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HomeMy Public PortalAbout5607 ROSEMEAD BLVD_Building__ APPLICATION FOR COUNTY OF LOS ANGELES INE ARTBUILDING PERMIT DEPENT OF SAFETY YY IIVVISIOON BUILDING FOR APPLICANT TO FILL IN ADDRESS O BUILDING MMGG ADDRESS VJL LOCALIT NEAREST CITY ZIP CROSR ST NOFfBLOGS ASSESSOR SIZE OF LOT NOW 0 LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE 55ED BY TRACT , h LOT NO �=U Q C NS 66Z- W GD TEL v OW NE NO STATISTICAL CLASSIFICATION //�t Lu �7 / � SEWER MAP (/ ADDRESS D GU L,50) SL CLASS NO �'DWELL UNITS BK PG USE ZONE MAP CITY L E GLS IIA NO C,?0 G ARCHITECT TEL 3 SPECIAL ENGINEER NO CONDITIONS ADDRESS / ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONTRACTOR C.LS 15,e�-/✓S (TEL BLDG SETBACK FROM ADDRESS 1134g ��))/J FRON PROP LINE OF (STREET( // INO HIGHW i YARD _ TOTAL SETBACK FROMI TYPE OF EXISTING LIC /'� FRONT PROP LINE MIDMWAV WIDTH CITY CLASS [.i _ CONSTRUC O LENDER NAME AND BRANCH BLDG SET 3 ADDRESS CITY y SIOEPROP LINED (STREET) 50 FT NO OF NO OFO CHECK HIGHWAY } YARD v TOTAL SETBACK PROM EXISTING 0 SIZE STORIES FAMILIES ONE SIDE PROP LINE XIGHW WIDTH F NEW + _ H DESCRIPTION OF WORK DO CORNER CUTOFF YES ❑ NO ❑ Z_ LTER ❑ I EPAIR❑ IN OPEN SPACE YES ❑ NO ❑ USE OF j IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG 41 EMOL APPLICANT I TEL (PRINT) NO BY (SIGNATUR 1 HEREBY ACT HOWL OE THAT HAVER THIS PPLICAT ION ANO STATE TNAT TN ASOYf If CORRECT D AGREE TO COMPLY WITH ALL ORD(NA ES AND LAWS REGULATING BUILDING CON- STRUCTION I CER IFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT OY ANY PERSON,I VIO TION OF THE LABOR CODE OF T C S ATE 0 CAL OR A IN RELATING TO WORKMEN 9 COMP 3 T INBU H I SIGNATURE OF FINAL BY PERMIT TEE DATE ADDRESS b TEL C Fee$ s! Permit Fee CITY t NO Zo Issuance Fee VALUATIONS 1 Total Fee PLAN CHECK VrALIDATION CK M O CASH PERMIT VALIDATION a? Y O CABH 846'wOj% 723 0 3Q 0 1.3 6w A! 20 2 3^8 } 1 Q 13 71 At 1 7 8.0 0-" TSASSSA CBOSGSB IE/TB 'I V V� Sg✓fa,In. pcoo � APPLICATION FOR BUILDING PERMIT Ti APPLICANT TO FILL IN (Pn Rt or tyPl allyl BU.VbiNG COUNTY OF LOS ANGELES ADDRESS !00 I QlJ�. ��p DEPARTMENT OF COUNTY ENGINEER CITY �,�GA ZIP BUILDING AND SAFETY DIVISION NO OF SLOGS BUILDING gloop SIZE OF LOT NOW ON LOT ADDRESS / rm eq TRACT C. LOCK LOT NO LOCALITY JQ f- //,,,, TEL NEAREST T' OWNER 1 L..� NO CROSS ST S TLC Q S ASSESSOR ADDRESS OG7 ft—V1z:, MAP BOON PAGE PARCEL DISTRICT GROUP TYPE FIRE PROCESSED BY CITY E kY 'e ZIP OZ� Z 004 � DD ` ^ CONST ZONE' ARCHITECT R Y` HEEL �( ENGINEER 1 /•'� � STATISTICAL CLASSIFICATION �.L SEWER ADDRESS93& CLASS NO DWELL UNITS---] BKI G CONTRACTORAO O t4ekTEL gtA21 USE ZONE NO11 O LIC ADDRESS NO 3 SPECIAL CITY CONDITIONS L, / LIC I'r/ CUS'' ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH BLOC SETBACK FROM o s '.Ah at FRONT PROP LINE OF (STREET) ADDRESS CITY HIGHWAY } YARD TOT AL SETEACK FROM TYPE OF EXISTING SG FT NO OF NO OF CHECK FRONT PROP LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE pp /I-� �L/ DESCRIPTION OF WORK NEW �V ' } 0'- 0 KI/� /�v' op DD ❑ BLDG SETBACK FROM cA SIDE PROP LINE OF ISTREETI ¢ ALTER ❑ HIGHWAY } YARD _ TOTAL SETBACK FROM TYPE OF EXISTING - REPAIR❑ SIDE PROP LINE HIGHWAYI WIDTH ly _ Cl_ USE OF EXISTING BLDG EMOL } 2 APPLICANT ./ TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) /�` DY ISIGNA TUR IN OPEN SPACE YES ❑ NO ❑ IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATIONS 0115D01" D O QQ 4 [!A V�TA�TJW-wd A,yp�G�s� I HEREBY THAT ABL THAT I HAVECORRECT READ THIO A TO COT LY AND !TATE THAT TAND IO WS RCT AND AOMEE TO COMPLY WITH ALL ORDINANCES AND LAW!DOING THE K AUTHORIZED COM- ST HERE TION I CNOTIIY THAT IN DOINO THl WORT AUTNORIIlO HLREOY i WILL NOT&6" LOYT ANY PERSON VIOLATION I; THL LABOR COOLTHE OI DATINO TO WORKMEN l COUPE SIGNATURE PERMITTEE ADDRESS ✓"�+LF V•W I FINAL/ DY Y CITY �H4 DATE %I IKE CHLCAS PAIAHLL 70 PC IFEE $ PEE PUT HARVEY T BRANDT. COUNTY ENGINEER Q 60,3 PLAN CHECK VALIDATION CK MD GASH PERMIT VALIDATION cK MD CASH 183�-VFR 1323 D 32 .5.1 A" 1-2 S�-nPR 2 3 D 9 0.0 0 1 2 6 OR 2 1 D 6 8 8.5 0 •tD TiAUISA C•MOS 0/74 ^ 1 ( ' APPLICATION FOR BUILDING PERMIT RAPPLCANTTOFILLIN (Prinlortype only) HE c �j COUNTY OF LOS ANGELES ADD S6 SJR 1!D • DEPARTMENT OF COUNTY ENGINEER E E ZIP BUILD NG AND SAFETY DIVISION NO OF BLDGS BUILDING LOT NOW ON LOT ADDRESS BLOWN_ OT NO LOCALITY TEL NEAREST NO CROSS ST ASSESSOR SS S MAPBOOK PAGE PARCEL DISTRICT YPE' FIRE �D ZIP J,� Si NEr ECT OR T• ' S 1TNEL O OER J CAL CLASSIFICATION SEWERMAfSS L •Q , CASS NO DWELL UNITSACTOR tl NEL O ,53� /U]SEZONE Nno 6 ADDRESS A] J IC NOLIC / SPEOAL IC //LL 1. CONDITIONS REXWINGBLDG ,s4v ,t L1ASS %:-rl ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO RUCTION LEN R AND BRANCH BLDG SETBACK FROM FRONT PROP LINE OF ISTREETI SS CITY NO OF NO OF CHECK HIGHWAY + YARD TOTAL SETBACK PROPKLINM HGHWAY PEOF EXISTING TY STORIES FAMILIES ONE 4;r. y IPTION OF WORK �� NEW ❑ a + SOI FRwM L STFLII IOD O BLDG SETBACK FROM z O! ADD ❑ SIDE PROP LINE OF (STREET) rO ALTER ❑ TOTAL SETBACK FROM TYPE OF EXISTING • HIGHWAY + YARD SIDEPROPLINE HIGHWAY WIDTH REPAIR ❑GBLDG ,s4 44&1 DEMOL ❑ + ANT b � CORNER CUTOFF YES ❑ NO ❑T( IN OPEN SPACE YES ❑ NO ❑ NATURD IN COASTAL PERMIT ZONE YE ❑ NO ❑ LADDRESS TION d0 O REBY ACKNOWLEDGE THAT HAVE READ THIS APRIUTION AND STATE E ABOVE IS CORRECT AND AGREE TO COMYIY WITH ALL ORDINANCES WS REGULATING BUILDING CONSTRUCTION I CERTIFY THAT IN DOING THE Uf110R1�HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATION OF R CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN 5 CDM 1N URE OF ' - TEE Aft A/ S Q� TEL NO FINAL BY N(AKE CHECKS PAYABLE TO P E $ V (PMTS$--���. HARVEYT BRANDT COUNTY ENGINEER FEE FEE 3 100 O PLAN CHECK VALIDATION S v o CANH PERNUT VALIDATION c w o CASH 6 � 4�: DEG 12 2 3 D 3 6.0 0 g 5 5"DEC 27 1 D 6 0.0 0 e Os 7U MA CE M3 75 WORKERS' COMPENSATION DECLARATION ^ I hereby affirm et the I have Wor orkers' ome of consent ra ,elf APPLICATION Mj Re BUILDING PERMIT 711UIII insuse, or a ceRificate of Workers' Compensation Insurance, or a certified Copy thereof(Sec 38DO, Lob C) ' - COUNTY OF LOS ANGELES . BUILDING AND SAFETY Policy NJb7 y74-P'Company I C.erhBUILDING Certified copy is hereby furnished �� FOR APPLICANTJO,FILL IN „ - , D7 L`-T fion ded copy n filed with the county bulldl IrgpxADDRESS- BUILDING / 6 tion epa ent ADDRESSLv sin a CITY r-r -f / ZIP , LOCALm Date/ ppllwnt NO OF BLDG _ NEAREST CERT KATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCEC (This section need rot be completed if the permit is for one TRACT BLOCK LOT NO �BOOK ,30 7 PAGE 19/ PARCEL hundred dollen ($100)or less ) J o r f�i� USE ZONE MAP OWNER V /n/ I certify that in the performance of the work for which this �/ C.� - SOCIAL } permit is issued, I shall not employ any person in any manner ADDRESS C, p4 C L�}p INO CONDITIONS 6 .7 d so as to become subject to the Workers'Compensation Lave O CIN � Pv /f ZIP U Date Applicant ARCHITECT OR TEL oc NOTICE TO APPLICANT If, after making this Certificate of ENGINEER A-got/ NO l.7 DISTRICT- GROUP TYPE FIRE PROCESSED BY rOr Exemption, you should become subject to the Workers- �D� E W Compensation provisions of the Labor Code, you must forth- ADDRESS u(i � - .lD. with comply with such provisions or this permit shall be TEL J STATISTICAL CLASSIFICATION APT I CONDO Z deemed revoked CONTRACTOR NO LICENSED CONTRACTORS DECLARATION ��� ! �� V.a� Y�2 CLASS NO DWELL UNITS— A412 I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 70DD)of Division 3 of the Business UC AT O S and Professions Code,and my license is in full force and eff CI CLASS �TALLDAl10N // SO FT OF NO OF CHECK BK �' ;i'"- - License Number is Li lass La SIZE STORIES FAMIUES ONE VALUA710N Contractor ` to DESCRIPTION OF WORK v�/i vi;� NEW ❑ /J/Dom am Lampt under Sec cyyTosy I.s/}/� /d 4� '� ❑ f � I!"i,: P TER ❑ ► .- B 8P C for this reason /d CU b r� /Nna (VI V(OZtPAIR ❑ $ - ate 115E EXISTING BLDG -1 DEMOLL IPAN 7F' - Signatur ^ APPLICAT NT) Vale L�NO is pfJ FINAL ER-BUILDER ECLARATION I hereby affirm that I am exempt from the Contractor s License / LJ �'a �rss DATE -7.� Law for the following reason (Section 7031 5, Business and L FINAL Professions Code) NT By - ❑ ro BUILDING I, as owner of the property, or my employees with ADDRESS I!�•T Il _ wages astheir sole compensation,will do the work and LOCALITY , the structure is not intended or offered for sale(Section - - - 704I, Business and Professions Cade) MOVING TEL 1 T ��: ❑ I as owner of the property am exclusively contracting CONTRACTOR NO _ with licensed contractors to construct the project (Sec- ADDRESS - ; -II I� � I' y},-g non 7041, Business and Professions Code ) s - CONSTRUCTION LENDING AGENCY 9PRED YARD HWY TAL SETBACK FROM IST L , =H�CIi WIDTH hereby affirm that there u a construction lending agency for FRONT i �'Ih,Y j� •1111 the performance of the work for which this permit a issued Pl. 1 (Sec 3097, Civ C ) SIDE PL Lenders Name LDMA Ref N PC Fees Pmmn Fee Lender s Address I certify that I have read this application and a that the Issuance Fee a% 75- IPLFDA&A P/C N above information is car t I agree to compI it all County Invmngahon Fee /S�3 ordinances and Stat ng to buil ng onstruction, Total Fee LDMA Perm N < and hereby,author a pr tahves of t s unty to ant r 1YR up t eve- o proptyy for ion urpo FAM REVERSE FOIL EXPLANATCNLY LANGUAW rwlue of imN ar Agent e • WORKERS COMPENSATION DECLARATION ^ ( herebyraf�rm cthat ertificate f W r ZertificAteCoglp of consentIra ,elf APPLICATION FOR BUILDING PERMIT `�IIU11I i nsere, or a certificate of Workers' Coptpensonon Insurance, or a certified copy thereof ( 3800,, Lob C ) - COUNTY OF LOS ANGELES BUILDING AND SAFETY D Mp Policy NoQLZJ ny Watl all LWAI f'ILgL_�JTI BIIIIDING �60 Certified copy LF hereby furnished EACORESS OR APPLICANT FILL IN ADDjBSS7 22 Certified copy is filed with the county building inspec- Dtr�IG d0 tion(d�eportment RE Date�1—�Applicant &44k ZIP LOCALITY NO OF BL NEAREST CERTIFICATE OF EXEMPTION FROM WORKERS OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ASSESSO (This section need not be completed If the permit is for oneT BLOCK LOT NO ,NAP KR PAGE �� PARCEL hundred dollars ($100)or less ) TEL ER L e NO 115E ZONE MAP I certify that in the performance of the work for which this /f 5PECIA Y permit is issued I shall not employ any person in any mannerRESS Q (� CONDITIONS o. so as to become subject to the Workers Compensation Laws O ZIP U -Dab Applicant HITECT OR TEL DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT If, after making This Certificate ofINEER NO CONST ZONE rOr Exemption, you should become subject to the Workers' 1/ V Compensation provisions of the Labor Code, you must forth- RESS r0� I a with comply with such provisions or this permit shall be TEL TATISTICAL CLASSIFICA APT CONDO Z deemed revoked TRACTOR A C NO /O UC CUSS NO WELL UNITS_ LICENSED CONTRACTORS DECLARATION RESS er &1 ND a I hereby affum that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the BusinessIF �� LIQand Professions CooddTe,an1d my liicTense is in full forrc�e and ^ect An ALIDATION License Number)/�rY� / Lic Class`��� Q 7 STORIES FAMINO �S ONSO NO OFKBK �r(1 VALUATIONCOniractor Date PTION OF WORK •►, 1 •D P.I NEW ❑ ('� T ✓(A, �; ADD ❑ $ 11 0�• ❑1 am exempt under Sec TOTAL f 11 P _ ALTER ❑ I(.I I rl� -.�'-L� m 1'C} B BP C for this reason �{ .Q-Q�f f' Date 4 ` rL SOF REPAIR ❑ f EXISTING BLDG DEMOL ❑ SgnatureAPPLICANT TEL �. FINAL �ILDER DECLARATION (PRINT) NO DATE (j"(L• 1 ' J ,J ]hereby affirm that I am exempt from the Contractor's License y'y�y_i I�ITi, r -- Low for the following reason (Section 7031 5, Business and ADDRESS FINAL t Professions Code) _ E BY ❑ I as owner of the property, or my employees with ADDRESS jl wages as their sole compensation,will do the work and tt the structure is not intended or offered for sole(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 ) CONSTRUCTION LENDING AGENCY SET a CK YARD HWY RED oTAL ONEFROM ' EXIST I hereby affirm that there o a construction lending agency for FRONT IJI V Ill-fill_i 7 'J Gy the performance of the work for which this permit a issued P L (Sec 3097, Civ C) SIDE PL yy Lender's Name / / p p jDMA Ref N n P C Fee S �G e, Permit Fee C C 0 Lender's Address o I certify that I have read this application and state that the Issuance Fee a 7- 3 LDMA P/C N above information is correct 1 agree to comply with all County Investigation Fee ordinances and State jaws relating to building construction, Total Fee LDMA Perm N and hereby authorize representatives of this County to enter upon the above mentioned property for inspection purposes n SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant w Agent Dole WORKERS COMPENSATION DECLARATION / hereby affirm fthdtica I have r certificateComp of canon, to nee, APPLICATION FOR BUILDING PERMIT insure, a a certificate of Workers Compensation Insurance, or a certified copy thereof (Sec 3BDO, lab C COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No,07'111,:�_ Company BUILDING �❑ Certified copy is hereby furnished FOR APPLICANT TO FILL IN WL11 L"1 Certified copy Is filed with the county budding Inspec- O C m a4� &11lDING-c /� tion department ADD `� L�'✓t �e 1, s Date L1-22, Y1 Applicant att C , ZIP NO ORLDGS LOCALITY CERTIFICATE OF IX FROM WORKERS SIZE OF LOT NOW ON LOT NEAREST CROSS ST COMPENSATION be co if ASSESSOR (This section need not be completed the permit is fa one TRACT BLOCK LOT NO MAP BOOK PAGE O:fl PARCEL hundred dollars ($100) or less TEL OWNER Uris 4ETR. t NO 32077$0 USE ZONE IMAP I certify that in the performance of the work for which this I /J permit a issued, I sholl not employ any person in any manner ADDRESS 5Z o - (j 3 SPECIAL a CONDITIONS w as to become subject to the Workers Compensation lows O CITY ZIP U Dote Applicant ARCHITECT OR TELDic NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY O Exemption you should become subject to the WakenCONST ZONE G w Compensation provisions of the labs Code, you must forth-- ADDRESS k1 3 a with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT CONDO N deemed revoked CONTRACTOR No 3zU 7?fSU ? LICENSED CONTRACTORS DECLARATIONuC CLASS NODWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS fry (J NO l62 f d 6 SEWER MAP (commencing with Section 7000)of Division 3 of the Business UC and Professions Code,and my license is in full face aril effect CITY C4 �� e 1O BK PG VALIDATION J'[ (� 50 FT NO OF rao OF CHECK Ucense Number tibl'�b6 Lic Class `+' f<) SIZE STORIES FAMILIES ONE {� _ VALUATION Contractor Dote '2-gy DESCRIPTION OF WORK n'el NEW ❑ V ❑I am exempt under Sec sT1O �g ❑ f ► •J�i/�J63 B 8P C for this reason REPAIR ❑ Dae - USE OF //// EXISTING BLDG N/_ MiVC,i ❑ -yaa - �Z �� APPLICANT ,II ' ) /�n Signature op IV,ER-BUILDER DECLARATION (PRINT) ✓1LJ NO ZD77®� DATE "Ci'7'v d�0 I hereby offs shot I am exempt from the Contractor's License ADDRESS �y 70 VCcr1�V ��r4 e Low fa th allowing reason (Section 7031 S, Business and FINAL Professions Code) PRESENT By ❑ 1 as owner of thero BUILDING p party, or my employees with ADDRESS wagescis then sole compensation will do the work and LOCALITY - Poo - the structure a not intended or offered fa wee(Seniors 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 PA011DRESStion 7044, Business and Professions Cade )CONSTRUCTION LENDING AGENCY ACK , OTAL SETBAgC FRCYA i PROP E WIDTH I hereby affmm that there a a construction lending agency fathe performance of the work for which this permit is issued(Sec 3097, Gv CLender s NameLDMA Ref NLender's Address Permit Fee ,I certify that I have read this application and state that theIssuance F Lil. PTC N above information is correct I agree to comply with all County Investigation Fee / t{ ordinances and State jaws relating to building conshuction, Total Fee i 4 ✓ LDMA Perm N ` and hereby authorize representatives of this County to enter (Yq upon thp 9bovementioned property for inspection purposes UK RffVUM FOR EXPLANATORY LANGUAGE - 4r Sigrwture of Applicant or Agent Date WORKERS' COMPENSATION DECLARATION hereby affirm that I have r certificate of tion Int to ,elf APPLICArtION FOR BUILDING PERMIT insure, « a certificate of Workers Compensation Insurance, or a certified copy theree_of�_JSSec 3800, Lab C ) COUNTY OF l05 ANGELES LEMNG 6UILDING AND SAFETY PoI�Y No "Com7;;/ .S-rlii�'L>•tJD ❑Q� Certified copy a hereby furnished FOR APPLICANT TO FILL IN ADDRRESSS (pQ Certified copy Is filed with the county building unpec- AM 1.5jj tion epa ent Date r pplicant OT�;K ZIP LOCALITY /CERTIFICATE NEAREST ATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ST COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is f« one TRACT BLOCK LOT NO MAP BOOK PAS pqj CEI undred dollars ($100)or less ) OWNER L JA / £D e.}- NO $7.0'7-r9l USE ZONE MAP �7 I certify that in the performance of the work for which this r ? os permit Is issued, I shall not employ any persan in any manner ADDRESS INO SPECIAL�/� C� J CONDITIONS d so as to become subject to the Workers'Compensation Lows �,.,yz O cm� ZIP - V Date Applicant ARCHITECT OR TEL OC NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO DISTRICT GROUP O NST ISE PROCESSED BY O Exemption you should become subject to the Workers 6 1/ �] Compensation provisions of the Labor Code, you must forth- ADDRESS Qa ;?- with with comply with such provisions « this permit shall be TEL - STATISTICAL CLASSIFICATION APT I CONDO deemed revoked CONTRACTOR n _ LICENSED CONTRACTORS DECLARATION LIC �`NO CLASS NO DWELL UNITS— LICENSED hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS (commenting s Co Section 7000)ns Drvuion 3 of the Business C_Jy---� �Y LIC SEWER AMP IIIIIIIIIN and Professions Code,and my bcense is m full face and a act IIS 7 � CLASS =BKPG VALIDATION r� SO FT NO OF NO OF CHECK License Number �b Lic ClassSIZE STORIES FAMILIES ONE ftp e7 �' DESCRIPTION OF WORK NEWA� ©O❑I am exempt under Sec �- ❑ ► ALTER B 8P C for this reason $ REPAIR ❑ Do! USE OF EXISTING BLDG DFhKK ❑ Signature�/4J' APPLICANT Tf TEL FIN A OWNER-BUILDER DECLARATION (PRINT) AST/A aW�oL Np ye I hereby affirm that I am exempt from the Contractor s License DA Law for the following reason (Section 7031 5 Business and 'CRESS FINAL 2J Professions Code) NT BY — A ❑ I, as owner of the property or my employees with BUIgppDIu v —D -c ACCT" wages w their sole compensation,will do the work and ► �7 48.75 the structure is not intended or offered for sale(Section LOCALITY T'�'� 7004, Business and Professions Code) MOVING TEL - 1 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO ACCT J•A ' with licensed contractors to construct the project (Sec- non 7044, Business and Professions Code ) ADDRESS 3307 144.45 CONSTRUCTION LENDING AGENCY FIRED CK Y,� H,`, AL SETBACK FROM EXIST I hereby affirm that there Is a construction lending agency f« FROM PROP E_ WIDTH 2 ITEMS the performance of the work for which this permit is issued P L (Sea 3D97, Civ C ) SIDE TOTAL 193. 20 PL Lender's Nome J .y ry[� 193.20 / /D LDMA.Rel Y lfVtlT� .� P C Fee Pvmn Fee Lender's Address , I certify that hhave read this application and state that the I w ce Fee W 7, LDMA.P/C Y above mformatioAcort ree to comply with ail County Inve•egonon FeeQQ�-QQI]1 1/SCJ/93 ordinances a ing to buil onstruction, Total Fee 7 .� LDMA,Perm Yand hereb uthes of t s unto enterupon ve- Pe for �o urp 7M 1 �10:1v I SEE REVERSR FOR EXPLANATORY LANGUAGE Sillnature of Applicant cr Agent • COUNTY OF LOS ANGELES TEMPLE CITY A 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9611060028 PHONE (818) 285-0488 EXT- LEGAL ID NO OF CONST BUILDING ADDRESS BK 105 PG 86 PC 2 SO FT STORIES TYPE 5607 ROSEMEAD BL STRUCTURE 3900 V TEMP CA 917801804 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY 5387-031-062 THOMAS PAGE 596 GRID H3 LOCALITY- TEMPLE CITY TENANT EXIST BLDG USE CUKME USE ZONE C-2 ISSUED ON PROCESSED BY EXPIRES ON LIMITED SAVINGS EXIST OCC GRP 11/06/96 TC 11/06/97 mm ER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE FINAL Bt,,,,,�-ME ELTINGE GRAZIADIO,SAMPSON DEV CO - 1 5,000 }t-17 q ) FEES PAID PT 6nTRTON 51-�iK7 `L K RECOVER WITH 72 LB. CAP AND BUILT-UP FEE DESCRIPTION QUANTITY- UOM AMOUNT APPLICANT: TEL NO H2O ROOFING (909) 612-0659- AA BLDG PERMIT ISSUANCE 27.75 21632 LAUREL RIM DR AC STRONG MOTION RESID 5000 00 VAL 0 50 SPECIAL CONDITIONS. D2 PERMIT W/0 EN-HC1 L L- C5000.00 FES VA� 133 OS TEL NO `N`_(`.wJ` TOTALALFEES 161 30 CONTRACT�H2O ROOFING (909) 861-7548- DIAMOND LAUREL RIM DR. 98 LIC NO O/'� LOCATION AND SETBACKS DIAMOND BAR, CA 91765 715695 SOILS ENGINEER APPRUVAr- LIC NO till SLABAINDER FLOOR RAISED FLOOR FRAMING MAP No SEWER MAP BOOK PAGE mrm� FLOOR SHEATHING NO 22 150H265 3 D., PUBLIC WVO KS 90 OF FAMILIES: DWELLING LIMITS APMWF� .f\ '��1 T.J ' J;SCHOOL WITHIN HAZARDOUS ' Y SHEAR PANELS AIR QUALITY 1000 FEET MATERIALS / NO NO NO REQUIRED TOTAL SETBAU-TffffiF—URVr-- FIRE-SMNKCER RANGERS SET BACK YARD HWY PROP LINE WIDTH `"�{� ��� FRONT PL- �/"�� SIDE PL- li v REPORT ID DPR261 ROUTE TO BS0508 WORKERS COMPENSATION DECLARATION �I hereby affirm that I have certificate of rAnsent to APPLICATION FOR BUILDING PERMIT DISI re, or a certificate of Worr kers Compensation Insurance insure, . .� or a certified copy thereof(Sec 3800, Lob C ) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No Company Certified copy Is hereby furnished FOR APPLICANT TO FILL IN AD= CJ Certified copy is filed with the county building Impec- BUILDING hon department ADDRESS 5&0 IAJ LOCALITY NEAREST Date ApphLnn CITY ZIP CROSS ST CERTIFICATE OF EXEMPTICIROM WORKERS OF&DGS ASSESSOR COMPENSATION INSURANCE SIZE OF LOT ON LOT MAP BOOK I PAGE PARCEL (This section need not be completed If the permit is for one USE ZONE I MAP hundred dollen($100)or leu ) TRACT BLOC' LOT NO INO SPECIAL I comfy that in the performance of the work formh this OWNER NO CONDMONS d permit is Issued I shall not employ any person in any manner DISTRICT GROUP TYPE FIRE PROCESSED BY O so as to become subject to the Worker'Compensation Lows ADD RE CONST ZONE U / ad 7 b Date Applicant ARCHITECT IF ZIP TEL STATISTICAL FICATION CONDOij�f 0 NOTICE TO APPLICANT If after raking thisCertrficale of ENGINEER NO CLASS T40 DWELL UNITS_ su Exemption, you should become subject to the Worker jy Compensation provisions of the Labor Code, you must forth ADDRESS SEWEgP Z with comply with such provisions or this permit shall be deemed revoked CONTRACTOR NLp BK IG VALIDATION LICENSED CONTRACTORS DECLARATION ^ LIC I hereby offnm that I am licensed under provisions of Chapter 9 ADDRESS 010 NOC VALUATION (commencing with Section 7000)of Division 3 of the&mneu and LIC /' C / Profeuaa m Code, and my license in full force and effect CTY�/l CLASS L - f �l 0 to TT (/ ( SO FT OF NO OF nt0 CHECK , Llcenw Number V 2, LIc Class / Y SIZE STORIES IFAhMUES ONE IX k' DESCRIPTION OF WORK NEW C] _S Cantroctp Date AW ElI am exempt under Sec 3 / I V S�I/ r ALTER ❑ DAT L �� B 8P C for this reason REPAIR FINA❑ Date USE OF OEA10l ❑ EXISTING BLDG /� FI Signature APPUCANTT ♦ A S Tei TEL 4 5 A OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License �'�z.7.IT--A G # •i• e.e 3 Law for the following reason (Section 7031 5, Business and ADORE fl77(( 2 • • 3 � Jr Q Professions Code) PRESENT I, as owner of the property, or my employees withADDRESS DIN O •� 7t y�.� b cii wages as their sale compensction,will do the work and (_ JF the structure is not intended or offered for sale(Section LOCALITY . . . e 7044, Business and Profession Code) MOVING TEL I as owner of the property,am exclusively contracting CONTRACTOR NO 2;• - 4 9 8 8 with licensed contractor to construct the project (Secy • • • 4 9, 8 8 v tion 7041 Busaeu and Professions Code) ADDRE1 REWIRED TOTAL SETBACK FROM EXIST CONSTRUCTION ti AGENCY SET BACK YARD HWY PROP u WIDTH , 0 Q 2 8 -8 4 1 hereby rmanoff irm that there is r construction far whicht is perd I agency for j:jTONT the performance of the work for which this permit a Issued P (Sec 3047 Civ C ) 1 SIDE PL Lender a Name 6 Lender a Address P C Fee$ Permit Fee - I certify that I have read this application and state that the jounce Fee < above Information Is correct I agree to comply with all County Investigation Fee pr B$ ordinances and State lows relating to building construction Total Fee (J and hereby authorize representatives of this County to enter upon bove-mentioned property for Inspection purposes i L LEE REVQH FOR EXPLANATORY LANGUAGE S) vzNn of Applicant or Agent Date ms COUNTY OF L40S ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC FORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1003180049 PHONE (626) 205-0488 EXT LEGAL ID NUMBER OF SIGNS 3 BUILDING ADDRESS 1 BK 105 PG 86 PC 2 SIGN DESCRIPTION INSTALL THREE ILLUMINATED FWLL SIGNS 5607 ROSEMEAD BL TEMP CA 917801804 (ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET BROADWAY 1 5387-031-062 THOMAS PAGE 596 GRID H4 LOCALITY TEMPLE CITY Cl TENANT IrXIST BLDG USE ISSUID ON PROCESSED BY IEXIST OCC GRP 03/18/10 SR _ TEL NO I (BEINGS NOW ON LOT VALUATION F NAL DATE FINAL BY CODE IGRAZIADIO INVESTMENT CO 10, SS'000 149 PAIRS VERDES BL IREDONDO BEACH CA FEES PAID DESCRIPTION OF FORK INSTALL THREE ILLUMINATED WALL SIGNS, REFACE THE EXISTING IFEE DESCRIPTION QUANTITY COM AMOUNT (POLE SIGN AND REFACE THE ATM SIGN PANEL APPLICANT TEL NO (STEVE TERRIAULT (619) 571-9675- IAA BLDG PERMIT ISSUANCE 27 75 14444 FEDERAL BLVD AS STATE GREEN BLDG FEE 10000 00 VAL 1 00 SPECIAL CONDITIONS ]SAN DIEGO CA 92102 AX BUILDING REVIEW PEE 54 70 ] D2 PERMIT W/0 EN-HC 10000 00 VAL 216 60 ] TOTAL FEES 300 05 ]CONTRACTOR TEL NO APPROVALS DATE INSPECTOR SIGNATURE 1 ISIGNTECH ELECTRICAL ADVERTISING (619) 527-6100- 1 14444 FEDERAL BLVD LIC NO LOCATION AND SETBACKS ] ISAN DIEGO CA 92102 06/30/2010 ' 1 SOILS ENGINEER APPROVAL 1ARCHITECP OR ENGINEER TEL NO 1 FOUNDATION/TRENCH PORM9 1 1 LIC NO 1 ISUPPORT STRUCTURE I I MAP NO 9B'YIER MAP BOOR PAGE FIRE ZONE CMP I 001 ] I NO OF FAMILIES DWELLING UNITS AFC/GOND STAT CLASS I ] NO 20 1 SCHOOL WITHIN HAZARDOUS ] 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 • ADDITIONAL DATA ON FILE I I I REPORT ID DPR261 ROUTE TO BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY r L # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 1 - + BL 0508 9611130090 PHONE (818) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS: BK 105 PG 86 PC 2 SQ FT STORIES TYPE 5607 ROSEMEAD BL STRUCTURE 0 V TENP CA 917801804 ASSESSOR INFORMATION NUMBER NARE5387-031-062 THOOMAS PAGESS596 GRID H3 LOCALITY TEMPLE CITY TENANT EX I ST BLDG USE COW ---MT ZONE C-3 ISSUED ON PROCESSED BY EXPIRES ON EXIST OCC GRP 11/13/96 TC 11/13/97 OWNER TEL NO BLDGS NOW ON LOT VALUATION FINAL DATE rINAL ELTINGE GRAZIADIO,SAMPSON DEV CO - 1 2,000 FEES PAID bE4CRTF 7 H STUCCO OVER FACIA BOARD FOR BANK BUILDING FEE DESCRIPTION. QUANTITY UDM AMOUNT APPLICANT TEC—WF— AKITECH ASSOCIATES (818) 458-9088- AA BLDG PERMIT ISSUANCE 27 75 55 S RAYMOND AVE AE STRONG MOTION OTHER 2000 00 VAL 0 50 SPECIAL CONDITIONS ALHAMBRA, CA D2 PERMIT W/0 EN-HC. I E Czoo0.00 VAL 82.20 `( �'(- TOTAL ^� 110.45 CONTRACTOR TEL NOAPPROVALS DATE I msPnTdFTrd9TMT-- AKI TECH ASSOCIATES (818) 458-9088- O� ` _ q� 55 SO RAYMOND AVE #106 LIC NO �6/moiLOCATION AND SETBACKS ALHAMBRA, CA 91801 578143 B SOILS ARCHITECT OR ENGINEER TEL NO FOUNDATION/TRFNL;H FORMS AKITECH ASSOCIATES (818) 458-9088- 55 SO RAYMOND AVE #106 LIC NO SLABIUNDER FLOOR ALHANBRA, CA 91801 578143 B 14AP NO SEWER MAP BOOK PAGE7H265 ;' 04 PU�LBC WORKS NO OF FAMILIES DWELLING UNITS. APT/COND S AT CLASS FLOOR SHEATHING NO 220 O S a co ROOF SHEATHING ---gcgaac-wTTgnr--- HAZARDOUS O AIR QUALITY 1000 FEET MATERIALSNO NO NO FRAME iNsPrCTrffW— SET BACK YARD: HWY PROP LINE WIDTH FRONT PL- S��►ce ��� SIDE PL- h� ` REPORT ID DPR261 ROUTE TO BS0508 WORKERS COMPENSATION DECLARATION t '-t"r � /p U' - - , `� 4 • a/2• hereby afTAkiat I have o cexlhcote of consent to "If - APPLICATION FOR. B I ILDING PERMIT` - msure or a certd¢otrof Workers Compensation Insurance or a certified copy thereof (Sec 38010,La}b C ), G- T - Pobry No11 �51`6Company�Qr Un10�1 /Q L - COUNTY OF LOS ANGELES I BUILDING AND SAFETY 00 Cenifled copy is hereby furnished FSSSkp PPLICANT TO FILL IN BUILDING ADDRESS Certified copy Is filed with the county building nnpec non department /N ODate 1� ��� v`� Appnc M 1. ZIP LOCALITY CERTIFICATE OF E% FROM WORKERS FBLDGSNEAREST COMPENSATION INSURANCE NOW ON LOT ST(This section need not be completed if rhe permitofor one BLOCK LOT NO ASSESSOR hundred dollars ($100)or leas ) yi(t-[y alt ht MAP BOOK PAGE PARCEL I certify that m the performance of the work for which this OWNER 0j��/� -�ss [� - �1 r� 6/ I MAP ND permit is Issued, I shall not employ any person In any manner ADDRESS �V_7 N , 1��W'N�K 1�� K� � so as to become subject to the Workers'Compensation Laws CONDITIONS DoteIlcanf P 1./' APP CITY ZIP ARCHITECT OR TEL 0 NOTICE TO APPLICANT j4 ober making this Certificate of ARCHITECT NO DISTRICT GROUP TYPE FIRE D BV O Exemption, you should become subject to the Workers' ADDRESS T, CONST FIRE W Compensation provisions of the Labor Code you must forth- JrV D g with comply with such provisions or this permit shall be Il deemed revoked CONTRACTOR Q TEL STATISTICAL CLASSIFICATION AP4 1 T CONDO N LICENSED CONTRACTORS DECLARATION LIC CLASS NO LL UNITS_DWELL Z I hereby affirmthat I am licensed under provisions of Chapter 9 ADDRESS CT d NO a -1.7 (commencing with Section 7000)of Division 3 of the Business and k 1C SEWER MAP Professions Code, and my license is In full force and effect CITY C10 M 5 BK PG VALIDATION �L7 /' A 50 FT OF NO OF CHECK License Number 1 -1 r— LcCl d---45 ( V SIZE STORIES FAMILIES ONE �,����1� Gln [] vuL1AT��(ON v Connactok-&%A V;iTd tJC S Date I_ I'��rJ DESCRIPTION OF WORK NEW $ U�O a/ r ADD Pilo. I am exempt under Sec LL VI _ ALTER 2 8 7 6 6 A B 8P C for this reason 'Ce— e REPAIR $ # • • • • 2 3 Date USE OF pFlAOL EXISTING BLDG I • - 49.41 Signature APFLIGANT nLs TEL 7 HNAI OWNER-BUILDER DECLARATION PRIM ` NO DATE • • e 4 9 4!1 5 I hereby affirm that I am exempt from the Contractor's License ADDRESS 2 V rtr W Law for the following reason (Section 7031 5, Business and FWAL Q 1, 13-88 Professions Code) RIM By 1, os owner of the property, ywill employees BUILDING p p na or m do to ees sand ADDRESS wages thea sole compensation, red f o the work and N 8'is '] the structure, Busina not intended a offered for sale(Section LOCALITY , Xis 1, as Business and Professions Code) CONTRACTOR TEL I • • 6 a 6 3 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (SecADORE T • • • b 8 6 3 5 tion 70" Business and Professions Code) CONSTRUCTION LENDING AGENCY BACK YARD NWY TOT PROP LINE WIDTH O 1, 13-88 I AL SETBACK FROM hereby affirm that there is a construction lending agency for FRONT Rhe performance of the work for which this permit is Issued P L (Sec 3097 Civ C ) SIDE PL Lenders Name P C fee$ LDMA Ref I` Permit Fee J� N Lender aAddress I certify that I have read this application and state that the [assent.Fee S LDMA P/C/ above Information a correct I agree to comply with all Count' Invealgotbn Fee $ ordinances and State la Iating to building construction, Total Fee jDMA Perm Y R tee___ eby authonze re ae atI �IhsrCounty ro enter C u nth obove-me n edn purposes n su EEVEILEE FOR EXPLANATORY LANGUAGE , mNre of Apphcant or Agent Date