HomeMy Public PortalAbout4908 GOLDEN WEST AVE_BUILDING_5/17/2016_COUNTY OF WE ANGELES
DEPARTMENT'OF PCBLRC WORKS
BUILDING AND SAFETY'/ LAN[�DEVEIGPMENT
TEMPLE CITY
9701 LAS TUNAS
TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
ygo8 Golden l4c-6 -
R 0508 BUILDING PERMIT
NEW RESIDENTIAL
BL 0508 1510150055
LEQAL ID:
N0. OF CONST NEW
BUILDING ADDRESS:
TR: 13986 LT: 8
SQ. FT STORIES TYPE OCCUP GROUP(
4908 GOLDEN WEST AV
ISTRUCTURB: 3700 2 V -B R-3
GARAGE:
TEMP CA 917803937
NEAREST CROSS STREET:
ASSESSOR INFORMATION NUMBER:
18589-020-008
OTHER: 171 1 V -B U
THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY CA
09E ZONE: R-1
ISSUED ON: PROCESSED BY:
1TENANT:
1
1`
05/17/16 SR
TEL. NO:
NOW ON LOT: VALUATION:
IFI�TE IC Y: CODE:
10WNER:
4908 GOLDEN WEST LLC
2275 HUNTINGTON DR
IBLDGS.
505,720
ISAN MARINO CA 91108
FEES PAID
DESCRIPTION OF WORK
NEW 2 -STORY SFD: 5 BEDROOMS, 5.5 BATHROOMS, FRONT PORCH AND
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IREAR
I
PATIO 274 SF.
APPLICANT: TEL. NO:
JKUO, SAMUEL (626) 285-3408-
81 PLANCHECK W/ENERGY 505720.00 VAL 3,710.40
ISPECIAL CONDITIONS:
112 N EARL.E STREET
AA BLDG PERMIT ISSUANCE 34.40
SAN GABRIEL CA 91775
AB STATE GREEN BLDG FEE 505720.00 VAL 21.00
(FIRE SPRINKLERS REQUIRED
AC STRONG MOTION REBID 505720.00 VAL 65.70
�B2 PERMIT W/ENERGY 505720.00 VAL 5,470.40
JD7 ADDNL PLANCHECK FEE 2.00 HOU 272.60
CONTRACTOR: TEL. NO:
(APPROVALS DATE INSPECTOR SIGNATURE
ISO DESIGN CONSTRUCTION CORPORATION (626) 279-1800-
108 CERTIF OF OCCUPANCY 125.80
i
19324 GARVEY AVENUE LIC. NO
TOTAL FEES 9,700.30
(LOCATION AND SETBACKS
IEL MONTE CA 91733 930443
I
(� ,[� �,,��
SOILS ENGINEER APPROVAL
�M
/"V 1ILIC/
FOUNDATION/TRENCH FORMS
ARCHITECT OR ENGINEER: TEL. NO:
CTMALC DEVELOPMENT INC. (626) 285-3408-
112 N. EARLE ST. LIC. NO:
FLOOR
GABRIEL, CA 91775 930764
1SLAB/UNDER
1SAN
RAISED FLOOR FRAMING
MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
UNDEAFIAOR INSULATION
3 all
1ST LEVEL FLOOR SHEATH
2ND LEVEL FLOOR SHEATH
ROOF SHEATHING
�
1
N0. OF FAMILIES: DWELLING ONITS: APT/GOND: STAT CLASS:
1 NO 01
SCHOOL WITHIN HAZARDOUS
AIR QUALITY: 1000 FEET MATERIALSI
o
NO NO NO
�'kiBLOO
IFIRE DEPT. FRAME INSPECT
DEPT. FRAME INSPECT{
1
(SHEAR PANELS
(INSULATION/WEATHER STRIP(
iR
INTERIOR (ATH/DRYWALL
1
EXTERIOR LATH
�SMOXR
LOT DRAINAGE
PERMIT EXPIRES 180 DAYS IF
1) {YORK DOES NOT COMMENCE, OR
�2)
DETECTION DEVICES
7A 711b'
WORK IS SUSPENDED OR ABANDONED, OR
j
3) FAILS TO OBTAIN CODE REQUIRED INSPECTION I
FIRE DEPARTMENT APPROVAL
CXR` �/
REPORT ID: DPR261 ROUTE TO: BS 0508 �
1
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 (J) 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 1, 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 Contra or pursuant to the Contractors' State License
Law).
U: I am exemf t 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 priorlto completion of the improvements covered by
this permit, I cannot 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:/A%ww.leginfo.ca.gov/calaw,htmi.
Date:
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 my
license is in full force and effect.
License Class /h License No. V
11
Date fi�? Contractor Signature
ORKERS' 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.
pty 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
kers' omperrsati Ins nc er and pot( number
abler of c um r xplration Date
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' com
insions of Section 3700 of the Labor
Code, 16
with those provisionsure of ate
LOBBYIST ORDINANCE CERTIFICATION
Complete this section for permits in
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 application process.
Applicant (Print Name) Applicant Signature
Company Name Date
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
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
ordinances and state laws relating to building
construction.
I authorize representatives of this county to enter the
above -identified pr rty for inspection purposes.
Signet_ Owner or Authorized Agent