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Home My Public Portal About5623 ROSEMEAD BLVD_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND AFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING A DRESS I hereby affirm that I have a certificate of consent to self insure, BUILDIN AD RES 3 or a certificate of Workers'Compensation Insurance,or a certified ' copy thereof(Sec.3800,Lab.C.) CITY r ZIP c LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER TEL NO. COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred DRESS L DISTRICT GROUP TY CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) ff~ I certify that in the performance of the work for which this permit MY_ r�, ZIP 1 is issued, I shall not employ any person in any manner so as to C become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TE O. STATISTICALCL�TION 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' CONTRACTOR TEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith `. co ___W FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS 01 EM.NO. PL LICENSED CONTRACTORS DECLARATION PILE CITY UC.CLASS 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 SQ.FT.SIZE NO.OF STORIE7 NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW BK PG ® a a License Number LIC.Class DESCRIPTION 9F WORK ADD ❑ VALUATION C Contractor Dates ALTER ❑ $ C ❑ I am exempt under Sec. L 411 REPAIR 11 $ C BAP.C.for this reason O/fi/ J_ DEMOL ❑ C LDMA P/C# Date: USE OF (STING BLDG URM ❑ a Cr. Signature APPLICANT(PRINT) TEL NO LDMA Perm# L ❑ I, as owner of the property, or my employees with wages as ZO r•r a their sole compensation, will do the work and the structure is ADDRESS H;•t� -O not intended or offered for sale (Section 7044, Business and I FINAL DATE Q 0. - _ Professions Code.) -1-1A � 1` �'� ` HALL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of the property, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE Q y T E.N. P y. Y 9 AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY ` licensed contractors to construct the project (Section 7044, YES❑ NO❑ +"IiIL 66- 45 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING L�C(+( L OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH (tL41: G oC CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR GUIDELINES ,, I hereby affirm that there is a construction lending agency for YES 11 NO❑ CHANGE 'LIj G) the performance Of the WOfk for which this permit IS ISSUed(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING w 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE TITLE 2•CHAPTER 2 20 SECTIONS 2 20.100 THROUGH 2 20.140 CONCERNING HAZARDOUS f jtyw Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. L Ji+ LI 1 17 0 Lender's Address 0611 1 } 12-:32Wr>,ER OR AGENT f7`i o I certify that I have read this application and state under penalty of perjury that the above information is correct.I agree to comply P.C.FEE PERMIT FEE N with all county ordinances and State laws relating to building C1 construction, and hereby authorize representatives of this County ISSUANCE FEE ato enter upon the above-me tinned pfoperty for inspection purposes. (G ro 4 INVESTIGATION FEE TOTAL FEE De. IF SEE REVERSE FOR EXPLANATORY LANGUAGE A' COUNTY OF LOS ANGELES TEMPLE CITY # 111508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS >t' ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9902110037 PHONE: (626) 285-0488 EXT: LEGA ID: No. OF CONST D G ADDRESS: BK: 62 PG: 2 PC: FSTRUCTURE: T STORIES TYPE 5623 ROSEMEAD BL VN TEMP CA 917801804 SS SSO IN 0 IO R: NEAREST CROSS STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY E A T: : COMME S 0 : C- IS ED 0 : P OC SSE BY: EXPIR S ON: LIM'S BAKERY T OCC GR : 02/11/99 UT 02/11/0 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DAT FINAL BY: E: ELTINGE GRAZIADIO;SAMPSON DEV CO - 1 5,000 01-/57"_ ,Q ES PAID ESC P 0 0 Z REPLACE BROKEN BEAM (4X12) TO 6 X42 FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: EL. 0• G S HANNA CONSTRUCTION (626) 798-4188- AA BLDG PERMIT ISSUANCE 27.75 1890 QUEENSBERRY RD AC STRONG MOTION ESID 5000.00 VAL 0.50 SPECIAL CONDITIONS: PASADENA,CA 97104 D2 PERMIT W,W�EB X5000.00 VAL 132.60 CONTRACTOR: TEL. N0: G ��GELEST160.85 �T®�� APPROVALS DATE INSPECTOR SIGNATURE G S HANNA CONSTRUCTION (626) 798-4188- �. 1890 QUEENSBERRY RD LIC. NO LOCATION AND SETBACKS PASADENA CA 91104 585010 B / SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: / 0 D T ON/T E C S OR LIC. N 1111111 SLAB/UND R FLOOR RAISED FLOOR FRAMING--- NAP R I G 147H265 SEWER NAP BOOK: PAGE: FIRE 20N3: CM�¢'U _-R K S pD ��j UNDERFLOOR NS CATION MC �I FLOOR SHEATIUNG 0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS'. NO 22`\� ROOF SHEATHING \� " [Ali SCHOOL WITHIN HAZARDOUS ` r t y SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS ! 0 ❑ Al NO NO NO ® A, FRAME INSPECTION REQUIRED 0 SETB C RO IS 48 -�1 C�� FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONTPL- aSei'vice,T�at�tl INSULATION/WEAT ER STRIP SIDE PL- INTERIOR L EXTERIOR LATH RATED FLOOR-7-CE-TCASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS -BAR CEILINGS OT DRAINAGE �• REPORT ID: DPR261 ROUTE TO: BS0508 ,e COUNTY OF LOS ANGELES TEMPLE CITY # 0508 D:NfG PERMI,_ DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN -` BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 - L 05.08 990.Tg00011 PHONE: (626) 285-0488 EXT: LE GAL ID: NUMBER OF SIGNS: B DI G ADDRESS; BK: 62 PG: 2 PC: SIGN DESCRIPTION: CHANNEL LETTERS-ILLUMINATED ' 3--5'621 ROSFhJFAD-Bt- LTEMP CA X801804 ASSESSOR I FO 0 BER: NEAREST•CROSS STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY NANT: EXIST BDG ISSUED ON: PROCESSED BY: EXPIRES ON: 7 * 7 BAKERY EXIST OCC GRP: 01/20/99 UT 01/20/00 OWNER: TEL. 0: BLDGS. NOW ON LOT: VAL TION: FINAL DDAATTEFINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 800 S PAID 7DESCRTPTIF-vORK7— - -- �1*9ML�HANNEC=I ETTER='SIGNZI•LLUMLNAT-ED- FEE DESCRIPTION: QUANTITY: I=: AMOUBFYc LI TEL. NO: 88 SIGN CORP. (626) 442-8033- AA BLDG PERMIT ISSUANCE 27.75 1904 #A DOREEN AVE. AE STRONG MOTION 0H 800.00 VAL 0.50 SPECIAL CONDITIONS: SO. EL MONTE, CA AX BUILDING 6VI l-FE 54.70 D2 PERMI WjO� I�E L 0 Q VAL 65.40 148.35 CONTRACTOR: TEL. NO: CJ �/,.� APPROVALS DATE INSPECTOR SIGNATURE 88 SIGN CORP (626) 442-8033- 1904 DOREEN AVE #A LIC. NO LOCATION CKS SOUTH EL MONTE, CA 91733 702474 C10 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: 0: FOUNDATIONPRENCH FORMS LIC. NO 1111111 SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: gMp n n D L C W O Lr�,K S 0. OF FAMILIES: WELLING S: PT/COND: STAT CLAS .. NO 20 O ❑ �� SCHOOL A RDOUS d Ll AIR QUALITY: 1000 FEET MATERIALS ❑ ', �� NO NO NO Ll El0Q� is Service That * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 v COUNTY OF LOS ANGELES TEMPLE CITY # 0508 --BUIL-DING--PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 9910260013 PHONE: (626) 285-0488 EXT: LEGAL ID: NUffB R OF SIGNS: 1 BUI O NG ADD SS: BK: 62 PG: 2 PC: SIGN DESCRIPTION: WALL SIGN 5623 ROSEMEAD Bl; TEMP-CA 917801804 ASSESSOR INFORMATION NUMBUR- NEAREST CROSS STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY ENANT: EXIST BLDG-USE: SS ED ON: PROCESSED Y: EXPIRES 0 : OLYMPIC BAKERY EXIST OCC GRP: 10/26/99 UT 04/23/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUAT FON: FINAL FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 1,200 FEES PAID DESCRIPTION-- 0.-. R -- ,--I-L'LUMINATED WALL SUN- FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:-—--- --- PL CA T: EL. O: 88 SIGN CORP. (626) 442-8033- AA BLDG PERMIT ISSUANCE 27.75 1904 #A DOREEN AVE. AE STRONG MOTION OTHE 1200.00 VAL 0.50 SPECIAL CONDITIONS: SO. EL MONTE, CA D2 PERMIT W/0 N� 20_0.00 VAL 82.20 ��ELESTO IL—FE-S 110.45 CONTRACTOR: TEL. NO: �0�3 ®��A� APPROVALS DATE INSPECTOR SIGNATURE 88 SIGN CORP (626) 442-8033- 1904 DOREEN AVE #A LIC. NO LOCATION AND SETBACKS - SOUTH EL MONTE, CA 91733 702474 CIO SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: 0: - 0 IO / R NC RMS LIC. NO / 1111111 SUPPORT STRUCTURE L , MAP N0: SEWER MAP BOOK: PAGE: FIRE 20NE: - T1 n n D L C W O ILDF-Ra n/J 0. OF FAMILIES: ELLING UNITS: PN/OCO D: STA CLASS� 8 not u U o ��nl�_ SCHOOL WITHIN HAZARDOUS epi tt*. AIR QUALITY: 1000 FEET MATERIALS a El 444"1 i��- NO NO NO A f Fg c �ervoce That * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508