HomeMy Public PortalAbout5797 ROSEMEAD BLVD_Building__ .-'WORKERS' COMPENSATION DECLARATION ,1 `� �� L�r�
. isure, o Arm that I have r certificate of consent to selfAPPLICATION FOR f�U I L D I N G PERMIT .
insure, or a certificate of Workers' Compensation Insurance,
or a certified copy thereof(Sec. 3800,'Lob. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. Company BUILDING
❑ Certified copy is hereby furnished'. FOR APPLICANT TO FILL IN gaADDRESs � 27,
El copy is filed with the county building inspec- BUILDING '
tion department. ADDRESS 4
'CITY . .E L i ) ZIP :i:LOCALITY G/
Date Applicant NO. OF BLD S. I 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 ($100)or less.) ' y-� p /,
OWNER' �U O '/J � n1iN0.0l$ ��I USE ZONE' MAP
I certify that in the performance of the work for which this /� �' No
SPE
permit is issued, I shall not employ any person in any manner ADDRESS-9—
DDRESS ,' t4o. Q ir-C�o Av a �p� SPECIAL
so as to b comes bject amp on ws. CONDITIONS O
ipp
CITY • -l> tOC . ZIP 33Date t0 �,flicy ���.••CCC ARCHITECT OR TEL.
NOTICE TO AP (CA : If, after making this Certificat of ENGINEER NO DISTRICT GROUP TYPE FIRE PROCESSED BY
Exemption, you should become subject to the Workers' CONST.,/ Z2ONE U
Compensation provisions of the Labor Code, you must forth- ADDRESS Q� a I� J �w a
with comply with such provisions-or this permit shall be AA11``ii' pp ( (`�1, TEL. 1 N
deemed revoked. CONTRACTOR IOCIA COOKA& NO. i/ a Ql•Q STATISTICAL CLASSIFICATION f_ABT_ CONDO. Z
LICENSED CONTRACTORS DECLARATION a q r�A �(Iy n LIC. ; CLASS NO. AL DWELL. UNITS -
I hereby affirm-that I am licensed under provisions.of Chapter 9 ADDRESS 1 VLI •�Vhi` u� ��-}
y�� LIC. SEWER MAP
(commencing with Section 7000)of Division 3 of the Business i y jI
and Professions Code,and my license is in full force and effect. CITY W TOUY) s 060 t CLASS � BK VALIDATION _
r SQ. FT. O NO. OF CHECK
License Number SS Lic. Class_ SIZE STORIES FAMILIES ONE {- " _ 13
1 n T _ ` jet VALUATION _d"II:'t•":. 7 ;.s
Contractor�Mw c'_ 'A 'C_6IV 9 Date 10 7—x'7._�7� DES RI I WORK � 1���0� y1INy.� NEW ❑ F $ 1,!5000,� � ,r
i 4 1 " ® :1 CHANGE o t o
. ❑I um exempt under Sec. /�����,� ar f . ,Z 1ti�6 � GS DQ,� ADD ❑ ' I•
ALTER ❑
BAP.C. for this reason REPAIR ❑ i a. ` l; ti;j.;•,;;
✓f )n $
D te:A_,(Y—.d..7—�of USE OF
EXISTING BLDG. DEMOL ❑ �
Si nat APPLICANT TEL.
FINAL
NER- (PRINT) NO.BUDATE
I hereby affirm that I am exempt from the Contractor's License : —?' TT EM
Law for the following reason (Section 7031.5, Business and .ADDRESS FINAL
Professions Code): PRESENT By HL
BUILDING i
El 1, as owner of the property, or my employees with ADDRESS i•I-�=•E Qa
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY ."HINGE
GE ,j=;;j
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 chic Ll
tion 7044, Business and Professions Code.) IIIIE&
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 I.
the performance of the work for which this permit is.issued P.L. t
(Sec. 3097, Civ. C.). SIDE !;
P.L.'
Lender's Name
P.C. Fee$ J°. Permit Fee . �(� Ref. q
Lender's Address
I certify that I have read this application and,state that the Issuance Fee 4r LDMA P/C#
above information-is correct. I agree to comply with all County Investigation'Fee �. /
ordinances and State laws-relating to building construction, Total Fee (o -LDMA Perm. #
< hereby authorize representatives of this.County to enter
up } e ve-m io ed operty for inspectAi�rpose,// SEE REVERSE FOR EXPLANATORY LANGUAGE
Signal re of APP,.
ent Date
•WORKERS' COMPENSATION DECLARATION
insure, or affcertif catte of Wo ke s'tCompensat on Insurance, APPLICATION F®R BUILDING P E RAIZ I T
or a certified copy thereof(Sec. 3800, Lab. ) COUNTY OF LOS ANGELES BUILDING AND SAFETY
Policy No. A It�Company � tea'
NG
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS p
11171
`lam
Certified copy is filed with the county building inspec- BUILDING
tion department. ADDRESS J O p L,
Date 10-1 r Z CITY' ZIP LOCALITY L
eC
NO.OF BLDGS. c NEAREST
CERTIFICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT !V CROSS ST. //*r. Q�
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.) L TEL.
OWNER Q 0.4 O hl V 0 Y't RI NO, USE ZONEMAP
1 certify that in the performance of the work for which this MN
permit is issued, I shall not employ any person in any manner ADDRESS Zo p JYt4--0 ArVIO SPECIAL
so as to become subject to the Workers'Compensation Laws. CONDITIONS J O
CITY J ZIP If U
Date Applicant ARCHITECT OR TEL. Ix
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO DISTRICT GROUP TYPE FIRE P OCESSED BY O
Exemption, you should become subject to the Workers' 0� n CONS'./ ZONE
Compensation provisions of the Labor Code, you must forth- ADDRESS V o( CL
with comply with such.provisions or this permit shall be TEL. STATISTICAL CLASSIFICATION APT. CONDO. Z
deemed revoked. CONTRACTOR NO. i _
LICENSED CONTRACTORS DECLARATION LIC. CLASS NO: DWELL. U ST
I hereby affirm that i am licensed under provisions.of Chapter 9 ADDRESS Q- NO. SEWER_MAP
(commencing with-Section 7000)of'Division 3 of the Businesse LIC. r r
and Professions Code,and my license is in full force and effect.• CITY �'` C �em CLASS BK. PG VALIDATION
t�� SQ. FT. NO. OF NO. OF CHECK
License Number Lic. Class GT� SIZE STORIES FAMILIES ONE.
' 2• VALUATION
Contractor _-Ol�t�'S� S Date DESCRIPTION OF WORK NEW T �
ElI am exempt under Sec. Q` b ADD k $ ,
ALTER El .',
B.BP.C. for this reason I.tJ (G f Q c-�'yI $
R
REPAIR ❑ �::
Date: USE OF '
EXISTING BLDG. DEMOL E]APPLICANT
Signature FINAL
i (PRINT) NO.
OWNER-BUILDER DECLARATION DATEZ �
I hereby affirm that I am'exempt from the Contractor's License �� j, + y
Law for the following.reason (Section 7031;5, Business and ADDRESS �� s KV", FINAL ,
Professions Code): PRESENT' By
BUILDINGL•; a
❑ I, as owner of the property, or my employees with ADDRESS rT
nx
wages as their sole compensation,will do the work and LOCALITY +�=�=LI?
the structure is not intended or offered for sale(Section
7044, Business and Professions Code.) MOVING TEL. ? ® '•
❑ I, as owner of the property,am exclusively contracting CONTRACTOR NO.
,-•-•,
with licensed contractors to construct the project (Sec- N 1=• .¢ , .
ADDRESS
tion 7044, Business and Professions Code.)
CONSTRUCTION LENDING•AGENCY SETT BACK YARD HWY TOTAL SETBACK
LINEFROM WIDTH i - + '�'•4
I hereby affirm that there is a construction'lending agency for FRONT ; 1 '•`;;;
the performance of the work fot'which this permit is issued P.L.
A
:L
• (Sec. 3097, Civ. C.). � • � '- •SIDE i i I't -•, I�„a4821
P.L. _
Lender's Name
P.C. Fee$ p/ Permit Fee O �M0`Ref.#
Lender's Address H•;. ty _
'`'���
1 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 Investigation Fee pp
3 d .�
� ordinances and State laws relating to-building construction, Total Fee LDMA Perm. #
and hereby authorize representatives of this County to enter -+-- ..
I f�
upon=bove-mtiorne1d property for
in �
rspe tion purposes. � '�= � - r 5
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent DfO1e I T
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 0907200043
PHONE: (626) 285-0488 EXT:
(LEGAL ID: INUMBER OF SIGNS: 1 I BUILDING ADDRESS: I
1 ON FILE ISIGN DESCRIPTION: WALL SIGN ILLUMINATED CHANNEL LETTERSI 5797 ROSEMEAD BL
MP CA 91780
(ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: I
15397-012-043 I I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl
ITT: IEXIST BLDG USE: (ISSUED ON: PROCESSED BY: I
1 1EXIST OCC GRP: 107/20/09 SR I
(OWNER: TEL. NO: 1HUGS. NOW ON LOT: VALUATION: IF AL DATE FI BY: CODE: 1
ILEW, SUSAN (858) 565-8333- 1 2,500 1 I
15797 ROSEMEAD BLVD. I I I
TEMPLE CITY CA 91780 1 FEES PAID IDE RIPTIO OF WORK 1
IWALL SIGN ILLUMINATED CHANNEL LETTERS
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:I I
(APPLICANT: TEL. NO: I I I
IFARGO ADVERTISING, INC. (626) 733-2960- IAB
BLDG PERMIT ISSUANCE 27.75 1 1
12213 SASTRE AVE. AB STATE GREEN BLDG FEE 2500.00 VAL 1.00 ISPECTAL CONDITIONS:
IS. EL MONTE CA 91733 IAX BUILDING REVIEW FEE 54.70
ID2 PERMIT W/O EN-HC 2500.00 VAL 99.00 1 1
1 TOTAL FEES 182.45 1
(CONTRACTOR: TEL. N0: 1 APPROVALS DATE INSPECTOR SIGNATURE 1
IFARGO ADVERTISING, INC. (626) 733-2960- 1 1 I I I
12213 SASTRE AVE. LIC. NO I ILOCATION AND SETBACKS
1S. EL MONTE, CA 91733 932785 C45 I I I I I
I (SOILS ENGINEER APPROVAL 1 I I
1ARCHITECT OR ENGINEER: TEL. N0: - 1 1FOUNDATION/TRENCH FORMS I I I
LIC. NO: 1 (SUPPORT STRUCTURE I I
1 I i I i I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:1
1 001 I I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I I
I NO 20 I I I I I
1 SCHOOL WITHIN HAZARDOUS I 1 I I I
(AIR QUALITY: 1000 FEET MATERIALS 1
1 NO NO NO 1 I 1 I 1
I I I I I
I I I I I I
1 I I 1 I 1
I I I I I
I I I I I
I 1 1 I I
I I I I
I 1 I I I I
1 I I I I
1REPORT ID: DPR261 ROUTE TO: BS0508 I I I I
I I I I I
T
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 0710170050
PHONE: (626) 285-0488 EXT:
LEGAL ID: !NUMBER OF SIGNS: 1 BUILDING ADDRESS:
ON FILE ISIGN DESCRIPTION: ILLUMINATED CHANNEL LETTERS 5797 ROSEMEAD HL
TEMP CA 91780
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
15397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl
TENANT: 1EXIST BLDG USE: ]ISSUED ON: PROCESSED BY: EXPIRES ON:
REGAL COSMETICS INC. 1EXIST OCC GRP: 110/17/07 SR 04/14/08
1(OWNER: TEL. N0: IBLDGS. NOW ON LOT: VALIIATION: FINAL DAT D n BY" CODE:
CALAC INVESTMENT - 2,500 � n
13709 L� l� LJ
ISAN DIEGO, CA9211137 FEES PAID IDESCRIPTION OF WORK
]ILLUMINATED CHANNEL LETTER
IFEE DESCRIPTION: QIIANTITY: UOM: AMOUNT:]
APPLICANT: TEL. NO: I I
IJ & H SIGN INC. (626) 448-1166- 1AA BLDG PERMIT ISSUANCE 27.75
19441 VALLEY BLVD. 1AX BUILDING REVIEW FEE 54.70 ISPECIAL CONDITIONS:
ROSEMEAD, CA 91770 ID2 PERMIT W/O EN-HC 2500.00 VAL 99.00 1
TOTAL FEES 181.45
CONTRACTOR: TEL. NO: I _ ]APPROVALS DATE INSPECTOR SIGNATURE
IJ AND H SIGN (626) 448-1166- 1 1
19441 VALLEY BLVD. LIC. NO ILOCATION AND SETBACKS 1
]ROSEMEAD, CA 91770 873439 C45 I
1 (SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: [SUPPORT STRUCTURE
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:(
1 001
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I I
NO 20
SCHOOL WITHIN HAZARDOUS
(AIR QUALITY: 1000 FEET MATERIALS
NO NO NO
I I I 1 I I
I 1 I I I I
I 1 I I I I
I I I I I I
I I I I I I
IREPORT ID: DPR261 ROUTE TO: BS0508
I I I I I I
t `
` COUNTY OF IAS 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 0708300010
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST NEW I BUILDING ADDRESS: I
ON FILE I SQ. FT STORIES TYPE OCCUP GROUPI 5797 ROSEMEAD BL I
ISTRUCTURE: 1120 1 VN B I TEMP CA 91780 I
(ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LAS TUNAS
15397-012-043 I I THOMAS PAGE: GRID: LOCALITY: TEMPLE CIYT, C
I I I I
ITENANT: EXIST BLDG USE: COMME USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON:
IYAO KELVIN EXIST OCC GRP: B 109/11/07 SR 03/09/08
10WNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1F E FIN CODE: 1
YAO, KELVIN (626) 215-7999— 1 3,000 /7/�1 DAT/
15797 ROSEMEAD BLVD. I I e
ITEMPLE CITY CA 91780 1 FEES PAID iDikSCRIPTION CTF WORK
I ITENANT IMPROVEMENT (36 LINEAR FEET) PARTITION WALL TO CREATEI
IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:INEW OFFICE AND STORAGE ROOM 1
IAPPLICANT: TEL. NO: I I I
IWU (626) 524-3164— 1A1 PLANCHECK W/EN—HC 3000.00 VAL 96.77 1 [
14205 E. LIVE OAK AVE 1AA BLDG PERMIT ISSUANCE 27.75 ISPECIAL CONDITIONS:
]ARCADIA, CA 91006 1AE STRONG MOTION OTHER 3000.00 VAL 0.63
IA2 PERMIT W/ENERGY—HC 3000.00 VAL 113.85 1
I I TOTAL FEES 239.00 I I
ICONTRACTOR: TEL. NO: 1 APPROVALS DATE INSPECTOR SIGNATURE 1
ICASTLINK ARCHITECTURAL GROUP (626) 461-0566— 1 1 I
1217 SOUTH FIRST AVENUE LIC. NO 1 ILOCATION AND SETBACKS I I I
1ARCADIA CA 91006 677550 C36 *[ I 1 I I
1 SOILS ENGINEER APPROVAL I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS 1 I
1WU, JACK (626) 524-3164— 1 1 I I I
4205 E. LIVE OAK AVE. LIC. NO: I [SLAB/UNDER FLOOR I I I
�ARCADIA, CA 91006 C21951 [ 1I I I
RAISED FLOOR FRAMING
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ (UNDERFLOOR INSULATION I
1 3 041 I I I
I I IFLOOR SHEATHING I I I
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I 1 I 1 I
1 NO 22 1 IROOF SHEATHING I I I
1 SCHOOL WITHIN HAZARDOUS 1 ISHEAR PANELS I I I
[AIR QUALITY: 1000 FEET MATERIALS
NO NO NO1 IFRAME INSPECTION I I
1 1 IFIRE SPRINKLER HANGERS I 1
I I (INSULATION/WEATHER STRIPI II ell
I
I I IINTERIOR LAT DR I
[ i [EXTERIOR LATH '
I I IRATED FLOOR/CEIL ASSEM. I I I
IRATED WALL ASSEMBLIES I I
I 1
IRATED SHAFTS/OPENINGS
[ 1 I
IT—BAR CEILINGS I I I
I* ADDITIONAL DATA ON FILE I I I I
I I ILOT DRAINAGE
[ [REPORT ID: DPR261 ROUTE TO: BS0508 1
I I I i I I
u 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 0303040055
PHONE: (626) 285-0488 EXT:
LEGAL ID: ER OF SI S: I BUILDINGADDRESS:
ON FILE SIGN DESCRIPTION: "RICCINI" (EACH LETTER IN A DIFFERENT 5797 ROSEMEAD SL
TEMP CA 91780
ASSESSOR INFORMATION NU NEAREST CROSS STREET: LAS TUNAS
5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY
TENANT: S BLDG USE: ISSUED ON: PROCESSED B P R S .
NINA CHAN EXIST OCC GRP: 03/05/03 JK 02/28/04 .
OWNER: TEL. 0: BLOGS. NOW ON LOT: VALUATION: FINAL DAT f7 IFINAL BY: CODE:
CALA3709CCONVEYTSTN#300 (626) 292-6638- 1,200 ���/
SAN DIEGO, CA9211137 -FEES PAID P lUNO
ILLUMI ATED CHANNEL LETTER SIGN
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO.-
CHRISTINA YU (626) 444-8181- AA BLDG PERMIT ISSUANCE 27.75
2812 PECK RD AC STRONG NOTION RESID 1200.00 VAL 0.50 SPECIAL CONDITIONS:
EL MONTE 91731 D1 PLANCHECK W/O EN-HC 1200.00 VAL 82.11
D2 PERMIT W/0 EN-HC 1200.00 VAL 82.20
TOTAL FEES 192.56
CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE
SUCCESS SIGN PRINTING INC. (626) 444-8181-
2812 PECK RD LIC. NO LOCATION AND SETBACKS
EL MONTE CA 91731 739177C45
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. N0: FOUNDATION/TRENCH FOR S
LIC. NO: SUPPORT STRUCTURE
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
00
0. OF FAMILIES: DWELLING D: STAT CLASS:
NO 20
SCHOOL 0
AIR QUALITY: 1000 FEET MATERIALS
NO NO NO
REPORT ID: DPR261 ROUTE TO: BS05O8