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HomeMy Public PortalAbout6269-6271-6273-6275 ROSEMEAD BLVD_Building__ WORKERS' COMPENSATION DECLARATION insure bor a certif catte of Workers' Compensation Insurancef APPLICATION FOR BUILDING PERMIT NO, or a certified copy thereof.(Sec. 3800, Lab. C. COUNTY OF"LOS ANGELES BUILDING AND SAFETY Policy No. l,[ $Q 3Company p FOR APPLICANT TO FILL IN BUILDING Certified copy is hereby furnished. ADDRESS 4:;��%:;;271 ❑ Certified copy is filed with the county building inspec- ' BUILDING y tion department. ADDRESS pY CITY ZIP LOCALITY Date pplicanT NO.'OF BLDGS. NEAREST ERTI ICATE OF EXEMPTION FROM WORKERS' SIZE OF LOT NOW ON LOT CROSSST. 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.) TE rSE ZONE MAP OWNER N4 i-i/V N I NO. I certify that in the performance of the work for which this N SPECIAL >_permit is issued, I shall not employ any person in any manner ADDRESS J 4 CONDITIONS a so as to become subject to the Wor rs'Compensation Laws. 0 J CITY ZIP Cie Date Applicant ARCHITEC OR TEL. DISTRICT GROUP TYPE FIRE PROCESSED BY O NOTICE TO APPLICANT: If, after aking this Certificate of ENGINEER NO. CONST. ZONE ►- Exemption, you should become subject.to the Workers'� / �, �r a Compensation provisions of the Labor Code, you must forth- ADDRESS IU) N with comply with such provisions or this permit shall be t1, TEL. STATISTICAL CLASSIFI TION APT, CONDO. Z deemed revoked. CONTRACTOR /Aol �s J� NO. 3 O G J� LICENSED CONTRACTORS DECLARATION, A�� N/ ,� LIC. G 3 Z CLASS NO. D L. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 ADDRESS L4 NO. (commencing with Section 7000)of Division 3 of the Business LIC. SEWER MAP and Professions Code,and my license is in full force and effect. CITY hl W CLASS li BK PG VALIDATION /1�►L/�yy /�� �J��' SQ. FT. NO. OF NO. OF CHECK License Nu12.0t>"l.J!Z Lic. Classes SIZE STORIES FAMILIES ONE � VALUATION Contractor Date l DESCRIPTION OF WORK C NEW ❑I am exempt under Sec. i e- _ ADD ❑ ; '► ALTER ❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT TEL. FINAL NER-BUILDER DECLARATION (PRINT) j./K'Q NO. o> `� DATE I hereby affirm that I am exempt from the Contractor's License W Law for the following reason (Section 7031.5, Business and ADDRESS t� /A14'41 �-. FINAL =' Professions Code): PRESENT ` By' ACCT. ❑ I, as owner of the ro ert or m employees with BUILDING A P P Y% YADDRESS � �� � � -a '' wages as their-sole compensation,will do the work and `I+f. 41.21 the structure is not intended or offered for sale(Section LOCALITY , { 7044, Business and Professions Code.) MOVING TEL. '-J7.V1 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. 3 p O P P Y, Y 9 A1.:.).a with licensed contractors to construct.the project (Sec- ADDRESS tion 7044, Business and Professions Code.) 3yp� �?.; REQUIRED TOTAL SETBACK FROM EXIST. . CONSTRUCTION LENDING AGENCY SET BACK YARD HWY" PROP. LIN WIDTH ? EIS I hereby affirm that there is a construction lending agency for FRONT + the performance of work for which this permit is issued P.L. TOTAL 12.x.� �.t�. (Sec. 3097, Civ. C.).' SIDE LL�� ��j { P.L.. �t/�� irft f_ri 124.34 Lender's Name LC m r t /� (/ P.C. Fee$ —71, Permit Fee �O O LDMA Ref. # J CAE ,t{ 1 n Lender's Address �A,*��h 0 1 certify that I have read this application and aW-t t e Issuance Fee � /" �, LDMA P/C# �y above information is correct. I agree to comply with all County Investigation Fee �/ / i_ 0000-0001 8/19/92 0 ordinances and State laws relating to building construction, Total Fee U (o LDMA Perm. # 5100i A�l �:r a and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. a SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent' Date a WORKERS' COMPENSATION DECLARATION e • insure bora certificatirm e of Workers' Compensat on I have a certificate of eInsuran elf APPLICATION FOR BUILDING PERMIT ora certified copy thereof (Sec. 3800, Lab. C.) COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No. Company BUILDING r� ElCertifiedcopy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS �L� ❑ Certified copy is filed with the county building inspec- BUILDING 2 tion department. ADDRESS /� Date Applicant CITY T t�T Y ZIP 7'7' LOCALITY W Cl 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.) TELUSE ZONE MAP OWNER w O. �� j NO. I certify that in the performance of the work for which this SPECIAL >_ermit is issued, I shall not employ any person in any manner ADDRESS 371 N L.tA CONDITIONS d so as to become subject to the Workers' Compensation Laws. 0 Q �p2 CITY PhSfrb„&Y-:A ZIP 4 I013� DateApplicant ARCHITECT OR' TEL. DISTRICT I GROUP TYPE FIRE PR ESSED BY 0 NOTICE T6 APPLICANT: If, after maks th' Certificate of ENGINEER NO. ��}}.,, CONST. Z E U Exemption, you should become subl cT to the Workers' �,UL ( -4 w Compensation provisions of the Labor Code, you must forth- ADDRESS a with comply with such provisions or this ✓ STATISTICAL CLASSIFICATION APT. M .0 D N p y p permit shall be TEL. Z deemed revoked. CONTRACTOR t NO. — LICENSED CONTRACTORS DECLARATION LIC. CLASS NO.ADDRESS NO. ZZ DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP (commencing with Section 7000)-of Division 3 of the Business LIC. and Professions Code,and my license is in full force and effect. CITY' CLASS BK PG VALIDATION SQ: FT. NO. OF NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION 0� ' Contractor Date DESCRIPTION OF WORK NEW ❑ $ ❑I am exempt under Sec. B't'u V.66 v.,-,, ADD v 110111.ALTER ❑ BAP.C. for this reason L1 VG�� REPAIRE]. $ USE OF., " Date: EXISTING BLDG. DEMO' ❑ } Signature APPLICANT TEL.. FINAL OWNER-BUILDER DECLARATION (PRINT) NO. r9z _'ir' __. •, DATE �"JJ I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5, Business and ADDRESS FINAL _ "••, �_ ® Professions Code): PRESENT BY '9_`•i sig yy== '-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 CONTRACTOR NO. with licensed contractors to construct the project (Sec- tion 7044, Business and Professions Code.) ADDRESS f i REQUIRED TOTAL SETBACK FROM EXIST. s 1 _T( CONSTRUCTION LENDING AGENCY SET BACK YARD HWY 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 r`+ o LDMA Ref. # P.C. Fee$ Permit Fee f ! +F Lender's Address PO. o I certify that I have read this application and state that The Issuance Fee 4 �� LDMA P/C# , _- ".t-I_ _a - above information is correct..I agree to comply with all County Investigation Fee r.:;-,-.;, 8 r� t. f-�.r: R ordinances and State laws relating to building construction, '�J Total Fee LDMA Perm. # f and hereby authorize representatives of this County to enter ;"i A ti-•!" g upon the-ybove-mentioned property for inspection purposes. / g SEE REVERSE FOR EXPLANATORY LANGUAGE - v Sigq ur o pp scant or Agent Ddie APPLICATION FOR. BUILDING PERMIT COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN PBUILDING ADDRESS BUILDING ADDRESS I hereby affirm that I have a certificate of consent to self insure, ^ I or a certificate of Workers'Compensation Insurance,or a certified a / copy thereof(Sec.3800,Lab.C.) CITY ,n` L zIP •r--+ Policy No. Company SIZEpOOFF LOT/`!� NO.OF BLOGS.NOW ON LOT ❑ Certified copy is hereby furnished. O /X NEAREST CROSS ST. ❑ Certified copy is filed with the county building inspection TRACT BLOCK LOT NO. department. USE ZONE MAP NO. Date Applicant ASSESSOR MAP BOOK PAGE PARCEL PP SPECIAL CONDITIONS OWNER TEL.NO. CERTIFICATE OF EXEMPTION FROM WORKERS' r � �� �� z �Z/ YES NO COMPENSATION INSURANCE 6 WITHIN 1000 FT OF SCHOOL? ADDRESS j (This section need not be completed if the permit is for one hundred ,j 0— J�t7 /C� D E Al DISTRICT GROUP TYPE CONST.' FIRE ZONE OCESSED BY dollars($hat or less.) C95-0- 16, nI certify that in the performance of the work for which this permit CI��L.�� �' LT zIU Dy is issued, I Shall not employ a�yEo.n .n an man er so aS to ARCHITECT R ENGINEER .NO.become ubject to the Workers' tlOJn STATISTICAL CLASSIFICATION APT NDO Dated 2 Applicant ADDRES CLASS NO. DWELL UNITS NOTICE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you ShOUId b@QQm@ subject t0 the Workers' TRACTOR NO.� SETBACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwith " �" `$:7iv !�J _ } comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO FRONT F L LICENSED CONTRACTORS DECLARATION CITY LIC.CLASS SIDE �L moi? e,-1 7-657' J' P L o I hereby affirm that I am licensed under provisions of Chapter 9 SEWER MAP C3 (commencing with Section 7000)of Division 3 of the Business and SQ.FT.SIZE NO.OF STORES NO.OF FAMILIES a Professions Code,and y licensYA Is in full force and effect. NEW BK PG , v License Number S 7L, " Lic.Class S DESCRIPTION OF WORK ADD ❑ VALUATIO 0 W �LL-G� l0 y Contractor ���M� Date Zs ALTER ❑ $ ' Z 1:1I am exempt under Sec. .S REPAIR F-1 B.BP.C.for this reason DEMOL ❑ USE OF EXISTI BLD LDMA P/C# Date: ��- t� ���ET/��� URM ❑ Signature APPLICANT(PRINT) / TEL.NO. LDMA Perm# Z 1 ❑ I, as owner of property, or my employees with wages as �y �� ,4C�=a_ J 7 p E•�• a their sole coml nsation, will do the work and the structure is ADDRESS CL T- H y1•:• 08 i Com/ L-1 0! FINAL D i �. not intended or offered for sale (Section 7044, Business and �� 1,1/) � Q F r,7 •s= Professions Code.) ; v r'``" _ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL ❑ I, as owner of theproperty, am exclusively contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN Q TTEIIMS Y 9 THE AMOUNTS SrPEtCrIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDET FINAL BY licensed contractors to construct the project-(Section 7044, YES❑ NO ' TOM{t�L ate' �-6 Business and Professions Code.) WILL THE INTENDED USE OF THE BUILDING BY THE APPLICANT OR FUTURE BUILDING C OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CHECK •C'SU o f CONSTRUCTION LENDING AGENCY COAST AIR QUALITY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR GUIDELINEi Si' I hereby affirm that there is a construction lending agency for YES❑ NO S CHANGE L` 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.). PERMITTINP CHECKLIST.1 UNDER TAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY 'I .TITLE 2,C E .20 CTIONS 2.20.100 THROUGH 2.20.140 CONCERNING F iII�El_ i( T �y� i (f Lender's Name HAZAR S ATERI PO D FOR OBTAINING A PERMIT FROM THE SCAQMD.- V CL Lender's Address AGENT i �t o 1 certify that I have read this application and state that the above $ information is Correct. I agree t0 Comply with all County P.C. EE PERMIT FEE •FLi ordinances and State laws relating to building construction,and a hereby authorize representatives of this County to enter up ISSUANCE FEE O the ab e-mentioned pr I for inspection purpQs INVESTIGATION FEE TOTAL FEE I n Alca « SEE REVERSE FOR EXPLANATORY LANGUAGE /I WORKERS'COMPENSATION DECLARATION T. hbareby insm off icm,that,l have,o certificate,of consent,to.self APPLICATIONTOR BUILDING PERMIT ' ure, or a certificate of Workers' Copensation Insurance,. -or a certified copy rhereof (Sec. 3800, Lab.'C.) - - .A COUNTY OF LOS ANGELES BUILDING AND SA ETY Policy No Company F]- Certified copyis•herebyfurnished. FOR APPLICANT TO FILL IN BUILDING ADDRESS 11, Certified copy is filed with the county building inspec- BUILDING y^ �/��7�/� Q q� tion department. ADDRESS /l��G�'/CT7/.i Date- Applicant CITY ' e/a�G �t' olp- ZIP / sU LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS: - NEAREST COMPENSATION INSURANCE SIZE OF LOT e NOW ON LOT CROSS ST. (This.secfion need not be completed if the permit is for one "-� �` ... ASS BOOK' PAGE. PARCEL ASSESSOR n T,-hundred dollars ($100)or less.) TRACT BLOCK LOT NO. TE! �r USE ZONE MAP OWNER A certify that it the performance of the work for which this L. NO. NO. permit is.issued, I shall not employ any person in any manner / q�9 -SPECIAL so as to become subjectto the Work e ompen Lows. ADDRESS r/6®, =/�r /C QSj,./_ D � CONDITIONS n / 6J �— Date Applicant CITY 1J. /f _ C/T..: .ZIP. NOTICE TO APPLICANT:If, afte making this rf' Y to of ARCHITECT OR TEL. DISTRICT .GROUP TYPES FIRE ZONEPROCESSED BY :. ENGINEER NO. CON T. Exemption, you,should become subject to the 'Workers'. t - •s Compensation provisiohs,of the Labor Code, you.must forth- ADDRESS `�' y - W withcomply-with-such•provisions or, this permit shall be deemed revoked. TEL. CONTRACTOR NO. STATISTICAL CLASSIFICATION I APT. J.§NDO. � � .. LICENSED CONTRACTORS DECLARATION: -- LIC. 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 _ _-_._ _ _ LIC: _,_ SEWER MAP Professions Code, and my license is in full force and effect. CITY CLASSBK VALIDATION SQ. FT. NO. OF ... NO.OF CHECK License,Number Lic.Class SIZE STORIES FAMILIES ONE VALLI TION_ ❑ Contractor Date DESSC/�RIPTIIO�}N OF WORK ' T d NEW ADD ❑ a � �Q 4 Q Q A am exempt under Seca - B I/ T?oeO udat� . I . _ oilo 0 0 0 ALTER ❑ #. , 023 B.&P.C. for this reason _ REPAIR .❑ _ .; 0 3 USE OF j o 7 5.0 Date EXISTING BLDG. DEMOL ❑ _ " APPLICANT TEL. _y a 037,50 _• Signature FINAL OWNER-BUILDER DECLARATION N PRINT) w EL 0 4,09--86 _O' DATE v I hereby-affir-that I am exempt from the Contractor's license _ �,y�,. i G Law for the following reason (Section 7031.5, Business and ADDRESS CK!\L� M66- , I'�/� FIN } Professions Code)?` BUILDING BY � 2 4 4YQ � A - I, as owner of The property, or my employees with ADDRESS wages as'their sole compensation,will do the work and LOCALITY # 0 0 0 0 0=� the structure is not intended or offered for sale(Section 7044;Business and Professions Code). MOVING' - TEL "' - - (`0 0 2 5 I, as owner of the property, am exclusively contracting CONTRACTOR NO. [�- with'licensed contractors to-construct the project (Sec- ADDRESS © o o a 5 0,�, ' tion 7044, Business and Professions Code). ° REQUIRED... YARD" HWY TOTAL.SETBACK FROM XI 40-9-86 ' 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 P.L. Lender's Name S)� /t LDMA Ref. # P.C.'Fee$ 1 L// Permit Fee Lender's Address I certify that I have read this.application and.state that.the - Issuance fee ,e J - 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.'# v and hereby authorize representatives of this County to enter U pon a obese-m tinned roperty for inspection purposes. SEE REVERSE FOR EXPLANATORY LANGUAGE •Signature A pli ant or Agent- •• Dote - - -- •• _ _•.___ . ._ - -.__ _. _ ._ Q i i WORKERS' COMPENSATION DECLARATION 1 1 S I her4b affirm that I have a certificate of consent to self insure, or a certificate of Workers' Compensation Insurance, ' APPLICATION FOR' BUILDING PERMIT r or a certified copy thereof (Sec. 3800, Lab. C.)` - . //yy. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No.c5�.�Z.::16 Company.. Certified copy is hereby furnished.•v,. FOR APPLICANT TO FILL IN BUILDING 2 C, ,�5r/I/l� ADDRESS OCertified copy'is filed with the county building inspec- BUILDING 162 I/tion department. ADDRESS 6 `r ALJ r/vl Date LG S Applicant S(t;N= w.l2_F CITYY/�/�P�--G CI ZIP LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO:OF BLDGS.- NEAREST ��NG/��N . COMPENSATION INSURANCE SIZE OF LOT NOW ON LOT CROSS ST. (This section need not be completed if the permit is for one ASSESSOR hundred dollars ($100) or less.) TRACT BLOCK LOT NO. MAP BOOK PAGE PARCEL TEL. USE ZONE MAP OWNER M4SN E SV DIT NO. I.'certify that in the performance of the work for which this NO. }- permit is issued, I shall not employ any person-in any manner SPECIAL so as to become subject'to'tHb Workers'Compensation Laws. ADDRESS S ME CONDITIONS V Dat CITY__ ZIP _ .� Ilk e Applicant • NOTICE TO APPLICANT: If, after making ARCHITECT OR TEL.thi3 Certificate of DISTRICT GROUP TYPE FIRE PROCESSED BY 0 ENGINEER NO. V� CONST. ZONE V Exemption, you •should become subject to the Workers' j Compensation provisions of the Labor Code,.you must forth- LU ADDRESS {/l._. 0. with comply with.such provisions'or. this.permit shall be - / TEL. t Oe H deemed revoked. CONTRACTOR SIGN NO o C $B STATISTICAL CLASSIFICATION APT. CO DO. Z LICENSED CONTRACTORS DECLARATION LIC. CLASS NO. DWELL. UNITS hereby affirm,that I am licensed under provisions of Chapter 9 ADDRESS[ pA'S ��N aQL51QN0. (commencing with Section 7000)of Division 3 of'the Business andA LIC. SEWER MAP Professions Code, and my'license is in full force and effect. CITv A4WQ)r CA- CLASS `195 VALIDATION LiSQ. FT. NO.OF NO. OF CHECK BK. PG. License Number ��`�V / c.Class'ComSIZE STORIES FAMILIES ONE \. VALUATION Contractor S IC;N—le//Z Date I'Z $S DESCRIPTION OF WORK JNS�TL,L 2 5I(, NEW �C 2 ADD I am exempt under Sec. P D N G h EQS1' - Q ALTER B.&P.C. for this reason 0-9",K 15-9tt �Gtt I 9NX )Z,�l a REPAIR S Date: USE OF EXISTING BLDG. DEMO' Q �_3 613 A Signature APPLICANT TEL. FINAL A /'} # o-o o-0 2 3 PRINT)S I t-3—w(Z� N G�F$8 'j.��' OWNER-BUILDER DECLARATION DAT �✓v CJ I hereby affirm that hamexempt from the Contractor.'s License z ( � 5� '� �SQ ��LNU 0 0 4 1.45 Law for the following reason (Section 7031.5, Business and ADDRESS�tN FIN Professions Code): PRESENT BY o'o o 4 1.4 5 U F] .1, - - - - - - I, as owner of the property, or my employees with ADDRESS jj �f_ wages as their sole compensation,will do the work and LOCALITY , �a Lr b/7 r 2 0 6-8-5 the structure is not intended or offered for sale(Section 7044, Business and Professions Code). MOVING TEL. 1, as owner of the property, am exclusively contracting CONTRACTOR NO. ;2 3 6 1.4 A with licensed contractors to construct the project (Sec- FRER # 0.0 0 0 0'1 tion 7044, Business and Professions Code). TOTAL.SETBACK FROM EXIST. `'CONSTRUCTION LENDING AGENCY YARD HWY' PROP. LINE WIDTH I hereby affirm that there is a construction lending agency for I o.4 59.25 the performance of the work for which this permit is issued o 0 0 5 9.2 5 cxi (Sec. 3097, Civ. C.).Lender's Name 1206-8.5 / �� LDMA Ref. It Lender's Address Permit Fee - I certify.that I have read this.application and state that the Issuance Fee U LDMA P/C# < above information is correct. I agree to comply with all County Investigation Fee ordinances and State laws relating to building construction, U and hereby authorize representatives of this County to enter Total Fee LDMA Perm. # upon the above-mentioned property for inspection purposes. 12 SEE REVERSE FOR EXPLANATORY LANGUAGE Sign ure of Applicant or Agent ate - - - - - - -- - 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 0402200038 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 5904 LT: 87 SQ. FT STORIES TYPE 6269 ROSEMEAD BL STRUCTURE: 9000 VN TEMP CA 917801562 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5384-003-023 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: COMME USE ZONE: C-2 ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 02/20/04 VG 02/14/05 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAI DATE FINAL BY: CODE: FELIKIAN MARTIN CO TR (310) 947-8118- 10,000 / L/ 8112 STONERIDGE DR WHIT 906051372 FEES PAID DESCRIPTION OF WORK T/O EXISTING ROOF AND INSTALL HOT MOP ROOFING APPLICANT: TEL. N0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: JOHNSON ROOFING SERVICE (310) 638-1773- AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 10000.00 VAL 1.00 SPECIAL CONDITIONS: D2 PERMIT W/O EN-HC 10000.00 VAL 216.60 TOTAL FEES 245.35 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE JOHNSON ROOFING SERVICE (310) 638-1773- 2045 E 130TH ST LIC. NO LOCATION AND SETBACKS COMPTON, CA 90222 636996 C39 SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS LIC. NO: SLAB/UNDER FLOOR RAISED FLUOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: UNDERFLOOR INSULATION XX 3 04 NO. OF FAMILIES: DWELLING UNITS: APT/TO-ND.--§T-AT CLASS: fL00R SHEATHING NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATION/WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T-BAR CEILINGS LOT DRAINAGE REPORT ID: DPR261 ROUTE TO: BS0508 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 9703170009 PHONE: (818) 285-0488 EXT: LEGAL ID: NUMBER OF SIGNS: BUILDING ADDRESS: TR: 5904 LT: 87 SIGN DESCRIPTION: CLASSY CUT 6275 ROSEMEAD BL TEMP CA 917801562 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN AVENUE 5384-003-023 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON: CLASSY CUT EXIST OCC GRP: 03/17/97 LC 03/17/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BYjV CODE: FELIKIAN MARTIN CO TR (310) 947-8118- 1,500 8112 STONERIDGE DR WHIT 906051372 FEES PAID DESCRIPTION OFWORK ONE WALL SIGN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:. APPLICANT: TEL. NO: ARTIK AVANESSIANS (818) 545-7360 AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION OTHER 1500.00.VAL 0.50 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/O EN-HC 1500.00 VAL 82.20 TOTAL FEES 165.15 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE ARTIK AVANESSIANS (818) 545-7360- 6000 SAN FERNANDO ROAD LIC. NO LOCATION AND SETBACKS GLENDALE, -CA 91207 623580 B SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. 0: FOU D�FI ATION/TRENCH FORMS LIC. NO: SUPPORT STRUCTURE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 20 SCH00L WITHIN HAZARDOUS 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 0812040047 PHONE: (626) 285-0488 EXT: LEGAL ID: INUMBER OF SIGNS: 1 BUILDING ADDRESS: ITR: 5904 LT: 87 ISIGN DESCRIPTION: ONE ILLUMINATED CHANNEL LETTER WALL SI 6269 ROSEMEAD BL I I I TEMP CA 917801562 (ASSESSOR INFORMATION NUMBER: I I NEAREST CROSS STREET: LONGDEN 15384-003-023 I I THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, Cl (TENANT: IEXIST BLDG USE: 11SSUED ON: PROCESSED BY: (EXIST OCC GRP: 112/04/08 SR 1 I I I I (OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: (FINAL DATEEXPIRE Y: CODE: IFELIKIAN, GREG (626) 255-5767- 1,200 1-18112 STONERIDGE DR IWHIT 906051372 I FEES PAID 1DESCRIPTION OF WORK 1 I ZONE ILLUMINATED CHANNEL LETTER WALL SIGN 1 I _IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT: 1 (APPLICANT: TEL. NO: I I1 IRICHARDSON (626) 841-2560- 1AA BLDG PERMIT ISSUANCE 27.75 1 1 12116 SEAMAN AVE. 1AX BUILDING REVIEW FEE 54.70 ISPECIAL CONDITIONS: 1 IS. EL MONTE CA 91733 ID2 PERMIT W/O EN-HC 1200.00 VAL 82.201 1 I TOTAL FEES 164.65 I I I I ICONTRACTOR: TEL. NO: I 1APPROVALS DATE INSPECTOR SIGNATURE 1 ILEE'S SIGN CO. (626) 258-2977- 1 1 1 12116 SEAMAN AVENUE LIC. NO 1 ILOCATION AND SETBACKS 1 1 IS. EL MONTE CA 91733 794860 C45 1 I 1 I 1 ISOILS ENGINEER APPROVAL 1 1 I I I I I I 1ARCHITECT OR ENGINEER: TEL. NO: 1 IFOUNDATION/TRENCH FORMS I I 1 LIC. NO: 1 ISU=PORT STRUCTURE I I I I I I I I I I I I I I I 1MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 1 I I I I G01 1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I I I I 1 NO 20 1 I I 1 SCHOOL WITHIN HAZARDOUS 1 1 I 1 1 (AIR QUALITY: 1000 FEET MATERIALS NO NO NO I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I 1 IREPORT ID: DPR261 ROUTE TO: BS0508 1 I 1 1 I I I I I I