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Home My Public Portal About5821 ROSEMEAD BLVD_Building__ WORKERS' COMPENSATION DECLARATION ek;(14 . I•h eby affirm that I have a certificate of consent to self insu , or a certificate of Workers' Compensation Insurance, ATI ® R I ®I PERMIT or a certified copy thereof(Sec. 3800, Lab. C.) ' COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company �' -�t' BUILDING ❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL INADDRESS ��.—��?'� ❑ Certified copy is filed with the unty g inspec- BUILDINGJ-9;2 S�Z cnre ��• ® 7•� /"LGc Y 9 !78 d tion department. ^ ADDRESS `3 t�� - ; CITY !Ey"�P�� Ci7`y zip 9d $ o �9A�t� Lit`f cS`6zuii/ Date Applicant a LOCALITY Tom• �*GLL4/�Q OF BLDGS. NEAREST t CERTIFICATE OF EXEMPTION KERS' SIZE OF LO W ON LOT a. CROSS ST. L��`p TLir✓iJ 1P �' u COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit is or one TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL hundred dollars ($100)or less.) 7! OWNER � d USE ZONE MAP I certify that in the performance of the work for which this i r' NO. permit is issued, I shall not employ any person in any mannerADDRESS Z d AZ,4A1CA J-G/P-AJ SPECIAL CONDITIONS O� so as to become subject to the Workers'Compensation Laws. CITY ^V-14"/of ��,.A/�ZIP Qf 7 6 O U Date Applicant ARCHITECT OR L 61CX NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER fw �y�� cr, 97�-N-2' DISTRICT GROUP TYPE FIRE PROCESSED BY CONST. ZONE Exemption, you should become subject to the Workers' ;S 6 s�J- v,�,,/ yf `�,p �� Z �� W Compensation provisions of the Labor Code, you must forth- ADDRESS . a• with comply with such provisions or this permit shall be �•-� TEL• a 1 STATISTICAL CLASSIFICATION APT. CONDO. rn deemed revoked. CONTRACTOR �r�y .•- 4w /JpmzeC •NO-MIS �TCI`r Z LICENSED CONTRACTORS DECLARATION LIC: CLASS NO. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS �i2d 3� •�u .� 2$ NO. �� f••-- +t (commencing with Section 7000)of Division 3 of the Business SEWER MAP G.7&+4 , LIC. �, y; and Professions Code,and my license is in full force and effect. CITY '�e CLASS BK. PG. LTKLIDATION U SQ. FT. NO. OF NO. OF CHECK License Number �� ii % Lic. Class SIZE a 7 90STORIES EAM**S ONE VALUATION `*3137 337.82 �S /�� q � Contractor D��G� "v"—Date I'I O~ `2— DESCRIPTION OF WORK N $ [r��(�• 1 ITEMS At, /tA/7- Td CGR/�')^ D ❑ �D El am exempt under Sec. !OTAL37 o 82 B.&P.C. for this ?/}l�TF T'!Z►N LV/7Ld J'� FTC s Al LJ r �7 O'y Date: �� "L USE OF �1PLCrd $Elie—d!N� REPAIR ❑ $ 1- E �i .�J7 o s_y EXISTING BLDG. DEMOL ❑ tlyljE ,I]Q Si natur ' g N *ecti ATION APPLICANT 6 p/L� /C/d B Z!/'P / t,/3 6 FINAL ^ -• ;.-. o } DATE I hereby affirm t e Cantr tor's License �j'Zy¢rT/�/SC/fA/ /�L. /� /diejJ?_CIG iI -9 . 199Lawfor the following tea 7031 Business and ADDRESS FINAL NG ti as Professions Code): :PRESENT By +y•Q AMijt7:40 I ❑ I, as owner of the property, or my employees with ADDRIESSSS f �7M 262.09 wages as their sole compensation,will do the work and ZTE the structure is not intended or offered for sale(Section LOCALITY - TOTAL ` 7044, Business and Professions Code.) MOVING TEL. CONTIN RACTOR NO. TOTAL 262.[39 I,as owner of the property,am exclusively contracting ��+•.uu�C��/ with licensed contractors to construct the project (Sec- ADDRESS CHECK 262.09 tion 7044, Business and Professions Code.) /�L�/��r �,�• REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. 41i1tl7NE o{atI CONSTRUCTION LENDING AGENCY SET BACK 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 , IJQOOaJl 1 9/ 3/92 P.L. Lender's Name 5.740 1 AM 8(;2? 8 /� LDMA Ref. # P.C. Fee$ [�S• Permit Fee Lender's Address 7 • I certify that I have read this application and state that theIssuance Fee LDMA P/C# POl above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, Total Fee �a LDMA Perm. # = and hereby authorize representatives of this County to enter upon the yla �-mentioned property for inspection put os � SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date 1: a 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 0501250009 PHONE: (626) 285-0488 EXT: LEGALI : NO. OF CONST NEWBUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUP 5821 ROSEMEAD BL STRUCTURE: 258 1 VN C TEMP CA 91780 ASSESSOR OR ON NUMBER: NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, C ST B DG SE: COME USEZONE: TRUE-DOW PROCESSED 8 : EXPIRES 0 : EXIST OCC GRP: C 01/31/05 JK 01/26/06 OWNER: TEL. N0: BLDGS. NON ON LOT: VALUATIO : FINAL DATE FINAL BY: CODE: PHAN, THUY (626) 285-8066- 30,000 5821 ROSEMEAD BLVD. _ TEMPLE CITY CA 91780 FEES PA rD DESCRIPTION OF WORK TENANT IMPROVEMENT WORK, NAILS STORE INSTALL NEW PEDICURE APICANT: TEL. NO: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SPA CHAIRS, NEW FACIAL ROOM, WAXING ROOM, BREAKROOM & SATURN SYSTEMS INC. (310) 329-2728- Al PLANCHECK W/EN-HC 30000.00 VAL 524.61 15916 S. FIGUEROA ST AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: GARDENA, CA 91248 AE STRONG MOTION OTHER 30000.00 VAL 6.30 A2 PERMIT W/ENERGY-HC 30000.00 VAL 617.21 TOTAL FEES 1,175.87 CONTRACTOR: TEL. 0: APPROVALS DATE INSPECTOR SIGNATURE SATURN SYSTEMS INC. (310) 329-2728- 15916 S. FIGUEROA LIC. NO LOCATION AND SETBACKS- GARDENA, CA 90248 683127 B SOILS ENGINEER APPROVAL ARCHITECT R ENGINEER:__ TEL. 0: 0 DA I / RNC OR S LIC. NO: SLAB/UNDER SLAB/UNDERFLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATIO 3 04 LO0 G 0. OF-FAMILIES: DWELLING U ITS: APT/COND: STAT CLASS: NO 22 ROOF SHEATHING SCHOOL IN HAZARDOUS SHEAR PANEL AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME -INSPECTION FIRE SPRI LRHNER r INS L TIO /W THER S RIP INTERIOR CARTFURRUM. EXTERIOR LATH RATED__FL /CEIL ASSEM. RATED WALL ASSEMBLIES RATED T PE G T-BAR CEILINGS * ADDITIONAL DATA ON FILE LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 A/ 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 0502160037 PHONE: (626) 285-0488 EXT: LEGAL D: NUMBER OF SIGNS: I BUILDING ADDRESS: ON FILE SIGN DESCRIPTION: ONE SET INTERNAL ILLUMINATED CHANNEL 5821 ROSEMEAD BL TEMP CA 91780 ASSESSOR INFORMATION N NEAREST CROSS STREET: LAS TUNAS 5397-012-043 THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, C TENANT: S DG U : PROCESSED EXPIRES 0 : EXIST OCC GRP: 02/16/05 JK 02/11/06 OWNER: TEL. 0: BLDGS. NOW ON T: VALUATION: FINAL DATE FINAL BY: CODE: PHAN, THUY (626) 285-8066- 1,050 5821 ROSEMEAD BLVD. TEMPLE CITY CA 91780 FEES PAID ESC PTIONOOF'WOR ONE SET INTERNAL ILLUMINATED CHANNEL LETTER WALL SIGN APPLICANT: TEL. NO: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: FIRST SINGS CO. (626) 448-1616- AA BLDG PERMIT ISSUANCE 27.75 9647 E. RUSH ST AX BUILDING REVIEW FEE 54.70 SPECIAL CONDITIONS: S. EL MONTE 91733 D2 PERMIT W/0 EN-HC 1050.00 VAL 82.20 TOTAL FEES 164.65 CONTRACTOR: TEL. NO: APPROVALS DATE --INSPECTOR SIGNATURE FIRST SINGS COMPANY (626) 448-1616- 9647 E. RUSH STREET LIC. NO LOCATION AND SETBACKS SOUTH EL MONTE, CA 91733 605688C45 SOILS ENGINEER APPROVAL ARCHITECT OR E G EER: TEL. 0: FO DA 0 R C OR S LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 0. OF FAMILIES: DWELLING NITS: APT CO D: STAT C SS: NO 20 SC QO ITH1 HA 0 S AIR QUALITY: 1000 FEET MATERIALS NO NO NO REPORT ID: DPR261 ROUTE TO: BS0508 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 0806190055 PHONE: (626) 285-0488 EXT: ILEGAL ID: INUMBER OF SIGNS: 1 BUILDING ADDRESS: I ON FILE (SIGN DESCRIPTION: ILLUMINATED LED CHANNEL LETTER i 5821 ROSEMEAD BL I TEMP CA 91780 I (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: I 5397-012-043 I I THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY, Cl [TENANT: (EXIST BLDG USE: ]ISSUED ON: PROCESSED BY: EXPIRES ON: [ ITHE NAIL BOUTIQUE (EXIST OCC GRP: 106/19/08 SR 12/16/08 I (OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: ]FINAL r BY: CODE: [ ICALAC INVESTMENT - I 1,800 1 ( P-) I� �_71n, 3709 I [ )�1 II 1r SAN DIEGO, CA9211137 I FEES PAID (DESCRIPTION OF Wb2ki I I (ILLUMINATED LED CHANNEL LETTER [ I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:( I [APPLICANT: TEL. NO: I I I IJ & H SIGN INC. (626) 448-1166- IAA BLDG PERMIT ISSUANCE 27.75 1 [ 19441 VALLEY BLVD. IAX BUILDING REVIEW FEE 54.70 ISPECIAL CONDITIONS: I IROSEMEAD CA 91770 ID2 PERMIT W/O EN-HC 1800.00 VAL 82.20 I 1 TOTAL FEES 164.65 (CONTRACTOR: TEL. NO: [ [APPROVALS DATE INSPECTOR SIGNATURE IJ AND H SIGN, INC. (626) 448-1166- [ 1 ] 19441 VALLEY BLVD. LIC. NO I ILOCATION AND SETBACKS ] I ] IROSEMEAD, CA 91770 873439 C45 [ I [ I I ISOILS ENGINEER APPROVAL [ I ]ARCHITECT OR ENGINEER: TEL. NO: I FOUNDATION/TRENCH FORMS I I I ] LIC. NO: ISUPPORT STRUCTURE I I I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: I ] [ I I I I INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: [ I I [ I NO 20 [ I [ I [ SCHOOL WITHIN HAZARDOUS [ [ I [ [AIR QUALITY: 1000 FEET MATERIALS I I I [ NO NO NO [ I [ [ IREPORT ID: DPR261 ROUTE T0: BS0508 [ [ I I I ] I I