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HomeMy Public PortalAbout5122 ROSEMEAD BLVD_Building__ WORKERS'COMPENSATION 6ECLAR;4TIC hereby.affirm that I have a,certificate of consent to self e isure, ora certificate'of Workers'Compenstion Insurance,or APP L I CAT I O-N .F O: R U I L D I td G PERMIT certified copy,thereof (Sec' 3800, Lab. C. -- y . N /Cn9c+j�% -COUNTY OF LOS ANGE'ES , 'BUILDING AND SAFETY._ clic No ! / .5Company J Certified..copy is hereby furnished r BUILDING. , . � " FOR,APPLICANT.TO FILL IN, - ADDRESS Certified copy is filed with the county building mspec- BUILDINGt , tion department. ADDRESS_�7 r /�,� ' C. 1 c �' E'N 4 C'19 LOC L'IT :.' NEARE T y< Applicant - £ITY. *ZIP- ^- CROSSSST. CERTIFICATE OF EXEMPTION FROM WORKERS' -,SIZE.OF,LOT.._. NOW ON LOTS MAP BOOK PAGE : PARCEL ` NCE -COMPENSATION be completed IO P eted if the permit is for one MAP undredTdollarse$100t or less leted if TRACT BLOCK LOT NO. , ONE NO: ( ). ) L. SPECIAL'' USE TEL. CL. certify that in the perforrriance df the work for which this OWNER r" i NO. CONDITIONS' o DISTRICT UP TYPE FIRE PR CESS BY ermit is issued, I sholl'not employ any person.in any manner rt'- ^ U ' ADDRESS 4� �` fJriit4,"f Zt:�J L(�l11 JF /w ONST. ZO E as to.become'.*subject'.to•:thd W ' kers',Compensation'Laws. I . CITY - •ZIP G:� i ate Applicant STATISTICA C L AP. CONDO. ARCHITECT-0R TEL.. OTICE TO.APPLICANT:. If,'after"making.this 'CertiftcaTe of "' 9 ' W. cemption; you' should become subject'-to the Workers' ENGINEER f?.� V // NO: ?�� CLASS NO. -DWELL. UNITS d, ompensation provisions of the Labor Code, you must-fooh ADDRESS /. �, L�ic� 9. �V. SEWER MAP ,ith'Comply, with such.'p'roAsions or- this.permit.shall be eemed revoked. - w w i`u5 �►1 TEL' ? �` BK;, PG_, - VALIDATION' CONTRACTOR �) Lt;� 1L- NO'3Sl� LICENSED CONTRACTORS DECLARATION'.. J hereby affirm that I am licensed under provisions.of Chdpter9 ADDRESS' `� /: _ �, %f} L{t - NO.//Z) E16�r ,VALUATION :ommencing with Section 7000)of Division 3 of the Business'and LIC. ,ofessions Code, and.my license is in full force and effect. CITY, LAS !�/J� ' $ .CLASS :f��7. _ j SQ..FT. NO.OF NO. OF CHECK cense Number 47/0 G�%C'�- Lic.Class SI SIZE STORIES FAMILIES ONE r r. - DESCRIPTION OF WORK_,... NEW .$ ontractor✓t'/J.Z,x"0.- v .'rl Date ` 7 �Z - - - ADD t _ - ] I am exempt from The li rising requirements as l,am a / I._ O licensed architect or a registered,professional engineer ALTER Q FINAL acting •in 'my professional capacity (Section 7051, ( DATE 1 REPAIR Business and Professions Code). USE O 4 FINAL !' EXISTING BLDG. ) DEMOL' B c or Reg No.l Date APPLICANT TEL. Y 'OWNER-BUILDER DECLARATION (PRINT) ' NO�; 2,T6 7A ; T._.. '�, hereby affirm that.I am exempt from the Contractor's License ADDRESS _ _ ro'o'd e �w for the following reason (Section 7031.5, Business and C ! #, 2 rofessions'Code.).r PRESENT BUILDING _ 2• o''0 6 9,7 2 I, as,owner. of the property, or my employees with ADDRESS 1 6 ;wages as their sole compensation,will do the work-and LOCALITY _9,7_2'H -"the structure iv-not intended or'offered'forsale(Section• - 7044, Business and Professions Code). MOVING - TEL - - - - a �,2'7'—8.2 ' as owner of the property, om.exclusively-contracting CONTRACTOR NO. with'1icensed contractors to construct The project (Sec- ADDRESS tion 7044, Business and.Professions Code). - CONSTRUCTION LENDING AGENCY REQUIRED. `.YARD HvO '• 'TOTAL SETBACK FROM 'EXIST: SET BACK. PROP. LINE WIDTH .. hereby affirm that there is a,construction'lending agency for FRONT - - ` -ie performance of the work for which this permit is issued • P.L. Sec:,3097, Ciy. C ) , _ _ f SIDE... P.L 27 68 A ender's Name ender's Address P.C. Fee$- .' Permit Fee # '0 0 0 0.o ) t. certify that I have read this application and state,that the ssuance Fee s �/ 2 f01 `3 3 0.0. bove inforrriation is correct. I agree t 'comply with all.'County nvestigation'Fee" rdinances and State laws relating to building construction, Total Fee ° ° �,3, nd hereby'authorize representatives of this County to enter ;'' ' pon,the'above= entioned property for''inspection'pu'rposes. - 01,2 7—8 2;. ' SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature of Applicant or Agent ' ' Dote .. .. - ©3 WORKERS ,COMPENSATION DECLARATION I hereby affirm that-I Have a.certificate;of consent to self' �P P�'I ,t e T I O FOR , Q R U I L D I,N� PERMIT- 'E RM I T . insure, or a certificate of Workers'Compenstion Insurance; or C O a c r f'ed No copy thereof (Sec. 3800, Lob Com.) y'� COUNTY OF-LOS ANGELES BUILDINGBUILDINGAND'SAFETY PoliEy Company c_Z/r' BUILDING a Certified.copy is furnished: FOR'-APPLICANT TO FILL IN ;. •' ADDRESS Certified copy is-fjled with the county b ,ilding inspec BUILDING •� i' tion department: ' ADDRESS J�O�r. ALITY. NEAREST - i Date. ��kft Apphca CITY F'. 'ZIP. CROSS'ST. " E IFICATE`OF EXEMP ON'FR 'WORKERS NO. OF BLDGS. ASSESSOR ANCE SIZE OF LOT _ NOW;ON LOT.,. .C7 _ MAP BOOK PAGE PARCEL COMPENSATION INSU, (This•sec ion-need norbe,completed if the permit_is.for one ON Pm,. USE ZONE MAP hundred dollars'(t1'0Q)-or less.),. 4 • 3 ✓J ? TRACT �b T BLOCK LOT NO NO. D, / TEL:. SPECIAL G. ., 1 certrfy that in the performance of the work.for which this OWNER' ,L NO. CONDITIONS l S `® . ermit is,issued,,I shall not em to an person in an 'manner DISTRICT. GROUP TYPE FIRE' PR SSED BY P P Y Y P Y `, CONST., Z NE so as to•becorne subject(o the Workers'Compensation Laws. ADDRESS ./ LCJv'F/ �/� ,v I CITY. �. k9 ZIP.',%��� A �-� "/ o' Date Applicant `' TEL STATISTICAL CLASSIFICATION APT. CONDO. NOTICE TO,APPLICANT: If; after.making ihis Certificate'of ARCHITECT OR -7 V / W ENGINEER NO. ` CLASS NO: DWELL',UNITS —/ CL Exemption,'you ,should become.subject ;to the Workers' to Compensation provisions of the labor Ccde,.'you must forth- ADDRESS' SEWER NEAP.: _Z with comply with such provisions or. this..permit shall be ` r/ • deemed revoked �' EL' C��f�- b 7 . BK. PG, VALIDATION. CONTRACTOR' ,t�'! S'./ Q. LICENSED CONTRACTORS'DECLARATION ` LIC,1 /� I hereby affirm that 1.0m licensed under provisions of.Chapter 9 ADDRESS 5 ,• p �/ N VALUATION (commencing with Section 7000)of,Division'3 of the Business gr d _ LIC. �- R.� $ '} •'is in full force-and'effect. CITY � CLASS_ l�/(J Professions Coded m ��4nse i D , , SQ, FT., NO. OF NO. OF CHECK License Num/ber Lic.,Class �� SIZE STORIES FAMILIES E. ',Contractor �iDate DESCRIPTION OF,WORK NEW x, ❑ ADD I`am exempt from he licensing req re ents as I'am a GGS licensed architect or a registered professional engineer .w ALTER E FINAL acting in my•professional capacity (Section 7051 ° % REPAI a DATE 1 Business and Professions Code): USE-0F r" DEN10L B NAL . EXISTING BLDG. Lic or Reg No o9S. C-+�l Date �/ APPLICANT TEL /p Y OWNER-BUILDER DECLARA71 N ' (PRINT) i O. /.-� 7 J I herebyaffirm that I am'exem t from the Contractor's License P - ADDRESSaL Law.for the following reason(Section 7031,5, Business and Professions-Code) . ;. w.,, PRESENT I; LDING as owner of the property,'or my employees with r ADDRESS, wages as their-sole compensation;will do the'work and the structure isnot intended;or offered for sale Section LOCALITY 1 8 3 70441 Business-and Professions Code,).,,. MOVING TEL. z 3 A CONTRACTOR.._ NO. ' I, as owner of the property;am.exclusively.contracting : £ , with licensed contractors to construct the project (Sec-, # e o 0 0.'0 1-. ' Yion,7044; Business and Professions Code). ADDRESS, REQUIRED ' • TOTAL SETBACK FROM EXIST. 1 ro io 3 1. 0 0 ' CONSTRUCTION LENDING AGENCY SET BACK YARD HWY,.. PROP. LINE; WIDTH thereb affirrn that there'is a'construction lending agency for FRONT } O,,o e U ' the performonce.of the,'work•for which this permit is issued P.0. S 0 �1 o� 3 1`,0 0= (Sec. 3097,Civ: C.): SID - , i P.L. _81, I.1, 04 Lender's Name ; P.C. Fee$ - Permit Fee Lender's'Address ` w I certify that.I,'have redd this application and state that the` Issuance Fee ;,.. above information"is correct:,)agree to comply with,all County, vesrigaiionlFee \ a ' .ordinances and State laws r gatin to buildin construction J g 9 Total Fee and h Ireb uthocize repre enfatives of this County to,enter upon`t dbove-me 'one rope or inspection rp ses _'-SEE REVERSE FOR EXPLANATORY LANGUAGEIL , n \ signatLA of Applicant or Agent ./Date.Date. RKERS' COMPENSATION DECLARATION ffirm that I have a certificate of consent to self_ APPLICATION FOR •B U I L D I N G, /PERMIT i , or certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, Lab. C.) vCOUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING F1Certifiedcopy is'hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 5122 '5t2Z ❑ Certified copy is filed with the county building inspec- BUILDING ) rr �C101'Tion department. ADDRESS c�SIZ2 LOCALITY /r FMI—,�L�.�+1 Date ' Applicant CITY /EMP / 7 ZIP CROSS NEARE5T. FC�_L� 5�` CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT /000 2-S Ij NO. OF NOW ON LOTS MAP BOOK PAGE PARCEL ASSESSOR COMPENSATION INSURANCE (This section need not be completed if the permit is for one@@ USE ZONE MAP qq hundred dollars ($100)or less.) TRACT3G3 OC LOT NO. NO. d } TEL. -ZZ'ZZ�B g� 3 SPECIAL I certify that in the,performance of the work for which this OWNER NO. CONDITIONS 1' permit is issued, I shall not employ any person in any mannerDDRESS ���L DISTRICT GROUP TYPEST. ZONE FIRE PROC ED BY u � so as.to become subject.to the Workers'Compensation Laws. AFz. CON`y, CITY LvS 1 E ZIP 9�1�3� �l ba Date Applicant STATISTICAL CLASSIFICATION APT. COND NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR (/�/r rj,"tK /W0 TEL. �ZZ Z,9Og L� Exemption, you should become,subject to the Workers' ENGINEER S NO. CLASS NO. —2 �� DWELL. UNITS CL Compensation provisions:of the Labor Code, you must forth- ADDRESS SEWER MAP W with ,comply with such provisions or this permit shall be TEL. p deemed revoked. X e�-o1®c9p BK. R PG, VALIDATION CONTRACTOR I�.r��� 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 LIC. Professions Code, and my license is in full force and effect.. CITY CLASS $ SQ. FT. )> NO. OF NO. OF CHECK License Number Lic.Class SIZE {ID STORIES FAMILIES ONE /�J Contractor ` Date � DESCRIPTION OF WORK T 4Jsce� NEW $ /� 2 2 2 9.3 A ❑ I am exempt from the licensing requirements as I am a ADD ❑ # o'o o.0 23 P 9 a /j 70 — v�-a�1� licensed architect or a registered professional engineer ALTER ❑ FINAL_?_ , c" � 2 0 o39.60 REPAIR acting in my professional capacity (Section 7051, [}— G rt ❑ DATE �J Business and Professions Code). USE OF EXISTING BLDG. DEMOL E] By AL`� �r •° ° ° 3 J,9,6 0= c� Lic.or Reg. No. Date APPLICANT TEL. "�""~ ) 2 1 -4-8 1 OWNER-BUILDER DECLARATION (PRINT) NO. I-hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section-7031.5, Business and ADDRESS 5 f Professions Code): PRESENT i 3 BUILD0ING. 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 p 704 Business and Professions Code). I MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS �,2 29. 4 A tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST' # 0 °'O 0 0 1 CONSTRUCTION'LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FInvestigation 2 0 2 bJ 0 0 the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). ° .0 2'6'S 0 0 U Lender's Name / �— 2, 1 4-81 m 6s i 0 Permit Fee Lender's Address Q� w I certify that I have read this application and state that the j Issuance Fee d f50) aabove information is correct. I agree to comply with all County ee ordinon es nd State laws relating to building construction, Total Fee 69- 01 � and e authorize representatives of this County to enter up e above-menti ed prop G}6r ins on Pur s, a l�"�� �2.. '� SEE REVERSE FOR EXPLANATORY LANGUAGE .Signature Applicant or Agent Dote ©s .. WORKERS',COMPENSATION DECLARATION - I; insure a,ce0 that I have a certificate of consent c self APPLICATION'. FOR . U I L D I-IV G• °P E RM I T insure, or,a certificate of Workers'Compenstipn Insurance;"or, ` a certified.copy thereof (Sec..3800 Lob..C ) i,.. I Q SAFETYTY:OCOUNFCOS ANGELES BUILDING AND .� Policy-No Company.:. Certified co is hereb 'furnished: BUILD ❑ ' pY y FOR APPLICANT TO-FILL'IN 'Certified copy is filed with'the county building inspec BUILDING • :• BUILDING,' G �+ tion'departrrient. ADDRESS .7 '• O�Ve7�!!�i /' �1�• LOCALITY 1 y►► _ _. Date Applicant ' .I CITY f ,".rie/i.7" `. ZIP ``- CROSSSST, - - CERTIFLCATE OF*EXEMPTIONFROM WORKERS', ZE of LOT �� �� NO.:OF.,,BLDGS, �N4j ASSESSOR t COMPENSATION INSURANCE. S �. �" NOW ON,LOT.. , MAP^BOOK PAGE PARCEL _-';(This`section'need not'be completed if the permit`is-for one. �' USE•ZONE: a MAP .l3' F 'ndred'dollars ($100)or.less:), - �g TRACT 46ii J'` ,BLOCK LOT NO.TEL ECIAL rAOWNER &.iASW4NONDITIONS I certify.that it..the performance of the:work for,which this F ' r permit is issued, I shall not employ any person in any manner. �.I�r TYPE IRE ' ' r ADDRESS 75 1Z� Jq`JNt7 fAJ67 N ZM� �� CONST ZONE fir` . 'DISTRICT GROUP PR ESSE so as to become sublect•to the Workers Compensation Law's -.� AN CITY 406.....140) �_ s a7 ZIP' Date Applicant STATISTICAL CLASSIFICATION "` APT..) 'CONDO: U y ARCHITECT OR _-=j�Li,.� . T: If, after'makin this Certificate of e ! :' •. NOTIC6,TO APPCICAN g � Z - `. 3. '�; ',' C ENGINEER ���_':�• CLASS NO. DWELL UNITS Exemption you should become- subject to.the Workers ,y X61 F . Co'mpensaiion provisions of the,Labor-Code;you'must forih ADDRESS; .5.�(e�' �Isl�rfAj ,rW' •D4 "I0 Z permit shall"be SEWERCMAP wrth•.,comply:.vvith such'provisions or.This F ♦.. deemed-revoked ;R` TEL 1 BK: PG, ` VALIDATION CONTRACTOR',. NO LICENSED.CONTRACTORS DECLARATION`., LIC. I hereby,affirm that I am licensed under provisions of Chapter 9 ADDRESS- ,her >NO: �" VALUATION (commencing with Section 7000)of Division:3 of the Business and Professions Cdde,'and'my license is m full force gr d effect.. CITY CLASS - $ O s..a F` SQ. S/ NO. O NO: OF HEC FT..-S ~C K - License:Number. Lic.,Class SIZE ' c -c' /�.'STORIES FAMILIES ONE DESCRIPTION OF WORK NEW ' :Contractor �'' Date.. I am exempt fromrthe licensing requirements as ham a i bJ/l�/�Oi/o�l�v ADD' A 9 P 9 r �. licensed architect or a re istered rofessional en neer -,,• ALTER � FINAL� 2 acting in my professional capacity (Section, 7051 rPI��J�Tr � '.� ATE ' 3 3'�.'9 _Business+and Professions•Lode). USE OF, REPAIR` #'-o, o .o e 2 3 D EXISTING BLDG.. 'A1C1iE'► L .❑ By A PRI . !�� +AnO v 9 �G O !� Lie:or Reg No. Date APPLICANT: TEL ?:o' 0 0 D •� OWNER-BUILDER DECLARATION ( NT) I hereby affirm that]am exempt from th_e.Contractor's License /!�>''L o'q (7'R`0.0 v _ ."Low for the'following reason-(Section 7031.5,-Business and. ADDRESS. 2re2S'a4daJY'saJ67bA)' .D4*• Professions Lode) i - PRESENT ( 7 .. � I, as'owner of the ,property, •oc;my employees with ADDRESS BUILDING5i2Z.r �' vQ`• wages as their sole eompensahon,'will do'the'work and yy ;a.`. thestructure LOCALITY .!"�MP�y.. �f4-Y ction t. ( -MO VIN TEL: 044, Business aondl Professions Coded for sale Se '+ dd s : � .CONTRACTOR l;.as owner of`the.property, am exclusive)y,contracting with licensed contractors to con'struct`the project (Sec- ADDRESS-,. • tion 7044;".Business.ard Brofessions-Code)." REQUIRED' TOTALSETBACK'FROM EXIST :CONSTRUCTION LENDING AGENCY f: SET BACK' . YARD HWY, -PROP, LINE WIDTH. ?'I"hereby'affir ;that'there:is a construe{ion;lending agency for- FRONT, " z 2. �1,0 ' the.performonce of;the work for which this permit is issued P.L. /. v (Sec. 3097 Civ:tC.,).. SIDE- a . a P:L L�ender.s Name -ry•� ,��}y ,� ` m - A4 19- - ..Fee `Permii_Fee Off' J 'Lender's Address: V J X2'•5 0 w f certify that%I have'read this application and state that the rt'+ ' +�� '.Issuance Fee a ..abov,e,information is.correct,l agree to comply;with.alL,County`. •- nvestigation Fee:' ordinance a State laws relating'to building construction, 3 .. Total Fee w and he otborize representative f this-County`to enter' 8 ,_ Q. upon boveenti e prop ori ection purposes SEE REVERSE FOR EXPLANATORY LANGUAGE - Signature-of' pplicant or Agent Date , COUNTY 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 9712090035 PHONE: (818) 285-0488 EXT: LEGAL ID NO.'OF CONST BUILDING ADDRESS: TR: 38313 UN: 3 SQ. FT STORIES TYPE 5+122 ROSEMEAD BL A-C STRUCTURE: 0 VN SGAB CA 917762266 . ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5388-019-040 THOMAS PAGE: 596 GRID: H5 LOCAVITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-3 ISSUED ON: PROCESSED BY: tEXPIRES ON: EXIST OCC GRP: 12/09/97 UT 12/09/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL B CODE: RICHTOWN REALTY (626) 288-3330- 3 3,880 8748 E. VALLEY BLVD. t1V0 TEMPLE CITY, CA FEES PAID " DESCRIPTIO OF WORK T/0 2 EXISTING LAYERS-HOT MOP FL ROOF & BUILT-UP CLASS A FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: C & A ROOFING (818) 285-7107- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 3880.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN&LE x-3880.00 VAL " 116.10 TOTAL _F.EE�S 144_35 CONTRACTOR: 'TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE C & A ROOFING (818) 285-7107- 4927 FIESTA AVE LIC. NO LOCATION AND SETBACKS TEMPLE CITY CA 91780 536091 C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: ® FOUNDATION/TRENCH FORMS LIC. NO: TSLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CM01 �(� (���B�n A Ila A� UNDERFLOOR INSULATION 144H265. 3 0. U 1`/I U p Cl FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: D YES 21 �'. �! ROOF SHEATHING Q� SCHOOL WITHIN HAZARDOUS 0 o SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS - NO NO' NO �� 0 ® FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST z FIRE SPRINKLER HANGERS SET BACK YARD: HWY:_ PROP LINE: WIDTH: cU FRONT PL- � INSULATION/WEATHER STRIP SIDE PL 1%g INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CELL ASSEM. RATED WALL ASSEMBLIES RATE SHAFTS/OPENINGS T-BAR`CEILINGS LOT DRAINAGE 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 1202090057 _ PHONE: (626) 285-0488 EXT: ILEGAL ID: - i - NO. OF CONST I i BUILDING ADDRESS: 1 ITR: 38313 UN: 3 1 SQ. FT STORIES TYPE I 5122 ROSEMEAD BL A-C (STRUCTURE: 22 VN 1 SGAB CA 917762266 1 1ASSESSOR INFORMATION NUMBER: 1 1 NEAREST CROSS STREET: 1 -15388-019-040 - 1 .. I THOMAS PAGE: 596 GRID: H5 LOCALITY: TEMPLE CITY I (TENANT: �1EXIST BLDG USE: RESID .USE ZONE: R-3 11SSUED ON: PROCESSED BY: 1 I IEXIST OCC GRP: 102/09/12 SR I (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFIN.� D TE F!]/NAI/ BY: CODE: I IZHANG, MIKE (626) 255-7888- 1 3 7,000 1� � V I I. FEES PAID 1DtSCRIPTION OF WORK I I ITEAR OFF EXISTING ROOFING MATERIAL INSTALL 04 PLY BUILT UP I 1 _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISYSTEM ON 3 UNITS & INSTALL WHITE COATING 1 (APPLICANT: TEL. NO: I I ISUNSHINE ROOFING (909) 598-8988- 1AA BLDG PERMIT ISSUANCE 27.801- -I I IAB STATE GREEN BLDG FEE 7000.00 VAL 1.00 ISPEGIAL CONDITIONS: I 1 1AC STRONG MOTION RESID 7000.00 VAL 0.70 I" I - ID2 PERMIT W/O EN-HC - 7000.00 VAL 166.60 1 I E 1 1 TOTAL FEES 196.101 I ICONTRACTOR: TEL. NO: I ('APPROVALS DATE INSPECTOR SIGNATURE . I __1SUNSHINE ROOFING (909) 598-8988- 1516 N DIAMOND BAR BLVD #183 LIC. NO 1 - ILOCATION AND SETBACKS (DIAMOND BAR CA 91765 755126 C39 I 1' " 1 1 1 1 I (SOILS ENGINEER APPROVAL I 1 1ARCHITECT OR ENGINEER: TEL. NO: I _ LF=!DATION/TRENCH FORMS I I 1 I - I 14Y - 1 LIC. 'NO: 151AB/UNDER FLOOR I 1 I f { (RAISED FLOOR FRAMING 1 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( . �� { IUNDRFLOOR,,INSULATION I I I144H265 3 07.1 1 `z I 1 I _i (FLOOR SHEATHING 1 1 INO. OF FAMILIES: DWELLING UNITS: APT/GOND.: STAT CLASS: 1 1'. 1 YES 21 i IROOr SHEATHING �� 1 'SCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS 1 I I 1AIR QUALITY: 1000 FEET MATERIALS 1 I 1 1 I NO NO NO I (FRAME INSPECTION 1 1 1 . 1 (FIRE SPRINKLER HANGERS 1 1 1 1 p (INSULATION/WEATHER STRIPI I I 1 (INTERIOR LATH/DRYWALL 1 1 I I I 1 (EXTERIOR LATH I I I . (RATED FLOOR/CEIL ASSEM. 'I I I I 1 (RATED WALL ASSEMBLIES I 1 1 I IPAT17D SHAFTS/OPENINGS 1 I I IT-BAR CEILINGS I 1 - _ F ILOT DRAINAGE 1 1 I 1 (REPORT ID: DPR261 ROUTE TO: BS0508 I 1 I 1 i,