HomeMy Public PortalAbout5570 ROSEMEAD BLVD_Miscellaneous__ COUNTY OF LOS ANGELES TEMPLE CITY { 0508 MISCELLANEOUS PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS I MP 0508 0610100003
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY G 91180
PHONE (636) 385-0488 ETT
LEGAL ID a0 OF CONST NEW BUILDING ADDRESS
ON FILE BQ FT STORIES TYPE OCCUP GROUP 5570 ROSEIEAD BL
STRUCTURE 1 VN C TEMP G 917801601
ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET
5387-078-019 EXIST BLDG USE THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY, C
EXIST OCC GRP USE FOSE
TENANT ISSUED ON PROCESSED BY EXPIRES ON
HOME OF CHRISTIANS ARCADIA SLOGS NOW ON IDT VALUATION 11/16/06 XX 05/15/07
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OWNER TEL SO PIN DATE PI BY CODS
5558 LAI (333) 869-1666- LIST ITEM //� —
TEMP H CITY
CARD BL ✓ ✓ ��*fff���^�
TEMPER CITY G 91780OP WORK ",/
CHURLS UR(Sa USE DSS SPACE APPROXIMATELY 7700 8 P (EO MALL WINDOW
OCCUP LOAD EXIST LIGHTING ETC CHANGE)
APPLICANT TEL NO DCCUP LOAD NEW
LEO NU, ARCHITECT (676) 462-9302-
67 H LIVE OAK AVE PARKING SPACES REQUIRED SPECIAL CONDITIONS
ARCADIA, CA 91006 PARKING SPACES PROVIDED
BLIT HARDWARE _
CONTRACTOR TEL NO LIMITED TIME USE
LHO NU (676) 467-9307- MR OF EXITS PROM TO
67 E LIVE OAK AVE, #701 LIC NO
ARCADIA CA 91006 04784 PEES PAID
APPROVALS DATE INSPECTOR SIGNATURE
FEE DESCRIPTION QUANTITY DOM AMOUNT
ARCHITECT OR ENGINEER TEL NO TRAI-&R USE
- 07 OCC/USE ISPBCT OTHER 7700 00 SOF 359 40
LIC NO TOTAL FEES 359 40 SAPS" PERMIT
TEMP STRUCT APPROVED
MAP NO 9BM68 MAP BOOK PROS PIAS EONS CMP '� TEMP' 91EUCT REMOVED
NO OF PAMILIH9 DWELLING IRIITB APT COHb STAT CLASS
NO
i
SCHOOL WITHIN HAZARDOUS _
AIA QUALITY 1000 FEET MATERIALS _
NO NO HO
REQUIRED TOTAL SETBACK FROM EXIST -
SET BACK YARD HMT PROP LINE WIDTH
FRONT PL-
SIDE PL-
REPORT ID DPR767 ROUTE TO HSO508
WORICERJ COMPENJAILUN L)tI-LAK&i1VN 20-00e3oM12rW IM11JtrL,LLH1�lGVVJ Hlrrg-.i�t+i ivies
I hereby affirm that I have a certificate Of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DMSION
•nasure,or a certificate of Wbrhrs' Compensation Insarmce,or
a certified copy thereof (See 3800 lab. Cy
Policy No Company FOR APPLICANT TO FILL IN IauILDING
' UILDING ADDRE59 wODR¢se
• ® Certified copy is hereby furnished. (JX <5176 LOCAL17'I,
Certified copy is flied with the county building mspectio elTv? / ZIP
' department. / U I moss Sr
Date Applicant SIZE OF LOT NO DF BLDGS NOW ON LOTDISTRICT NO GROUP TYPE PROCESSED BY
CERTIFICATE OTI
F EXEMPTION FROM WORKERS coNsr OO
I COMPENSATION INSURANCE TRACT BLOCK PUT NO MAP Rw .AY
I..., STAT¢MAJOR SECOND LOCAL
(This Section need not be completed if the work involved ASSESSOR MAP BOOK PAGE PARCEL No
by the permit is for one hundred dollars ($100) or le ) ME ZONE sPEGAL CONDITIONSss
I certify that In the performance of the work for which R S
permit is issued. I shall not employ any person in any man y
so as to become subject to the Workers Compensation La ADDRE59 to
OCCUPANCY GROUP Z
Date Applicant CITY - z)P
NOTICE TO APPLICANT If after making this Certificate I OCCUPANT LOAD
of Exemption you should become subject to the Workers AP LIGATION FOR EXIT HARDWARE
Compensation provisions of the Labor Code you must forthwith
comply with such provisions or this permit shall be deemed TRAILER USE❑ GEOLOGY INSPECTION❑ No Spec Knowl ❑
' revoked
LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION CI Panic Devices ❑I^1
I hereby affirm that I am licensed under provisions of Chapte SAFETY PERMIT❑ (LIST ITEMS BELOW) NO OF"ITS
J '
1 9(commencing with Section 7000)of Division 3 of the Bus! s e o 118 esa
and Professions Code and my license is in full force and eft t
PARKING RED D � PROVIDED
License Number Lic Class !� Chi ,�z0 sPAces
I Contractor Date ��" LIMITED TIME USE
I ern
-
I ❑ exempt from the licensing g gments I am a DATE
licensed architect or a registered professional engineer FROM to DATE
actInj in my professional capacity(Section 7051 Business SMzE OF NO of INSPECTOR•E
1
and rofessions Code) BIMSTING LDIG
G STORIES SIGNATURE,
-
Lic or Reg. No - Date PRESENT USE OF BUILDING FINAL APPROVAL 3
' HOME OWNER-BUILDER DECLARATION NO OF MDiiSTING BUILDINGS
GN LOT AND USE
I hereby affirm that I am exempt from the Contractors License
Law for the following reason (Section 70315 Business and
Professions Coda) NO PARKING
PACES PROWDED
❑ I as owner of the property will fo the work and t ,
structure s not intended or offered for Sala(Secnon 7 oPo9e0 uae of SuaoweTV Ait
Business and Professions Code)
CONSTRUCTION LENDING AGENCY -
I hereby affirm that there is a construction lending agency for
the performance of the work for which this permit is issued
i (Sec 3097 Civ C) PROPOSED MAX OCC.
( Leader's Name APP CANT( i 10� 1 TEL No
i I N bi- 6
Lender's Address A RESS
I certify that I have read this application and state that the
above iaformatnou is correct I agree to comply with all County PERMIT FEE GG
I ordinances and State laws relating to building construction and - I
�^ hereby authoria representatives this County to enter upon ISSUANCE Fee ,
i t the abovtmentioned pro rt iaspectian purposes - -
TOTAL FEE
�— SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Permittee ate
COUNTY OF LOS ANGELES TEMPLE CITY 6 0508 MISCELLANEOUS PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS MP 0500 0611270001
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780
PHONE (676) 785-0488 EXT
LEG" ID No of COMET NEW BUILDING ADDRESS
ON FILE SQ FT STORIES T7PE OCCUP GROUP 5570 ROSEMEAD HL
STRUCTURE 1 VN C TEMP CA 917801801
ASSESSOR INFORMATION NUMBER NBARSST CROSS STREET LAS TUN"
5187-078-019 EXIST BLDG USE THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY C
EXIST OCC GRP USE ZONE
TENANT ISSUED ON PROCESSED BY EXPIRES ON
BLOGS NON ON LOT VALUATION 11/77/06 JK 05/76/07
1,000
OWNER TEL NO FINAL DAPXPIR BY CODE
LAI, MAI H (777) 068-1666- LIST ITPJ18
5570 N ROSEMEAD BL
TEMPLE CITY CA 91780 DESCRIPTION OF WORK
INSPECTION To CHECK MORE NITTLOUT PERMITS
_ OCCUP LOAD EXIST
APPLICANT TEL No OCCUP LOAD NEW
SAID; AS OWNER -
PARKING SPACES REQUIRED SPECIAL CONDITIONS
PARKING SPACES PROVIDED
_ EXIT HARDWARE
CONTRACTOR TEL NO LIMITED TIME USE
SAME AS OWNER - USE OF EXITS FROM TO
LIC NO
FEES PAID
APPRO'ALS DATE INSPECTOR SIGNATURE
PRE DESCRIPTION QUANTITY DOM AMOUNT
ARCHITECT OR ENGINEER TEL NO TRAIL3R USE
OA PERMIT ISSUANCE 27 75
LIC NO O1 R/M OCC/USE INSPECT 145 95 SAFETY PERMIT
TOTAL FEES 171 70
TEMP STRUCT APPROVED
MAP NO SEWER MAP BOOR PAGE FIRE ZONE CMI TEMP STRUCT REMOVED
NO OF FAMILIES DWELLING UNITS APT COMD STAT CLASS _
HO
SCHOOL WITHIN wpm us
AIR QUALITY 1000 PRET MATERIALS
NO No No
REQUIRED TOTAL SETBACK "ON EXIST
SET BACK YARD HWY PROP LINE WIDTH
FRONT PL-
SIDS PL-
REPORT ID DPR267 ROUTE TO BS0508
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