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Home My Public Portal About5446 PERSIMMON AVE_Building__ DEPARTMENT OF BUILDING AND SAFETY APPLICATION FOR PERMIT COUNTY OF LOS ANGELES v ' ® � WM. J. FOX, CHIEF ENGINEER FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY BUILDING �t DISTRICT NO. PLAN CK.NO. PERMIT NO. ADDRESS 406 Persimmon Avenue 74 7 0 V� 0 9q . C. Ila LOCALITY TA le Ci RE C VED BY D E OF 411212L. DAVk ISS/ED NEAREST Daines Drive CROSS ST. o�n �p BUILDING 4® OWNER �a �L�Q ��'a?��9 ��.i/o ADDRE5B 0 - O MAIL sJ89b Irl.".La bn:VE LOCALITY ®K/, ADDRESS 10.i wldGadLni3 Rc;Aj 11�� L �f NEAREST CITY NOld1 6-623® CROSS ST. FIRE NO.OF STYPE I GROUP ENGINEER Owwr ARCHITECT NG NEERT OR' �r 'EOL ZONE PLANE / BLDG. ORD.NO. ADDRESS SETBACK LINE QI'a gypt mas ; any APPROVED CONTRACT' V. / NO./ O BY DATE USE APPROVED 191-13&, -NGtLc.,41,CALIF, ZONE / BY DATE ADDRESS LEGALe ®� CORRECTIONS DESCRIPTIONLOT NO. 1� I BLOCK TRACT No. 136113 NO.OF SLOG SIZE OF LOT 60 7C 115 I NOW ON LOTS 1yone USE OF I NO.OF I NO.OF EXISTING BLDG. FAMILIES ROOMB DESCRIPTION OF WORK NEW ALTERATION ADDITION - O REPAIR MOVING DEMOLISH p BlFT. NO.OF �I 5iE 306 ROOMS 6 STORIES 1 > WALL COVERING §"ce �I COVERING uar Wood USE OF NEW DJLQJug ShingNo BUILDING -151 ng3d Fam;ly Residence PIAN NU.. RGv a� I 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPROVAiS APPLICATION AND STATE THAT THE ABOVE IS CORRECT FOUNDATION:LOCATION IN13PEOTOR DATE AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FORME,MATERIALS I 1 �j Itc; i rice AND STATE LAWS REGULATING BUILDING CONSTRUCTION. cfl FRAME: FIRE STOPS, J SIGNATU �/��(� nf�Sl aagee eYi a BRACING,BOLTS PERMITTE �ff ^7/ LATH,INT.. AUTHORIZED AOT .1 i LATH,EXT.: DBS-3 513M SETS 7-47P.P.C.isp A tYj PLASTER,INT. FEE PLASTER,EXT. VALUATIONCPO FINAL Le, FEE ,. 76A638A CE 9803 1/71 ,.. . . :. APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES I ASSErSOR DEPARTMENT OF COUNTY ENGINEER MAP BOOK PAGE PARCEL BUILDING AND SAFETY DIVISION BUILDING ADDRESS COLEMAN W. JENKINS, SUPT OF BUILDING f LOCALITY FOR APPLICANT TO FILL IN NEAREST i Print or tvoe onl CROSS ST. BUILDING "1 DIST N GRO TYPE P ADDRESS coNST. Q STATISTICAL CLASSIFICATION SEWER MAP LOT NO.. BLOCK r CLASS No. 4-2 J / DWELL,UNITS BK OPG TRACT42 USE ZONE[SPECIAL AP �j ��] qq NO.OF BLDGS. O. �0J 0 SIZE OF LOT NOW ON LOT USE OF ONDITIONS EXISTING BLDG. TEL. f iqq OWNER n ! �NO. l BLDG.SETBACK FROM ADDRESS S jsj ,g VV FRONT PROP.LINE OF (STREET) TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL CITY y �i HIGHWAY WIDTH FROM C.L. ARCHITECT OR TEIL. + _ ENGINEER NO. BLDG,SETB FROM ADDRESSSIDE PROP.LIN (STREET) u yVf/ y�•� C.,bl" EL. f TYPE OF EXISTING SET HIGHWAY + YARD = TOTAL O C RACTOR NO. �5 LIS HIGHWAY WIDTH FROM C.L. V (v O LIC. v CITY CLASS CORNER CUTOFF YES ❑ NO ❑ Lu CONSTRUCTION LENDER �- NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS ADDRESS SQ. FT. NO. OF NO. OF NEW ❑ SIZE STORIES FAMILIES ❑ ' USE Nj ADD STRUCC TURE .� � ALTER. REPAIR❑ SIGNATURE OF APPLICANT E O VALUATION S APPROVALS DATE INSPECTOR'S SIGNATURE P.C. PMT. FOUNDATION: LOCATION FEE S FEE$ f FORMS, MATERIALS // e -a'• 9 a FRBRACINGEBOLTS ✓ f 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS STRUCTION. IC THAT IN DOING THE WORK AUTHORIZED HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT. LABOR CODE OF THE STATE OF 'CALIFORNIA IN RELATING TO WORKMEN'S COMPE NSA INSURANCE. LATH, EXT. SIGNATURE OF HOUSE NUMBER COR- i PERMITTEE RECT AND POSTED ADDRESS P I N AL . M1 J Z ' JOHN F. LEWIS. PRINCIPAL STRUC URAL PLAN CHECK VALIDATION CK. M.O. cnsH _ PERMIT VALIDATION CK.' M.O. N CABH uaUo 3 9 4;:! . 22 2.8.50N WORKERS' COMPENSATION DECLARATION re affirm that I have certificate of consent to self P P L I CI TION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or4a certified copy thereof(Sec. 3800, Lab. C.) ` COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.—Company ,!'Vd1)t� BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESSS� Certified copy is fil d with the couq1ty building inspec- BUILDING / 7��C tion department. ADDRESS ST Date I` Applicant Z CITY '7,C-ofPCE C.-f 7-Y zip qlmv LOCALITY FEMPLE NO.OF BLDGS. NEAREST CERTIFICATE OF EXEMPTION FROM W RKERS' SIZE OF LOT NOW ON LOT CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL' ��q US ONE MAP _ OWNER �, _E'1 E( NO. Oa / I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS (p }7�tZSI 41 os.0`1� �, SPECIAL CONDITIONS CONDITIONS O so as to become subject to the Workers'Compensation Laws. Q�� V CITY -TE�L2 Lr- C lT y ZIP -1 Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE OCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. / j�// CON / ZONE /Exemption, you should become subject t the Workers' V ]j N U Compensation provisions of the Labor Code, you must forth- ADDRESS / (/ 0u'.. with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z 2� �J Z deemed revoked. CONTRACTOR NO.c� LICENSED CONTRACTORS DECLARATION LIC. r CLASS NO. 1. DWELL. UNITS — 'E.) hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS t sq�N NO.J Z SEWE MAP (commencing with Section 7000)of Division 3 of the Business �A- 1 q gv� LIC. and Professions Code,and my license is in full force and effect. CITY Gl-' AJ-1 E C14• /j 7JG CLASS -3 BK. VALIDATION �f `'r /� SQ. FT. NO. O NO. OF CHECK License Number -6 6 / ZSLAS� Lic. Class 2`_3 q SIZE STORIES FAMILIES ONE Contractor � Cs� WI• Date I `� LUATION DESCRIPTION OF WORK � }(Z,-()�Q- NEW ❑ $A `�..0� ADD ❑ /J ❑I am exempt under Sec. wOfun( IF ALTER ❑ B.BP.C. for this reason w I ug 4AsA03,WIMIA1 eO'U?' I REPAIR ❑ $ Date: USE OF EXISTING BLDG. St�wg DEMOL ❑ Signature APPLICANT TEL• FINAL OWNER- (PRINT) �• r �Z NO. DATE LDER DECLARATION ®p /� 1 hereby affirm that I am xempt from the Contractor's License ADDRESS L �IL�.tQ� �(, 01.91732 . Law for the following reason (Section 7031.5, Business and FI Professions Code): PRESENT y ACCTeirA ❑ 1, as owner of the property, or m employees with BUILDING P P Y� YADDRESS t:- '" wages as their sole compensation,will do the work and 1,307 50.3: the structure is not intended or offered for sale(Section LOCALITY ITEMS 7044, Business and Professions Code.) MOVING TEL. 1 ITEMS ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. TI�T�1. ��o�-;7 with licensed contractors to construct the project (Sec- ADDRESS 1 tion 7044, Business and Professions Code.) CHECK � ++ REQUIRED TOTAL SETBACK FROM EXIST. t J�evt CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH ,(Il? I hereby affirm that there is a construction lending agency for FRONT CHANGE the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE Lenders Name P.L. 0000-00301 11/ 3/29 q P.C. Fee$ Permit Fee 9, 3 Ref.# Lender's Address 6549 1 Aft 8:30 J f� I certify that I have read this application and state that the Issuance Fee ` v• O LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMA Perm. # ` and hereby authorize representatives of this County to enter ie b n prpopeerty,for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Applicant or Agent Date `� �• APPLICATION FOR BUILDING PERMIT � • ' ` COUNTY OF LOS ANGELES BUILDING AND SAFETY + WORKEdFOR APPLICANT TO FILL%IN BUILDING ADDRESS 'S COMPENSATION DECLARATION I her0by affirm that I have a certificate of consent to self Insure, BUILDING e� 1i"geph 0� or aasrtiTicete of Workers'Compensation Insurance,or a certified CI ZIP 1 copy thereof(Sec.3800,Lab.C.) �a @e �/)" LOCALIT�ven L C IL 1 a Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT Certified copy is hereby furnished. r NEAREST CROSS ST. ❑ Certified copy is filed with the count building Inspection TRACT BLOCK LOT NO. Y 9 USE ZONE MAP NO. department. ASSESSOR MAP BOOK PAGE PARCEL Date Applicant � SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER J � � % TEL NO.,__ WITHIN 1000 FT OF SCHOOL? YES NO COMPENSATION INSURANCE ADDRESS (This section need not be Completed if the permit is for one hundred 6 ��+ toDISTRICT GROUP TYPE CONST' FIRE INROCESS dollars($100)or less.) CITY jZIP i' I certify that in the performance of the work for which this permit 0'.- 12 l'm G If ��K �`� ! " Is issued, I shall not employ any person in any manner so as W ARCHITECT OR ENG EER TEL.NO. become subject to the WOrkere'C pensation Laws. 4^ STATISTICAL CLASSIFICATION APT CONDO Datepplicant ADDRESS CLASS NO. DWELL UNITS NO CE TO APPLICANT. If, after me in this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become sub t to the Workers' CON TEL.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 S 0 LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE D. I hereby affirm that I am licensed under provisions of Chapter 9 &x _.&_-,". SEWER MAP p (commencing with Section 7000)of Division 3 of the Business and SQ FT Q NO.OF ST RES .OF FAMILIES NEW ❑ BK PG ACCT°v O Professions Code, n is in full force and effect. Q DESC IQN F I 0 ADD VALVA ON `y� 3307 46 °l?,_� License Num r Lic.Class ��i Contractor CL'� 4 Data � p ALTER ❑ $ 1 ITEMS � p P.�Corouew REPAIR ❑ 9 TOTAL 462.06 ❑ I am exempt under Sec. l C)r B.BP.C.for this reason DEMOL ❑ LDMA Pic A i CHECK `62.ti D Date: USE OF EXISTING BLDG. E URM ❑ CHANGE Signature APPLI (PRI ) TE NO. LDMA Perm M ❑ I, as owner of the property, or my employees with wages as off" 6 mase!a � p their sole compensation,will do the work and the structure is ADDRESSd ,- ¢ ',�I /� F, [000--0001 4/24/9D not Intended or offered for sale (Section 7044, Business and 3-so L�p r ee,* Q a FINAL DATE pv A �i�a Professions Code.) WILLTHEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA HAZARDOUS MATERIAL �,� 59 El 1. as owner of the ro OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN -� 524 p party, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 3307 -7d'.. i. licensed contractors to construct the project (Section 7044, Business and Professions Code.) vEs❑ No( -- i ITEM'S WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH p �' s. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST 19 1 TOTAL FOR GUIDELINES. 13 ( r`Ii�°{,r r I hereby affirm that there is a construction lending agency for YES ElNo(k CHECK the performance of the work for which this permit is issued(Sea I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD CHANGE 3097,Civ.C.). PERMITTING CHECKLIST.1 UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE,TITLE 2,CHAPTER 22DSECTIONS 210.100THROUGH 2.20.140 CONCERNING z Lender's Name NAZAR REPOPO GAND ttjlaTAINING A PERMIT FROM THE SCAOMD. a Lender's Address owNmanAGwr r 030 I.30-0100316/11/91J o I certify that 1 have read this application and state that the above RC.FEE PERMIT FEE rj information is correct. 1 agree to comply with all county ° e �a ordinances and State laws relating to building construction,and `f' �i hereby authorize representatives of this County to enter upon ISSUANCE FEE p 7 th bove-mentioned erty��tion purposes.I ,3. 0 ,o ( x INVESTIGATION FEE TOTAL FEE�-�� /1 V J aAppO . omo d` SEE REVERSE FOR EXPLANATORY LANGIi t`aE