TRENCH FORMS 1 1 LIC. NO: I (SLAB/ANDER FLOOR I 1 1 1 1 1RAISED FLOOR FRAMING I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ (UNDERFLOOR INSULATION I I I I I I 3 O1 I I [1ST LEVEL FLOOR SHEATH I I [ INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 NO 21 I 12ND LEVEL FLOOR SHEATH I I [ SCHOOL WITHIN HAZARDOUS [ [ROOF SHEATHING [AIR QUALITY: 1000 FEET MATERIALS I I I I 1 NO NO NO 1 1FIRE DEPT. FRAME INSPECT[ I [ IREQUIRED TOTAL SETBACK FROM EXIST 1 1BLDG DEPT. FRAME INSPECT[ I I ISET BACK YARD: HWY: PROP LINE: WIDTH: [ I I I I IFRONT PL— I ISHEAR PANELS 1ly LI I SIDE PL— I I LK I I I I (INSULATION/WEATHER STRIPI�I I I 1 I NTERIOR LATH/DRYWALL 1 ff 9S1 riI y� [ I I 1EXTERIOR LATH ILOT DRAINAGE 1I i 1 1SMOF.E DETECTION DEVICES 1 I IFIRE DEPARTMENT APPROVAL[ I IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I I I I I I 1 I COUNTY OF IAS ANGELES I TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS I 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1310010049 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 13613 LT: 20 SQ. FT STORIES TYPE 5410 PERSIMMON AV I : STRUCTURE32 V-B TEMP CA 917802803 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 18573-005-008 1 I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY CAI TENANT: EXIST BLDG USE: RESID USE ZONE: R-1 ISSUED ON: PROCESSED BY: 1 1EXIST OCC GRP: 110/01/13 SR 1 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFI DATE F BY: CODE: IMINH DUC NINH (626) 786-4613- 1 7,200 1f� 15410 PERSIMMON AV I II IN ITEMP 917802803 I FEES PAID VESCRIPTIO OF WORK I I 1 1T/0 REROOF WITH 30 YRS CLASS "A" COMP 1 I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 I (APPLICANT: TEL. NO: i I I ICORTEZ, FIDEL (909) 865-6782- IAA BLDG PERMIT ISSUANCE 27.80 I 1 145 WESTBROOK LN IAB STATE GREEN BLDG FEE 7200.00 VAL 1.00SPECIAL CONDITIONS: 1 1POMONA CA IAC STRONG MOTION REBID 7200.00 VAL 0.70 1 1 1 CD2 PERMIT W/O EN-HC 7200.00 VAL 183.00 1 1 TOTAL FEES 212.50 1 1 1CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 ICORTEZ ROOFING (626) 918-1007- I 1 11308 E GREENVILLE DR LIC. NO ILOCATION AND SETBACKS I I (WEST COVINA CA 91790 762520 * I 1 1 1 1 I1 (SOILS ENGINEER APPROVAL 1 1 1 1 ARCHITECT OR ENGINEER: TEL. NO: 1 ]FOUNDATION/TRENCH FORMS 1 1 1 I LIC. NO: ISLAB/UNDER FLOOR I ] I I I (RAISED FLOOR FRAMING 1-1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 1UNDERFLOOR INSULATION I I I 1 3 001 IFLOOP. SHEATHING I I 1 INO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: I I I I NO 21 i IROOF SHEATHING1 I SCHOOL WITHIN HAZARDOUS I I 10/ I (AIR QUALITY: 1000 FEET MATERIALS 1 ISHEAR PANELS I I 1 I NO NO NO I IFRAME INSPECTION 1 (FIRE SPRINKLER HANGERS 1 1 (INSULATION/WEATHER STRIPI I 1 IINTERIOR LATH/DRYWALL 1 1 1 1 [EXTERIOR LATH 1 I IRATED FLOOR/CEIL ASSEM. 1 1 I [ I IRATED WALL ASSEMBLIES I I 1 1 1 IRATED SHAFTS/OPENINGS-1 1 ] IT-BAR CEILINGS 1 1 1* ADDITIONAL DATA ON FILE ILOT DRAINAGE I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 1 I 1 I I I