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Home My Public Portal About9911 LOWER AZUSA RD_BUILDING_6/13/2016_ (2)1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 5 YES 04C 1 SCHOOL WITHIN HAZARDOUS 1 1AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO PERMIT EXPIRES 180 DAYS IF 1) WORK DOES NOT COMMENCE, OR 12) FORK IS SUSPENDED OR ABANDONED, OR 13) FAILS TO OBTAIN CODE REQUIRED INSPECTION REPORT ID: DPR261 ROUTE TO: BS0508 11ST LEVEL FLOOR SHEATH I I^ I (2ND LEVEL FLOOR SHEATH Y Y„I (ROOF SHEATHING D fiw FIRE DEPT. FRAME INSPECT( / C/G Z4 hy 1BLDG DEPT. FRAME INSPECT( SHEAR PANELS I I I INSULATION/WEATHER STRIPI� /! INTERIOR LATH/DRYWALL 1 1EXTERIOR LATH 1 1 LOT DRAINAGE 1 1 1 1SMOKE DETECTION DEVICES l0 iJ IFIRE DEPARTMENT APPROVALI a9 < < L-oL�OL Alk --45A COUNTY OF IAS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF GUBLIC WORKS 9701 LAS TUNAS NEW RESIDENTIAL BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1501220160 PHONE: (626) 285-0488 EXT: 1 LEGAL ID. NO. OF CONST NEW I BUILDING ADDRESS: TR: 9848 LT: 12 SQ. PT STORIES TYPE OCCUP GROUPI 9911 LOWER AZUSA ED (STRUCTURE: 1554 2 V -B R-3 I TEMP CA 917804041 1 ASSESSOR INFORMATION NUMBER: I GARAGE: 432 1 V -B UNEAREST CROSS STREET: 18589-029-024 OTHER: 1 THOMAS PAGE: 597 GRID: B5 LOCALITY: TEMPLE CITY CAI (TINT'( USE ZONE: R-2 ISSUED ON: PROCESSED BY: 106/13/16 SR OWNER: TEL. NO: BLIKiS. NOW ON LOT: VALUATION: (FINAL A FINAL BY: CODE: 1559WEI SHARON 15593 ANGELUS AVE I 228,742 //� ( � ` ITEMP917804041 I FEES PAID IDESRIPT ON OF WORK 1 I I 1NEW 2 -STORY DETACHED CAM 4 BEDROOMS, 3 BATHROOMS, WITH (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IATIACHED 2 CAR GARAGE (APPLICANT: TEL. NO: ITSOI, VINCENT (626) 799-8816- D4 STANDARD PC W/ EN 228742.00 VAL 1,400.80 1 I 11414 FAIR OAKS p2 IE1 PC EXTENSION FEE 25$ 350.20 DOL 350.20 SPECIAL CONDITIONS: I (SOUTH PASADENA 91030 AA BLOG PERMIT ISSUANCE IAB 34.40 (FIRE SPRINKLERS REQUIRED 1 STATE GREEN BLDG FEE 228742.00 VAL 10.00 I IAC STRONG MOTION REBID 228742.00 VAL 29.70 I (CONTRACTOR: TEL. NO: IB2 PERMIT W/ENERGY 228742.00 VAL 2,941.40 (APPROVALS DATE INSPE R SIGNATURE 1 IMCWONG HOLDING CO. (626) 570-9969- 108 CERTIF OF OCCUPANCY 125.80 I 1809 S ATLANTIC BLVD, STE 201 LIC. NO I TOTAL FEES 4,892.30 AND SETBACKS (MONTEREY PARK, CA 91754 685220 VOCATION 7 I ISOILS ENGINEER APPROVAL 1�1s1i 1 (ARCHITECT OR ENGINEER: TEL. NO: 1 (FOUNDATION/TRENCH FORMS �� /, SPACE LIGHT STRUCTURE DESIGN (626) 799-8818- 1 _ I SFJ:/�5/`I 11414 FAIR OAKS AVE STE 2 LIC. NO: I (SLAB/UNDER FLOOR (SOUTH PASADENA, CA 91030 23755 I I 1RAISED FLOOR FRAMING 1 SEWER MAP BOOK: PAGE: ( FIRE ZONE: CMZI (UNDERFLOOR INSULATION 1 NO: OPMAP 1 1NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 1 5 YES 04C 1 SCHOOL WITHIN HAZARDOUS 1 1AIR QUALITY: 1000 FEET MATERIALS 1 NO NO NO PERMIT EXPIRES 180 DAYS IF 1) WORK DOES NOT COMMENCE, OR 12) FORK IS SUSPENDED OR ABANDONED, OR 13) FAILS TO OBTAIN CODE REQUIRED INSPECTION REPORT ID: DPR261 ROUTE TO: BS0508 11ST LEVEL FLOOR SHEATH I I^ I (2ND LEVEL FLOOR SHEATH Y Y„I (ROOF SHEATHING D fiw FIRE DEPT. FRAME INSPECT( / C/G Z4 hy 1BLDG DEPT. FRAME INSPECT( SHEAR PANELS I I I INSULATION/WEATHER STRIPI� /! INTERIOR LATH/DRYWALL 1 1EXTERIOR LATH 1 1 LOT DRAINAGE 1 1 1 1SMOKE DETECTION DEVICES l0 iJ IFIRE DEPARTMENT APPROVALI 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 I, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or L) 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' Stale License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). L) I am exemdt from licensure under the Contractors' State License Law for the following reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priori to completion of the improvements covered by this permit, Ignnot legally sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by 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 the following Web site: htto:/ANww.leainfo.ca.goy/calaw.htmi. Date: 3 1 Signature of Property Owner or Authorized Agent 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 m JOB ADDRESS'-. LOCALITY y license is in full force and effect. HAZARDOUS MATERIAL DECLARATION %,7i0 �ilt the applicant or future building occupant handle a hazardous License Class License No. aterial or a mixture containing a hazardous material equal to or Date ontractor Si natu S greater than the amount specified on the hazardous materials 9 r.....,�r,.... ..,adeo WORKERS' COMPENSATION DECLARATION Yes ❑ No ❑ 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 w�orkQers' comgensation Insurance rr e d policy n mber e: CPolicy Number Et ration ate rrier A Name of Agent Phone Number I certify that, in the performance of the work for which this 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 workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions Signature of Applicant Date LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits In Unincorporated Los Angeles County only 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 owners behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county This is to certify that I, as permit applicant, am familiar with the ordinances and state laws relating to building requirements of Los Angeles County Code Chapter 2.160 at seq., construction. (relating to the Los Angeles County Lobbyist Ordinance) and that I authorize representatives of this county to enter the all persons acting on behalf of myself complied and will continue above -identified property for inspection purposes. to comply therewith through the app I' do processs � � Sign lure Propeer�Authorized Aggnt Applicant (Print Nam Applicant S' n re ' d a/� N //✓(� t' Date .� Company Name I Da