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Home My Public Portal About6260 TEMPLE CITY BLVD_Building__ WORKERS COMPENSATION DECLARATION n hereby affirm that 1 have r certificate of tionconsent to ,elf APPLICATION FOR BUILDING PERMIT fllylf insure, or a certificate of Workers Compensation Insurance, or a certified co thereof (Sec 3800, Lab C) COUNTY OF LOS ANGELES BUILDING AND SAFETY Poli No 1079140 Company State Fund Policy Y BUDDING ❑ Candled copy Is hereby furnished FOR APPLICANT TO FILL IN ADDRESS ® Certified copy r filed with the county building mopec- BUILDING ADDRESS tion department 6260 T.C Blvd. T. Cy. 91780 Date' 11-1-89 Applicant Randol Roofing CITY T•Cy• ZIP LOCALITY PP NO OF BL NEAREST EXOM WORKERS' SIZE OF LOT CERTIFICATE OF EXEMPTION FROM NOW ON LOT LROSS ST COMPENSATION INSURANCE ASSESSOR (This section need not be completed if the permit r for one TRACT BLOC( LOT NO - MAP BOOK ' PAGE PARCEL hundred dollars ($IOD)ar Iess ) OWNER Frank Miller Z�285-3731 USE ZONE MAP NO I certify that in the performance of the work for which this SPECIAL >_permit is issued, I shall not employ any person in any manner ADDRESS Same CONDITIONS a sa as to become subject to the Workers Compensation Laws - O 5-11-89 Randol Roofing Cm ZIP J Date Applicant ARCHITECT OR TEL DL4RI GROUP TYPE IRE PROCESSED BY O NOTICE TO APPLICANT If, after making this Certificate of ENGINEER NO / ^� CON57ZONE Exemption you should become subject to the Workers v Compensation provisions of the Labor Code, you must forth- ADDRESS with comply with such provisions or this permit shall be CONTRACT Rnndol Roofing TEL STATISTICAL CLASSIFICATION APT CONDO N deemed revoked OR"" LICENSED cohiccened un DECLARATION ADDRESS 529 E. Valley Blvd LNCO 451937 °�NO D� u"�- 1 hereby affirm that I am licensed under provisions of Chapter 9 LIC SEWER MAP (commencing with Section 7000)of Division 3 of the Business CITY San Gabriel, Ca. LIC C-39 VALIDATION and Professions Code and my license is in full force and effect SS NO BK PG License Number 451937 Lic Clogs C-39 SIZE FT STORIES FAMILIES ONE Re—roof t of h t� [:1vALuwnoN Contractor Randol Roof ing�e 1-30-90 DESCRIPTION OF WORKe-roopart ADD 1:1 $ 1000.00 ❑I am exempt under Sec with fiber las 3tab shingles Class A. Roof. poll. 1:1B 8P C for this reason REPAIR ® f Date USE OF- EXISTING REMIX ❑ EXISTING BLDG Signature APPLICANT Randol Roo ng TEL — —FINAL OWNER-BUILDER DECLARATION DATE I hereby affirm that I am exempt from the Contractor's License ADDRESS 529 E. Valley Blvd. S.G.91776 _fl 1 Law for the following reason (Section 7031 5 Business and Professions Code) PRESENT AWA A/�/�T A El I, as owner of the property or my employees with BUILDINGADDRESS ��rs-7 wages as their sole compensation,will do the work and .7Ju! 40.50 LOCALITY the structure Is not Intended or offered for sale(Section , 1 I1Q�$ 7044, Business and Professlonu Code ) MOVING TEL ❑ 1, as owner of the property, am exclusively controcting CONTRACTOR NO _ MAL 410.50 with licensed contractor to construct the project (Sec- ADDRESS tion 7044, Business and Professions Code ) CECK 40.50 CONSTRUCTION LENDING AGENCY til -YAC . TOTALS LNC FROM ITT .00 I hereby affirm that there Is a construction lending agency for FRONT the performance of the work for which this permit Is issued _EL _ (sec Som, cIY c) PILE 0000-OQOl 5/19/89 PL �t�Yf Css��f G[ y Lender s Name LDMA Ref F .7422 1 PM12:56 ^ PC Fee$ Permit Fee Aq Lender's Address I certify that I hove read this application and state that the Inuonce Fee $10.50 LDMA P/C 0 above Information Is correct I agree to comply with all County Invntlgonan Fee 40.5 ordinances and State jaws relating to building construction, Total Fee LDMA Perm 0 ` and' hey4y/uthon r sentanves of hr County t enter ^ upo"a/rB/I�AL/aL,fov t pro f nspectl r ' UK■EVEREE FOR EXPLANATORY LANGLIAGE SIgnuture of Apphcant or Agent Dan COUNTY OF IAS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1012290034 PHONE (626) 285-0488 EXT` LEGAL ID NO OF CONST NEW BUILDING ADDRESS ON FILE SQ FT STORIES TYPE OCCUP GROUP 6260 TEMPLE CITY BL I (ASSESSOR INFORMATION NUMBER GARAGE 220 1 V-B R-3 I TEMP CA 917801749 GARAGE NEAREST CROSS STREET LONGDEN 15385-016-013 OTHER 1 V-B U I THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY, Cl (TENANT EXIST BLDG USE USE ZONE 11ON PROCESSED BY EXIST OCC GAP 106/29/6/29/11 SR OWNER TEL NO JBLDGS NOW ON LOT VALUATION F NA:. DATE FINAL BY CODE XU JENNY (626) 389-4919- 24 200 'J}}\�) 6260 TEMPLE CITY BL 'I TEMP 917801749 FEES PAID 1D C 'erION OF WORK I 11-SMRY ADDITION OF BATHROOM, 1 CLOSET 138 SQ FT AND I FEE DESCRIPTION QUANTITY UOM AMOUNT 1ENCLOSED EXISTING PORCH TO STUDY ROOM 82 SQ FT 5"?. D I IAPPLICANT TEL NO I I 'B��.VpN` lol�3 XU JENNY (626) 388-4919- B1 PLANCHECK W/ENERGY 24200 00 VAL 439 60 1 IAA BLDG PERMIT ISSUANCE 27 80 SPECIAL CONDITIONS IAB STATE GREEN BLDG FEE 24200 00 VAL 1 00 IAC STRONG MOTION REBID 24200 00 VAL 2 40 182 PERMIT W/ENERGY 24200 00 VAL 517 10 CONTRACTOR TEL NO 108 CERTIF OF OCCUPANCY 101 30 1APPROVAIS DATE INSPECTOR SIGNATURE XU JENNY (626) 386-4919- TOTAL FEES 1 089 20 1 6260 TEMPLE CITY BLVD LIC NO 1LOCATION AND SETBACKS i TEMPLE CITY, CA 91780 NONE I ISOILS ENGINEER APPROVAL ` 1ARCHITECr OR ENGINEER TEL NO FOUNVATION/TRENCH FORMS III I CHEN JASON (626) 964-3313 1623 CAROLIE LANE LIC NO SLAB/UNDER FIAOR IWALNUT CA 91789 C040169 IRAIS D FLOOR FRAMING I�('' (MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP I 1UNDERFLDOR INSULATION I 3 U)I _I 1ST LEVEL FLOOA SHEATH NO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS 0 NO 21 1 12ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS ROOF SHEATHING AIR QUALITY 1000 FEET MATERIALS / NO NO NO IFIRE DEPT FRAME INSPECT( 1 ( I I IBLMi Deer eRr.MA: INSPECT io 1H ISHEAR PANELS 1 I 1 IINSULATION/WEATHER STRIP(/� INTERIOR ATH/DRYWALL I[t>- I EXTERIOR LATH I I ILDT DFA IMAGE 1 I I (SMOKE DETECTION DEVICES 1 I I I I I IFIRE DEPARTMENT APPROVAL( I I I I I I I I REPORT ID DPR261 ROUTE TO BS0508 COUNTY OF LOS ANGELES TEMPLE CITY p 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1207270015 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS ON FILE I SQ PT STORIES TYPE I 6260 TEMPLE CITY BL [ [STRUCTURE 1200 V-B TEMP CA 917601749 [ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET 15385-016-013 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY CAI I I TENANT EXIST BLDG USE RESID USE ZONE R-3 IISSLED ON PROCESSED BY I 1EXIST OCC GRP 107/27/12 SR I [OWNER TEL NO IBLDGS NOW ON LOT VALUATION (FINAL DATE FINAL BY CODE I 1NING, AN— (626) 286-9566- 1 5 500 11_ / 6260 TEMPLE CITY BL I 1 —7 1 ITEMP 917801749 I FEES PAID IDE CRIPTION OF WORK I ITEAR OFF AND RE ROOF INSTALL 1/2' OSB WITH RADIANT SHEATHINGI I _1FEE DESCRIPTION QUANTITY DOM AMOUNT APPLICANT TEL NO MANUEL, CORREA (626) 786-2347- AA BLDG PERMIT ISSUANCE 27 80 1 1 12509 EUCLID CRESCENT AS STATE GREEN BLDG FEE 5500 00 VAL 1 00 ISPECIAL CONDITIONS I UPLAND CA 91784 AC STRONG MOTION RESID 5500 00 VAL 0 60 1 - I D2 PERMIT W/O EN-HC 5500 00 VAL 149 40 1 [CONTRACTOR TOTAL FEES 178 80 1�NtndiT � TEL NO IAPPRJ DATE INSPECOR SIGNATURE I X-TREME BUILDERS (909) 931-4464- 1 12509 EUCLID CRESCENT EAST LIC NO (LOCATION AND SETBACKS 1UPLAND CA 91784 6271aze 1 1 ISOILS ENGINEER APPROVAL I I I (ARCHITECT OR ENGINEER TEL NO IFOT DATION/TRENCH FORMS LIC NO I ISLAP/UNDER FLOOR 1 [RAISED FLOOR FRAMING I [ [MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMF I J 1`J UNDERFLOOR INSULATION 1153H269 3 COI I I �\ L IFLOOR SHEATHING 1 [ I IND OF FAMILIES DWELLING UNITS APT/GOND STAT CIAS9 ( J 1 0 NO 21 _1 ` ; ' 1ROOF SHEATHING �L SCHOOL WITHIN HAZARDOUSSHEAR PANELS LAIR QUALITY 1000 FEET MATERIALS __ NO NO NO 1 N' IFRAME INSPECTION I r ' IFIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP[ I I 11NTERIOR LATH/DRYWALL I I I EXTERIOR LATH [ I - ` RATED FLOOR/CEIL ASS64 [RATED WALL ASSEMBLIES 1 _ [RATED SHAFTS/OPENINGS [T-BAR CEILINGS [LOT DRAINAGE I IREPORT ID DPR261 ROUTE TO BS0508 I I I I I I COUNTY OF LOS ANGELES TEMPLE CITY C 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING ACID SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1305010086 PHONE (626) 285-0488 EXT LEGAL ID NO OF CONST BUILDING ADDRESS I ON FILE SQ PT STORIES TYPE 1 6260 TEMPLE CITY BL 1 I (STRUCTURE V-B TEMP CA 917801749 1 ASSESSOR INFORMATION NUMBER NEAREST CROSS STREET I 15385-016-013 THOMAS PAGE 596 GRID J2 LOCALITY TEMPLE CITY CAI TENANT IEXIST BLDG USE RESID USE ZONE R-3 11SSUFD ON PROCESSED BY (EXIST OCC GRP 105/0./13 SR I TOWNER TEL NO BLDG9 NOW ON IAT VALUATION IF DATE FINIAL BY CODE AN NING (626) 297-9285- 1 1,000 f//c �/D^vn I 6260 TEMPLE CITY SL 1TEMP 917801749 FEES PAID D SCAIPTIOH OF PORK REPIACC 4 WINDOWS IN LIVING ROOM AND 2 WINDOWS IN KITCHEN FEE DESCRIPTION QUANTITY DOM AMOUNT 1 APPLICANT TEL NO SA1� AS OWNER - IAA BLAG PERMIT ISSUANCE 2] 80 IAB STATE GREEN BLDG FEE 1000 00 VAL 1 00 ISPECIAL CONDITIONS IAC STRONG MOTION REBID 1000 00 VAL 0 50 ID2 PERMIT W/O EN-HC 1000 00 VAL 65 40 TOTAL94 70 (CONTRACTOR TEL NO (APPROVALS DATE INSPECTOR SIGNATURE SAME AS OWNER - LIC NO I (LOCATION AND SETBACKS I I (SOILS ENGINEER APPROVAL I ARCHITECT OR ENGINEER TEL NO IFOUND.ATION/TRENCH FORMS I I I LIC NOI ISI.AB/DNDEA FIAOR I (RAISED FLOOR FRAMING I I MAP NO SEWER MAP BOOK PAGE FIRE ZONE CMP IUNDERFLOOR INSULATION I 153H269 3 OU IFLOOR SHEATHING AO OF FAMILIES DWELLING UNITS APT/COND STAT CLASS NO 21 I IRGO- SHEATHING I I SCHOOL WITHIN HAZARDOUS I SHEAR PANELS (AIR QUALITY 1000 FEET MATERIALS NO NO NO I FRAME INSPECTION I 1 I I FIRE 3PRINRLER HANGERS (INSULATION/WEATHER STRIP( I I I I INTERIOR LATH/DRYWALL EXTERIOR LATH I IRATED FLOOR/CELL ASSEM I IRATED WALL ASSEMBLIES I I RATED SHAFTS/OPENING— IT-RAR HAFTS OPENINGT-BAR CEILINGS (IAT DRAINAGE REPORT ID DPR261 ROUTE TO RS0508