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HomeMy Public PortalAbout5417-5429 ROSEMEAD BLVD_Building__ WORKERS' COMPENSATION DECLARATION C, L ✓f��l/ /� W �L�� ��� insureboraaffirm certif certificate of Wo ke s' Compensation ent Insuran elf APPLICATION FOR BUILDING" P E RIVI I T or a certified copy thereof ec. 3800, Lab. C.) --- ��'� COUNTY OF LOS ANGELES BUILDING ANDS TY Policy Noll—5— LS Company S� �e / AJO Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS '✓ ❑ Certified copy is filed with the county bAdi inspec- BUILDING tion deportment. /�c^C � ADDRESSDate � ApplicanAFROM,146RIKERS ��` CITY ZIP LOCALITY L CERTIFICATE OF EXEMPTI ' NO. OF BLDGS. NEAREST COMPENSATION INSUf� CE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed i the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK P E PARCEL TEL. USE ZONE MAP / I certify that in the. performance of the work for which this OWNER /r; f�d iNO. n NO. 4 permit is issued, I shall not employ any person in any manner SPECIALi so as to become subject to the Workers'Compensation Laws. ADDRESS / /�e" ��fJ �/� CONDITIONS U Date Applicant CITY ZIP NOTICE TO APPLICANT: If, after making this Certificateof ARCHITECT OR TEL. DISTRICT G OUP I TYPE FIRE I PRCCESSED BY O ENGINEER NO. r. NST. ZE U, Exemption, you should become subject to the Workers' ` Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be t,� Zp„9TEL,�� t�/ STATISTICAL CLASSIFICATION APT. C NDO. to deemed revoked. CONTRACTOR P s �vKl�d NO. a` • Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.—L—'-7-1--DWELL. UNITS '— I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS (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 CLASS BK PG j 3 VALIDATION SQ. FT. NO.OF NO. OF CHECK License Number ✓ �/ ( Lic.'Class c— C SIZE STORIES FAMILIES ONE a / 1:1VALUATION Contractor—&J'_ J �,pate U—! —� DESCRIPTION OF WO/RK, NEW lJ ❑ �J � ADD [J $ , I am exempt under Sec. ON ALTER L] B.BP.C. for this reason G REPAIR ❑ $ Date: USE OF �j7S' DEMOL ❑ :981 S 7 A EXISTING BLDG. Signature APPLICANT / TEL. 7— /!6 L FINAL / a a o 0 2 3 PRINT) C� ��AJ�/�NO. 6( / !� OWNER-BUILDER DECLARATION / DATE ()i (�// I hereby affirm that I am exempt from the Contractor's License b'Z� R 1[�.fr� ) ° 037.50 Law for the following reason (Section 7031.5, Business and ADDRESS FIN Professions Code): PRE EN BY G 0'0 0 37.500' BUILDING ❑ 1, as owner of the property, or my employees with ADDRESS, wages as their sole compensation will do the work and :I Q 1 7-87 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). MOVING TEL. �$ 1 5 8 A ❑ I, as owner of the property, am exclusively contracting LADDR OR NO. with licensed contractors to construct the project (Sec- # ° o 0 0:0 tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY ID BACK YARD HWY ED TOTAPREOTPAINEF WIDTH ro 0 49.88 I hereby affirm that there is a construction lending agency for 0-0 0 4 9.8 8 czi EQU the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). „� Q 1 7-t Lender's Name LDMA Ref. # Lender's Address V V Permit Feea I certify that I have read this application and state that the Issuance Fee t/d�] LDMAP/C# above information is correct. I agree to comply with all County n Fee 0 ordinances and State laws relating to building construction, Total Fee LDMA Perm. # R and hereby authorize representatives of this County to enter upon the'a ye-ment' n property for i spection purposes. f �� /tel—/ j—F SEE REVERSE FOR EXPLANATORY LANGUAGE Signature Applicant or Agent Date APPLICATION FOR BUILDING PERMIT . COUNTY OF LOS ANGELES - BUILDING AND SAFETY WORKER'�p COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDI?ADDRESS'�/� I hereby affirm that I have a certificate of consent to self insure, BUILDINGG/{+-DDRESS -/ / ' • .R 13ZV - or a certificate of Workers' Compensation Insurance,or a certified `I '�' �� m Ea`7 �V6v ." ^' 63x, q i,']76 . copy thereof(Seca 00;Lab.C.) _�. j GIT�wC� �a I ZIP 17 7z, LOCALITY 1 Policy No. Company V^/ SIZE OF LCT /J NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished NEAREST CROSS ST ❑ Certified copy is filed with the county building inspection TRACT BLOCKLOT NO. °�QL�wt�il department. I^ I 1 USE ZONE MAP NO. .— DateA- AppliCBnt �J/el•(Q PJ,05a/• ASSESSOR MAP BOOK PAGE PARCEL ' SPECIAL CONDITIONS CERTIFICATE OF.EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE G'R�AT W��TFIg'.✓ . (fig 2�Q-lo64 WITHIN 1000 FT.OF SCHOOL? YES `/ NO (This section need not be completed if.the permit is for one hundred ADDRESS » DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED 13Y dollars ($100)or less.) �— I certify that in the performance of the WoCITY ZIP rk for which this permit cQ is issued, I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. �1 �j STATISTICAL CLASSIFICATION. APT CONDO Date l rt pplicaht ��)P[,)a '���,rr% ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT If, after making" this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' Ck>TRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must .forthwith R—�_ [ N I��qQ I-7111 FRONT comply with such provisions or this permit.shall be deemed revoked. DDRESS _ LIPEI_q,NO. PL } LICENSED CONTRACTORS DECLARATION Cc�� Fri ` �Zd3' SIDE O CI Y n ryl /•v, LIC. LASS PL U I hereby affirm that I am licensed,underprovisions of Chapter 9 �a'"� A/c, fri —I �-/• SEWER MAP (commencing with Section 7000)•of Division 3 of the Business and. SQ.F .SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,and my license is in full force and effect. �ji2 j �' NEW BK PG �, O DESCRIPTION OF WORK VALU ON , i F�' U License Numb - Lic.Class — / ADD ❑ LLJ Contracto Date ALTER ❑ ACC a_ ❑ I am exempt under Sec.' REPAIR El 3303 ° ' Z BAP.C. for this reason DEMOL ElLDMA P/C# F F Date: USE OF EXISTING BLDG. URM ❑ ( TAL 154 - 13 Signature ICAN (PRINT) T L NO. LDMA Perm# CHECK 15 4°1 ❑ I, as owner of the property, or my employees with wages as Q tr » `61�S�Gd�^���� O CHANGE GE .LTLI D ES ��}� their sole.compensation, will do the work and the structure is T �1 H not.intended or offered for sale (Section 7044, Business and t I�F'i�� Vim`' /^�qj FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZA OUS AP OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE /fA J s I fi }11I-1 ''t� `tj aFJ El 1, as owner.of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY > � 4 t licensed contractors to construct the project (Section 7044, YEs❑ No❑ t °aa, F11 62-1110 Business and.Professions Code.) t4�� �•1 WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING =I=- iZ OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION.OR MODIFICATION FROM THE SOUTH 3303 - 'CONS'TRUC.TION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. - 1 ITEMS I hereby-affirm that there is a construction lending agency for YES❑ NO❑ the performance Of the work for which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING TOTAL AL -_80 nz 50 3097,CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, 51-1.510i F=yi TITLE 2,CHAPTER 2.20 SECTIONS 2.20.100 THROUGH 2.20 140 CONCERNING HAZARDOUS ,h}.i:,j •1�°'_F' 01Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. - - Lender's Address CHANGE °GO Ir OWNER OR AGENT 3 I certify that I have read this application and-state under penalty a P.C.FEE ,_ t-y� PERMIT FEE 3/141'96,1 t :9�_ p w perjury that the above information is correct.I agree to"comply Q ' with all county rdinances and.State laws relating to building f (a j[Vfi F1 r f l 1 st _rr In c Fast on, a 'he by u brize representatives of this County ISSUANCE FEE ,z °j fi 0 0:ent upon e a ve boned property for insgectioq pya-pose/ , 3® !�1� ' f /L� �j INVESTIGATION FEE TOTAL FEE 2 gnaw, of rw cam o�Aga oa�e �f SEE REVERSE FOR EXPLANATORY LANGUAGE ! KFOR T APPLICATIC BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY FOR APPLICANT TO FILL IN BUILDING ADDRESS WORKER'S COMPENSATION DECLARATION c 1 hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS .541 or a certificate of Workers' Compensation Insurance,or a certified copy thereof (Sec.3800,Lab.C.) CITY ZIP Policy No. 11-7 $ -9 3 Company -' }� e r l LOCALITY of SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ ertified copy is hereby furnished. NEAREST CROSS ST. ertified copy is filed with the co my bui in nspection TRACT BLOCK LOT NO. W� 1 //__ department. USE ZONE MAP NO. i ASSESSOR MAP BOOK PAGE PARCEL Date "' i,)''�3 Applicant SPECIAL CONDITIONS CERTIFICATE OF EXEMPT ON FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE 1.4L 106 WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS r _ Q �1� DISTRICT GROUP TYPE ONST FIRE ZONE PROCESSED BY dollars ($100)or less.) 19 CITY J ZIP I certify that in the performance of the work for which this permit LIE C ��Q is issued, I shall not employ any person in any manner so as to 0 become subject to the Workers'Com ensation Laws. ARCHITECT OR ENGINEE TEL NO. P STATISTICAL CL A SSI FICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT.' If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become Subject t0 the Workers' CONTRACTOTyEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith 0. C Q FRONT comply with such provisions or this permit shall be deemed revoked. ADRESS LIC.NO. P L tJAUJ 19 S?7 LICENSED CONTRACTORS DECLARATION VV- PILE CITY. A F. LIC.CI�.SS PL >_I hereby affirm that I am licensed underprovisions of Chapter 9 (" SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SO.FT.SIZE NO.OF STORIES NO.OF FAMILIES a Professions Code,an my license is in full force and effect. NEW BK PG , U C 5 DESCRIPTION OF WORK ADD ❑ VALUATION License Numbe Lia Class T ,.1 �1LvL o Contractor Date ALTER ❑ $ 0 N. �� REPAIR ❑ ~ ❑ 1 am exempt un er Sec. $ V BAP.C.for this reason DEMOL ❑ W LDMA P/C# d Date: USE OF EXISTING BLDG. URM ❑ N '"�: Z Signature APPLICAIJ(PRINT) TEL O. LDMA Perm# - ;,;•_V. s i� 9 3 Z •_ ❑ I, as owner'of the property, or my employees with wages as their sole compensation will do the work and the structure is ADDRESS„ O not intended or offered for sale (Section 7044, Business and Y.- S—k 0XI Ir to FINAL DATE _ a0 Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ 1, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J Y g AMOUNTS SPEC IFIE N THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY :wig,;,3 °L licensed contractors to construct the project (Section 7044, YES❑ NoIt/ 2: Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING '�•��'�I OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH. CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR i I t E ice' GUIDELINES. �,{/ _ I herebyaffirm that there is a construction lending agency for > E TA 5__ '`°C' r• 9 9 Y VES❑ NO TOTA_t 1 i� �-._E-._F+c i�.P is a the performance of the work for which this permit is issued(Sec. I HAVE READ THE HA2 RDOUS MAT RI S INFORMATION GUIDE AND THE SCAQMD PERMITTING 3097,Civ.C.) CHECKLIST.I UND TAND MY Q EMENTS UNDER THE LOS ANGELES Y CODE, ' i ':3\ _=-1°`=l•= TITLE 2.CHAPTE .20 SEGTI S 2 .100 THROUGH 2.20.140 CON NG HAZARDOUS d Lender's Name MATERIALS REP ING AND O INING A PERMIT FROM A. �:€st4;'y o Lender's Address L1 9 O OWNER OR AGENT o I certify that I have read this application and state under penalty _ O of perjury that the aboveLhorize is correct.I agree to comply P.C.FEE PERMIT FEE�p ISO t_I_j_"j_t'll�j_j with all co ty ordin cte laws relating to building r=: W,� _L;a m construct n and her presentatives of this County ISSUANCE FEE t-tl j a_,°h:.m to enter p the ab -mperty for inspection purposes. -/f q% INVESTIGATION FEE TOTAL FEE � Ggnawr o�Aee Daae SEE REVERSE FOR EXPLANATORY LANGUAGE WORKERS'COMPENSATION DECLARATION e i 1 heriby. affirm that I have a certificate of consent to self insure, or o certificatq of Workers' Compensation Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800,.Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.48- Company F1ADDRESS /BUILDING S E/IC'G Certified copy is hereby furnished. FOR APPLICANT TO FILL IN Q f/C<ertified copy is filed with the-county building inspec- BUILDING /�7 LLJJ tion d�eepartent. ADDRESS // Date c/ v Applicant CITU f ZIP LOCALITY CE TIN ATE OF EXEMPTION FROM W RKERS' NO.OF BLDGS. NEAREST. COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. /T (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. — OWNER. NO IDI DI USE ZONE MAP 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 SPECIALt so as to become subject to the Workers'Compensation Laws. ADDRESS (O ZS � �' CONDITIONS U CITY T� (/+a'( ZIPS 1 ,9-0,3, Q Date - Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT+: If, after making this Certificate of DISTRICT ENGINEER NO. GROUP TYPE CONST. ZONE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' �' („)t3 Compensation provisions of the Labor Code, you must forth- ADDRESS / b G V J W with comply with,such provisions or this permit shall be ti TEL. STATISTICAL CLASSIFIC/,JION deemed revoked. APT. ONDO. N CONTRACTOR O NO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. /1DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESStai R1 NO., SEWER P (commencing with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY 40rc CLASS BKS VALIDATION �J SQ. FT. �]1� NO. OF NO. OF CHECK License Number Lic.Class �C 7� SIZE 9/� STORIES FAMILIES ONE ❑ I VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ IY�P��VtsTNil ADD El I am exempt under Sec. Z ALTER E] ;27.7 3, B B.BP.C. for this reasonS #.* o o • s REPAIRUSE OF ❑ a 66 Date: il EXISTIING BLDG. DEMOL ❑ ®fl 29.09 Signature APPLICANT TEL. 'glia FINA _ 8 O ER- UI DE DE RATION PRINT / ) NO. SOl O DAT, , 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS �`�� �/yli Vt< �JI . :5,C2 FIN Professions Code): PRE 8 ;' ';27823A ❑ BUILDING I, as owner of the property, or my employees with ADDRESS #•e e o 0.2 3 wages as their sole compensation,will do the work and the structure is not.intended or offered for sole(Section LOCALITY ® '�'o o 4 7,8 2 7044, Business and Professions Code). MOVING TEL. ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. ° o 0 4 7,8'2 5 with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 1 hereby affirm that there is a construction lending agency for FRONT 9,02-$7 the performance of the work for which this permit is issued - P.L. (Sec. 3097, Civ. C.). SIDE P.L. ;97 82 -d'Lender's Name LDMA Ref. # ® ® o •f® m P.C. Fee$ 4 0q Permit Fee # t Lender's AddressPol 1 certify that I have read this application and state that the Issuance Fee C-(/ V LDMA P/C# ,0 2,] 8 6 3 g above information is correct. I agree to comply with all County Investigation Fee _ 0 ordinance and State laws relating to building construction, Total Fee. LDMerm A P :N 6 and he y authorize representatives of this County to enter upon t o e- a toned property for inspection purposes. 9,0 2t- 7 r SEE REVERSE FOR EXPLANATORY LANGUAGE n Sign ture of Applicant or Agent Ocite WORKERS'COMPENSATION DECLARATION insure, or afcertif carte of\0'orke s' itbmpensation InsurancI have a certificate of consent to e, APPLICATION F O It BUILDING PERMIT �] or a certified copy thereof (Sec. 3800, Lab. C.) Policy No. F 3 5 5 6 Q Company FAT RMnNT COUNTY OF LOS ANGELES BUILDING AND SAFETY Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS 5417 ROSEMEAD BLVD . ❑ Certified copy is filed with the co u ty building inspec- BUILDING tiot dep oment. ADDRESS 5.417 ROSEMEAD BLVD , TEMPLE CITY 91780 Date Applicant CITY TEMPLE CITY zip q 1780 LOCALITY ERTI I AT OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. BROADWAY (This section need not be•completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL OWNER S U P E R C U T S NO. USE ZONE MAP 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 SPECIALi so as to become subject to the Workers'Compensation Laws. ADDRESS 1 5 0 GATE FIVE CONDITIONS O Date Applicant 4 6 CITY SAUSALITO zip v d-' NOTICE TO APPLICANT: If, .after making this Certificateof ARCHITECT OR TEL. DISTRICT. GR UP TYPE FIRE PROCESSED BY O ENGINEER NO. CONST. J ZONE F— Exemption, you should become subject to the Workers' � /L V V Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or,this permit shall be deemed revoked. EL. STATISTICAL CLASSIFICATION APT. JONDO. Cn CONTRACTOR,NITS LITE SIGNSTNO41 Z LICENSED CONTRACTORS DECLARATIONLIC• CLASS NO. vDWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 21.0.01 . SUPERIOR S TNo. 309508 SEWER MAP (commencing'with Section 7000)of Division 3 of the Business and LIC. Professions Code, and my license is in full force and effect. CITY CHATSWORTH 91311 CLASS C—10 BK PG VALIDATION 3 O 9 5 O S SQ. FT. NO. OF NO.OF CHECK License Number Lic.Class C—1 0 SIZE STORIES FAMILIES ONE VALUATION Contractor N I TE LITE S I GUS ie DESCRIPTION OF WORK ®Vr_ NEW 1:1S ADD El ' n F-1I am exempt under Sec. ^��L lTtO.�' ALTER ❑ 01111� 2 7 9 6'0 A B.&P.C. for this reason �t:Jt�:'�� 1�����lT REPAIR ❑ $ # 0 0 0.0 0 1 Date: USE OF ❑ EXISTING BLDG. DEMOL I -.049.88 Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION PRINT NO. DATE7 0 a 0 4 9,8 8.5 I hereby affirm that I am exempt from the Contractor's License _` Low for the following reason (Section 7031.5, Business and ADDRESS FIN 0 9 2.1 '°`8 7 Professions Code): PRESENT B �^ I, as owner of,the property, or my employees with BUILDINGADDRESS wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CK FROM Mbl. CONSTRUCTION LENDING AGENCY SET BACKK YARD HWY TOTAPROP.L NE 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 P.L. Lender's Name LDMA Ref. # P.C. Fee$ .Permit Fee Lender's Address I certify that I have read this application and state that the Issuance Fee (!. LDMA P/C#. above information is rrect. I agree to comply with all County Investigation Fee ordinances an Stat laws relating to building construction, ; N oncl hereby tho a iepresentatives•of this County to enter Total Fee LDMA Perm. # upon the v d property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE ignature of pplicant or Agent Date WORKERS'COMPENSATION DECLARATION reb.-oEfirm..4 at I have a certificate of consent.to self cate of Workers' Compensation insurance, APPLICATION FOR BUILDING PERMIT c,copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND. SAFETY Policy No.` Company ❑ Certified,copy is hereby furnished. FOR,APPLICI T TO FILL IN., ao�REss �' P VK SE�t-� bi_v � Certified copy is filed with the county building inspec- BUILDING V4 Date tion department. ADDRESS, F3� ' L+/iD Date Applicant CITY + M -� ZIP LOCALITY CERTIFICATE OF EXEMPTION'FROM WORKERS' y� � NO. bF BLDGS: NEAREST COMPENSATION INSURANCE SIZE OF LOT f YAC NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one PARC • hundred dollars ($100)or less.) TRACT LOT NO. MAP BOOK PAGE PARCEL EL. USE ZONE MAP I certifyOWNER �INO._that in the performance of the work four which this NO. > permit is issued, I sHoll not employ any person in any manner SPECIAL so os'to become subject to the Wo kers;,-omWIM, aws. ADDRESS /Y CJ�VP CONDITIONS , �i Date pplicant CITY - ZIP�� �. C ARCHITECT O TELf�i DISTRICT GROUP TYPE.. FIRE PR CESSED BY O OT 11.E O PPLI ANT: If, after making this Certificate of ENGINEER O Exemption, you should become subject.-to the Workers' CONST. / E I yu: Compensation provisions of the Labor Code, you must forth-_ s ADD_RESS� fy+v �'� �P lt�� I/ with comply with such- provisions or this permit shall be, -,_ fTEL. STATISTICAL CLASSIFICATION APT. CONDO. rA deemed revoked. CONTRACTOR ���G��Y; NO:- 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 7000)of Division 3 of the Business and, LIC SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASS BK.(�_ PG. /✓ VALIDATION I, SQ. F OF NO.OF _CHECK License Number ��O Lic.Class �D SIZE STORIES FAMILIES^'� ONE �I 9 7.7 Iq. NEW # o 0 VALUATION Contractor bAow+la P Date DESCRIPTION OF WORK DD $ ° ° 23 I am exempt under Sec. p ALTER l] I �t� •.. B.&P.C. for this reason USE OF REPAIR ❑ $ � I �,4 47.75 *Date: EXISTING BLDG. DEMOL ❑ �i' APP(PRINT) �l TIVE02Sj-7 [> 1.4 4 7.7 5 Signatur FI NA ° O 'NER- UI DER` CLA ATION DATE I hereby affirm that I am exempt from the Contractor's License7,08'-86 Law for the following reason (Section 7031.5, Business and ADDRES ` `""+�'�� FINA T, Professions Code): PRESENT By ❑ BUILDING 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. CONTRACTOR NO. ❑ I, as owner of the property, am exclusively contracting z 6 T 4,7 A r 1 with licensed contractors to construct the project (Sec- ADDRESS r% tion 7044, Business and Professions Code). # 0 0 0 0 0 1 REQUIRED TOTAL SETBACK FROM - `- CONSTRUCTION LENDING AGENCY SET BACK YARD "HWY PROP. LINE WIDTH' I T,6 1 386 � I hereby affirm that there is a construction lending agency for FRONT \'A r the,performance of the work for which this-permit is issued P.L. ° 1,-6 1 .3 8 6,J �! (Sec. 3097, Civ. C.). SIDE { :I 21 9-&6 o P.L.. Lender's Name P.C. Fee$ n Permit Fee r LDMA Ref. # l D3 3 Lender's Address > {� 1,certify that I.have read this application and state that the �T Issuance Fee (� O LDMA P/C# ' F. above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating.to building construction, Total Fee "'/ /3 1 0 LDMA*Perm. #" u and hereby authorize representatives of this County to enter upon Bove- a oned property for inspection purposes. a `` // I Z SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Da -WORKERS' COMPENSATION DECLARATION insure,oraafcertif cafirm thatte of Workes' Compensatioa certificate of n Insuran ent to self APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) - p COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No@](J -Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO•FILL IN BUILDING ADDRESS ' Certified copy is filed with the county building inspec- BUILDING tion department. Y r(pa y�, ADDRESS Dote4 14 -9S Applicant MLS; -�4'�� _ CITY ZIP ISOLOCALITY , CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST G COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BL�OCK LOT NO. MAP BOOK P PARCEL OWNER 3 { " ©NO. �, USE ZON MAP 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 �� t ? C SPECIAL so as to become subject to the Workers'Compensation Lows. ADDRESS + �} CONDITIONS O CITY fin/ r L ZIP /9� U Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of DISTRICT GROUP TYPE FIRE PRO SSED BY O ENGINEER NO. -t/ CONST. ZONE U Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. �- } �j STATISTICAL CLASSIFICATION APT. JPNDO. deemed revoked., CONTRACTOR NO*a t _ Z LICENSED CONTRACTORS DECLARATION C Alm LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS T N 2� (commencing with Section 7000)of Division 3 of the Business and � e LIC SEWER MAP Professions Code, and my license is in full force'ond effect. CITY �it- r �17 CLASS B BK VALIDATION j� SQ. FT. NO.OF NO.OF CHECK License Number ' 2":1 Lic.Class `� SIZE STORIES FAMILIES ONE .c VA770 M� b "1 Date DESCRIPTION OF WORK NEW iContractor ❑ ❑ i�C�i� �`' ADD I am exempt under Sec. ALTER ❑ 2 9 2 9,9 A B.BP.C. for this reason REPAIR ❑ $ Date: USE OF ❑ # 0 0 0.0 23 EXISTING BLDG. DEMOL Signature APPLICANT J In j,� 1 ', i NO. ��iiA1 FINAL 10 o37,50 PRINT `-+\ 6-ly -C Sp ��Q OWNER-BUILDER DECLARATION DATE C!/% C/ I hereby affirm that I am exempt from the Contractor's License o 0 0 37.5 0 5 Law for the following reason (Section 7031.5, Business and ADDRESS o �� FINA Professions Code): PRESENT 4,0 4-8 8 ❑ I, as owner of the property, or my employees with BUILDING 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. 9 3 Q 0'A ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- #.a 0 0 0 0 11 tion 7044, Business and Professions Code). ADDRESS CK FIFT' CONSTRUCTION LENDING AGENCY SETBACK YARD HWY TOTAPREOTPAINE WIDTH I b 0 4 Q 5 0 I hereby affirm that there is a construction lending agency for FRONT 4,0.5 0 the performance of the work for which this permit is issued P.L. o,o o (Sec. 3097, Civ. C.). SIDE P.L. 04,04-88 Lender's Name m P.C. Fee$ 331-50 Permit Fee LDMA Ref. # Lender's Address 3 g I certify that I have read this application and state that the Issuance Fee (L/t 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, N and hereby authorize representatives of this County To enter Total Fee LDMA Perm. # upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date RKERS'COMPENSATION DECLARATIONthat I have a certificate of — tl it sure, or arcertif certificate of Workers' Compensation eInsuran ont to f APPLICATION FOR l.J I L D I N G " P E RAiI I T �] or o certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING Certified copy is hereby furnished. FOR APP (CANT TO FILL IN VNEAREST Certified copy is filed with the county building inspec- BUILDING /�tion department. ADDRESS — -6 f�IF Date Applicant CITY ZIP g k0 CERTIFICATE OF EXEMPTION FROM WORKERS' '/� NO. OF BLDGS.° dCOMPENSATION INSURANCE SIZE OF LOT V 0oNOW ON LOT . (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL, USE ZONE MAP OWNER I certify that in the performance of the work for which this NO. (/'y permit is issued, I shall not employ any per so 'n any manner DDRESS �Q /�� CONDITIONS so as to become subject to the Worker 'C ensation Laws. Q / CITY )Z 1/ ZIP U Date Applicant NOTIC TO APPLICANT: If, after maki is Cerfi ica o ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE PRO C ED BY O Exemption, you should become subject to the Workers' ENGINEER NO. � CONST. ZONE W Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. DO.' N deemed revoked. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION LIC, CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (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 BK. Pc VALIDATION SO. FT. NO.OF NO. OF CHECK License Number Lic.Class SIZE STORIES FAMILIES ONE 288 Q,5 A Q DESCRIPTION OF WORK �i9 NEW VALUATION # 0 0 o e '�3 Contractor Date ,e ADD $ v I am exempt under Sec. r ALTER (0:] ) o - 37,50 B.BP.C. for this reason V REPAIR C3 $ a 0 0. 8-3: Date: Date: U E OF t DEMOL ❑ \\\ EXISTING BLDG. Signature APPLICANT TEL. , Cg FINAL 0 1 2 O'`8 8 / i g OWNER-BUILDER DECLARATION PRINT ^ Z tit NO ' DATE/ .y khereb °affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS (� _ S �S FINA Professions Code): BY r �8 8 5 2 A BUILDING 1, as owner of the property, or my employees with ADDRESS .,', # o 0 oto 2 2 7• wages as their sole compensation,will do the work and LOCALITY iy the structure is not intended or offered for sale Section 7044, Business and Professions Code). MOVING TEL. 1, as owner of the property, am-exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). CONSTRUCTION LENDING AGENCY REQUIRED TOTAL SETBACK Z6 _� SET BACK YARD HWY PROP. LINE WIDTH O 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 °7•�� T e P.L. Lender's Name u �V ^ P.C. Fee$ JS� Permit Fee LDMA Ref. # Lender's Address l a ac 5 s . j;�2 RI"/ , I 8 8 ra 3 A 3 Fl g I certify that I have read this application and state that the / Lj cr./Q Issuance Fee LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee # 0 0 o 0.0,J 0 ordinances and State laws relating to building construction, Total Fee �� LDMA Perm. #" $ and hereby authorize representatives of this County to enter ) o 0 4 Q 5.0 LP upo=boeed propsp�rty for inn purposes. �SEE REVERSE FOR EXPLANATORY LANGUAGE ?,6 _9 CJ(1 Signal f Applican or Agent Date ,WORKER 'COMPENSATION DECLARATION *'hereby affirm that I have certificate of consent to self iAPPLICATION FOR BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lab � 7�Jy)� COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No nI 17 Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING S f- ADDRESS /c'V ❑ Certified copy is filed with the county building •nspec- BUILDING W2 q ?.40 � B/ tion department. ADDRESS T`'� >' ! Date •Applicant CITY � � G" ZIP LOCALITY ER • FICATE OF EXEMPTI N F OM W RK S' NO. OF BLDGS. NEAREST COMPENSATIO I URANC SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be competed if the rmit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL UOWNER S v NO. USE ZONE MAP �7 / I certify that in the performance of the work for which this NO. G� permit is issued, I shall not employ any person in any mannerADDRESS C/ SPECIALi so as to.become subject to the Workers'Compensation Laws. CONDITIONS CITY ZIP V Date Applicant NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR TEL. ICDI�STR APTYPE FIRE PROCESSED BY O Exemption, you should become subject to the Workers' ENGINEER NO. CONST --;,z8ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be U ILL deemed revoked. /� / TEL. STATISTICAL CLASSIFICATION _ APT. rNDO. to CONTRACTOR D11- NO. Z Z LICENSED CONTRACTORS DECLARATION 0-51 MdQ>� IyC, CLASS NO. � LL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS e. `Z (commencing with Section 7000)of Division 3 of the Business and Q LIC SEWER P G. Professions Code, and my license is in full force and effect. CITY �'�' C4- L-OOOS CLASS BK P VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number " L v/ Lic.Class SIZE STORIES FAMILIES ONE VALUATION 9 5 3 A aDESCRIPTION OF WORK NEW ElQ #•0 0'0 • 23 Contractor Date ADD E] s , I am exempt under Sec. ::I •a p ALTER ❑ a37.50 B.BP.C. for this reason -v REPAIR ❑ $ •o 0 o 37,505 Date: USE OF DEMOL E] •.0 a 0 5"8 8 EXISTING BLDG. Signature APPLICANT /}STEL. p/ PRINT r/1/� /7/V/Q NO. O/ FINAL OWNER-BUILDER DECLARATION DAT I hereby affirm that I am exempt from the Contractor's License Low for the fallowing reason (Section 7031.5, Business and ADDRESSL 2 9.5 3,8 A Professions Code): PR Y ❑ ; BUILDING / 1 oto 0 4 9,'8 I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and LOCALITY ' o 0 o 4 9 8'8 10 the structure is not intended or offered for sale(Section 7044, Business and Professions Code)., MOVING TEL. :O 5 O 5.-8 8 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code). FROM CONSTRUCTION LENDING AGENCY SETT BAQIRCK YARD HWY TOTAPROP.LIETBCNE 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 P.L. Lender's Name m CDMA Ref. # Permit fee P.C. Fee$ - Lender's Address ' I certify that I have read this application and state,that the Issuance Fee t10 �v LDMA P/C# g above information is correct. I agree to comply with all County Investigation Fee 0 ordinances and State laws relating to building construction, Total Fee W LDMA Perm. # N and hereby authorize representatives of this County to enter upon the above-me tioned erty for inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE (_1/1ature of Applicant or Agent fDole WORKERS' COMPENSATION DECLARATION to self insureboraafirm certifcateofWorkes' Comthat I hove atpennsatoof nent Insurance, APPLICATION FOR BUILDING PERMIT or a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company Certified co is hereby furnished. BUILDING 'lull copy v FOR APPLICANT TO FILL IN ADDRESS 7 ❑ Certified copy is filed with the county building inspec- BUILDING p xx ' tion department. ADDRESS L4T L) Date Applicant CITY ZIP LOCALITY / CERTIFICATE OF EXEMPTION FROM WORKERS' NO.,OF BLDGS. NEAREST. �L COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS SL o om l) (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100)or less.) TRACT BLOCK F NO. MAP BOOK PAGE PARCEL I certify that in the performance of the work for which this OWNER r,��.' �L NL . 03 J USE ZONE O' permit is issued, I shall not employ an erson . n manner �i 'y //,' SPECIAL p p y y p r y ADDRESS V d S Sd /ZC �> CONDITIONS so as to become subject to the Workers' n ation Laws. Q �{ Date r�� ` ` Applicant CITY /J�� �/1 ZIP a i ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE "CESSED NOTICE TO APPLICANT: If, after a ing this Certificate of ENGINEER NO. Exemption, you should become subject to the Workers' 2/ CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS �/ — 3 with comply with such provisions or this permit shall be EL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR IN IT VV NO. !J LICENSED CONTRACTORS DECLARATION ULIC. CLASS NO. ^� DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. SEWER MAP (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 BK PG VALIDATION SQ. FT. NO. OF / NO. OF CHECK License Number Lic.Class SIZE Z Sv ISTORIES ( FAM LIES ONE Q A VALUATION V Contractor Date DESCRIPTION OF W,yO,fRK �i✓.4'! / /0�a NEW ❑ /�} .�' C V/r+� ADD ❑ s ���..0�...��� ❑ I am exempt under Sec. �� ALTER LV, B.BP.C. for this reasonREPAIR E] $ 1 0,6 2 A Al USE OF p p/ # ° 0 0 6 0,J N Date: EXISTING BLDG.. GAN` L �( !�� DEMOL ❑ z_ Signature APPLICANT TEL. FINAL ° ° 4 Q 5 0 OWNER-BUILDER DECLARATION (PRINT) NO. DATE o e o 4 Q 5 0 26 I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL0(� 8 Prof sions Code): PRESENT BY BUILDING 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, with licensed contractors to construct the project (Sec- ADDRESS j tion 7044, Business and Professions Code). CK FROM CONSTRUCTION LENDING AGENCY SETT BACKREQUIREYARD HWY TOTAPROP.ALINE 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. is N Civ. C.). SIDE P.L. Lender's Name � 30,00 o © LDMA Ref. # fO P.C. Fee b Permit Fee JO,Q ' Lender's Address 3 $ I certify that I have read this application and state that the Issuance Fee , %S LDMA P/C# 2 above information is correct. I agree to comply with all County Investigation Fee o 0" Total ces and State laws relating to building construction, Total Fee sly O LDMA'Perm. # R an re author' representatives of this County to enter oth bov n oned,property fort pection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signaturkof Applicant or Ag t Date WORKERS' COMPENSATION DECLARATION Hereby affirm that I havecertificate of consent to self APPLICATION FOR BUILDING PERMIT % insure, or a certificate of Workers' Compensation Insurance, or a certiked-copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING /J ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with �cou c- BUILDING ,ti aADDRESS *,7 CI p1g ( Z�I P LOCALITY NO. OF BLDGS. NEAREST CERTIFICATE OF EXEMPTIO FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST. a e. 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 less.) TEL. USE ZONE MAP OWNER G` NO. S 1~ NO. Co I certify that in the performance of the work for which this -3 SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS 1J2( O r, e&A (J CONDITIONS so as to become subject to the Woarm �n Laws. J j �o/ 0 p CITY Lf/ �l7/e ZIP C v�C x Date V_AlApplicant ARCHITECT OR TEL. DISTRICT GROUP' TYPE FIRE PRO SSED BY O NO CE110 PLICANT: If,, afte making this Certificate of ENGINEER NO. CON ZONE R Exemption, you should become subject to the Workers Q / ^Z U Compensation provisions of the Labor Code, you must forth- ADDRESS V" U� J W CL with'comply with such provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. N 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. SEWER MAP (commencing with Section 7000),of Division 3 of the Business LIC. - and Professions Code,and my license is in,full force and effect. CITY CLASS BK. PG. VALIDATION SQ. FT. �o NO. OF NO. OF CHECK License Number Lic. Class SIZE 2 i`j STORIES MILIES ONE VALUATION Contractor Date DESCRIPTION OF WORK (uv Qi I �lN NEW ❑C❑ ADD El $I am exempt under Sec. f(6 Uli (i�V ALT B.&P.C. for this reason 0 @ IkZR ❑ $ Date: USE OF EXISTING BLDG. C DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL ,� 'nL Professions Code): PRESENT' BY . BUILDING I, as owner of the property, or my employees with ADDRESSI �F� -- �.T,*wages as their sole compensation,will do the work andLOCALITY U the structure is not intended or offered for sale(Section M` , � 3.00 7044, Business,and Professions Code.) MOVING TEL. ❑ 1, as owner of,the property, am exclusively contracting CONTRACTOR NO. 1 ITEMS with licensed"contractors to construct the project (Sec- 'i � _�� ADDRESS J tion 7044, Business and Professions Code.) CASH CONSTRUCTION LENDING AGENCY SET BACKK YARD HWY TOTAL ROP.SETBALINEFROM WIDTH �\ `ASH 33.00 I hereby affirm that thele is a construction lending agency for FRONT the performance of the'work for which this permit is issued P.L. CHANE (Sec. 3097, Civ. C.). SIDE P.L. 7/28/89 % i/28 89 Lender's Name. ­1 1 O CDMA Ref. # `7d/G' r 'w. P:C. Fee$ Permit Fee ' i 8:1) 3 Lender's Address h 4721 1 Ali v•,: o I certify that I have read this application and state that the Issuance Fee h LDMA P/C# , above information is correct. I agree to comply with all County Investigation Fee �' 6 yhe and State laws relating to building construction, Total Fee LDMA Perm. # Q thorize representatives of this County to enter ve-ment'n property for,inection ur ses. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature o Applicant or Ag ate r COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0403290015 PHONE: (626) 285-0488 EXT: LEGAL ID: INUMBER OF SIGNS: I BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: 1 ILLUMINATED WALL SIGN AND FACE CHAN 5419 ROSEMEAD BL SGAB CA 917762212 �j f� ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LA D U09 / 5388-024-064 THOMAS PAGE: 596 GRID: H4 LOChhLITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: CITI FINANCIAL EXIST OCC GRP: 03/29/04 VG 03/24/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DP/TE FINAL BY: CODE: A&M ENTERPRISES 1,200 1025 FREMONT AV -- ALHM 918031324 FEES PAID )N OF WORK INSTALL 1-SET ILLUMINATED CHANNEL LETTERS - 52 SF AND FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: FACE CHANGE ON EXISTING POLE SIGN APPLICANT: TEL. NO: BRADLEY SIGN ADVERTISING (909) 948-7232- AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION OTHER 1200.00 VAL 0.50 SPECIAL:_CONDITIONS D1 PLANCHECK W/O EN-HC 1200.00 VAL 82.11 D2 PERMIT W/0 EN-HC 1200.00 VAL 82.20 CONTRACTOR: TEL. N0: TOTAL FEES 192.56APPROVALS DATE INSPECTOR SIGNATURE BRADLEY SIGN ADVERTISING (909) 948-7232- 10390 REGIS COURT LIC. NO LOCATION AND SETBACKS (RANCHO CUCAMONGA, CA 91730 795630 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORI•IS LIC. NO: SUPPORT STRUCTURE -i ! MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: -� CMP: 001 NO. OF FAMILIES: DWELLING UNITS: AP1'/COND: STAT-CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: OPR261 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 0910200034 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 5419 ROSEMEAD BL (STRUCTURE: 2000 V-B SGAB CA 917762212 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 15388-024-064 ! THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY 1 (TENANT: IEXIST BLDG USE: COMME USE ZONE: C-3 JISSUED ON: PROCESSED BY: ICITI FINANCIAL IEXIST OCC GRP: 110/27/09 SR 1 I I I I - OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: FINAL DATE, INA BY: CODE: IA&M ENTERPRISES (805) 445-7733- 1 15,000 11227 FLYNN ROAD #301 ICAMARILLO, CA 93012 FEES PAID jDD-SFRIPTION OF WORK STRUCTURAL REPAIRS INCLUDING RESTORATION OF INTERIOR & IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT: JEXTERIOR FINISH MATERIALS (APPLICANT: TEL. NO: I I I IPROGRESSIVE AE (714) 632-0411- JAI PLANCHECK W/EN-HC 25000.00 VAL 458.06 1 I 11811 4 MILE ROAD NE IAA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: 1 (GRAND RAPIDS MI49525 JAB STATE GREEN BLDG FEE 15000.00 VAL 1.00 JAE STRONG MOTION OTHER 15000.00 VAL 3.15 IA2 PERMIT W/ENERGY-HC 15000.00 VAL 345.69 (CONTRACTOR: TEL. NO: I TOTAL FEES 835.65 JAPPROVALS DATE INSPECTOR SIGNATURE 1 ADORN CONSTRUCTION (714) 632-0411- I 1 13160 LA PALMA AVE #A LIC. NO (LOCATION AND SETBACKS 1 ANAHEIM CA 92806 734975 B i SOILS ENGINEER APPROVAL JARCHITECT OR ENGINEER: TEL. NO: I 1FOUNDATION/TRENCH FORMS I ISAI STRUCTURAL ASSOC., DIRK A BUTTK (616) 457-8100- 1 I 1 162 COMMERCE AVE S.W. SUITE 100 LIC. NO: SLAB/UNDER FLOOR GRAND RAPIDS MI 49503 63069 I IRAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I JUNDERFLOOR INSULATION I I 1147H265 3 001 1 11 1 I I IFLOOR SHEATHING I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLAS`: I I I I I' 1 NO 22 1 IROOF SHEATHING I I I I I I I I I I SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I (AIR QUALITY: 1000 FEET MATERIALS I I_ 11 I I NO NO NO I (FRAME INSPECTION I I I I I I I i I IREQUIRED TOTAL SETBACK FROM EXIST I (FIRE SPRINKLER HANGERS I I ISET BACK YARD: HWY: PROP LINE: WIDTH: I I I I (FRONT PL- I (INSULATION/WEATHER STRIPI I I SIDE PL- I I 11 1 I 1 (INTERIOR LATH/DRYWALL 1 I I 11 I EXTERIOR LATH I IRATED FLOOR/CEIL ASSEM. _ � d hyl-e I I 1 (RATED WALL ASSEMBLIES (RATED SHAFTS/OPENINGS 1 1 1 I I IT-BAR CEILINGS I I I I i I I I I I I ILOT DRAINAGE I I I I I I I I (REPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT • DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT v BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1106020037 PHONE: (626) 285-0488 EXT: (LEGAL ID: NO. OF CONST NEW I BUILDING ADDRESS: ON FILE j' SQ. FT STORIES TYPE OCCUP GROUP 5427 ROSEMEAD BL 1 (STRUCTURE: 1000 1 V-B B I SGAB CA 917762212 ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: BROADWAY 15388-024-041 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: COMME USE ZONE: JISSUED ON: PROCESSED BY: IEXIST OCC GRP: B 106/13/11 SR OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: FI AL D TE F Y: CODE: JA & M ENTERPRISES (805) 443-7733- 1 5,000 11227 FLYNN ROAD #301 ICAMARILLO, CA 93012 FEES PAID. 1 SCRIPTION F WORK 1 i INEW PARTITION WALL TO DIVIDE THE EXISTING STORE INTO TWO J 1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ISTORES (APPLICANT: TEL. NO: j KWON, YONG JU (213) 324-1288- !Al PLANCHECK W/EN-HC 5000.00 VAL 129.80 123051 ASPEN KNOLL DR IAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: 1 (DIAMOND BAR 91765 JAB STATE GREEN BLDG FEE 5000.00 VAL 1.00 1 JAE STRONG MOTION OTHER 5000.00 VAL 1.10 1 JA2 PERMIT W/ENERGY-HC 5000.00 VAL 152.80 CONTRACTOR: TEL. NO: TOTAL FEES 312.50 JAPPROVALS DATE INSPECTOR SIGNATURE IMI CONSTRUCTION INC. (626) 201-7852- 1 11267 S. BREA CANYON ROAD LIC. NO ILOCATION AND SETBACKS DIAMOND BAR, CA 91765 839687 1 SOILS ENGINEER APPROVAL JARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS 1 KWON, YANG JU (213) 324-1288- 1 123051 ASPEN KNOLL DR. LIC. NO: I SLAB/UNDER FLOOR (DIAMOND BAR, CA 91765 NONE I RAISED FLOOR FRAMING I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1 - �_. JUNDERFLOOR INSULATION 1 I 1 3 041 1 I I IFLOOR SHEATHING 1NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1• I I 1 0 NO 22 1 IROOF SHEATHING 1 1 SCHOOL WITHIN HAZARDOUS J 1SHEAR PANELS 1 JAIR QUALITY: 1000 FEET MATERIALS j 1 NO NO NO 1 (FRAME INSPECTION 1 1 1 IFIRE SPRINKLER HANGERS 1 1 (INSULATION/WEATHER STRIPI I I 1 JINTERIOR LATH/DRYWALL 1 I I I I I 1 (EXTERIOR LATH 1 1 1RATED FLOOR/CEIL ASSEM. 1 (RATED WALL ASSEMBLIES J 1 1 1RATED SHAFTS/OPENINGS 1 1 J JT-BAR CEILINGS 1 1 1 (LOT DRAINAGE (REPORT ID: DPR261 ROUTE TO: BSO508 1 1 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0006130025 PHONE: (626) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: 1 BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: CHANNEL LETTERS 5419 ROSEMEAD BL SGAB CA 917762212 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5388-024-064 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: WASHINGTON MUTUAL FINANCE EXIST OCC GRP: 06/13/00 UT 12/10/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL CODE: A;M ENTERPRISES (818) 457-2945- 2,500 ii 1025 FREMONT AV ALHM 918031324 FEES PAID DESCRIPTION OF WORK SIGN REPLACEMENT-EXISTING ELE�l HOOK-UP FEE DESCRIPTION: QUANTITY: UOM:' AMOUNT: APPLICANT: TEL. NO: SITKA SIGNS (818) 708-8343- AA BLDG PERMIT ISSUANCE 27.75 7355 RESEDA BL. D2 PERMIT W/O EN-HC 2500.00 VAL 99.00 SPECIAL CONDITIONS: RESEDA, CA 91355 TOTAL FEES 126.75 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SITKA SIGNS (818) 708-8343- 7355 RESEDA BLVD. LIC. NO LOCATION AND SETBACKS RESEDA, CA 91355 625868 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. N0 ! SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO • REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1109010039 PHONE: (626) 285-0488 EXT: ILEGAL ID: INUMBER OF SIGNS: 1 BUILDING ADDRESS: 1 ON FILE ISIGN DESCRIPTION: ILLUMINATED CHANNEL LETTER 5429 ROSEMEAD BL I SGAB CA 917762212 1 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BROADWAY 1 15388-024-041 i THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: IISSUED ON: PROCESSED BY: I (YUAN LUNG HUNG IEXIST OCC GRP: 109/01/11 SR I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: IFINP.L DATE FINAL BY: CODE: 1 IYUAN LUNG HUNG - I 2,400 1 I 15429 ROSEMEAD BL. I ISAN GABRIEL 91776 1 FEES PAID IDESCRIPTION OF WORK 1 11LLUMINATED CHANNEL LETTER WALL SIGN READING "DENTAL SPECIALI IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ITY" I (APPLICANT: TEL. NO: I I I IAD ELECTRICAL ADVERTISING INC (626) 448-1166- IAA BLDG PERMIT ISSUANCE 27.80 1 1 19437 VALLEY BLVD 1AB STATE GREEN BLDG FEE 2400.00 VAL 1.00 ISPECCAL CONDITIONS: IROSEMEAD CA 91770 1AE STRONG MOTION OTHER 2400.00 VAL 0.50 1 1 1AX BUILDING REVIEW FEE 54.70 1 1 1 CD2 PERMIT W/O EN-HC 2400.00 VAL 99.10 1 CONTRACTOR: TEL. NO: I TOTAL FEES 183.10 1APPROVALS DATE INSPECTOR SIGNATURE IAD ELECTRICAL ADVERTISING INC. (626) 448-1166- IDBA AD SIGNS LIC. NO ILOCATION AND SETBACKS I 19437 VALLEY BLVD. 927951 C45 1 I 1 I I IROSEMEAD, CA 91770 j ISOILS ENGINEER APPROVAL I I I I i I I I I 1ARCHITECT OR ENGINEER: TEL. NO: (FOUNDATION/TRENCH FORMS I 1 1 LIC. NO: I (SUPPORT STRUCTURE I I ! I I I I 1 i I 1 I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 00! I I I I I I I INC). OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 1 1 I 1 NO 20 I i I I I I 1 SCHOOL WITHIN HAZARDOUS 1 I 1 I 1AIR QUALITY: 1000 FEET MATERIALS NO NO NO I I I I I I I I I I I I I I I I _ I I I I I I I I I I I I I I I I REPORT ID: DPR261 ROUTE TO: BS0508 1 ,T COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1112280024 PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: 1 1 ON FILE SQ. FT STORIES TYPE OCCUP GROUPI 5423 ROSEMEAD BL STRUCTURE: 1400 1 V-B B I SGAB CA 917762212 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15388-024-041 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY CAI TENANT: IEXIST BLDG USE: RETAI USE ZONE: JISSUED ON: PROCESSED BY: IEXIST OCC GRP: B 101/12/12 SR (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFI DATE FINAL BY: CODE: 1 A & M ENTERPRISES (805) 910-8926- 1 5,500 i 1227 FLYNN RD 301 1CAMARILLO CA 93012 FEES PAID IPK TENANTIMPROVVEMENTFOR INTERIOR REMODEL, ADD STORAGE ROOM ONI IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ITHE BACK AND REMODEL RESTROOM APPLICANT: TEL. NO: I IBAO, ZHEN (626) 416-9267- 1A1 PLANCHECK W/EN-HC 5500.00 VAL 146.30 I 1 118037 LA PUENTE RD IAA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: 1 ILA PUENTE CA 91744 IAB STATE GREEN BLDG FEE 5500.00 VAL 1.00 1 1 I IAE STRONG MOTION OTHER 5500.00 VAL 1.20 1 1 1 - IA2 PERMIT W/ENERGY-HC 5500.00 VAL 172.10 1 1 ICONTRACTOR: TEL., NO: IFS INV WORK W/O PERMIT 257.00 DOL 329.70 1APPROVALS DATE INSPECTOR SIGNATURE 1 IJAMES TSAI CONSTRUCTION, 6264832857 (626) 483-2857- 1 TOTAL FEES 678.10 1 1 179 W. MAGNA VISTA AVE LIC. NO ILOCATION AND SETBACKS 1ARCADIA CA 91007 701042 B 1 I 1 1 ISOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: jrOUNDATION/TRENCH FORMS I 1 LIC. NO: 1 ISLAB/UNDER FLOOR 1 I_ RAISED FLOOR FRAMING IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 IU4DERFLOOR INSULATION 3 041 1 I IFLOOR SHEATHING 1 1 1 1NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I 1 0 NO 22 1 IROOF SHEATHING 1 _ I 1 SCHOOL WITHIN HAZARDOUS 1 1--SHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS 1 1 1 1 1 1 NO NO NO FRAME INSPECTION 1 IFIRE SPRINKLER HANGERS JINSULATION/WEATHER STRIPI 1 1 ANTERIOR LATH/DRYWALL 1 1 1 1 1 IEXTERIOR LATH 1 1 1 IRA-ED FLOOR/CEIL ASSEM. 1 I I I I 1 (RATED WALL ASSEMBLIES 1 (RATED SHAFTS/OPENINGS 1 IT-BAR CEILINGS 1* ADDITIONAL DATA ON FILE I 1 1 ILOT DRAINAGE 1 1 IREPORT ID: DPR261 ROUTE TO: BS0508 I I a• COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1104260044 PHONE: (626) 285-0488 EXT: ILEGAL ID: INUMBER OF SIGNS: 1 I BUILDING ADDRESS: I ON FILE ISIGN DESCRIPTION: INSTALL (1) LATERNALLY ILLUMINATED WAI 5419 ROSEMEAD BL I I SGAB CA 917762212 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: BROADWAY 1 15388-024-064 I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl I I I I (TENANT: IEXIST BLDG USE: (ISSUED ON: PROCESSED BY: 1 IONEMAIN FINANCIAL IEXIST OCC GRP: 104/26/11 SR 1 I I I I DOWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL BY: CODE: 1 IKROSA, JAMIE (808) 445-7733- 1 2,300 11227 FLYNN RD. UNIT I I 1301 1 FEES PAID IDESCRIPTION OF WORK I I (INSTALL (1) LATERNALLY ILLUMINATED WALL SIGN (LED) TO READ IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IONEMAIN FINANCIAL JAPPLICANT: TEL. NO: I I ISTOUT, DENNIS (714) 744-2845- IAA BLDG PERMIT ISSUANCE 27.80 1 1504 E. PALMYRA AVE JAB STATE GREEN BLDG FEE 2300.00 VAL 1.00 ISPECIAL CONDITIONS: I JORANGE CA 92866 JAX BUILDING REVIEW FEE 54.70 1 ID2 PERMIT W/O EN-HC 2300.00 VAL 99.10 I I I I TOTAL FEES 182.60 CONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE COAST SIGN INC. (714) 520-1144- 1 I 11500 W EMBASSY ST. LIC. NO ILOCATION AND SETBACKS ANAHEIM, CA 92802 654238 I SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: I ISUPPORT STRUCTURE I I I I I I I I I I I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: ( I I I 001 1 11 I I I I I I I INO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: NO 20 I I I I I I I I I SCHOOL WITHIN HAZARDOUS I I I (AIR QUALITY: 1000 FEET MATERIALS I I 1 1 I I NO NO NOE X P 171 E I I I I I I I I I I I I I I I I I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS .9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1112220067 PHONE: (626) 285-0488 EXT: - ILEGAL ID: INUMBER OF SIGNS: 1 I BUILDING ADDRESS: I ON FILE ISIGN DESCRIPTION: INDIVIDUAL CHANNEL LETTERS 5423 ROSEMEAD BL SGAB CA 917762212 (ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15388-024-041 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: (ISSUED ON: PROCESSED BY: - IZHU SUMMER MEMORIES OF AMERICA IEXIST OCC GRP: 112/22/11 SR I I I I (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IFTNAL DATE FINAL Y: CODE: IKROS, JAMIZ (805) 910-8926- 1 1,150 1 11227 SLYNN RD. #301 1 1 , ICAMARTLLO, CA 93012 1 FEES PAID IDESCRIPTION OF WORK I I IPROPOSED & INSTALL EACH INDIVIDUAL CHANNEL LETTERS I (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ( 1 (APPLICANT: TEL. NO: I I IDIEP, HUNG (626) 285-8870- IAA BLDG PERMIT ISSUANCE 27.80 1 1 1115 N. SAN GABRIEL JAB STATE GREEN BLDG FEE 1150.00 VAL 1.00 ISPECIAL CONDITIONS: 1 ISAN GABRIEL CA 91775 JAC STRONG MOTION RESID 1150.00 VAL 0.50 1 ID2 PERMIT W/O EN-HC 1150.00 VAL 82.20 1 TOTAL FEES 111.50 1 (CONTRACTOR: TEL. NO: 1 JAPPROVALS DATE INSPECTOR SIGNATURE ISPECIAL SIGNS (626) 285-8870- 1 1 1115 N SAN GABRIEL BLVD LIC. NO 1 ILOCATION AND SETBACKS I 1 1 ISAN GABRIEL, CA 91775 783838-C45 *1 I 1 1 - ISOILS ENGINEER APPROVAL I I i I I I JARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I LIC. NO: 1 ISUPPORT STRUCTURE 1 I i I I I I I i I I I I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 001 I I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I 1 1 1 NO 20 1 I I I I I SCHOOL WITHIN HAZARDOUS JAIR QUALITY: 1000 FEET MATERIALS 1 I 1 1 1 NO NO NO 1 I I 1 I I I I I I I I ! I I I I I I I I I I I i I I I I I j I I I I I i I I I I I I I I I I I I I I I I I I I I I I ! I I I J I* ADDITIONAL DATA ON FILE 1 J IREPORT ID: DPR261 ROUTE TO: BS0508' J I I I I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1106020029 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST NEW BUILDING ADDRESS: I ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5429 ROSEMEAD BL 1 STRUCTURE: 952 _ V-B B 1 SGAB CA 917762212 I (ASSESSOR INFORMATION NUMBER: I - I NEAREST CROSS STREET: BROADWAY I 15388-024-041 ( THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl JTENANT: (EXIST BLDG USE: COMAE USE ZONE: (ISSUED ON: PROCESSED BY: J IYUAN LUNG HUNG (EXIST OCC GRP: B 106/15/11 SR J (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: FINaL DATE FIN CODE: I IYUAN LUNG HUNG - I 43,600 J 1 15429 ROSEMEAD BL. 1 1 I JSAN GABRIEL 91776 J FEES PAID JD CRIPTION OF WORK I I 1 ITENANT IMPROVEMENT DENTAL O ICE I 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: ) I JAPPLICANT: TEL. NO: 1 I 1 )JEFFREY DY (626) 523-6071- JAI PLANCHECK W/EN-HC 30000.00 VAL 524.30 1 _ 1216 S. GRAND AVE #17 ID7 ADDNL PLANCHECK FEE 4.00 HOU 437.60 JSPEC_AL CONDITIONS: I I IAA BLDG PERMIT ISSUANCE 27.80 1 I 1 JAB STATE GREEN BLDG FEE 43600.00 VAL 2.00 1 1 1 IAE STRONG MOTION OTHER 43600.00 VAL 9.20 J I (CONTRACTOR: TEL. NO: IA2 PERMIT W/ENERGY-HC 43600.00 VAL 825.90 (APPROVALS DATE INSPECTOR SIGNATURE I ISAN LUIS BUILDERS, INC. (626) 945-5725- 108 CERTIF OF OCCUPANCY 101.30 1 I 11422 LEMON AVE LIC. NO I TOTAL FEES 1,928.10 )LOCATION AND SETBACKS 1 1 I IBRADBURY, CA 91008 556398 I 1 1 I I I I ISOILS ENGINEER APPROVAL I I 1 JARCHITECT OR ENGINEER: TEL. NO: I )FOUNDATION/TRENCH FORMS 1 1 I 1 LIC. NO: I JSLAB/UNDER FLOOR 1 I I 1 I )RAISED FLOOR FRAMING 1 I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( �' - '. 1-UNDERFLOOR INSULATION 1 1 I 1 3 041 1 1 1 I I 1FLOOR SHEATHING I I I 1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 I I I 1 0 NO 22 1 1ROOF SHEATHING I I I 1 SCHOOL WITHIN HAZARDOUS I )SHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO J )FRAME INSPECTION 1 I IFIRE SPRINKLER HANGERS 1 I JINSULATION/WEATHER STRIPI I I 1 I 1 11NTERIOR LATH/DRYWALL 1 1 1 1 1EXTERIOR LATH I Iy 1 I I IRATED.FLOOR/CEIL ASSEM. I I I 1 1 IRATED WALL ASSEMBLIES I 1 I I 1RATED SHAFTS/OPENINGS 1 1 1 I IT-BAR CEILINGS 1 I I* ADDITIONAL DATA ON FILE 1 1 1 1 1 1LOT DRAINAGE 1 I 1 1 IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 I 1 I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0207030043 PHONE: (626) 285-0488 EXT: LEGA ID: NO. OF CONSTNEW D G ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5419 ROSEMEAD BL STRUCTURE: 0 1 VN B SGAB CA 917762212 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5388-024-064 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USE ZONE: ISSUED N: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: B 07/03/02 JK 12/30/02 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATA FINAL BY: CODE: A&M ENTERPRISES 20,000 x- 1025 FREMONT AV L �Z_ ALHM 918031324 FEES PA D DESCRIPTION OF WORK T.I. FOR WASHINGTON MUTUAL-CREATING NEW OFFICES (3) IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL NO: KEN KAY (714) 920-8044- AA BLDG PERMIT ISSUANCE 27.75 20726 NECTOR AVE AC STRONG MOTION RESID 20000.00 VAL 2.00 SPECIAL CONDITIONS: LAKEWOOD 91715 Al PLANCHECK W/EN-HC 20000.00 VAL 375.95 A2 PERMIT W/ENERGY-HC 20000.00 VAL 442.29 TOTAL FEES 847.99 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE KAYCO CONSTRUCTION (800) 832-4696- 9211 STEWART & GRAY RD LIC. NO LION AND SETBACKS DOWNEY CA 90241 511688/8 SOILS ENGINEER APPROVAL ARCHITECT OR ENGIN TEL. NO: FOUNDATION TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l UNDERFLOOR INSULATION 3 04 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: PT COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION FTWE SPR NKLER HANGERS INSULATION/WEATHER STRIP INTERIO LATH/DRYWALL 7 EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508