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HomeMy Public PortalAbout5645 PERSIMMON AVE_Building__ TEMPLE tlTY N e 70AG38A CE 8081-82 APPLICATION FOREUILDING PERMIT COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS �,�-,,�. BUILDING AND SAFETY DMSION LOCALITY f JOHN A. LAMBIE. COUNTY,ENGINEER NEAREST C WILLIAM A.•JENSEN, SUPT OF BUILDING CROSS ST. ;DISTRICT N . G P TYPE P SSED BY FOR APPLICANT TO FILL IN CONsr. ' BUILDING �Jv� d.STATISTICAL CLASSIFICATION SE ER MAP ADDRESSh/ BK yPG CLASS.NO. DWELL.UNITS J LOT NO. �' BLOCK WATER CERTIFICATE: NOT REQUIREDlz RECEIVED TRACT MAP HIGHWAY STATE MAJOR SECOND, CA J NO.OF BL.DGS. _ .NO. (CIRCLE) SIZE OF LOT 60 ,K160 NOW ON LOT ` .USE ZONE SPECIAL USEOF EXISTING LE TTING BLDG. r .,VA!? CONDITIONS TEL. OWNER QS (,, NO. BUIL G YARD HWY STREET NAME EXIST. ` _ M� 'SETBACK WIDTH ADDRESS %�7. `�MQ�a FRONT ARCHITECT OR- TEL. P• L ENGINEER (f O+LJLC NO. SIDE ' P. L. a ADDRESS V TEL I CONTRACTOR '��G NO. `7 ? s�� n � � ADDRESS DESCRIPTION OF WORK W . / Le iNEW 1/ ADD ALTER REPAIR DEMOLISHi•�•;j_ %i9 r�. ^� � '^•. SQ.FT. NO:OF' NO.OF r•: `'SS°'1r _n 6..• SIZE STORIES FAMILIES USE OF STRUCTURE EZ7— °'"." `;�`✓rrs`' ! L— SIGNATURE OF APPLICANT VALUATION r� APPROVALS DATE r jpPECTO_t+§SIGNATURE P.C. ".FEE $ FOUNDATION: LOCATION FEE $ FORMS. MATERIALS s FRAME: FIRE STOPS, • I.HEREBY ACKNOWLEDGE THAT 1 HAVE'READ THIS APPLICATION ) BRACING. BOLTS AND STATE THAT THE ABOVE IS CORRECT AND-AGREE TO COMPLY_'• FURNACE: LOCATION, 'j WITH ALL COUNTY ORDINANCES AND STATE LAWS 'REGULATI.NG GAS VENT, DUCTS. BUILDING CONSTRUCTION. I CERTIFY THAT IN DOING THE WORIC' AUTHORIZED HEREBY I WILL NOT EMPLOY ANY..PERSON IN'VIOLA--'ti LATHINT. TION OF THE LABOR CODE-OF THE STATE OF CALIFORNIA,R ,ELAT. I $' e ING TO WORKMEN'S CO NS ON INSURAN LATH,EXT. - ''•V ` SIGNATUE OF C HOUSE NUM RBER COR- PERMITTEE1 RECT AND POSTED ADDRESS oa p' 'FINAL JOHN F. LEWIS, PRINCIPAL ST - URAL ENGINEER PLAN CHECK VALIDATION CK. M.D. CASH `_ PERMIT VALIDATION �CK. M.D. CASH 76AS36ACE'a8092-69 APPLICATION FOR-BU'ILDING.-PER•MIT ' COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER.— ADDRESS BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE, COUNTY ENGINEER NEAREST WILLIAM A.JENSEN,SUPT OF BUILDING CROSS ST. DISTRICT O. GROUP TYPE P r SSED BY FOR APPLICANT TO. FILL IN'-."' d CONST. BUILDING - 'STATISTICAL CLASSIFICATION SE ER MAP ADDRESS AIL . ' CLASS.,No. DWELL.UNITS�•/`. K F LOT NO. 20 BLOCK WATER N.OT REQUIRED',IM.. RECEIVED ❑ CERTIFICATE:. L� TRACT MAPq d e O HIGHWAY- STATE MAJOR SECOND,L CA NO:OF BLDGS. NO.OPV (CIRCLE)"•'" SIZE OF LOT NOW.ON LOT USE ZONESPECIAL' USE OF a g -CONDITIONS EXISTING BLDG. A EL. i OWNER g O. BUIL NG YARD HWY STREET NAME EXIST. SETBACK WIDTH ADDRESS FRONT cy pJ ARCHITECT OR TEL. P..L. ENGINEER NO. SIDE ADDRESS P L CONTRACTOR TEL. :� �,� '+9 ADDRESS DESCRIPTION OF WORK w NEW ADD ALTER EPAIR DEMOLISH r�rk � if N r �+ 1, Z SQ.FT. NO.OF NO. OF SIZE STORIES I ',FAMILIES USE OF STRUCTURE SIGNATURE OF , APPLICANT VALUATION $ es � - APPROVALS P.AT91 INSPECTOR_*SIGNAVBE P.C. PMT. FOUNDATION: LOCATION FEE $ ^� FEE $ . FORMS, MATERIALS FRAME: FIRE•STOPS, G R:��tI ••_�/ +�+s/ 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS ,1,.�+ /F•/[} G'J..,! •"�' J AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION. WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING '-GAS VENT, DUCTS aj BUILDING CONSTRUCTION. 1 CERTIFY THAT.IN DOING THE WORK J AUTHORIZED,HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH. INT. ,jr •!' TION OF THE LABOR CODE OF THE STATE OF ORNIA R A _ ING TO WORKMEN'S CO SA N N URA LATH, EXT. f ', SIGNATURE OF HOUSE NUMBER COR- PERMITTEE. kECT AND POSTED ADDRESS ,FINAL JOHN F. LEWIS. PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH' ' _ PERMIT VALIDATION CK. / M.O. CASH 3 3 J�;L3 '- �' -v APPLICATION FOR GAG"`-- COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT . BUILDING AND SAFETY DIVISION BUILDING FOR APPLICANT TO FILL IN ADDRESS — � BUILDING pp /may ADDRESS G MO/v Ad LOCALITY CITY / Cj`� Zip �! �f��! NEAREST CROSS ST. / O.OF BLOGS. 9 ASSESSOR SIZE OF LOT b0g, NOW ON LOT Bim./ MAP BOOK PAGE PARC L DISTRICT GROUP ITYPE FIRE P OC ED BY TRACTr" 3'- B�L9OCK ����++�� LOT NO. O OWNERAmes Wi RpI�L?yiNOL ��9 STATISTICAL CLASSIFICATION ]LIPIWE�MAP ADDRESS j fir-lij"�?na,. c CLASS NOT" OWELL,UNITS BKISPG 4� /� � 'USE ZONE MAP ° ��••�1 CITY ZIP [ I ) NO. �Q V ARCHITECT O TEL. / SPECIAL ENGINEER NO. CONDITIONS ADDRESS �r ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTOR TEL.' BLDG.SETBACK FROM NO FRONT PROP.LINE OF (STREET) LIC— ADDRESS IC—ADDRESS NO. HIGHWAY + YARD - TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP. LINE HIGHWAY WIDTH CITY r_ CLASS _ CONSTRUCTION LENDER + NAME AND BRANCH BLDG.SETBACK FROM ADDRESS CITY SIDE PROP.LINE OF (STREET) C a SQ, FT. NO. OF NO. OF. CHECK HIGHWAY + YARD = TOTAL BACK FROM TYPE OF EXISTING O STORIES FAMILIES ONE Si PR LINE HIGHWAY WIDTH I-- SIZE DESCRIPTION OF WORK 13jgC_r NEW + FL FL ADD ❑ CORNER CUTOFF YES ❑ NO ❑ Z avvi-v ve' 1-�` 6 ` 60' ALTER ❑ IN OPEN SPACE YES ❑ NO ❑ REPAIR[] USE OF .mom DEMOL ❑ IN COASTAL PER ZONE YES ❑ NO ❑ EXISTING BLDG, j n�� y/yy �/ APPEL LICANT QJ�/'11T�1V.V�11 NO- 1 l- BY (SIGNATURE) t 1 HEREBY ACKN W GE THAT I HAVE MEAD THI PLICATION AND STATETHAT THE ABOVE IS.CORRECT ANDA TO COMPLY WITH ALL .ORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION. I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORN IN RELA ING TO WORKMEN'S COMPENSA N INSURANCE. •��, SIGNATURE OF i FINAL 'r°� "` 1 �7' BY ; Is;:�' ,., PERMITTEE DATE J e ADDRESS TEL CITY p,C. Fee$ Permit Fee / NO. Issuance Fee VALUATION O I Total Fee \ PLAN CHECK VALIDATION CK. M.O. CASH o PERMIT VALIDATION K. M.O. CASH I � I O - j 75211.8FER 1 76AG38A CIE#8033 12/75 FBASSSA CE#SDS B_63 APPLICATION FOR BUILDING PER IT 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. DIST5fT NO GROUP TYPE PR C S ,B FOR APPLICANT TO FILL IN \ CONST. BUILDING STATISTICAL GLA ]CATION SEWER MAP ADDRESS P B [ CL4`SS:.NO. DWELL.UNITS J LOT NO.. Z v BLOCK WATER J q CERTIFICATE; HIGHWAY REQUIRED RECEIVED TRACT / / S NO. J 'V (CIRCLE) STLLLATJJIE MAJOR SECOND. CAL ' NO.OF BLDGS. SIZE OF LOT NOW ON LOT USE ZONE SPECIAL USE OFCONDITIONS EXISTING BLDG. OWNER /�r��' &POU�Y,ff71DAll. NO. BUILDING EXIST. • �! �^ SETBACK YARD HWY STREET NAME WIDTH �' ADDRESS N XA y/ m v /lvZ � /;�7 FRONT ARCHITECT OR TEL._ P. I ENGINEER NO. SIDE ���gg P. L. ADDRESS �1JT• TEL. , a'ZD `-NI FO 0 LQiV&0_ C CONTRACTOR NO. U ADDRESS ' Qj Iso. .C..Piit^S" a'• tX•`'(���rl-Q,tF.'� dCC • � If 0 DESCRIPTION OF ..J NEW !//" ADD ALTER PAIR DEMOLISH _ z SQ.FT. NO. F NO OF Z �9 j FAMILIES SIZE �/����/ T IES � USE OF STRUCTURE ,� I r r GNATURE O c /: APPLICANT VALUATION $ y` APPROVALS DATE SPECTOR'S SIGNATURE P.C. PMTFOUNDATION: LOCATION FEy� FEE $ / FORMS,.MATERIALS - FRAME: FIRE STOPS, rr 1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING. BOLTS ,rt / � EeLQ.ASA fin AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION— WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING GAS VENT, DUCTS BUILDING CONSTRUCTION. I .CERTIFY THAT IN DOING THE WORK � f} AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA- LATH, INT. 16 :wt9J.+Lt..�:41t_ TION OF THE LABOR CODE OF THE STATE OF CALIFORNIA RELAT- ING TO WORKMEN'S COMP SATION INS NCE LATH.EXT. 711 W SIGNATURE OF HOUSE NUMBER COR- PERMITTEE i ///���!!!/// RECT AND POSTED ADDRESS S- fir?� FINAL .' JOHN F. LEWIS. PRINCIPAL ST7CK./ RAL ENGINEERPLAN CHECK VALIDATION cK. M.o. CASH PERMIT VALIDATION M.0. GASH L.7 9 3 4- JAN2 7 1 D 1 .5,00, b ' 76A638ACE98032-63 APPLICATION FOR BUILDING PERMIT - COUNTY OF LOS ANGELES BUILDING. DEPARTMENT OF COUNTY ENGINEER ADDRESS ) BUILDING AND SAFETY DIVISION LOCALITY JOHN A. LAMBIE. COUNTY ENGINEER NEAREST WILLIAM A.JENSEN. SUPT OF BUILDING CROSS ST. .(,B DIST ICT NO. GROUPTYPE P SSED BY FOR APPLICANT TO FILL IN CONST. 0 BUILDING STATISTICAL CLASSIFICATION SE ER MAP ADDRESS �/�S I V CLASS. NO. DWELL.UNITS--- �K LOT NO. �-O BLOCK WATER NOT REQUIRED LA RECEIVED ❑ p CERTIFICATE:- BLDGS. TRACT 3 7 3 5 NO.pI j HIGHWAY HWA STATE MAJOR SECOND, OCA NO.OF / SIZE OF LOT Q () NOW ON LOT USE ZONE SPECIAL USE,OF CONDITIONS EXISTING BLDG. e �� 4 e— ll�� OWNER TEL. �/ Q hT(Fk70. 370 BUILDING EXIST. SETBACK YARD HWY STREET NAME WIDTH ADDRESS O7 •S^ '%'"� X011- V FRONT ARCHITECT OR TEL. P• L. ENGINEER d-?l Q__ NO. �� SIDE a P. L. ADDRESS 0 TEL.`) CONTRACTOR v 4 j-/= I � ADDRESS DESCRIPTION OF WORK o6J. I N NEW i-- ADD ALTER REPAIR DEMOLISH SQ.FT. 11 NO.OF NO. OF //'' SIZE V 6 STORIES f FAMILIES/�71 USE OF STRUCTURE r ('� TO e.d orii 3AvP SIGNATUREOF APPLICANT VALUATION $ /QO o• APPROVALS DATE INSPECTOR'S GNATURE FOUNDATION: LOCATION / F E $ FEE $ �— FORMS. MATERIALS FRAME: FIRE STOPS, Q I 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. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY 1 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 OF / HOUSE NUMBER COR- PERMITTEE U wwci RECT AND POSTED ADDRESS, FINAL /—Z7-&5 JOHN F. LEWIS. PRINCIPAL ST URAL ENGINEER PLAN CHECK VALIDATION CK. M.G. CASH _ PERMIT VALIDATION GK. M.O. CASH Lito a 3 2 5%G i'lAY "_I_ 1 D 8.G Q N '\vv'_ ='APPLICATION FOR ,BUILDING PERMIT FOR APPLICANT TO.VI.LL IN (Print or'tYpe only) FSIZE'OF LDING. s•' �� COUNTY OF LOS ANGELES RESS DEPARTMENT OF COUNTY ENGINEER Cj zlP a�� BUILDING AND SAFE Y DIVISION NO.OF BLDGS. BUILDING /-/I- L ^/L LOT NOW ON LOT ADDRESS) (rj TRACT I.3%3S' BLOCKZ99'�'�� LOT NO. ZLOCALITY TEL. NEAREST OWNER v NO. CRosS'ST. ASSESSOR ADDRESS S S MAP BOOK PAGERCEL- DISTRICT GROUP TYPE ' FIR PROC SSED BY CITY i4ms ZIP -77CONST. ZO E ! ARCHITECT OR TEL. �1/ ENGINEER O• STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS nil DWELL.UNITS BK PG TEL. �' CONTRACTOR NO �' ZONE MA No _, `� LIC. ADDRESS NO, ISPECIAL LIC. CONDITIONS CITY CLASS .. R CONSTRUCTION LENDERAD DEPARTMENT APPROVAL REQUIRED YES❑ NO-[]. NAME AND.BRANCH AM ly, LOG.SETBACK FROM ONT PROP.LINE OF (STREET) ADDRESS 1 CITY `ice HI WAY + YARD -_ 7OTAL SETBACK FROM TYPE OF.EXISTING SQ. FT. NO. OF NO. OF CHECK. FRONT PROP:LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE + DESCRIPTION OF WORK NEW cm ADD BLDG.SETBAC M p SIDE PROP.LINE OF (STREET) 0 ALTER ❑ - TOTAL SETBACK M,TNG YPE OF EXISTING k HIGHWAY + 'YARD - V REPA IR❑ SIDE PROP. LINE IGHWAY WIDTH a USE OF _ N EXISTING BLDG. l• - DEMOL ❑ + Z APPLIC;NT ` s v EOL �/) CORNER CUTOFF YES ❑ NORIN ❑ �/(J // IN OPEN SPACE YES ❑ NO BY (SIGNATURE ❑ _ •or IN COASTAL PERMIT ZONE YES,❑ NO ❑ 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 CON- STRUCTION. 1 CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF •CALIF IIA IN RELATING TO, WORKMEN'S COMPENSAT URANCE , SIGNATURE OF PERMITTEE r1 s*— ADDRESS 4J21A(7 -• FINAL A. lf BY CITY NODATE .r'uL- •. hIAKE CHECKS PAYABLE TO: P.C.'�' FEE HARVEY T.' BRANDT, COUNTY ENGINEER PLAN'CHECK•VALIDATION - CK. M.O. CASH PERMIT VALIDATIO CK. M.O. CASH a 9.0 76AG36A CR*803 5/74 r• '• , APPLICATION FOR BUILDING PERMIT � COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKERS COMPENSATION DECLARATION FOR APPLICANT TO FILL IN FUILDING ADDRESS BUILDING AD R I hereby affirm that I have a certificate of consent to self Insure, , �S� r or a certificate of WDDrkers'Compensation Insurance,or a certified ~ n ti copy thereof(Sec.3800,Lab.C.) riT� /T_—{i ZIP �� ©yl Ci L' CALIT� �� 1 Policy No. Company SIZE OF L NO. BLDGS NOW ON LOT. NEAREST CROSS ST ❑ Certified copy Is hereby furnished. 2 ❑ Certified copy is filed with the county building Inspection TRACT ��� BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR M�8 K 3 PAGE D 0.—9112 SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' R �i anw) TEL ' 0.—9ii 2 YES NO COMPENSATION INSURANCE I (J� WITHIN 1000 FT.OF SCHOOL? ADDRESS (This section need not be completed If the permit is for one hundred S 6 S S/ a.. DISTRICT GROUP TYPE CO ST.' FIRE ZON JOjETBY dollars($100)or less.) CI .ZIP �7 I certify that in the performance of the work for which this permit �� is issued, i shall not employ any person in an ner so to ARCH TE ENGINEER TEL.NO. becomes bje to the Workers'C p satin STATISTICAL CLASSIFICATION A O Date 4 Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this ificate of REQUIRED TOTAL SETBACK FROM EXIST, Exemption, you should become subject to the Workers' CONTRACTO TEL NO. SETBACK 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 I.CITY LIC,CLASS SIDE PL O I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP v (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORES NO.OF FAMILIES O Professions Code,and my license is in full force and effect. NEW BK PG H: DESCRI ON OF RK ADD ❑ VALUATION , W License Number Lie.Class x• $ iu/tsR! y Contractor Date ALTER ❑ O��tJ ❑ I am exempt under Sec. REPAIR ❑ B.1 RC.for this reason DEMOL ❑ LDMA P/C q Date. USE EXISTING BLDG; URM ❑ r " Signature APP (CANT PRI ``I LEEL. , LDMA Perm p I,as owner of the property, t T p will do the work and the structure is DRESS. t H -ACCT.= not intended or offered for sale (Section 7044, Business and .- r f A I%W\ 1 c FINAL DATE O 67% 00jvl� 5 Professions Code.) WILLTHEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA HAZARDOUS MATERIAL J OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN ° T ❑ I, as owner of the property, am exclusively contracting With THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BYT {��' 'I licensed contractors to construct the project.(Section 7044, YES❑ NO Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING TOTAL 52- .75 OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CASH v'8 e7.5 CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR I hereby affirm that there is a construction lending agency for YES❑DELNESa CHANGE =00 the performance Of the Work for which this permit Is issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMO 3097,CIV.C.). PERMITTIiNG CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES r Lenders Name CHa ARoxODE TIT IANC A GASECTIONS 220 7 THROUGH 22M140 CONCERNING NO A PERMIT FROM THE SCAQMD. 000E I-00101 7/30/911 Lenders Address „, -11 1 Aid 0:29 Af o' 1 certify that I have read this application and state that the above Information is Correct. I agree to comply With all County P.C.FEE PERMIT FEE ordinances and State laws relating to building construction,and ' hereby agWize represen of this County to enter upon ISSUANCE FEE ]'� the eb n r in e n purp c. • V -� INVESTIGATION FEE TOTAL FEE 11%mW 0fAPPk WAPM oma SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS'COMPENSATION DECLARATION I l APPLICATION FOR BUILDING PERMIT I hereby affirm that I have a certificate of consent to self insure,or a certificate of Workers'Compensfion Insurance,or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY i Policy No. company BUILDING Certified copy is hereby furnished. i FOR APPLICANT TO FILL IN ADDRESS c3 Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESSF I V,Y'S`/17Th Gym L OCALITY /� NEAREST Date pp i an i CITY ,% ZIP ��(! CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT yO X NOW ON LOT .2— MAP BOOK PAGE I 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. I rS S 6 e TEL. (}/1 y SPECIAL CONDITIONS 6 i LV i � (��' I certify that in the performance of the work for which this OWNERF NO. WSPO DISTRICT GROUP TYPE FIRE PRO SSED BY permit is issued, I shall not employ any person in manner '' is U ADDRESS CONST ZONE r so as to •ecome subject QQt�i' a Work Compe ion Laws •. S O� p3 Datepplicant CITY �) ZIP �� STATISTICAL CLASSIFICATION APT. CONDO. . u NOTI TO PPLICANT: If, after making this Certif' to of ARCHITECT OR �` M. ' LU Exemption, ou should become subject fo the orkers' ENGINEER NO. CLASS NO. [7� DWELL. UNITS H Compensation provisions of the Labor Code, you ust forth- ADDRESS ` SEWER MAP with comply with such provisions or this permit shall be deemed revoked. TEL' BK. �pG VALIDATION CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC. I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. VALUATION (commencing with Section 7000)of Division 3 of the Business and Professions Code, and my license is in full force and effect. LIC CITY �� CLASS $ c,' SQ. FT. NO.OF NO.OF CHECK License Number+ Lic.Class SIZE STORIES FAMILIES ONE $ Contractor Date DESCRIPTION OF WORK d'(_ NEW ❑ t ADD I am exempt from the licensing requirements as I am a �– .Fr•r�, licensed architect or a registered professional engineer ALTER FINAL acting in my professional capacity (Section 7051, E REPAIR"® DATE Business and Professions Code). USE OF r DEMOL FINAL f EXISTING BLDG. ❑ By 4–��,d. Lic.or Reg.No. Date APPLICANT ��1 EL. ^Sy��� OWNER-BUILDER DECLARATION (PRINT) �V ti 0 10 NO. 7—S VI hereby affirm that I am exempt from the Contractor's License d1 .; Law for the following reason (Section 7031.5, Business and ADDRESS �� ��im �� fiL t Professions Code): PRESENT 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 `+ 7044, Business and Professions Code). MOVING' TEL. 0 6 6 5 A 1, as owner of the property, am exclusively contracting CONTRACTOR NO. ` with licensed contractors to construct the project (Sec- ADDRESS # 0 0 0 0 0 1 tion 7044, Business and Professions Code). REQUIRED YARD HWY TOTAL SETBACK FROM EXIST: p o 0 1 9.0 0 CONSTRUCTION LENDING AGENCY SET BACK PROP, LINE WIDTH 1 hereby affirm that there is a construction lending agency for FRONT the perfor ante of the work for which this permit is issued P.L. 0 --- 19,006 (Sec. 3097, i SIDE P.L. 08.07-81 Lender's Name ii P.C. Fee$ Permit Fee e ' Lender's Address ' I certify that I have read this application and state that the Issuance Fee above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, ° and hereby authorize representatives of this County to enter Total Fee s upon ^e above-men ed property fpr inspection purposes. 'c � SEE REVERSE FOR EXPLANATORY LANGUAGE 0 Signature of Applicant Date -®s WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION F OR U I L D I N G P E RM I T J1 insure, or a.certificate of Workers'Compensation Insurance, • or a certified Copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified copy is filed with the county building inspec- BUILDING 0 tion department. ADDRESS sp //�� r 6%..— ' .., bate Applicant CITY— (pl ZIP l d LOCALITY p CERTIFICATE OF EXEMPTION FROM WORKERS' V NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT •O JC A O NOW ON LOT — CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL I certify that in the performance of the work for which this OWNER p �,f e�f�' . USE ZONE O. permit•is issued, I shall not employ any person in any nner ` SPECIAL so as to become subject to the Work C mpens aws. ADDRESS /� CONDITIONS O cit ZIP •G.r' �C Date Applicant ° ARCHITEC TEL• DISTRICT GROUP TYPE FIRE PRO SED BY NOTICE O A LICANT: If, after making this ertXrk.r.f oENGINE NO. 0 Exemption, you should become subject to the ' CONST.I/ Z E U Compensation provisions of the Labor Code, you mth- ADDRESS �' _• [� with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. ,• CONTRACT NO. LICENSED CONTRACTORS DECLARATIONLIC; CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (commencing with Section 7000,)of Division 3 of the Business and LIC. Professions Code, andy license is in full force and effect. CITY CLASS BK PG VALIDATION SQ. FT. NO.OF NO..OF CHECK License Number Lir.Class SIZE STORIES FAMILIES f ONE VALUATION DESCRIPTION OF WORK NEN/ ❑ Contractor Date ADD $ F1 I am exempt under Sec. CSL &,Ct pillALTER �_�; B.BP.C. for this reason 7 REPAIR ❑' $ DUSE OF Date: DEMOL EXISTING BLDG. AV Signature APPLICANT e TEL. i FINAL g OWNER-BUILDER DECLARATION (PRINT)A. 1 �"iS��/ DATE (p I hereby affirm that I am exempt from the Contractor's License % .. Law for the following-reason (Section 7031.5, Business and ADDRESS LtJ s M FINAL `/ Professions Code): PRESENT By �' `�°'��' _ 1 717 8 A BUILDING IR I, as owner of the property, or my employees with ADDRESS 7+ o o 0 0 o ' wages as their sole compensation,will do the work and : the structure is not intended or offered for sale(Section LOCALITY + ® 2 0 0 2 8,�z 0 7044, Business and Professions Code). MOVING TEL. I,as owner of the property,am exclusively contracting CONTRACTOR NO. �, 0 0 2 G 5 OJOS with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). 0 60 6-8 4 CONSTRUCTION LENDING AGENCY ; REQUIRED BACK YARD HWY TOTAPROP.LICNEFROM WIDTH -a 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. (Sec.13097, Civ. C.). SIDE g P.L. Lender's Name LDMA Ref. # t P.C.Fee$ Permit Fee Lender's Address �. I certify that I have.read this application and state that the Issuance Fee ® � TDMA P/C# plo. above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee o LDMA Perm.# and hereby authorize representatives of this County to enter ( upon th o - entio open for•nspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE � Signature of A scant o gent Date l WORKERS'COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT c insure, or a certificate of Workers'Compensation Insurance, ' or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING 0ADDRESS E] Certified copy is filed with the county building inspec- BUILDING (� �/p tion department. ADDRESS /flft kS M(401[ /[ Date Applicant CITY � (1 ZIP f ✓ LOCALITY a a CERTIFICATE OF EXEMPTION FROM WORKERS' Nb.OF SIZE OF LOT (�C G NOW ON LOTS NEAREST COMPENSATION INSURANCE CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL.O •/r8,f 2- USE ZONE. I certify that in the performance of the work for which this OWNERU � rT�N N � NOMAP . � permit is issued, I shall not employ any person in any manner ADDRESS 7S�/� (`/�/ t ! SPECIAL IL so as to become subject to the Workers'Comp en ion Law CONDITIONS Date Applicant CITY s- _ j ZIP q/7 ARCHITECT OR TEL. O NOTICEAO APPLICANT: If, afte making this Certific of e� DISTRICT G UP TYPE FIRE PROCE ED BY Exemption, you should become subject to the W ers' S ENGINEER NO. CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS �—' Va� 3 IL with comply with such provisions or this permit shall be �� TEL sA deemed revoked. STATISTICAL CLASSIFICATION APT. C O. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION �---- LIC. CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and ----�� LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK PG VALIDATION SQ.FT.. NO OF NO.OF CHECK License Number Lic.Class SIZE 2000 STORIES FAMILIES ONE VALUATION DESCRIPTION OF WORK NEW ❑ $ �t Contractor Date V I am exempt under Sec. ADD ❑ , ALTER ❑ { B.BP.C. for this reason _ REPAIR $ USE OF Date: EXISTING LDG. DEMOL' ❑ Signature APPLICANT S _I O _Q�/Z FINAL �6 4 7.5 A OWNER-BUILDER DECLARATION rll/I U DATF� I hereby affirm that I am exempt from the Contractor's License ,�s,,.�.� � ` # 0 0 0 0 0 Law for the following reason (Section 7031.5, Business and ADDRESS �-/3IM (Jf� FIN Professions Code): PRESENT B a - 49,88- �j al BUILDING " , I, as owner of the property, or my employees with ADDRESS wages as their solecompensation,will do the work and / 0 0 0 4 9.8 8 6 the structure is not intended or offered for sale(Section LOCALITY ' 1El 7044, Business and Professions Code). MOVING TEL. 2 C J (�—8 7 CONTRACTOR NO. ` 77 � I,as owner of the property,am exclusively contracting � •+ •,: f �+`! with licensed contractors to construct the project (Sec- ADDRESS CONSTRUCTION LENDING AGENCY Si `r` . Jsir tion 7044, Business and Professions Code). - REQUIRED TOTAL SETBACK FRO H ` ET YARD HWY BACK PROP. LINE WIDT 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. i (Sec. 3097, Civ. C.). SIDE I $ P.L. Lender's Name LDMA Ref. R P.C.Fee$ Permit Fee r, - Lender's Address /j @ I certify that I have read this application and state that the Issuance Fee 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 upon above- n ioned pr-29t-for inspection urposes. `/07 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applic or Agent D6te @1 APP "POR N"POR BUILDING PERMIT ,. AP � a COUNTY OF Lq-%"AN ,ELES , BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS C I hereby affirm that I have a certificate of consent to self insure, BUILD A DRE ti 11, or a certificate of Workers'Compensation Insurance,or a certified s 0 copy thereof(Sec.3800,Lab.C.) -CITY. Q , ZIP / -0 LO -LITY O Policy No. Company SIZE OF L NO.OF BLDGS,NOW ON LOT ElNC Certified copy is hereby furnished. 0 N1,00 2— NEAREST CROSS ST. ❑ Certified copy is filed with Ahe 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' OWNER r TEL NO. r�/ YES NO COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? ' AD6112E � (This section need not be completed if the permit is for one hundred d1Mold s DISTRICT GROUP TYPE CONST. FIRE ZONE PRO SSED BY dollars($100)or less.) I certify that in the performance of the work for which this permit ; ZIP / S"� JR-b /become- I shall not employ any person in any manner so as to A C ITE O ENGINEER TEL NO. �^ TI /become- ubject to the Workers'C pensation La STATISTICAL CLSIFlCATION AP C DO Date Applicant ADDRESS CLASS NO. 24 DWELL UNITS NOTICE TO APPLICANT If, after'making this C irate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to t Workers' / CONTRACTOR TEL NO. SET BACK YARD HWY PROP UNE WIDTH Compensation provisions of the Labor Code, you must forthwith FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS UC.NO. PL SIDE LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS 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 E NO.OF STORIES NO.OFrIUES NEW El BK PG Professions Code,and my license•is•in full force and effect. , a License Number Lic.Class DES IPTION OF-WOR ADD ❑ VALUATION (/ C C Contractor Date ALTER - ® Ix` ❑ I am exempt under Sec. ` REPAIR p C BAP.C.for this reason DEMOL ❑ LDMA P/C# NO FEE It Date: USE OF EXISTING BLDG. URM ❑ a U• -Signature APPLICANT(PPoNT) TEL NO. LDMA Perm# z I, as owner of the'property, or my employees with wages as Z 000 -0001 4/26/93 their sole compensation, will do the work and the structure is ADDRESS 2 9346 1 AM 7951 FINAL DATE not intended or offered for sale (Section 7044, Business and a00. Professions Code.) WILL:THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL �fJ OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE ❑ 1, as owner of the.property, am exclusively-contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY +"•" i ' licensed contractors to construct the project (Section 7044, ACC ■a Business and Professions Code.) WILYESL ❑ No❑ �y ,WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING 33Ll7+ 50.65 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY ,COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR ITEMS— TCFe1 i , ;GUIDELINES. 1_ F 1 1 E 1 I hereby affirm that there is a construction lending agency for YES❑ No❑ c iA the performance of the work for which this permit is issued(Sec. I E DTHE IALS IN GbIEE AND THE SCAOMD PERMITTING TOTAL 3097,CIV.C.) I UND UIREME U R THE LOS ANGELES COUNTY CODE, W.65 te, C' T PIER .20.10 R 2.20.140 CONCERNING HAZARDOUS CHECK SIJe65Lender's Name �R REPOH� If BrAlI41N� T FROM THE SCAQM0. o Lender's Address �, ' " b CHANGE .011 TOWNERENT c I certify that I have read this application and state under penalty 0 of perjury that the above information is correct.I agree to comply RCw�E PERMIT FEE ^7`�'� C11 with all county ordinances and State laws relating to building I • F 1 4/26/93 co constru 'on,and hereb a nze representatives of this Count ISSUANCE FEE -,,7 ro to on t b y n' ned prop specti purp es. 124 Z �O 934 f 1 At 1 �:51 (D d INVE�ST� ION FEE JRDTAL FEE -7o. i ft m Aogiant or AgentBit ,,,,,,�ry� 1 t j �:.•d SEE rsAV E)WANATORY LANGUAGE i APPLICATION FOR BUILDING PERMIT 5 COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION-DECLARATION FOR APPLICANT TO FILL IN ELOCA ADDRESS I hereby affirm that I have a certificate of consent to self insure, BUILG;uaA�DRIf�t or a certificate of Workers'Compensation Insurance,or a certified COW tereof(Sec.3800.Lab.C.) 7 f, ,, ` ZIP +�: l / / LITY J'; �; �f i ` r / Policy Na Company SI CF LOT c NO.OF BLDG OW ON LOT V , f i..: / ❑ Certified copy is hereby fumished �c' n /6-J1 't NEAREST GROSS ST. ❑ Certified copy Is filed with the county building InspectionTRAf r? ,� BLOCK Lor NO. \_ departmentK� USE ZONE MAP NO. Date �Applicant ASSE.CSOR � / PAG `r PARrL� {, (f SPECIAL CONDITIONS f_/ CERTIFICATE OF EXEMPTION FROM WORKERS' 7 C ` ,� r �J - ,/f YES NO COMPENSATION INSURANCE if tDISTRICT THIN sato Fr of scHooL� ADDRI'l �/,''� (This section need not be Completed if the permit is for one hundred �J ' 1¢!'f S r'1'z:{.L t ROUP TYPE FIRE ZON FROG ED BY dollars($ino)or less) CITw.+� I zip "1 certify that in the performance of the work for ch this permit A #''x \, r �' a✓ 4 �- � is Issued. I shall not employ any person in a nner so ARCH rE ENGINEER TEL No. -3 born b e �the Workers'�O STATISTICAL CLASSIFICATION DO Date 0 Applicant ADDRESS CLASS NO. DWELL UNITS AW ,69 NOTICE TO APPLICANT: If, after making this. rtificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' CONTIRACTO ., TEL No. Compensation provisions of the Labor Code,you must forthwith I SET BACK YARD HWY PROP LINE WIDTH comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. FRONTPL L > t I . p LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDEPL C� 1 hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and FT SIZE NO.of STORES NO.of FAMILIES u•. Professions Code,and my license is in full force and effect. NEW � BK PG , >. License Number Lia Class CR NOF RK ADD [3VALUA�ON drCt) Contractor Date �! ALTER ❑ ❑ 1 am exempt under Sec. REPAIR ❑ # � B.&P.C.for this reason USE�F i Q(ISTING BL DEMOL ❑ LDMA PIC R Date: R a , f_. .l Ir : URM ❑ Signature AP ICANT'PRIIP LDMA Pam M I,as owner of the property,131 Ply 10 IPV*Ki WNWWOW&M , ( +�' f(,j f;fT f ,y `T T!� !� Z iO ,will do the work and the structure is ADpRESS - q ` not intended or offered for sate(Section 7044, Business and i' I1 `�+r `+~` �d �. f• C. Fl D Ta Professions Code.) t] 1 VALL714EAPPLICANT OR FUTURESUILDING OCCUPANTHANDLEA HAZARDOUS MATERIAL "r yr 61' OR A?pAAIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN 1 i 1 ❑ 1,as owner of the property, am exclusively contracting with THE AMOUNTS Flet ON THE HAZARDOUS MATEg1ALS INFORMATION GUIDE? FINAL licensed contractors to construct the project (Section 7044, YES n No }),')p+{� zy+L',t . {u fy Business and Professions Code.) i -ILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING L '• C OOCUpANT REOUIREA PERMITFORCONSTRUCTION OR MODIFICATION FROM THE SOUTH 'Cl.'d :'a CONSTRUCTION LENDING AGENCY FOUR T AIR QUALITY), MANAGEMENT DISTRICT(SCAOMO)SEE PERMITTING CHECKLIST { "Jt I hereby affirm that there is a construction lending agency for YES[] (J�w the roe of the work for which this permit is issued(Sea I HNE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMO 30977.Civ.CIV.C.C.). PERMITTING CHECKLISTT,I UNDERSTAND MY REOUIREMENTS UNDER THE LOS ANGELES - •_ •+ COUNTY CODF.TTn.E2,CHAPTE R'L20S�71oNS220.i00 THROUGH 8.20.140 CONCERNING C i •.. t•: Lender's Name HAZN.? NGAND FORA,BT� RMr FROM THE SCAOMa ' Lenders Address `r � ` • `'` c 4: to I certify that I have read this application and state that the above P OWC.FEE IM PR ALUM PERMIT FEE tr' Information is correct. I agree to comply with all county ordinances and State laws relating to building construction,and ' hereby re rese of this unty t0 enter upon ISSUANCE FEE ,r thea rT fj �j4 INVESTIGATION FEE TOTAL FEE slp�,�a Aroeveape,+ D.r ! J I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT J DEPARTMENT OF PUBLIC WORKS / 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 EtL_05.08 9907260072 PHONE: (626) 285-0488 EXT: LEGKL D:. 0. 0 S NEW B' tG-ADD E S:i TR: 13935 LT: 20 SQ. FT STORIES TYPE OCCUP GROUP 5645 PERSIMMON AV­., STRUCTURE: ' 0 1 VN R3 TEMP-,CA 91780200.9 ' ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: 8573-001-018 OTHER: 84 1 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY E A E ST B DG USE: USE ONE: SSUED 0 OC ED B : PIRON:. EXIST•OCC GRP:' 07/27/99 UT 01/23/00 OWNER: TEL. 0: BLDGS. NOW ON OT: VALUATION: FINA DATE FINAL Y CODE: BROUGHTON MOB W CO TR (818) 447-8119= 1 840 5645 PERSIMMON AV TEMP 917802809 FEES PAIDDESCRIPTION-OF- � OR -" SOLI II GARDEN PATIO COVER `_ FEE DESCRIPTION: QUANTITY: UOM: AMOUNT`APPLICANT:. T SAME AS-OWNER - AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RE<SI.D 840.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/ E 5T0.00 VAL 65.40 sELESTO ® S 93.65 CONTRACTOR: TEL. NO: a®�J �/� APPROVALS DATE INSPECTOR SIG AT RE SAME AS OWNER - LIC. NO LOCATION AND SETBACKS 0 SOILS ENGINEER APPROVAL. . i ARCHITECTOR GI ER: TEL. 0:. / FOUNDATIONJTRENCH FORMS �- LIC. NOE 1111.111 SLAB NDER,FLOOR FLOORRAISED R MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: M SU UNDERFLOOR INLATIO 3 91. UpWC W0 �� S E OOR SO. 0 FAMILI S: DW G TS: P CO D: S A CLASS: NO 21�C ND'LEVEL FLOOR SHEATH SCHOOL HAZARDOUS �' t"��t�+ Roo SHEATHING AIR QUALITY: 1000 FEET MATERIALS 0 ❑ i4li}1'. NO NO NOA �l ��y FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM E S 46� ptsBLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- . �C servic �hat�v S EAR PANELS• SIDE PL- INSULATION/WEATHER L- S ATIO ER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTO CS FIRE DEPARTMENT APP OVAL REPORT ID: DPR261 ROUTE TO: BS0508 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 0704040042 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: 1 ITR: 13935 LT: 20ISTRUCSQ. FT STORIES TYPE I 5645 PERSIMMON AV I 809 (ASSESSOR INFORMATION NUMBER: TORE: I NEAREST CROSS TEMP CA STREET: 18573-001-018 I I THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl TENANT: (EXIST BLDG USE: RESID USE ZONE: R-1 TISSUED ON: PROCESSED BY: EXPIRES ON: (EXIST OCC GRP: 104/04/07 JK 03/29/08 (OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: IFINAL DA I F CODE: IBROIIGHTON AMOS W CO TR (626) 447-8112- I 4,960 I 15645 PERSIMMON AV 9 I��y/ (TEMP 917802809 1 FEES PAID IDESCRIPTI N OF WORK 1 I IWE WILL PROVIDE AND INSTALL 15 WHITE WINYL DUAL PANE WINDOWS( IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ITHEY WILL BE INSTALLED LIKE FOR LIKE. I APPLICANT: TEL. NO: ISAAC (714) 996-1807- IAA BLDG PERMIT ISSUANCE 27.75 I I 11315 E. BLUE GUM IAC STRONG MOTION RESID 4960.00 VAL 0.50 (SPECIAL CONDITIONS: I (ANAHEIM, CA 92806 ID2 PERMIT W/O EN-HC 4960.00 VAL 132.60 I TOTAL FEES 160.85 I I I ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE HARDY WINDOWS CO. (714) 996-1807- 1 1315-D BLUE GUM LIC. NO IVACATION AND SETBACKS I I ANAHEIM, CA 92806 503323 C17 I ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I LIC. NO: 1 (SLAB/UNDER FLOOR I I I (RAISED FLOOR FRAMING I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: (UNDERFLOOR INSULATION I I I I I I I150H273 3 OlI I I I I I I (FLOOR SHEATHING I I I [NO. OF FAMILIES: DWELLING UNITS: APT/OCOND: STAT CLASS: NO I I I 21 IROOF SHEATHING SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I I I I I AIR QUALITY: 1000 FEET MATERIALS NO NO NO I IFRAME INSPECTION I I I (REQUIRED TOTAL SETBACK FROM EXIST j (FIRE SPRINKLER HANGERS 1 ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I I IFRONT PL- (INSULATION/WEATHER STRIP( I I SIDE PL- IINTERIOR LATH/DRYWALL I I I I (EXTERIOR LATH I I I I I I (RATED FLOOR/CEIL ASSEM. I I I IRATED WALL ASSEMBLIES I I I (RATED SHAFTS/OPENINGS I I IT-BAR CEILINGS ILOT DRAINAGE I I I (REPORT ID: DPR261 ROUTE TO: BS0508 i I I I • 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 1006220012 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 13935 IT: 20 SQ. FT STORIES TYPE 5645 PERSIMMON AV [STRUCTURE: 568 V-B TEMP CA 917802809 1 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LIVE OAK 18573-001-018 1 1 THOMAS PAGE: 597 GRID: C3 LOCALITY: TEMPLE CITY, Cl TENANT: EXIST BLDG USE: PATI USE ZONE: R-1 ISSUED ON: PROCESSED BY: 1 1EXIST OCC GRP: 06/22/10 SR 1OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: �FINA_l DATE FI BY: CODE: 1 BROUGHTON AMOS (626) 201-8820- 4,000 .6 5645 PERSIMMON AV r TEMP 917802809 FEES PAID 4ESCRIPTION OF WORK 1DEMO EXISTING REAR PATIO ROOF INSTALL 568 SOFT. OF NEW 1/2" FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TECH SHEILD PLYWOOD. INSTALL NEW TORCH DOWN ROOFING MATERIAL APPLICANT: TEL. NO: STP ENTERPRISES INC. (626) 287-7544- JAA BLDG PERMIT ISSUANCE 27.75 5454 TEMPLE CITY BL. JAB STATE GREEN BLDG FEE 4000.00 VAL 1.00 SPECIAL CONDITIONS: TEMPLE CITY CA 91780 JAC STRONG MOTION RESID 4000.00 VAL 0.50 1 ID2 PERMIT W/O EN-HC 4000.00 VAL 115.80 TOTAL FEES 145.05 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE STP ENTERPRISES, INC. (626) 287-7544- 15454 TEMPLE CITY BLVD. LIC. NO ILOCATION AND SETBACKS TEMPLE CITY, CA 91780 598157EC36 1 1SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS 1 LIC. NO: SLAB/UNDER FLOOR 1RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I JUNDERFLOOR INSULATION I I1 115OH273 3 001 i 1 _1 IFLOOR SHEATHING INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: � ,. 1 NO 21 1 1ROOF SHEATHING 1 SCHOOL WITHIN HAZARDOUS 1 SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO 1 1FRA1-E INSPECTION 1 1 1 FIRE SPRINKLER HANGERS 1 I 11NSULATION/WEATHER STRIP( I 1 1 INTERIOR LATH/DRYWALL (EXTERIOR LATH 1 1 1RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES 1 J 1RATED SHAFTS/OPENINGS 1 �* ADDITIONAL DATA ON FILE IT-BAR CEILINGS LOT DRAINAGE 1 REPORT ID: DPR261 ROUTE TO: SS0508 1