HomeMy Public PortalAbout6324 ROSEMEAD BLVD_Building__ 76A6H9A CE#8036-ee APPLICATION FOR BUILDING PERMIT it
COUNTY OF LOS ANGELES BUUI EIN 6 3 L E�
DEPARTMENT OF COUNTY ENGINEER
BUILDING AND SAFETY DIVISION LOCALITY D7;e...
JOHN A.LAMBIE,COUNTY ENGINEER NEAREST
CASSATT D.GRIFFIN SUPT OF BUILDING CROSS-ST.
U'ln11 e I
DISTRICT NO. GROUP TYPE —/V PROCESSED BY
FOR APPLICANT TO FILL IN 5 I CONST. / I
BUILDING J• I SEWER MAP
ADDRESS G 3 z CISc Q-A STATISTICAL CLASSIFICATION BK PG
CLASS. NO. DWELL. UNITS
LOT NO. BLOCK
_ NUMBER 2-00 -3STATE
�.WYYE NO '
TRACT USE ZONE SPECIAL
NO.OF BLDGS. CONDITIONS
SIZE OF LOT I NOW ON LOT {/��
USE OF
.EXISTING BLDG. BUILDINGEXIST.
OWNER
YARD HWY STREET NAME
(( { SETBACK WIDTH
LUjLr�l'(7 Gnfg� Ac.lt Shtl �A FRONT
AMAILDDRESS J �-(v /�O S C•Tn"G P.L.
j Y SIDE
CITY _ TY ..•n 1 f 1. , 4 Ln NO. P.L.
ARCHITECT OR TEL. INSPECTION RECORD
ENGINEER NO.
ADDRESS
CONTRACTOR .M 0 A.)t-,C? S/(ryS ITvo'l;L 53 ly1 G7
ADDRESSC et`) S, P Ak I A-4 IQG Sf
DESCRIPTION OF WORK
NEW) ADD ALTER REPAIR DEMOLISH
SO.FT. NO.OF NO.OF •
SIZE STORIES FAMILIES ,
USEOFSTRUCTURE F. PLA5 IC AC
SIG- V
SIGNATURE OF APPROVALS
APPLICANT
DATE INSPECTOR'S SIGNATURE
ADDRESS S, PP 1J40-0FOUNDATION: LOCATION
�_— FORMS,MATERIALS
P.C. S FRAME: FIRE STOPS.
FEE BRACING, BOLTS
VALUATION $ <- FURNACE: LOCATION.
FEE -��� GAS VENT, DUCTS
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS AP- LATH,INT.
PLICATION AND STATE THAT THE ABOVE IS CORRECT AND
AGREE TO COMPLY WITH ALL COUN (ORDINANCES AND
STATE LAWS REGUL NG BUIL NG CONSTRUCTION. LATH, EXT.
SIGNATURE OF HOUSE NUMBER COR-
PERM]TTE RECT AND POSTED C� /
ADDRESS—' FINAL
CLYDE N.DIRLAM, PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
L:f&42233 "RR 30 1 A 3.00 M
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76A636A CE#6031-67
APPLICATION FOR BUILDING PERMI LJ
COUNTY OF LOS ANGELES BUILDING
DEPARTMENT OF COUNTY ENGINEER ADDRESS
BUILDING AND SAFETY DIVISION LOCALITY
JOHN A. LAMBIE. COUNTY ENGINEER NEAREST J
COLEMAN W. JENKINSSUP'T OF BUILDING CROSS ST. [ ••�J�/ /� �[/
DISTRICT NO,. GROUP /YYPE. PR
FOR APPLICANT TO FILL IN _ �'r ( t°�'� ,,(-4CONST.
BUILDING STATISTICAL CLASSIJ ICATION SE ER MAP
ADDRESS. �� ` BKS PG
CLASS NO. O LL UNITS.
LOT NO. BLOCK USE ZONE MAP
n " NO. ) -S
TRACT SPECIAL
NO. OF SLOGS. CONDITIONS
SIZE OF LOT NOW ON LOT
USE OF
BLDG. SETBACK FROM
TEL. FRONT PROP. LINE OF (STREET)
OWNER NOTYPE OF EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADD S HIGHWAY WT FROM G.L.
• -
CITY
ARCHITECT O L BLDG. SETBACK FROM
ENGINEER NO. SIDE PROP. LINE Of (STREET)
TYPE OP EXISTING SETBACK HIGHWAY + YARD = TOTAL
ADDRESS WGHWAY WIDTH FROM C.L.
TEL. + _
CON TRA CTO cC NO ,j
ADDRESS/ `(� L LIC CORNER CUTOFF YES NO a C
Llc C' �5 SEE REVERSE SIDE FOR SPECIAL APPROVALS c
CITY
C
DESCRIPTIO F WORK
u
n
NEW ADD ALTER REPAIR DEMOLISH - a
2
SQ.FT. NO. OF NO. OF
SIZE O STORIES FAMILIF_S
USE OF
STRUCTURE
SIGNATURE OF
APPLICANT
VALUATI N
' �. .00 APPROVALS DATE INSPECTOR'SSIGNATURE
P.C. PMT. 9 op. 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 COUNTY. ORDINANCES AND STATE LAWS REGULATING GAS VENT. DUCTS
9UILDI NG CONSTRUCTION, I CERTIFY THAT IN DOING THE WORK
AUTHORIZED HEREBY I WILL NOT EMPLOY ANY PERSON IN VIOLA. LATH. INT.
TION OF THE LABOR DE OF THE STATE OF CALIFORNIA RELAT-
ING TO WORKME PENSATI INSURA E. LATH. EXT.
SIGNATURE •F HOUSE NUMBER COR-
PERMITTEE RECT AND POSTED
ADDRE S �? =- -
' F I NAL
JOHN F. LEWIS. PRINCIPAL ST RAL ENGINEER
PLAN CHECK VALIDATION cK. M.o. CASH _ PERMIT VALIDATION CK. M,O CASH
U
Lhl,o 1 8 9 5r- N V 2 7 1 D �'.t� M
,
APPLICATION FOR BUILDING PERMIT
COUNTY OF LOS ANGELES . C�I^�� �S �5-1A-G,*-4 BUILDING AND SAFETY
WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUI,LGp,�J ADDRESS
BUI Da G ADDRESS "'o '�' y ���.,y.--�J t°r� ���✓
I hereby affirm that I have a cerrtificate of consent to self insure,
or a certificate of Workers'Compensation Insurance,or a certified ,
copy thereof(Sec.3800,Lab.C.) "' CIT i ZIP �U LO uTY
Policy No. Company hC
SIZE OF LOT NO.OF BLDGS.NOW ON LOT
10"Certified copy is hereby furnished. NEAREST CROSS ST. /J}
TRACT BLOCK LOT NO. /-� V6.���
❑ Certified copy is filed with the county building inspection USE ZONE MAP NO.
department.
Date, pplicant ` I m ASSESSOR MAP BOOK PAGE PARCEL
SPECIAL CONDITIONS
CERTIFICATE OF EXEMPTION FROM WORKERS' NER TEL.NO.
YES NO
COMPENSATION INSURANCE WITHIN 1000 FT.OF SCHOOL?
ADDRESS
(This section need not be completed if the permit is for one hundred � � DISTRICT GROUP TYPE CONST.' FIRE ZONE OCESS BY
dollars($hat or less.) rF �(f ^� ..►�.-/+
I certify that in the performance of the work for which this permit ITY �r✓� (q/� Z�1�-� `/.J/l-' J/J( � �
is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL.NO. --
become subject tgthe Workers'Co pensation Law . J STATISTICAL CLASSIFICATION APT ONDO
Date 1S�L—Applicant ADDRESS CLASS NO. DWELL UNITS
NO 1/CE TO APPLICANT: If, after making this Certificate of REQUIRED TOTAL SETBACK FROM EXIST
Exemption, you should become subject to the Workers' CONTRACTOR TEL.NO.
1 / ll SET BACK YARD HWY PROP LINE WIDTH
Compensation provisions of the Labor Code,you must forthwith x 7 FRONT
comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.ITO. PL
�r Z3 G a 5-6-f� SIDE
LICENSED CONTRACTORS DECLARATION CITE' �, �. S Llc.cwss PL
I hereby affirm that I am licensed under provisions of Chapter 9 SQ.FT SIZE NO.OF ST NO.OF FAMIL ES- SEWER MAP
(commencing with Section 7000)of Division 3 of the Business and
Professions Code,and my license is in full force and effect. NEWBK PG ► U
License Number 5"9 Lia Class 0�yd DESCRIPTIONF WORK ADD7101
VALUATION rW
Contractor-lam C4EC- Date 7 �^%a ALTE $ z
❑ I am exempt under Sec. ELL n1 44 REPAIR ❑ $ �� (y ; : .s
BARC.for this reason J DEMOL ❑ i
U OF EXISTING BLDG. ) 7 0 a "
Date: LDMA P/C# 7•� s URM. ❑ iTE"M}_,
Signature APPLICANT(PRINT) TEL.NO. LDMA Penn#
❑ I, as owner of the property, or my employees with wages as 1 OT
AL 70 333
their sole compensation,will do the work and the structure is ADDRESS �
not intended or offered for sale (Section 7044, Business and FINAL DA G 1 i�I i7._t_K 10 3_
PfOf@SSIODS Code.) CHAI
WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A HAZARDOUS MATERIAL NG;- 00
❑ 1, as owner of theproperty, am exclusive) contracting with OR A MIXTURE CONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN
Y g
licensed contractors to construct the project.(Section 7044, THE AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Business and Professions Code.) YES El No❑
WILL THE INTENDED USE OF THE BUILDING 6Y THE APPLICANT OR FUTURE BUILDING `II3i 0-0_01 7 rUl I
OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH
CONSTRUCTION LENDING AGENCY COAST IQUALITY MANAGEMENT DISTRICT(SCAOMD)SEE PERMITTING CHECKLIST
FOR GUIDELINES. V Aki 41 dJ}c C f
I hereby affirm that there is a construction lending agency for YES El NO ElI it
the performance of the work for which this permit is issued(Sec.
3097,CIV.C.). I HAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAOMD
PERMITTING CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES
Lenders Name COUNTY CODE.TITLE2,CHAPTER 2.20SECTIONS 2.20.100THROUGH 2.20.14000NCERNING
HAZARDOUS MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD.
Lenders Address ownERaRAGENT
0
o' I certify that I have read this application and state that the above
$ information is correct. I agree to comply with all county RC.FEE PERMIT FEE
•Fli ordinances and State laws relating to building construction,and .
hereby authorize representatives of this County to enter upon ISSUANCE FEE
the above-mentioned property for inspection purposes.
'/ – –3 •-�� INVESTIGATION FEE TOTAL FEE
.r o of Iraylsr e1�i p.�p
SEE REVERSE FOR EXPLANATORY LANGUAGE
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 0009050072
PHONE: (626) 285-0488 EXT:
LEGAL ID: NUMBER OF SIGNS: 1 BUILDING ADDRESS:
ON FILE SIGN DESCRIPTION: ONE SET OF CHANNEL LETTERS (ILLUMINAT 6324 ROSEMEAD BL
TEMP CA 917801544
ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN
5382-021-026 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY
TENANT: EXIST BLDG USE: ISSUED ON: PROCESSED BY: EXPIRES ON:
EXIST OCC GRP: 09/05/00 UT 03/05/01
OWNER: TEL, NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE F L BY: CODE:
VANNIER WILTON E CO TR VANNIER TRUS (818) 355-1239- 1,700 /l
209 OAK MEADOW RD 6.,#-W
SIER 910242611 FEES PAID DESCRIPTION OF WORK
ONE SET OF CHANNEL LETTER (ILLUMINATED SIGN)
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:
APPLICANT: TEL. NO:
SIGN ART CO. (626) 287-2512- AA BLDG PERMIT ISSUANCE 27.75
423 S. CALIFORNIA ST AE STRONG MOTION OTHER 1700.00 VAL 0.50 SPECIAL CONDITIONS:
SAB GABRIEL CA AX BUILDING REV-YEW—FEE��� 54.70
D2 PERMIT�W%0�ENE L E AL^00FEES VAL 82.20
T,OT165.15
CONTRACTOR: TEL. N287-2512 APPROVALS DATE INSPECTOR SIGNATURE
SIGN423 S CALIFORNIA LIC. NO _ LOCATION AND SETBACKS
SAN GABRIEL CA 91776 491427 C45
SOILS ENGINEER APPROVAL
ARCHITECT OR ENGINEER: TEL. NO: FOUNDATION/TRENCH FORMS
LIC. NO: 1111111 SUPPORT STRUCTURE
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMPo: U
oL AIGNK
" 00
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:—
NO 20\�� O pI
SCHOOL WITHIN HAZARDOUS 10 E) 1 r+*
AIR QUALITY: 1000 FEET MATERIALS ❑ 'r
NO NO NO El
o ®�
REPORT ID: DPR261 ROUTE TO: BS0508