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Home My Public Portal About9001 LAS TUNAS DR_Building__ WORKERS'COMPENSATION DECLARATION / ' - I hereby-affirm that I have a certificate of consent to self . insure, or a certificate of Workers'Compenstion Insurance, or APPLICATION FOR BUILDING. PERMIT a certified copy thereof (Sec. 3800, Lab ' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy Noy/ l- ,�� Company_ BUILDING ❑ Certified copy is hereby furnished. FOR APPLIC T TO FILL.IN ADDRESS DD Z �4— Certified copy is filed with the county building inspec- BUILDING m ' tion department: ADDRESS LOCALITY NEAREST Date - -P v Applicant CIT ZIP CROSS ST CERTIFICATE OF.EXEMP ON 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 d hundred dollars ($100)or,less.) TRACT BLOCK LOT NO NO TEL ��' SPECIAL 0 % I certify that in the,performance of the work for which this OWN E T L CONDITIONS permit is issued, I,shall not employ any person in any manner 4 DISTRICT GROUP TYPE FIRE X�� U so as to become subject to the Workers'Compensation Laws ADDRESS PL 3/ f e ,� CONST _ ZONE O i CITY ZIP ©S H Date Applicant ARCHITECT OR TEL STATISTICAL CLASSIFICATION APT CONDO U W NOTICE TO APPLICANT' If, after making this Certificate of ENGINEER NOa. Exemption, ,you should become subject to the Workers' CLASS NO DWELL UNITS N Compensation provisions of the Labor Code, you must forth- ADDRESS SEWER MAP Z ,with comply with such provisions or this permit shall be - TEL 6p y^ ISE_ deemed revoked CONTRACTO NO f oBK �PGVALIDATION 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 UC Professions Code, and my license is in full force and effect CITY CLASS �� ' $ 0o �` SQ FT NO OF NO OF CHECK License Numb Ofr Lic Class lSIZE STORIES FAMILIES ONE Contracto Date �Z/ DESCRIPTI N OF WORK NEW' ❑ $ ADDamexempt from the licensing requirements as I am acensed architect or a registered professional engineerALTER ❑ DATEFINAL®�acting in my professional capacity (Section 7051, REPAIR ❑ Business and Professions Code). USE OF DE OL FINAL EXISTING BLDG. By C, �—� Lic or Reg.No _Date APPLICANT / TEL OWNER-BUILDER DECLARATION (PRINT) /QE� ��2J0-7 /1NO t?-16V I hereby affirm that I am exempt from the Contractor's License ADDRESS Oj( _ ?�-TirO E�/7 ��e7 Low for the following reason (Section 7031 5,'Business and Professions Code)- PRESENT BUILDING 1, 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 �,LI 7.7 A 1, as owner of the property, am exclusively contracting CONTRACTOR NO i ! with licensed contractors to construct the project (Sec- ADDRESS # 0 0:0 0 0 tion 7.044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP LINE WIDTH _ 2o;o 3 8,5 0 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 0 3 i�5'0'� (Sec 3097 Civ C.) SIDE O r�O -82 8 2 Lender's Name Lender's Address P.0 Fee$' Permit Fee el w I certify that,I have'read this application and state that the Issuance Fee � ) aabove information is correct I agree to comply with all County Investigation Fee ``,, ordinances and State laws relating to buildmg•construction, Total Fee 3�i �ve and hereby authorize representatives of this County to enter a the above-menI ned property for msp tion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE a Signature of Applicant or Agent Date is COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9701070049 PHONE: (818) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: 1 BU TR: 11213 LT: 4 SIGN DESCRIPTION: PLASTIC LETTERS WITH FOAM BACKING 9001 LAS TUNAS DR TEMP CA 917801835 ASSESSOR I IBER: NEAREST CROSS STREET: ROSEMEAD 5387=013-015 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY G PROCESSED FAMILY BARBERS EXIST OCC GRP: 01/07/97 TC 01/07/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAT FINAL B E: EDWARDS JAMES JR;BERNICE E - 200 _ 300 NEWPORT CENTER D FEES PAID DESCRIPTION 1 Urn SIGN WITH PLASTIC LETTERS WITH FOAM BACKING FOR NEW FEE DESCRIPTION: IPUANTISY:,UOM: 1G1 AMOUNT: BARBER SHOP PP SAME AS OWNER - AA BLDG PERMIT ISSUANCE- AC AC STRONG MOTION RESID' 200.00VAL' �_ 0:50 SPECIAL CONDITIONS: D2 PERMIT W/O EN=HC' .200.00 VAL �:�43:50 TOTAL FEES CONTRACTOR: N � �� ` APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC. NO D SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH LIC. N0: SUPPORT STRUCTURE MAP 0: SEWER 14AP AG ONE: CMP: 00 . APT/CO : ST NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS � NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508