The URL can be used to link to this page

Home My Public Portal About5727 ROSEMEAD BLVD_Building__ .WORKERS' COMPENSATION DECLARATION /� 'G vu•`-� /�"�I�'G"o— hereby affirm that I'havecertificate of consent to self APPLICATION. FOR BUILDING, P E RM I T insure, or a certificate of Workers' p kers' Com ensation Insurance, ' or a certified copy thereoarmlociny ec. 3800, L�ab.�� I �� COUNTY OF LOS-ANGELES BUILDING AND SAFETY �Polis . 3 i Certified copy is hereby furnished. . FOR APPLICANT TO FILL IN BUILDING I ADDRESS • &-;7a 7 ❑ -Certified copy-is filed with the countybuildinginspec- BUILDING ! ^, - tion department. P ADDRESSJ 29Z CP l'L`7 zI l Z` 1 CITY C,►V,P L'V 6 !N zIP � LOCALITY _ G. ee Date Applicant NO. OF BLDGS. '• NEAREST CERTIFICATE'OF'EXEMPTION FROM WORKERS' SIZE OP 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 I PARCEL hundred dollars ($100)'6r less.) - TEL. OWNER i•`•t ; f��(,l NO. j 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 SPECIAL CONDITIONS so as to beco 'e subject to the Workers' ompe s ion L S. O CITY ZIP U Date + Applicant ARCHITECT OR TEL. DISTRICT GROUP'TYPE FIRE PROCESSED BY Q NOTICE, PPLICANT: 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- ADDRESS / LU "Q_i/C %A1 ed's�d -oC+ 1� �''iG✓�' "s deemedwith mevokedh such,.provisions or this permit shall be CONTRACTOR� VG r/I`! s NO`xf 3/jT,b 7� STATISTICAL CLASSIFICATION ,�:APT. CONDO. Z LICENSED CONTRACTORS DECLARATION q LL LIC. �> �J�r CLASS NO. DWELL. UNITS — I hereby affirm that.1 am licensed under provisions of Chapter 9 ADDRESS • & // NO. 7• 0 / 71 (commencing with Section 7000)of Division 3 of the Business CITY w .l ' �^+ LIC' G.� SEWER MAP and Professions Code,and my license is in full force and effect. rn CL. BK. PG. VALIDATIQN SQ. FT. NO.OF NO.OF CHECK • _:,•_ SIZE STORIES FAMILIES ONE License IV`u/m7/bei ,o Lic. Class VALUATION Contractor�� / Date DESCRIPTION OF WORK NEW ❑ $ 5(J 5 r9 0 4° ADD ❑ I am.ex'. t under Sec. ► CHANGE- El • (s+'. P ALTER 0 1 :B.&P.C. for this reason REPAIR $ Date: USE OF _ EXISTING BLDG. DEMOL 0 +_€,I_i;-Ijl-IJ Signature APPLICANT TEL. I �j -• gam"--✓ (PRINT) NO. FINAL ?, _�!/ - @ i izl b utl.: OWNER-BUILDER DECLARATION DATE .[ I hereby affirm that I am exempt from the Contractor's License - Low for the following reason .(Section 7031.5, Business and ADDRESS FINAL Professions.Code):. PRESENT B - BUILDING y EJ 1, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the'work and j the structure is not intended or offered for sale(Section LOCALITY Poo Ci•, 7044, Business and Professions.Code.) MOVING TEL. i i j.s I.:- 1,-as :I,-as owner of the property,am exclusively contracting CONTRACTOR NO. with licensed..contractorsto construct the project (Sec-. ADDRESS. - tion 7044, Business and Professions Code.) +:;�;!_W REQUIRED TOTAL SETBACK FROM EXIST, ° CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH -1- 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 , Lender's'Nome - s o LDMA Ref.# t. Ali ao tic" 1 Li• � P.C. Fee$ [1C1.` / Permit Fee � �0 '- Lender's Address �-- a 1 certify that I have read this application and state that the Issuance Fee 7�7 LDMA P/C# G above information is correct. I agree to comply with all County Investigation'Fee 8 ordinances and State laws relating to building construction,, Total Fee /` /` .::rLDMA Perm. # and hereby authorize representatives of this County to enter' upon the above-mentioned property for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date ' I WORKERS'COMPEN44TION DECLARATIONI here ' insure, or affcertif tate of Wo ke s''Compensat on consent to APPLICATION FOR BUILDING PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company El certified Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ❑ Certified copy is filed with the county building inspec- BUILDING - O� C tion department. ADDRESS !/ CITY •S ZIP LOCALITY Date Applicant •f NO. OF BLDGS. 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 undyed dollars ($100)or less.) TEL. USE.Z E MAP OWNER G.L D X NO. NO. I certify that in the performance of th or for which this is SPECIAL permit is issue , I sh II not employ any rso in any mann r ADDRESS d �/ a CONDITIONS O so as to beco esu lett tot Wo rs am a ation Law . U ' CITY ZIP U Date plicant ARCHITECT'OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLI T: If,. afte aking this tificat ENGINEER NO. Exemption, you should become ubject to th Wor er - — NST. U Compensation provisions of the Labor Code, you must rt ADDRESS GW with comply with such provisions or this-permit shal a to TEL. _ STATISTICAL CLASSIFICATION APT. CONDO. N C� NO. Z deemed revoked. CONTRACTOR LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. �q DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS (� No. SEWER MAP (commencing with Section 7000)of Division 3 of the Business LIC. / and ProfessioWddcense is in full force and eff t. CITY '�'l L CLASS G- BK PG VALIDATION \lSQ. FT. NO. OF NO.OF CHECK Lice NumLic. Class SIZE STORIES FAMILIES ONEVALUATION Cont tDateDESCRIPTION OF WORK In NEW ❑ 6❑I am eADD ❑ ► • ALTER ❑ B.&P. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. EMOL ❑ Signature APPLICANT TMI. FINAL OWNER-BUILDER DECLARATION (PRINT) U NO.' 929/41DATE �� r Z I hereby affirm that I am exempt from the Contractor's License J tl g �� Law for'the following reason (Section 7031.5, Business and ADDRESS FINAL e <::� ❑ Professions Code): PRESENT By a:•-•-r BUILDING I, as owner of the property, or my employees with ADDRESS wages as their sole compensation,will do the work and v )j r' '•,;`tip ' the structure is not intended or offered for sale(Section LOCALITY 7044, Business and Professions Code.) MOVING' TEL. ❑ I,as owner of the property,am exclusive) contracting CONTRACTOR NO. P P Y: Y 9ACCT with licensed contractors to construct the project (Sec- ' ADDRESS -•�-. tion 7044, Business and Professions Code.) ,:;ti�Ll� �.C= REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a-construction lending agency for FRONT. _ L the performance of the work for which this permit is issued P,L. ,,. ..T•, (Sec. 3097, Civ. C.). SIDE j''•I;-IL `Y m =� P.L. vl4:r Lender's Name ' �>=;ala' .i=;'o•.:!u B LDMA Ref. # r• .}::t-� Lender's Address PC. Fee$ �l� Permit Fee •O FiA.i G)E f l ?� I certifyA at I•have.read this-application and state that the Issuance Fee v�/ 7� LDMA P/C# Poo W i is correct. I agree to comply with al l County Investigation Fee State laws relatin to buildin construction, `'''�'9 9 Total Fee �o LDMA Perm. #t oriz representatives this Coun •to a ter LI[::' ;i, :i e men i ned property f r inspection purp ses• o fj I SEE REVERSE FOR EXPLANATORY LANGUAGE gnatu of plic nt or Agent Date 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 0101110017 PHONE: (626) 285-0488 EXT: LEGAL ID: . OF CONST E1 BUILDING A SS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5727 ROSEMEAD BL STRUCTURE: 0 1 VN A3 TEMP CA 91780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: 4 GRID: LOCALITY: TEMPLE CITY TENANT: E IST BLDG SE: COMME USE ZONE: - SUED O : PROCESSED BY: EXPIRES ON: EXIST OCC GRP: B 03/15/01 UT 09/11/01 OWNER: TEL. NO: BLDGS. NOW ON OT: VALUATION: HESTrON TE FI 8Y: CODE: 3AALOAAC INVESTMENT - 1 8,500SAN DIEGO, CA9211137 FE S PAID OF WORK EXPAND EXISTING RESTAURAd TO NEX7UT WITH STORAGE APPLICANT: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: WINSTON CONSTRUCTION - Al PLANCHECK W/EN-HC 8500.00 VAL 195.30 AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: AE STRONG MO.T.•ION OTHER: :-8500.00 VAL 1.79 A2 PERMI9..-;N%ENERGY,HC* ; ? 8500:OO�VAL 229.77 — {='•'- =TOTAL,;F.EES.+�„ 454.61 CONTRACTOR: TEL. NO: "Oro" �- � •4�: APPROVALS DATE INSPECTOR SIGNATURE WINSTON CONSTRUCTION (909) 483-0707- •°/" 2011 GREENWOOD LANE LIC. NO LOCATION D SETBACKS POMONA, CA 91766 576739 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. N0: r', li 1 FOUNDATION/TRENCH FOR S LIC. N0: ;/ SLAB/UNDER FLOOR RAI S FLOOR -FRAMING AP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 15OH265 3 04 UNDERFLOOR INSULATIO TCOOT STUTHING NO. OF FA IES: G UNITS: T ON : STAT CLASS: NO 22 ',�, ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PA S AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION ��,''.�:;•, f { ,;:., s. FIRE SPRINKLER G RS s: `'c"_�� ;•_; 4�f INSULATION/WEATHER STRIP INTERIOR AT /DR A fl _ EXTERIOR LAT RATED FLooR7CEIF—ASSEM. RATED WALL ASSEMBLIES RATED S A S/0 I GS T-BAR CEILINGS OT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT 10. , DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0101170005 PHONE: (626) 285-0488 EXT: LEGAL D: NUMBER OF SIGNS: BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: ILLUMINATED CHANNEL SIGN 5727 ROSEMEAD BL TEMP CA 91780 ASSESSOR N OR N UMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: EXIST B G USE: ISS E ON: PROCESSED BY: EXPIRES N: EXIST OCC GRP: 01/17/01 UT 07/16/01 OWNER: TEL. N0: SLOGS. NOW ON LOT: VALUATION: FINAL DATE FI BY: CODE: CALAC INVESTMENT - 1,000p 3709 SAN DIEGO, CA9211137 FEES PAID DESCRIPTION OF WORK ILLUMINATED CHANNEL LETTER SIGN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. NO: HUNGSBSANEL AIGABRISPECIAL SIGNS AA BLDG PERMIT ISSUANCE 27.75 126 AE STRONG MOTION OTHER 1000.00 VAL 0.50 SPECIAL CONDITIONS: SAN GABRIEL AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/0 EN-HC 1000.00 VAL 65.40 p G TOTAL FEES 148.35 HUNG CONTRSAO DIEP rr�J"�/o��(626,%-28e-*%4- APPROVALS DATE INSPECTOR SIGNATURE DBA SPECIAL SIGNS LIC. NO LOCATION AND SETBACKS 126 S. SAN GABRIEL BLVD. 783838 C45 SAN GABRIEL CA 91776 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 NITS: AP COND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508