The URL can be used to link to this page

Home My Public Portal About5126 ROSEMEAD BLVD_Building__ WORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self. APPLICATION_ FOR BUILDING PERMIT insure, or a certificate of Workers'Compenstion Insurance, or a certified copy thereof (Sec. 3800, lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No: Company BUILDING _ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS Alz Certified copy is filed with the county building inspec- BUILDING 512.70-0 + r�. tion department. ADDRESS 512. r �/'�G I' LOCALITY NEAREST Date ' Applicant' CITY /�/K ft6Gly ZIP CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' - �� S NO. OF BLDGS. ASSESSOR COMPENSATION INSURANCE SIZE OF LOT v NOW ON LOT MAA BOOK PAGE PARCEL (This section need not be completed if the permit is for one US ZONE MAP �} hundred dollars ($100)or less.) TRACT ye� BLOCK LOT NO. / �,� NO. CX � l'� �. TEL ,�aym�ij SPECIAL I certify that in the performance of the work for which this OWNER 5• LVK.. � v024f�" CONDITIONS �+�r. .�w .�w-1 DISTRICT GROUP TYPE FIRE PR SSED. U permit is issued, shall not employ any person in any manner ADDRESSS.1Z� Va l 1 , + � �, C (/ CONS j ZONE so as to become subject to the Workers'Compensation Laws. �L �J V j CITY 1— Z-.A ZIP 90032. Date Applicant STATISTICAL CLASSIFI TION_ APT. CONDO. 6� NOTICE' TO APPLICANT: If, after making this Certificate of ARCHITECT O TEL. / ua Exemption, you .should become subject to the Workers' ENGINEER ��(p S. �rV�i �. +NO CLASS NO. ® DWELL. UNITS �/ 9L Compensation provisions of the Labor Code, you must forth- ADDRESS Sy 2.A5 1��T�NOb� �► �• SEWER MAP z with comply with such provisions or this permit shall be TEL. ^^ BK PG VALIDATION deemed revoked. CONTRACTOR /V d NO. l LICENSED CONTRACTORS DECLARATION t .�� Lhereby affirm that I am licensed under provisions of ChapterLIC.- 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. 70 NO. OF !� NO. OF CHECK License Number Lic.Class SIZE STORIES 2 FAMILIES ONE `spy /J Contractor Date DESCRIPTION 8 F WORK d♦ cowNEW ❑ ' ❑ I am exempt from the licensing requirements as I am a / (Ja/7' Tb-P1NtFoO$e ADD licensed architect or a registered professional engineer11 ALTER E] FINAL /® —9234,3 A acting in my professional capacity (Section 7051, IPA4JfC ��.� 2! REPAIR ❑ DATE . Business and Professions Code). USE OF - o.o - 2 3 EXISTING BLDG. AJOA19 DEMOL ❑ FINAL' Cz L Lic. or Reg. No. _Date APPLICANT ' TEL r� Y 2 ° ° 3 8,0 0 OWNER-BUILDER DECLARATION PRINT)XfA3C9 S•CoO4 ASSDC+,NO.f=-7-04S I hereby affirm that I am exempt from the Contractor's License ADDRESS SS K7NT�~ T�a ' �C ° 0 0 3.�y' 0 0 U Law for the following reason (Section 7031.5, Business and Profesoons Code): PRESENT /� ► 2 1 6,-81 ILD ❑ BU MING V/Z2.-�4 fc�t454,* r t, I, as owner of the property, or my employees with ADDRESS wages as their sole compensation, will do the work and T'CMPL� GI l 7.57 C' the structure is not intended or offered for sale (Section LOCALITY 7044, Business and Professions Code). MOVING - TEL. fJC 1 1, cis owner of the property, am exclusively contracting CONTRACTOR NO. /l�a T 9 N f v with licensed contractors to construct the project (Sec- ADDRESS �! tion 7044, Business and Professions Code). REQUIREDTOTAL SETBACK FROM EXIST. HW CONSTRUCTION LENDING AGENCY SET BACK YARD, Y PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT (� the performance of\the work for which this permit is issued P.L. (Sec, 3097, Civ. C.) -SIDE QQ r /A ` ;a A AC.d•A'�C_ V� P.L. Lender's Nam �� /,�1, l '� Cc � � o o.0 0 0 1 m ,Lender's Addres�R{QI OC-I1�, "a��'r P.C. Fee$ '73-�j.0 Permit Fee �- {� 2 .1,05250 1. 1 certify that I have read this application and state that the t) Issuance Fee C, 2 above information is correct. I agree to comply with all County Investigation Fee ��1 ° 1, 05 2.5 0') -o ordinances an State laws relating to building construction, Total Fee CG' and her uthor.we repre tativ of this County to enter 12. 16-81 Qupon bove-menti y.for ection urposes. a ` � SEE REVERSE FOR EXPLANATORY LANGUAGE v Signature of plicont or Agent t Date ` Os 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 9712090039 PHONE: (818) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 38313 UN: 3 ( SQ. FT STORIES TYPE 5126 ROSEMEAD BL A-C STRUCTURE: 0 VN SGAB CA 917762266 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: . 5388-019-040 THOMAS;PAGE: 596 GRID: H5 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE ZONE: R-3 ISSUED ON: PROCESSED Y: EXPIRES ON: EXIST OCC GRP: 12/09/97 UT 12/09/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: RICHTOWN REALTY (626) .288-3330- 3 3,880 8748 E. VALLEY BLVD. "V TEMPLE CITY, CA FEES PAID DESCRIPTION OF WORK T/O 2 EXISTING LAYERS HOT MOP FLAT ROOF & BUILT-UP CLASS FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: A/HOT MOP ROOF APPLICANT: TEL. NO: C & A ROOFING (626) 285-7107- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 3880.00 VAL 0.50 SPECIAL CONDITIONS: D2 PERMIT W/O EN-'H CS f-3880.00 VAL 116.10 _tT,OTAL ,FEES 144.35 CONTRACTOR: TEL. NO: p APPROVALS DATE INSPECTOR SIGNATURE C & A ROOFING (818) 285-7107- U U/� 4927 FIESTA AVE LIC. NO LOCATION AND SETBACKS TEMPLE CITY CA 91780 536091 C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FORMS LIC. NO: FI I - \ SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: �� ,� r�11 9 !,� UNDERFLOOR INSULATION 144H265 3 01 �r ��_ I� q V/� q f� ------ - - - ----- ----'/ FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/CORD: STAT CLASS v - If '/ �� YES 21 �� i 1 ��'� �1' Y p ROOF SHEATHING SCHOOL WITHIN HAZARDOUS VA q � '� SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO %� ��V /,' >�/;�j FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST °�%�; ��:`_��--_� - =,%�� FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL _ INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFT /OPENINGS T-BAR CEILINGS LOT DRAINAG 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 1202090059 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ITR: 38313 UN: 9 SQ. FT STORIES TYPE 5126 ROSEMEAD BL A-C J STRUCTURE: 22 V-B SGAB CA 917762267 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS.STREET: 1 15388-019-046 THOMAS PAGE: 596 GRID: HS LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: RESID USE ZONE: R-3 JISSUED ON: PROCESSED BY: 1 1 EXIST OCC GRP: 102/09/12 SR 1 OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINFI, A E FI AL BY: CODE: JZHANG, MIKE (626) 255-7888- 1 3 7,000 FEES PAID SCRI TION OF WORK J J ITEAR OFF EXISTING ROOFING MATERIAL INSTALL 04 PLY BUILT UP I IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: ISYSTEM ON UNITS & INSTALL WHITE COATING 1 1APPLICANT: TEL. NO: I . I J ISUNSHINE ROOFING (909) 598-8988- 1AA BLDG PERMIT ISSUANCE 27.80 1 J 1 JAB STATE GREEN BLDG FEE 7000.00 VAL 1.00 ISPECIAL CONDITIONS: 1 I IAC STRONG MOTION RESID 7000.00 VAL 0.70 1 J 1 ID2 PERMIT W/0 EN-HC 7000.00 VAL 166.60 1 J 1 _1 TOTAL FEES 196.10 1 J ICONTRACTOR: TEL. NO: i 1APPROVALS DATE INSPECTOR SIGNATURE ISUNSHINE ROOFING (909) 598-8988- 1 1516 N DIAMOND BAR BLVD #183 LIC. NO ILOCATION AND SETBACKS J J IDIAMOND BAR CA 91765 755126 C39 IJ 1 1SOILS ENGINEER APPROVAL I I 1 J I I J I I JARCHITECT OR ENGINEER: TEL. NO: ( IFOUNDATION/TRENCH FORMS I I LIC. NO: I (SLAB/UNDER FLOOR 1 I I I J I I IRAISED FLOOR FRAMING I I I I J I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION I I I 1144H265 3 001 I 11 1 I IFLOOR SHEATHING I J INC. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I I 0 NO 21 i iROOF SHEATHING �1 SCHOOL WITHIN HAZARDOUS ISHEAR PANELS J I (AIR QUALITY: 1000 FEET MATERIALS J I I I I NO NO NO IFRAME INSPECTION J J I I I I I I I 1 i IFIRE SPRINKLER HANGERS J J I I I I I J I (INSULATION/WEATHER STRIPI I I I I I J I I 1 j 11NTERIOR LATH/DRYWALL I 1 I I (EXTERIOR LATH I I J I i I I I I I IRATED, FLOOR/CEIL ASSEM. I I IRATED WALL ASSEMBLIES I 1 I I I IRATED SHAFTS/OPENINGS I 1 IT-BAR CEILINGS I J i i I J I I LOT DRAINAGE I I I (REPORT ID: DPR261 ROUTE TO: BS0508 J J I I I i I J I I