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HomeMy Public PortalAbout5551 PERSIMMON AVE_Building__ ®s 7GA638A '! CE/803,REV.6/78) APPLICATIO FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDINGS ADDRESS j BUILDING ADDRESS LOCALITY ti NEAREST CITY 1 ZIP CROSS ST. -bWOF BLDGS. ` ASSESSOR SIZE OF LOT.6-7,-L L W ON LOT MAP BOOK PAGE PARCEL r— DISTRICT �GROUPY TPE FIRE PRO ESSED BY TRACT —3 BLOCK LOT NO. �l✓S _� CONST.-V Z—OyE T EL. OWNER , r r _I STATISTICAL CLASSIFICATION SEWER MAP ADDRESS Smcoon, CLASS NO. DWELL.UNITS � BK6 PG CITY !�,Y1'l �� ZIP ARCHITECT OR I TEL. VALUATION $ ��JJ h ENGINEER NO. t?G� v 6 O ADDRESS BLDG.SETBACK FROM CONTRACTOR �{�j� ]'� '�N� _/„j,�` FRONT PROP.LINE OF (STREET) ~su+ HIGHWAY + YARDTOTAL SETBACK FROM I TYPE OF EXISTING LIC. - FRONT PROP.LINE HIGHWAY WIDTH ADDRESS E. l r{ NC -3 LIC. + CITY ("J, C CLASS CONSTRUCTION LENDE BLDG.SETBACK FROM NAME AND BRANCH �i urdtl1 SIDE PROP.LINE OF (STREET) �pc''� TOTAL SETBACK FROM TYPE OF EXISTING � ADDRESS I V�y rc�TYBwcl' • Enck ,O HIGHWAY + YARD = SIDE PROP.LINE HIGHWAY WIDTH SQ.FT. NO.OF NO.OF CHECK + _ i3 SIZE d STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ❑ P.C.Fee$ Permit Fee --2 3 Y- frG�L�yy\. ADD ❑ Issuance Fee j IALTER {\, REPAIR ❑ Total Fee USE OF DEMOL ❑ I� _.._� EXISTING BLDG. - � � ��i�yr C APPLICANTTEL (PRINT) vi )G��Q sJ CJ j yer BY ISIGNATUREl I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE Y THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES AND LAWS REGULATING BUILDINGCONSTRU ION.I CERTIFY THAT IN DOING THE Z WORK AUTHORIZED HEREBY I WILL NOT EM Y Y PERSON IN VIOLATION OF L.7 THE LABOR CODE F THE TATE OF CALIFORNI I E TING TO WORKMEN'S COM- Z 6 951-- A PENSATION INSU CE. g IL tf SIGNATURE OF PERMITTEE P o 12 (L 1,0 0 ADDRESS ' �[?1-3 TEL. g67•G�,�� g o n 2 61 1,v 0 CITY ~ USE ZONE MAP - Q I Q C 1 —7 y fr NO. > `- SPECIAL CONDITIONS FINAL 9 2 �, t BY DATEI 'r+,7 r r —�•..) IF" �i WORKERS'COMPENSATION DECLARATION herebyaffirm aa certificate of Workers'Compensation Insurance,self APPLICATION FOR BUILDING PERMIT Il or p certified copy thereof(Sec. 3800, Lab. C.)` COUNTY OF LOS ANGELES BUILDING AND SAFETY L Pol' N ig Company � BUILDING p � Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ��MMod ❑ Certified copy is filed with the county building inspec- BUILDING tion depar ent. ADDRESS ) !�- /��j'`v -72511/ LOCALITY .?—, Cwt Q �+� NEAREST Date —2r o Applicant CITY , L ZIP CROSS ST. CERT[ICATE OF EXEMPTI FROM KERS' O.OF BLDGS. ASSESSOR COMPENSATION INSURANCK SIZE OF LOT V NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP �O (�� hundred dollars($100)or less.) TRACT BLOCK LOT NO. SPE 41 SPECIAL I certify that in the performance of the work for which this OWNER .vr j^ /fC j e CONDITIONS IL permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY 0 so m to become subject of the Workers'Compensation Laws. �� ADDRESS ;11476 �, e(..1 CONST. ZONE U . O Im Date Applicant CITY Ol YYl ZIP 2 STATISTI ALCLASSIFICATION APT. CONDO. U NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. s� Exemption, you should become subject to the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS Q. Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP with comply with such provisions or this permit shall be pp deemed revoked. CONTRACTOR 1- V����« G��`�� cBK PG, VALIDATION LICENSED CONTRACTORS DECLARATION G� IC. �+3 ©�� 1 hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS Q 3 , /lY/i�( NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and i LIC• G .p a Professions Code, and my license is in full force and effect. CITY R0Lc)J* , Es• CLASS $ 3CG , SQ.FT. NO.OF NO.OF CHECK License Number ,y 313'3 V .2- Lic�.�C_lajss Is SIZE- STORIES FAMILIES ONE Contractor PRt R E— C"�Date C-0 �fESCRIPTION O WORK ,�:.. NEW $ ADD ❑I am exempt under Sec. ` FINAL ALTER ❑ DA E ' B.BP.C. for this reason REPAIR ❑ I USE OF FINAL Date: EXISTING BLDG. DEMOL ❑ By Signature — APPLICANT TEL. OVAIER-BUI R DECLARATION PRINT NO. I hereby affirm that I am a empt from the Contractor's License 00 Law for the following reason (Section 7031.5, Business and ADDRESS Professions Code): PRESENT 4 5,5 A ❑ BUILDING 1, as owner of the property, or my employees with ADDRESS ' c o 0 0 0 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 o a 5 D E C ❑ I,as owner of the property,am exclusively contracting CONTRACTOR NO. ` " 5 .,Q m with licensed contractors to construct the project (Sec- ADDRESS ? 2 tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY 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. tSec. 3097, Civ. C.). SIDE 6 P.L. P Lender's Name 3 P.C.Fee$ Permit Fee Lender's Address rI certify that I'have read this application and state that the Issuance Fee above information is correct.I agree to complywith.all County Investigation Fee ordinances and Stcte.ldws relating•to'buiildin,g constructiori, a nd hereby authorize representatives of this Courity to enter Total Fee, upon the above-mentioned property,for inspection'purposes. /��'�Ag.nl SEE REVERSE FOR EXPLANATORY LANGUAGE /`/ Signature o Appllw47 Oafs es i COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9807070047 PHONE: (818) 285-0488 EXT: LEGAL D: NO. OF CONST BUILDING ADDRESS: TR: 13613 LT: 141 SQ. FT STORIES TYPE 5551 PERSIMMON AV STRUCTURE: 0 VN TEMP CA 917802807 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 8573-002-004 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R- ISS TE-DO N: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 07/07/98 UT 07/07/99 OWNER: TEL. NO: 'BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: 5CHAN LET 551 PERSIMMONEAV (213) 627-2372- 1 2,500 TEMP 917802807 FEES PAID UESC IFT40N OF WOW REMOVE/RECOVER WITH PLYWOOD AND 20 YR. GAF COMP. SHINGLE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: BROTHER'S ROOFING (213) 732-2700- AA BLDG PERMIT ISSUANCE 27.75 2418 W. WASHINGTON AC STRONG MOTION RESID 2500.00 VAL 0.50 SPECIAL CONDITIONS: LOS ANGELES, CA D2 PERMIT W/O-EN-HC- 2500.00 VAL 99.00 ;TOTAL FEES 127.25 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE BROTHERS ROOFING CO. (213) 732-2700- = ' 2418 W. WASHINGTON BLVD. LIC. NO `• ,� LOCATION AND SETBACKS LOS ANGELES, CA 90018 C39 * 3• . _ `. , SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEE L. NO: FOUNDATIONPRENCH FORMS LIC. N0: I -� SLAB/UNDER FLOOR - RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 150H273 3 01 FLOOR SHEATHING 0. OF FAMILIES: DWELLING UN S: APT/CO D: STAT CLASS: _ NO 21 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO "� FRAME INSPECTION REQUIRED 0 L SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: - FRONT PL- INSULATION/WEATHER STRIP SIDE PL- v _ _ - - -_ - ' NTERIO L T DRYWALL EXTERIOR LATH RATED LOOR/C IL ASSE . RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS * ADDITIONAL DATA ON FILE ' LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 v