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Home My Public Portal About5783 ROSEMEAD BLVD_Building__ WORKERS'COMPENSATION DECLARATION hereby affirm that I have'a certificate of consent to selfAPPLICATION ��I® ® "W I L D I N PERMIT ERMIT insure, or a certificate of Workers'Compensation Insurance, or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS k7 3 °sear V'd ❑ . Certified co is filed with the count building inspec- BUILDINGl� h! n PY Y 9 P ADDRESS SE-71 - �S(�j�" �- �� 0�1U� e C1. tion department. -i•' 7 Date Applicant `CITY G' ZIPCph �� LOCALITY OF BLDGS. r NEAREST CERTIFICATE OF EXEMPTION FROM-WORKERS' SIZE OF LOT V DC NOW ON LOT 0 u S^ 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. OWNER NO. USE ZONE MAP I certify that in the performance of the work for which this SPE permit is issued, I shall not employ any person in any manner ADDREsao 1,2 '0!5eo 7?1 I to �Y� L. , CONDITIONS a_ so as to become subject to the Workers'Compensation Laws. O CITY 00 I ZIP Date Applicant. ARCHITECT OR TEL. NOTICE TO APPLICANT: If,. after making this Certificate of ENGINEER W. KO NQ�� DISTRICT GROUP CONST. FIRE E PROCESSED BY Q Exemption,. you should ,become subject to the Workers' t fITYPE .II yl3—s v 86d3 or 0L Compensation provisions,•of,the Labor Code, you must forth- ADDRESS fV Cc. •�/'O _Z V with comply with such provisions or this permit shall be ` rr TE� +- STATISTICAL CLASSIFICATION APT.' CONDO. Z deemed revoked. CONTRACTOR W;�S�r� VC 8 lI NO. — tICENSED CONTRACTORS DECLARATION ��F . �((`am CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �, y ��1 ( NO.' LIC. SEWER MAP .(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and,effect. CITY CLASSBK PG VALIDATION ' SQ. FT. NO. OF NO:OF. CHECK . License Number Uc. Class' SIZE STORIES FAMILIES ONE s-i?.A-1, VALUATION Contractor Date DESCRIPTION OF WORK NEW ❑ p&-0 a. 1LIC i;' C; + :. ADD ❑ ❑I am exempt under Sec. ( I t) ALTER B.BP.C:for this reason REPAIR'❑ $ OECD t,i -- USE OF Date: ,EXISTING BLDG. DEMOL ❑ �1 -;''+ °=l 'i APPLICANT TEL Ff` jRkj Signature Q 22 FINAL 't:.._nL.B.3 _ ss1 OWNER:BUILDER DECLARATION (PRINT). all o NO. -0�7 DATE g- Z/- -" I hereby affirm that I am exempt from the Contractor's License ADDRESS OSe�7 60.c1 Law for the following reason (Section 7031:5, Business and FINAL Professions Code): PRESENT .{' �j B BUILDING I I&mf e Ce C Y ❑ I, as owner of the property, or my employees with ADDRESS ? .+c:w 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.. ®' I, as owner of the property,am exclusively contracting CONTRACTOR NO. :_:.i with licensed contractors to construct the project (Sec- . ADDRESS '• ' tion 7044, Busiriess and Professions Code.) REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 7j12 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. "7' :-�-• (Sec. 3097,'CIV. C.). SIDE P.L: Lender's Name / 7 �^ S ?+ P.C. Fee$ ��'�v Permit Fee' //�•J LDMA Ref. # Lender's Address ,1 7 ► a I certify that I have read this application and state that the ' Issuance Fee �7" / LDMA P/C# 3 above information is correct.I agree to comply with all County .Investigation Fee ordinances and State laws relating to building construction, Total-Fee /• d LDMA Perm. # and hereby authorize representatives of this County to enter upon the above-menfioned'property for inspection purposes. o �. ,3 "'3 Q•� Z SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of �pllwnt or Agent Date WORKERS'COMPENSATION DECLARATION hereby affirm, that I have certificate of consent to self- insure, I CAT I®IV F BUILDING PERMIT insure, or a certificate of Workers' Compensation Insurance, " or a certified copy thereof(Sec. 3800, Lab. C.) COUNTY OF.LOS ANGELES BUILDING AND SAFETY Policy No.U9.7 mpany Iii m f,\ Certified copy is hereby furnished. FOR ;BLOCK T TO FILL IN BUILDING •ADDRESS BUILDING ❑ Certified copy is filed.with the county building inspec- gDDRESS LS IPF�� tion department. V_QStw. „ Date Applicant �'�f CITY n ZIP 13LOQ LOCALITY s ` �1 NO.OF BLDGS. NEAREST f CERTIFICATE OF EXEMPTIO F M WOR ERS' SIZE OF LOT NOW ON LOT CROSS ST. ' COMPENSATION I S RANCE +�.ASSESSOR (This section need not be completed if the permit is for one TRACT ell LOT NO. ;'s'MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) TEL > C OWNER ,3/'/ USE ZONE MAP I certify that.in the performance of the work for which this SPECIAL >- permit is issued, I shall not employ any person in any manner ADDRESS_ / l)Q CONDITIONSCL so as to become subject to the Workers'Compensation Laws. '$i Q CIN /V 91. P ZIP � U Date Applicant ARCHITECT OR TEL. NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED 8Y Q' Exemption, you should become subject to the Workers' Q CONST. ZONE Compensation provisions of the Labor Code, you must forth- ADDRESS _ V a with comply with such provisions or this permit shall be TEL. Z deemed revoked. CONTRACTOR F"IS'4-• �— N0.7 , ) STATISTICAL CLASSIFICATION APT. CONDO. - LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS — LICENSED hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS ! C, NO. (commencing with Section 7000)of Division 3 of the Business 0 LIC. SEWER MAP ' and Professions Code,and my license is in full force and effect. CITY f 9 J CLASS 6—V1 BK VALIDATION SQ. FT." NO. OF NO. OF CHECK License Number � ZA22-9 Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor -Cl!'l7.�t I �✓Ili�bte /.�vZ_ DESCRIPTION OF WORK NEW 11I am exempt under Sec: /�� "��7I � ADD ❑ $ , coo rf .`j01 ALTER ❑ ?°d B.&P.C. for this reason �� REPAIR ❑ . $ Date: USE OF EXISTING BLDG. DEMOL ❑ APPLICANT Si nature - TEL. FINA g 0,W -BUILDER Dg664RATION (PRINT) ��//✓ _ NO. . ' DAL I hereby affirm t6aYLam exempt from the Contractor's License r ADDRESS Law for the following reason (Section 7031.5,•Business and AFINAL Professions Code): j PRESENT By ❑ 'I, as owner of the property, or m' employees with BUILDING ;=; P P Y� Y ' ADDRESS 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. ❑ I, as owner of the property,am exclusively contracting rADDRE CTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code:) .-,,.... ED TOTAL SETBACK FROM EXIST. w% 01••' CONSTRUCTION LENDING AGENCY CK YARD HWY PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for ;C the performance of the work for which this permit is issued (Sec. 3097, Civ. C.). �(a __� 'Lender's Namelei-Y LDMA Ref.#$ . e PermitFee17 Lender's Address 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 tion Fee ,E':; —�i:(�I �• Y� ordinances and State laws relating to building construction; Total Fee A 3 LDMA Perm. # -- -- ( and hereby authorize representatives of this County to enter upon habove n' ned property for.inspection purposes. / 7 SEE REVERSE FOR EXPLANATORY LANGUAGE t Signe re oficant or Agent Date ' + •~ 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 9703040115 PHONE: (818) 285-0488 EXT: LEGAL I : NUMBER OF SIGNS: 0 BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: ONE CHANNEL LETTER ILLUMINATED SIGN 5783 ROSEMEAD BL TEMP CA 91780 ASSESSOR N 0 NEAREST CROSS STREET: 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY TENANT: ST G USE: ISSUED 0 PROCESSED BY: XPIR S 0 : FANTASTIC SAM'S EXIST OCC GRP: 03/04/97 TC 03/04/98 OWNER: TEL. NO: BLOGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY CODE: CALAC INVESTMENT - 2,500 3709 SAN DIEGO, CA9211137 S A DDESCRIPTION OF OR � ONE CHANNEL LETTER ILLUMINATED SIGN FEE DESCRIPTION: I QG NT Tcq:�,U�9� � AMOUNT: RITE APPLILITE:SIGNS (818) 767-2059- AA BLDG PERMIT ISSUAISGE �� 27.75 AC STRONG MOTION RESIds2500:00'-- �p`:h0 SPECIAL CONDITIONS: D2 PERMIT W/0 EN H(4 �X2500-00-VAL \�99415, FEES II \1`2,7:40 CONTRACTOR: TEL. N0: f/ "; !1 �/ \ r6 APPROVALS DATE INSPECTOR SIGNATURE RITE LITE SIGNS (818) 767-2059- `1- / �r-:�Vii' q `\ 11116 TUXFORD LIC. NO f _� _� cl n .2 10CATION D SETBACKS SUN VALLEY, CA 91352 577974C45 - �- - �� -r ^ 1 0--1 1 s n c SOILS ENGINEER APPROVAL ARCHITECTER: O: � �� ;f�y1l/ FO CH FORMS LIC. N0: ` - I SUPPORT STRUCTURE ilk t MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CR- p-00 0. OF FAMILIES: DWELLING I S: APT/CO : STAT CLASS: �\ ' NO 20 �® SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NOZi REPORT ID: DPR261 ROUTE TO: BS0508 COUNTY OF LOS ANGELES TEMPLE CI•.Y # 050b BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS - TENANT IMPROVEMENT BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9702180042 PHONE: (818) 285-0488 EXT: LEGAL D: NO. OF CONST NEW RUILDING ADD SS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5783 ROSEMEAD SL STRUCTURE: 0 1 V B TEMP CA 91780 ASSESSOR NFO AT ON N NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE/py TENANT: 'ER-1-ST-B-059—USE: COMM USE ZONE: Ts—s-0—EF—M.— PROCESSED BY: EXPIRES ON: FANTASTIC SAM'S EXIST OCC GRP: B 02/19/97 TC 02/19/98 OWNER: TEL. NO: 9LDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: C 3709l C INVESTMENT - 14,000 _1/� _' SAN DIEGO, CA9211137 FEES PAID SCR PT ON UF WO ^^ , 41 TENANT INPROVEMENT FOR BEAUTY SALON FEE DESCRIPTION: %Q' NTI9,Y-_agg0:, // AMOUNT: PPL 0: l p 9 ) -, _ . `._�r� JIM WALTERS CONS. (714) 993-1274- ABLDG ES -/` ` -� �� 27-75 AEE STRONG NOTION 'OTHER 14000.00 VAL 2:94 SPECIAL CONDITIONS: AX BUILDING REVIM FEE 54.7,0 D2 PERMIT W/O EN-HC . - 14000.00 VAL 285.60 TOTAL FEES 3;70.99•' CONTRACTOR: TEL. NO: .APPROVALS DATE INSPECTOR SIGNATURE JIM WALTERS CONSTRUCTION (714) 993-1274- 4681 TORIDA WAY LIC. NO :-4; ' ' LCAT ON AND SETBAC S YORBA LINDA, CA 92688 554219 B SOILS ENGINEER APPROVAL ARCHITECT 0 NGINEER: TEL. NO: `= FO DA ION/ RE CH FORMS LIC. NO: __ _ SLAB/UNDER FLOOR + RAISED FLOOR FRAMING AP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 04NO ` '00 SHEATHING . 0 ES: DWELLING S: CO TOM: y..•' t,'•'. amiss `!y NO 22 �,�' = � `-- -�' <, ROOF SHEATHING SCHOOL WITM AIR QUALITY: 1000 FEET MATERIALS S R PANELS NO NO NO __;� FRAME INSPECTION FRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LA DR WALL Z Z7 EXTERIOR LATH RATED FLOOR CEIL ASS M. RATED WALL ASSEMBLIES RATEDSHAFTS OP N S T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: 990508 7 COUNTY OF IAS 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 1202210047 PHONE: (626) 285-0488 EXT: 1 LEGAL ID: INUMBER OF SIGNS: 1 BUILDING ADDRESS:ON FILE ISIGN DESCRIPTION: ILLUMINATED WALL SIGN 5783 ROSEMEAD BL TEMP CA 91780 [ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: 15397-012-043 I 1 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, CI TENANT: EXIST BLDG USE: [ISSUED ON: PROCESSED BY: ISANRIO TEMPLE CITY 1EXIST OCC GRP: 102/21/12 SR OWNER: TEL. NO: IBLDGS. NOW ON IAT: VALUATION: IFINAL DATE FINAL BY: CODE: ILEW, SUSAN - 3,800 13709 1 ISAN DIEGO, CA9211137 FEES PAID INSCRIPTION OF WORK 11LLUMINATED WALL SIGN I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:[ APPLICANT: TEL. NO: I I IMOCAL SIGNS (310) 941-2017- IAA BLDG PERMIT ISSUANCE 27.80 1 IAB STATE GREEN BLDG FEE 3800.00 VAL 1.00 SPECIAL CONDITIONS: 1AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/O EN-HC 3800.00 VAL 116.00 TOTAL FEES 199.50 I CONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE IMOCAL SIGNS (310) 941-2017- 1 I 1432 W. 166TH STREET LIC. NO ILOCATION AND SETBACKS GARDENA, CA 90247 910859 C45 ]SOILS ENGINEER APPROVAL ]ARCHITECT OR ENGINEER: TEL. NO: - 1 ]FOUNDATION/TRENCH FORMS I I I 1 LIC. NO: 1 ISUPPORT STRUCTURE I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:l 1 I I I 001 I I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I I NO 20 I I I I I SCHOOL WITHIN HAZARDOUS LAIR QUALITY: 1000 FEET MATERIALS NO NO NO �PD �'R E'U"' 1 1 I 1 1 1 1 1 ! 1 1 1 1 1 1 1 1 1 1 1 !REPORT ID: DPR261 ROUTE TO: BS0508 I I I 1 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 0904060008 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE 5783 5785 ROSEMEAD BL ISTRUCTURE: V-B TEMP CA 91780 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: 15397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl [TENANT: 1EXIST BLDG USE: COMME USE ZONE: C-2 JISSUED ON: PROCESSED BY: [TEMPLE CITY MARKETPLACE [EXIST OCC GRP: 104/06/09 SR 1 OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: IFII4AL DATEFINAL CODE: PROPERTY MANAGEMENT - 3,500 5783 ROSEMEAD BLVD. TEMPLE CITY CA 91780 FEES PAID IDESCRtPTIOj OF WORK 14 REPLACE WINDOW 2 STUDS IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: I APPLICANT: TEL. NO: I I I BEN TOMLIN (818) 341-6500- IAA BLDG PERMIT ISSUANCE 27.75 I I 19233 ETON AVE. IAB STATE GREEN BLDG FEE 3500.00 VAL 1.00 ISPECIAL CONDITIONS: ICHATSWORTH CA 91311 IAE STRONG MOTION OTHER 3500.00 VAL 0.74 ID2 PERMIT W/O EN-HC 3500.00 VAL 115.80 TOTAL FEES 145.29 I CONTRACTOR: TEL. NO: [APPROVALS DATE INSPECTOR SIGNATURE IKAPING CONSTRUCTION (818) 341-6500- I [9223 ETON ST. LIC. NO [LOCATION AND SETBACKS CHATSWORTH CA 91311 450320 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: IFOUNDATION/TRENCH FORMS I I 1 LIC. NO: [ [SLAB/UNDER FLOOR 1 I [ [RAISED FLOOR FRAMING [ [ [ MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ JUNDERFLOOR INSULATION I I I150H265 3 001 I I I I IFLOOR SHEATHING IND. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I [ ROOF SHEATHING NO 22 �R� C��L1C��`� SCHOOL WITHIN HAZARDOUS ISHEAP PANELS [AIR QUALITY: 1000 FEET MATERIALS I_ NO NO NO (FRAME INSPECTIOP -t-Pl' I/r REQUIRED TOTAL SETBACK FROM EXIST IFIRE SPRINKLER HANGERS ISET BACK YARD: HWY: PROP LINE: WIDTH: I [FRONT PL- [INSULATION/WEATHER STRIP I I SIDE PL- I [INTERIOR LATH/DRYWALL /a'0�j �1 EXTERIOR LATH II [RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES [ [ [RATED SHAFTS/OPENINGS [ IT-BAR CEILINGS ILOT DRAINAGE IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I I I I I I I