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Home My Public Portal About5701 ROSEMEAD BLVD_Building__ r WORKERS' COMPENSATION DECLARATION I APPLICATION FOR BUILDING PERMIT I -tereby affirm that I have a certificate of consent to self insure!or a certificate of Workers' Compensation Insurance, � or a certified copy thereof (Sec. 3800,,/Lab ) f COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No./-?-:Z.-4'2aCompany - X040& BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS C tified copy is filed with the c ty Fi 'I g inspec- BU IN ADDRESS Se/rl �{f ti de Oment. J,, Date plicant T^�^- CITY k ZIP LOCALITY ' CERT KATE OF EXEMPTIO FROM ORKERS' NO. OF BLDGS. NEAREST COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. 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.) r-- TEL. OWNER — p 4(`J USE ,ONE MAP I certify that in the performance of the work for which this SPECIAL !//// NO. permit is issued, I shall not employ any person in any manner ADDRESS — SC< rJ ✓ CONDITIONS so as to become subject to the Workers'Compensation Laws. J O CITY ZIP Date Applicant ARCHITECT TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY � NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER _54W A O. CONST. ZO E Exemption, you should become subject to the Workers' w Compensation provisions of the Labor Code, you must forth- ADDRESS c�'f 2 6.G a- with comply with such provisions or this permit shall be , TEL. STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR NO. ^ Z LICENSED CONTRACTORS DECLARATION CLASS NO. gA d DWELL. UNITS — I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS 022 " N ` SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. 2 and Professions ode,and my license is in full for; and effect. CITY CLA BK PG VALIDATION SQ. O. OF NO. OF CHECK License Num L Jl��l Q / Lic. Class SS STORIES / FAMILIES ONE �7y VALUATION ] Contractor''"` Date DESCRIPTION OF WORK r/� NEW ❑ ADD ❑ $ C`�/V , ❑I am exempt under Sec. 6 ALTER ❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF _ EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. DATE 12-- 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 By I, as owner of the property, or my employees with BUILDING ADDRESS 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. ElI, 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.) REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK PROP. LINE WIDTH 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. (Sec. 3097, Civ. C.). SIDE P.L. Lender's Name L� n LDMA Ref. # P.C. Fee$ L Permit Fee Lender's Address 1 certify that I have read this application and state that the Issuance Fee LDMA P/C# Sabove information is correct. I agree to comply with all County Investigation Fee ordinanc and laws relating to building construction, Total Fee i LDMA Perm. # a and her y out oriz representatives of this Count to nter u abov m tinned property for inspectio pur oses. a SEE REVERSE FOR EXPLANATORY LANGUAGE Sign of Applicant or Agent D e WORKERS' COMPENSATION DECLARATION �L I hereby affirm that I have certificate of consent to self APPLICATION F®R BUILDING PERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof (Sec. 3600, Lab. C.) T COUNTY OF LOS ANGELES BUILDING AND FETY Polity No. C� Company Sr /� !`�i/l � �❑ Certified copy is hereby furnished. fit`rl�g __11 FOR APPLICA O ILL IN BUILDING �DDRM ��t� L� Certified copy is filed with the c my buiinsp - BUILDING tion department. 1 ADDRESS lJ ; Date 2- _ plican CITY �(Yl j ZIP 'LOCALITY NO.OF BLDGS. :rr NEAREST CERTIFICATE 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 for one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) _ OWNER��r J � O, USE ZONE MAP I certify that in the performance of the work for which this NO. permit is issued, I shall not employ any person in any manner ADDRESS [� L ��/�} 2, �-�. SPECIAL CONDITIONS �- so as to become subject to the Workers'Compensation Laws. �' p CITY X71 L� ZIP Date Applicant ARCHITECTTRI; TEL. W NOTICE TO APPLICANT: If, after making this Certificate of is ENGINEER O DISTRICT GROUP TYPE FIRE PROCE ED BY 0 Exemption, you should become subject to the Workers' �0 �� tV Compensation provisions of the Labor Code, you must forth- ADDRESS a with comply with such provisions or this permit shall bepry TEL. 3'O STATISTICAL CLASSIFICATION APT. DO. N deemed revoked. CONTRACTOR77-0-20 � cV NO.' Z Q Z LICENSED CONTRACTORS DECLARATION 1 C LIC CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ! �•S. b 43IJ0. bzS . (commencing with Section of Division 3 of the Business jJ C and Professions Code,and myy license CITY y4 04- LICSEWER MAP license is in full force and effect. r CLASS BK. PG. VALIDATION f SQ. FT. NO. OF NO.OF CHECK License ber - Lic. Class(2-4�2 s - SIZE STORIES FAMILIES ONE VALUATION Contractor Date �L� Z ^L�� DESCRIPTION OF WORK NEW $ �Son.ov ❑I am exempt under Sec. BAP.C. for this reason I ALTER 1:1t L 7� REPAIR ❑ $ Dote: USE OF \\'' EXISTING BLDG. N T DEMOL ❑ Signature APPLICANT TEL.. ��O FINAL OWNER-BUILDER DECLARATION (PRINT) C ,� 1V1� N3/Z' az 0) DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS t��( 5. S r� t2cs QTS/�0!1 l�' Law for the following reason (Section 7031.5, Business and FINAL t� Professions Code): PRESENT B ❑ I, as owner of the property, or m employees with BUILDING y [ �( ,Q P P Y. YADDRESS 3307 ?9 v i'}1 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING TEL. Poo 1 ❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO. A with licensed contractors to construct the project (Sec- ADDRESS ACCT.Y tion 7044, Business and Professions Code.) �7 159.7t REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY PiFkRONIT MSS YARD HWY PROP. LINE WIDTH ISE I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued t�� ,r(Sec. 3097, Civ. C.). -d 3 o98 nLender's Name CHECK.� Permit Fee pp� LDMA Ref. N , CHANGE e�rl Lender's Address T r i CHANGE L 0 I certify that I have r •d this plication and state that the Issuance Fee /S LDMA P/C 0 B above infor ation is or�ect. I ag a to comply with all County Investigation Fee 13000-11300 i 10/29/92 o?tff ances d Stat laws relati g to building construction, Total Fee LDMA Perm. H and%r y au oriz repress tives of this County to enter 6242 1 3:53 v:. 1 upo the e e Toned ope�ty for inspection purposes. d'-7 J-C SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date • 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 0304040019 PHONE: (626) 285-0488 EXT: LEGAL I D: NUMBER OF SIGNS: 4 ON FILE SIGN DESCRIPTION: MONUMENT:BUS.NAMES;PYLON:CLOCK W "T C 5701 ROSEMEAD BL: TEMP CA ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:-LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: EXIST BLDG . ISSUED ON: ---PROCESSED BY: . EXPIRES EXIST OCC GRP: 06/03/03 JK 05/28/04 . OWNER: L. 0: BLDGS. N ON LOT: A 0 : NAL DA L Y• CODE: CALAC INVESTMENT - 200,000 3 Daj 3709 CONVOY ST #300 ' SAN DIEGO, CA9211137 FEEMID DOMMION OF-WORK NEW SIGNS is TEMPLE CITY MARKETPLACE: 2 DOUBLE-SIDED MONUMENT FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SIGNS & 2 DOUBLE SIDED PYLON SIGNS W/ CLOCK ON TOP APPLICANT: 0: FOR.SIGHT CREATIONS (714) 537-8175- AA BLDG PERMIT ISSUANCE 0.00 985 E GREEN AC STRONG NOTION RESID 200000.00 VAL 0.00 SPECIAL CONDITIONS: PASADENA 91101 D1 PLANCHECK W/O EN-HC 200000.00 VAL 0.00 D2 PERMIT W/O EN-HC 200000.00 VAL 0.00 TOTAL FEES 0.00 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE C AND C SIGNS (714) 537-8175- 11622 ANABEL AVE. LIC. NO LOCATION AND SETBACKS GARDEN GROVE, CA 92643 541345 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: 0 0 FORMS LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 0. OF FAMILIES: DWELLING UNITS: O : STAT CLAN: NO 20 SCHOOL -HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO op G_ic—off — /�o•�.��: .t'.��a �t- REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES 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 0311170041 PHONE: (626) 285-0488 EXT: EGL D: N0. OF CONST NEW BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5701 ROSEMEAD BL STRUCTURE: 0 1 VN B TEMP CA ASSESSOR INFORMATION NUMBER..NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: XIS BLDG USE: CO ME USE ZONE: ISSUED ON: PROCESSED EXPIRES ON: APPLEBEE'S EXIST OCC GRP: B 02/11/04 VG 02/05/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE: CALAC INVESTMENT - 400,000 / - 3709 % `� SAN DIEGO, CA9211137 FEES PAID DESCRIPTION OF WORK T.I. FOR RESTAURANT FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: CHARLES RAMM - Al PLANCHECK W/EN-HC 400000.00 VAL 3,195.25 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AE STRONG MOTION OTHER 400000.00 VAL 84.00 A2 PERMIT W/ENERGY-HC 400000.00 VAL 3,759.12 CONTRACTOR: CEL. N0: TOTAL FEES 71066.12 APPROVALS DATE INSPECTOR SIGNATURE CLARK CONTRACTORS, INC. (949) 581-6577- 19651 DESCARTES LIC. NO LOCATION AND SETBACKS FOOTHILL RANCH, CA 92610 570943 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FORMS CHARLES RAMM ASSOCIATES (949) 362-1986- -- 27111 ALISO CREEK RD #195 LIC. NO: SLAB/UNDER FLOOR ALISO VIEJO, CA 10352 RAISED FLOOR FP.AMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 04 FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/CO : STAT CLASS: NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION / FIRE SPRINKLER HANGERS a"Z`y JT S�Ga N INSULATION/WEATHER STRIP 11 72�0g;;L- NTERIOR LATH/DRYWALL r EXTERIOR LATH RATED F OOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE l REPORT ID: DPR261 ROUTE TO: BS0508 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 0312160032 PHONE: (626) 285-0488 EXT: GAL ID: NUMBER OF SIGNS: 6 BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: ILLUMINATED WALL SIGNS 5701 ROSEMEAD SL TEMP CA ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED EXPIRES ON: APPLEBEEIS EXIST OCC GRP: 12/22/03 VG 12/16/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL ¢ATE FINAL BY: CODE: CALAC INVESTMENT - 13,587 2 3709 SAN DIEGO, CA9211137 FEES PAID DESCRIPTI N OF WOR INSTALL 6 CHANNEL LETTER WALL SIGNS FOR RESTAURANT APPLICANT: TEL. +V� FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 3: "APPLEBEES",3: "NEIGHBORHOOD GRILL & BAR" - SUPERIOR ELECTRIC ADVERTISING (562) 495-3808- AA BLDG PERMIT ISSUANCE 27.75 1700 W ANAHEIM ST AE STRONG MOTION OTHER 13587.00 VAL 2.85 SPECIAL CONDITIONS: LONG BEACH CA D1 PLANCHECK W/0 EN-HC 13587.00 VAL 241.23 D2 PERMIT W/0 EN-HC 13587.00 VAL 283.80 TOTAL FEES 555.63 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SUPERIOR ELECTRIC ADVERTISING (800) 995-9099- 1700 W ANAHEIN STREET LIC. NO LOCATION AND SETBACKS LONG BEACH, CA. 271598 C45 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: PT COND: ST T CLASS: NO 20 SCHOOL-WITHIN A A DOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508 , n 1 • °. 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 SL 0508 0308290023 PHONE: (626) 285-0488 EXT: L . OF CONST NEW- BUILDING ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5701 ROSEMEAD SL � STRUCTURE: 0 1 VN B TEMP CA ASSESSOR INFORMATION NUM NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: COMME USEONE: C-2 ISSUED ON: PROCESSED B EXPIRES ON: EXIST OCC GRP: B 09/08/03 JK 09/02/04 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: :MN0F FINAL BY: CODE: CALAC INVESTMENT - 6,500 3709 S SAN DIEGO, CA9211137 FE PAID WOR DEMO DIVIDING WALL BETWEEN 5701 & 5703; BUILD NEW DIVIDING APPLICANT: TEL. 0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: WALL TO CREATE 2UNITS (5701: 4935SF; 5703: 1441SF) JOHN J GONG (714) 368-9881- AA BLDG PERMIT ISSUANCE 27.75 18071 IRVINE BLVD AC STRONG MOTION RESID 6500.00 VAL 0.65 SPECIAL CONDITIONS: TUSTIN 92780 Al PLANCHECK W/EN-HC 6500.00 VAL 162.46 A2 PERMIT W/ENERGY-HC 6500.00 VAL 191.13 TOTAL FEES 381.99 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SINGPOLI HOP KIN CONSTRUCTION AND (714) 368-9881- DECORATION NEVADA INC LIC. NO LOCATION AND SETBACKS 28071 IRVINE BLVD 761247 B TUSTIN, CA 92780 SOILS ENGINEER APPROVAl- ARCHITECTO ENGINEER: 0: FOUNDATIONUMERElffORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLOOR FRAMING MAP XNO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP04 UNDERFLOOR INSULATION N0. OFF I IES: DWELLING UNITS: APT/CO D: STAT CLASS: FLOOR SHTG NO 22 ROOF S EATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO -I FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LLATH/DRYWALL EXTERIOR LATH RATEDF 00 /CEI SSE . RATED WALL ASSEMBLIES TED SHAFTS/OPENINGS T-BAR CEILINGS LO D-RjMAGE REPORT ID: DPR261 ROUTE TO: BS0508 ��