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Home My Public Portal About10370 KEY WEST ST_PLUMBING_7/25/2017_TEMPLE CITY PERMIT NO. P17-34562 City of Temple City 1 9701 Las Tunas Dnve I Temple City, California 91780 1 (626) 285-2171 1 www.templeaty, us Address: 10370 Key West Street, Temple City, California 91780 Parcel: 8585-018-034 Permit No: P17-34582 Type: Plumbing Subtype: Subtype: Residential Description: CLEAN OUT INSTALL Special Conditions: Issue Date: 07-25-2017 Expire Date: 01-21-2018 Extension: Extension: Permit expires on date shown IC 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code required inspection. Contacts Owner Kim Gm 10370 Key West Street, Temple City, California 91780 (626) 382-6537 Applicant Abraham Torres 706 Arrow Grand Circle, Covina, California 91722 (626) 858-9284 Contractor Rescue Rooter 706 Arrow Grand Circle, Covina, California 91722 (626) 858-9284 765155 Plumbing Details Backwater 0 Backflow 0 Bathtub/Shower 0 Clothes 0 Dishwasher 0 Valve Device Washer Drinking 0 Floor Drain 0 Floor Sink 0 Hose Bibb 0 Interceptor/Clarifier 0 Fountain Lavatory/Sink 0 Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater D Regulator Pool Trap 0 Trap Primer 0 Water Closet 0 Water 0 Water Treatment 0 Heater Gas: Low 0 Gas: 0 Gas Meer 0 Gas 0 Alteration/ Repair 0 Press Med/High Regulator Press Greywater 0 Pipe 0 Future Branches 0 Other: 1.5 0 Other: 2-3 inches 0 System Replacement inches or less Other: over 3 0 Sewer: 0 Sewer: Manhole 0 Sewer: 0 Sewer: Private 0 inches Connection Addition Connection Sewer: 0 Sewer: Pit 0 Sewer: t Sewer: 0 Pit/Drainfield Extension Alteration Tap&Saddle Combo Wast./Vent Earthquake Chemical Rainwater Greywater Shutoff Waste Fees Total plan Check Fees $113.60 Permit Fees $39.36 Plumbmglnspectlons Approval Date Inspector Under Slab Work Water Service Mastic Y/N Metal Y/N Rough Plumbing Sewer Inspections Approval Data Inspector New House Sewer Connect Add'I Septic TanWMt Approval Gas Piping Gas Vent Hot Water Heater Plumbing Fi#ures Lawn Spnnklem Date Inspector Approval Date Inspec or Drywall Alter/Repatr Disconnectli Approval Date Inspector Gas Test Utility Co Notified CWV Gray Water System FINAL Approval Date Inspector Backfill Tari/Pit Gray Water System FIIUL r OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) Indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): U 1, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or (_) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner - Builder will have the burden of proving that it was not built or improved for the purpose of sale.). U I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contrh�tor pursuant to the Contractors' State License Law). LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License CCllas //tel (a License No. Date '7 ° r// Contractor Signatu a z WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self - insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My A° ers' oompensaiti n insurance ce er and li number r -- Carrier 4- cam -- Pot Nu9b/rq*Pyer plratio0 Til -- Agent Phone Number U I am exempt from licensure under the Contractors' State — I certify that, in the performance of the work for which this License Law for the following reason: permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the By my signature below I acknowledge that, except for my workers' compensation provisions of Section 3700 of the Labor personal residence in which I must have resided for at least Code, I shall f heel omply with those provisions one year prion to completion of the Improvements covered by this permit, I cannot legally sell a structure that I have built as an / r/ �% Z r -builder I ownef it has not been constructed in its entirety by ature of Applicant Date licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at LOBBYIST ORDINANCE CERTIFICATION the following Web site: hflo://www.leciinfo.ca.gov/calaw.html. Complete this section for permits in Date: Signature of Property Owner or Authorized Agent Unincorporated Los Angeles County only This Is to certify that I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that all persons acting on behalf of myself complied and will continue ,,to comply therewith through the applicatio ss. �liwnt`(�PNaBe) L`— PPlicantSj ryalure �2 Company Name 1�drJ D/attee JOB ADDRESS ! LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or greater than the amount specified on the hazardous materials information guide? Yes ❑ No ❑ Will the intended use of the building by the applicant or future building occupant require a permit for construction or modification from the South Coast Air Quality Management District (SCAQMD)? See permitting checklist for guidelines. Yes ❑ N o ❑ I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirements under the Los Angeles County Code Title 2, Chapter 220 Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a permit from the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbestos removal is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this county to enter the above -identified property for inspection purposes. Signa Owner or Authorized Agent Date %/z/` �2