HomeMy Public PortalAbout6128-6138 ROSEMEAD BLVD_Building__ "ass cc#803.9.60 APPLICATION FOR BUILDING PERM/ IT
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DMSION LOCALITY40A e Fe
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST
WILLIAM A.JENSEN SUPT OF BUILDING CROSS ST. /
DISTRICT GROUPTYPE 7=
BY
FOR APPLICANT TO FILL IN CONST.
BUILDING yyy���JJJ _ n STATISTICAL CLASSIFICATION SE R MAP
ADDRESS 6 , 9I�� C�y 4/' i CLASS.NO. DWELL.UNITS
—tJ
LOT NO. — BLOCK MAP STATE YES NO
NUMBER �. HWY.
TRACT S USE ZONE SPECIAL '
NO:OF BLDGS. CONDITIONS
SIZE OF LOT I NOW ON LOT
USE OF
EXISTING BLDG. BUILDING YARD HWY STREET NAME EXIST.
TEL. ETBACK WIDTH
OWNER k2 NO. FRONT
I P.L.
ADDRESS . I SIDE '
ARCHITECT OFr TEL. P.L.
ENGINEER NO. INSPEC
T
ION/RE
CORD
ADDRESSTEL
RAFCON NO.
ADDRESS
0'
DESCRIPTION60F WORK u
W
• a
NEW ADD ALTER REPAIR DEMOLISH h
SO.FT. NO.OF NO.OF
SIZE STORIES FAMILIES
USE OF
STRUCTURE I
SIGNATURE OFy(��
APPLICANT
VALUATION S 1' 6 � I
APPROVALS DATE INSPECTOR'S SIGNATURE
FP C.
EE`S' FEB•$ GI O FOUNDATION:LOCATION -
FORMS,MATERIALS
FRAME:FIRE STOPS,
1 HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING,BOLTS
AND STATE THAT THE-ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE'LOCATION,
WITH ALL COUNTY ORDINANCES AND STATE LAWS REGULATING ,GAS VENT DUCTS
BUILDING CONSTRUCTION. I CERTIFY THAT IN THE PERFORMANCE
OF THE WORK FOR WHICH THIS PERMIT IS ISSUED I SHALL NOT LATHINT
EMPLOY ANY PERSON IN ANY MANNER SO AS TO BECOME SUBUECT LATH,INT. '
TO THE WORKMEN'S COMPENSATION LAWS OF CALIFORNIA.
LATH,EXT.
SIGNATURE OFOUSE NUMBER COR- 1
PERMITTE RECT AND POSTED
ADDRESSP-UejaLINAL I
CLYDE N. DIRLAM, RIAC'IPAL STRU TURAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMT V LIDATION cK. M.o. CASH
J
LAC0 5 2 2 3 OCT. 5 1 D 4.0 0-
v
DIVISION OF BUILDING'AND SAFETY
Department of County Engineer BUILDING
County of Los Angeles
WM. J. FOX, COUNTY ENGINEER APPLICATION
FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY
BUILIDINS DISTRICT NO. PLAN CK.OR RFC.No. PERMIT NO.
ADDRESS o S� 3
ECEI 1 E/DB DATE OF ADPL DAT ISSUED
LOCALITY CFE e V' 72T
DROSSNEARE
a BUILDING
R0688T. (:2:,
:2
1 y ADDRESS \Q
OWNER
LOCAMAILLITY
AD RE89 S %O { �, , NEAREST /
CITY �ti/ TEL.
NO. • FIRE I NO.OF I TYPE J I GROUP
ARCHITECT OR j) Ir TEL ZONE PLANS �®
ENGINEER /'t NO. BLDG. A ORD. NO.
SETBACK LINE C!�e'1
ADDRESS UBE �j APPROVED
TEL ZONE BY DATE
CONTRACTOR NO. HOUSE NUMBERING
ADDRESS MAP NUMBERZ-/2® A NO. ASSIGNED BY
LEGAL CORRECTIONS
DESCRIPTION LOT NC.Y7 BLOCK
TRACT
NO. OF Swum
SIZE OF LOT NOW ON LOT r --
USE OF
1
NO.EXISTING BLDG. 0 F MILOIEi
DESCRIPTION OF WORK �•- � � ` A
00,
0
NEW ALTERATION ADDITION Z
D
REPAIR DEMOLITION r
_9 ZE ROOMS STORIES
EXT.WALL ROOF
COVERING I COVERING
USE OF STPUCTUR • •
! °'� moi! ��ff 1•.• �
f!
INSPECTION FOR APPROVALS
OCCUPANCYAB INSPECTOR'S SIGNATURE DATE
FOUNDATION:LOCATION /
F12MMB• MATERIALS �r:-)ee1SAT//y6- /, 2
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS IS ( �///I //l�J��3
PLICATION AND STATE THAT THE INFORMATION GIVEN 18 FRAME: FIRE9TOP9�
CORRECT. BRACING,BOLTS
1 AGREE TO OOMPL WITH ALL COUNTY ORDINANCES FURNACE: LOCATION,
AND STATE LAWS R TIN BUIL IND `ONSTRUCTION. DAB VENT,DUCTS
SIGNATURE OF LATH, INT.
PERMITTE
ADDRESS ` ° �THt EXT.
PLASTER, INT.
AUTHORIZED ADT-
PLASTER, EXT.
$ p FEE HOUSE NUMBER COR-
RECT AND POSTED
.VALUATION FEE • C)co FINAL
7SA63BA DBS 3 1-S2
76p638A CE 0803 1/71
w' APPLICATION FOR BUILDING_ PERM1
COUNTY OF LOS ANGELES ASSESSOR
DEPARTMENT OF COUNTY.ENGINEER MAP BOOK PAGE_ .• PARCEL
BUILDING AND SAFETY DIVISION BUILDING
ADDRESS °
• 0
COLEMAN W. JENKI.NS, SUPT OF BUILDING
LOCALITY
FOR APPLICANT TO FILL IN' NEAREST
Print or tvoe bnlvl CROSS ST.
BUILDING. DIST NO.,,° GR TYPE P BY
ADDRESS ° � D 01/ CONST,
STATISTICAL'CL SSIFICATION S ER MAP
LOT NO. BLOCK
a CLASS NO DWELL.UNITS PG
TRACT !/ USE ZONE MAP D y+�
NO.OF BLDGS. NO. (/
SIZE OF LOT NOW ON LOT. SPECIAL
USE OF CONDITIONS
EXISTING BLW.
TE
OWNE NO BLDG.SETBACK FROM
ADDRESS FRONT PROP.LINEOF _ (STREET)
TYPE OF EXISTING SETBACK HIGHWAY } YARD = .TOTAL
CITY •• HIGHWAY WIDTH FROM C.L.
ARCHITECT OR TEL. i
ENGINEER NO. BLDG.SETBACK FROM
ADDRESS SIDE PROP.LINE OF _ (STREET)
TEL A�� TYPE OF EXISTING SETBACK HIGH + YARD = TOTAL
CONTRACTOR NO, �f]l'�/ HIGHWAY WIDTH FROM C.L.
LIC Y�SIG + - C
ADDRESS,24(,f, NO. FF
LIC. ❑ i
CITY CLASS - CORNER CUTOFF YES_ ❑ No y,
CONSTRUCTION LENDER - a
NAME AND BRANCH SEE REVERSE SIDE FOR SPECIAL APPROVALS a
ADDRESS
SQ. FT. NO. OF NO.'OF NEW ❑ / / rllf t e�J�"a.(QFZ+,1 (1 G �%
SIZE STORIES FAMILIES /1�
USE OF ADD ❑ i�dAi? �lbt-g Z^
STRUCTURE ❑
ALTER ( lt. l° 4A1W�$ ( El Z C 0 �.i Al l�.epzlf:31cl�
SIGNATURE O 1 REPAIR t1�Vj
APPLICANT DEMOL ❑
VALUATION$ W4' _ APPRO
MW DATE INS0ECToii6s'S16NATURE
P.C. PMT• r' FOUNDATION: LOCATION
FEE'$ FEE$ FORMS, MATERIALS
FRAME:.FIRE STOPS,
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION BRACING BOLTS
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY FURNACE: LOCATION, '
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON- GAS VENT, DUCTS
STRUCTION. I CERTIFY THAT IN DOING THEWORK AUTHORIZED
HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLATION OF THE LATH, INT.
LABORCODE OF. STATE OF •CALIFORNIA IN RELATING TO
WORKMEN'S.COM NSA ON INSURA441
LATH, EXT.
SIGNATURE OF ' / HOUSE NUMBER COR-
PERMITTEE. RECT AND POSTED
ADDRESS FINAL
111-f 17L, (Ylf-
J'OHN F. LEWIS. PRS CI A-L- ST.R - URAL• ENGINEER
PLAN CHECK VALIDATION CK.. M.O. CASH _ MIT I AT�,ON CK. M.O. CASH LACO-65 6:054' 4922 lig 1 .5.00.
WORKERS' COMPENSATION DECLARATION
hereby affirm that.I havecertificate of consent to self insure, P L I CATION FOR 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-=302 Ll Company Sl- FutiO
�®- Certified copy is hereby furnished. . i FOR APPLICANT TO FILL IN BUILDINGADDRESS r/Pl,•? �3�
❑ Certified copy is filed with the county building inspe'c- BUILDING -
tion department. n ! ADDRESS d.
Date t- Applicant �° it `:ar`4Q CITY LIE i �/1 ZIP LOCALITY
NO.OF BLDGS. 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 a 1'3 USE ZONE MAP / r
OWNERa�a
K I � L + NO. ( —Z 1F�
I certify that in the performance of the work for which thisIf
permit is issued, I shall not employ any person in any manner ADDRESS gQ t1 L `f SPECIAL
CONDITIONS
so as to become subject to the-Workers'Compensation Laws. '., O.
CITY .Lc,� C4. zip 0c $'
Date Applicant ARCHITECT OR TEL. DISTRICT GROUP TYPE FIRE._ CESSED BY
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. CONST. ZONE. �-
Exemption, you.should become subject to the Workers'
U Q °z
w
Compensation provisions of the Labor Code, you must forth- ADDRESS
with comply %I/Ith'such provisions or this permit shall be TEL ` STATISTICAL CLASSIFICATION ___APT.^ CONDO. - Z
deemed revoked. CONTRACTOR r-1mo i NO. Q(n3 5 l Q
LICENSED CONTRACTORS DECLARATIONLIC. CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS '{ ,,r NO. 332213 LA _
(commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP
CITY . A Q D1 vA�4� Cls 4/7V CLASS C- [b � -`� ;['
and Professions Code,and my license is in full force and effeci. BK,9- pGfj VALIDATI a .�_� e
SQ. FT. NO. OF NO.OF CHECK
License Number .332.Zg Lic. Class d LCA• SIZE I STORIES FAMILIES ONE
i VALUATION
DESCRIPTION OF WORK �1 2 S 2 S NEW
ADD
Contractor�IG F1 A� Ro 17 Dote f Q A.j!6 f-9, $ O QQQ
I ❑ 1 1
❑ op. _
I am exempt under Sec. ❑
� ALTER = :-•I?I.I':-••I_I__ - -
BAP.C. for this reason REPAIR ❑ : $
Date: USE.OF
EXISTING BLDG. DEMOIL ❑ _
Signature APPLICANT TEL. FINAL Gy 9
OWNER-BUILDER DECLARATION (PRINT) &12 Me6C_, 1
DATE
I hereby affirm that I am exempt from the Contractor's License
Law for the following reason (Section 7031.5, Business and ADDRESS f36"( -ro 0. CT- S• M h% S • A. FINAL 1"11114 1
Professions Code): PRESENT 7 By ACCT.BUILDING
❑ I, as owner of the property,•or my employees with ADDRESS
wages as their sole compensation,will do the work and p�� �-+ �] #'rG
the structure is not intended-or offered for sale Section LOCALITY 3307 a � 124.88
7044, Business and Professions Code.) ( MOVING TEL. , 3 3 b 7 97 2 1 ITEMS
EMS
❑ 1, as owner of the property,am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- C�� TOTAL 124 Z-3
ADDRESS
tion 7044, Business and Ptofessions Code.) �f u 1,�
REQUIRED YARD HWY TOTAL SETBACK FROM EXIST. / CHECK 124a VV
CONSTRUCTION LENDING AGENCY . • SET BACK PROP. LINE WIDTH
I hereby affirm that there is a construction lending agency for FRONT i � CHANGE ,()Ll
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name 01300-011f$ 8115189
$ ( , LDMA Ref. # iG4 1 ACI 5°e Ilr
_PC. Fee$ —Permit Fee / , ti
� Lender's Address r �. •
o I certify that I have read this application and state that the Issuance Fee O J LDMA P/C#
S above information is correct. I agree to comply with all County Investigation Fee.
ordinances and State laws relating to building construction, Total Fee / LDMA Perm. #
and hereby authorize representatives of this County to enters
upon the above-mentio d property for inspection purposes.,
Cir F, 011 SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature of Applicant or Agent Date I
;YVORKERS'COMPENSATION DECLARATION C i f L s Ox,
I•hereby affirm that I have certificate of consent to self APPLICATION
P P L I CATION F®R WILDING PER �Y ILJI
insure, or a certificate of Workers'Compensation Insurance,
,or a certified copy thereof 3800, Lo§,C.)
y �,� COUNTY OF LOS ANGELES BUILDING A SAFETY
PolicyNo. an IN
F1 Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING Q• a�,QA
ADDRESSEr
Certified copy is filed with the co t build! inspec- BUILDING Ry
�(
tion de art enf. ADDRESS I {r/l/�/ r
rA
'41 �� J
Date Applicant CITY w �L ZIP LOCALITY
CERTI CATE OF EXEMPTION R WORKERS' (�� 6 NO.OF BLDGS. NEAREST �►1
COMPENSATION IN NCE SIZE OF LOT 3 NOW ON LOT CROSS ST. 1 v
(This section need not be completed if the permit is for one 0 BLOCK LOT NO. ®® ASSESSOR '.
hundred dollars ($100)or less.) TRACT rjigye MAP BOOK PAGE PARCEL
pG�p T1NO.g` �` USE ONE OP �-7
I certify that in the performance of the work for which this OWNER r/(7
_57-
permit is issued, I shall not employ an person in an manner tt � ��r�66 `)(� SPECIAL O'
so as to become subject to theWorkers'Compensat on Laws. ADDRESS F C /VI f�V� ppv�� r r CONDITIONS
CITY � C ZIP 0(10 U'
Date Applicant ARCHITECT O TEL. ( �
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER I NOS' Z DI,STRICi GROUP TYPE FIRE PROCESSED BY
Exemption, you should become subject to the Workers' �p�- pi t `( (� Ov ZONE C)
Compensation provisions of the Labor Code, you must forth- ADDRE55�0� r,/l� Iv` (/ IP., �{ � pW}
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASSI ATION APT. C C0
deemed revoked. CONTRA NO. z
LICENSED CONTRACTORS DECLARATIONLIC, CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO.
(commencing with Section 7000)of Division 3 of the Business and to LIC SEWER MAP
Professions Code, and my lice is in full force and effect. CITY CLAS BK. VALIDATION
SO.FT. NO. F NO.O CHECK
License Number 3 Lic.Class � (/ SIZE STORIES FAMILIES Z ONE
�-,/ eA�v VALUATION
Contractor Date l DESCRIPTION OF WORK 1WJJ1DM NEW 11 ADD $
F1 /'r, s
I am a pt under Sec. IV 1zp?Es a
ALTER
B.BP.C. for this reason REPAIR $
Date: USE OFf1 DEMOI 1 2�J
EXISTING BLDG. P
Signature APPLICANT /� TEL.! $ FINAL
OWNER-BUILDER DECLARATION PRINT 00 NO. 1'Z'3
/23 DATEl °� # 0 0 0 0 0 1
1 hereby affirm that I am exempt from the Contractor's License ADDRESS 2�� C� i'1 V G a .�L ( o o60.50
Law for the following reason (Section 7031.5, Business and FIN
Professions Code): PRESENT BY smallumilawLEMO ' 0 6 0 ` 0 v
❑ BUILDING
I, as owner of the property, or my employees with ADDRESS ( 2 0 1 —F-8
wages as their sole compensation,will do the work and t
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 N.O. f.
with licensed contractors to construct the project (Sec- ADDRESS 'f J
tion 7044, Business and Professions Code). 11111I - 9)
REYARD HWY TOTAL SETBACK R
CONSTRUCTION LENDING AGENCY SETT BACK 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
P.L.
Lender's Name �) LDMA Ref. #
o P.C.Fee$ Permit Fee 57)
I'✓
Lender's Address
I certify that I have read this application and state that the Issuance Fee t� LDMA P/C#
61
above inform 'on is correct. I agree to comply with all County Investigation Fee
ordinances State laws relating to building construction, Total Fee LDMA Perm.#
and h by u orize epresentatives of this County to enter
upon t e a -men ned property for inspection p repos
' t I r�b��' UG
e SEE EVERSE EXPLANATORY LANGUAGE y�
� nCfre of Applicant Zr Agent ate � ) 0&4,4 ��y 31 s 67� I-11, ''I
,WORKERS'COMPENSATION DECLARATION
hereby affirm that I have certificate of consent to self A P L I CAT I N FOR" BUIL®I P E RM O U
insure, or a certificate of Workers'Compensation Insurance,
or a certified co yQWec.
3800, Lab ). LbCOUNTY OF LOS ANGELES BUILDING APiDSAFETY
Policy No. ® mpany
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
;.ADDRESS �' v
911par'
copy i filed with the cou t buA ins ec- BUILDING �� �,crilAe�ptn OW
_6 Fpm /
tion art e t ADDRE (����CJlt� F�1/L/
i
Date Applicant CITY ZIP /� ?LOCALITY e
CERTIFICA OF EXEMPTIO F WORKERS' 'O Cb NNO.OF OW ONLDGS 2 NEARESST.
COMPENSATION 1 ANCE SIZE OF LOT LOTCROSS
(This section need not be completed if the permit is for one ASSESSOR
hundred dollars($100)or less.) TRACT V BLOCK LOT NO. 1 MAP BOOK PAGE PARCEL
TEL.-%Jy USE Z NOP r, / C
1 certify that in the performance of the work for which this OWNER (✓ GNO. �j —z. 11 J }}
permit is issued, I shall not employ any person in any mannerp i SPECIAL Q�t
so as to become subject to the Workers'Compensation Laws. ADDRESS y� &A BWP• CONDITIONS U
CITYA�MZIP ai
Date Applicant ARCHITECT O TEL.
NOTICE TO APPLICANT: If, after making this Certificate of pp�� DISTRICT GROUP TYPE FIRE PROCESSED BY C)
ENGINEER o �6VA NO TJ 3 •� CONST. ZONE I""
Exemption, you should become subject to the Workers' rr (�
Compensation provisions of the Labor Code, you must forth- ADDRESS G
with comply with such provisions or this permit shall be
TEL. STATISTICAL CLASSIFICATION APT. NDO. N
deemed revoked. CONT R NO. el
LICENSED CONTRACTORS DECLARATION ,�,��• LIC, CLASS NO.�s_.LDWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDR r✓`I.- NO.
(commencing with Section 7000)of Division 3 of the Business and LIC, /' SEWER j
Professions Cod y,RiMMI
se is in full force and eff ct. CITY CLASSi BK G PG VALIDATION
rt, V' SQ.FT. N OF NO.OF C ECK
License Num r Lic.Clas- SIZE STORIES FAMILIES ONE
t ft(/MON 0 NEW El VALUATION
DESCRIPTION OF WORK $
Contractor Date ADD
I am e t under Sec. NILL, ALTER
B.&P.C. for this reason $ � 1 2 2 9 A
REPAIR
USE OF
Date: r r DEMOL # 0 0 6 a 9 6
EXISTING BLDG. 1 0 0
Signature APPLICANT TEL. FINAL
OWNER-BUILDER DECLARATION PRINT• per r �•� �NO.'.7igD `Ti3 DAT i�0 0 0 - 60.505
I hereby affirm that I am exempt from the Contractor's License gDDRESS //"y r/ �i I IZ�+rJ•
Law for the following reason (Section 7031.5, Business and FIN 12,01 —LOB
Professions Code): PRESENT BY
E] 1,1, as owner of the property, or my employees with 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 CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROPLINEF 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
P.L.
Lender's Name flPl LDMA Ref. #
00 Address
P.C.Fee$ Permit Fee 10V
Lender's
1 certify that I have read this application and state that the Issuance Fee Da• LDMA P/C#
above information is correct. I agree to comply with all County Investigation Fee �J`)
in
laws relating to building construction, Total Fee D J `� LDMA Perm.#
representatives of this County to enter Elm
$ Toned property for inspection ur os s. / ieeSEE REVERSE FOR EXPLANATORY ANGUAGE �t5 ll/icant or Agent Dat `111'7. -;2- _/. A)j zw
f;/ '�V (`�v W ��, «r
'IRS',COMFENSATION DECLARATION �i
P..ore or afcerirmtii cair rte of Workss' Compensatoa certificate of n ent to Insuranelf PPLICAT1 N ■ 0R" I� IN PE 9T
a certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
•Policy No. CompanyEAKM BUILDING
❑ Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS ( (/11(•
❑ Certified copy is filed with the count u'ding inspec- BUILDING /� '
tion department. ADDRESS
Date -Z—,2 Applicant CITY IJL% C ZIP LOCALITY
CERTIFICATE OF EXEM FROM ORKERS' NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. A i
(This section need not be completed if the permit is for one ASSESSOR
hundred dollars($100)or less.) TRACT BLOCK LOT NO. /G d� •MAP BOOK PAGE I PARCEL
TEL. I. USE E MAP —7 J
I certify that in the performance of the work for which this OWNER NO. NO. f/d?
Rs permit is issued, I shall not employ any person in any manner Ihi'' y� SPECIAL O
so as to become subject to the Workers'Compensation Laws. ADDRESS O M fr }�ry.f t CONDITIONS
CITY ZIP LT DO` U
Date Applicant ARCHITECT OR TEL•4I + DISTRICT GROUP TYPE FIRE 7SED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER bd� NO. 'tD �i7
!- CONST. ZONE 0
Exemption, you should become subject to the Workers' r r L / 1 LU
Compensation provisions of the Labor Code, you must forth- ADDRESS 2 rkV. �i � `� [/''�tiJ 3
with comply with such provisions or this permit shall be TEL. STATISTICAL CLASS F1 ON APrJ CONDO. U)
deemed revoked. CONTRACTOR O. --C j� Z
LICENSED CONTRACTORS DECLARATION LIC.Lf"]/1� J CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS' NO. /7
i I
(commencing with Section 7000)of Division 3 of the Business and 2� LIC �Q SEWER MAP
Professions Code, and my license is in full force and effect. CITY e� CLASS 16 BK �� �� V,6 D09�8 A
^^'�� SQ. FT NO.OF +� NO.OF CHECK rr 3
License Number 41-7 Yy_2Lic.Class SIZE STORIES Li FAMILIES ONE
f�Q 4- We
/./J y��7 �F/�) VALUATION ? 18 4 ca
Contractor LC vL����D� a " _�V DESCRIPTION OF WORK NEW $ . o=
ADD
r_1I am exempt under Sec. ALTER E] /0/6/]J) ® 2 y
B.BP.C. for this reason 6� r V�v�`°`rT 1 REPAIR ❑ $ /1 (/[J
te: USE OF El .
EXISTING BLDG. `� /' [� J
Signature APPLICANT
(��(� NO. �� FINAE C� Q
TE
O R-BUIL R DECLARATION DATp�( `�
I herebyaffirm a I am exempt from the Contra is License 2,D �' r
Low fothe following reason(Section 7031. Business and ADDRESS/v� �' � ° FINALQ���'r"
Professions Code): BUILDING L By `'
❑ 1, as owner of the property, or my employees with 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 CONTRACTOR NO. c u I
with licensed contractors to construct the project (Sec- ADDRESS IT 3
tion 7044, Business and Professions Code). ( 1 Q •7 5 7 5
REQUIRED TOTAL SETBACK PON
CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH a I FJ% 5 'I 5
I hereby affirm that there is a construction lending agency for FRONT ( 228-1-, 8
the performance of the work for which this permit is issued P.L.
(Sec. 3097, Civ. C.). SIDE
P.L.
Lender's Name
a P.C.Fee$ s Permit Fee A W771!i�;?,.J LDMA Ref. #
Lender's Address
I certify that I have read this application and state that the Issuance Fee ,S LDMA P/C# Poo
R above information i corre omply with all County Investigation F ibC Q �,
q ordinances and to ws relating to b ilding construction, v 1 -� Total Fee (J v ( S LDMA Perm.#
$ and hereby ou or' a repress tatives of t is County to enter
upon a ab -m ntioned operty for 1 spection purposes.
m
SEE REVERSE FOR EXPLANATORY LANGUAGE
Signature ofApplicant or Agent Date
QRS'COMPENSATION DECLARATION
"1n..er.;ro
ffirm that I have W r certificate of consent to self APPLICATION
P P L i C®T I N F R BUILDING PERMIT
a certificate ofWorkers'Compensation Insurance, �1W�ed copy thereof(Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY
f Policy No. Company
Certified copy is hereby furnished. FOR APPLICANT TO FILL IN BUILDING
ADDRESS
Certified copy is filed with the count i in inspec- BUILDING ((��pQ,���� /
/tion departmmee�rA/�/. ADDRESS D6 6 awtlJ BL
Date/ -2-9 vV Applicant CITY [ 4/IJ c ZIP '.LOCALITY
CERTIFICATE OF EXEMPTIO FROM WORKERS' NO.OF BLDGS. NEAREST
COMPENSATION INSURANCE SIZE OF LOT �� NOW ON.LOT CROSS ST.
(This section need not be completed if the permit is for one , Q �y ASSESSOR
hundred dollars($100)or less.) TRACT �+ @ cBLOCK Q� LOT NO. II �}V Mqp BOOK PAGE PARCEL
OWNER L aPS qy NO.TEL. USE Z E MAP
1 certify that in the performance of the work for which this NO.
Ao
" permit is issued, I shall not employ any person in any manner .a p SPECIAL O
so as to become subject to the Workers'Compensation Laws. ADDRESS ,� G+1 V CONDITIONS
CITY L_ zip Cl ri b i U
Date Applicant
ARCHITECT OR rrr'' U�j C�t�) `` � TEL.%1 DISTRICT G UP TYPE FIRE PROCESSED BY O
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER ��w l.lt V� NO., Z3
Exemption, you should become subject to the Workers' CONS ®/ ZONE F—
Compensation provisions of the Labor Code, you must forth- gDDRESS"205� " ,��{� {` �/I"V � �` W
with comply with such provisions or this permit shall be T STATISTICAL CLAS FI ION APT. ENDO. N
deemed revoked. CONTRACTOR Z
LICENSED CONTRACTORS DECLARATION LIC. GA55 NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS NO. IR SEMR MAP
(commencing with Section 7000)of Division 3 of the Business and LIC. F �7r�
Professions Code, and my license is in full force and effect. CITY CLASS E VACID9A710%9 A
L,� SQ. FT NO.OF .rte NO.OF CHECK BK. �'' 0 0 0 0 3
License Number r ����? Lic.Clgss SIZE STORIES L/ FAMILIES ONE
% �F'/,4Un ^� VAL. TION 11.58S46
Contractor �~ pa�}e a_d DESCRIPTION OF WORK ' � 4 NEW $
b ADD j a 1,585,46
El I am exempt under Sec. Xaml 110.
yl �//
B.BP.C. for this reason �•00S �T REPAIR ❑ $ �"'7f �d 0& 02-88
: USE OF /� �"'
D EXISTING BLDG. `� s DEMOL ❑'"
APPLICANT Ca/,�, • TEL. , ryQ
Signature C 3� ; FINAL
ER-BUILD DECLARATION PRINT NO. N DATE
I herebyaffirm that I am exempt from the Contractor's/Lins'e q ,ril i!-iLaw fothe following reason(Section 7031.5, Busip ADDRESS �ry • (.< 7?<V s FINAL
Professions Code): PRESENT By ►yam'
13 1,
I, as owner of the property, or myemployees with ADDRESS
wages as their sole compensation,will do the work and
the structure is not intended or offered for sale(Section LOCALITY r 14 1,3 A
7044, Business and Professions Code). MOVING TEL. #0 0 0 0 0 1
I,as owner of the property, am exclusively contracting CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS 1 1.87575
tion 7044, Business and Professions Code). FROM LiF 0 1,8 7 5.7 5 6
CONSTRUCTION LENDING AGENCY SETT BACK YARD HWY TOTAPROP L NE WIDTH 1 228-88
1 hereby affirm that there is a construction lending agency forpinvestigationF
the performance of the work for which this permit is issued
(Sec. 3097, Civ. C.).
Lender's Name
'l LDMA,Ref.q
3 r Permit Fee v l ,
Lender's Address
j a
1 certify that I have read this application and state that theIssuance Fee [ r5V LDMA P/C#
above information is correct. ee to comply with all Countyordinances and tate s relatin tobuilding construction, u e Total Fee116.
LDMA Perm. #
and hereby au ori representativ s of this County to enterupon the abo - ntion propert for inspect* n purps1 OREVERSE FOR EXPLANATORY LANGUAGE
0
Signaturelfof Applicant or Agent Date
WORKERS'COMPENSATION DECLARATION
r
hereby
irm that I have a certificate
ent to self
RVWsureor acertifcate of Workers' Insurance, AF.P� CAU � V FOR � �
or a certified co th r (b423800, Lab. .)s- COUNTY OF LOS ANGELES BUILDING AICD AFETY
Policy No. pony _;..;.:..
BUILDING
ts
reby furnished. FOR APPLICANT TO FILL IN ADDRESS
ed with th co uildin 1 pec- 4 BUILDING wig ereQ1
ADDRESS :/D I��/
Datepplicant f CITY �. ZIP LOCALITY EMPTIO FR ORKERS' • O /' NO.OF BLDGS. NEAREST
COMPENSATION IN CE SIZE OF LOT 10 NOW ON LOT CROSS ST.
(This section need not be complete if the permit is for one ASSESSOR
hundred dollars($100)or less.) TRACT BLOCK LL LOT NO. MAP BOOK PAGE PARCEL
TELfi- NO. I USE ZONE MAP
I certify that in the performance of the work for which this OWNER g tl4� p� r. NO. �
permit is issued, I shall not employ any person in any manner ADDRESS 6�y V �r �N�� W' -� SPECIAL
CONDITIONS
so as to become subject to the Workers'Compensation Laws. ���� `�• !!,A� � �
CITY VNPi CA_ ZIP `�[[OW
Date Applicant ARCHITECT O TEL. $
NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER �y�,,��jr' y�/� 2� + DISTRICT ROUP TYPE FIRE PRO SED BY
1811/USN/, ®- �j9°r NO. (moi CONST. ZONE
Exemption, you should become subject to the Workers' _ /( ? (�
P Y I y�„ _ �1 dR_
?_
Compensation provisions of the Labor Code, you must forth- ;ADDRESS /4UG \J( _J
with comply with such provisions or this permit shall be TEL. TATIS7ICAL CLASSIFICATION APT. DO. Cn
deemed revoked. CONTRALTO NO.
LICENSED CONTRACTORS DECLARATION LIC, c CLASS NO. DWELL. UNITS
I hereby affirm that I am licensed under provisions of Chapter 9 ADD NO. SEWt R
(commencing with Section 7000)of Division 3 of the Business and LIC. ��'� ''
IW
Professions Code, d my li ns is in full force and effect CITY o CLASS— �'� BK. � VALIDATION
�� SQ.FT. NO. F NO.OF CHECK a
License N.. e Uc.Class C SIZE STORIES FAMILIES ONE VALUATION'
Contractor Date x,DESCRIPTION OF WORK of NEW ❑'' $
I am�xe pt under Sec. l� N� eltmawADD o 0 0 0 0
�I cl ���
ALTER ❑:'�
B.BP.C. r this reason REPAIR $ o o (� C,5
USE OF
Date: y EXISTING BLDG. �f DEMOL iy o o o 6 0.5 0 5
Signature APPLICANT TEL.$r$ FINAL 2 (}
—88
OWNER-BUILDER DECLARATION r PRINT NO. DATE f `
I hereby affirm that I am exempt from the Contractor's License �f (j�
Law for the following reason (Section 7031.5, Business and ADDRESS _GI�r�e�
FIN
Professions Code): PRESENT By i
❑ !BUILDING
I, as owner of the property, or my employees with 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 c CONTRACTOR NO.
with licensed contractors to construct the project (Sec- ADDRESS
tion 7044, Business and Professions Code).
CONSTRUCTION LENDING AGENCY SETA'BACK YARD HWY TOTAL
SETBACK FROM
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
P.L.
Lender's Name J�
i P.C.Fee$ Permit Fee .6 o P.C.
N
Lender's Address a�
g 1 certify that I have read this application and state that the Issuance Fee 9 J 11EPIC N
? above iinAPrmation is correct. I agree to comply with all County Investigation Fee
ordinan s and St to laws relating to buildi4Do
structio r Total Fee r LDMA Perm. q
and her y auth ze representatives of this t enter
upo t above- ntioned property for inspep rpo s. �1
0 1 b&EHEV S FOR EXPLAPIATORY eUAGE /nature of Applicant or Agent e "7
Ar A �/
• 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 1211270061
PHONE: (626) 285-0488 EXT:
LEGAL ID: NO. OF CONST BUILDING ADDRESS:
ITR: 5904 LT: 99 SQ. FT STORIES TYPE 6138 APT B ROSEMEAD BL
[STRUCTURE: V-B TEMP CA 917801564
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET:
15384-006-009 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY CAI
(TENANT: JEXIST BLDG USE; REBID USE ZONE: R-3 (ISSUED ON: PROCESSED BY:
]EXIST OCC GRP: 111/27/12 SR ]
(OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: 1FINAL DATE FINAL BY: CODE: 1
1RICHWELL DEVELOPMENT LLC (626) 535-0388- ] 5,200 ]/ � f Z Z-/I\ 1
2500 E FOOTHILL BLVD ` 7 A/
PASADENA CA 91107 J FEES PAID IDESCRIVTION OF WORK 1
I J 1KITCHEN AND BATHROOM REMODEL 1
I JFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 I
(APPLICANT: TEL. NO: 1 1 1
JDAM, QUAN V (626) 757-3442- JAA BLDG PERMIT ISSUANCE 27.80 1 1
1306 ELIZABETH AVE JAB STATE GREEN BLDG FEE 5200.00 VAL 1.00 JSPECIAL CONDITIONS: 1
1MONTEREY PARK 91755 JAC STRONG MOTION RESID 5200.00 VAL 0.50 1 1
J JB2 PERMIT W/ENERGY 5200.00 VAL 164.30
J 1 TOTAL FEES 193.60 J
1CONTRACTOR: TEL. NO: 1 (APPROVALS DATE INSPECTOR SIGNATURE
1T & A CONSTRUCTION CO (626) 757-3442- 1 1 J
306 N ELIZABETH AVENUE LIC. NO 1 1LOCATION AND SETBACKS I I
1MONTEREY PARK CA 91755 852143 * 1 1
1 1 ]SOILS ENGINEER APPROVAL ] ] ]
]ARCHITECT OR ENGINEER: TEL. NO: - ] ]FOUNDATION/TRENCH FORMS J I I
LIC. NO: J ]SLAB/UNDER FLOOR
I i ]RAISED FLOOR FRAMING J ] ]
JMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:J JUNDERFLOOR INSULATION ] 1 I
115OH265 3 001 1 1 J 1
J J IFLOOR SHEATHING I I 1
1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 I I I J
] 0 NO 21 ] 1ROOF SHEATHING i1 1
1 SCHOOL WITHIN HAZARDOUS 1 1SHEAR PANELS 1 I
JAIR QUALITY: 1000 FEET MATERIALS 1 1 1 1
] ]
NO NO NO ] ]FRAME INSPECTION 1 ]
1 J 1FIRE SPRINKLER HANGERS ] I 1
1 1 ]INSULATION/WEATHER STRIP( ] I
1 ] (INTERIOR LATH/DRYWAIS,
] 1 ]EXTERIOR LATH 11S�y/YID` 1
I I 1RATED FLOOR/CEIL ASSEM. I 1 J
] I] (RATED WALL ASSEMBLIES 1 1 I ] I
] ]RATED SHAFTS/OPENINGS I I
I I IT-BAR CEILINGS I I
1 1* ADDITIONAL DATA ON FILE 1 1 I 1
1 1 1LOT DRAINAGE
1 JREPORT ID: DPR261 ROUTE TO: BS0508 J 1 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 1211270062
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST BUILDING ADDRESS: [
ITR: 5904 LT: 100 I SQ. FT STORIES TYPE I 6128 APT F ROSEEMAD BL
ISTRUCTURE: V-B I TEMP CA 917801500
1 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: GARIBALDI AVE [5384-006-011 [ I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY [
(TENANT: (EXIST BLDG USE: RESID USE ZONE: R-3 [ISSUED ON: PROCESSED BY: 1
(EXIST OCC GRP: 111/27/12 SR
(OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IFIN L ATE FINAL BY: CODE: [
IRICHWELL DEVELOPMENT LLC (626) 535-0388- 1 2 5,200 [ [
12500 E FOOTHILL BLVD I 1
IPASADENA CA 91107 1 FEES PAID [DESCRIPTION OF WORK [
[ I IKITCHEN AND BATHROOM REMODEL
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 I
JAPPLICANT: TEL. NO: I I I
IDAM, GAN V (626) 757-3442- IAA BLDG PERMIT ISSUANCE 27.80 1 1
1306 ELIZABETH AVE IAB STATE GREEN BLDG FEE 5200.00 VAL 1.00 ISPECIAL CONDITIONS: 1
IMONTEREY PARK 91755 IAC STRONG MOTION RESID 5200.00 VAL 0.50 1
I JB2 PERMIT W/ENERGY 5200.00 VAL 164.30 I I
I 1 TOTAL FEES 193.60 I
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE 1
IT & A CONSTRUCTION CO (626) 757-3442- 1 1 1
1306 N ELIZABETH AVENUE LIC. NO J ILOCATION AND SETBACKS I I I
IMONTEREY PARK CA 91755 852143 * J I I I
I I ISOILS ENGINEER APPROVAL I I I
(ARCHITECT OR ENGINEER: TEL. NO: 1 [FOUNDATION/TRENCH FORMS I [ I
LIC. NO: I JSLAB/UNDER FLOOR J I I
RAISED FLOOR FRAMING I 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ [UNDERFLOOR INSULATION I I I
115OH265 3 021 1 1-1 -I
I I IFLOOR SHEATHING [ [
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I [ I [
1 1 YES 21 1 IROOF SHEATHING [ [ [
SCHOOL WITHIN HAZARDOUS [ ISHEAR PANELS I I [
[AIR QUALITY: 1000 FEET MATERIALS I [ I I
1 NO NO NO IFRAME INSPECTION I I I
I I I I I
1 IFIRE SPRINKLER HANGERS [ [ [
I [ IINSULATION/WEATHER STRIPI I [
[ [ I
INTERIOR LATH/DRYWALL I I
I_ �� I
[ JEXTERIOR LATH [ 1 [
IRATED FLOOR/CEIL ASSEM. I I I
[ IRATED WALL ASSEMBLIES J I
i
[
IRATED SHAFTS/OPENINGS
I IT-BAR CEILINGS
I I
1* ADDITIONAL DATA ON FILE J
IJ I I
1 LOT DRAINAGE
IREPORT ID: DPR261 ROUTE TO: BS0508 1 I I I
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 1304230024
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
ITR: 5904 LT: 100 I SQ. FT STORIES TYPE 6128
TISTRUCTURE. V-B TEMP CA917801500� BL
I
[ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: GARIBALDI AVE I
15384-006-011 [ I THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY [
ITENANT: (EXIST BLDG USE: RESID USE ZONE: R-3 TISSUED ON: PROCESSED BY:
(EXIST OCC GRP: 04/23/13 SR
(OWNER: TEL. NO: 1BLDGS. NOW ON LOT: VALUATION: 1F ATE FI CODE:
IRICHWELL DEVELOPMENT LLC (626) 535-0388- 1 2 2,500
12500 E FOOTHILL BLVD 1 I i I
IPASADENA CA 91107 [ FEES PAID 1 ?4
SCR TIO OF WORK [
I [ IKITCHEN REMODEL [
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT-.1 I
[APPLICANT: TEL. NO: I I I
IDAM, QAN V (626) 757-3442- IAA BLDG PERMIT ISSUANCE 27.80 1 [
1306 ELIZABETH AVE IAB STATE GREEN BLDG FEE 2500.00 VAL 1.00 ISPECIAL CONDITIONS: I
MONTEREY PARK 91755 AC STRONG MOTION RESID 2500.00 VAL 0.50 I
IB2 PERMIT W/ENERGY 2500.00 VAL 108.90 I [
I I TOTAL FEES 138.20 1
ICONTRACTOR: TEL. NO: I (APPROVALS DATE INSPECTOR SIGNATURE
IT & A CONSTRUCTION CO (626) 757-3442- [ 1
1306 N ELIZABETH AVENUE LIC. NO ILOCATION AND SETBACKS I I I
IMONTEREY PARK CA 91755 852143 * I 1- 1 ]
I ISOILS ENGINEER APPROVAL I I [
(ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I I
[ LIC. NO: I ISLAB/UNDER FLOOR I 1 I
I (RAISED FLOOR FRAMING
I I
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:[ 1UNDERFLOOR INSULATION I I I
115OH265 3 001 1 1-1 1
I I IFLOOR SHEATHING I [ [
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I [ I I
0 YES 21 I IROOF SHEATHING
� I �
[ IrCHOOL WITHIN HAZARDOUS 1 (SHEAR PANELS [ I
1AIR QUALITY: 1000 FEET MATERIALS I
1 NO NO NO [ IFRAME INSPECTION
]FIRE SPRINKLER HANGERS I I [
I I (INSULATION/WEATHER STRIPI I I
1 [ [INTERIOR LATH/DRYWALL [ 1 I
I [ 1EXTERIOR LATH I 1 I
I I I
1 I (RATED FLOOR/CEIL ASSEM. I 1
I (RATED WALL ASSEMBLIES I I
I I (RATED SHAFTS/OPENINGS I I I
1 I IT-BAR CEILINGS I I 1
I 1* ADDITIONAL DATA ON FILE I
I I ILOT DRAINAGE I I I
[ IREPORT ID: DPR261 ROUTE TO: BS0508
I
1 1 I I I
COUNTY OF IAS 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 1406020049
PHONE: (626) 285-0488 EXT:
LEGAL ID: N0. OF CONST BUILDING ADDRESS:
ITR: 5904 LT: 100 1 SQ. FT STORIES TYPE 6128 ROSEMEAD BL
I ISTRUCTURE: 38 V-B TEMP CA 917801500 1
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
15384-006-011 i 1 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY CAI
TENANT: ]EXIST BLDG USE: RESID USE ZONE: R-3 JISSUED ON: PROCESSED BY:
1 1EXIST OCC GRP: 106/02/14 SR 1
[OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: ' DATE FJWAL BY: CODE:
(JOANNE (626) 375-9101- 1 10,500
FEES PAID 4ASMIPTION OF WORK
NEAR OFF EXISTING LAYER REPLACE BAD SHEATHING INSTALL 1 BASE
[FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ISHEET 2 PLY 11 POUND AND CAP SHEET I
APPLICANT: TEL. NO: I
ICASTRO, MARGARITA (310) 346-1792- IAA BLDG PERMIT ISSUANCE 27.80 I_
13366 W 134TH PLACE IAB STATE GREEN BLDG FEE 10500.00 VAL 1.00 ]SPECIAL CONDITIONS: 1
IHAWTHORNE CA 90250 1AC STRONG MOTION RESID 10500.00 VAL 1.10 I
1 CD2 PERMIT W/O EN-HC 10500.00 VAL 233.40 I
1 [ TOTAL FEES 263.30 I [
ICONTRACTOR: TEL. NO: I IAPPrOVALS DATE INSPECTOR SIGNATURE
ICASTRO'S ROOFING INC. (310) 346-1792- ] 1 I
13336 W. 134TH ST. LIC. NO 1 ILOCPTION AND SETBACKS I I
1HAWTHORNE, CA 90250 911050 ] 1 1
I 1 ISOILS ENGINEER APPROVAL 1 1 1
]ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS I
1 LIC. NO: 1 [SLAB/UNDER FLOOR 1 1 1
1 IRAISED FLOOR FRAMING 1 I 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: [UNDERFLOOR INSULATION
I ] I
1 3 OOi IFLOOR SHEATHING 1 1
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I
1 NO 21 I IROOF SHEATHING ]
I SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I
]AIR QUALITY: 1000 FEET MATERIALS 1 I 1 I 1
NO NO NO I IFRAME INSPECTION I I 1
IFIRE SPRINKLER HANGERS ] ]
1 I 1 NSULATION/WEATHER STRIP( 1
1 I IINTERIOR LATH/DRYWALL 1 1 1
[EXTERIOR LATH
IRATED FLOOR/CEIL ASSEM. I I ]
] I IRATED WALL ASSEMBLIES ] ] I
I IRATED SHAFTS/OPENINGS 1 I
[
1 ] 1T-BAR CEILINGS
1
1 [ [LOT DRAINAGE [ 1
1 (REPORT ID: DPR261 ROUTE TO: BS0508 I [ 1 1
I I I I I I
r, ,
COUNTY OF IAS 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 1406020052
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST BUILDING ADDRESS: I
TR: 5904 LT: 99 I SQ. FT STORIES TYPE 6138 ROSEMEAD BL I
(STRUCTURE: 38 V-B I TEMP CA 917801564 1
(ASSESSOR INFORMATION NUMBER: 1 NEAREST CROSS STREET: LONGDEN I
15384-006-009 1 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY CAI
I L I I
(TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-3 JISSUED ON: PROCESSED BY: I
EXIST OCC GRP: 106/02/14 SR I
(OWNER: TEL. N0: IBLDGS. NOW ON LOT: VALUATION: IF ,AL fi F BY: CODE: ]
IJOANNE (626) 375-9101- 1 10,500 I
Iko
I
1 FEES PAID fffES(KTIPTION OF WORK [
1 I 1TEAR OFF EXISTING LAYER RE CE BAD SHEATHING INSTALL 1 BASEI
IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:ISHEET 2 PLY 11 POUND AND CAP SHEET 1
(APPLICANT: TEL. NO: I I I
ICASTRO, MARGARITO (310) 346-1792- IAA BLDG PERMIT ISSUANCE 27.80 I_ 1
3366 W 134TH PLACE IAB STATE GREEN BLDG FEE 10500.00 VAL 1.00 ISPECIAL CONDITIONS: I
IHAWTHORNE CA 90250 IAC STRONG MOTION RESID 10500.00 VAL 1.10 I 1
ID2 PERMIT W/0 EN-HC 10500.00 VAL 233.40 I
1 I TOTAL FEES 263.30 I I
(CONTRACTOR: TEL. NO: I [APPROVALS DATE INSPECTOR SIGNATURE 1
ICASTRO'S ROOFING INC. (310) 346-1792- 1 1 [
13336 W. 134TH ST. LIC. NO I ILOCATION AND SETBACKS [ I [
IHAWTHORNE, CA 90250 911050 I 1- 1 I 1
I I ISOII.S ENGINEER APPROVAL 1 1 1
I _
1ARCHITECT OR ENGINEER: TEL. NO: I (FOUNDATION/TRENCH FORMS I I I
1 LIC. NO: 1 (SLAP/UNDER FLOOR I I 1
1 IRAISED FLOOR FRAMING I I 1
IMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( (UNDERFLOOR INSULATION 1 [ ]
3 00
I I IFLOOR SHEATHING I I [
INO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I_- I I I
[ NO 21 I IROOF;SHEATHING I 1 1
1 SCHOOL WITHIN HAZARDOUS I ISHEAR PANELS I I 1
1AIR QUALITY: 1000 FEET MATERIALS I I I I [
[ NO NO NO I IFRAME INSPECTION I I
1 I IFIRE SPRINKLER HANGERS ] 1
1 1 IINSULATION/WEATHER STRIP( I 1
1 1 IINTERIOR LATH/DRYWALL I 1 I
1 1 (EXTERIOR LATH I [ I
I I IRATED FLOOR/CEIL ASSEM. 1 1 1
1 I IRATED WALL ASSEMBLIES 1 1 I
(RATED SHAFTS/OPENINGS
I I I I I I
IT-BAR CEILINGS I I I
[ I ]LOT DRAINAGE I 1 I
IREPORT ID: DPR261 ROUTE TO: BS0508 ] I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATION/REPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 9711100036
PHONE: (818) 285-0488 EXT: DUPLICATE
LEGAL N0. OF CONSTBUILDINGADDRESS:
TR: 5904 LT: 100 SQ. FT STORIES TYPE 6128 ROSEMEAD BL
STRUCTURE: 0 VN TEMP CA 917801500
ASSESSOR INFOR14ATION NUMBER: NEAREST CROSS STREET: GARIBALDI AVE
5384-006-011 THOMAS PAGE: 596 GRID: H3 LOCALITY: TEMPLE CITY
TENANT: E ST 8 DG SE: RESID USE ZONE: R-3 ISSUED ON: ROC ED PIR ON:
EXIST OCC GRP: 11/10/97 RN 11/10/98
OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY: CODE:
K M;K E HUANG FAMILY LIMITED PARTNE - 2 5,500 I
1590 CALIFORNIA BL l
PASD 911064104 FEES PAID DESCRIPTION OF WOR
REROOF-OVER EXISTING (1) LAYER W/COMP MINGLES.
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: EL. N
JAY-AR CONSTRUCTION (818) 286-6471- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 5500.00 VAL 0.55 SPECIAL CONDITIONS:
D2 PERMIT W/0 EN-H 5500.00 VAL 101.10
-AA BLDG6Cf rte- 27.75
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NO NO NO - FRAME INSPECTION
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* ADDITIONAL DATA ON FILE
0 AG
REPORT ID: DPR261 ROUTE TO: BS0508
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BLTO 0810120716 058
PHONE: (626) 285-0488 EXT:
ILEGAL ID: I NO. OF CONST I BUILDING ADDRESS: I
]TR: 5904 LT: 99 I SQ. FT STORIES TYPE 1 6138 ROSEMEAD BL I
]ASSESSOR INFORMATION NUMBER: ISTRUCTURE: 0 VN I TEMP CA 917801564 I
15384-006-009 ] I NEAREST CROSS STREET: GARIBALDI AVE 1
THOMAS PAGE: 596 GRID: H2 L.00ALITY: TEMPLE CITY I
]TENANT: 1EXIST BLDG USE: RESID USE ZONE: R-3 ]ISSUED ON: PROCESSED BY: ]
]EXIST OCC GRP: 107/16/12 SR
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OWNER: TEL. NO: - ]BLDGS. NOW O
ON LOT: VALUATION:
I
IFI DATE FIIN,AALLBY: CODE:
61NY I IN I� I
6138 ROSEMEAD BLVD. Z
ITEMPLE CITY CA 91780 I FEES PAID ID SCRIPTION OF WORK VI
1KITCREN AND BATHROOM REMODEL 1
I IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:1 I
(APPLICANT: TEL. NO: I I I
]DAM, STEVEN (626) 625-5248- 1AA BLDG PERMIT ISSUANCE 27.80 1 I
I IAB STATE GREEN BLDG FEE 2000.00 VAL 1.00 ISPECIAL CONDITIONS: 1
]AC STRONG MOTION RESID 2000.00 VAL 0.50 1 I
B2 PERMIT W/ENERGY 2000.00 VAL 90.40 1 I
I IFR INV WORK W/O PERMIT 342.20 DOL 342.20 I I
ICONTRACTOR: TEL. NO: TOTAL FEES 461.90 (APPROVALS DATE INSPECTOR SIGNATURE 1
ISEASON CONSTRUCTION INC. (626) 625-5248- 1
19824 HOWLAND DRIVE LIC. NO ILOCATION AND SETBACKS ] I I
ITEMPLB CITY, CA 91780 827959-B * 1 I
SOILS ENGINEER APPROVAL 1
]ARCHITECT OR ENGINEER: TEL. NO: - ] ]FOUNDATION/TRENCH FORMS I I ]
LIC. NO: I (SLAB/UNDER FLOOR I I
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] ]* ADDITIONAL DATA ON FILE ILOT DRAINAGE 1 I I
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IREPORT ID: DPR261 ROUTE TO: BS0508 I I I I
-I I I I
COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9071 LAS TUNAS ALTERATIONAEPAIR
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA BL 0508 971110003$
PHONE: (81$) 285-0488 EXT: DUPLICATE
LEGAL • f ST BUILDING ADDRESS:
TR: 5904LT: 99 SQ. FT STORIES TYPE 6138 ROSEMEAD BL
ASSESTRUCTURE: 0 VN TEMP CA 917$01564
SS INFORMATION .B NEAREST CROSS STREET: GARIBALDI AVE
5384-006-004 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG E: RESID USE 20 Or- PROCESSED EXPIRES
EXIST OCC GRP: 11/10/97 RN 11/10/98
OWNER: TE O: SLOGS. OT: ALUA • FINAL DATE FINAL BY:&�CODE:
K M•K E HUANG FAMILY LIMITED PARTNE - 2 5,500 `f /_/}�
1546 CALIFORNIA BL .l�(
PASD 911064104 FEES PAID DESCRIPTION
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: REROOF OVER EXISTING (1) LAYER W/COMP SHINGLES.
APPLICANT: T
JAY-AR CONSTRUCTION (818) 286-6471- AA BLDG PERMIT ISSUANCE 27.75
AC STRONG MOTION RESID 5500.00 VAL 0.55 SPECIAL CONDITIONS:
D2 PERMIT WO EN-HC 5500.00 VAL 101.10
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150H265 3 02
FLOOR SHEATHING
FAMILIES:NO. OF DWELLING S: : STAY CLASS:
YES 21 J L r• ROOF SHEATHING
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AIR QUALITY: 1000 FEET MATERIALS
NO NO NO FRAME INSPECTION
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SET BACK YARD: HWY: PROP LINE: WIDTH: , `
FRONT PL- r INSULATION/WEATHER S IP
SIDE PL-
OR
EXTERIOR ATH
RATUD FLOOR/CEIL ASSER7.
RATED WALL ASSEMBLIES
RATED SHAFTS70PENINGS
CEILINGS
* ADDITIONAL DATA ON FILE '
LOT,DRAINAGE
REPORT ID: DPR261 ROUTE T0: BS0508
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