HomeMy Public PortalAbout5773 ROSEMEAD BLVD_Building__ • ` :;•WORKERS' COMPENSATION DECLARATION lam/° G�GC�ZC
hereby affirm that I have a certificate of consent to self L'I CATION F®R "U I L D I N C PERMIT
insure, or a certificate of Woikers' Compensation Insurance,
or a certified copy thereofo� .c. 3800, La C.) p COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No� m/Copan ' .! BUILDING�
/❑' Certified copy is hereby furnished. FOR APPLICANT TO FILL IN �'`ADDRESS ��/
❑ Certified copy is filed with the county building inspec- f"UL
IDING
tion department. ?,%, DDRESS J
'd? �CJ/�7l f=1
TY �' C ZIP �/ LOCALITY _
P Date Q Applicant -- �� - NO.OF BLDGS. NEAREST
RTIFICATE 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 ($100)or less.) TEL,
n:OWNER NO. ";USE ZONE r
AP
I certify that in the performance of the work for which this O.
permit is issued, I shall not employ any person in any manner ADDRESS �� PECIAL a-so as to become subject to the Workers'Compensation Laws. ONDITIONS O
CITY ZIP
Date Applicant .;ARCHITECT OR TEL.e2t3
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER ST QW5TR. N0 _ 9 DISTRICT GROUP TYPE FIRE PROCESSED BY O
CONST. Z$NE U
Exemption, you should become subject to the Workers' _ 6
Compensation provisions of the Labor Code, you must forth- ADDRESS d0 a-
with comply with such provisions or this f r STATISTICAL CLASSIFICATION APT. CONDO. I N
p y p permit shall be TEL. .�- Z
deemed revoked. CONTRACTOR �� C71 0. -Xq7 ; _
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO121A DWELL. UNITS
'
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS eANO. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business LIC.
and Professions Code,and my license is in full force and effect. CITY f RA AR CLASS BK PG VALIDATION
L�License Number- 1)AD 320 Lic. Class SIE STORIIEA
ES I FMILLIIES ONEK VALUATION
Contractor���; C`lJ11.7 �, Date C DESCRIPTION OF WORK ` NEW ❑ $ �O '�`
❑
El am exempt under Sec. LJ die
ADD Poo
ALTER ❑ '-
BAP.C. for this reason REPAIR ❑ $
Date: USE OF
EXISTING BLDG. DEMOL ❑ '
ICANT
Signatur �/�' -fr d� :' APP(PRINT) NO FINAL
W -BUILDER DECLARATION DATES-1 ,�
I hereby affirm that am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and :ADDRESS FINAL
Professions Code): PRESENT B
❑ I, as owner of the property, or m em to ees with t. BUILDING )I :::' y
P P Y� Y P Y ADDRESS
wages as their sole compensation,will do the work and -�-- -_
the structure is not intended or offered for sale(Section LOCALITY ® i= ,'•-
7044, Business and Professions Code.) MOVING TEL. i
CONTRACTOR NO.
1,as owner of the property,am exclusively contracting _f,.r.- t•
with licensed contractors to construct the project (Sec- I- i ,
tion 7044, Business and Professions Code.) ADDRESS
'.'7= r
REQUIREDTOTAL 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
the performance of the work for which this permit is issued P.L. _
(Sec. 3097, Civ. C.). SIDE
•ti's. .�:�....a � 5'.v
P.L.
Lender's Name
i LDMA Ref.li
P.C. Fee$ , Permit Fee / -IIy;J�3.�lC
Lender's Address -
I certify that I have read this application and state that the Issuance Fee a LDMA P/C tf
i above information is correct. I agree to comply with all County Investigation Fee ¢ ic
I ordinances and State laws relating to building construction, Total Fee 1�76- 6 O LDMq perm. #
and hereby authorize representatives of this County to enter f•. y,_r +� s _Y-
E upon'the above-mentioned property for inspection purposes.
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date
r
WORKERS' COMPENSATION DECLARATION �r/!� `ZJ °" �� t
hereby affirm that I have certificate of consent to self APPLICATION F®R 13 U I L D I N C PERMIT
� sur
� e, or a certificate of Workers' Compensation Insurance,
certified copy thereof(Sec. 3800, Lob. C
.)
i�•`a COUNTY OF LOS ANGELES BUILDING AND SAFETY
Certified co is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
PY Y ADDRESS
❑ Certified copy is filed with the county building inspec- BUILDING ;�,r�c- M :r
tion department. ADDRESS 5171 ' 0Sa- 1 1^ fib,
Date - pplicant_ CITY �V\ & ZIP :r LOCALITY � </
NO.OF BLDGS. F 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.) TEL'/ e�
OWNER l C, 0 NO. 0 USE ZONE MAP
I certify that in the performance of the work for which this _ _ ,^l NO.
permit is issued, I shall not employ any person in any manner ADDRESS �� I ^ 6J1vSPECIAL
�+ CONDITIONS n
so as to become subject to the Workers'Compensation Laws. O
CITY �i E C'C ZIP
Date Applicant ARCHITECT OR TEL. ly
DISTRICT 7GUP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO.
CONST. ZONE ~-
Exemption, you should become subject to the Workers' w
Compensation provisions of the Labor Code, you must forth- ADDRESS ,�� `2 a-
with comply with such provisions or this permit shall be TEL• p I-1'w STATISTICAL CLASSIFICATION APT. CONDO. Z
deemed revoked. CONTRACTOR NO O` 0 oo��/� Z
LICENSED CONTRACTORS DECLARATION LIC. CLASS No._�DWELL. U TS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS -2 sBU NO.
LIC. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business �¢�
and Professions Code,andel my license is in full force and effect. CITY CLASS BK. PG. VALIDATION
`�'�u� Lic. Class SIZE STORIES FAMILLIIES ONE CHECK
License Number k
�j ,r
Contractor C 7-�� Jim'Date `2 VALU/�TION
...
DESCRIP�TIONN�OF WORK NEW /
/.• 4w �C .f1, ADD EJ ,! $
El �•Z�O t� ►
1 am exempt under Sec. 1 I�
'—�c ALTER [Ell
BAP.C. for thi aso n / `��• --kms-� REPAIR ❑ . $
USE OF 1
EXISTING BLDG. cmueeCAS DEMOL ❑ '
--sign APPLICANT `�� TEL.
OWfRBUILDER DEELARATI (PRINT) S 1 NO. FINAL
DATE
Ihereby affirm thaexempt from the ntractor's License ADDRESS
Law for the following reason S'ecfion 7 31.5, Business and FINAL �.
Professions Code): PRESENT By ii..•. .
BUILDING
❑ I, as owner of the pr perty, or my employees with ADDRESS * -
wages as their sole co pensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY
7044, Business and Professions Code.) MOVING TEL.
CONTRACTOR NO. ^' a
I,as owner of the property,am exclusively contracting ':`:• �v
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code.) J7
REQUIRED
�-
REQUIRED TOTAL SETBACK FROM EXIST. _.
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH „'_,'I-
1 hereby affirm that there is a construction lending agency for FRONT _s ter,
the performance of the work for which this permit is issued P.L. = 1.7'G� • `_+
(Sec. 3097, Civ. C.). SIDE .` .�r t`.,t •_.,
P.L.
Lender's Name _ y
8 LDMA Ref.
Lender's Address P.C. Fee$ �. Permit Fee oa• d O_
I•certifythat I have read this application and state that the Issuance Fee j LDMA P/C#
PP I'i': l^_4_'1 R" _;: x `•
above information is correct. I agree to comply with all County Investigation Fee ' .41 ;
Z ordinances and State laws relating to building construction, Total Fee ,.-,a f s LDMA Perm. # - :- ,--
and hereby authorize representatives of this County to enter `• fA�::•L°+-=
upon the above-mentioned property for inspection purposes.
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 TENANT IMPROVEMENT
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0303260050
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS:
ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5773 ROSEMEAD BL
STRUCTURE: 4900 1 VN B TEMP CA 91780
ASSESSOR 0 B NEAREST CROSS STREET: LAS TUNAS
5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
IST B DG USE: COMER USE MET- ISS ED 0 R 7 PROCESSED B RES 0 :
BANK OF EAST ASIA EXIST OCC GRP: B 05/13/03 JK 05/07/04
OWNER: TEL. NO: SLOGS. NOW ON LOT: VALUATION: FINAL DATE FINAL 8 : CODE:
3CAALLAAC INVESTMENT - 247,000 -7-16 - o-3
SAN DIEGO, CA9211137 ----FEE S SC 0 0WORK
TENANT IMPROVEMENT FOR BANK
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL.-NO:
JOHN GONG (714) 368-9881- Al PLANCHECK W/EN-HC 150000.00 VAL 1,582.38
28071 IRVINE BLVD AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS:
TUSTIN 92780 AC STRONG MOTION RESID 247000.00 VAL 24.70
A2 PERMIT W/ENERGY-HC 247000.00 VAL 2,232.68597.85
TOTAL FEES 4,
'
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
r
ARCHITECT OR ENGINEER: E 0: FO DA 0 CH ORMS
LIC. N0: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
P 0: SEE MAP BOO : PAGE: FIRE ZONE: CMP UNDERFLOOR INSULATION
3 04
FLOOR SHEATHING
0. 0 FAMILIES: DWELLING S: APT : S S .
NO 22 ROOF SHEATHING
SCHOOL Wr"IN HAZARDOUS SHEAR PANELS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
i
Trffff 5 H G RS
INSULATION/WEATHER STRIP
- INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED00 C ASSEM.
RATED WALLASSEMBLIES
TED A 0 GS
T-BAR CEILINGS 03
LOT DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
F COUNTY OF LOS ANGELES TEMPLE CITY # 0508 IBUILDI'NG PERMIT-
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS SIGN
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 98_12020008
PHONE: (818) 285-0488 EXT: -- '
EGA ID: N MB R 0 SIGNS: 2 zBU. ING—ADDRESS:
ON FILE SIGN DESCRIPTION: CHANNEL LETTERS - ILLUMINATED 5771 ROSEMEAD BL
TEMP—CA 91780
ASSESSOR IN 0 MA ION NUMBER: NEAREST CROSS STREET:
5397-012-043 THOMAS PAGE: GRID: LOCALITY: WORLDWEAR
TENANT-. E T D BLDG S SS 0 : PROCESSED EXPIRES ON:
� EXIST OCC GRP: 12/02/98 UT 12/02/99
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
3709C INVESTMENT - 5,000 �i��
D
SAN DIEGO, CA9211137 FEES PAID �/jIPT OF WORK
INSTALL 2 SETS ILLUMINATED CHANNEL LETTERS ON WALL SIGNS
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
LORENZO VILLASENOR MARTINEZ (213) 829-2033- AA BLDG PERMIT ISSUANCE 27.75
825 S. MAPLE #2 AE STRONG MOTION OTHER 5000.00 VAL 1.05 SPECIAL CONDITIONS:
MONTEBELLO, CA AX BUILDING RV•I•EW`FEE�� 54.70
62 PERMIT W/ENERGY�d 5w000`00"-VAL 145.86
�yG OTA•fEEES 229.36
CONTRACTOR: TEL. NO: `O� APPROVALS DATE INSPECTOR SIGNATURE
LORENZO VILLASENOR MARTINEZ (213) 829-2033-
825 S. MAPLE LIC. NO LOCATION AND SETBACKS
#2 432339CIO
MONTEBELLO CA 90640 \ SOILS ENGINEER APPROVAL
ARCHITECTOR ENGINEER: TEL. 0: FOUNDATION/TRENCHii FOR S
LIC. N0: — I `w,;� , SUPPORT STRUCTURE
s^Za 17 f7 G:Z,MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP,: � � `�0 �li1
0. OF FAMILI S: D ELLING UNITS: AP CO D: STAT CLASS- 1-
NO
ASS- 1-NO 20 ` I� /
SCHOOL WITHIN R O S �`� i
AIR QUALITY: 1000 FEET MATERIALS 10
NO NO NO
Li
� Service'Ths�
REPORT ID: DPR261 ROUTE TO: 8S0508
COUNTY OF LOS ANGELES TEMPLE CITY 0 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0504250027
PHONE: (626) 285-0488 EXT:
ON FILE CONST ADDRESS:
SQ. FT STORIES TYPE 5773 ROSEMEAD BL
S SSO R 0 STRUCTURE: VN TEMP CA 91780
5397-012-043 NEAREST CROSS STREET: LAS TUNAS
THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, C
TENANT: n-07-K-0-ME: C SS ED 0 : PROCESS D Y: EXPIRES
EXIST OCC GRP: 04/25/05 JK 04/20/06
OWNER: TEL. NO: B DGS. NOW ON LOT: TION: FIN ATE FIA BY: CODE:
TEO, JOE - 4,000
386 VALLEY BLVD.
ALHAMBRA, CA 917801 FEES PAID DESPRI PYON 0
FEE DESCRIPTION: QUANTITY: LION: AMOUNT:
CREATE OPENING FOR ATM, PACKAGE RECEIVE A NIGHT DROP
APPLICANT: TEL. NO:
REGAN (714) 368-9881- AA BLDG PERMIT ISSUANCE 27.75
18071 IRVINE BLVD. AC STRONG NOTION RESID 4000.00 VAL 0.50 SPECIAL-CONDITIONS:
TUSTIN, CA D2 PERMIT W/O EN-HC 4000.00 VAL 115.80
TOTAL FEES 144.05
CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR MGMATUR
SINGPOLI CONSTRUCTION (714) 368-9881-
18071 IRVINE BLVD. LIC. NO LOCATION
TUSTIN, CA 92780 7612478
SOILS ENGINEER APPROVAL
ARCHITECTOR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ONE: CMP:. UNDERFLOOR INSULATION
XX 3 01
FLOOR SHEATHING
O. OF F S: D G S: : STAT CLS :
NO 21 ROOF SHEATHING
SCHOOL HAZARDOUSAIR QUALITY: 1000 FEETTHIN MATERIALS S LS
NO NO NO FRAME- INSPECTION--
REQUIRED TOTALSPRINR R
SET BACK YARD: HUY: PROP LINE: WIDTH:
FRONT PL- INSULATION/WEATHER STRI
SIDE PL-
INTERIOR
I
EXTEPIOR LATH
RATEP FLOOR/CEIL ASSEM.
I
RATED WALL ASSEMBLIES
D S TS 0 N GS
-BAR CEILINGS
LOlf I
DRAINAGE
REPORT ID: DPR261 ROUTE TO: BS0508
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 0305050018
PHONE: (626) 285-0488 EXT:
NUMBERLEGAL ID: SIGNS--. G ADDRESS:
ON FILE SIGN DESCRIPTION: RED CHARACTERS W/ "BEA" 8 "THE BANK 0 5773 ROSEMEAD BL
TEMP CA191780
ASSESSOR N 0 0 NEAREST CROSS STREET: LAS TUNAS
5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
TE E IST-BLX US E i TS-9999-01r-- PROCESSED B EXPIRES 0 :
BANK OF EAST ASIA EXIST OCC GRP: 05/05/0 JK 04/29/04
OWNER: TEL. NO: BLDGS. NO ON OT: VALUATION: FI DAT FINA, CODE:
CALAC INVESTMENT - 10,000
3709
SAN DIEGO, CA9211137 FEES CR rION OF WORK
' ETS NTERALLY ILLUMINATED CHANNEL LETTER SIGNAGE
APPLICANT: TEL. NFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: EA" "THE BANK OF EAST ASIA"
0:
JOHN YU (626) 448-1616- AA BLDG PERMIT ISSUANCE 27.75
9647 E RUSH STREET AC STRONG MOTION RESID 10000.00 VAL 1.00 SPECIAL CONDITIONS:
S EL MONTE 91733 D1 PLANCHECK W/0 EN-HC 10000.00 VAL 184.11
D2 PERMIT W/O EN-HC 10000.00 VAL 216,60
TOTAL FEES, 429.46
CONTRACTOR: TEL. N0: 't'`• _ APPROVALS DATE INSPECTOR SIGNATURE
FIRST SIGN CO. (626) 448-1616-
9647 E. RUSH ST. LIC. NO �+ f �% LOCATION D SETBACKS
SOUTH EL MONTE, CA 91733 B/L27903
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. 0 : DWELLING UNITS: APT/GOND- STAT L SS:
NO 20
SCHOOL WITHIN HAZARDOUS
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO
�tdv pct- 1
* ADDITIONAL DATA ON FILE
REPORT ID: DPR261 ROUTE TO: BS05O8