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Home My Public Portal About5739 ROSEMEAD BLVD_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRESS �D 1 hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified CIT �V ZIP 4-439 copy thereof(Sec.3800,Lab.C.) LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. OSS TM department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNER t ��L� EL No. COMPENSATION INSURANCE G A L 3 —00 WITHIN 1000 FT.OF SCHOOL? Yes No This section need not be completed if the permit is for one hundred ADDRE L ( P P n w +� 5 T DISTRICT G UP TYPE CONST, FIRE ZONE PROCESSED BY dollars($100)or less.) vv vv IIII��1 1 CITY � ZIP " I :roil certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL No. become33sub1'ect to the Workers'Compe ation Laws. STATISTICAL CLASSIFI TION APT CONDO Date J w plicant ADDRESS CLASS NO. DWELL UNITS AC Tog p� NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SE3$kK FROM EXI a 7•J Exemption, you should become subject to the Workers' CONTRACTOR / /� TEL O..r� SET BACK YARD HWY P -[[ E WIDTH Compensation provisions of the Labor Code, you must forthwith r ihNl( A e ip ' �DOO FRONT 17 comply with such provisions or this permit shall be deemed revoked. ADDRESS �v ' 1 LIC o�/ PL - ate LICENSED CONTRACTORS DECLARATION W 7 G SIDE CITY L� UC.CLAS � PL CC I hereby affirm that I am licensed underprovisions of Chapter 9 (� SEWER MAP 5 (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO,OF FAMILIES I Professions Code,and.my licen e i In full force and effect. NEW ❑ BK PG CHANGE �� n N3`72k)2k) DESCRIPTION OF WORK ADD ❑ VALUATION ® C License Number^ Lic.Class ` � ( I�� d� Contractor -�( >��IG�Date C• ALTER ❑ 0000-0001 3/18/93 C ❑ I am exempt under Sec. v :2 C REPAIR ❑ EINA °7�i� 1 A{111�� CF', B.BP.C.for this reason DEMOL ❑ C# C Date: 3 USE OF EXISTING BLDG. URM ❑ .13 V Signature APPLICANT(PRINT) TEL NO. m# L ❑ 1, as owner of the property, or my employees with wages as Z ACCT o 4 their sole compensation, will do the work and the structure is ADDRESS 0 33177 93.66 not intended or offered for sale (Section 7044, Business and TE G Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL 1 ITEMS OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J ❑ 1, as owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? 0 53. 66 licensed contractors to construct the project (Section 7044, YES 11 NO❑ TOTAL Business and Professions Code.) J� 53.66 WILL THE INTENDED USE MI THE BUIN TG TI THE APPLICANT OR FUTURE BIfLDITH CASH OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR OUAUTY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKUST FOR GUIDEUNES. CHANGE .00 I hereby affirm that there is a construction lending agency for YES❑ NO❑ cu the performance Of the Work for Which this permit Is Issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING a 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, ((''��{{''��{{99((''�� ((''�� 'yy ��yy TITLE 2,CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20.140 CONCERNING HAZARDOUS t,r{;00-0001 3/18/7J Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lender's Address S7b1 1 AI�11" � OWNER OR AGENT eI certify that I have read this application and state under penalty G of perjury that the above information is correct.I agree to comply P.C.FEE � , j PERMIT FEE N with all county ordinances and State laws relating to building (tea mconstruction, and hereby authorize representatives of this County ISSUANCE FEE Ar. co to nter upon the above-mentioned property for inspection purposes. m INVESTIGATION FEE TOTAL FEE A Sql W of APWl a Aqt<t D:.o SEE REVERSE FOR EXPLANATORY LANGUAGE • APPLICATIC,N.F®R UILQING PERMIT COUNTY OF LOS ANGELES B(JIL ING AND SAFETY -�' WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING ADDRe�S I hereby affirm fhat I have a certificate of consent to self insure, "BUILDIG or a certificate of Workers'Compensation Insurance,or a certifiedcopy thereof(Sec.3800,Lab.C.) ZIP 7R R LOCALITY Policy No. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROSS S ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL �-0� o / /I/ e SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' OWNE TEL NO. COMPENSATION INSURANCE e�tt" WITHIN 1000 FT OF SCHOOL? YES NO (This section need not be completed if the permit is for one hundred ADDRESS� er ��^"v DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) CIT ZIP I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any ann as to Q become s b' to the Workers'C m en a ARCHITECT ENGINEER TEL NO. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. dadw? UNITS NOTICE TO APPLICANT If, after ing is Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become ubject t0 the Workers' CON TEL NO. �i SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith / �� FRONT comply with such provisions or this permit shall be deemed revoked. ADD SS LIC.NO PL LICENSED CONTRACTORS DECLARATION 3 ?:.f- 2 z SIDE CITY LIC.CLASS / PL I hereby affirm that I am licensed underprovisions of Chapter 9 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIES Professions Code,an my license is in full force and f t. NEW •fIA BK PG ® a License Number . .Class DESCRIPTION OF WORK ADD ❑ VALy1nIO o.�/�j C Contractor ate `� j ALTER ❑ � ////,, D ❑ I am exempt under Sec. / REPAIR ❑ $ F B.BP.C.for this reason DEMOL ❑ LDMA P/C# Date: USE OF E06TING BLDG. URM ❑ U Signature APPLICANT(PRINT) TEL NO. LDMA Perm# 4-F ❑ I, as owner of the property, or my employees with wages as ZO their sole compensation, will do the work and the structure is ADDRESS = not intended or offered for sale (Section 7044, Business and FINAL DATE Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J ❑ 1, as Owner of the property, am exclusively contracting with AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? ^• FINAL BY 0 licensed contractors to construct the project (Section 7044, r:CCI°� Business and Professions Code.) ves❑ NO❑ WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING f 3707 14't. 2 OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COOIDE AIR L QUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR 2 ITEMS EMS I hereby affirm that there is a construction lending agency for YES[I NO ❑ t CD the performance of the work for which this permit is issued(Sec. TOTAL -193. 47 I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD PERMITTING 3097,CIV.C.) CHECKLIST I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, +1H�J '0 cliTITLE 2 CHAPTER 2 20 SECTIONS 2 20 100 THROUGH 2 20.140 CONCERNING HAZARDOUS CHECK L7 3.47 Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. 0 Lender's Address CHANGE °VI] K OWNER OR ENT O o I certify that I have read this application and state under penalty 0 of perjury that the above information is Correct.I agree to comply P.C.FEE PERMIT FEE J cm with all county ordinances and State laws relating to building / IlCID�t— I�I)-I 'sr # =' construction, and hereby authorize representatives of this County ISSUANCE FEE G ,�� . AM W to enter upon the above-mentioned property for inspection purposes. ''`` ''p 1 1�° 'I] m INVESTIGATION FEE TOTAL FEE /J / � saRmm of Mo'cm«npem 0:o SEE REVERSE FOR EXPLANATORY LANGUAGE COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUI-L"DTWd PERM_LT.i J DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS S-IaN� =- BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA ;.BL-7508-9809340023 PHONE: (818) 285-0488 EXT: LEGA ID: NUMBER OF SIGNS: BUILDING ADDRESS:- ON DDR SS:-ON FILE SIGN DESCRIPTION: INSTALL 18" PAN CHAN LETERS "5739-RtSEMFAD BL '.;,TEMP CA 91780 ASSESSOR INFORMATION BER: LNEAR-ES-F--eROSS-S•TREET•:, 5397-012-043 THOMAS PAGE: --GRI.D: LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: SS ED 0 : PROCESSED BY: EXPIRES N: CHECK IN GO EXIST OCC GRP: 09/11/98 UT 09/11/99 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINALBY ODE: CALAC INVESTMENT - 1,500 3709 SAN DIEGO, CA9211137 FEES PAID ESCRIPT 0 0 WORK- --l-NST-A!-.-L-1811--PAN-CHANNEL S I --PAN-CHANNEL"LETTERLLUMINATED) _ FEE DESCRIPTION: QUANTITY: UOM: - AMOUNT-:--T APPLICANT: TE O• QUIEL BROS SIGN. (909) 885-4476- AA BLDG PERMIT ISSUANCE 27.75 272 S. "I" AE STRONG MOTION OT,►ER�1500.00 VAL 0.50 SPECIAL CONDITIONS: SAN BERNARDINO, CA AX BUILDING RE�V,I•ECI'FE�—�. 54.70 D2 PERMIT W'O EN "�SGIELE�� 1�5OTA-iF,EE 165.15 00:,,00a L 82.20 CONTRACTOR: TEL. NO: 0� APPROVALS DATE INSPECTOR SIGNATURE QUIEL BROS ELECTRIC SIGN SER. (909) 885-4476- V 272 S. "I" LIC. NO LOCATION AND SETBACKS SAN BERNARDINO, CA 92710 217345 SOILS ENGINEER APPROVAL ARCHITECT OR GINEER: TEL. NO: FOTAT ON/ C S E FOR LIC. NO: 1111111 SUPPORT STRUCTURE (J � --lK3 MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMG IP OWC � O ID 0. OF FAMILIES: DWELLING UNITS: APT CO D: STAT C ASS- NO 20 J p r:, 7 SCHOOL I HAZARDOUS AIR QNLITY: 10NO FEET NO O Q Ilih1®y �b��c �ervice'Yha� o< REPORT ID: DPR261 ROUTE TO: BS0508 r 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 0804100015 PHONE: (626) 285-0488 EXT: [LEG ID: NO. OF CONST NEW BUILDING ADDRESS: ON SQ. FT STORIES TYPE OCCUP GROUP 5739 ROSEMEAD BL ISTRUCTURE: 1122 1 V-B M I TEMP CA 91780 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: LAS TUNAS 15397-012-043 I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl 1 TENANT: EXIST BLDG USE: COMMS USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON:(EXIST OCC GRP: B 105/15/08 SR 11/11/08 OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: �FI DATE FINAL BY: CODE: 1CALAC INVESTMENT (858) 565-8333- 1 38,000 1 � 3709 � �_/ ISAN DIEGO, CA9211137 FEES PAID ID SCRIPTION OF WORK ITENANT IMPROVEMENT MEDICAL OFFICE 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ (APPLICANT: TEL. NO: I I [PHAN (626) 279-7390- 1A1 PLANCHECK W/EN-HC 38000.00 VAL 626.66 I 1 110838 WEAVER AVE #6 IAA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS: 1 IS EL MONTE CA 91733 AE STRONG MOTION OTHER 38000.00 VAL 7.98 1 1 I 1A2 PERMIT W/ENERGY-HC 38000.00 VAL 737.27 I 1 TOTAL FEES 1,399.66 I 1 ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE IKIM WONG PLUMBING, INC. (626) 286-6080- 1 1 1 11300 E LAS TUNAS DR LIC. NO 1 ILOCATION AND SETBACKS ISAN GABRIEL CA 91776 752619BC36 1 I I I 1 1 ISOILS ENGINEER APPROVAL 1 I [ARCHITECT OR ENGINEER: TEL. NO: [ [FOUNDATION/TRENCH FORMS I I I LIC. NO: I ISLAB/UNDER FLOOR [ I [ I 1 I 1 i RAISED FLOOR FRAMING I 1 1 IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ [UNDERFLOOR INSULATION I I I 1 3 041 [FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: AP1 I IT/COND: STAT CLASS: I I I I I 1 NO 22 1 [ROOF SHEATHING I 1 I SCHOOL WITHIN HAZARDOUS1 ISHEAR PANELS I I I (AIR QUALITY: 1000 FEET MATERIALS I 1 1 1 1 NO NO NO 1 [FRAME INSPECTION I 1 r 1 I IFIRE SPRINKLER HANGERS I I I 1 [INSULATION/WEATHER STRIP( 1 1 I I INTERIOR LATH/DRYWALL I I 1 I 1EXTERIOR LATH 1 1Vi 1 [ I IRATED FLOOR/CEIL ASSEM. I [ I [RATED WALL ASSEMBLIES I [ I I 1 i [RATED SHAFTS/OPENINGS I I I 1 1 1T-BAR CEILINGS �1 I I ILOT DRAINAGE 1 [ [ 1 [REPORT ID: DPR261 ROUTE TO: BS0508 I I 1 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 0803310025 PHONE: (626) 285-0488 EXT: ILEGAL ID: (NUMBER OF SIGNS: 1 I BUILDING ADDRESS: I ON FILE ISIGN DESCRIPTION: ILLUMINATED CHANNEL LETTER ] 5739 ROSEMEAD BL I TEMP CA 91780 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 15397-012-043 I I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl (TENANT: 1EXIST BLDG USE: 1ISSUED ON: PROCESSED BY: EXPIRES ON: 1 IMEDICAL CLINIC ]EXIST OCC GRP: 103/31/08 SR 09/27/08 I 1OWNER: TEL. NO: ISLDGS. NOW ON LOT: VALUATION: IFINALjDAATTEE FIN Y: CODE: INVESTMENT - 1 z,soo 33709 ISAN DIEGO, CA9211137 1 FEES PAID IDESCRIPTION OF WORK I I I IILLDMINATED CHANNEL LETTERS 1 1 IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT-1 1 1APPLICANT: TEL. NO: I I 1 1J & H SIGN, INC. (626) 448-1166- 1AA BLDG PERMIT ISSUANCE 27.75 1 1 19441 VALLEY BLVD. 1AX BUILDING REVIEW FEE 54.70 ISPECIAL CONDITIONS: 1 1 ROSEMEAD, CA 91770 ID2 PERMIT W/O EN-HC 2500.00 VAL 99.00 1 ] 1 TOTAL FEES 181.45 1 1 ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 IJ AND H SIGN, INC. (626) 448-1166- 1 1 1 19441 VALLEY BLVD. LIC. NO I ILOCATION AND SETBACKS I I I IROSEMEAD, CA 91770 873439 C45 1 I 1 1 I I I ISOILS ENGINEER APPROVAL 1 1 I (ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I I LIC. NO: 1 ISUPPORT STRUCTURE I I I I I I I I ] I I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP001 ] I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 20 1 SCHOOL WITHIN HAZARDOUS I 1 1 I 1 1AIR QUALITY: 1000 FEET MATERIALS 1 1 1 1 1 1 NO NO NO 1 1 1 ] 1 1 I I I 1 I 1 1 I I I I 1 I I I I I I I I I I 1 IREPORT ID: DPR261 ROUTE TO: BS0508 1 1 1 1 I I I I I I