HomeMy Public PortalAbout5561-5563-5573 ROSEMEAD BLVD_Building__ APPLICATION FOR COUNTY OF LOS ANGELESEPARTMENT OF
BUILDING PERMIT DBUILDNGANDSOUM ENGINEER
!!
FOR APPLICANT TO FILL IN ADNESS
BUILDING 5563 A10L LOCAIITV
ADDRESS
O L.
/� r NEAREST
l: 1 ZIP Ob55 T
NO OF BLDGS ASSESSOR
SIZE OF LOT NOW ON LOT MAP BOOK PAGE I PARCEL
u DISTRICT GROUP TYPE FIRE SSEDB
TRACT M BLOCK l07 NO p � CONS
EL
OWNER 12.44 T� STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS CLASS NO 22 —DWELL UNITS BK;5-�
CITY ZIP USE ZONE MAP NO - Q
ENGIN EEE Tryp4 SPECIAL
A-I � 3 CONDITIONS
ADDRESS O & G ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO❑
TEL
CONTPACTO .NO —2% 3 BLDG SETBACK FROM
LIC FRONT PROP LINE OF ISTREETI
ADDRESS] AD NO D TOTAL SETBACK FROM TYPE OF EXISTING
WAY + YARD LIC FRONT PROP LINE HIGHWAY WIDTH
OTY SCJ Ih�Q.IA/D Gd1 CLASS 16
CONSTRUCTION LENDER + i
NAME AND BRANCH BL CK FROM
ADDRESS CITY SIDE PROP (STREET) O
50 FT NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK TYPE OF E%(STING r
SIZE STORIES FAMILIES ONE SIDESWF LINE IGHWAY WIDTH a
N
+ Z
DESCRIPTION OF WORK NEW —
ADD CORNER CUTOFF VES ❑ NO ❑
ALTER IN OPEN SPACE YES ❑ NO ❑
REPAIR
USE OF _ IN COASTAL PERMIT ZONE YES ❑ NO ❑
EXISTING BL DEMOL
APPLICANT TEL
(PRINT) NO
BY ISIGNATUREI
HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPOCATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGLAATING BUILDING CONSTIZUCTgN I CERTIFY THAT IN DOING THE
WOM ALMMORTZED HERBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO VARI(MEN S COM
PENSATION INSURANCE
SIGNATURE
PERMITTEE FINAL BY
_
ATE
ADDRESS
TEL PC Fee S Permit Fee Z�
CITY NO
QQ Issuance Fee
VALUATION y
Total Fee
PLAN CHECK VALIDATION -
uc it ct ewrH PERMIT VALIDATIONcK _ r o AS
CH
,SEP 1 2 3 0 2 520 °5" 5 6 O,SEP 1 1 D ¢) s�
®E 76"M^C6 IeatA ene
-
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Prmtortype only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS DEPARTMENT OF COUNTY ENGINEER
ary ZIP BUILDING ANDS MSION
OF BLDGS INEAREST
LDING S
SIZE OF LOT NOW ON LOT RESS
TRA(5P�j 19
/ BLOCK LOT NO ALITY
T
OWNER SSST
ESSORADDRESS P BOOK PAGE PARCEL
ISTRICT GROUP TYPE FIRE P ED BY
Gtt - 0 D ZARCHITECT OR TEL OAdENGINEER NO TWICALCLASSIFICATION EWER
ADDRESS CLASS NO -2-�-DWELL UNITS BK/
NEL �
CONTRACTOR USE ZONE OP _Vl r1
LIC VC/
ADDRESS ♦ NO PEDAL
LIC CONDITIONS
CITY CLASS
CONSTRUCTION ENDER �, ROAD DEPARTMENT APPROVAL REOUIR® YES ❑ NO ❑
NAME AND BRANCH BLDG BACK FROM
FRONT LINEOF (STREET)
ADDRESS CITY TOTAL SETBACK FROM TYPEOF EXISTING
50 FT NO OF NO JU ONE HIGHW Y + YARD FRONT PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE
DESCRIPTION OF WORK NEW O
C/ ADD ❑ DDE PROP UNEOFF (STREET) O
ASETBACK FROM m
LTER ❑ TOTAL SETBA TYPEOF EXISTING
❑ HIGHWAY + YARD SIDE PROP LINE GHWAY WIDTH
115E OF REPAIR
EXISTING BLDG DEMOK ❑ +
APPLICANT TEL CORNERCUTOFF YES ❑ NO ❑
IPRINTI � `
OPEN SPACE YES ❑ NO ❑
BY(SIGNATURE(
IN COASTAL PERMIT ZONE Y6 ❑ NO ❑
VALUATION$
I XEREBY ACKNOWLF THAI I HAVE READ TH6 APPLICATION AND STATE
THAT THE ABOVE 5 MMMT A AGREE i0 COMRY WITH ORDINANCES
AND(AWS REGULATING BUIL R1/LTION 1 CERTIFY IN DOING THE
WORT!AUTHORIZED HEREBY ILL T EMPLOY ANY PERS M VIOLATION OF
THELABOROOOEOFTHEST EOE FORMA IN 11NG TO RKMENSCOM
PENS TK)N INSURANCE
SIGNATURE OF
PERMITTEE
ADDRESS
� FINAL BY �
CITY /
MAKE CHECKS PAYABLE TO PC FFEE $ �/ FET $
HARB
VEYT RANDT,COUNTY ENGINEER /(� 7 a
PLAN CHECK VALIDATION w o cwsH / 7PERMIT VALIDATION o CASH
4 7 6�DEC 5 2'51D 1 4.4 0 e a
—
47 7FDEC 5 1, D 2 4.0 0 �=d
es Zbb38ACENe033RS _ 7;?,
— —
r4 1
APPLICATION FOR BUILDING PERMIT
FOR ApIPLICANTTOFILLIN IPrmtortype any
BUILDING COUNTY OF LOS ANGELES
ADDRESS 4 DEPARTMENT OF COUNTY ENGINEER
CITv U' ZIP BUILDING AND SAFETY DIVISION
NO OF 8LDG5 BUILDING
SIZE OF LOT NOW ON LOT ADDRESS
TRA B/LO/C�K ( LOT NO -7 LOCALITY Y
iT
OWNER / L L�T\ NOS/Z CROSS ST
A55ES50R
ADDRESS MAP BOOK PAGE I PARCEL
��,/ DISTRICT GROUP TYPE FIRE ED BY
.CITY AI JLZIP v CONST ZON
ARCHITECT O /Lp TEL p vCJ
ENGINEER t101(,,,I NO b$
_ 5 STATISTICAL ClAS51 FICATION SEWER MAP
ADDRESS //_P_AAH � OASSNO _AL2_-_- DWELL UNITS 4_ BK/J PG
TEL
CONTRACTOR NNO USE ZONE MAP
LIC NO
ADDRESS NO SPECIAL
LIC CONDITIONS
CITY CLASS
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED YES [INO ❑
NAME AND BRANCH BLDG SETBACK FROM /J
ADDRESS CITY FRONT PROP LINE OF ✓�=--�='^^ • (STREET)
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
50 FT NO OF NO OF CHECK HIGHWAY PROP LINE HIGHWAY WIDTH
SIZE STORIES FAMILIES ONE , N,
DESCRIPTION OF WORT( NEW +
BLDG SETBACK FROM ADD ❑ SIDE PROP LINE OF (STREET) O
STD1• . ALTER ❑ OTAL SETBACK FROM TYPE OF EXISTING
❑ HIGHWAY + YARD SIDE PROP LINE HIGHWAY WIDTH a
USE OF REPAIR
Z
EXISTING BLDG DENAL Cl + _
APPLICA TEL p CORNER CUTOFF YES NO ❑
'PR NT, Ka,( N0�1p0
0 IN OPEN SPACE YES NO ❑
BY 151GNATURE11
IN COASTAL PERMIT ZONE YES NO
VALUATION 0-off I
I HEREBY ACKNGE OWLEDTHAT I HAVE READ THIS APPLIUTION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ORDINANCES
AND LAWS REGNATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE
WDRK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WOIIKMBI 5 LOM
PENSATION INSURANCE
SIGNATURE
PERMITTEE
ADDRESS
FINAL BY
CITY -`
TEL DATE I I 6
NO
MAKE CHECKS PAYABLE TO FEE T $.L�� •� O FEE
HARVEY BRANDY COUNTY ENO INFER
PLAN CHECK VALIDATION cLL ABH PERMIT VALIDATION � r 0 c"H
6561ZJUL 1923 4140A,9d
5 6 BSEP 1 1 9 6 9.0 O A�
�R )6b]BA CE MBD]])B ,
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Pr)nt or type only)
COUNTY OF LOS ANGELES
FAROilTECTORw
LID �3 N �O '
_,.iv�c) DEPARTMENT OF COUNTY ENGINEER
1 C. ZIP BUILDING AND SAFETY DIVISION
NO OF BLDGS BUILDING
LOT NOW ON LOT ADDRESS J
�1' BLOCK LOT LOCALITY
NEAREST
SS S6.o�S NO 2,x5--SlTEL 'iI CROSS ST
ASSESSOLal F _ S>,x { L. Sr MAPBOORK PAGE PARCEL
DISI ICT GROUP 'TYPE FIRE P ED BY
f' sus zIP '6cRGol �J` ST noel
CT OR TEL
RNO STATISTICAL CLASSIFICATION SEWERMAP CLASS NO ut -21 DWELL UNITS
CONTRACTOR .. 1.�t1..S AJCo� NO USE ZONE I LIC No O
rEFA
DRESS G Y 5 L t vc, Oh1' NO 3 1,1 53{. C PECIAL n
�( ,� CONDITIONS /C
ry=LL .+! CLASS C'4 s ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑
STRUCTION LENDER
ME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINEOF (STREET)
DRESS CITY HIGHWAY + YARD TOTALSETBACKFROM TYPEOF EXISTING
FT NO OF NO OF CHECK FRONTPROPLINEHIGWAVWIDTH
E S'O STORIES FAMILIES ONECRIPTION OF WORK NEW ❑ +ADD BLDG SETBACK FROMSIDE PROP LINE OF (BTREEf) O
ALTER ❑ TOTAL BETBAIX FROM TYPE OF E%(STINGHIGHWAY + YARD SIDEPROPLINEHIGHWAY WIDTH 2� REPAIR ❑TING BLDG DEMOL ❑ +ICANT TEL CORNER CUTOFF YES NORINT) NOIN OPEN SPACE YES ❑ NO ❑SIGNATURE( _LJ IN COASTAL PERMIT ZONE YES ❑ NOUATION$ S-00- DaHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPIICAT)ON AND STATE
T THE ABOVE IS CORRECT AND AGREE TO COMPLY WTN ALL ORDINANCES
UWS REGUUTING BUILDING CONSTRUCTION CERTIFY IHAi fN DOING THE
RK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VK%ATION OF
LABOR COOS OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN S COM
SATION INAIRANCENATUITTE
ADDRESS
TEL FINAL BY
CITY NO DATE
MAKE CHECKS PAYABLE TO FL FEE $ FET $
HARVEY T BRANDT COUNTY ENGINEER 9 8 G)
PLAN CHECK VALIDATION cK w o uuH PERMIT VALIDATION CK mo CMM
O •.
'OLICYf��T � y/9/1 ,, 3 7 2 fi rlov a� 1 D _ 3 3.0 0 •
m. 7M MA t DZ R
'OLICY NI1MRp-D. ::.,O/ o 3 oYc
APPLICATION FOR BUILDING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
BUILDING COUNTY OF LOS ANGELES
ADDRESS S S'7 00, DEPARTMENT OF COUNTY ENGINEER
clrY (,c C, ( ZIP BUILDING AND SAFETY DIVISION
NO OF BLD 36 BUILDING
SIZE OFF LOT NOW ON LOT ADDRESS
TRAC? �� / BLOCK LOT LOCAUTV
NEAREST
OWNER MRL { (�jLN oS t- NEL
O Y3 CROSSST
n _ ASSESSOR
ADDRESS s Z C( L].1K.v u k L - MAP BOOK PAG PARCEL
y� p DISTRICT GROUP TYPE FIRE P ED BY
LIN - QA1 Trt��ro ZIP _Il7L 1 Qu _� CONST ZONE
ARCHITECT OR TEL IJ ._/Q��
ENGINEER NO STATISTICAL CLASSIFICATION SEWER MAP
ADDRESS TEL LASS NDWELL UNITS jw- B,/4;-
CONTRACTOR
K SCONTRACTOR w• O.-L IJ es .
N0773-411jZ USE ZONE MAP
^ NO
ADDRESS L L i A 00W NO .3 L L�S316 — C9 SPCCIAL %L
CITY L7 2 Lr, ..i LIOgSS C- ys CONDITIONS /7
CONSTRUCTION LENDER ROAD DEPARTMENT APPROVAL REQUIRED VES NO
NAME AND BRANCH BLDG SETBACK FROM
FRONT PROP LINE OF )STREET)
ADDRESS CITU - HIGHWAY + YARD TOTALSETBACK FROM TYPEOF EXISTING
SO FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH
SIZE XOO STORIES FAMILIES ONE
DESCRIPTION OF WORK NEW ❑ + O
V
ADD BLDG SETBACK FROM oc
SIDE PROP LINE OF STREET) rO
ALTER ❑ HIGHWAY + YARD TOTAL SETBACK FROM TV PE OF EXISTING Yi
REPAIR ❑ SIDE PROP LINE HIGHWAY WIDTH
USE OF Y
EXISTING BLDG DEMOL ❑ + -
APPLICANT TEL CORNER CUTOFF YES 0 NO 11
(FIR NTI NO
IN OPEN SPACE YES NO ❑
BY(SIGNATURE) Lj f IN COASTAL PERMIT ZONE YES ❑ NO
VALUATION .JXs aU
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE
THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH All ORDINANCES
AND LAWS REGULATING BUILDING CONSTRI1CTK)N I CERTIFY THAT IN DOING THE
WOW AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF
THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WgiKA1EN S COM
SENSATION
SIGNATURE
PERMITTEE .,
ADDRESS
FINAL 7 BY
TEL CITY NO DATE � -3 I' 2A
MAKE CHECKS PAYABLE TO FEE PC $ FEET $
HARVEY T BRANDT,COUNTY EN EER r/A �/
PLAN CHECK VALIDATION CLL. o CAA PERMIT VALIDATION cK o C H
271E-NOV x2 `2' 3 D / 1 ,80 eJo
3 6,8I-elUV ey L: 3 U✓ 0 8 0 3.6 9-40V ey 1 D 5 1.0 0 ems,
es 76Rb3e d,$803375 t
CE aBDa(REV ,,,79)+
• APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
BUILDNG
FOR APPLICANT TO FILL IN
ADDRESS
BUILDIN _ T�M G l..rLT
ADDRES O�JELOCALITY
AREST
CITY KA IF
OSSST
O OF BLDG5SESSOR
SIZE OF LOT NOW ON LOTP BOOK PAGE PARCEL
ISTRICT GROUP TYPE FIRE P ESSED BY
TRACT BLOCK LOT 'I p' CONSTnn / � TEL /VQ B,+AODpRE55�i3I ,p NOTI5TICAL CLASSIFICATION SEWER MAP
(jQA55N0OWELL UNITS B JPG
CITY r �� ZIP oto 44ARCHITECTTELLUATION $ENGINEER NOADDRESS DG SETBACK FROM
TEL ONT PROP LINEOF 15TREETI
CONTRACTORS )e NOGHWAY + VARD TOTAL SETBACKFROM TYPE OF E%(STING
ADDRESS �� LIC NOFRONT PROP LINEHIGHWAYWIDTH
LICCITY CLACONSTRLKTION LENDER DG SETBACK FROM
NAME AND BRANCH — E PROP LINE OF (STHWAY + YARD - TOTAL SETBACK FROM TYPEOF EXISTING
ADDRESS CITY SIDE PROP LINE HIGHWAY WIDTH Q
SOFT NO OF NOOF + U
SIZE STORIES FAMILIES ONE
USE ZONE MAP �o
DESCRIPTION OF WORK FiW S NEW NO
SPECIAL
M n L ADD CONDITIONS
ALTER LJ FINAL 7, By
"1 7 REPAIR DATE 7� �
.USE TI 2E,� C�O� DEMOL
EXISTING BLDG �I
LJ
APPLICANT TEL Z
(PRINT( NO
Z2�� G3
BY(SIGNATURE) __
I HEREBY ACKNOWLEDGE THAT I HAVE0 THIS APPLICATION AND STATE FYF.F B r 7 u O n
THAT THE ABOVE IS CORRECT AND AGREE COMPLY WITH ALL ORDINANCES F➢
APD LAWS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE S # Is . 0 0
WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATCN OF V
THE LABOR CODEOF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN 500M
PENSATON INSURAN 11 2 - - 52-00
SIGNATURE OF A •'5 2 O O 6
PERMITTEE
ADDRESS Toj 11 14'-79
L n TEL
CITY Yf NOL
PC Fee E Permit Fee (7l >
Issuance Fee !�1��v
s1
Total Fee
,da
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN
I hereby affirm that I have a certificate ofInsure,to self BUILDINGADORE
or a certificate o( Workers Compensation Incur a c",ad
COW tirereof . ZIP LOCALITY
Policy CorinPe�' OFLOT NO OF BLDGS NOW ON LOT
❑ C Trliad copy s hereby furnished NEAREST CROSS ST
❑ Certified copy ;filed with the buildrq N / TRACT BLOCK LOT NO
USE
t ZONE MAP
Date r ApplCent ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM KERS OWNERTEL No
COMPENSATION INSURANC WmyaN 1000 FT OF SCHOOL? res NO
(The section need not be completed it the Permit is for one hundred 3CT
dollars($100)or less) DISTRICT GROUP TYPE CONST FIRE 20tE PROCESSED BY
I certify that In the performance of the work for which the permd �IS I Shall arty n I sossf// ENGINEER TEL NO
bec l STATISRCAL TKNJ APT CONDO
Dat Apps ADDRESS CLASS NO = DWELL UNITS
NOTICE TO APPLICANT If after rIW p 16 Certificate of REpUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subfect to the Mbrlrere /_, SET BACK YARD HWY PROP uNi WIOTH
Compensation provggns of the Labor Code a must forthmm FRONT
comply with such provisions or the permit shall be deemed revoked LIC PL
LICENSED CONTRACTORS DECLARATION SIDE
PL
I hereby affirm that I am licensed underprowsons of Chapter 9 - SEWER ANAP d
(commencing with Section 7000)of DNesK)n 3 of the Business and FT E NO O�STORIES NO OF FAMILIES pp
/
Professions Cade end mry a M m full force epd el NEW 11 BK PG U
Lecerlse Lac llfasc (� DESCRIPF ADD ❑ p
Con O to ALTER ❑ $ D� w
❑ 1 em exempt u REPAIR ❑ $ Z
BBPC for the meson DEMOL ❑
LdAA P/C
Date USE OF EXISTING BLDG URM ❑
Signature A{'PLICANT(RiTT) TEL NO ,
LOMA Perm
❑ I as owner m the property or the
Work and with wages as
their Sale canperuatron will da the work Brad the atrucNre Is ADDRESS �
not Intended or offered for sale (Section 7044 mess and FINAL DATE
Professions Code 1 wu TRE APRICANT OR FUTURE BUAnNG occuirNT HAN A HnzAFmws rn nT {
OR A MexiLRE COHWIAIG A IIAUlOOl19 MATERp EO M OR GMAiER THAN Tif 1
❑ I n owner of the Property em exclusrvey contracting with AAOVlT9 sPEcreo ani TIE IuriPpocs MATERVlb KoraiATON clpE+ FINAL Q
licensed cardrectors to construct the protect (Sectoin 7044i — T
Professions C
ess and Professions 'mss 11 Noll rl__ I .
N1LL THE INTENDED USE 6 THE WICUG aV THE ARLC,WT OR FUME BULNNG
OCCIIRWT FEOIRiE A MAW FOR CONSTnULTx1N OR MCO61CATgN FROM THE SOUTH JJ�J �
CONSTRUCTION LENDING AGENCY Lair OUR ouN/rY MANAaEAENT DISTP r ISCA $SEE FEwUrtxo cit MeT FOR
��Ea IiRlc
I hereby affirm that them m a construction lending agency for YES❑ NDfl
the performance of the work for which the permit re issued(SecnADUIDEAND TOTAL 1387 . 16
m 3087 CIy C) O CXILST UNDERSTDD w REOUIREW Ta UNDERG Ips ANGELES S COUNTY LODE
Lendera Name NN RAI Porrrw AND FC1ii OR 0'oe UANGA AW FRRONI TIE "�A"DOUS CrtcH 1C�.
LenderaAddress lHftr f1-1
O pIM:R O1 IOFM
I certify that I have reed the application and state urKW penalty
$ of pam" that the above Tdomaton is correct IPC FEE PERMIT FEE
$ agree W u
county ordunarpea and State Iowa relewg 10 btxilderp 6/ /
S Won hereby erepresentatives of thn County ISSUANCE FEE �y/ '�/�
b o ab re- enho sB property for Nns� nO'r(O %F� 47 S4 1 F'M 4%4 i
INVESTIGATION FEE TOTAL FEE
SEE REVERSE FOR EXPLANATORY LANGUAGE
APPLICATION FOR BUILDING PERMIT
• COUNTY OF LOS ANGELES BUILDING AND SAFETY
WORKER S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUI SS
I hereby affirm that I have a certlfo to of consent to self Insure BUILDING ADDRESS5573 po` 0 gLVu
or a certificate of Wm
Workers Copereatlon Insurance or a certified3, /� N+'"•
copy thereof(Sec 3800 lab C) CITY T IIP U LOCA Y
Policy No Company SIZE OF LOT NO OF SLUGS NOW ON LOT
❑ Candied copy is hereby furnished NEAREST CROSSSPt
ElCertified copy a filed with the county bulldog Inspection TTI^ BLOCK LOT NO
department USE MINE MAP NO
Date Applicant ASSESSOR MAP BCOK 538,7 PAGE PARCEL ^
7 C � SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS 'E TE No
COMPENSATION INSURANCE r G Z$800 WTHIN 1000 FT OF SCHOOL? YES NO
(This sedwn need not be completed If the permit is for one hundred ADDRESS
dollars($100) or less)
232-3 `Pts rW AvC-- STE DISTRICT GROUP TYPE CONST FIRE ZONEPROCESSED BY
1 cerhty that In the performance of the work for which the permit CITY A AIA CAd
ZIP q�7pS�
�slued I shall net employ any pe�5on In any manner so as to
me t to the Worker �I ens n 5 ARCHITECT OR ENGPIEER TEL NO
///J STATISTICAL CLASSIFICATION APT CONDO
Date Applicant ADDRESS CLASS NO DWELL UNRS
AbT110E TO A, --tCANT If atter Ing the Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption you should become subject to the Workers CONTRACTORTEL No SET BACK
Compereaton prevlslons Of the Labor Cede you must forthwith � 1 G-- YARD HWY PROP LINE WIDTH
FRONTcomply with such pNVlsore or this permit shall he deemed revoked ADDRESS LIC NO P L
LICENSED CONTRACTORS DECLARATIONSIDE
CfTY LIC CLASS P L
I hereby affirm that I am licensed underprwlsKXe of Chapter 9 SEWER MAP
(commencog with Section 7000)of Division 3 of the Buvress and SO FT SIZE NO OF STORIES 1 110 OF FAMILIES T i
ProfessionNEW ❑s Code and my license is In full force and effect }
nr"I' '
License Number LAC Class DESCRIPTION x NDRK N A ADD ❑ VALUATION , Tjcl7 r 1,✓_� O"
Contractor Date ALTER I $ '7-114i'9'0 I :TJ1r 0
❑ I em exempt under Sec / REPAIR ❑ $ TOTAL'
80 - 07
88PC for the reason mil Id"2 $ DEMOL ❑ �A PTC• -'H}EfK 1_,1?- W
Date USE OF EXISTI BLDG Q r"T%T10 URM ❑ rFAIVL ,f�l
Sgnature APPLICANT( �) L O LDMA Perm. Z
El as owner of the property or my employees with wages as �LN� -3—W7 Z
474
their sole Compensation will do the work and the structure a ADDRESS (1 �J F 111101}-1?I]I?1 1110/1:4
not Intended or offered far Sale (Section 7044 Buvness and 5 /r "Y" 01709 FINAL DATE
Professions Code) /�„` 1a j 333; 1 AMICI:?_
YALL THE AFRICAN Qq G A BUL S U`E A FIUI pT A RAGREAT R THAN
E "` Y
El aR A AMOMIXUNTS
WNWN THE
HPASDCUS TERIM-S INFOR 10 OR GREATER THAN THE /� J'
1 0a OWrler f (lie property 8m e%C111aNEly contracting Wlth r.,ypNriT$yECIFlEa IXJ THE MAZOADOUS AUTERNLS INFORIMTION GUIDE' FINAL BY Ar C T.i
licensed contractoi1s to construct the project (Sector, 7044 YES❑ ria
Busmess and Professions Code) `_11`
I WILL THE INTENDED USE CF THE BUMUNG Er THE PPRJGANT OR FUTURE SUIIDNG 1e`•�l
OCCUPANT RECURS A PERW FOR CONSTRUCTION OR MODIFICATK)N FROM THE SOUTH
CONSTRUCTION LENDING AGENCY ccAsr NR QUALITY MANAGEMENT DISTRICT(c D)SEE PERMr NG CIEcnUST FOR 1 ITEMS
GUIDEUNEs
I hereby affirm that there m a construction lending agency for e 4
m the performance of the work for which this permit Is Issued(Sec YES❑ No TOTAL Z,J.ly
3097 City Ci) (HAVE REST I UN TAND MY HEOLiREI ENTS U DER THE Lee THE SCIS GQUW MCOOF C
N MILE 2IIST TER220 SECTIONS
TS USER THE OGERMLOAMYCODE CASH 1JJ.4,
Lenders Name r�umRiais afro zzo sEm�s zz�Ao�loyoGn�rnortzFaow;TlEscAoni+®HAzaoous
Lender Address � I1L/I r.H(� .7E .��
I certify have read the apiNicaten and state
ce
8 f Pefluryhthat the above Information a correct I agree to uxryly PC FEE O �J PERMIT FEE Q� �� 0090-0W1
fr(fl 1 `/1 �G4
R oath all county ordinances and State laws relating to building / F'� VVJI 0JU /
Constructgnn hereb authorize representatives of the County ISSUANCE FEE �-'Co ^ Q 41318 1 AM 10:4?
ito efer h see t ned property fpr Ins pun s L1Y
w INVESTIGAT)ON FEE TOTAL FEE 1 S
so,.o..a too I s
SEE REVERSE FOR EXPLANATORY LANGUAGE
-le- 4.10 S/S/ tiS-7 31—�j
WORKERS' COMPENSATION DECLARATION
hereby off certificate
that I have r certificate of canon, to self APPLICATION FOR BUILDING PERMIT
insure, or a certificate of Workers Compensation Insurance,
or a certified copy thereof (Sec 3BOO, Lab C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Polic o 6 o Company SU&X4. pltiNa
Certified copy Is hereby furnished FOR APPLICANT TO FILL IN ,ppm S,<6 I Pow k
❑ Certified copy is filed with the county building tnspec- BUILDING
DateItis department ADDRESS
Applicant CITY ZIP NEARELOCALST NO ff CROSS
RTI ICATE OF EXEMPTION FROM WORKERS SIZE OF LOT Now oil LOT Otoss 57
COMPENSATION INSURANCE ASSESSOR _
(This section need not be completed if the permit is for one TRAGI BLOCK I LOT NO MAP BOOK PAGE PARCEL
hundred dollars ($100)or less ) TEL <
OWNER NO v�J USEZOONE
I certify that in the performance of the work for which this
permit Is issued, I shall not employ any person in any manner ADDRESS (J .�'` COrNI ITIONS 0
so as to become subject to the Workers Compensation Laws NS
L
CITY t� NSC.. ZIP U
ad
Date Applicant ARCHITECT OR TELDISTRICT GROUP BY 0
NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO _ CO T O E
Exemption, you should become sub ect to the Workers q (�
Compensation provisions of the Labor Code, you must forth- ADDRESS •�(/ 13 a
with comply with such Provisions or this Permit shall beI, TEL STATISTICAL CLASSIFICATION APT CONDO N
deemed revoked NIRACTOR 1 C ,,4,JO z
LICENSED CONTRACTORS DECLARATION3 S S ` ,� C ,s/S 2 S OnS5 No � U. UNITS_
I hereby offum that I am licensed under provisions of Chapter 9 ADDRESS
(commencing with Section 7000)of Division 3 of the Businessm /� SEWER MAP
and Professions Code,and my license is in full force and effect CITY *kft I N 5ra 6 6 CLASS -35 BK PG VALIDATION
/± SO FT NO OF NO OF CHECK
License Number '5/,,��1T -f Lic Class ,CI SIZE STORIES FAMILIES ONrE
Contractor Fh.LBII ZAII ` t-1(^Date _bk� Ji^ (V ) y �, ❑ VALUATION a c
DESCRIPTION OF WORK $ ' '1 a{t O
f ADD ❑ d LJ ,
❑I am exempt under Sec r L
ALTER ❑
B 8P C for this reason I IV t,-- REPAIR ❑ $
Date USE OF
EXISTING BLDG V DEMO ❑
Signature APPLICANT TEL FIN/LL /
OWNER-BUILDER DECLARATION (PRINT) NO DATE IQ
I hereby affirm that I am exempt from the Contractor a License
Law for the following reason (Section 7031 5, Business and 'CRESS FIN 1
Professions Code) ENT By
❑ I, as owner of the property, or myemployees with ADDRESS ILDING ACCT..
wages as their sale compensation,-wilI do the work and 33307 143.63
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code ) MOVING TEL 1 ITEMS
iJ
❑ 1,as owner of the property,am exclusively contracting CONTRACTOR _ NO
63
TOTAL 143�
with licensed contractors to construct the protect (Sec- ADDRESS
tion 70", Business and Professions Code ) CHECK 143.63
CONSTRUCTION LENDING AGENCY I D YARDHWY VALB NK E WIDTH
FROMEXIST
hereby affirm that there is a construction lending agency for FRONT C .DD
the performance of the work fa which this permit is issued P L
(Sec 3097 Civ C ) SIDE
Lenders Nome
PL DO00—OD01 7/ 3/89
N
PC Feer Permit Fee TDMA Ref
•�
Lenders Address 4W5 1 AM11a47
I cemfy that I haveread this application and state that the Iamance Fee Z P/C Y
above information is correct I agree to comply with all County Inv.I,ganon Fee
ordinances and State taws relating to building construction, Totol Fee 3., IDAkA Perm Y
and hereby authorize representatives of this County to enter
upon e a v m ned property for inspection
/yu/ry�,a`sea
n , y, ,Q 7 fEli REVQSF FOR EXPLANATORY UNOUAGE I
Signature of Applicant m Agent Dote
WCJRKERS COMPENSATION DECLARATION J'I
APPLICATION FOR BUILDING PERMIT `ILL�If
I hereby affirm that I have a certificate of consent to self
insure or o certificate of WorkersCompensation Insurance
I.-, or o certified copy thereof (Sec 38M Lab C )
COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No Company
Certified copy is hereby furnished FOR APPLICANT TO FILL IN WILDING { / y
Elr-C
Certified copy is filed with the county budding mADDRESS V ,61
spec BUILDING a I
tion department ADDRESS !Vlea Si2im
//��//�I p�
Dote Applicant CITY ZIP CA Q V LOCALITY
CERTIFICATE OF EXEMPTION FROM WORKERS' It dV NO OF BLDGS NEAREST
COMPENSATION INSURANCE SIZE OF LOT / NOW ON LOT ST r
(This section need not be completed if the permit is for one TRACT .f7 BLOCX LOT NO O ASSESSOR
hundred dollars ($100)or less ) MAP BOOK P PARCEL
TEL USE ZONE
I certify that m the performance of the work for which this OWNER NO 2 � 1J0 _
permit is issued I shall not employ any person in any nner ADDRESS C�� SPECIAL ,
so as to
become subject to the Worke Compensoh _,a
CONDITIONS
Date" Applicant �/ CITY ZIP
NOTICE TO APPLICANT If after making this Cabificate of ACh OR LeKk �TEELLbl� DISTRICT GROUP CO ST ZONE MOCESSED BY O
Exemption, you should become subject to the Workers 2 Y R , /
I CA
Compensation provisions of the Labor Code you must forth- ' U 6_ V 3 V
with comply with such provisions or this permit shall be ADDRESS I if TEL STA7SnCAL CLASSIFICATIONAPT D.
deemed revoked CONTRACTOR HD Z
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 Z VALIDATION
SO FT NO OF NO OF CHECK
License Number Lic Class SIZE STORIES JFAMIUES ONE
VALUATION
Contractor Dote DESCRIPTION OF YAM NEW f ry.YT Cro
ADDV N
ADD
am exempt under Sec o ❑
ALTER
8 8P C for this reason MOMREPAIR S
Dote EOF
%STING BLDG OkAXP . 4 d CILI�� DEMIX
SignatureAPPLICANT TEL _ RNA
VY -04
OWNER-BUILDER DECLARATION PRIM Z 2-Q IDAT&— 2 76 1„1 A
1 hereby affirm that 1 am exempt from the Contractor s License
Law for the following reason (Section 7031 5, Business and ADDRESS # • • • • 2 3
Pr ssions Code)
I as owner of the property y P y BUILDING
proper or m em to ees with ADDRESS 111 • - 41.45
wages as their sole compensation,will do the work and i
the structure is not intended or offered for sale(Section LOCAL" • 4 1.4 5 9
7044 Business and Professions Code) - MOVING TEL NO 01306-87 13Ob-87
I as owner of the Property, am exclusively contracting CONTRACrOR
with licensed contractors to construct the project (Sec- ADDRESS7 b 1.2{+
tion 7044, Business and Professions Code)
CONSTRUCTION LENDING AGENCYSET BACK YARD Hwy TOTAL CK FROM MST
LINE WIDTH # • • • • • 1
1 hereby affirm that there is a construction lending agency for FRONT
the performance of the work for which this permit is issued P L 1 5925
(Sec 3097,Civ C ) SIDE
PL •• • 59.259
Lender's Name
LDMA Ref Y
Lender's Address P C Fee• Permit Fee loop9 0 6-8 7
I certify that I have read this application and state that the Issuance Fee LDMA P/C•
above information is correct I agree to comply with all County Investigation Fee
$ ordinances and State laws relating to building construction, Total FM S IDASA Perm •
R and hereby authorize re esentotives of this County to enter
upon the ve-mento property for inspection purposes
p
• /� (]�_—O 7 s9 tlVMU MR OVIANATORY WIGUAGA
/ ` Signature of Applkont or Agent Dote /
COIRITY 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 8L 0508 0301170051
PHONE: (626) 285-0488 EXT
LEGAL ID NUMBER OF SIGNS- I BUILDING ADDRESS
BK: 105 PG 86 PC 10 SIGN DESCRIPTION 'SYLVIA'S WEDDINGS' IN HOT PINK NEON 5561 ROSEMEAD BL
TEMP CA 917801802
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LAS TUNAS
5387-032-059 THOMAS PAGE 596 GRID- H4 LOCALITY: TEMPLE CITY
TENANT EXIST BLDG USE ISSUED ON PROCESSED BY EXPIRES ON
SYLVIA'S WEDDING EXIST OCC GRP 01/21/03 JK 01/16/04
OWNER —7n No BLDGS NOW ON LOT. VALUATION FINAL DATE FINAL BY CODE
T C ASSOCIATES (714) 997-1100- 1,800 - 2-_ O-3
747 W KATELLA #102
ORANGE 92867 FEES PAID 6ESCRIPTTDI6FORK
NEW NEON SIGN;C/O FACE OF BOX SIGN
APPLICANT -7nwts FEE DESCRIPTION QUANTITY U0M AMOUNT
ARTIST SIGNS 8 ART SERVICE (626) 625-2888- AA BLDG PERMIT ISSUANCE 27 75
8919 GARVEY AVE #C3 AC STRONG MOTION RESID 1800 00 VAL 0 50 SPECIAL CONDITIONS
ROSEMEAD 91770 D1 PLANCHECK_W/O_EN=HC�1800 00 VAL 82 11
D2 PERMIT W/O-EM-HC—�18OO-00 VAL 82 20
PN�ELESTOTAL-FEES 192 56
ARTIST SIGNS AND ART SERV CO (626) 288-6780-1 5 J�ry
8919 E DARVEY AVE #C3 LIC NO / LOCATION AND SETBACKS
ROSEMEAD CA 91770 811413 C45
wnTi
ARCHITECT OR ENGINEER. TEL NO FOUNDATION/TRENCH TMW
��
LIC N0SUPPORT STRUCTURE
I'IJI—(L 1111111
MAP NO SEWER MAP BOOK: PAGE FIRE ZONE CNP. )° ''MCL�0C VV(0 GvOQ5
NO OF FAMILIES' DWELLING LIMITS APT7C5WT-9TXr-C1X9r--
NO 20
SCHOOL WITHIN HAZARDOUS
AIR QUALITY: 1000 FEET MATERIALS \ O Q t3�' 1
NO NO NO E) co
Gb/�e
service That
�0
REPORT 1D DPR261 ROUTE TO SS0508
• COUNTY OF LOS ANGELES TEMPLE CITY t 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC HONKS 9071 LAS TIBIAS SIGN
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9802090074
PHONE (818) 285-0488 EKT
LEGAL ID: OF SIGNS I BUILDING ADDRESS
BK 105 PG 86 PC 10 SIGN DESCRIPTION- INSTALL BACKGROUND ON EXISTING SIGN 5563 ROSEMEAD BL
TEMP CA 917801802
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET LAS TIBIAS
5387-032-059 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY
TENANT: EXIST BLDG USE ISSUED ON. PROCESSED BY EXPIRES ON
PAYLESS SHOES EXIST OCC GRP 02/09/98 UT 02/09/99
OWNER TEL NO BUDGS NOW ON LOT VALUATION FINAL DATE FINAL BY CODE
T C ASSOCIATES 1 500 9_ •,O
2323 TUSTIN AV FEES PAID 7
REMOVECHAN a
REMOVE CHANNEL LETTERS, INSTALL BLA K BACKGROlA1D REINSTALL
FEE DESCRIPTION QUANTITY LAM AMOUNT CHANNEL LETTERS
APPLICANT TEL
SWAIN SIGN INC (909) 460-2530- AA BLDG PERMIT ISSUANCE 27 75
1384 E STH ST AE STRONG MOTION OTHER 500 00 VAL 0 50 SPECIAL CONDITIONS
ONTARIO, CA AX BUILDING REV IEW-FEE— `----� 54 70
D2 PERMIT W/O:EN-HCjGE LE S 500 OO.VAL 43 50
5 E*` TOTAL,FEESry 126 45
CONTRACTuN TEL NOAPPROVALS DATE INSPECTOR SIGNATURE
SWAIN SIGN, INC (909) 460-2530- I VG Ty
1384 E FIFTH ST LIC NO LOCATION AND SETBACKS
ONTARIO CA 91764 643004C-45 SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRENCH FORMSI
LIC NO !I I 71L11`1
KAP NO SEWER MAP BOOK PAGE. F Dlo [RUSUCC ��voG�3Ks
NO 20
AIR QUALITY 1000 FEET MATERIALS
NO NO NO
\ SLrvice Yha�
REPORT ID DPR261 ROUTE TO SS0508
i
COUNTY OF LOS ANGELES TEMPLE CITY C 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT -
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0212170034
PHONE (626) 285-0488 EXT DUPLICATE
LEGAL ID NO OF CONST NEW BUILDING ADDRESS
SK 105 PG 86 PC 10 SO. FT STORIES TYPE OCCUP GROUP 5561 ROSEMEAD SL
STRUCTURE- 3210 1 VN 8 TEMP CA 917801802
ASSESSOR INFORMATION NUMBER- NEAREST CROSS STREET: LAS TUNAS
5387-032-059 THOMAS PAGE. 596 GRID H4 LOCALITY TE)PLE CITY
TENANT EXIST SLOG USE COKME USE ZoNr-- ISSUED ON PROCESSED BY' XPIRES ON
SYLVIA'S WEDDING EXIST OCC GRP B 01/10/03 JK 1/05/04
OWNER TEL NO BLDGS. NOW ON LOT VALUATION FINAL DATE FINAL BY LUDE
T C ASSOCIATES (714) 997-1100- 10,000 -3
747 W KATELLA 0102
ORANGE 92867 FEES PAID — DESCRIPTION OF WORK
T I FOR WEDDING STOREBSTU)f0(NONNEARING PARTITIONS W/DOORS&
APPLICANT TEL 90 FEE DESCRIPTION QUANTITY UOM AMOUNT WINDOWS,REVISE EXIST ALUM GLASS STOREFRONT,REMODEL RESTROOM)
SAME AS OWNER (626) 285-8298- Al PLANCHECK W/EN-HC 3000 DO VAL % 77
Al PLANCHECK W/EN-HC 10000 00 VAL 114 %
CHUCK LIN AA BLDG PERMIT,ISSUANCE=7-_� 27 75 FIRE SPRINKLERS REQUIRED
AE STRONG,NOTIL71 ,OTHER 10000 00 VAL 2 10
A2 PERMIT.W/ENERGY=HC`-'=S (10000:OOIVAL 249 09
CONTRACTOR TEL NO SANE AS OWNER _ 0S TOTAL(-FEES 490 67 APPROVALS DATE INSPECTOR SIGNATUWF--
LIC NO LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER FOUNDATION/TRENCH FDMK-
LIC XORAISED FLOUR FRAMINEi
MAP NO SEWER MAP BOOK PAGE' F
SLAB/UNDER FLOOR
Ind R\` r 11�1n�1((lpll
3 104 FLOOR SHEATHING
NO OF FAMILIES DWELLING LIMITS APT/COND. STAT CLASS Lo o �� C� 17��Or�- IJ �1S
NO 22 h
SCHOOL WITHIN
HAZARDOUS `\\ SHEAR� i
AIR QUALITY 1000 FEET MATERIALS eg 0
NO NO NO ��.. � r-�
6t`
FIRE SPRINKLER HANGR'§--
v6/�� Ser Vice -flibn
INSULATION/WEATHER STRIP
INTERIOR LATH/URYWALL
EXTERIOR LATH
RATED SHAFTS/DPENINUr—
T-BAR CEILINGS
LOT DRAINAGE
REPORT ID DPR261 ROUTE TO BS0508