The URL can be used to link to this page

Home My Public Portal About6330 ROSEMEAD BLVD_Building__ WORKERS' COMPENSATION DECLARATION hereby affirm that I have certificate of consent to self APPLICATION FOR BUILDING P E RM I T ' insure, or a certificgte of Workers' Compensation Insurance, - or a certified copy thereof (Sec."3800, Lab. C.) . a COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No10851. 2 STATE FUND.-Company BUILDING L J Certified copy is hereby furnished. FOR APPLICANT TO FILL IN ADDRESS 633.0 ROSEMEAD BLVD. Certified copy is filed with the county building inspec- BUILDING 6330 ROSEMEAD BLVD. TEMPLE CITY,lY , CA tion department. ADDRESS Date 3/20/96 Applicant " SIGNS EXPRESS CITY TEMPLE CITY ZIP 91780 LOCALITY CERTIFICATE OF EXEMPTION FROM WORKERS' NO. OF BLDGS. NEAREST 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.) JAMES MONVILLE TEL. 3091762 USE ZONE MAP OWNER NO. NO. I certify that in the performance of The work for which this 2446 MERCEL AVE . SPECIAL permit is issued, I shall not employ any person in any manner ADDRESS a CONDITIONS so as to become subject to the Workers'.Compensation Laws. S 0 CITY 0 . EL MGNTE zip 9 1 7 3 3 Date Applicant ARCHITECT OR TEL. 0� NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. DISTRICT GROUP TYPE FIRE PROCESSED BY Exemption, you should become subject to The Workers' CO ZONE U Compensation provisions of the Labor Code, you must forth- ADDRESS �� 6 ✓ a with comply with such provisions or this permit shall be TEL STATISTICAL CLASSIFICATION APT. CONDO. deemed revoked. CONTRACTOR NO EXPRESS NQ 4433333 Z LICENSED CONTRACTORS DECLARATION r LIC. 7 CLASS NO. �y DWELL. UNITS ADDRESS X446 MEKCED AVE .. NQ.55209 i I hereby affirm that I am licensed under provisions of Chapter 9 - SEWER MAP (commencing with Section 7000)of Division 3,of the Business CIS S. EL 1�iONTE CLASS .C45 and Professions Code,and my license is in full,force and effect. BK PG. VALIDATION X 52097 CL}5 SQ. F i t . rr NO. OF 1 NO. OF CHECK License Number Lic. Class SIZE STORIES FAMILIES ONE VALUATION Contractor SIGN'S EXPRESSDate 3/20/96 DESCRIPTION OF WORK NEW }r $ 840. 00 ILLUMINATED CHANNEL LTRS ADD ❑ ❑I am exempt under Sec. ALTER ❑ B.&P.C. for this reason REPAIR ❑ $ Date: USE OF' EXISTING BLDG. DEMOL ❑ 23 Signature APPLICANTSIGNSEXPRESS TEL' 4433333 FINAL o OWNER-BUILDER DECLARATION (PRINT) NO. DATE 4 LS��(� ACCT.a I hereby affirm that I am exempt from the Contractor's LicenseL446 1�iERCED AVE .Law for the following reason (Section 7031.5, Business arid ADDRESS FINAL ` 36-03 Professions Code): PRESENT By 'v ❑ I, as owner-of the property; or my "em to ees with BUILD IN G ADDR a wages as their sole compensation,will do the work and ACCT.v the structure is not intended or offered for sale(Section LOCALITY , 3 g7 7044,'Business and Professions Code.) MOVING TEL. 2.2 ❑ I, as owner of the ro erT CONTRACTOR NO. ITEMS p p y,:am exclusively contracting `) with licensed contractors to construct.The project (Sec- tion 7044, Business and Professions Code.) ADDRESS TOTAL 1 ? m 75 REQUIRED TOTAL SETBACK FROM EXIST. CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH 142.75 1 hereby affirm that there is a construction lending agency for FRONT CHECK the performance of the work for which this permit is issued P.L. . CHANGE e00 (Sec. 3097, Civ. C.). SIDE -P.L. Lender's Name, _ P.C. Fee$ �./I/' Permit Fee LDMA Ref. # 0000_0001 3/26/96 Lender's Address , 5549 1 PM b=14 a I certify that I have read this application and state that the Issuance Fee 3 p LDMA P/C# 8 above information is correct. I agree to comply with all County Investigation Fee • 9 R ordinances and State laws relating to building construction, Total-Fee LDMA Perm. # < and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. 3/20/96 SEE REVERSE FOR EXPLANATORY LANGUAGE Signature of Applicant or Agent Date WORKERS' COMPENSATION DECLARATION insure, or�afcertif cafirm thdirte of Workers' Comipen ation Insurance, APPLICATION FOR BUILDING PERMIT or a certified.. cGy thereof (Sec. 3800, L C. COUNTY OF LOS ANGELES BUILDING AND SAFETY Policy No&V29?zz Company AA 11 ❑ Certified copy is hereby furnished. FOR APPLICANT TO ILLBUILDING ,IN ADDRESS 1-;;,'3'3'6 /V osep-�@ Certified copy is filed with the co ty building inspec- BUILDING 3- - tion department. ADDRESS' CJ Date, _ Applico CITY . :moi/v C^ ZIP LOCALITY NO. OF BLD T NEAREST CE TIFICATE OF EXE TION FRO 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.). OWNER TEL.. �7 f� USE ZONE MAP 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 ADDRES / 4 v- /r6(/ [61 SPECIAL CONDITIONS a so as to become subject to the Workers'Compensation'Laws. � 0 I CITY ZIP U ' Date Applicant ARCHITECT OR TEL. cz DISTRICT GROUP TYPE FIRE CZN PROCESSED BY NOTICE TO APPLICANT: If, after making this Certificate of ENGINEER NO. (�. CONST. ZONE Exemption, you should become .subject to the Workers' r'1 �� l,_�jJ/ 1 U Compensation provisions of the Labor Code, you must forth- ADDRESS. C/ �v with comply with such rovisions or this STATISTICAL CLASSIFICATION APT CONDO. N p y p, permit shall be //'� TEL. deemed revoked. CONTRACTOR �CQ�. NO. f Z LICENSED CONTRACTORS DECLARATIONuC. CLASS No. DWELL. UNITS I hereby affirm that I am licensed under provisions of Chapter9 ADDRESS 1_7001C-0. l 7c-Ck�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 effey CITY ��yt CLASS (J BK. PG VALIDATION SQ. FT. NO. OF NO. OF CHECK License Number �5 Lic. Classes SIZE STORIES FAMILIES ONE VALUATION Contra r Datg�Z _7 DESCRIPTION OF WORK NEW ❑ s 1 ❑I am exempt under Sec. cia��` (�(/YL(li{ ADD ❑ (/ll , B afa iy� ALTER ❑ B.&P.C. for this reason L Y/(Lf G(A,(/ �7yrF'!/ ice/ REPAIR ❑ $ Date: USE OF EXISTING BLDG. DEMOL ❑ Signature APPLICANT / TEL. g�7" 0 //--1G FINAL NOgf/ / (PRINT (pGLC-Q C� U OWNER-BUILDER DECLARATION DATE � V� I hereby-affirm that I am exempt from the Contractor's License �?_ . -_ f/ u Law for the following reason (Section 7031.5, Business and ADDRESS.- �2 a Z C c c FINAL Professions Code): PRESENT . BY FCCT.a BUILDING El 1, as owner of the property, or my employees with ADDRESS '3.307 59.25 wages as their sole compensation,will do the work and the structure is not intended or offered for sale(Section LOCALITY 00. T MS 7044, Business and Professions Code.) - MOVING TEL. ,j��`t0 ❑ I, as owner of the property, am exclusively contracting CONTRACTOR NO. TOTAL i5 25 TOTAL w with licensed contractors to construct.the project (Sec- tion 7044, Business and Professions Code.) ADDRESS CHECK `9.25 REQUIRED TOTAL SETBACK FROM EXIST. Alf r" CONSTRUCTION LENDING AGENCY SET BACK YARD HWY PROP. LINE WIDTH CHANGE .00 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. 01301 -I�Q�1 ill 1�IL 1 Lender's Name, 8: • m � LDMA Ref. # f 457 t I•�i t !} P.C. Fee$ Permit Fee r , a Lender's Address a I certify that I have read this application and state that the Issuance Fee _� LDMA P/C# 6 8 above information is correct. I agree to comply with all County Investigation Fee •n� ordinances and State laws relating to building construction, Total Fee LDMA Perm. # a and her thorize representatives of this County to enter up a abA Toned property for inspection Pur oses. SEE REVERSE FOR EXPLANATORY LANGUAGE Sign a of Applicant or Agent Date APPLICATION FOR BUILDING PERMIT > COUNTY OF LOS ANGELES BUILDING AND SAFETY WORKER'S COMPENSATION DECLARATION FOR APPLICANT TO FILL IN BUILDING AD Rss I hereby affirm that I have a certificate of consent to self insure, BUILDING ADDRE a or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Sec.3800,Lab.C.) CITY Zil LOCALITY C.`•�� Policy No. Company SIZE OF LCT I NO.OF BLDG OW ON LOT ❑ Certified copy is hereby furnished. NEAREST CROS 31ST. ❑ 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 SPECIAL CONDITIONS OWNER / TEL NO. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE �� X_ "r4 1 `J CJ WITHIN 1000 FT.OF SCHOOL? YES NO (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.) I certify that in the performance of the work for which this permitCITY ZIP is issued, I shall not employ any person in any manner so as to ARCHITECT OR ENGINEER TEL NO. become subject to the Workers'Compensation La S. \) STATISTICAL LL�AISS�IFIICATI0N APT CONDO Date�.i Applicant QQ-�� D)i�—� ADDRESS CLASS NO. � DWELL UNITS NOTICE TO APPLICANT. If, after making this Certificate Of REQUIRED TOTAL SETBACK FROM EXIST Exemption, you Should become subject t0 the Workers' CONTRACTORTEL NO. SET BACK YARD HWY PROP LINE WIDTH Compensation provisions of the Labor Code, you must forthwithID-P, It FRONT comply with such provisions or this permit shall be deemed revoked. ADDRESS LIC.NO. P L LICENSED CONTRACTORS DECLARATIONSIDE LIC.CLASS P L I hereby affirm that I am licensed underprovisions Of Chapter 9 7 SEWER MAP (commencing with Section 7000)of Division 3 of the Business and Q.FT.SIZE NO.OF STORIES I NO.O FAMILIES a Professions Code,and my license is in full force and effect. I NEW ❑ BK PG , O License Number -6 73 _ Lic.Class DESCRIP ION OF WORK ADD ❑ VALUATION V 1 pO Contractor C�PG>t'i�^?'eD)„3 Date �� y� ALTER ❑ $ d O ElI am exempt under Sec. REPAIR ❑ $ H B.BP.C. for this reason DEMOL ❑ W LDMA P/C# CL Date: USE OF EXISTING BLDG. URM ❑ W Signature ,i �l.� a, `- �� APPLICANT(PRINT) TEL NO. LDMA Perm# "" Z c Z -. ❑ I, BE owner the property, or my employees with wages as Q their sole compensation, will do the work and the structure is ADDRESS . . . .... .... not intended or offered for sale (Section 7044, Business and FINAL DATE 0 Professions Code.) - _ WILL THE APPLICANT OR FUTURE BUILDING OCCUPANT HANDLE A.HAZARDOUS MATERIAL G r �•}_ OR A MIXTURECONTAINING A HAZARDOUS MATERIAL EQUAL TO OR GREATER THAN THE J C3 1, as owner of the property, am exclusively contracting With AMOUNTS SPECIFIED ON THE HAZARDOUS MATERIALS INFORMATION GUIDE? FINAL BY Q licensed contractors to construct the �'�'-� project (Section 7044, ves❑ No❑ f�. _ > t f-'I`)�- -0 Business and Professions Code.) WILL THE INTENDED USE OF THE BUIDLING BY THE APPLICANT OR FUTURE BUILDING OCCUPANT REQUIRE A PERMIT FOR CONSTRUCTION OR MODIFICATION FROM THE SOUTH CONSTRUCTION LENDING AGENCY COAST AIR QUAUTY MANAGEMENT DISTRICT(SCAQMD)SEE PERMITTING CHECKLIST FOR HANG , GUIDELINES +�S fi{'}�j� y e•)= I hereby affirm that there is a construction lending agency for YES❑ No❑ N the performance of the work for which this permit IS Issued(Sec. IHAVE READ THE HAZARDOUS MATERIALS INFORMATION GUIDE AND THE SCAQMD PERMITTING _ _ 9i 3097, CIV.C.) CHECKLIST.I UNDERSTAND MY REQUIREMENTS UNDER THE LOS ANGELES COUNTY CODE, !`�-e!-:- TITLE 2.CHAPTER 2.20 SECTIONS 2 20.100 THROUGH 2.20.140 CONCERNING HAZARDOUS t�)!��-' IDI Of 1 11:•{•7+' f'-z 10*v,-Lender's Name MATERIALS REPORTING AND FOR OBTAINING A PERMIT FROM THE SCAQMD. o Lender's Address i min OWNER OR AGENT o I certify that I have read this application and state under penalty = oP.C.FEE PERMIT FEE b w of perjury that the above information is correct.I agree to comply with all county ordinances and State laws relating to building �Q Q construction, and hereby authorize representatives of this County ISSUANCE FEE - /. D :0F to ente on the abentio �d property f insp�� d (0 .A .� ^ri-, INVESTIGATION FEE TOTAL FEE /if i i i I f_ �"nature o pl%anl IX Agent 6 DateV( _ SEE REVERSE FOR EXPLANATORY LANGUAGE ' /1_ }OTHL �' s 1 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 0502110004 PHONE: (626) 285-0488 EXT: LEGAL ID: N0. OF CONST BU1 DING ADDRESS: ON FILE SQ. FT STORIES TYPE 6330 ROSEMEAD BL STRUCTURE: 8 - VN TEMP CA 917801544 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: LONGDEN 5382-021-026 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C TENANT: EXIST BLDG USE: COMME USE ZONE: C ISSUED ON: PROCESSED BY: EXPIRES ON: HIGH CLASS WIRELESS EXIST OCC GRP: 02/11/05 JK 02/06/06 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL ATE FINAL BY: CODE: ORCHANIAN, LEVON S (626) 318-2735- 800 '" 6330 ROSEMAD BLVD O� �' '� - __- TEMPLE CITY CA 91780 FEES PAID DESCRIPTION OF WORK MOVING 15 X 9 WALL BACK ABOUT 8 SQ FT� APPLICANT: TEL. N0: FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: SAME AS OWNER - AA BLDG PERMIT ISSUANCE 27.75 AE STRONG MOTION OTHER 800.00 VAL 0.50 SPECIAL CONDITIONS: AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/O EN-HC 800.00 VAL 65.40 _ CONTRACTOR: TOTAL FEES 148.35 TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER LIC. NO LOCATION AND SETBACKS 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 XX 3 01 N0. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: FLOOR SHEATHING NO 22 ROOF SHEATHING SCHOOL WITHIN HAZARDOUS SHEAR PANELS i AIR QUALITY: 1000 FEET MATERIALS NO NO NO FRAME INSPECTION / /Y REQUIRED TOTAL SETBACK FROM EXIST FIRE SPRINKLER HANGERS SET BACK YARD: HWY: PROP LINE: WIDTH: FRONT PL- INSULATIO /WEATHER STRIP SIDE PL- INTERIOR LATH/DRYWALL / EXTERIOR LATH �i RATED FLOOR/CEIL ASS M. 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 9711120035 PHONE: (818) 285-0488 EXT: LEGAL ID: NUMBER OF-SIGNS: 1 BUILDINGADDRESS: ON FILE SIGN DESCRIPTION: 25 S.F. WALL SIGN 6330 ROSEMEAD BL TEMP CA 917801544 ASSESSOR INFOR ATION"NUMBER: NEAREST CROSS STREET: LONGDEN 5382-021-026 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY, C TENANT: XIST BL G USE: ISSUED ON: PROCESSED BY: EXPIRES ON: EXIST OCC GRP: 11/12/97 VG 11/12/98 OWNER: TEL. NO: BLDGS. NOW ON LOT: VALUATION: FINAL DATE FINAL BY CODE: YANG, KEE CHUN (626) 292-7900- 900 6330 ROSEMEAD BLVD. TEMPLE CITY 91780 FEES PAID DESCRIPTION OF WORK INSTALL 1 ILLUMINATED WALL SIGN FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: APPLICANT: TEL. N0: LIM (213) 734-3361- AA BLDG PERMIT ISSUANCE 27.75 2982 W. PICO BLVD. AC STRONG MOTION RESID 900.00 VAL 0.50 SPECIAL CONDITIONS: LOS ANGELES 90006 AX BUILDING REVIEW FEE 54.70 APPROVED BY PLANNING DEPT. 11-10-97 D2 PERMIT W/OHC,�E Q90 0 VAL 65.25 TOTAL (FEES 148.20 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE L A NEON SIGN (213) 734-3361- 2982 W. PICO BLVD. LIC. NO LOCATION AND SETBACKS LOS ANGELES, CA 90006 653806 C35 SOILS ENGINEER PPROVAL ARCHITECT OR ENGINEER: TEL. NO: n / J FOUNDATION/TRENCH FORMS LIC. N0: \/ j i11 _ SUPPORT STRUCTU E l X-_ MAP NO: SEWER.MAP BOOK: PAGE: FIRE ZONE: CMP: l^00 0. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 20 vv\ SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ✓r� �� REPORT ID: DPR261 ROUTE TO: BS0508