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Home My Public Portal About5630 ROSEMEAD BLVD_Miscellaneous__ ;Elim MENT'oF'cow rmq ; :1 I.ISCELL i..1oT E 0US .DIVISION-.OF BUILDING AND'SAFETY' co nv�rY OF'Los AW(i I"S OCCUPANCY SAFETY TRAILERS WILLIAM J. F.OX, COUNTY ENGINEER ;; n •- CASSATT D.- GRIFFIN,.SUP!T, OF BUILDING ° APPLICATION = FOR APPLIIrANT: FILL I:N. "' "euILDING ..q t,.. ADDRESS �L ' BUILDING' �`/ `� (// //- O dJ7a�:,rr? risC ' ADDRESS LJ ' 6 7 O t/1 A '.�, Lry LOCALITY G .'•: - LOCALITY .L . .. ,a-- C CarC.:..` 'NEAREST - NEAREST _ J CROSS-ST. 'G i=_ - +w�✓ GROSS ST.. J : qq : DIST.RICT�10. PLANCK.OR.Riga.No;- "/ PERMIT W06 OWNER i MAIL - ' �R GE V BY DATE OFAPPL. DATE ISSUED . ADDRESS ,. TEL.. CITY NO USE ZONE MAP NO. TYPE GROUP 7FIRE ZONE. CONTRACTOR DATED ZONING _ • APPROVED BY— BUILDING - LEGAL• - - D •� -tJ B.UILD'ING - - ORD.No.. D.ESCRIPT..ION'. ,LOT NO _ J 11I,BLOCK SETBACK LINE: _ •DATE- APPROVED - _ - �^ NO:•GF.BLDGS. TRACT J if CSC E��F NOW ON LOT ! DATE: - _ 'HOUSE NO. USE OFG•�^ ASSIGNED BY - SIZE EXI5TIN6 BLDG , - APPLICATION FOR CORRECTIONS''. OCCUPANCY- • A r INSPECTOR INSPECTION "" __._ I SAFETY = �D�TEj... .:................._.- /._`_ _-._.j•_:.'._._,.::-._- MISCELLANEOUS I' /�r1 ...... ze TRAILER USE I LIMITED TIME U8E'" i; �.. . ..r_f` _.�_-0T ! :--.. .... .................... - .DATE - ' .. t; .USE O•F-STRUCTURES. OR DEVICES- � INSPECTION FOR _- =-j- = - _...._._..._-:... ---------.j...;r•-. ............, _ OCCUPANCY-AS - I F-EREBY ACKNOWLEDGE THAT 1 .HAVE' READ -.. PLICATION.AND STATE:THAT THE. INFORMATION IVEN_ISj :__-,,-;:.-••--j---___---__.-�•_----•:_.,-_••_•�:-_:_-•_: _•--j_„-_,_, CORRECT. y _ _.._............. 1 AGREE.TO. COMPLY WITH ALL COUNTY ORD:IMANCESf-_ AND STATE LAWS REGULATING BU'IL'DING CONSTRUCTION.'; ”"''-j'"""''__......:__ _ _ ...... :j.....:._.,__.._______ _ I :.APPROVALS SIGN14T,URE OF'— +* INSPEOTOR'S:SIGNATURE I DATE PERMITTEE�' -`,' ' ✓`�✓ .. + _'. OCCUPANCYA_PPROVAL. _ +♦�� N. •—. - - /'� GROUP OCC:LOAD .:ir •ADDRESS e �' i'•!' �Y- 11 I II kA LER USE m AUTHORIZ _ AY'PERMITG SFETr - D STRUCTURE APPROVED TEMPORARY a• WSCELLANEOUS FEE TEMPORARY ,Zp. STRUCTURE REMOVED ... PERMIT FEE - IVle - DEPARTMENT OF COUNTY ENGINEER MISCELLANEOUS DIVISION OF BUILDING AND SAFETY COUNTY OF LOS ANGELES OCCUPANCY SAFETY TRAILERS WILLIAM J. FOX, COUNTY ENGINEER CASSATT D. GRIFFIN, SUPT OF BUILDING APPLICATION BUILDING FOR- (Ap PPL, IC_OA_N. TQ FILL IN � ADDRESS " ' Gc'). No a5�AOX19p0 ADDRESS / „ TfLOCALITY LOCALITY NEAREST NEAREST ;I CROSS ST. 4 C1 S 6E CROSS ST. 1 . J DISTRICT NO. PLAN CK.OR REc.NO. / PERMIT NO. OWNER IJP' /'"l• MAIL EGEIVEp BY DATE OF APPL. DATE ISSUED ADDRESS (p �C If 'I —,e O CITY NEL. USE ZONE MAP NO. TYPE GROUP FIRE ZONE TEL. CONTRACTOR NO. DATED / ZONING ADDRESS APPROVED BY_ LEGALfj- BUILDING ORD.NO. DESCRIPTION LOT NO. 9 I.BLOCK SETBACK LINE: APPROVED DATE NO.OF BLDGS. By; TRACT - cai J NOW ON LOT I DATE /� USE OF \/oL v GNED BY ` j HOUSE NO. SIZE OF LOT .5 n , 5 U I EXISTING BLDG. ! �51 APPLICATION FOR CORRECTIONS OCCUPANCY �+' DATE INSPECTOR INSPECTION /` SAFETY PERMIT t..._._...._.__...._._.._... -I-----------=------••--•--•- MISCELLANEOUS I IltP✓NCY •P _..v-S�..t... 5............. .._••••.. .. _..._. TRAILER USE I LIMITED TIME USE ! '.t: 1..-#,d el r JP ...-._.Ar-.... -pp•.._......_,------------- k FROM- DATE DATETOz t•+f/j ` . y.. USE OF STRUCTURES OR DEVICES ' Yt.3�- �y ai y ..» ....._....._GGC- ....1.__Y_C _—. ............•....-•-t••----•--•--....,._..__... .._........•••..t---_--------------- r-/ .r_ ..............t---- -•-..---- -----. ................t..-•----._....-•-••---•----•---••••••-••--•__._...._•- - .t......._.........._:••••. • ................I......................._......_.........................._.._.......t........................... ........._..t.._......_.__.............._.........................._.__.._...I---------------.--.----- INSPECTIONFOR -•••••••••••••••t________________________________...___.._..___...__......_.._.......I......._.................. OCCUPANCY A9 C .......••••__...t-------.....__-------------------------------------------------------t......._.................. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ JAIS AP- PLICATION AND STATE THAT THE INFORMATION RIVEN IS t..............................._____._._.___.___...__.__......_...t.__••_-.................... CORRECT. 1AGREE TO COMPLY WITH ALL COUNTY ORDINANCES t...__.._._____________......_............__...._.._......._._____t--------------------------- AND STATE LAWS REGULATING BUILDING CONSTRUCTION. APPROVALS SIGNATURE OF INSPECTOR'S SIGNATURE DATE N PERMITTEE `''�1 OCCUPANCY APPROVAL / GROUP (-. OCC.LOAD�(.3 r \_V• ADDRESS yWAILER.USE c G AUTHORIZED AGT. J SAFETY PERMIT m D STRUCTURE APPROVED MISCELLANEOUS FEE I $ o TEMPORARY TEMPORARY ,a STRUCTURE REMOVED - r PERMIT FEE I $ IFINALAPPROVAL f<,5 I WORKERS'COMPENSATION DECLARATION 7610444 MISCELLANEOUS APPLICATION 1 I ]hereby affirm that i have a certificate of consent tself CE 875(11-84)COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, or a certificate of Workers'Compensation Insurance,e,or - I p certified copy thereof(Sec.3800,Lab.Q. BUILD Policy No. Company FOR APPLICANT TO FILL IN ADDR NG / e, ADDR 55 ❑ Certified copy is hereby furnished. Bu1LDING �O e) ;3705!,.-/)7F--,rJl� •/Q/v LOCALITY B AOOR ESS �1 �(J /TLJ /�•Is_ ICertified copy is filed with the county building inspection g LOCALITY NEAREST department. I �� f� ! cnOSS ST. Date Applicant NEAREST DISTRICT NO. GR P 1TYPX,�1—.,10ESSED BY CROSS ST. CONST. ! CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL '✓a COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP rJIGHWAV No. (CIRCLE! STATE MAJOR SECOND LOCAL NO. OF BLD GS. ((This section need not be completed if the work involved TRACT NOW ON LOT USE ZONE ISP ECIAL CONDITIONS by the permit is for one hundred dollars (SI00) or less.) UXSE OF I I certify ilial in the performance of the work .`or which this SIZE OF LOT EISTING BLDG. _ permit is issued. I shall not employ any person in any manner % OWNER ` �/f• .S so as to become subject to the Workers' Compensation Laws. X MAILOCCUPANCY GROUP ADDRESS /0 /7LU 4--, 7,,U �RJ 1 Datc .applicant / _ NOTICE TO APPLICANT: If,after making this Certificate of g CITY � N� NO. (Q�_CFL � �I�aU OCCUPANT LOAD - Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forth- 6?11d APPLICATION FOR EXIT HARDWARE: with comply with ;udi provisions or '.Itis permit sihall be TRAILER USE 11 GEOLOGY INSPECTION �_• No Spec. Knowl. Ej deemed revoked. Panic Devices H LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION B °' I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT C] (LIST ITEMS BELOW) 1 9 (commencing with Section 7000) of Division 3 of the Busi- NO. of EXITS ness and Professions Code,and my license is in bill force and effect. PARKING REO'D PROVIDED ,A SPACES O D License dumber Lic. Class I LIMITED TIME USE Contractor Date DATE DATE w _ i I am exempt from -lie licensing requirements as I sins Roo M. D. INSPECTOR'S a ► licensed architect or s registered professional andneer 31ZE OF uo. of sIG TURE acting in ml• professional capacity iSection -0_5I. Bits- EXISTING BLDG. sro RIES inessand Professions Codel. R FINAL APPROVAL PRESENT USE OF BUILDING i Lic.or Reg.No. Date _ X I 1 D -009E 1/2L,/98.I HOME OWNER-BUILDER DECLAR.3LT10N NO. OF EXANO USE BUILDINGS �I L 1 PM 3:36 I Thereby affirm ilial [ am exempt from the CJRLraCiOi'i ON LOT i License Law for the following reason +Section -031.5. Busi- ness and Professions Codel: No. PARKING ❑ 1, as owner of die property. will do the work and tlhe SPACES PROVIDED structure is not intended or offered for ;ale ISrction 1 7044.Business and Professions Code). AGENCY 'PROPOSED USE OF BUILDING CONSTRUCTION LENDING AGENC I Hereby affirm that there is a construction lending agency for the' performance of the work for which this permit is l issued(Sec.3097,Civ.C.1. Lender's Name PROPOSED MAX. OCC. Lender's Address 25.00 I I certify that I Ihave read this application and state that the PERMIT FEE • above information is correct.I agree to comply with all County 'ISSUANCE FEE � ordinances and State laws relating to building construction. and Thereby authorize representatives of this County to enter TOTAL FEE 25.00 I� upon the above-mentioned property for inspection purposes. _ SEE REVERSE FOR EXPLANATORY LANGUAGE % % i Signature nt"-!r^tirtee Date • WORKERS'COMPENSATION DECLARATION 76 CE 8754(11-84) MISCELLANEOUS APPLICATION I hereby affirm, that I have a certificate of consent tself COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure, br a certificate of Workers'Compensation Insurance,e,or a certffled copy thereof(Sec.3800,Lab.C.). yyy BUILDING Policy No. Company FOR APPLICANT TO FILL IN !L ADDRESS �'�'C�!LZIP G� FiCertified copy is hereby furnished. BUILDING 5630 LOCALITY DDR ESS JJ �' Certified copy is filed with the county building inspection NEAREST LOCALITY department. T 91780 CROSS ST. Date Applicant NEAREST DISTRICT NO. G OUPTYPE CESSED BY CROSS ST. T & ' �j� �� CONST. il M �� CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL (� COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY NO. F BLDGS. NO. (CIRCLET STATE MAJOR SECOND LOCAL (This section need not be completed if the work involved TRACT NOWOON LOT USE ZONE SPECIAL CONDITIONS by the permit is for one hundred dollars ($100) or less.) USE OF SIZE OF LOT EXISTING BLDG. } I certify that in the performance of the work for which this c permit is issued, I shall not employ any person in any manner OWNER 01Fej Collen Kroha so as to become subject to the Workers' Compensation Laws. MAIL OCCUPANCY GROUP o ADDRESS 1020 Huntington Drive. Z3 Date Applicant LLI NOTICE TO APPLICANT: If, after making this Certificate of CITY San M r NDL OCCUPANT LOAD z Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions oI this permit shall be TRAILER USE ❑ GEOLOGY INSPECTION❑ No Spec. Knowl. deemed revoked. LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION ❑ Panic Devices I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commencing with Section 7000) of Division 3 of the Busi NO. OF EXITS ness and Professions Code,and my license is in full force and 'A l s I effect. KC O� Bits SS, . PARKING SPACES REO'D D PROVIDED License Number Lic. Class DYNA MEDICAL GROUPLIMITED TIME USE Contractor Date DATE DATE FROM: TO: I am exempt from the licensing requirements as I am a licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES SIG ATURE iness and Professions Code). FINAL APROVAL PRESENT USE OF BUILDING ® � ca Lic.or Reg.No. Date ` HOME OWNER-BUILDER DECLARATION NO. OF EXISTING BUILDINGS ,� _ !t,;c ON LOT AND USE o 1 �t-)„I{ ,L� .1 +-, I hereby affirm that I am exempt from the Contractor's 'I AM!0-12L License Law for the following reason (Section 7031.5, Busi- ness usi ness and Professions Code): NO. PARKING I, as owner of the property, will da the work and the SPACES PROVIDED structure is not intended or offered for sale (Section 7044,Business and Professions Code). CONSTRUCTION LENDING AGENCY PROPOSED USE OF BUILDING Medical I Hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Sec. 3097,Civ.Q. Lender's Name PROPOSED MAX. OCC. Lender's Addressy I certify that I have read thisJae p ication and state that the PERMIT FEE v above information is correct.I e to comply with all County ISSUANCE FEE ordinances and State laws r to building construction, and hereby authorize representa ' es of this County to enter TOTAL FEE , 00 upon tl}e-sboti e-mentioned pr, rty for inspection purposes. Y i r -7- F, A.SEE REVERSE FOR EXPLANATORY LANGUAGE Date iature o ermittee WORKERS'COMPENSATION DECLARATION I CE 875(2-80) W S C E L LA d t7 E®tom+S APPLICATION I hereby affirm that I have certificate of consent to self COUN'T'Y OF ]LOS ANGELES BUILDING AND SAFE'T'Y DIVISION insure,or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy No. CI ❑ ompany BUILDING FOR APPLICANT TO FILL IN ADDRESS Certified copy is hereby furnished. 9U ILD ING r LOCALITY ADDRESS � O 'EA e� Certified copy is filed with the county building inspection : NEAREST department. �- LOCALITY / - CROSS ST. Date Applicant I NEAREST V DISTRICT NO. Gj�O TYPE PROC -CROSS ST. S-1.145 {� CONST. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL Il COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAPHIGHWAY >_NOOF BLDGS. No. (CIRCLE) STATE MAJOR SECOND LOCAL Il . (This Section need not be completed if the work involved � TRACT NOW ON LOT USE ZONE SPECIAL CONDITIONS V by the permit is for one hundred dollars ($100) or less.) USE of ' SIZE OF LOT EXISTING BLDG. 1 certify that in the performance of the work for which this I O permit is issued, I shall not employ any person in any manner_it, NER 1-- so as to become subject to the Workers'Compensation Laws. MAIL OCCUPANCY GROUP EDZ IL Date Applicant -D'11RESS ! L Z NOTICE TO APPLICANT: If, after making this Certificate of r evT 4y/off. �r OCCUPANT LOAD Exemption, you should become subject to the Workers' APPLICATION FOR EXIT HARDWARE: Compensation provisions of the Labor Code, you must forth- with comply with such provisions or this permit shall be TRAILER USE� GEOLOGY INSPECTION NOSpec. Kr10Wi. ❑ deemed revoked. p Panic Devices E]OCCUPANCY INSPECTION�{ LICENSED CONTRACTORS DECLARATION Im I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT Q (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000)of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING. effect. SPACES REQ'D PROVIDED License Number Lic.Class LIMITED TIME USE I Contractor Date I DATE DATE ❑ I FROM: TO: I am exempt from the licensing requirements as 1 am a. licensed architect or a registered professional engineer SIZE OF NO. OF INSPECTOR'S acting in my professional capacity (Section 7051, Bus- EXISTING BLDG. STORIES S!,G NATURE IneSS and PI'OfeSSIODS Code). _.PRESENT USE OF BUILDING ffe &&4 INAL APPROVAL - r Lic.or Reg.No. Date HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS Oi1V LOT AND USE I hereby affirm that- I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Busi- ness and Professions Code): NO.-PARKING /�! SPACES PROVIDED d I, as owner of the property, will do the work and the I structure is not intended or offered for sale (Section a 7044,Business and Professions Code). J PROPOSED USE OF BUILDING CONSTRUCTION LENDING AGENCY G4 0 5 5 A I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is 0 0 0 0 8 8 issued(Sec.3097,Civ.C.). Lender's Name PROPOSED MAX. OCC. il� o 0 0 0 0 0 0 �. Lender's Address PERMIT FEE QT Y�B 1 certify that I have read this application and state that the I ,\ 218j-86 above information is correct. 1 agree to comply with all County ISSUANCE FEE J 0 ordinances and State laws relating to building construction, I Aandereby uthorize re ntatives of this County to enterTOTAL FEE the ve-nle one operty for inspec ion purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE `�Signature of Permit a Date WORKERS'COMPENSATION DECLARATION I CE 875(2-801 MISCELLANEOUS APPLICATION ` I hereby affirm that I have certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insurr, or a certificate of Workers'Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) Policy No. Company FOR APPLICANT TO FILL IN Bu1LDIDNG �® F-1CertifiedCertified copy is hereby furnished. v BUILDING / �� LOCALITY ADDRESS Y� ❑ Certified copy is filed with the county building inspection NEAREST department: V LOCALITY CROSS ST. Date Applicant V NEAREST DISTRICT/N�O/. G UP TYPE PROLE BY CROSS ST. M,Q�, $ w�'l�,j vVV CONSTA CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL UV V COMPENSATION INSURANCE DESCRIPTION LOT NO. BLOCK MAP HIGHWAY } No. (CIRCLE) STATE MAJOR SECOND OCAL tZ e work involved TRACT NOW ON LOT (This section need not be completed if the ilved NO. OF USE ZONE SPECIAL CONDITIONS U OT by the permit is for one hundred dollars ($100) or less.) USE of SIZE OF LOT EXISTING BLDG. (r I certify that in the performance of the work for which this Q permit is issued, I shall not employ any person in any mannertl OWNER s 'L c, so as to become subject to the Workers'Compensation Laws. MAIL qq ` OCCUPANCY GROUPQ ! � a Date Applicant ADDRESS t. l $ �JQ, yd W Q )Q to NOTICE TO APPLICANT: If, after making this Certificate ofV CITY y NOL Q�� ' Zd7-yl� OCCUPANT LOAD - Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- APPLICATION FOR EXIT HARDWARE: with comply with such provisions Or this permit shall be TRAILER USE GEOLOGY INSPECTION NOSpec. KnOWI. ❑ deemed revoked. P ❑ LICENSED CONTRACTORS DECLARATION OCCUPANCY INSPECTION Panic Devices I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT `I (LIST ITEMS BELOW) NO. OF EXITS 9 (commencing with Section 7000)of Division 3 of the Busi- ness and Professions Code, and my license is in full force and PARKING. effect. SPACES REO'D PROVIDED License Number Lic.Class LIMITED TIME USE Contractor Date D ATE DATE ❑ I am exempt from the licensing requirements as I am a FROM: TO: licensed architect or a registered professional engineer SIZE OF NO. OF Iry PECTOR'S acting in my professional capacity (Section 7051, BUS- EXISTING BLDG. STORIES IG NATURE IneSS and P[OfeSS10RS Code). �`d PRESENT USE OF BUILDING FINIAL APPROVAL Lic.or Reg.No. Date GGCC// HOME OWNER-BUILDER DECLARATION NO.OF EXISTING BUILDINGS ON LOT AND USE hereby affirm that- I am exempt from the Contractor's ense Law for the following reason (Section 7031.5, Busi- SS find Professions Code): NO. PARKING 6 8 3.5 A SPACES PROVIDED I, as owner of the property, will do the work and the # D o D D 3 0 structure is not intended or offered for sale (Section 7044, Business and Professions Code). V PROPOSED USE OF BUILDING O o o D D D D CONSTRUCTION LENDING AGENCY OIL 09-8 7 hereby affirm that there is a construction lending agency rbi.I'i�2 i for the performance of the work for which this permit is issued(Sec. 3097,Civ.C.). Lender's Name PROPOSED MAX.OCC. Lender's Address PERMIT FEE I certify that I have read this application and state that the ISSUANCE FEE �� 1�1 above information is correct.I agree to comply with all County 0 ordinances and State laws relating to building construction, TOTAL FEE ,a �\� and hereby authorize representatives of this County to enter OLD upon Pa above-mentione property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Permittee Date