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Home My Public Portal About6023 ROSEMEAD BLVD_Building__ APPLICATION FOR BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING ND SA TY WORKER'S COMPENSATION DECLARATION FOR APPLICAN TO FILL,IN BUILDIN A S I hereby affirm that I have a certi' e f consent to self Insure, BUIL G or ificat f Wo c pens ' n Insurance r ertified copy t 0 C. CIT LOCALITY SIZE OF LOT NO.OF BLOGS.NOW ON LOT ❑ Certified copy is hereby furors d. NEAREST CROSS ST. ❑ Certified copy is filed with t coun wilding nsp to TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Ap cant/ ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FROM WORKERS' ow R�/- o�Q�s n YES NO COMPENSATION INSURANCE G �/ �/ WITHIN 1000 FT.OF SCHOOL? (This section need not be completed if the permit is for one hundred ADDRESS DISTRICT GROUP TYPE CONST. FIRE ZONE PROCESSED BY dollars($100)or less.) CITY ZIP 1 certify that in the performance of the work for which this permit1;�� is issued, I shall not employ any person in any manner so as to d 6� become subject to the Workers'Compensation Laws. ARCHITECT OR ENGINEER TEL NO. STATISTICAL CL SI KATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you should become subject to the Workers' / 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. ApgR S u2ygc,q��/ PL LICENSED CONTRACTORS DECLARATION Com( SIDE CIN uC.C�I[>96S 2 PL I hereby affY:�e' MI nderprovisions f Cha 9 (�� SEWER MAP (commencintivisior 3 of Bu a nd SQ.FT.SIZE NO.OF STORIES NO.OF FAMILIESProfessions f orce nd fec. NEW ❑ BK PG } CL LicensenhbL"- ic.Cla DE i F ADD ❑ VALUA N Contrac I� Q�rTER ❑ $ 55 °C ❑ I am exempt under Sec. REPAIR ❑ $ FC- B.&P.C.for this reason c DEMOL ❑ LDMA P/C s W Date: USE OF EXISTING BLDG. URM ❑ '1 CIL Signature APPLICANT(PPoNT) TEL NO. LDMA Perm# a 2 ACCT. Ci�C T a 4 ❑ I, as owner of the property, or my employees with wages as Z their sole compensation, will do the work and the structure is ADDRESS � 33035 108.90 not intended or offered for sale (Section 7044, Business and FINAL DATE C 1 ITEris Professions Code.) WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL rI u�r�� S 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 > TOTAL 108 o 90 licensed contractors to construct the project (Section 7044, YES❑ No❑ Business and Professions Code.) CHECK 108.900 OCCWILL THE INTENDED USE MI THE BUINS R TI THE APPLICANT OR FUTURE BUILDING CHANGE o++'� OCCUPANT REQUIRE PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUALITY NAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST FOR GUIDELINES I hereby affirm that there is a construction lending agency for VES❑ N N the performance of the work for which this permit is issued(Sec. IHAVEREA EHAZAR&REQUIR FO ON GUIDE THE SCAOMD PERMITTING 0000-0001 11/22/95 3097,CIV.C.) CHECKLI . NDE STEN THE L ANGELES COUNTY CODE, a Lender's Name TITLE RE ORTINP R T F20 THE SCAOMD.CONCERNING HAZARDOUS f�10A 3409 1 .30 O Lender' dress 7 P1 tJ 0 OWNER OR AGENT o Icer' that I have read this application and state under penalty Of jury that th bOve in atiOn is Correct.I agree to comply P.C.FEE PERMIT FEE N h c my inances n tate laws relating to building D tio ereb a e epresentat've of this C un ISSUANCE FEEerupon e a e o ed roperty fore pc 7�,�ccnstrul < INVESTIGATION FEE TOTAL FEE /O f� �d � Sgnaro m Aoo zm o, m w_o (J SEE REVERSE FOR EXPLANATORY LANGUAGE APPLICATION FOR 13UILDING PERME7 COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING 3 DRESS I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRESS or a certificate of Workers'Compensation Insurance,or a certified 6023 Rosemead copy thereof(Sec.3900,Lab.C. CITY ZIP LOCALITY WP06282Pacific Com _Temple Cit Policy NO. Company SIZE OF LOT NO.OF BLDGS.NOW ON LOT Temple C I t y +❑ rtifiEd copy Is hereby furnished. NEAREST CROSS ST. Certified copy Is filed with t nspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date--a--9-9 OApplicant ASSESSOR MAP BOOK PAGE PARCEL SPECIAL CONDITIONS CERTIFICATE OF EXEMPTION FRO iili WO RS' OWNER TEL A 1 d0 h Co 11 a s o 8 NO — WITHIN 1000 FT OF SCHOOL? YES NO COMPENSATION INSURAN ADDRESS (This section need not be completed if the permit is for one hundred DISTRCT GROUP TYPE CONST' FIRE ZONE CESSE BY dollars($hat or less.) Same CITY ZIP 5.16� /,/I certify that in the performance of the work for which this permit Same ��p\' J is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEERTEL NO. become subject to the Workers'Compensation Laws. STATISTICAL CLASSIFICATION APT CONDO Date Applicant ADDRESS CLASS NO. DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate of REQUIRED TOTAL SETBACK FROM MST Exemption, you should become Subject to the Workers' CONTRACTOR TEL NO. SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code,you must forthwith Cham FRONT comply with such provisions or this permit shall be deemed revoked. ApI� LIC. O. P L .1257 Verdugo 429481 BIDE >- LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS C- I hereby affirm that I am licensed under provisions of Chapter 9 Los An �ih6s C39 stINERMAP v (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES Professions Code,and my license is in full force and effect. NEW ❑ BK PG CRIPTION �-.� VALUATION ® W License Number 4 2 9 4 81 IaQ C 3 9 a ADD ❑ 013 Contractor. Champion Date 8-9-90 ALTER ❑ ' ❑ I am exempt under Sec. LA5rr B.BP.C.for this reason �6 Q a� ��: R El MOL ❑ LOMA p/C# Date: F IXISTING L � M ❑ Signature APPLICANT( 1 TEL NO. LDMA Perm# j ❑ I. as owner of the roe z p p rty, or my employees with wages as -a -� O their sole compensation,will do the work and the structure is ADDRESS ' F ACCT.v not intended or offered for sale (Section 7044, Business and FI !g z Professions Code.) WILLTHEAPPLICANTOR FUTURE BUILDING OCCURANTHANDLEA HAZARDOUS MATERIAL ® 33'7 y` . ❑ I, as owner of the ro e OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN � g y�ry^ '+ p p rty, am exclusively contracting with THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? 1 I i GMISJ licensed contractors to construct the project (Section 7044, YES❑ NO❑ I p a Business and Professions Code.) TOTAL 93 e 63 WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING CONSTRUCTION LENDING AGENCY OCCUPANT REQUIREA PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THESOUTH raj 93.63 )J� +� COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST CHECK ? a 63 FOR GUIDELINES. I hereby affirm that there is a construction lending agency for YES❑ NO❑ CHANGE a 00 the performance of the work for which this permit IS issued(Sec. I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD 3097,CIV.C.). PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTYCODE,TITLE 2.CHA 2.20 SECTIONS 220.100THROUGH 2 I40 CONCERNING Lenders Name HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAOMD. Lenders Address UNERORAGENT T/`,►n� . 294 1 ASI 7-40 0 1 certify that I have read this application and state that the above P.C.FEE PERMIT FEE Sp i�►^j,.`',`',J Information Is correct. I agree to comply with all county o •a and S to laws relating'to building construction,and he e a hor ntatives of this unt to a ter upon ISSUANCE FEE ® 1/ th t pertyfor ins D p INVESTIGATION FEE TOTAL FEE r « m SEE REVERSE FOR EXPLANATORY LANGUAGE v � t COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 93.780 BL 0508 0511080021 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 5904 LT: 157. SQ. FT STORIES TYPE OCCUP GROUP 6023 ROSEMEAD BL STRUCTURE: 1125 2 VN R3 TEMP CA 917801539 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: 5384-017-034 OTHER: THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 03/31/06 JK 03/26/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: F L T FIN BY: CODE: PFIRRMAN, FRANK (626) 285-3177- 125,000 6023 ROSEMEAD BLVD. TEMPLE CITY CA 91780 FEES PAID DINCRIPTIOW OF WORK ki ADD FIRST FLOOR BATHROOM, NSDROOM, E. FAMILY ROOM, SECOND FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: FLOOR MASTER BEDROOM, & MASTER BATHROOM 1125 S.F. APPLICANT: TEL. NO: •(-bz PFIRRMAN (626) 285-3177- B1 PLANCHECK W/ENERGY 93150.00 VAL 1,156.08 6023 ROSEMEAD BLVD. AA BLDG PERMIT ISSUANCE 27.75 SPECIAL CONDITIONS: TEMPLE CITY CA 91780 AC STRONG MOTION REBID 125000.00 VAL 12.50 B1 PLANCHECK W/ENERGY 125000.00 VAL 203.22 B2 PERMIT W/ENERGY 125000.00 VAL 1,599.18 CONTRACTOR: TEL. NO: TOTAL FEES 2,998.73 APPROVALS DATE INSPECTOR SIGNATURE PFIRRMAN, FRANK (626) 285-3177- 6023 ROSEMEAD BLVD. LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 NONE SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: - FOUNDATION TRENCH FORMS �� ^ LIC. NO: SLAB UNDER FLOOR l� v RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 01 IST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING �y AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS SIDE PL- INSULATION WEATHER STRIP INTERIOR LATH DRYWALL EXTERIOR LATH i LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508 [ COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT ' DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0605310003 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: TR: 5904 IT: 157 SQ. FT STORIES TYPE OCCUP GROUP 6023 ROSEMEAD BL STRUCTURE: 62 2 VN R3 TEMP CA 917801539 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET: 5384-017-034 OTHER: THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY, EXPIRES ON: EXIST OCC GRP: 05/31/06 JK 05/26/07 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: q;6AT F Y: CODE: PFIRRMAN, FRANK (626) 285-3177- 5,134 6023 ROSEMEAD BLVD. TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF WORK ADD TO FAMILY ROOM 62 S.F. FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: APPLICANT: TEL. NO: PFIRRMAN (626) 285-3177- AA BLDG PERMIT ISSUANCE 27.75 6023 ROSEMEAD BLVD. AC STRONG MOTION RESID 5134.00 VAL 0.51 SPECIAL CONDITIONS: TEMPLE CITY CA 91780 AX BUILDING REVIEW FEE 54.70 B2 PERMIT W/ENERGY 5134.00 VAL 164.34 TOTAL FEES 247.30 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE PFIRRMAN, FRANK (626) 285-3177- 6023 ROSEMEAD BLVD. LIC. NO LOCATION AND SETBACKS TEMPLE CITY, CA 91780 NONE SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION 3 01 1ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY: 1000 FEET MATERIALS NO NO NO FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST BLDG DEPT. FRAME INSPECT SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- SHEAR PANELS SIDE PL- INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL REPORT ID: DPR261 ROUTE TO: BS0508