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Home My Public Portal About4343 TEMPLE CITY BLVD_Miscellaneous__ 15ORI,IRS (OAIPI NSA[ION UI (LARATION CE 875 11 1 841 M ISCELLANEOUS APPLICATION CE 876 I hitt o affirm Leri that 1 have a s'( mlcen of coneenoto self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION mshre or a Lertifieale of Workers'( Insurance or I Lcrlrfwd L„fy lhCrcof 1SCL 3800, Lab C) Pohry No ___(onlpiny — FOR APPLICANT TO FILL IN woAUIID N DREs XX • o%7 CerllOtd Lop) Is hereby furnished GUILDI. �? LUQ LOCALITYy .Downs (Citified Soft, is filed with the county building inspection ouuTY p E n[Aw[sT dep hrtment / eRoss Sr Appliclnl —__ _ _ NEAREST DIST• T PNO GwooP IT •E Chino et, CROSS ST O!! CONT ( I R I II I( A ll OI LXEMPIION I ROM WORKERS' LEGAL (OA1PI NSA[ION INS(IRAN(l oEscwvnon Lor No ions MAP arwrE Mwrow SECOND Locwl NO Or IS (This section need not be completed If the work involved TRACT NOB ON LOY USE :On[ SPECULI CONDITIONS by the permit n for one hundred dollars ($100) or lest) USE or uZK Or LOT EXISTING BLDG LertJy that m the performance of the work for wh'ch this >Q� _ _ permit Is Issued, I dell not employ any person in any mann 'Of=Uuuildin � Is to bcunuc sdgLLI to (fit Workers Iompenahm, lawsMAIL - OCCUPANCY GROUP Soo OREeE `v Date _ _ Appllunt — - - - - __ _ NOII(I 1 O APPI R AN1 If Tfter making lhn Cert)Cate of eI — - - �!��' OCCUPANT LOAD 1 \empllon, )on Should become subject to the Workers APPLICATION FOR EXIT HARDWARE (ompenahon provlsons of the labor Code you must forth 3 with Lompl) with Uo.b pmslsrons or thm permit shall be TRAILER USE ❑ GEOLOGY INSPECTION ❑ NO Spec Knowl Ej deemed revoked j El ICI NSI U(UN I RA( I ORS DECLARATION I OCCUPANCY INSPECTION Panic Devices I hLnb) altirmh IILIt I am licensed under provisionsof( hapter SAFETY r[wMIT ❑ (LIST ITKMe BELOW) 9 (commenting with Secunn 7000) of Division 3 of the Bun No or EXITS news and Professions(ode and m) license is in full force a CffCll IQSIRe—Of bunine88 ---7p � IWACKSO well D PROVIO EO — - C/L arweE• I iLLnw Number _—_—_ I is (lass LIMITED TIME USE (ontrhLlor _ ___ _ __ Date __ G... T. T. Ell Som exempt from the licensing requirements as 1 am a INSPECTOR S Inensed archuect or a registered professorial engineer SIZE or no or I ATaRE acting in my professional LaP3LIty (Section 7051, Bur EXISTING BLDG STowlne hness and Professions(ode) FINAL APPROVAL PRESENT USE of BUllornG 1 u or Reg No _ _— ___—__— Date 'I//II10 Il _-fhllfl HONII OWNI R BIM MR DECLARATION no or XX ISTING BUILDING I Irg 1 c ON Lor AND USE G l7I)h 1 hereb) dfum thTl I Im exempt from the Contractors 7 I v.ensc I7w for the follow mg re hint ISCLIIon 7031 5 Dust- runs uo-news and Professions Codel Soo PARKING I as owner of the property wLdl do the work end the SPACES PROVIDED strucuuc IS not intended or offered for sale (Section 7044 Business and Professions(ode) (ONSI RV I ION I ENDING AGLNCY PROPOSED us[or BUILDING I hereb) affirm th7t there n 7 construction Iendinglagency f' for the perfurmmnL.e of the work for whILh this Wont O issued ISee 3097 (iv ( 1 I ender s N unc PROPOSED "As-OCC uhdu s Address PERMIT FEE 25. 00 1 Lrrtdy Ilut 1 hoc mid this apphLltion ins state that the ' ibove inform lthnn IS LO RTO l hgree to compply u nit all(Ounty ISSUANCE FEE admoanw aces d Slate las relating to burding construction, and hereby authorve representatwes of this County 'o enter TOTAL FEE 25.00 the hbuve mentioned pro f ir) for mspet,thon purposes SFE REVERSE FOR EXPLANATORY LANGUAGE e upon at 1, „iln, a P", III IIIIP 1 AOR61 RS (OhIPLNSATION DI CLARATION 76101444 �� '� CE 875 (11 84) MISCELLANEOUS APPLICATION mwt hereby affirm that I have a certificate of consent nc self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION insure or a cer46cate of Workers (ompensatron Insurance or i certified copy thereof(Sec 3800 Lab C) Polic) No (ompiny FOR APPLICANT TO FILL IN BUILDING ADDRESS Certified cop) is hereby furnished ILOINoLoew ury A Dor 0 Certified copv Is filed with the county budding insllecltocwurr MEARES department CROSS Sr Dile Applimnt N weesr OIaTRIcr no awouP TVPe • c¢seED Br Dee Sr LOWER AZUSA n O 1 toner (I R 111 ICATI Of EXEMPTION FROM\YORKERS LEGAL UC O' (OkIPFNSA ZION INSURANCL DESCRIPTION Lor No BLOCK A1 jCal..L• STATE MAJOR eeconD LOCAL NO Or ELT no by t section need not be completed ll the work or less) rwwcr Non on Lor uee zone VESTAL comm�onS by the permit Is for one hundred dollars (ft00) or less) uSE SIZE OF LOT TINGuunBLDG I certify shit m the pperformance of the work for which this pernn is I%tlled, I sh111 not Employ any person it any mOWNER Of oc r. Ic la onlc gU II+Irto the Wom Workers (opens.illon Llw%Lnvs MwIL iii hnn OCCUPANCY GROUPa c� Date _ Appluinl uI NOIK I IO APPLI(ANI If after making tiro Certdlcate of Err Trio OCCUPANT LOAD N I xemptron, )ou should become sub)ect to the Workers = (onipenvllon pnwiaons of the Labor Cade you must forth- APPLICATION FOR EXIT HARDWARE With Lomp1) with such pro+Islun+ or this permit snail be TRAILER USE ❑ GEOLOGr INSPECTION ❑ NO Spec KnoWl deemed rI(I NS ed 1 NSU ® Panic Devices I (UN 1 RACIORS DECLARATION I OCCUPANCY er INSPEINSPECTIONecon I hLlcb> affirm that I am htttnwd under provrsionsof(hapter SAFETY PERMIT ❑ (LIST ITEMS BELOW) 9 (commenting with Section 7000) of Division 3 of the Bus- NO OF EXITS nese and Profession%(ode and my license is in full force and rffeLl xX Name Of b iness rwwwlna Srwccs REG o � rwOVIDCD 11unw Number Lie (lass LIMITED TIME USE (anti ubn Date-- F-1 ate Dwrw Dwra I on exempt from the licensing requirements as I am a I T. Incrow licensed archllect or a registered professional engineer Sag or No or acting m my professional capanly (Section 7051, Bus EXISTING BLDG SroRIEe 01 N aP ATuwc iness and Professions Code) FINAL APPROVAL 1 ie or Reg No Date PRESENT me or BUILDING l — _ IIOAII OWNFR RUILDFR DLCLARATION wo of Ea[STING BUILDINGS Q G n LOT AND USE I A I hereby affirm that 1 am exempt from the Contractors `"�—�,�� I Icenm Iaw for the following re lam (SeLnon 7031 5 Bum 01 1� nese Ind Professions Code) NO PARKING I, as owner of the property will do the work and the SPwcce PROVIDED structure is not intended or offered for sale (Sectiur 7044 liu%iness and Professions(ode) (ONSI RUCI ION LLNDING AGENCY } PRoroccD uee Or BUILDING I herebl affirm that there w i construction lending agenN for the performsnLe of the work for which this permit is issued(Sec 3097 (tv ( 1 I I ender s N true PROPOSED MAE-OCC I ender s Address — I cerhN tial I hoc rad this IpphLdwand d state that the PERMIT FEE nol jind udurm pion ILO I14rcc i comply Anti ill(ounly ISSUANCE Fee nL to aws re li to budding construL(ion, by thYew ryes of this County to enter TOTAL Ffifi 25. OOthe I n n u r inspection purposes SFE REVERSE FOR EXPLANATORY LANGUAGE XX CP p1111Ii .d Pl onion _— _ 11Ir WORF.ERS COMPENSATION DECLARATION �, 4 CE 876 111 841 MISCELLANEOUS APPLICATION CE 87 I•n-reby ;form that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION ensure, or a artsficate of Wodcers'Compensation Imurantx,or a certilled copy thereof(Sec 3800,Lab C I OD Policy No Company FOR APPLICANT TO FILL IN euILDINo wp lq[[l Cer[illed copy of hereby furnished eulwlNa LOLw tier ADDR tit 1Certified copy is tiled with the Aunty bedding inspection LOC4LIrY Temple City cwoii ST department Date Applicant "EASIEST DISy1! T NO6111{�t000��1F TYF e6lSRO [Y C. Off ST , (. CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL a /d COMPENSATION INSURANCE 1 DESCRIPTION A C/LOT No BLO.. MOP 1�°ACEI)no OF SLOG{T�� STATE MAJOR tcconD LOCAL (Thu section need not be completed If the work involved TRACT Nose ON LOT USE ZONE SPECIAL CONDITIONS by the permit IS for one hundred dollars (5100) or less) Usa of } l I certify that in the performance of the nod for which this SIZE OF Lor [zltnga SLoa permit is issued, I shall not employ any person in any manner I o1rnER Q D y o G `"s so u to become sugect to the Workers' Compensation Laws. 7. MAIL nn OCCUPANCY GROUP CD 1 Date Applicant licant w.DRESS i ()RO k 1D NOTICE TO APPLICANT If, after inalirig this Certificate or OCCUPANT LOAD CITY 9�L .oL — —lp — Exemption you should become subject to the Workers — Compensation provisions of the Labor Code lou must .orth APPLICATION F :XIT HARDWARE D 1 neth comply with such prosuions or this permit snag be TRAILER Lee = a[OLOGY INSPE=-ION _ No Spec Knowl deemed re,oked LICENSED CONTRACTORS DECL 4R ITION I OCCUPANCY INSPEC-IONti Panic Devices Q 1 hereb) alfirm that I am licensed under prolmons of Chapter SAFET" PERMIT — (LIE- ITENs [ELov I 9 tcommenang nith Station 1000) of Dnssion 3 of ,he Busr — No OF EXI-s _ ness and Professions Code and ms license s in ull ,orce .Ino effec• PA PKINa y SPA CEf !ED D PRovID[a s License Number aa, G LIMITED TIME USE Contractor Date O.*. D.*• z g � 1 am exempt .Yom ,he uLensing equuemenis as 1 am g I licensed architect o• a registerea Dro4i,ional engufee• J see OP I sin IN. O= U+EPEc-Oq s acting in m, profesnonal anaun �Se, fan "051 Bu> EXISTING BLDG S-OgIEs rue[ mess and Prale551anS ladq •w ESEN- USE OF •UILDING FIC AL APPROVAL Lic or Reg No Da,, s 1 _ HOME OWER-BLILDER DECL 01 4`70\ NO OF EXISTING BUILDINGS w ON LOT AND 0SX I hereb, affirm that I am exempt Yom the 0tor, 1 License Lan for the folloing reaIS son r,uon "03131 5 5 Burr nese and Professions Code) , No PARKING - 1 as owner of ,he property Hill do he and and the SPACES PwovIOED structure is not intended or offered for We iSection f 7044 Business and Proresnons Code ZI f CONSTRL CTION LENDING 4GENCl PROPOSED USE of QUILDING I hereb, affirm that there is a Lonsinictwn lending agenc, I( for the performance of the norl for ahe.h this permit is Issued(Sec 3097,Civ C) .00< as ,Q �3>.Si �•_ Lender s Name PROPOSED MAX OCC Lender s address I aruf) that 1 have rad this application and state that the PERMIT F[[ 25.00 above information fs correct I agree to comply with all County ISSUANCE FEE ordinances and State laws relating to budding consuucuon is I and herebV authorize representatives of this County to enter TOTAL FEE 25.00 upon the above-mentioned property for inspection purposes CAD IL2,2"11, SEE REVERSE FOR EXPLANATORY LANGUAGE (1�) Signature ofof Permittee I Dale 1 � WORKLRS'COMPENSATIONDECLARATION CE 975 111 841 MISCELLANEOUS APPLICATION CE 875 I hereby affirm that I have a of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION mwrc, or a certJlLale of Workers' Compensation sation Insurance,or a Certified copy thereof(Sec 3800,Lab C) Polity No Company GUILDIxo i FOR APPLICANT TO FI LL IN wu DR esS 3 �7jL LC.+ -L Certified copy is hereby furnished BU.R`E— NUA EIT L' XX Aoow Ess Certified copy Is filed with the county budding inspection LOCALITY xw wR BST department 3tX CROSS ST Date Applicant NEAREST DIGYR_!5O y qqu• const ces SKD BY ewose eT U vvppr CERTIFICATE OF EXEMPTION FROM WORKERS' LEGAL COMPENSATION INSURANCE DESCRIPTIOn I LOT No BLoeR '^"^wr arwrE MAJOR SECOND LOCAL rrra^P IcucLy __ _ No or BLum (Chis section need not be completed If the work Involved TRACT Now on LOT USK SONS VRCIAL CONDITIONS by the permit Is for one hundred dollars ($100) or less) USE or EXunnD • 1 Certify that m the Performance of the work for which this SIZE of LOT LDG L n permit is Issued, I shall not employ any person in any manneSM OWNER of building 0e.' to as to become w ect to the Workeri Compensation Laws ^� bl P wuL � OCCUPANCY GROUP n Dale Applicant It 7 �'--/� NOTICE TO APPLICANT If, after making this Certificate of CITY q C(; at 0 1f Js� ^(O OCCUPANT LOAD Exemption, you should become subject to the Workers' App LIC TION FOR EXIT HARDWARE Compensation provisions of the Labor Code,you must forth- ❑ with Comply with such provisions or this permit shall be TRAILER wE E] GEOLOGY INSPECTION No Spec Knowl deemed revoked Panic Devices I ICENSCD CONTRACTORS DECLARATION OCCUPANCY INSPECTION El I hereby affirm that 1 am licensed under provisions of Chapter 9 (Commencing with Section 7000) of Division 3 of the Busy Swrerr PERMIT 0 (LIST ITEMS soot) ness and Professions Code, and my license Is m I fun force an no or EEl XITS effect Name of business PARKING SPA CBS REO o PR ovIDEo License Number LIc Class I l LIMITED TIME USE Contractor Date DATA OATS I nm exempt from the licensing requirements as I am a r T. PPO. licensed architect or a registered professlonal engineer SIZE or no OP In uGNATrURwE S acting in my profesmonal capacity (Section 7051, Bus- EXISTING BLDG STORIES axw iness and Professions Code) FINAL APPROVAL Lic or Reg No Date PRESENT USE or BUILDING IC IIOMI OWNFR BIIII DER DLCI ARArION NO OF EXISTING BUILDINGS V 1 hereby for or' that 1 am exempt from the Contracts oN LOT AND USE ��,V 1/' License i cawWfor the fu0uw mg reason (Setfion 7031 S, Dusr � nest and Professions Code) NO PARKING i, as owner of the property, will da the work and the SPACES PROVIDED structure Is not Intended or offered for sale (Section 7044,Business and Professions Code) CONSIRUCI ION LENDING AGENCY PROPOSED USE or BUILDING I hereby affirm that there Is a Construction lending agency for the performance of the work for which this permit n ( ,_ Issued(Sec 3097,Cry C 1 ,moi Lender's Nam —� q >• PROPOSED MAX Bee Lender s Address— 1 certify That I have read this application FEE tion ins stale That the oolI 'i � 'TI above information is correct 1 agree to Comply with all County ISSUANCE FEE ^ ordinances and State ws relating 10 lwlldhng construction, and here thor eprcsentatrves of this County to enter TOTAL PEE 25 .00 1' r upon t above- property for Inspection purposes ' XX XX SEE REVLRSE FOR EXPLANATORY LANGUAGE _ _ _ Signxnuc of Permilice Date t WORKERS'COMPENSATION DECLARATION 20Iz,BD MISCELLANEOUS APPLICATION I hereby affirm that I have a certificate of consent to self COUNTY OF LOS ANGELES BUILDING AND SAFETY DIVISION - iffiure,or a certificate of Workers'Compensation Insurance.or a certified copy thereof (Sed. 380D Lab.C) Policy No. Company_ - - FOR APPLICANT TO FILL IN eulr.DrraG ® P BUILDING ADDRESS ADDRESS Certified copy is hereby furnished.furnished.Certified copy is filed with the county budding inspection aTv ZI department NEAR[sr 0 osa er Date Applicant SIZE OF LOT NO OF SLOGS NOW ON LOT DIaTRRT No GROUF TVFS 'nOCEasm sY d CFIOTFI COMPENSATIONEXEMPTION EMPIINSUR ONCE WORKERS TRACT BLocK Lor NO cwasT V rn 'Cl .c) !TATE MAJOR[[COND LOCAL (This section need not be completed If the pork involved AsSESSOq MAP BOOK PAGE PARCEL - by the permit is for one hundred dollars (SI00) or less) in[zoNE aP[uAL coeomoMe l((FfJJJ I certify that in the performance of the work for which this PA*Q 0 TEL NO permit is issued I shall not employ any person in any manner a so as to become subject to the Workers Compensation Laws ADORES OCCUPANCY GROUP h 34 em 1e it 1v Z Date Applicant Cm I ZIP NOTICE TO APPLICANT If after making this Certificate OCCUPANT LOAD of Exemption you should become subject to the Workers APPLICATION FOR Compensation provisions of the Labor Code.you most forthwith EXIT HARDWARE comply with such provisions or this permit shall be deemed TRAILER UES❑ GEOLOGY INSPECTION❑ No Spec Knowl ❑ revoked LICENSED CONTRACTORS DECLARATION OccumtocY iiJSr[crIDN Panic Devices ❑ I hereby affirm that I am licensed under provisions of Chapter SAFETY PERMIT❑ 1LIST ITEMS BELOW) I 9(commencing with Section 7000)of Division 3 of the Business O UH e8ii NO OF"ITS and Pmfessions Code and my license is in full force and effect ING I License Number Gc Class MdXSllk Inc a� REO D PlxoviD[D PACES Contractor Date LIMITED TIME USE I ❑ I am exempt from the licensing requirements as I am a FROM DATE TO DATE licensed architect or a registered professional engineer Seim m my professional capacity(Section 7051 Business �zE°F No or INSPECTOR 9 and in Code) E%IfT141G BLDG 32 ,000 $ ft. aTomEa SIGN RE. rn[asitT USE OF SUILONG Ij�-3o-03 Lic or Reg. Na Dale FINAL APPROVAL HOME OWNER-BUILDER DECLARATION No OF ExiiiTINa BUILDINGS I ON LOT AND US[ I hereby affirm that I am exempt from the Contractor s Lmeom Law for the following reason (Section 70315 Business and Profcf ns Code) NO PANG ❑ T as owner of the property will do the work and the erwcm PROvroED 15 structure is not intended or offered for sale(Section 7044 1 PROIrosaD USE OF BUILDING Business and Professions Code) CONSTRUCTION LENDING AGENCY Warehouse and Wholesale I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (SCC 3097, Civ C) RLOFODED MAX OCC Lender s Name rPw T0.NOLeader s Address Icertify that 1 have read this application and state that thIabove informehon rs correct I agree to comply inti aB Countordinances and State laws relating to building construction,anhereby authona representatives of thi ty to enter upone-met ned property pec pu� SEE REVERSE FOR EXPLANATORY LANGUAGE --"lure M Pbrmrti<e Date