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HomeMy Public PortalAbout5665 ROSEMEAD BLVD_Building__ A.PPL I CA �1:®til:-F+�7_F ®I 9 C� PER f�/I.� K_ f ICANfi Tq FILL IN (Print type only) =If s^ r^l [! �ti. rRiE'S "B • b ` COUNTY OFLOS ANGELESDEPARTMENT OF' COUNTY ENGINEER ZIP _ rBUILDING AND SAAF'ETY DIVISION— ~ + NO.OF BLOGS. ` BUILDING `r SIZE OFjLOT NOW ON'LOT ADDRESS ;t,:.L ;dc i. ''TRACT BLOCK LOT NOr� LOCALITY :y.y TEL NEAREST ._QWNER NO. CROSS ST. ;/:ry r��-a' -•7 _ ASSESSOR.•• s ADDRESS a2© L •MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE CESSED BY CITYjJ4ZIP. tt� s-. CONST• — Zp ARCHITECT � - TEL.-2-:34-'ll � y •• : - �- _�'•',r'-''� • ENGINEER �s IS + NO GS .�l.7 r STATISTICAL CLASSIFICATION e J SEWER MAP A'D'DRESS L.. CLASS NO, __DWELL.UNITS 6K PG, E, CONTRACTOR NOL USE ZONE MAP- t7 r rlo. ��-�! P✓ i- - ��'ff _ LIC. oQ. `/�_'L' SPECIAL _. ADDRESS V_4 NO. .� - , CONDITIONS' CITY +.- LIC. G LyC'OQ• CLASS ROA6fD'1:PA•QTMEN.T %1PRROVAL REQUIRED YES" •NO❑'• '` CONSTRUCTION LENDER NAME AND BRANCH BL' R `- .Ffr jSTREET) •,i ADDRESS CITY, OTA.L SE'TBA•CK FROM TYPE OF EXISTING L •SQ. F ..NO..OF. ' NO. OF o CHECK FRONT PROP•._L'INE HIGHWAY WIDTH -I:F SIZE 7� STORIES FAMILIES ONE =� DESCRIPTION OF WORK.�.�,(gM L_ NEW s ADD' ❑ 9 OM " ' gSTREETI LTER•❑ HIGHWAY } YARD TOT.ALSETBACK FROM `TYp.EOF EXISTING ` EM �V SIDE PROP..LINE FiIGF1WA•Y WIDTH REPAIR❑ SE OF :EXISTING BLDG. DEMOL ❑ ' + -' APPLICANT T CORNER CUTOFF. . YES ❑. :,NO,❑': (PRINT) •4f . _ - - -BY (SIGNATURE) IN OR•EN.SPACE (YES ❑ NO .❑;•- ' IN COASTAL ZONE YES ❑, NO'.❑. -VALUATION _ ' - CATEGORICAL E%EMFTION YES❑l, NO ❑ 1 HEREBY ACK WLEDGE I NAVE READ THIS APPLIC"AT10N. .'ENVIRONMENTAL .AND STATE THAT THE,ABOV 1 CORRECT D,AGREE TO COMPLY IMPACT E%EMPTION DEC.LARATION•SIGNED (DATE) WITH ALL ORDINANCES- LAWS REGU ATING BUILDING CON- S.TRUCTION. I 'CERTIFY AT IN DOING HE WORK.AUTHORIZED- ,.c•--c •-I M,PACT'RkOORT PROCESSED' (DATE)' 'HEREBY I WILL'NOT E LOY ANY PER N IN VIOLATION OF THE ' LABOR. CODE OF TH STATE OF CA FORNIA IN RELATING-TO, �`�Y��i 1, +(' -• ,�+ WORKMEN'S COMPEN ION INSURANC SIGNATURE O �_.� !A(jrr�:. � r E. '% f �+�A i,_ f.✓M"v' PERMITTEE ADDRESS + n %•.f 4- 1=.s -TEL. - ;DATE � --'' f_. Jr—k� "r.•-..•.� ' CITY NO. ,X; rr KE. CHECKS-PAYABLE- TO: FEE .. .FEE. 1 ' HARVEY T. BRANDT,_COUNTY ENGINEER r PLAN CHECK VALIDATION cK. M.O. CASH' PERMIT VAC' TION' cK. M.O.' ' CASH. ++ Ir, DN 112 5 D - 'i Ayz '5.L'nf.,T 9 2. 3 D 2.5.0 0 ,&96 o'.,. �.. _ _ _ D V q. "6,3 4 .3.5 0 A8.8 76A638A.C,E#;803 7/73 -- - 0 6)nrT 9 J:. . -APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER BUILDING PERMIT BUILDINGB//U��ILDING A AFETY DIVISION FADDR R APPLICANT TO FILL IN ADDRESS �f�(o� S LOCALITY 41 NEAREST L,F ZIP CAN- N& ROSS ST. N .OF BLDGS. ASSESSOR N ON LOT MAP BOOK PAGE PARCEL DISTRICT GROU YPE FIRE SSED BY BLO LOT NO. i,O r GANST. Z2= TEL. (J(f OWNER NO. STATISTICAL CL��JJASSS)) (CATION ]- SEWER p ADDRESS � CLASS NO�DWELL.UNITS BK PG CITY ZIP USE ZONE MAP NO. ARCHITECT OR TEL. ,�// /� SPECIAL ENGINEER `� No. ?6°N�()I CONDITIONS ADDRESS ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ EL„ i BLDG.SETBACK FROM CONTRACTOR �-S NO FRONT PROP.LINE OF (STREET) LIC. ADDRESS `Z(y /�� NO. E1/� HIGHWAY + YARD = TOTAL SETBACK FROM TYPEOF EXISTING CITY L f/(�`L CLic.LASS � J FRONT PROP. LINE HIGHWAY WIDTH > > CONSTRUCTION LENDER + NAME AND BRANCH BLDG.SETBACK FROM ADDRESS CITY SIDE PROP.LINE OF (STREET) SQ. FT. NO. OF NO. OF CHECK HIGHWAY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING 9k SIZE STORIES FAMILIES ONE SIDE PROP. LINE HIGHWAY WIDTH 'C DESCRIPTION OF WORK NEW ❑ + CL F: ADD E] CORNER CUTOFF YES ❑ NO ❑ 6So S d ALTER ❑ IN OPENSPACE YES ❑ NO E]REPAIR❑ USE OF IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLDG. DEMOL ❑ A APPLIC (PRINT) \ �� `� • BY IS I G N A T U R E 1 a "Pt w I HEREBY ACKNOkE THAT I AVE EA THIS APPL ATION �^J�[J� J '' paw t� AND STATE THAT TME OVE IS CORRECT AND AGREE TO COMPLY ("•�—`�'� � � �� ; WITH ALL ORDIN AND LAWS REGULATING BUILDING CON- ST ON- STRU-TI ON. I RTIFY AT IN ..IN THE WORN AUTHORIZED HEREBY I WIL NOT EMP OY ANY PER N IN VIOLATION OF THE LABOR CODE OF THE ATE OF FORM IN RELATING TO WORKMEN'S MP NSA INS A SIGNATURE F FINAL PERMITTEE DATE„ ADDRESS TEL. n P.C. Fee$ �P.,.It Fee CITY NO. QQ ® - Issuance Fee -� VALUATION•P -� ��VJJ Total Fee PLAN CHECK VALIDATION K. M.O. CASH © PERMIT VALIDATIONCK. M.O. CASH 666rDEC 823 U 4 6.8 0 56 — -- 9 2 9'0 lltG 28 1 U 7 8.0 u A 76AG38A CE#8038 12/75 Q /JSP APPLICATION FOR COUNTY OF LOS ANGELES DEPARTMENT OF COUNTY ENGINEER 13.U I L®I N G PERMIT BUILDING AND FETY DIVISION BUILDING 6, FOR APPLICANT TO FILL IN ADDRESS BUILDING ADDRESS LOCALITY � � NEAREST CITY �' ZIP CROSS ST. NO.OF BLDGS. ASSESSOR SIZE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL DISTRICT GROUP TYPE FIRE SSED BY TRACT BLOCK LOT NO. 67 `CONSTZ � g OWNER Y',•' NOL STATISTICAL CLASSIFICATION SEWER M P ADDRESS " �Q - iif `.'�J� CLASS NO. y1�DWELL.UNITS BK PG CITY !� ZIP ^'USE ZONE MAP �U G NO. Jri ARCHITECT OR TEL / SPECIAL ENGINEER ''' NO. •y�� 'C-L CONDITIONS ADDRESS ,ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑ CONTRACTORNES- t BLDG.SETBACK FROM LIC. FRO PROP.LINE OF (STREET) ACY;RESS L-� NO. HIGH AY + YARD _ TOTAL SETBACK FROM TYPE OF EXISTING LIC. FRONT PROP. LINE HIGHWAY WIDTH CITY I' .A. ° CLASS r CONSTRUCTION LENDER + — yy NAME AND BRANCH BLDSETBACK FROM C ADDRESS CITY SIDE LINE OF (STREET) SQ. FT NO. OF NO. OF CHECK HIGHWAY + YARD = TOTAL SETS FROM TYPE OF EXISTING C SIZE STORIES FAMILIES ONE SIDE PROP. LIN HIGHWAYI WIDTH ` DESCRIPTION OF WORK NEW _ + Cr ADD ❑. CORNER CUTOFF YES ❑ NO ❑ ALTER ❑ • REPAIR❑: IN OPEN SPACE YES ❑ NO ❑ USE OF J IN COASTAL PERMIT ZONE YES ❑ NO ❑ EXISTING BLJ3 G DE APPLICANT TeL (PRINT) N0. BY (SIGNATURE) .y 1 ���+ t•f :b'��iY .liV' •'=w 'StJ ' 1 HEREBY ACNN W DGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY ' WITH ALLORDINANCES AND LAWS REGULATING BUILDING CON- STRUCTION.' ON-STRUCTION.' I CERTIFY THAT Rcg--:� WORK AUTHORIZED ' HEREBY I WILL NOT EMPLOY Y VIOLATION OF TME LABOR CODE OF THE STA OF IN RELATING TO /}�°WORKMEN'S COM EN rFl"jr 00SIGNATURE OF p PERMITTEE DATE 6 ea .-7') BY `F�--�- ADDRESS C7 64 �v c(rY 37// NOL - 3' i P.C. Fee$ 3� j , Q Permit Fee 2) Kf 5v- Issuance Fee VALUATION _ Total Fee PLAN CHECK VALIDATIONCI M.O. CASH o PERMIT VALIDATIO CK. ' M.O. CASH 4 4 7 APR 21 ' 3 D 7 0 8.7 0 6 3 6 r APP, .�C 1 D 5 1 4.5 0 Aw� 76AG38A CE#8038 12/75 i - 4�. n �t�T APPUcA�T°�I F®R "ir6ODING PERMIT FOR APPLICANT-TO PILL IN',(Printortype only) BUILDING COUNTY OF LOS ANGELES ADDRESS S,6 DEPARTMENT OF COUNTY ENGINEER cl ZIP BUILDING AND,SARJY DIVISION O.OF BLDGS. BUILDING SIZE OF LOT NOW ON LOT ADDRESS TRACT BLOCK LOT NO. LOCALITY ] TEL. NEAREST OWNER NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL -CITY ZIP DI1 UP IRE ICT GROTY FPR SSED B FIRE -- ARCHITECT OR TEL. Q ENGINEER NO. STATISTICAL CLAS$IFI N SEWER MA ADDRESS CLASS NO. Z 12-- DWELL.UNITS BK PG TEL. CONTRACTO N USE ZONE MAP NO. 0,19ADDRES N 8 _L SPECIAL LI CONDITIONS CITY , CLA — ROAD EPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER NAME AND BRANCH AMBLDqj SETBACK FROM FRO T PROP.LINE OF ISTREETI ADDRESS CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIG WAY + YARD = FRONT PROP.LINE 1HIGHWAY1 WIDTH SIZE STORIES FAMILIES ONE } CL DESCRIPTION OF WORK r NEW + - O _ ADD ❑ .` SIDE P OPBLINE OFA ISTREETI O S r ALTER ❑ C FROM TYPEOF EXISTING USE OF /�W a 02 o REPAIR ❑ HIGHWAY + YARD = IDE HIGHWAY WIDTH . Z EXISTING BLDG. DEMOL ❑ + APPLICANT TEL CORNER CUTOFF YES ❑ NO ❑ (PRINT) qm l IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) I IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION p 1 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 CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIPLATION F THE LABOR CODE OF THE Sr E F CALIFORNI INR O VJOWMEN'S M. PENSATION INSURAN �/.6��.�� a � SIGNATURE OF PERMITTEE ADDRES//S / l CITYli1 TE DATE BY4^' - MAKE CHECKS PAYABLE TO: FEEck r� FET HARVEY T.BRANDT.COUNTY ENGINEER .tel�, J/ 1 PLAN CHECK VALIDATION ��1 /M.O. CASH — lJ PERMIT VALIDATION CK. M.O. CASH 9 24 2 3 U l U U. 0 9 1 1 0 0.0 v "Bs 76A63BACE#8033.75' A re v APPLICATION FOR BUILDING PERMIT FOR APPLICANT TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ADDRESS 215 DEPARTMENT OF COUNTY ENGINEER CITY ZIP BUILDING AND Y DIVISION NO.OF BLDGS. BUILDING SIZE OF LOT �^ NOW ON LOT ADDRESS TRACT `,Y y PLOCK LOT NO. LOCALITY TEL. NEAREST OWNER -- NO. CROSS ST. ASSESSOR ADDRESS r MAP BOOK PAGE PARCEL CITY ZIP DISTRICT GROUP YPE FIRE PR CESSE BY �{ QNST. Z ARCHITECT OR TEL. ENGINEER NO. j STATISTICAL CLASSIFICATIOrf SEWER MAP ADDRESS CLASS NO. Z �� DWELL.UNITS BK PG CONTRACTO �� TE USE ZONE NO.LIC. o,6 ADDRESS ?�_Z SPECIAL oorC. CONDITIONS CITY G ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CO CTIO ENDER NAME AND BRANCH BLDG.SETBAqK FROM FRONT PROP LINE OF ISTREETI ADDRESS CITY ST SQ.FT. NO.OF NO.OF CHECK HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXIINGFRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE } DESCRIPTIO OF Nq oNEW + — O ADD ❑ BLDG.SETBACK FROM De !� SIDE PROP.L NE OF —(STREET) O /of ❑ HIGHWAY YARD = TOTAL SETBACK FROM TYPEOF EXISTING .a USE OF10 REPAIR ❑ SIDE PROP.LINE HIGHWAY WIDTH . Z EXISTING BLDG. 21DEMOL ❑ + APPLICANT T CORNER CUTOFF YES ❑ NO ❑ IPRINTI IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION$ % s 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 CONSTRUCTION.I CERTIFY THAT IN ING THE WORK AUTHORIZED HEREBY I WILL NOT EMP/'yOAYYY AENNYYiPE N IN LATION OF THE LABOR CODE OF THE ST F CALI �R/ GTO S COM- PENSATION INSURAN SIGNATURE OF PERMITTEE PRE 4.c ADDRESS FINAL BY CITY N TEL DATE 9--;,-y 'Z( r�—P--w— MAKE CHECKS PAYABLE TO: ` FEE @ FEET `P HARVEY T.BRANDT,COUNTY ENGINEER PLAN CHECK VALIDATION CK M.O. CASH o PE MIT VALIDATION cLc. M.O. CASH 9 4 2.6 U 5.0 0 O �� 5 3 b N APR 26 1 0 6.0 0 ®s 76A63BA CE#803 3.75' APPLICATION FOR BUILDING PERMIT FOR APPLICANT-TO FILL IN (Print or type only) BUILDING COUNTY OF LOS ANGELES ADDRESS4adV DEPARTMENT OF COUNTY ENGINEER CITY t ZIP BUILDING AND DIVISION NO.OFBLDGS. BUILDING SIZE OF LOT NOW ON LOT 1 ADDRESS TRACT S BLOCK LOT NO. LOCALITY l� + TEL. NEAREST OWNER S64 C7 NO. CROSS ST. ASSESSOR ADDRESS MAP BOOK PAGE PARCEL CITY ZIP DISTRICT GROUP PE FIRE PROC SED BY r�;G NST. ZO,7 % ARCHITECT OR TEL. �J �l ENGINEER NO. S 7 STATISTICAL CLASSIFICATION SEWE AP ADDRESS CLASS NO..124f9 DWELL.UNITS BK PG CONTRACTOR TEL. NO, xt USE ZONE SPECIAL NOP .7 U MALIC. ADDRESS NO. �`L LIC. CONDITIONS CITY CLASS ROAD DEPARTMENT APPROVAL REQUIRED YES ❑ NO ❑ CONSTRUCTION LENDER , NAME AND BRANCH .t S BLDG. ETBACK FROM FRON PROP.LINE OF (STREET) ADDRESS ! /} �� .t CITY TOTAL SETBACK FROM TYPE OF EXISTING SQ.FT. NO.OF NO.OF CHECK HIG AY + YARD = FRONT PROP.LINE HIGHWAY WIDTH SIZE STORIES FAMILIES ONE CL DESCRIPTION OF WORK NEW ❑ + - O ADD ❑ BLDG.SET FROM SIDE PROP.LINE (STREET) O ALTER ❑ TOTALS OM TYPE OF I EXISTING HIGHWAY + YARD = SIDE PROP.LIN HIGHWAYI WIDTH USE OF REPAIR ❑ Z EXISTING BLDG. DEMOL ❑ + APPLIC NT k6 TEL _'3�yj d CORNER CUTOFF YES ❑ NO ❑ IN OPEN SPACE YES ❑ NO ❑ BY(SIGNATURE) IN COASTAL PERMIT ZONE YES ❑ NO ❑ VALUATION p Q IHEREBY 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 CONSTRUCTION.I CERTIFY THAT IN DOING THE WORK AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LABOR CODE OF THE STATE OF CALIFORNIA IN RELATING TO WORKMEN'S COM- PENSATION INSURANCE. SIGNATURE OF PERMITTEE ADDRESS TEL. p pp FINA CITY `4•�-��. fps NO. . DATE BY .L�.� MAKE CHECKS PAYABLE TO: FEE FET HARVEY T.BRANDT,COUNTY ENGINEER - ` G 0 PLAN CHECK VALIDATION CK. M.O. CASH a PERMIT VALIDATION M.O. CASH 9 '7­7'� ®S 76A63BA CE#803 3.75' J0 v4-;, els WORKERS' COMPENSATION DECLARATION 1.•` insu7e bor a certifiE atte of Workers'tCompensat ificate of on eInsurance, P L I CAT iiFF"A BUILDING PERMIT cs'" certified Sopy thereof (Sec. 3800, LLayb�. C.) .,-1 COUNTY OF LOSk ANGELES BUILDING AND SAFETY Policy N OQ Company �qaw� BUILDING rtified copy is hereby furnished. FOR APPLICANT TG FILL IN ADDRESS ;���S UILING A / ! L'� Certified copy is fi ed with the county building inspec- BDADDRESS /� , t'on epartment. CITYPGF lilt ZIP ' LOCALITY Date Applica NO.OF BLDGS. .NEAREST CERTIFICATE OF'EXEMPTION WORKERS' SIZE OF LOT NOW ON LOT f.CROSS ST. COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one t TRACT BLOCK LOT NO. MAP BOOKPAGE PARCEL' hundred dollars ($100)or less.) TEL. OWNE NO. USE ZONE MAP I certify that in the performance of the work for which this y NO. permit is issued, I shall not employ any person in any manner ADDRESS SPECIAL a so as to become subject to the Workers CONDITIONS Compensation Laws. O CIN ZIP �` U Dote Applicant ARCHITECT OR TEL. ' DISTRICT GROUP I TYPE FIRE PROCESSED BY V NOTICE TO APPLICANT: If,. after making.this Certificate of ENGINEER NO. CONST. ZONE Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forth- ;. ADDRESSarm r ,3 with comply with such provisions or this. permit shall be p TEL. .STATISTICAL CLASSIFICATION APT. CONDO. ' Z deemed revoked. TRA OR L NO. /� — LICENSED CONTRACTORS DECLARATION' LIC. CLASS NO. DWELL. UNITS — LICENSED hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. CJ (commencing with Section 7000)of-Division 3.of the Business SEWER MAP LIC. / , n-+ • and Professions.Code,and my license is in full force and effect. CITY• I Jl1 CLASS �{Q ' BK PG `VALIDATION SQ. NO. OF NO. OF CHECK Number � 'Lic ClassSIZE STORIES FAMILIES ONE ;ALUATIO � 19i)� 77.e, 60 fhnsu iractor pate DESCRIPTION OF WORK NEW ❑ El1 am exempt under Sec. ADDJ. ALTER e. polo ACC 8.8P.C. for this reasonREPAIR ❑ ; {;I�� Date: USE F 1 :I -105.613 ' EXISTING BLDG. a— EMOL El ' Signature APPLICANT TEL FINAL q IS !I EI41D ' OWNER-BUILDER DECLARATION (PRINT NO. 0 DATE ��� �G TOTAL �a�,_°. � 40 I herebyaffirm that I am exempt Law fofrom the Contractor's License the following reason Section 7031.5; Business and i ADDRESS ZZ L�IL/OT/ UN FINAL j Q CHECK, jLa4_I Professions Code): PRESENT By tj _ ❑ I, as owner of the property, or m employees with I BUILDING CHANGE I tl j P .P Y. YADDRESS wages as their sole compensation,will do-the work and LOCALITY the structure is not intended or offered for sale(Section 7044, Business and Professions Code.) MOVING TEL. ® 0I-I�I_01I{I i `}�I/ ,� CONTRACTOR NO. ❑ I,as owner of the property,am exclusively contracting t:-�; •with licensed contractors to construct the project.(Sec- •�' � i i�l'I10:3 ADDRESS tion 7044, Business and Professions Code.) CONSTRUCTION LENDING AGENCY REQUIRED CK YARD HWY TOTAL SETBACK LINEFROM WIDTH I hereby affirm that there is a construction lending agency for FRONT the performance of the work foe which this permit is issued P.L. (Sec. 3097, Civ: C.). SIDE P.L. r. Lender's Name s 3 Lender's Address P. Permit Fee LDMA Ref.# C. Fee$ I certify that I have read this application and state that the Issuance Fee LDMA P/C# 3 above information is correct. I agree to comply with all County Investigation Fee �� ordinances and State laws relating to b ilding construction,. Total Fee / LDMA Perm. # and hereby a representatives this Count to enter t e ove- on roperty inspectio purp es.'. o !Z SEE REVERSE FOR EXPLANATORY LANGUAGE. ignature afTp7lCant or Agent Dae- WORKERS'COMPENSATION DECLARATION 1 I hereby affirm that I have certificate of consent to self L'CAT F I p I L I PERMIT cu insure, or a certificate of Workers'Compensation Insurance, � or a certified copy thereof (Sec. 3800, Lab. C.) I COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS ADDRESS771 ❑ Certified copy is filed with the county building inspec- fADDRESS DING tion deparfinen. 5665 Rosemead Blvd , Date V� o_v1Applicant �.(A ZIP LOCALITY CERTIFICATE OF EXEMPTION FR WORKE S' NO.OF BLDGS. NEAREST COMPENSATION INSUR CE OF LOT NOW ON LOT CROSS ST. `tom (This section need not be completed if he permit is for oneASSESSOR hundred dollars($100)or less.) ;TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONEOP ry I certify that in the performance of the work for which this OWNER K,-Ma —NO•permit is issued,I shall not employ any person in any manner Z SPECIAL L so as to become subject to the Workers'Compensation Laws. ADDRESS 1900 Heide CONDITIONS 00 CITY T o M ZIP 48084 29 Date Applicant O NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR ' TEL. DISTRICT GROUP TYPE FIRE X:;2 Exemption,'you should become subject to the Workers' ENGINEER CONST. ZONE � Compensation provisions of the Labor Code, you must forth- ADDRESS 5095 Sixth. Street 905 i S�� /— with comply with such provisions or this permit shall be STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked, CONTRACTOR Industrial TEL. 684 LIC. LICENSED CONTRACTORS DECLARATION l CLASS NO. 0 DWELL. UNITS t; - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 5095 NO. (commencing with Section 7000)of Division 3 of the Business and LIC. SEWER MAP Professions Code, and my license is in full force and effect. ;;CITY rorpiptpria CLASS C,,,51— BK /;(PG/%r'7— VALIDATION SQ.FT. INO.OF NO.OF CHECK License Number `�l`n Lic.Class C SIZE STORIES I FAMILIES ONE 1 9 7,0 P _ VALUATION Contractor �1"1%L►7f� �fttiWIJ C;Date (� DESCRIPTION OF WORK Install , NEW ❑ �$��y� ri o 0 0 0 2 3 ADD I am exempt under Sec. 'f nee -ALTER pill. , 0 0 73.32 B.&P.C. for this reason et l REPAIR $ USE OF onT1 ❑ c o 0 ] J `�U Date: EXISTING BLDG. Retail d tDEMOL o- APP(PRINT) Industrial St uctu TEL. Q 6 1 3-84 Signature FINAL OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL Professions Code): PRESENT BY3 R Q ❑ BUILDING 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and ;;`. 0 0 0 0 0 1 the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code). ! MOVING TEL. % o ! 8 ❑ 1,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). ���, ?o 0 9675 REQUIRED TOTAL SETBACK FROM I T.. , CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP.LINE WIDTH 7c L I hereby affirm that there is a construction lending agency for FRONT the performance'of the work for which this permit is issued P.L. Q r, � ' J —84 (Sec. 3097, Civ. C.). SIDE � m P.L. Q Lender's Name I LDMA Ref. # $ P.C. Fee$ 22-3.2-- Permit Fee I Lender's Address 1 certify that I have read this application and state that the Issuance Fee LD P/C# above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee LDMR Perm. # and hereby authorize representatives of this County to enter upon t a ve-ment'oned property for inspection purposes. j f a _ SEE REVERSE FOR EXPLANATORY LANGUAGE /J`( g oture of ppl cant or Agent Date QPPLECAMON FOR BUILDING PERMIT ' COUNTY OF LOS ANGELES BUILDING AND SAFETY wPORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUI �D, S I hereby affirm that I have a certificate of consent to self Insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified Qs�evvltZ6a> � copy thereof(Sec.38M,Lab.C.) CI G zlPp`� Policy No.�/r'2 �%� Company-(1Ale F4,,° LOCALITY r SIZE OF LOT NO. BLDGS.NOW ON LOT NEAREST CROSS ❑ Certified copy Is hereby furnished. �F-f—7 ® Certified copy Is filed with the county building inspection TRACT BLOCK LOT NO. USEZONE MAP NO. department. Date/-7--3-0 Applicant.ILL ASSESSOR MAP BOOK PAGE PARCEL PP r - SPECIAL CONDITIONS y��- CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER� �, TEL NO. � � COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL? YES NO ADDRESSM/q ,r� . (This section need not be completed ifthe pepermita�D� G�6fy5 At8 for one hundred d V+[7 DISTRICT 'GROUP TYPE CONST.' FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ^'A .ZIP I certify that In the performance of the work for which this permit 014#JA . cA. �!U l 6 Is Issued, I shall not employ any person In any manner so as to ARCHITECT OR ENGINEER I TEL NO. e� become subject to the Workers'Compensation Laws. G t G(L S > STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS A CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of �J b A REQUIRED TOTALSET�►CWIDTH EXIST Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO. SET BACK YARD HWY PR(iINE Compensation provisions of the Labor Code,you must forthwith �+l^ Od1 ! r comply with such provisions or this permit shall be deemed•revoked. ADDRESS LIC.NO. LOQ 4,0 ! =a s D:i% �.t i LICENSED CONTRACTORS DECLARATION C LIC.Cuy�s PILE l! I hereby affirm that I am licensed under provisions of Chapter 9 H ti �i SEWER MAP �� �'� c SQ.FT.SIZE NO:OF STORES NO.OF FAMILIES CM (commencing with Section 7000)of Division 3 of the Business and ,� Professions Code,and my license Is In full force and effect. NEW ❑ BK PG I{�I AL 94�- 9�o License Number_y3110SL DESCRIPTION OF WORK VALUATION Lia Class /� ADD ❑ // �� CHECK ���,'f 1a Contractor__6g Fe: �oaS7�D /— Z 3— Y/. ALTER � 6 ®O®' CHANGE � ❑ E] REPAIR I am exempt under Sec. t,�®` d� BARC.for this reason 'Vim /� NS DEMOL ❑ 0000-0001 •I/ r- 01, US EXISTING BLDG. LDMA P/C# �1! �. ��� Date: URM. ❑ .1 =1 Signature , ^ 1 APPLICANT PRI P �'l44 t r M 1s= ~ NT) NO. LDMA Perm# �f o� 0 ❑ I, as owner of the property, or my employees with wages as �1 R� A b/tO-17 � ® ' their sole compensation,will do the work and the structure Is ADDR not Intended or offered for sale (Section 7044, Business and ODs �r�r�C/ f�ro (l /q FINAL.DATE Professions Code.) WILLTHEAPPLICANT OR FUTURE BUILDING OCCUPANT HANDLEA HAZARDOUS MATERIAL/D—19/ ❑ I. as owner Of the ro e OR A MIXTURE CONT#VINO A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN p p rty, am exclusively contracting with THE AMOUNTS ?ECJFIED ON THE HAZARDOUS MATERIALS INFORMATION'GUIDE? FINAL BY /!!I licensed contractors to construct the project.(Section 7044, YES❑ NO rLJ'r Business and Professions Code.) . WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIREAP MIT FOR CONSTRUCTION OR MODIFICATION FROMTHESOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY WMAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES. I hereby affirm that there is a construction.lending agency for YES❑ NO -n c_•;, r - 04 -J> F•-'• the performance of the work for which this permit Is Issued(Sec. ;•.� -� 3097,CIV.C.. I HAVE READ THE HAZARDOUS MAT INFORMA N GUIDE AND THE SCAOMD ,.•.•,. ,-j 3> Fr --� f�'r f•••., PER WG CHECKLIST.11 UND UI UNDER THE LOS ANGELES 1•1 ,- , r=:...• - 1 3> _J Lenders Name _TITLE DOW T E2 CfIAPTEA2 E O 2 100 U 2014000NCERNING � frl ,'Z; (" G FO OBTAIN THESCAOMD. ,I). 11LLenders Address_,VACr -, o 1 certify that I have read this application and state that the above ►-,// C� Information Is correct. I agree to comply with all county P.C.FEE PERMIT FEE ordinances and State laws relating to building construction,and hereby authorize representatives of this County to enter upon ISSUANCE FEE the above-mentioned property hfor inspection purposes. 1-+ C:I•• 4 INVESTIGATION FEE TOTAL FEE .J f/ 3VAhn01A➢W WAFM CMN / /4� • ®!/ �:�5 '� �S ICY i•l SEE REVERSE FOR EXPLANATORY LANGUAGE, �, - WORKERS'COMPENSATION'DECLARATION (thereby affcertithat I haver certificate of consent to self i Fon BUIL I ®E MI ninsure, or a certificate of Workers'Compensation Insurance, 1t1PL' W' A79GN_ U ■ U or a certified copy thereof(Sec. 3800, Lab. C.) • I .000IUTY OF LOS ANGELES BUILDIPIG APUD SAFETY •- Policy No. Company ❑ Certified copy is hereby furnished. IP. FOR APPLICANT TO FILL IN BUILDING ADDRESS C 67 L��?� Certified copy is filed with the county building ihspec- BUILDING tion department. ADDRESS 5665 N_ Rnspmipad Date Applicant- CITY Temple City ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO.OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST.. __ (This section need not be•com'pleted'if the permit is for one ASSESSOR hundred dollars($100)or less,) : I TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL j TEL. USE ZONEJN APOWNERK— Mart COr - NO.I certify that in the performance of the work for which this O.permit is,issued, Ishat l not employ any person in any manner ADDRES531OO BIAL IL ONDITIONS so'as to become subject to the Workers'Compensation Laws. V CITY T .• -ZIP 09 Date Applicant ARCHITECT-OfTEL. DIS ICT GROUP TYPE FIRE . PROCESSED BY. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER.. Gerald R..• Hail l eCk NO. ONE Exemption, you'should become subjeto the Workers' CONST. Z ct Compensation provisions of the Labor Code, you must forth- ADDRESS 3100 w � LM with comply•with such provisions or this permit shall be an -deemed revoked. - TEL STATISTICAL CLASSIFICATION APT. CONDO. CONTRACTOR NO. LICENSED CONTRACTORS DECLARATION. 'LIC. CLASS NO. DWELL UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. (commencing with Section 7000)of Division 3 of the Business and -LIC. SEWER P 00"F7 i Professions'Code,•and my license is Tn full force and effect. CITY CLASS BK VALIDA7'ION7 A SQ.FT. NO.OF• NO.OF CHECK License Number Lic.Class j SIZE STORIES FAMILIES ONE VALUATION it o r �� '• Contractor Date DESCRIPTION OF WORKRemeve NEW ❑ , OOO.00 ` 1 1 ADD El am exempt under Sec. block i-n �, ..' ALTER loll'. B.$P.C. for this reason _ REPAIR ❑ $ ( Date: USE OF t, DEMOL ❑ EXISTING BLDG.MerChandi;Se i Signature I APPLICANT TEL.818 FINAL p r p OWNER-BUILDER DECLARATION '+ PRINT NO. 91_ DATE 24187 ]-hereby at I am exempt from the Contractor's License ` he eby affirm that p 1184 Citrus Covina C Law for the following' reason (Section 7031.5, Business and ADDRESS s FINAL ;h� ( .tea✓• - Professions Code): PRESENT BY C " ❑ I, as owner of the property, or my employees with BUILDING wages as their sole compensation,will do the work and LOCALITY the structure is not intended or offered for sale(Section G J,2 A 7044, Business and Professions Code). `- MOVING TEL. ' CONTRACTOR NO. I, as owner of the property,am exclusively`contracting i! 0 0 0 9 with licensed contractors to construct the pro'LeEt (Sec- ADDRESS tion 7044, Business and Professions Code). +I o C,�, ] REQUIRED TOTAL SETBACK FROM CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency forFRONT the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE f ( .7 02— 8`4 3 P.L. Lender's Name LDMA Ref. # 3 P.C.Fee$ Permit'FeeM1 i Lender's Address I certif .that I have read this a lication and state that the y pp Issuance Fee J LDMA P/C# above information is correct. I agree to comply with all County Investigation Fee ordi[Lances and State laws relating to.building construction, Total Fee 6;� LDMA perm. # J and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 0 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date t ''W IRIZERS'COMPENSATION DECLARATION I herebHfflirm that I have a certificate of consent to insure, or C6 certificate of Workers'Compensation Insuran elf P P L I CAT 1 G F%"�)Q SUILL)PING P E RM I T or'a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company " BUILDING Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS © Certified copy is filed with the county building inspec- [ADDRESS ING / tion department. ESS 6 aS to LOCALITY Gy7 NEAREST Date 1 Applicant 1 ZIP Q(J CROSS ST. CERTIFICATE OF EXEMPTION FROM WORKERS' Nib.OF BLDGS. ASSESSOR COMPENSATION INSURANCE OF LOT NOW ON LOT MAP BOOK PAGE PARCEL (This section need not be completed if the permit is for one USE ZONE MAP hundred dollars($100)or less.) T BLOCK LOT NO. NO. TEL. �i� SPECIAL `�- I certify that in the performance of the work for which this ER a. d� NO. tt/J CONDITIONS �. permit is issued,I shall not employ any person in any manner ^T U0 ✓1 � �� 1 DISTRICT GROUP TYPE FIRE PR ED BY UO so as to become subject to the Workers'Compensation Laws. c G- I 1� LI CONST. Zol� t Date Applicant CITY t/ ZIP v V&l STATISTICAL CLASSIFICATION• APT. JCONDQ(I NOTICE TO APPLICANT: If, after making this Certificate of ARCHITECT OR/ / �/ _ EL. Exemption, you should become subject to the Workers' ENGINEER C�'� �° L�'� O. CLASS NO. DWELL.UNITS Compensation provisions of the Labor Code, you must forth- ADDRESS /2(f V /V L r SEWER MAP with comply with such provisions or this permit shall be // deemed revoked. !r CONTRACTOR C L DAX— NO. M —MI VBK" PG, VALIDATION LICENSED CONTRACTORS DECLARATION Sr I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �/ _"` NO. r VALLI ION (commencing with Section 7000)of Division 3 of the Business and // _ LIC L?� Professions Code, and my license is in full force and effect. CITY N �L 7dGP CLASS $ 56 S ,.. SQ. FT. I NO.OF NO.OF CHECK License Number Lic.Clas `s,,1 1 *SIZE STO S FAMILIES ONE Q8 A Contractor• 1 `�- Date 1 1-2J `� DESCRIPTION OF WOR NEW ❑ $ # o o a o 2 3 ADD ❑ I am exempt under Sec. ALTER FINAL /Q �® I - 30(190 B.BP.C. for this reason j REPAIR ❑ DATE G , Date: USE OF EXISTING BLDG. `(� /�/. �}' .@S DEMOL ❑ By A o a 3 0 Q 9 0 c=.t Signature APPLICANT j� a TEL."/ ! I1.21 -84 OWNER-BUILDER DECLARATION NNO. �Y�d/ G , I hereby affirm that I am exempt from the Contractor's License c I V ADDRESS Law for the following reason (Section 7031.5, Business and , PEZ Professions Code): ?PRESENT❑ 5 7.8 A BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work andLOCALITY # 0 0 0 0 0 1 the structure is not intended or offered for sale(Section o 3 b�#,5 0 7044, Business and Professions Code). MOVING TEL. I I,as owner of the property,am exclusively contracting CONTRACTOR NO. 0 0 with licensed contractors to construct the project (Sec- ADDRESS 2 " tion 7044, Business and Professions Code). REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH D I hereby affirm that there is a construction lending agency for FRONT the performance of the work for which this permit is issued P.L. tSec. 3097, Civ. C.). SIDE o P.L. o Lender's Name `_� 099Lender's Address P.C. Fee$ Permit Fee V AA t rI certify that I have read this application and state that the Issuance Fee U above information is correct. I agree to comply with all County Investigation Fee // ordinances and State laws relating to building construction, Total Fee .16 9 and hereby authorize representatives of this County to enter r -,... u the ab -mintionedpropert for inspectio Pur ses. s -� • a bo 4 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ®s ' "RKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION F®RBUILDING P E RM I T insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof (Sec,(.j3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Polic No. u � d��ipffl IiAl; C BUILDING I� Certified copy is hereby furnished. FORAPPLICANT TO FILL IN : ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING //__ //6--• j � �j tion department. ADDRESS L f i Date�� / OA licant �iG/[� ` CITY'. ��✓,�� Gr'r ZIP t LOCALITY L PP NO.OF BLDGS. ✓J CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSS ss. COMPENSATION INSURANCE ASSESSOR (This section need not be completed'if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. OWNER _ NO. y USE ZONE MAP NO. I certify that in the performance of the work for which this /��/�,r �`�MG,r� ��•f SPECIAL � permit is issued, I shall not employ any person in any manner ADDRESS �(r/f lit /"�T C CONDITIONS so as to become subject to the Workers'Compensation Laws. ? U n CITY /�A//vL G�/ ZIP Date Applicant ARCHITECT OR TEL. 0 PP r, DISTRICT GROUP TYPE FIRE PROCESSED BY NOTICE TO APPLICANT: If, 'after making this Certificate of ENGINEER NO. CONST. ZONE Exemption, you should become subject"to the Workers' p �/ Compensation provisions of'the Labor Code, you must forth- y. ADDRESS No "OS G a with comply with such provisions or this permit shall be STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTORF6� / LPX LNO. 7O / rZn — LICENSED CONTRACTORS•DECLARATION CLASS NO. a+t DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 4 L' i� 6� SEWER MAP (commencing with Section 7000)of Division 3.of the Business LIC. r and Professions Code,and my license's in full force and elle t. CI �CL'• CLASS _ BK.' VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number Lic. Class v SIZE STORIES FAMILIES ONE //Jj �,,// VALUATION , Contractar12-61,92 19 L Date a DESCRIPTION OF WORK _ /l�[(� NEW 1:1 $p 0 I ��,rr' fl,141-zl�1 ADD- El DD 10 lI am exempt under Sec, fes- ALTER ❑ 1S B.BP.C. for this reason ..���� au REPAIR ❑ $ USE OF Date: y� EXISTING BLDG. r._% /�� DEMOL ❑ Signature APPLICANT<_ ' FINAL ' (PRINT) /�-H NO: OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License �f'. � .�� Law for the following reason (Section 7031.5, Business.and ' ADDRESS N FINAL- Professions Code): PRESENT BY 23 ❑ I, as owner of the property, or my employees with BUILDING ACCTAL ADDRESS wages as their sole compensation,.wilI do the work and105.98 !�ci the structure is not intended or offered for sale(Section LOCALITY ® .3,307 105n 7V ❑ 7044, Business and Professions Code.) MOVINGCONTRATOR NO. I,as owner of the property,am exclusively contracting s with licensed contractors to construct the project.(Sec- ADDRESS ACCT. tion 7044, Business and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. ,�j �7 2095.71 CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for FRONT ITE S the performance of the work for which this permit is Issued P.L. _ (Sec. 3097, Civ. C.). . SIDE TOIL 3 1.1-69 P.L. CHECK 311.69 Lender's Name /ry���/ LDMA Ref. # /.y�r P:C. Fee$ Permit Fee U (o ' 1yt'1VE ot�l Lender's Address l` I certify that I have read this application and state that the Issuance Fee CVY LDMA P/C# above information is correct.I agree to comply with all Count Investigation Fee r r� ordinances and State laws relating to building construction, Total Fee �dou• / LDMA Perm. # 00110-1313101 10/30/92 and herebyauthorize re resentatives of this Count to enter » � a-me 'one erty for inspection p rposes. 6281 1 AM 10:is 3 ` SEE REVERSE TOR EXPLANATORY LANGUAGE Signaturofof Applicant or Agent Date WORKERS' COMPENSATION DECLARATION insure,hereby c ryf carte of Worke s'tCompensat on Insurance, APPLICATION F®R BUILDING PERMIT r a cernfi'ed copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Polioll y c 5(o2io�SsGi3 C'U�TI r r� Tic Pcy No. Company Certified copy is hereby furnishe �5 _ ADDRESS ` d�' " _ �9 FOR APPLICANT TO FILL IN �BUILDING 1 ' Certified copy is filed with the county building ni spec- BUILDING— Certified fk� LL I tion department. ADDRESS� ��! 'V ; Z E,,j/�� i R�42 & L -' Date'li'30-"l_6 'Applicant-..3E X.A A/'E. aI.(4l/✓. CITY I rc LE- CA •.ZIP `-I I / 90 :'LOCALITY CZ-f4 p� C-LT J NO.OF BLDGS. NEARTCERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT >CROSS ST. 'T_LI M AS 2i U(_ COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL. OWNER �A)" IV DF_VJFt:NO, USE ZONE MAP I certify that in the performance of the work for which thisSPECIAL >_ t� No. permit is issued, I shall not employ any person in any manner ADDRESS l BB"') RAG6RD b\\s CONDITIONS CL soas to become subject to the Workes"Compensation Laws.. /� {; U // O CITY (� ZIP cl• J4� � t"„tea Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this.-Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE P OCESSED BY CONSToe ZONE (- Exemption,• you should become subject to the --Workers' ` w Compensation provisions of the Labor Code, you must-forth- ADDRESS ��O a with comply with such provisions or this permit shall be ��``++ �"� TEL.(; (j(7- STATISTICAL CLASSIFICAT N - APT. CONDO. rn deemed revoked. CONTRACTOR ) !� lSF NO. cao zs 3a Z - 'LICENSED CONTRACTORS DECLARATION r T _, LIC. (144W, 011-)1CLASS NO. DWE . UNITS - I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS f�� S C. NO. (commencing with Section 7000)of Division 3 of the Business 0, v TA��� e�. CLASS �+ �� LIC. SEWER MAP and Profess ions-Code,and my license is in full•force and effect. CIN BK. PG. VALIDATION SQ. FT. ' NO. OF NO.OF CHECK License Number 6QU2) -��yMLLic. Class SIZE I STORIES FAMILIES ONE DESCRIPTION OF WORK NEW 9 VALUATION Contra ctor<� Q `� S'I(ehbate ADD ❑ $ LD QQ-� - ► ❑I am exempt under Sec. `��r 1' f Z_ 5' 8 • ��.... ALTER ❑ B.BP.C. for this reasoL-tt'teP- LOC Inc. REPAIR ❑ $ Date: USE OF EXISTING BLDG. . _:C'/`1 Pip )A/1'7 DEMOL ❑ .7� Signature APPLICANT r EL•CleiQ - FINAL ,] OWNER-BUILDER DECLARATION (PRINT) ; \ �� NO. �L?Z1 DATE �"�7 ACCT. I hereby affirm that I am exempt from the Contractor's License ADDRESS (SSS' �7�-t s ) (PNS t 50.50 Law for the following reason (Section 7031.5, Business and FINAL 3303 Professions Code): PRESENT ey 1 ❑ BUILDINGI, as owner of the property, or mY•employees with ` ADDRESS � a wages as their sole compensation,will do the work and ACCT:a the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) .MOVING TEL. 3303 72.00 ❑ 1, as owner of the property,am exclusively contracting CONTRACTOR NO. 2 ITEM$ with licensed contractors to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code.) • • TOTAL x.22 m 50 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH r . I hereby affirm that there is a construction lending agency for FRONT CHECK 122.50 the performance of the work for which this permit is issued P.L. (Sec. 3097, Civ. C.). SIDE. CHANGE .00 P.L. Lender's Name $ P.C. Fee$ �i Permit Fee ,a� LDMA Ref. # rSCC0_r; 0I f31 {Lt} �£ Lender's Address ymoo , 7759 t� 1 PM 5002 o 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• A ordinances and State laws relating to building construction, Total Fees Q LDMA Perm. # a and hereby authorize representatives of this County to enter upon the above:mentioned property for inspection purposes. o ,�� «..( •, 11'50 tv SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of of Appl a or Agent Date COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0611300047 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: BK: 62 PG: 2 PC: SQ. FT STORIES TYPE 5665 ROSEMEAD BL STRUCTURE: VN TEMP CA 917801804 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: COMME USE ZONE: C-3 ISSUED ON: PROCESSED BY: EXPIRES ON: K—MART EXIST OCC GRP: 11/30/06 JK 11/25/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DA FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO — 20,000 5665 ROSEMEAD BLy i TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK NEW SELF SERVICE BEVERAGE CENTER & 3 COMPARTMENT SINK ROOM FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: APPLICANT: TEL. NO: WICKLUND (714) 385-1835— AA BLDG PERMIT ISSUANCE 27.75 914 E. KATELLA AE STRONG MOTION OTHER 20000.00 VAL 4.20 SPECIAL CONDITIONS: ANAHEIM, CA 92805 AX BUILDING REVIEW FEE 54.70 A2 PERMIT W/ENERGY—HC 20000.00 VAL 442.29 TOTAL FEES 528.94 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ICE. BUILDERS, INC. (714) 491-1317- 421 EAST CERRITOS AVE LIC. NO LOCATION AND SETBACKS ANAHEIM, CA 92805 775947 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION TRENCH FORMS PLUMP, RICHARD (714) 385-1835-103 914 E. KATELLA AVE LIC. NO: SLAB/UNDER FLOOR ANAHEIM, CA 92805 775947 B RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION XX 3 01 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION i REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL— INSULATION WEATHER STRIP SIDE PL— INTERIOR LATH DRYWALL op EXTERIOR LATH RATED FLOOR CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS OPENINGS T—BAIT CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 . I j COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR t BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0210230082 ' PHONE: (626) 285-0488 EXT: LEGAL ID: . OF CONST BUILDING BK: 62 PG: 2 PC: SQ. FT STORIES TYPE 5665 ROSEMEAD BL • STRUCTURE: VN TEMP CA 917801804 ASSESSOR INFORMATION NUMR: NEAREST CROSS STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: Eff G S : C- PROCESSED EXIST OCC GRP: 10/23/02 JK 04/21/03 OW ER: l / TE 0: B DGS. NOW ON LOT: VALUATION: FINE FINA CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 312,700 X? T .'� t FEES PAID DESCRIPTION OF WORK REROOF•REMOVE OLD RO /2" ISO 1/411DENSDECK 50MIL JM SINGLE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: PLY (1020 SQ;PITCH 1/4:12) APPLICANT: T 0: SOUTHERN CALIFORNIA ROOFING (800) 537-1402- AA BLDG PERMIT ISSUANCE 27.75 9612 E IMPERIAL HWY AC STRONG MOTION RESID 312700.00 VAL 31.27 SPECIAL CONDITIONS: DOWNEY 90242 D2 PERMIT W/O EN=HC 312700.00 VAL 2,694.60 TOTAL:FEES 2,753.62 { CONTRACTOR: TEL. N0: APPROVALS DATE INSPECTOR SIGNATURE SOUTHERN CALIFORNIA ROOFING (800) 537-1402- 9623 E. IMPERIAL HIGHWAY LIC. NO LOCATION A B C S DOWNEY, CA 90241 B/L27880 * i SOIL$ ENGINEER APPROVAL RCH I TECT—()-R--gffGIN R: TEL. NO- O N 0 R S r; LIC. NO:" SLAB/UNDER FLOOR S--D FLOOR FRAWfWG hI� P NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDEi LOOR INS TION 147H265 3 04 TL—OOt SHEATHING 0. OF FA I IE D ING S: /C ND: S A S : NO 21 y' �aJ- ROOF SHEATHING A ,C ^'a' t� CvMT7altfi SCHOOL HAZARDOUS + , '�J�' SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ++� 1 ,• FRAM INSPECTION REQUIRED O A SETBACK FROM EXIS E SPRINKLER.-HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: A `- - FRONT PL- - INSU A ON/ EATHER STR P SIDE PL- I -TM tIOR LATH/DRYWALL TE OR LAT D { 00 (. .SSE RATED UAI I ASSEMBLIES I �R C�I�NG * ADDITIONAL DATA ON FILELOT 'DRAINAGE { I REPORT ID: DPR261 ROUTE TO: BSO508 I � r COUNLY OF LOS ANGELES d' TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9701300049 PHONE: (818) 285-0488 EXT: LEGA D: NO. OF CONST NEW BUILDING ADDRESS: BK: 62 PG: 2 PC: SQ. FT STORIES TYPE OCCUP GROUP 5665 ROSEMEAD BL STRUCTURE: 0 1 V g TEMP CA 917801804 ASSESSOR I FOR TIO BER: NEAREST CROSS STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: —EX-1—ST-8—LUG—USE: COMME USE ZONE: ISSUED ON: PROCESSED B : EXPIRES ON: K MART EXIST OCC GRP: B 03/25/97 TC 03/25/98 OWNER: TEL. N0: BLDGS. NOW ON LOT: VALUATION: FI L DATE FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 5,000 FEES PAID D SCRIPTIOI OF WORK T.I. SHELVING SEISMIC ANCHORAGE APPLICANT: —TEL—. 0• IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: K-MART CORP. (810) 643-5894- Al PLANCHECK W/EN-HC 5000.00 VAL 130.05 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AE STRONG MOPION OTHER 5000.00 VAL 1.05 A2 PERMIT W/ENERGY-HC 5000.00 VAL 153.01 _ TOTAL FEES 311.86 , CONTRACTOR: TEL. NO: - r APPROVALS DATE INSPECTOR SIGNATURE JUNE A GROTHE CONSTRUCTION INC (909) 590-7090- 4075 SCHAEFER AVE LIC. NO FOCAMU AND SETBACKS CHINO CA 91710 671997 B-1 $OILS ENGINEER APPROVAL ARCHITECT OR ENGINEER, TEL. NO: FO A. ON R C 0 CLEMENTS AND CLEMENTS ARCHITECTS (818) 796-1768- 123 SOUTH LAKE AVENUE LIC. NO: f SLAB/UNDER FLOOR PASADENA, CA 91101 NONE III ISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 04 LAS T NG 0. OF FAMILIES: DWELLING, S: AP /CO D: S T C SS: NO 22. ROOF SHEATHING SC O WIT IHAZARDOUS SANE S AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION FIRESPSP SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED OOR/C ASSEM. RATED WALL ASSEMBLIES RATED S A TS OPE INGS -BAR CEILINGS OT DRAINATE— REPORT GEREPORT ID: DPR261 ROUTE TO: SS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706100007 PHONE: (818) 285-0488 EXT: _1EGAL ID: NUMBER OF SIGN: Z BUILDING BK: 62 PG: 2 PC: SIGN DESCRIPTION: REFACING THE PYLON SIGN AND ADDING AD 5665 ROSEMEAD BL � EXISTING WALL SIGN TEMP CA 917801804 ASSESSOR 0 NUMBER: NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: S G USEi_ D 0PROCESSED EXPIRE K-MART EXIST OCC GRP: 06/10/97 TC 06/ 98 . OWNER: TEL. NO: B DGS. NOW ON LOT: VALUATION: FINAL DATE FINAL B CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO (000) 000-0000- 7,500 >B/�� FEES P SC 0 OF WORK 1.49, REFACE THE PYLON SIGN ADD ADDITIONAL SIGNAGE TO EXISTING FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: WALL SIGN APPLICANT: TEL. 0: ACME—WILEY (909) 989-4900— AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION OTHER 7500.00 VAL 1.58 SPECIAL CONDITIONS: AX BUILDING REVIEW-FEE r, 54.70 D2 PERMIT W/0 EN.-HC 7500.00 VAL 183.90 TOTAL FEES:- 267.93 CONT TOR: EL. N0: �y• - �„s + APPROVALS DATE INSPECTOR SIGNATURE ACME-WILEY (909) 989-4900- 9359 FERON BLVD. LIC. NO ,:�~" - -` 1�z ',' LOCATION RANCHO CUCAMUNGA 402063/C45 `* SOILS ENGINEER APPROVAL ARCHITECT 0 ER: aFOUNDATION/ C LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: OD N .. NO. OF F . D G UNITS: D: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS - NO NO NO ". i REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 {{'BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS `SI-Gy_ BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0004050019 PHONE: (626) 285-0488 EXT: _!1 LEGA D: NUMBER OF SIGNS: B I ING-ADDRESS: BK: 62 PG: 2 PC: SIGN DESCRIPTION: WALL SIGN (ILLUMINATED) '-? 5665 ROSEMEAD BL ,-TEMP-_CA 917801804' ASSESSOR- INFORMATION NUMBER: NEAREST CROSS-STREET: LAS TUNAS 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED 0 PROCESSED BY: EXPIRES ON: WESTERN UNION EXIST OCC GRP: 04/05/00 UT 10/02/00 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY• CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 1,250 1+6b FEES PAID DESCRIPTION OF WORK ONE NEW WALL SIGN AT K-MART FOR WESTERN UNION FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: �1 APPLICANT: TEL. 0• MANCHEL AND CO. (818) 894-3883- AA BLDG PERMIT ISSUANCE 27.75 P.O. BOX 55067 AC STRONG MOTION RESI 1250.00 VAL 0.50 SPECIAL CONDITIONS: VALENCIA, CA AX BUILDING �II`Efd"FEE 54.70 D2 PERMI W A' i�C�� 12 0 VAL 82.20 165.15 CONTRACTOR: TEL. N0: �o� �(�r9- APPROVALS DATE INSPECTOR SIGNATURE MANCHEL AND CO. (818) 894-3883- P.O. BOX 55067 LIC. NO LOCATION AND SETBACKS VALENCIA, CA 91385-0067 483691 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. 0: FOUNDATION/TRENCH FORMS LIC. N0. 1111111 SUPPORT STRUCTURE r— MAP N0: SEWER O : PAGE: FIRE ZONE: 7�f0_�n (� D n �� W FD-) J NO. OF FAMILIES- DOLLING UNITS: APT/COND: STAT CL 5 U ILIA A\ NO 2j0s� ❑ ,, SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEETN MATERIALS Q ❑ �- NO NO NO A ❑ �� 46�� �ot C Service That REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS SIGN BOILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9706100007 PHONE: (818) 285-0488 EXT: LEGAL ID: R 0 5-10 10--. 2 BUILDING ADDRESS: BK: 62 PG: 2 PC: SIGN DESCRIPTION: REFACING THE PYLON SIGN AND ADDING AD 5665 ROSEMEAD BL EXISTING WALL SIGN TEMP CA 917801804 ASSESSOR 10 0 E : NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY TENANT: G SE: S ED 0PROCESSED K-MART EXIST OCC GRP: 06/10/97 TC 06/ 98 OWNER: TEL. N0: OLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL B CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO (000) 000-0000- 7,500 1e 1/-fo FEES D C P IO G0WORK liv REFACE THE PYLON SIGN ADD ADDITIONAL SIGNAGE TO EXISTING FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: WALL SIGN APPLICA0: ACME-WILEY (909) 989-4900- AA BLDG PERMIT ISSUANCE 27.75 AE STRONG NOTION OTHER 7500.00 VAL 1.58 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/O EN-HC 7500.00 VAL 183.90 CONTRACTOR: TEL. 0: TOTAL FEES 267.93APPROVALS DATE INSPECTOR SIGNATURE ACME-WILEY (909) 989-4900- 9359 FERON BLVD. LIC. NO LOCATION AND SETBACKS RANCHO CUCAMUNGA 402063/C45 SON-S. ENGINEER APPROV L ARCHITECTOR ENGINEER: 0: 0 FORMS LIC. NO: - SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 0. OF FAMILIES: DWELLING UNITS: APT/CO : STAT CLASS: NO 20 SCHOOL S AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS COMMERCIAL ADD/ALT/REP BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1012210047 PHONE: (626) 285-0488 EXT: ILEGAL ID: I NO. OF CONST NEW I BUILDING ADDRESS: 1 IBK: 62 PG: 2 PC: I SQ. FT STORIES TYPE OCCUP GROUPI 5665 ROSEMEAD BL I I ISTRUCTURE: 1 1 V-B M I TEMP CA 917801804 ] (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: BROADWAY - LAS TUNAS 1 15387-031-059 I I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl I I I I ITENANT: [EXIST BLDG USE: COMMS USE ZONE: C-3 (ISSUED ON: PROCESSED BY: I IK-MART DEPARTMENT ]EXIST OCC GRP: M 101/06/11 SR [ ]OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: [FINAL TE ?T: CODE: [ ISEARS HOLDING CORP. (214) 497-0965- 1 197,000 1 I 13333 BEVERLY RD. ] I IHOFFMAN ESTATES FEES PAID DESCRIPTION OF WORK I I IREMODEL EXTERIOR FRONT FACE OF K-MART BUILDING RE USE 1 I [FEE DESCRIPTION: QUANTITY: DOM: AMOUNT:IEXISTING SIGN 1 1APPLICANT: TEL. NO: I I [ IPAUL HEALEY (909) 993-9341- JA1 PLANCHECK W/EN-HC 197000.00 VAL 1,882.40 1 [ 115632 EL PRADO RD. 1AA BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: ICHINO, CA 91710 ]AB STATE GREEN BLDG FEE 197000.00 VAL 8.00 ] ] I 1AE STRONG MOTION OTHER 197000.00 VAL 41.40 1 [ IA2 PERMIT W/ENERGY-HC 197000.00 VAL 2,214.60 1 ICONTRACTOR: TEL. NO: TOTAL FEES 4,174.20 1APPROVALS DATE INSPECTOR SIGNATURE ] IJ G CONSTRUCTION (909) 993-9393- [ 1I I ] 115632 EL PRADO RD LIC. NO ILOCATION AND SETBACKS (CHINO, CA 91710 671997 B 1 I (SOILS ENGINEER APPROVAL I I (ARCHITECT OR ENGINEER: TEL. NO: I IFOUNDATION/TRENCH FORMS I I I IKEN OKOMOTO (714) 444-2422- [ 1I 13186 AIRWAY AVENUE LIC. NO: 1 1SLAB/UNDER FLOOR 1 1 ICOSTA MESA, CA 92626 2244 ] 1 I I 1 I 1 [RAISED FLOOR FRAMING I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( �744��C'"'ve "b' cc,"�o � ]UNO^ar^.FLOOR INSULATION [ 1147H265 3 001 ppy I I 9 3 Y �I ��� � I I HEATHING �11�/� INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I NO 22 1 IRO011 S EATHING ] SCHOOL WITHIN HAZARDOUS [ ISMSR PANELS 1 1 [ [AIR QUALITY: 1000 FEET MATERIALS [ [ [ [ NO NO NO 1 ]FRAME INSPECTION i [ [ I (FIRE SPRINKLER HANGERS I F/=lII [ I ` (INSULATION/WEATHER STRIP] ] I (INTERIOR LATH/DRYWALL [ I ] ] I ]EXTERIOR LATH [ [ [ IRATED FLOOR/CEIL ASSEM. I I I I IRATED WALL ASSEMBLIES I I (RATED SHAFTS/OPENINGS I ] IT-BAR CEILINGS I ] ] I [IAT DRAINAGE ] ] (REPORT ID: DPR261 ROUTE TO: BS0508 I I ] I COUNTY 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 BL 0508 1101110009 PHONE: (626) 285-0488 EXT: LEGAL ID: INUM13ER OF SIGNS: 1 I BUILDING ADDRESS: I BK: 62 PG: 2 PC: SIGN DESCRIPTION: CHANNEL LETTERS 5665 ROSEMEAD BL _ TEMP CA 917801804 I (ASSESSOR INFORMATION NUMBER: 1 I NEAREST CROSS STREET. LAS TUNAS 1 15387-031-059 I I THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, Cl I I I 1 TENANT: EXIST BLDG USE: TISSUED ON: PROCESSED BY: [K-MART 1EXIST OCC GRP: 101/11/11 SR 1 (OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1FINAL DATE FINAL BY: CODE: 1 ITODD LEGER W/COMMERCE REALTY (310) 373-2797- 1 2,500 I 1149 PALOS VERDES BL I I I IREDONDO BEACH 1 FEES PAID ID C PTION OF WORK I I [REMOVE 6' "KMART" CHANNEL LETTERS AND REINSTALL WHEN FACADE 1 I 1FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1WHEN FACADE IMPROVEMENTS ARE COMPLETED 1 1APPLICANT: TEL. NO: 1 ICARRERA, ARMANDO (714) 683-1120- IAA BLDG PERMIT ISSUANCE 27.80 1 12820 E. GRETTA LANE IAB STATE GREEN BLDG FEE 2500.00 VAL 1.00 ISPECIAL CONDITIONS: I (ANAHEIM, CA 92806 LAX BUILDING REVIEW FEE 54.70 1 1 1 ID2 PERMIT W/0 EN-HC 2500.00 VAL 99.10 1 I I TOTAL FEES 182.60 [ I (CONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 [P.S. SERVICES, INC. (714) 683-1120-2321 12820 E GRETTA LN LIC. NO I ILOCATION AND SETBACKS 1 I ANAHEIM CA 92806 614676 C45 I I I I I I ISOILS ENGINEER APPROVAL I 1 [ [ARCHITECT OR ENGINEER: TEL. NO: [ IFOUNDATION/TRENCH FORMS I I [ T LIC. NO: I ISUPPORT STRUCTURE I I I I I I [ I IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( I [ I I I 001 I I I I INO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: [ I I I [ 1 NO 20 I I I I I 1 SCHOOL WITHIN HAZARDOUS 1 I I [ I LAIR QUALITY: 1000 FEET MATERIALS [ [ I [ NO NO NO I I I I I I I I I I I I I [ I I I I I I I I I I I I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 [ I I COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 2701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0606120024 PHONE: (626) 285-0488 ERT: LEGAL ID: NUMBER OF SIGNS. 5 BUILDING ADDRESS. BK: 62 PG: 2 PC: SIGN DESCRIPTION: REMOVE 4 EXISTING WALL SIGNS INSTALL 5665 ROSEMEAD BL TEMP CA 917801804 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: K-MART EXIST OCC GRP: 06/12/06 JK 06/07/07 OWNER: TEL. NO: SLUGS. NOW ON LOT: VALUATION: FIND D5TE FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 10,000 5665 ROSEMEAD BL TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK . REMOVE 4 EXISTING WALL SIGNS INSTALL 5 NEW WALL SIGNS REFACE FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: MONEMENT SIGN APPLICANT: TEL. NO: CONTRACTOR PERMIT SERVICES (909) 721-7934- AA BLDG PERMIT ISSUANCE 27.75 1500 W. EMBASSY AX BUILDING REVIEW FEE 54.70 SPECIAL CONDITIONS: ANAHEIM, CA 92887 D2 PERMIT W/O HN-HC 10000.00 VAL 216.60 TOTAL FEES 299.05 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE COAST SIGN CO. (714) 520-4199- 1500 W. EMBASSY ST. LIC. NO LOCATION AND SETBACKS ANAHEIM, CA 92802 654238 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS PLUMP, RICHARD (714) 385-1835-103 914 E. KATELLA AVE LIC. NO: SUPPORT STRUCTURE ANAHEIM, CA 92805 654238 MAP NO. SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO • ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS A*ELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT 'TEMPLE CITY CA 91780 BL 0508 0605160058 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: BK: 62 PG: 2 PC: SQ. FT STORIES TYPE OCCUP GROUP 5665 ROSEMEAD BL STRUCTURE: 0 1 VN B TEMP CA 917801804 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: COMME USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: K-MART EXIST OCC GRP: B 06/09/06 JK 06/04/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FIWL DATE FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 45,000 5665 ROSEMEAD BL C ��Y TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK TENANT IMPROVEMENT (5) NEW FEATURE WALLS, REMODEL PHARMACY FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: DEMO FOOD DEPT. NEW OLAN MILLS PHOTO APPLICANT: TEL. NO: WICKLUND (714) 385-1835- Al PLANCHECK W/EN-HC 45000.00 VAL 715.97 914 E. KATELLA AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: ANAHEIM, CA 92805 AE STRONG MOTION OTHER 45000.00 VAL 9.45 A2 PERMIT W/ENERGY-HC 45000.00 VAL 842.32 TOTAL FEES 1,595.49 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE I.C.E. BUILDERS, INC. (909) 625-7275- 3202 N. MONTCLAIR AVE LIC. NO LOCATION AND SETBACKS CLAREMONT, CA 91711-1551 775947 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION TRENCH FORMS PLUMP, RICHARD (714) 385-1835-103 914 E. KATELLA AVE LIC. NO: SLAB/UNDER FLOOR ANAHEIM, CA 92805 775947 B RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 04 FLOOR SHEATHING NO. OF FAMILIES: VIELLING UNITS: APT COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION FIRE SPRINKLER HANGERS V sir rL/I Q �j�/ /! � ,fy -OAP INSULATION WEATHER STRIP INTERIOR LATH DRYWALL LATE To of_ �FIAA4� 2��� RATED FL OR/C -iiDrG�� rl �4020% �! RATED FLOOR CEIL ASSEM. h�� 1/ RATED WALL ASSEMHLIES Awo /�' RATED SHAFTS/OPENINGS T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0506 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS FIRE SPRINKLER BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0607310009 PRONE: (626) 285-0488 ERT: LEGAL ID: NUMBER OF ADDED RELOCATED BUILDING ADDRESS: BK: 62 PG: 2 PC: SQ. FT SPRINKLER READS 5665 ROSEMEAD BL STRUCTURE: TEMP CA 917801804 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 5387-031-059 THOMAS PAGE: 596 GRID: H4 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: K-MART EXIST OCC GRP: 07/31/06 JK 07/26/07 OWNER: TEL. NO: SLUGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: ELTINGE GRAZIADIO;SAMPSON DEV CO - 5,000 5665 ROSEMEAD BL TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK REMODEL FIRE SPRINKLERS SYSTEMS 9 HEADS RELOCATED FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: SHELTON FIRE PROTECTION CO. (714) 692-3573- DO FIRE SPRINKLER PC 5000.00 VAL 112.71 22745 LA PALMA AVE AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: YORBA LINDA CA 92887 D1 PLANCHECK W/O EN-HC 5000.00 VAL 112.71 TOTAL FEES 253.17 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SHELTON FIRE PROTECTION (714) 692-3973- 22745 LA PALMA AVE LIC. NO FIRE DEPARTMENT INSPECT YOREA LINDA, CA 92887 677631 C16 FIRE RPRINKLER HANGERS ARCHITECT OR ENGINEER: TEL. NO: FIRE DEPARTMENT APPROVAL PLUMP, RICHARD (714) 385-1835-103 914 E. KATELLA AVE LIC. NO: ANAHEIM, CA 92805 677631 C16 MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508