HomeMy Public PortalAbout5632 PERSIMMON AVE_Building__ 78A83Vq,CEN9D88;ea APPLICATION FOR BUILDI� G PERMIT
COUNTY OF LOS ANGELES BUILDING J n
DEPARTMENT OF COUNTY ENGINEER ADDRESS (9
BUILDING AND SAFETY DMSION LOCALITY 211
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
COLEMAN W. JENKINS,SUP'T.OF BUILDING CROSS ST.
DISTRICT N UP TYPE. -P
FOR APPLICANT TO FILL IN 212CONST.
BUILDING _ STATISTICAL CL SSIFICATION SE ER MAP
ADDRESSV
CLASS NO.��DWELL UNITS BK G
LOT NO. BLOCK USE ZONE MAP
TRACT A SPECIAL
NO. OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
E IS INC BLDG. BLDG. SETBACK FROM '
EL. FRONT PROP. LINE OF (STREET)
OWNER O. TYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADD SS `/ ' HIGHWAY WIDTH. �F OM'C.L.
CITY • s + O� -
ARCHI ECT OR TEL BLDG. 9ET ACK FROM
ENGINEER SIDE PROP. LINE OF (STREET)
TYPEOF EXISTING M SETBACK HIGHWAY + YARD = TOTAL
ADDRESS HIGHWAY WIDTH FROC.L. O}.
EL. /Q + = OU
CONTRALTO O
ADDRESS' LIC. CORNER CUTOFF YES El NO ElO
CITY i. LI ASS SEE REVERSE SIDE FOR SPECIAL APPROVALS v
W
DESCRIPTION OF WORK a
5.ag GS'- APersojea dlews is Q..eo!o z
NEW .40000' ADD ALTER ' REPAIR DEMOLISH
SQ.FT. NO. OF NO. OF tJ&s
SIZE STOR S FAMILIgj
USE OF I t-cn,
STRUCTURE �• 7'gw d..Cy�`llCfS 4'ti� ' ISR�s W�ar,�!'*•riC.
SI NA URE OF, Wli�r /9 -6.0 SiMS Xs '&I-f'oui
APPLICANT
VALUATION. ,�� �� �L f�Nb° b*4L�(Iel�{6�'i(!$h✓ ..:t
^/ , e, APPROVALS U DATE INSPECTOR'SSIGNATURE
FEE$ G"� FEE$ ��/� FO FORMSUNDAT,.MA!rERJALSLOCATION
FRAME, FIRE STOPS, \ /
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION BRACING BOLT I{
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION
WITHALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION. I CERTIFY THAT. IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. 1
TION OF THE'LABOR CODE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKMEN'S CnMPENSATION INSURANCE. r k /
LATH. EXT.
SIGNATURE OF HOUSE NUMBER 4
COR-• y Lr' ` ,1
PERMITTEE RE LAND POSTED /1 F Y� fJ {`�••
ADDRESS gega Tl NAL
JOHN F. LEWIS. PRINCIPALSC RAL ENGINEER
PLAN CHECK VALIDATION cK. . M.O. CASH _ PERMIT VALIDATION CK. M.O. CASH
�f tiuo 1 :1 55 3::, ;"ll'i 3 1 D
� I
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUIL?OG AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLI ANT TO FILL IN BUILDr4DJESS ��j
I hereby affirm that I have a certificate of consent to self insure, BUILDING, j5
VA
or a certificate of Workers'Compensation Insurance,or a certified �� l,YL O
copy thereo (Sec.3800,Lab.C.) SII -�/r"1� Y zIP
Policy No. Om5� Company5 •m-,• I LOCALITY;;--_-
4
SIZE OF LOTRawk NO.OF BLDGS.NOW ON LOT
❑ Certified copy is hereby furnished.
NEAREST CROSS ST.
I "
❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO.
department. C
�ei USE ZONE MAP NO.
Date G�s'Applicant '� 5�� ASSESSOR MAP BOOK PAGE PARCEL RI
ti 'I`�I SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' I TEL NO.
COMPENSATION INSURANCE I 6 e- WITHIN 1000 FT.OF SCHOOL? YES NO
(This section need not be completed if the permit is for one hundred ADDRESS �� "rn m DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY
I
dollars($100)or less.) [/D
I certify that in the performance of the work for which this permit I'e ZIP �• 3
is issued, I shall not employ any person in any manner so as to
become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO.
STATISTICAL CL�$fSfIFJCATION APT O
Date Applicant ADDRESS CLASS NO. LL DWELL UNITS
NOTICE 70 APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' NTRA R L NO. / SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith tier' eCIULI.j�I � 3� iS� FRONT
comply with such provisions or this permit shall be deemed revoked. 9 R SS ,/� f LIQ- PL P L
e4NCALICENSED CONTRACTORS DECLARATION / a Val • �T� " I7q/ SIDE
Y wi � LIC.CLA / PL
I hereby affirm that I am licensed underprovisions of Chapter 9 l SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and Q•F„• z NO.OF STORIES NO.OF FAMILIES
Professions Code,and m license is in full force and
/e�ffeet. NEW ❑ BK PG D}
License Nu be
Lic.Class - � DESCRIPTION OF WORK ADD ❑ VALUATION d , Q
Contractor Date h"�o'9'r �d ALTER ❑ U
❑ cc
I am exempt under Sec.
D REPAIR ❑ 1 O
B.&P.C.for this reason DEMOL ❑ LDMA P/C# ACCTog W
Date: I USE OF EXISTING BLDG. URM ❑ a C159 I 3303 188.10
Signature !CAW I , I EL LDMA Perm# 1 ITEMS Z
❑ I, as owner of the property, or my employees with wages as ` /'�J���� Z
their sole compensation, will do the work and the structure is AD E ° TOTAL 188 o JLCP
not intended or offered for sale (Section 7044, Business and y��- C� FINAL DATE a
Professions Code.) CHECK 188.10
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �'O•� J
❑ 1, as owner of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q
Y fa AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY 0 CHANGE .00
licensed contractors to construct the project (Section 7044, YES❑ NO❑
Business and Professions Code.) •
WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING �7 �y
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH 0004!—V0�1 10/10/95
CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR 0 00
GUIDELINES
I hereby affirm that there is a construction lending agency for YES❑ NO❑ 2693 1 AM 10"-16
W the performance Of the Work for Wf11Ch this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
N 3097,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.
oLender's Address
OWNER OR AGENT
O
o I certify that I have read this application and state under penalty
of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE /TO� t+1 O
N with all county ordinances and State laws relating to building ` v
m c truction,and hereby authorize representatives of this County ISSUANCE FEE 2`7
m to nter upon f?ab mentioned property for inspection purposes. I
a / TIGATION FEE TOTAL FEE p�
m
� ure of App6rinl a Cam ogre
SEE REVERSE FOR EXPLANATORY LANGUAGE
WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self I
insure, or.a certificate of Workers'Compensation Insurance, APPLICATION FOR BUILDING PERMIT
or o certified copy
(there of(Sec. 3800 b. C.) I COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. a s0Company r, —ft C_ r
- BUILDING
Certified copy is hereby furnished. '%•• FOR APPLICANT TO FILL IN ADDRESS ' fGy.�oL.
ertified copy is filed with the county building inspec- BUILDING ^� ,�A
urJ tion department. ADDRESS �` Mo LOCALITYe— ;Z NEAREST
i
Date E� Applicant CITY )� ZIP CROSS ST.
CERTIFICATE OF EXEMPTION FROM WORKERS' // NO.OF BLDGS. ASSESSOR
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL
(This section need not be completed if the permit is for one USE ZONE MAP
hundred dollars($100)or less.) TRACT BLOCK LOT NO. NO. SO
TEL. �-/ SPECIAL �
I certify that in the performance of the work for which this OWNER a NO. CONDITIONS !1.
permit is issued, I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PRO ED BY O
so as to become subject to the Workers'Compensation Laws. ADDRESS �� Z (�% '� CONST. ZONE i�e��
_ 7k2ZIP S 3
CITY !/ 3
Date Applicant • STATISTICAL CLASSIFICATION APT. CONDO. P_
NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL.
Exemption, you should become subject to' the Workers' ENGINEER NO. CLASS NO. DWELL. UNITS CL
Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP
with comply with such provisions or'this permit shall be —�-+ r
deemed revoked.. ' CONTRACTOR p�rj 6060 BK. �PG,/'� VALIDATION
LICENSED CONTRACTORS DECLARATION ol LK_.�,y.�
I hereby affirm that I am licensed under provisions of Chapter 9 . ADDRESS 5 'W W N�JbCJS VALUATION
(commencing with Section 7000)of Division 3 of the Business andLIC. iF^� $ ti-? �+y�
Professions Code, and my license is in full force and effect. CI7 L CLASS ®
SQ. FT. -?J NO.OF / NO.OF CHECK
License Number rLic.Class SIZE STONES / FAMILIES ONE
Contract o r ORK 4to — DES F , NEW ❑ $
I am exempt under Sec. -np44 I'l fo Q O ADD ❑
ALTER ❑ FINAL r.. 1
B.&P.C. for this reason REPAIR ❑ DATE '",
Date: USE OF • DEMOLr c_
EXISTING BLDG. IL� C] FINAL
Signature APPLICANT
PRINT L BY �� �.
C uSL NO.� d
OWNER-BUILDER DECLARATION //��
I hereby affirm that I am exempt from the Contractor's License ADDRESS WfJ01) Cs>tl46
Law for the following reason,(Section 7031.5, Business and
Professions Code): PRE ENT
El
BUILDING
I, as owner of the property, or my employees with ADDRESS '
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY 7463 A
7044, Business and Professions Code). MOVING TEL.
I,as owner of the property,am exclusively contracting CONTRACTOR NO. # 0 0 as o 0 1
with licensed contractors to construct the project (Sec- ADDRESS 2'- 178.0 0
tion 7044, Business and Professions Code).
REQUIRED TOTAL SETBACK FROM EXIST. s
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH ® ° ° 117 S,0 0
I hereby.offirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P.L. .1 1.09-82
Sec. 3097, Civ. C.). SIDE
0
P.L.
Lender's Name / �f
P.C.Fee$ Permit Fee G [ 1 If d
Lender's Address
c I certify that I have read this application and state that the Issuance Fee O �d
above.information is correct. I agree to comply with all County Investigation Fee p
ordinances and State laws relating to building construction, Total Fee 7d ` d d
y and hereby authorize representatives of this County to enter
ii upon the above-menfloned prop y for�ction purposes.
r�- SEE REVERSE FOR EXPLANATORY.LANGUAGE
Signature of Applicant or Agent Date ®s
i
APPLICATION FOR BUILDING PERMIT
i COUNTY OF LOS ANGELES BUILD G AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLI ANT TO FILL IN BUILDI D Ess lol
I hereby affirm that I have a certificate of consent to self insure, BUILDINC;A�[ E _? n
or a certificate of Workers'Compensation Insurance,or a certified fur O
in
copy thereo (Sec.3800,Lab.C.) S -f/�� -epY 1 ZIP
Policy.. O5�6 Company � •� 4, LOCALITY
SIZE OF LOT 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. C,n /- - USE ZONE MAP NO.
Date 6`iS Applicant 4 ® Sd-tir ASSESSOR MAP BOOK PAGE PARCEL
I'1 1 SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' 491VAIrpTEL NO.
COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES No
(This section need not be completed if the permit is for one hundred ADDR S
DD '�Y �• 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 I'Q ZIP ��
is issued, I shall not employ any person in any manner so as to
36
become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO.
eff44r
STATISTICAL CI-6SIFICATION APT Nod
Date Applicant ADDRESS CLASS NO. DWELL UNITS
NOTICE TO APPLICANT.• If, after making this Certificate of I REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' NTRA R / L NO. r SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code, you must forthwith �' [�(CVV�TI /�3� 6t/ FRONT
comply with such provisions or this permit shall be deemed revoked. gYgRgSsa VQ r , uC,n��7�/ PL
LICENSED CONTRACTORS DECLARATION l 1 l' ,S/`� SIDE
uc.cLA� PL
I hereby affirm that I am licensed underprovisions of Chapter 9 I44D iJl! li
(commencing with Section 7000)of Division 3 of the Business and Zf NO.OF STORIES NO.OF FAMILIES SEWER MAP
Professions Code,and m i license is in full force and fect. [J NEW ❑ BK PG , a
License Nu ber 4l Lic.Class C/ Z DES RIPTION OF WORK ADD ❑ VALUA ON O
Contractor Date�� ��-4 r ��h 1 6G U
ALTER ❑
cc
ElI am exempt under Sec. REPAIR 11 $ 1 0
BAP.C.for this reason DEMOL ❑ LDMA PTC# ACCT.$ W
Date: i USE OF EXISTING BLDG. URM ❑ 3303 1$$.10 co
I 1 L U0 2 LDMA Perm# Z
AtTI
❑ I, as owner of the property, or my employees with wages as Z 1 ITEMS
their sole compensation, will do the work and the structure is [ANDE FTOTAL '188® 10
not intended or offered for sale (Section 7044, Business and �a- C�► FINAL DATE Q
Professions Code.) I 10' 9 Oil.CHECK 188.10
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL (�(�
❑ 1, as owner Of theproperty, am exclusive) contracting With OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE FINAL BY > CHANGE DLIV
Y 9 I AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE?
licensed contractors to construct the project (Section 7044, YES❑ NO❑
Business and Professions Code.) L4�
WILL THE INTENDED USE OF THE BUIDUNG BY THE APPLICANT OR FUTURE BUILDING
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH (y (�
CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR 0000-0001 10/10/95
GUIDELINES
I hereby affirm that there is a construction lending agency for YES❑ NO❑ 2693 1 AM 10 a 16
a the performance Of the work for which this permit IS ISSUed(SBC. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING
N 3097,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
iLender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD.
o Lender's Address
0 OWNER ON nOENT
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 /60
truction,and hereby authorize representatives of this County ISSUANCE FEE O
ato nter upon �ab ve-mentioned property for inspJection purp000ses.
m It / ff INVESTIGATION FEE TOTAL FEE O� O
uoa a M��a nam I1yo V
l SEE REVERSE FOR EXPLANATORY LANGUAGE
YORKERS' COMPENSATION.DECLARATION
ea affirm that I have a.certificate of consent to self g p p L l CAT I O N FOR - BUILDING P E RM I T
inure, or a certificate of Workers' Compensation Insurance,
or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
01T4
Poli@yS'oc' .^ Company �ti �� ✓
❑ - Certified copy is hereby furnished. FOR APPLICANT TO FILL IN\ BUILDING r
ADDRE _? � 04/
CeVLfied copy is filed with the county building inspec- BUILDING
,P tion,aeep&±pent. p ADDRESS A� ' N .
D,-+ ''. €sn'/.Z APPlican6 � � �Yr . �P QTY ,ice CP ZIP LOCALITY
NO. OF BLDGS. NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT;4Xq se t FA 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 ($100)or less.) OWNER TEL.
H MAP Q 7
I certify that in the performance of the work for which this Yr-- NO, US ONE NO.
permit is issued, I shall not employ any person in any manner ADDRESS✓ f 6 _ SPECIAL
O
�p CONDITIONS
so as to become subject to the Workers'Compensation Laws. CITY —/ f'� �'j}'}`� ZIP U
Date Applicant ARCHITECT OR " TEL DISTRICT G UP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. / CONST. ZONE
Exemption, you should become subject to
the•Workers- \ �� -_.3 �j . C"
Compensation provisions of.the Labor Code, you must forth- ADDRESS J J 03CL
with comply with such.-provisions or this permit shall be jj^^�� a " TEL. ) !,�® STATISTICAL C SLS IFIOATION APT. CONDO. Z
deemed revoked. CONTRACTORfO/ lz 1 +� NO. g _
LICENSED CONTRACTORS DECLARATION ' • • s• , + r/ CLASS NO. _DWELL. UNITS
I hereby affirm that lam licensed under provisions of Chapter 9 'Rai rS/I'}'•44 A'A&? 24/A5X SEWER P
(commencing with Section 7000)of Division 3 of-the Business /" .✓ 1 ' LIC.
and Professions Code,and my license is in full force and effec,L, �L Cir f 0 4- CLASS VALIDATION
License Numbe Lic;.`Class yr _}-�l:$i� ET�„ TORIIEES/A�� p AAMILLIIES h �ONE
K BK. PG.
7 i� d7��� .�� N �/� `lN� l SALVATION
Contra tar a pate DESCRIPTION OF WORK ❑ ®��
❑I am exempt under Sec.— .* Q V�A "G—S ADD ►
ALTER
B.&P.C. for this reason . ` ` JR $
USE OF '_ �r REPAIR
Date: EXISTING BLDG. ��• DEMOL ❑
Signature APPLICANT r „ TEL. /� qEy FINAL
OWNER-BUILDER DECLARATION. PRIN t�Ipt� NO. •J Cn 7
/�, �/ _ DAT
I hereby affirm that I am exempt from the Contractor's License ADDRE fl1 / S'�' `� /Q ��//ey� '
Law for the following reason.(Section 7031.5, Business and 0 FI 1
Professions Code): -.• PRESENT
❑ I, as owner of the ro ert or my, employees with BUILDING ACCTe4
P P Y� ADDRESS ,
wages as their sole compensation,-will do the work and LOCALITY ? 11 0
the structure is not intended or offered for sale(Section Pilo
50
7044, Business and Professions Code.) ' MOVING TEL. 1 IT
❑ I,as owner of the property,am exclusively.contracting CONTRACTOR NO. Tri I
EM
with licensed contractors to construct the.project (Sec- ADDRESS TOTAL 115.50
tion 7044, Business and Professions Code.) �+t���+�)
REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. CHECK 115°50
-CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT coo
the performance of the work for which this permit is issued P•L•
(Sec. 3097, Civ. C.). SIDE.
1y3 j �'" P.L. 0000-0041 6/20/89
Lender's Name u`o e a 1�. i— /
LDMA P.C.,Fee$ Permit Fee / O Ref. # 4478 1 AN11:05
' Lender's Address _ '
I certify that I have read this application and state that the Issuance Fee - LDMA P/.0#
above information is'correct. I agree to comply with all County Investigation.Fee JT
�/"
ordinances and State laws relat�g to building construction, Total Fee / LDMA Perm. #
and hereby authori ped r'"esar t' ves of this County to enter
gupo a bove- nti ed •r pe for inspection pur�proses. ^
01
dj jj ` s� �,� SEE REVERSE FOR EXPLANATORY LANGUAGE
t"` SignaftSFe` f'Ap li t or Agent D�ate
P.
moo ;
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ,ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0103020003
PHONE: (626) 285-0488 EXT:
—]LEGAL—ID : - NO. OF CONSTDIN ADDRESS:
TR: 13935 LT: 31 I - SQ. FT - STORIES TYPE 5632 PERSIMMON AV
STRUCTURE: N/A TEMP CA 917802808
ASSESSOR INFOR14ATION NUMBER: NEAREST CROSS STREET: LAS TUNAS
8573-010-007 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY
TgNANT: EXIST BLDG S RESID USE 0 S D 0 - PROCESSED PIRES 0 :
EXIST OCC GRP: 03/06/01 LS 09/02/01
OWNER: TEL. 0: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FIN L Y: CODE:
STANLEY JOHN A JR;ELSIE L (626) 446-0543- 1 4,900 /
5632 PERSIMMON AV 5'�(
TEMP 917802808 FEES RA D—- - DESCRIPTIONOFWORK
-- -_ INSTALLATION OF ROOFMOUNTED SOLAR ELECTRIC PANELS
FEE DESCRIPTION: ,•QUANT1,TX'-lUOM:?AJ-9r+-AMOUNT,:
SOLAR WEBB INC (626) 447-9710- AA BLDG PERMIT ISSUANCE'`-<>b ,1 1 f r"1' 27.75> >�•
136 E SANTA CLARA AC STRONG MOTION RESID�'e,-."v 900•.00 VAL= !I Oe SPECIA CONDITIONS:
ARCADIA CA 91006 AX BUILDING REVIEWoFEE )�r;;;;_-_ �; 1 I 54.70"- \\'�s
D2 PERMIT W/0 EN-HC'� '14900�A0%VAL_i 132.60 \ ��
TOTAL-',:FEES' 215.55
CONTRACTOR: TEL. N0: �•,� `I;,`- , L-' APPROVALS DATE INSPECTOR SIGNATURE
SOLAR WEBS, INC. (626) 447-9710- \ '1�'c
136 E. SANTA CLARA, STE 6 LIC. NO --_-------- - ------ -.-----.-LOCAT-ION ANDST C S
ARCADIA, CA 91006 649147010 - :-- --, I
SOILS -ENGINEER APPROVAL
ARCHITECT OR G TE 0: FOU DATION/TRE CH FORMS
LIC. NO: r�`'Ii 'LLLIIIL'I ; I — SLAB%UNDER±FLOOR
-'� RAISED'FLOOR FRAMING
' I �
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDER
/90R INSU[AflOff
150H273 3 01 y�• �'� I / r
FLOOR' SHEATHING
0. OF FAMILIES: E G ITS: A T/COND: STAT
CLAS- •,•\'. ��r�r' � �'.'
NO 21 ��y� ` ROOF SHEATHING
SCHOOL HAZARDOUS
AIR QUALITY: 10000 FEET HI MATERIALS
`i 3 I c}C 'd S RMPA ELS
NO NO NO �� _ FRAME INSPECTION
REQUIRED- TOTAL SETBACK FROM EXIST IRE S R KL R HANGERS
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRIP
SIDE PL-
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOORICEIL ASSEM.
RATED WALL ASSEMBLIES
TED S AFS OPE GS
r I T-BAR CEILINGS
T DRAINAGE
I
REPORT ID: DPR261 ROUTE TO: BSO508