The URL can be used to link to this page

Home My Public Portal About9008 - 9010 BROADWAY_Building__ t _ WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, ' or a cerci a op reof (Sec. 3800, La . .) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING ElCertif`i'ed copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS - ❑ Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS L i CITY Cr/ Date la��Applicant ZIP LOCALITY CERTIFICATE OF EXEMPTION M WORKERS' NO. OF BLDG$. NEAREST 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 ($100)or lass.) �I,, OWNER B� [�, 1'rr7 L USE ZONE MAP I certify that in the performance of the work for which this )) � / NO. //1/ T GL.4/ S SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS 3 CONDITIONS d so as to become subject to the Workers'Compensation Laws. _ _ _ p� pp /1�� CITY S ZIP OU Date A icant LJ L•�--� ARCHITECT OR C't� it DISTRICT GROUP TY E PROCESSED BY NOTICE TO AP ICANT: If, after ma ng this Certificate of ENGINEER NO.r CO NE O Exemption, you should become subject to the Workers' (/ ID Compensation provisions of the Labor Code, you must forth- ADDRESS_ ��Q 1 U.1 with comply with such provisions or this permit Shall beTEL 0 STATISTICAL CLASSIFICATION APT. CONDO. L0 deemed revoked. CONTRACTOR -e NO. �`d'/ l Z LICENSED CONTRACTORS DECLARATIONLIC - CLASS NO. DWELL. UNITS_ I hereby off irm that I am licensed under provisions of Chapter 9 ADDRESS Y/L�✓ NO. .S$ (commencing with Section 7000)of Division 3 of the Business CITY !20/ GV' CLLICASEWER MAP ' and Professions Code,and my license is in full force and effect.TBK PG VALIDATION �/� / 50. R. NO. OF NO. OF CHECK License Number 9/12J- Lia Classy tia-7. SIZE 7Z- STORIES FAMILIES ONE VALUATION eI Contractor Dote y DESCRIPTION OF WORK �k. NEW ❑ $ r�D� .� ❑I am exempt under Sec.— E] f-O'rI •201' ADD �( poloALTER ❑ B.$P.C. for this reason REPAIR ❑ $ Dote: USE OF 7 ,1 t EXISTING BLDG. DEMOL ❑ Signnrma L �[;,r APPLICANT TEL, FINAL (PRINT) NO, !Ram DECLAR TION - DATE 1 hereby affirm th I am exempt from the Contractor's License Low for the following reason (Section 7031.5, Business and ADDRESS FINALAi:;l'C .Ts Professions Code): PRESENT By El 1, 32 I, as owner of the property, or my employees with ADDRESS `r*r�7 1.JJ.vc wages as their sole compensation,will do the work and the structure is not intended or offered for sole(Sect 1an LOCALITY _ER-COR •'Elft 7044, Business and Professions Code.) MOVING TEL. POP. 7'7(17 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. "'� -i3,i.:v; with licensed contractors to construct the project (Sec- = 7]7 tion 7044, Business and Professions Code.) ADDRESS CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY QUIRED iOTAPROPALINEFROM EXIST. 1 ITEMS I hereby affirm that there is a construction lending agency for FRONT TOTAL 113 872 the performance of the work for which this permit is issued P.I. (Sec. 3097, Civ. C.). SIDE CHECK y P.L. 113. ., Lender's Nome o + HANGE ,01) Permit Fee LDMA Ref. # - Lender's Address l o I certify that I have read this application and state that the Issuance Fee LDMA P/C# 77� 12/23/92:`. 8 ordinances and State laws relating to building construction, Total Fee above information is correct. I agree to comply with all County Investigation Fee 1/.J. �r52 LDMA Per, # y 1 AM11-21 a and hereby authorize representatives of this County to enter I upon t bove-menti necl p^erty for inspection purposes. l -Z3_ L SEE REVERSE FOR EXPLANATORY LANGUAGE nature of Applicant or Argefit Date WORKERS'COMPENSATTON.DECLARATION Isu"tj, o"r c?cmthatIhbver certificate oUconsent,lo ure =elf APPLICATION FOR BUILDING PERMIT insurd, or q certificate of Workers' Compensation Insurance, or a ied copy thereof (Sec. 3800, Lab. C.) •V(JC:. - COUNTY OF LOS ANGELES BUILDING AND SAFETY .Policy No. CM PanY PsrySY `Certified copy is hereby furnished. FOR APPLI FILL IN BUILDING ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING tion department.sepamenl. ADDRESS d Date 3 ' s. Applicant v CITYTem le City ZIP 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST —21 COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one TRACT 11218 BLOCK A LOT NO. 1 & 2 ASSESSOR hundred dollars ($100)or less.) MAP'BOOK PAGE PARCEL TEL (714) ZONE MAP I certify that in the performance of the work for which this OWNER ll NO. — V/ 2 NO. ILI permit is issued, I shall not employ any person in any manner P,0, $OX 4848 !''� ,J SPECIAL so as to become subject to the Workers'Compensation Laws. ADDRESSP.O. CONDITIONS 0 U Data Applicant CITY Anaheim. CA ZIP 928 ARCHITECT OR NOTICE TO APPLICANT: If, after subject Ito Certificate of Clyde Carpenter 814)754-009 DISTRICT GROUP TYPE FIRE PRO SSED BY Exemption, you should become subject to the Workers' ENGINEER Y P S- r CONST., ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS 2750 S. Harbor Blvd. Ste. I J ' O V/ W with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. NDO. deemed revoked. CONTRACTOR NO. Z 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 70170)of Division 3 of the Business and LIC SEWER MAP Professions Code, and my license is in full force and affect. CITY CLASS BK VALIDATION (y SO. FT. NO.OF NO. Of CHECK License Number '�"7 9 Y3.f Lic.Class SIZE 1 8(77 STORIES 1 FAMILIES 1 ONE g Q 9 a 6 A ❑ VALUATION Contractor R�JT� � Date DESCRIPTION OF WORK NEW $ 00 #'e e -.0 23 El am exempt under Sec. Remodel 2 Canopy + Alter ADD Q , I '• T1 7.2 0 ALTER h�4 B.BP.C. for this reason EX. Mini Mart. REPAIR ❑ $ o•e 7,1 7.2 0 5 Date: USE Of EXISTING BLDG. Photo Lab & Mini Mart DEMOL ❑ ,I 025-88 Signature APPLICANT TEL. FINAL /a O OWNER-BUILDER DECLARATION PRINT IN 7 DATE Ili 1 hereby affirm that I am exempt from the Contractor's License 2750 S. Harbor Ste. I Law for the following reason (Section 7031.5, Business and ADDRESS FINAL 1 Professions Code): By ❑ 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. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. i T I L. with licensed contractors to construct the project (Sec- TCl j B5 �5 tion 7044, Business and Professions Cade). ADDRESS IA- t..+'— 'A' VC: ; SET TOTA PROP LONE WIDTH NECK , CONSTRUCTION LENDING AGENCY YARD HWY t-s 1 hereby affirm that there is a construction lending agency for FRONT t the performance of the work for which this permit is issued P.L. !.v�H�'iVG (Sec. 3097, Civ. C.) SIDE // P.L. m Lender's Name—A& r r- / �j �/ LDMA Ref. p. �I�I�ILI,— Lender's Address P.C. Fee E Permit Fee (� 3� /� ' ,iO4`3 q ,AM 11 I certify that I hove read this application and state that the Issuance Fee �' J LDIII 2 I tMA P/C g above information is correct. I agree to comply with all County Investigation-Fee �� q ordinances and State laws relating to building construction, Total Fee TDMA Perm. R and he a authorize representatives of this County to enter m upo be ve-mentioned operty for inspection�Z rpos SEE REVERSE FOR EXPLANATORY LANGUAGE atuf�°f Applicant or Agent e a-C�+�-/�, ' - 3/2-y l JP? ''- •' WORKERS'COMPENSATION.DECLARATION - I kereGy affirm that I have a certificate of-consentdo self of 0 L�VIC^ATO 0 IN FOR -BUOLDNIG' 'PERMOT insure, or o.certificare of Workers',Compensation Insurance, �t yr�V or a certified copy thereof (Sec. 3800`d , Lab. C.) S ANGELES BUILDING AND SAFETY Policy No.� Company 7/!/1J /k/�/�,r - Certified copy is hereby furn,s e FOR APPLICANT TO FILL IN BUILDING —/ _ ADDRESS Ld Certified copy is filed with the county building inspec- '" ' BUILDING - -- -' - - - LLLJJJ tion deportment. ADDRESS Date I • APPlicant �gE�1,/ sSi�Llr. aTv LAG ZIP D LOCALITY G - ERTIF ATE OF EXEMPTION FROM WORKERS' SNO. OF BLDGS. NEAREST , COMPENSATION INSURANCE SIZE OF LOT O NOW ON LOT - CROSS ST. (ThiYsectiomnead not be completed if-dhe permit is forone - ---__._ -- -- . . __ -. .JF _ __ �- ASSESSOR - hundred dollars ($100)or less.) TRACT BLOCK - - - LOYNO. ' - MAP'BOOK -`-" - --` PAGE" - `_ PARCEL` --- -- iEl. USE ZONE MAP - OWNER I certify that in the performance of the work for whIch'ihis T NO NO permit is issued, 1 shall not employ any person in any manner / r �2) SPECIAL_ _ so as to become subject to the Workers'Compensation Laws. ADDRESS �,./ CONDITIONS O Data Applicoot CITY ZIP J9' - - - NOTICE TO'APPLICANT?9f; oftar'making"this Certificate of ARCHITECT OR - TEL.7( DISTRICT GROUP TYPE __ FIRE PRO SSED BY ENGINEER - - - - - NO: - `-- Exemption, you should become subject to the Workers -' ----ter 1� CONST.- "ZONE` ' "_ - ' W -- Compensalion provisions-of._the.Lobor Cade,.you must forth _ ADDRESS _ v G__ ,V/ JQ P Y P - - -. -_.dL_ with cam with such rovisiond or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. . NDO. N - deemed revoked. . CONTRALTO NO - LICENSED CONTRACTORS DECLARATION Z IC CLASS NO. DWELL. UNITS_ Thereby affirm that'1'am licensed under provisions of Chapter -_ - ADDRESS- NO.Z) (commencing with Section 7000)of Division 3 of the Business and LIC ^ SEWER MAP �l t'l //, - - - Professions Code, and my license is in full force and affect. CITY CLASS& 9K �� , VAftDAA(§42 A /J SO. FT. NO.OF NO,OF CHECK � e eie • Z3 License Number`^4 /I - Lic ClassG :� SIZE STORIES FAMILIES - ONE //� �j -T+� ❑ VALUATION ,( • e 57.38 �-1� / IR��/. DESCRIPTION OF WORK NEW Qd' _ Contractor / Ddte, El I am exempt under�ec.r— / ,/ S ADDCl s B.BP.C. for this reason REPAIR_ ❑ s - O 6. Dote: USE OF DEMO. ❑ -4 1 2 8..b A EXISTING BLDG, Signature APPLICANT - TEL. FINAL # e e e-e e.1 OWNER-BUILDER DECLARATION PRINT NO. DATE I hereby affirm that I.am exempt from the Contractor's License ADDRESS FT �dIUTT 471.�✓f'vTO l� ( ° e 78 00 R Law for the following.reason (Section 7031.5, Business and FINAL Professions Code): - PR - - - By4 • e 7 &000 ' ❑ BUILDING r I, as owner of the property, or my employees with ADDRESS ( 2 O 8-8 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. - I, as owner of the property, am exclusively contracting CONTRACTOR NO. , with licerised contractors toconstruct the project•(Sec- ADDRESS _ tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM 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.I. - (Sec. 3097, Civ. C.). 'SIDE ,P.L. Lender's Name - LDMA Ref. R m - P.C. Fee f Permit fee - G D Lender's Address - I certify that I have read this application and state that the Issuance Fee Q •. —0 LDMA P/C A ' above information is correct. I agree to comply with all County Investigation Fee Q DO ordinances and State laws relating to building construction, Total Fee d LDMA Perm. q and hereby authorize representatives of this County to enter ` upon t above-menti ned pr erty for inspection purposes. Q'+1i SEE REVERSE FOR EXPLANATORY LANGUAGE ra Sign re of Applicant or Agent f • - s WORKERS'.COMP,ENSA710N DECLARATION - �PTTMN I� I� r.� r� py� r�F�I�F�thereby affirmthat have a certificate of consehf to self. PO •LI}Oh( h(�-O�D�INUIIf v. Iprl}hy 1RyD�� insurAit a certificate ofWorkers' Compensation Insurance11 11 IID IJII VV 0 LSUOIIOUor a certified copy thereof (Sec 3800, Lab. C.) ]��- y '� ` Y OF LOS ANGELES .` �T BUILDING AND,SAFETY ^Pal No. - - Company BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS - v `.Certified copy is filed with the county building inspec- BUDDING tion department. ADDRESS -p�,�; /'' (� Date.(2 Applic IN v'F'- cl fz ZIP /Q 1 7(/ LOCALITY / O. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTIO FROM WORKERS' '-' SIZE OF LOT C7�.G NOW ON LOT CROSS ST. COMPENSATION INSURANCEASSESSOR (Thi section need not be completed if the permit'is for one TRACT ' ' - BLOCK - LOT NO:' MAPBOOK PAGE PARCEL' hundred dollars ($100) or less ) . - ' .' ii TEL OWNER -t.7 t U E ZONE 'MAP ; .. 1 I L , NO. - - . . NO. - . I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person in any manner ADDRESS SPECIA CO -DITIONS - - Ya so as to-become subject to the Wor s'Co pen tion Lo s. r O Q• / CITY ZIP t _ >•�• U - 'Date' (O6 '—Applica . _ - - ARCHITECT-OR - =TEL 0 NOTICE TO APPLICANT: If, after maki g this-Certificate of ENGINEER' �, O /S 'OC DISTRICT' GROUP' ONS . ZRE-E .. ROCESSED'BV - -.-0 - - " Exemption,. ,you should become.subject to. the Workers' _ _ Compensation provisions of the Labor,Code,you must forth-y ADDRESS- �7.$b i,c -with comply with such provisions or this permit.shall be " TEL. STATISTICAL CLASSIFICATION - APT.L CONDO. N deemed revoked. CONTRACTOR NO. - - - Z ATION - -=- - _ LIC. _ ) CLASS NO. DWft,. UNI7 5 LICENSED CONTRACTORS DECLAPI hereby affirm thot Lom licensed under provisions of Chapter,9 : „ ADDRESS - NO. ' (commencing with Section 7000)of:Div_ision 3 of the Business LIC. SEWER MAP t and Professions Code,and my license is in full force and effect. - CIN CLASS BK. L PG. VALIDATION , SO. FT / NO. OF NO. OF CHECK License Number. 1 O4 1 Lic Classes SIZE / L.Q STORIES FAMILIES - (� J ❑ VALUATION ' Contractsksjj�Jb• (G R' l DESCRIPTION OF WORK Q1Os� NEW $ I- �1 - 7 _ ." ADD Oh D ❑1 am exempt under Sea 4 - ,rzt ALTER 10• B.BP.C. for this.reason -" $.n USE OF REPAIR ❑ Date _ EXISTING BLDG. OO�, G-( -ft DEMO, ❑Signature - - APPUCANi p �t FINALOWNER-BUILDER DECLARATION (PRINT) pjf( Co �•�� •DATE t I 7S� hereby affirm that I am exempt from the Contractor's License •-T - /� SD w 1 "� +^'r Iu Law for the Followingt.reason (Section ADDRESS 7031.5; Business and FINAL( 7 3 'Professions Code): - PRESENT - _ By �p-p , BUILDING - �e CCT..a ❑ I, as owner of the property, or my employees with ADDRESS. ' wages as thein sole compensation,will do the work and - - - c - 3307 ' 460-92 the structure is not intended or offered for sale(Section LOCALITY D s 7044, Business and Professions Code.) - MOVING. .. TEL t `� r ,` 1 ITEMS:_ - CONTRACTOR NO. + ❑ I,,as owner of the property,am exclusively contracting _ F 'T4T� 460g? with licensed`contractors to construct the project (Sec- -- - - tion 7044, Business and Professions Code. ADDRESS` 3 R. REQUIRED. .TOTAL SETBACK FROM EXIST. 1a tG'HECY, 46i].92' CONSTRUCTION LENDING AGENCY SET BACK ' YARD HWV PROP. LINE WIDTH I hereby affirm that there is a construction lending agency efGH�� - •+ �(I Y or FRONT . the performance of the work for which-this permit is' nc issued P.L. (Sec. 3097,.Civ. C.).' - SIDE , . , r-n :t D • _ P.L. - L.t t.: • .� f:] f.. rVL Lender's Name F ? +� m b �i '-1: ,•Q000-0'0+31 9/27/39 $ // - LD Ref #IC' "�I-. 288 •� - ,• P.G. Fee$ TOOi Permit Fee�J "D .rJ9L- 1 12 Lender's Address u a certify that I have read this application and state that the Issuance Fee 0 L hYX'PiC q o - 8 above information is correct. I agree to comply with all County Investigation Fee �•' _ __Cq _ B ordinancesandState laws relating to building construction, Total Fee UDAILA.erm. q and hereby authorize representatives of this County to enter _ upon t abo -merYi - ed property f r inspectionpurposes. t,,, F... i_rl 1CrIr 'n , '/ FJ - �f- - SEE REVERSE FOR EXPLANATORY LANGUAGE .C3. \ ry Signa re of Applicant of Agent. - Date - - - � r _n�' G :_� �'1 :r'Uj a +1 4 ~ - • t' r ' - _ J Q. Q:QUNTY 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 9807170035 PHONE: (818) 285-0488 EXT: LEGAL ID: O. OF CONST BUILDING ADDRESS: TR: 11218 LT: 1 BL: A SQ. FT STORIES TYPE 5450 ROSEMEAD BL STRUCTURE: 0 VN SGAB CA 917762213 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5388-003-002 THOMAS PAGE: 596 GRID: H4 S LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USE ZONE: C- ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 07/17/98 UT 07/17/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: SHELL OIL COMPANY (909) 484-3811- 1 5,000 ��/�(/�_ l 3200 INLAND EMPIRE 1 / Z7-) ONTARIO, CA 91764 FEES PAT—D— D SCRIP ION 0 NEW TURBINE CONTAINMENT SUMPS, DISPENSER CONTAINMENT BOXES FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: - T L. N0: A 8 S ENGINEERING (818) 842-3644- AA BLDG PERMIT ISSUANCE 27.75 207 W. ALAMEDA 203 AE STRONG MOTION,OTHER,--,.5000.00 VAL 1.05 SPECIAL CONDITIONS: BURBANK, CA 91502 D2 PERMIT WZO•EN-HC- -- '5000-.00 VAL 132.60 GEL E:TOTAL FEES 161.40 CONTRACTOR: TEL. NO: v� ✓AAPPROVALS DATE INSPECTOR SIGNATURE S. J. WEAVER CONTRACTING (562) 663-1600- JEFFERSON ST. 1NO ?• �� LOLAfIO AND SETBACKS---- PARA 7 PARAMOUNT, LA 90723 717171 73 SOIU ENGINEER APPROVAL 1�. J r ARCHITECTOR E G E L. N0: �� AA� UNDAT[0 /TRRMS LIC. NO: I ��!.1 i i ��'A SLAB/UNDER FLOOR _L___�L RATS°D FLOOR f MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: J '��i;� � '�•' �' �- ��[� ' � 147X265 3 .04 lJ''' J I._ '! �I'' t'�' 1` L 11 ` `� UADE;2FLOOR INSULATION �. �._ �..�r \7 T1.002 S AT Hf�I G NO. OF FAMILIES: W CLING UNITS: APT/CON ST—AT CLASS: - -- - -- - - -- NO 22 !l / ROOF SHEATHING SCHOOL WITHIN ARDOUS \7 ':•="} t'• SSR PANELS ! AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SBACK FROM EXIST `S�• �� Oell F� S RINKLS HANGERS FRONSET TPL YARD: HWY: PROP LINE: WIDTH: 'C `�'@PVjC6 Y.ha�V SIDE PL- INTERIOR INSULATION/WEATHER STRIP .- INTERIOR LAT DRYW LL EXTERIOR LATH Z1ATED FLOOR/CELL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS OT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 i