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HomeMy Public PortalAbout8943-8951 EMPEROR AVE_Building__ 76AB38A CE.#803•,O 88 APPLICATION FO R ,E U I L®I N G PERMIT BUILDING AND SAFETY DIVISION BUILDING ADDRESS jr Department of County Engineer County of Los Angeles LOCALITY r JOHN A. LAMBIE, COUNTY ENGINEER NEAREST CASSATT D GRIFFIN, SUPT OF BUILDING CROSS ST DIST RI GF3QL,P TYPE SEWER MAP FOR APPLICANT TO FILL IN L I CONST BUILDING _ .t rf.0 STATISTICAL ASSIFICATION I ADDRESS y' • BLOCK CLASS NO DWELL UNITS LOT NO �F} MAP STATE YE NO NUMBER O HWY TRACT i 44 E ZONE SPECIAL �...,t NO OF BLDGS _ CONDITIONS SIZE OF LOT y....7 I NOW ON LOT `O d USE OF s EXISTING BLDG .� X/' E BUILDING EXIST SETBACK YARD HWY STREET NWID AME T '� H OWNER FRONT MAILF' L ADDRESS a� 1/ �` /I-P �• SIDE P L CITY i' ' rNEO `P�*P'.3 'u INSPECTION RECORD ARCHITECT OR TEL ENGINEER NO S� y/ GL isi4�/$IVGI'F ? ADDRESS TEL CONTRACTOR NO229 ADDRESS DE TION OF WORK NEW ADD ALTER REPAIR DEMOLISH v SQ FT NO OF NO OF SIZE STORIES FAM LIES USE OF STRUCTURE ' !/ APPROVALS SIGNATURE OF APPLICANT DATE INSPECTOR S SIGNATURE ADDRESS FOUNDATION LOCATION FORMS MATERIALS p C g FRAME FIRE STOPS ^ FEE BRACING BOLTS VALUATION Q� FURNACE LOCATION, ' FEE CAS VENT DUCTS I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,`INT PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY P.RDINANCES AND LATH EXT STATE LAWS REGULATING4B ILDIN CONSTRU TION SIGNATURE OF — ,LLwIYLO HOUSE NUMBER COR= - PERMITTEE__ ��"r''/T-'� i1 RECT AND POSTED S ADDRESS '� ~• )FINAL,-� J� O JOHN A LAMBIE, COUNTY ENGIN R CLYDE N DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK m o cwsH PMUCT_VALIDATION `CK M o CASH - 12"7 � AtfG 1 1 4.0'0 APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) _ COUNTY OF LOS ANGELES BUILDING ��`'�3r �ADDRESS ( ✓^• ;)� L'` DEPARTMENT OF COUNTY ENGINEER clTYhf _� ZIP, ,.• BUILDING AND SAFETY DIVISION ,.. NO.OF BLDGS. BUILDING S_ SIZEOFLOT U» NOW ON LOT ADDRESS _s 1 Cvc.•s� TRACT BLOCK LOT NO.. LOCALITY r TEL. NEAREST i OWNER c-iNO.rJ {C�(3 CROSS ST C. v---vh 'e- ASSESSOR ADDRESS' q 41 V-,� i MAP BOOK PAGE PARCEL I DISTRICT GROUP TYPE FIRE RO SED BY -CITY (�' h- ZIP `' �-r CONST., } ZONE ARCENGHITECT OR y , W NO 5Lj4U L,1j L (✓ STATISTICAL CLASSIFICATION SEWER MAP ADDRESS CLASS NO. DWELL.UNITS BK G CONTRACTOR TEL.NO. USE ZONE NOAP p* LIC. (/ ADDRESS NO. s—z SPECIAL LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH 4 BLDG.SETBACK FROM FRONT PROP.LINE OF (STREET) ADDRESS CITY HIGHWAY + YARD __ TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. 6Q..t NO.OF NO.OF CHECK FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE _ r DESCRIPTION OF WORK < Z NEW [Ell O ADD ❑ BLDG.SETBACK FROM SIDE PROP.LINE OF (STREET) O ALTER ❑ ~ HIGHWAY + YARD TOTAL SETBACK FROM TYPE EXISTING USE OF REPAIR .Ll SIDE PROP.LINE HIGHWAY WIDTH Z EXISTING BLDG. ¢ IDEMOL ❑ + i�2v►c. r APPLICANT TEL T Oj CORNER CUTOFF YES C] NO ❑ (PRINT) NO. T IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) zi IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ Z C�c3 be 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 CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM PENSATION INSURANCE. SIGNATURE OF PERMITTEE ADDRESS FINAL CITY NO. DATE MAKE CHECKS PAYABLE TO: FEE c FEET $� HARVEY T. BRAN DT,COUNTY ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH ®s 76A638A CE#803 3-75' 76A638A CE#803-6-57 APPLICATION FOR BUILDING PERMIT �. COUNTY OF LOS ANGELES BUILDING DEPARTMENT OF COUNTY ENGINEER ADDRESS 8949 .a S'f ,.. np..rn BUILDING AND SAFETY DIVISION LOCALITY Tem-01,6 City, Callforilia JOHN A. LAMBIE,COUNTY ENGINEER NEAREST CASSATT D.GRIFFIN,SUPT OF BUILDING CROSS ST. mawm DISTO. GROUP TYPE SEWER MAP FOR APPLICANT TO FILL IN I BK PG RICT I coNsr. BUILDING I ADDRESS 5949 East �+..''7I erOr STATISTICAL CLASSIFICATION CLASS. NO.-:"WELL. r UNITS LOT NO. BLOCK MAPSTATE NUMBER ep - HWY. ' NO TRACT U ZONE SPECIAL NO.OF BLDGS. CONDITIONS SIZE OF LOT I NOW ON LOT USE OF —i-,11G EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST. OWNER ARTHUR J. NELSON SETBACK WIDTH FRONT � ADDRESS 6012 1.uscatel S SIDE ' CITY San Gabriel Calif, TNckT-66947 P L " ARCHITECT OR TEL. INSPECTION RECORD ENGINEER NO. ,. ADDRESS iUVI TEL. & iEArIr CONTRACTOR N O O J 62 an -Gabriev - - •ADDRESS ab ' Pl i •f DESCRIPTION OF WORK NEW ADD ALTER REPAIR DEMOLISH SQ. FT. NO.OF NO.OF SIZE STORIES FAMILIES OSE OF STRUCTURE 50,000 BTU Wall Furnace SIGNATURE OF APPROVALS an Ganr e v • DATE INSPECTOR'S SIGNATURE ADDRESS _ /'� _1�,_,.• FOUNDATION: LOCATION FORMS,MATERIALS $ 200.100 ,. - P.C. $,_,... FRAME: FIRE STOPS. . FEE BRACING,BOLTS $ D 0 FURNACE: LOCATION, VALUATION ,may Q s FEE GAS VENT.DUCTS --ZD-9 9 6�/.��J.tjt�J 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT. , PLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND ' STATE LAWS R ULATING UILDING CON TRUCTION. LATH,EXT. SIGNATURE OF I � HOUSE NUMBER COR- PERMITTE ECT AND POSTED 3232 ADDRESS N. Sa Ga r•e�. lv a�i f FINAL - JOHN A. LAMBIE.COUNTY ENGINEER. CLYDE N. DIRLAM, PRINCIPAL STRUCTURAL ENGINEER PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH OF WORKERS'COMPENSATION DECLARATION I'hereby'.affirm that I have' certificate of consent to self p P L L.C�4T I O IN FOR BUILDING PERMIT 'insure,, br'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 F] Certifiedcopy is hereby furnished. FOR APPLICANT TO.FILL•-IN Ao RESS 81hcemperor avenue ❑ Certified copy is filed with the county building inspec- FADDRE..S " tion department. 894 emperor- avenue Date Applicant temmle• city ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE 7X.250 NOW ON LOT 0 CROSS ST. roseim ad blvd. (This section need not be completed if the permit is for one sunnineyars l_su ASSESSOR hundred dollars ($100)or less.) BLOCK LOT NO. MAP BOOK 5381 PAGE 30 PARCEL 7 TEL. 8 USE ZONE MAP 2 I certify that in the performance of the work for which this nstar dev NO: 2c 0—JCJZ�} NO. - permit is issued, I shall not employ any person in any manner 3� valley blvd rosemead R_2 SPECIALi so as to'become subject to the Workers'-Compensation Laws. CONDITIONS O Date CITY ZIP 91770 U 6-27— 8 Applicant Danstar dev ARCHITECT OR TEL. cs ) DISTRICT G OUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER r.n.oser bldg de w'1 634-7•-x-13 CONST. ZONE 1-- Exem tion, you should become subject to the Workers' p v I ,. U Compensation provisions of the Labor Code, you must forth- ADDRESS 1021 sa.nta ana blvd 502 ' 1 V 3 ! W with comply with such provisions or this permit shall be tl TEL STATISTICAL CLASSIF�ATION APT. rNDO. Zdeemed revoked. CONTRACTOR ansta.r-dev' No.280-9671j. � LICENSED CONTRACTORS DECLARATION LIC• CLASS NO. DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 9-312 valleyblvd No.452243 (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. CITYOS me d CLASS B-1 BK.F PG114 VALIDATION SQ. FT. 1 NO. OF NO. OF CHECK License Number ' 492243, Lic.Class B-1' SIZE STORIES `� 2 FAMILIES ONE ;20029A VALUATI N Contractor Date janstar deV 6-27--88 DESCRIPTION OF WORK construct new b .o NEW n � � � f✓ # o•o ® 2 3 ❑'I am exempt under Sec. Zatfl apartment with attache ADD s plop. B.BP.C. for this reason garage EPAIR ❑ $ 1 - 2 9 4,5 3 USE OF i R Date: EXISTIING BLDG.- ""n/a DEMOL ❑ ° ° 2 9 i.5 3 5 Signature APPLICANT TEL. o FINAL PRINT ;m.pearson NO. 200-g671j o6.29:-$$ OWNER-BUILDER DECLARATION DATE 1 hereby affirm that I am exempt from the Contractor's License 9312 valley blvd rosemead Law for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code): PRESENT 9219 p By 2 0 0'a 0 A ❑ BUILDING 8, em eror avenue t.c. I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and X �� the structure is not intended or offered for sale(Section LOCALITY =cs c R, TT ' \ i \" j #:o 0 0:® o 7044, Business and Professions Code). MOVING / TEL. n/a ° 6 2 7,0 0 © I, as owner of the property, am exclusively contracting CONTRACTOR n a No. with licensed contractors to construct the project (Sec- m'° 6 2 7 0 0 c=i tion 7044, Business and Professions Code). ADDRESS ti \ REQUIRED YARD HWY TOTAL SETBACK F y e :3 CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH 1 0 2 9 !®8 8 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. 3097, Civ. C.). SIDE P.L. Lender's Name fir t, am .r can bank 0 _ SO Ref. # Lender's Address 8`9Lj.l valley blvd rosemead P.C. Fee$ ( Permit Fee t ii f i AI — I certify that I have read this application and state that the e2 L Issuance Fee / o .56 LDMA.P%C# o above information is correct. I agree to comply with all County [Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee D 0 LDMA Perm. # N and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. j.m.pe:=,'rson 5-27-80 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKEkS' COMPENSATION DECLARATION I'hereby;affirmthat I have'a certificate of consent to self L,I-CAT I O N ,-0 R BUILDING PERMIT rinsure, ora certificate of Workers' Compensation Insurance, y r or a certified copy thereof (Sec. 3800,Lab. C.) COUNTY,Of LOS,ANGELIES'• BUILDING AND SAFETY Policy Na Company Certified copy is hereby furnished. FOR APPLICANT TCQ;fcJILL BUILDING - IN �_ ADDRESS894' em eror avenue Certified copy is filed with the county building inspec- BUILDING _ . tion department. ADDRESS 89 em eror avenue Date Applicant CITY temple city ZIP 91780 LOCALITY rosemead blvd. & emperor ave CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 79 X 250 NO. OF NOW ON LOT 3 CROSSNNEAREST . rosemead blvd. COMPENSATION INSURANCE pp Q (This section need not be completed if the permit is for one Sunn FRWpe Viney FA' n/a LCRTNO.rJ.OLn57 AMMOR MAP BOOK 5381 PAGE 30 PARCEL 7 hundred dollars ($100)or less.) s ubd VisionUSE ZONE MAP I certify that'in the performance of the work for which this OWNER anstar dev TEL /� NO. 2t� permit is issued, I shall not employ any person in any manner ADDRES59312 e •valley blvd blvd. , f 2— SPECIAL / so as to become subject to the Wor pensation Laws. l� CONDITIONS µ� 0 r develo me CITY rosemead ZIP 91770 v Date Applica p 0= NOTICE TO APPLICANT: ;I aft r makin is Certificate of ARCHITECT R TEL. DISTRICT GROUP TYPE FIRE PR SSED BY g ENGINEER $ ,maser .bld des �,o, 834-741 CONST. ZONE U Exemption, you should beta a subject t the Workers' Compensation provisions of the or Code you must forth- ADDRESS 1021 w. santa ana blvd �� with comply with such provisions or is permit shall be deemed revoked. CONTRACTOR j an s t ar d e V 280-861 TELSTATISTICAL CLASSIFICATION U)ICATION APT. CONDO.NO Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. QL�j D DWELL. UNITS411101ft I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 9 312 e.valley b lwo. 452243 SEWER MAP g (commencing with Section 7000)of Division 3 of the Business and LIC e`A 6 9;;�g 9 Professions Code, and my license is in full force and effect. CITY .semead CLASS B-117 VALIDATION – SQ. FT. NO.OF NO. OF CHECK BK. PG. License Number 452243 Lic•class B–1 SIZE STORIES 2 FAMILIES 5 ONE �} DESCRIPTION OF WORK construct 5 n e VALUATION NEW 7 Contractor Jans tar Dey. Dote detache s apartment units ADD � I am exempt under Sec, ,A g B.&P.C. for this reason with 3 bed, 2 bath & atta neQ Qs `7� '`jj]`Q� REPAIR [ `� SE Date: EXISTING BLDG.mll l t l-f am 1 1 r e S DEMOL c Signature APP PRANTT .m. ear s on TEL 0. -8 614 FINAL (J 10 J A OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License 9312 e Valle blvd rosemea #°o o.o a 23 Law for the following reason (Section 7031.5, Business and ADDRESS FINA Professions Code): PRESENT By I 1 ;-.0 0 3 2 8 ❑ I, as owner of the property, or my employees with BUILDING 8949 emperor avenue ADDRESS 'a S wages as their sole compensation,will do the work and 3.2 8 5 the structure is not intended or offered for sale(Section [DRESS CALITY rosemead blvd & em eror 7044, Business and Professions Code). VING / TEL. ; 0'6,2 91�8 8 I, as owner of the,property, am exclusively contracting NTRACTOR n a NO. with licensed contractors to construct the project (Sec- n a \ tion 7044, Business and Professions Code). r. EQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY ET 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. �,0 0 3.2 A (Sec. 3097, Civ. C.). SIDE * �� _ x ", 0 .•o jo o � Lender's Name First American .Bank I 6 2 7,OtO LDMA1:Ref. 6 2 7,,0 0 6 Lender's Address 8 9 41 E.V a 11 e B 1 vd. P.C. Fee$ �, Permit fee &IlLe #• \ }� \a`io ose�pea a j 0.6,29.-88 o I certify that I have read this applrl anon an s t tat.the C ✓12(� Issuance Fee LDMA P/C,#r ,'ti above information is correct. I agree to comply with all County Investigation Fee ,7y 0 ordinances and State laws relating to building construction, Total Fee V LDMA Perm. # R and hereby authorize representatives of this County to enter � upon the. - ;ntioned property for inspection purposes. .m. en SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of pplicant or Agent Date WORKE14S'COMPENSATION DECLARATION T I hereby'.affirm that I have r certificate of consent to self . 1 AP P.L'I CAS I C►-N O R BUILDING PERMIT • dnsure, arra certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, lab. C.) COUNTY. OF•LOS,ANEL GES:, BUILDING AND SAFETY Policy No. Company °> ElCertified copy is hereby furnished. FOR APPLICANT'TMTQ-F11: JN- BUILDING ADDRESS F1Certified copy is filed with the county building inspec- BUILDING Eb 'EPOR AVE S EiVPEROR AVENUE tion department. ADDRESS 949 • 949 Date Applicant CITY TE'NPIE.CITY ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST d?A AD BLUR. COMPENSATION INSURANCE SIZE OF LOT 79X250 NOW ON LOT 0 CROSS ST. (This section need not be completed if the permit is for one sun z S oge vinegar . SU ASSESSOR hundred dollars ($100)or less.) TRACCtT BLOCK I LOT NO. MAP BOOK 5381 PAGE 30 1PARCEL t OWNER 'anstar developmenTELN6.28086 USE ZONE MAP r 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 93� e. valley blvd R-2: SPECIAL so as to become subject to the Workers'Compensation Laws. CONDITIONS O CITY rosene-ad - zip 91770 0 Date b-27—�9��' Applicant janstar development � ARCHITECT OR TEL DISTRICT GROUP TYPE FIRE PROCE SED BY O NOTICE TO APPLICANT: If, after making this Certificate of 34-7413 Exemption, you should become subject to the Workers' ENGINEER r. Moser bld NO.FCONST. ZONE F— Compensation provisions of the Labor Code, you must forth- ADDRESS 1021 tiv,. .santa•ana" blvd santa an 502 All V 3 W with comply with such provisions or this permit shall be deemed revoked. TEL. STATISTICAL CLASSIFICATION APT. ICPDO. N CONTRACTOR janstar dev. NO, 280-861►. Z LICENSED CONTRACTORS DECLARATION e,valle b1vdLIC 4 22'i CLASS NO. (90 DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 93• y NO. 43 (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 rosemead CLASS B-1 114 VALIDATION SQ. FT. J;g NO. OF NO. OF CHECK BK. F PG. License Number 452243 Lic.Class B91 SIZE STORIES 2 FAMILIES 1 ONE VALUATION �t Contractor_janstar dev Date 6-27-1988 DESCRIPTION OF WORK construct neva 3bdM NEW ® $ d� 0 0 3 A ❑ I am exempt under Sec. 2vbath apartment With attached ADD ❑ garage ALTER ❑ ® # o o o!0 2 3 B.BP.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT l.-m.T%P,arson NO. 250-i 6-1 DATE l I hereby affirm that I am exempt from the Contractor's License ADDRESS 9312 Salley blvd rosernead Law for the following reason (Section 7031.5, Business and IF Professions Code): PRE BUILDING �, ! . 294,53 ❑ I, as owner of the property,,or my employees with ADDRESS emioe ror ave. t.c. �, _ wages as their sole compensation,will do the work and o>o 2.9 Lt,5 3;6 the structure is not intended or offered for sale(Section LOCALITY T OSeII'ad blvd. emperor 7044, Business and Professions Code). MOVING n "a" TEL, n a ' \ _ .06 2 9f 8 8 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code). ADDRESS Z ; CK FROM EXIST. CONSTRUCTION LENDING AGENCY SETT BACKK YARD HWY TOTAPROP.ALINE WIDTH — 4 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. �.0 0 Ll A (Sec. 3097, Civ. C.). SIDE i \. �. d Lender's Name first american bank P L \#'o 0 0,o o+� � LD Ref. � Lender's Address 891 valle=lT blvd, rOSem28d P.C. Fee$ [ Permit Fee Y �I ,a627.,00 o I certify that I have read this application and state that the Issuance Fee LDP�1A P/C q , o>;o 0 above information is correct. I agree to comply with all County Investi .tion Fee 6 2 7. 0 0 o ` 0 ordinances and State laws relating to building construction, g Total Fee CV LDMA Perm. tl \ 1 ` } b 2 9 R and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. .n.pearson 6-27-1g SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date � WORKEAS'COMPENSATION DECLARATION sure, o a cer that I have r certificate of consent to self IiNA,PPL-jl'.C�ATION,_ _F:0 R BUILDING PERMIT insure, br,a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) COUN..Y(O --LOS ANGELES„ BUILDING AND SAFETY Policy No. Company `''• ` "' \ ''' ❑ BUILDING Certified copy is hereby furnished. FOR N,TO�FILL•IN� �'<:, ADDRESS 0 emperor. ave.. Certified copy is filed with the county building inspec- BUILDING tion department. ADDRESS emperoravenue Date Applicant CITY temple' city ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT 79x250 NOW ON LOT CROSSSST . rosemead blvd.. COMPENSATION INSURANCE (This section need not be completed if the permit is for one SU-nr �lcr,�e vineyar Su ;p ASSESSOR hundred dollars ($100)or less,) TRACT BLOCK LOT NO, MAP BOOK 5391 PAGE 30 PARCEL 7 TEL. USE ZONE MAP I certify that'in the performance of the work for which this OWNER janstar dev No. 290-, G71� NO 2050 permit is issued, I shall not employ any person in any manner 12 valley blvd rSl lead R-2 SPECIAL ADDRESS 93 y rose mead so as to become subject to the Workers'Compensation Laws. � Date 6-27-88 Applicant J anstar dev CITY ZIP 91770 n= NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. DISTRICT., GROUP TYPE FIRE PR CESSED B O Exemption, you should become subject to the Workers' ENGINEER r.moser bldg desi�,B. 834-7413 CONST. ZONE V Compensation provisions of the Labor Code, you must forth- ADDRESS 1,021 Santa c']na blvd `jce �� V 3 LV_ with comply with such provisions or this permit shall be TELiL deemed revoked. r. �// STATISTICAL CLASSIFIC ION APT. �NDO. U) CONTRACTOR nstar dev NO. 200— U� LICENSED CONTRACTORS DECLARATION 2 Valle blvd ros I ead Z^ CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 93 y �& 45 2x•3 (commencing with Section 7000)of Division 3 of the•Business and LIC. T?— SEWER MAP Professions Code, and my license is in full*force and effect. CITY CLASS 1 BK.F PG. 1]Ll VALIDATION SQ. FT. NO.OF NO. OF CHECK License Number 457;2243 Lic.Gass B-1 SIZE , ✓ STORIES 2 FAMILIES I ONE VALUATIO Contractor 7anstar deV Date 6-27-88 DESCRIPTION OF WORK COnstruct Inew new NEW ® $ d �0.0 3.5 A ❑ 22' I am exempt under Sec. -ath•apartment vrith attar e ADD ❑ [-] #'a a 01a,23 garage. ALTER B.BP.C. for this reason REPAIR ❑ $ ° 2 9 4.5 3 Date: USE OF BLDG. "n a DEMOL ❑ x 294,53' Signature APPLICANT TEL. pt ) FINAL OWNER-BUILDER DECLARATION PRINT .m.Dearson NO. 280-bbl DATE 0`6 2 9-�-8 8 I hereby affirm that I am exempt from the Contractor's License X7]2 Valle U1vd rosemead Law for the following reason (Section 7031.5, Business and ADDRESS J �- FIN Professions Code): PRESENT By ❑ BUILDING 8949 emperor -avenue I, as owner of the property, or my employees with ADDRESS t 104 wages as their sole compensation,will do the work and y :20-036A the structure,is not intended or offered for sale(Section kADDRESS TY rosemead blvd emperor ave. 7044, Business and Professions Code). NG TEL. ° ° ° ° ° ❑ RACTOR n a NO• n a I, as owner of the property, am exclusively contracting • ° 6.2 7,0 0 with licensed contractors to construct the project (Sec- �y tion 7044, Business and Professions Code). UIRED TOTAL SETBACK `" > ° ° 6 2 7,0.0 CONSTRUCTION LENDING AGENCY BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT r\ f 06,29:- 88 the performance of the work for which this permit is issued P. L. (Sec. 3097, Civ. C.). SIDE a� ' Lender's Name first ameriean. bank - '�1 LDMA Ref. # m Lender's Address <:941 valley blvd rosemead P.C. Fee$ E`` Permit Fee &16 t5o o I certify that I have read this application and state that the gq Cv Issuance Fee LDMA P/C# 1 above information is correct. I agree to comply with all County Investigation Fee 0 -22 ordinances and State.laws relating to building construction, and hereby authorize representatives of this County to enter Total Fee l ® LDMA Perm:# M upon the above-mentioned property for inspection purposes. a j.m.pearson —27 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date W61RKERS' COMPENSATION DECLARATION • d hereby affirm that•I have a certificate of consent to self A P P•L I CAT 1.O I\1 ..F Q R BUILDING P E RM I T ti iniure, bra certificate of Workers' Compensation Insurance, fl or a certified copy thereof (Sec. 3800, Lab. C. 1 COUNTY OV LOS ANGELES BUILDING AND SAFETY Policy No. Compony "''" BUILUING El Certified copy is hereby furnished. FOR APPLICANT TO_FILLIN •. ADDRESS SqLi3emperor avenue Certified copy is filed with the county building inspec- BUILDINGEl , tion department. ADDRESS 89 emperor avenue Date Applicant CITY temple city ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT 79x250 NOW ON LOT CROSS ST. rosemead blvd (This section need not be completed if the permit is for one SU= Slone vineyar SU ri` ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK 5381 1 PAGE 30 1PARCEL 7 OWNER anstar development NO. 2&0-861i� USE ZONE MAP S3 e-� I certify that in the performance of the work for which this SPE ^ ✓iC permit is issued, I shall not employ any person in any manner n 1 2 Valle blvd rose-mead SPECIAL ADDRESS /3 R-2 CONDITIONS so as to become subject to the Workers'Compensation Laws. �7�7 U 6-27-88 janstar dev CITY ZIP ill I !0' Date Applicant ARCHITECT OR TEL. t0= NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER r.moser bldg de si LTO.B -741 DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' �4 CONST. ZO U Compensation provisions of the Labor Code, you must forth- ADDRESS 1021 santa ana•blvd 5�� /"` V W_ with comply with such provisions or this permit shall be jEL. STATISTICAL CLASSIFICATION APT. DO. N deemed revoked. CONTRACTOR anstar developmenryp c0—�1LJ /•y/ LICENSED CONTRACTORS DECLARATION vette blvd. LIC 1 522Lj 3 CLASS NO. Q 0 DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 33]2 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 osemead CLASS b-� VALIDATION SQ. FT. NO. OF NO.OF CHECK BK. F PG. 1 License Number 452243 Lic.Class B-1 SIZE 1 STORIES 2 FAMILIES ONE VALUATION J Contractor jan star dev Date 6-27-88 DESCRIPTION OF WORK construct new 3bdm NEW $ �ao I am exempt under Sec. 21 bath aiDartment :"Jlth attache.�+DD ❑ 10111,ALTER ❑ B.BP.C. for this reason casae REPAIR ❑ $ ;20027A Date: USE OF EXISTING BLDG. n/a DEMOL ❑ #'o o • • 2 3 Signature APPLICANT TEL. g PRINT •m•pe sonN0.280— FINAL l ,° 2 9 U,5 3 OWNER-BUILDER DECLARATION DATE r I hereby affirm that I am exempt from the Contractor's License 12 valley bl�rd rose^ead FI ° ° 2 9 6.5 3 5 Low for the following reason (Section 7031.5, Business and ADDRESS 93 y 1. Professions Code): p Y 0629.-88. r-1 1, 89 elTneror avenue t.c. 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY rOSelTiv ad blvd & er,T(�erOr ave the structure is not intended or offered for sale(Section ' 7044, Business and Professions Code). MOVING TEL. n/a I, as owner of the property, am exclusively contracting CONTRACTOR n/a NO. with licensed contractors to construct the project (Sec- ADDRESS 0.0 2,8 A tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK # oro e • o CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1 Y° 6 2 7.O I hereby affirm that there is a construction lending agency for FRONT ° ° 6 2 7,O O v the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE ;'0 6,2.9--8 8 first aver.ica.n bank P.L. Lender's Name LDMA Ref. #_ Lender's Address 3911.1 valley blvd,. ro-semead P.C. Fee$ Per Fee � ' 3 g I certify that I have read this application and state that the C� Issuance Fee Or-S LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee /� 0 ordinances and State laws relating to building construction, Total Fee A/ 0 LDMA Perm. # and hereby authorize representatives of this County to enter m upon the above-mentioned property for inspection purposes. j.m.pearson 6-27-•88" SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date