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Home My Public Portal About6435 GOLDEN WEST AVE_ELECTRICAL_4/19/2017_TEMPLE CITY PERMIT NO. E17-34047 City of Temple City 1 9701 Las Tunas Dnve I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us Address: 6435 Golden West Avenue, Temple City, Parcel: 5383-016-025 California 91780 Permit No: E17-34047 Type: Electrical Subtype: Subtype: Residential Description: 2 OUTLETS, 1 LIGHT FIXTURE FOR NEW Special BATHROOM Conditions: Issue Date: 04-19-2017 Expire Date: 10-16-2017 Extension: Extension: Permit expires on date shown if: 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code required inspection. Contacts Owner Zhiongqin Li Applicant Jin Huang Contractor Electrical Details New Multifamily 0 Carnival Ride: 0 Mechanical Branch Circuit: 0 Lights Residential 0 Appliance: 3 HP or less Power Apparatus: 0 Over 100 HP Service: Over 0 1000 Amps Fees Total J H Construction and Design Inc. New Single- 0 Family/Duplex Carnival Lighting 0 System Receptacle, 2 Switch, Lighting Outlets Non -Residential 0 Appliance: 3 HP or less Busway 0 Miscellaneous 0 Plan Check Fees $313.60 Permit Few $8.05 - Electrical Inspections Approval Date Inspector Temp Pole Underground Ufer Ground 6435 Golden West Avenue, Temple City, California 91780 488 Wrangler Way, Walnut, California 91789 (626) 720-7999 488 Wrangler Way, Walnut, California 91789 (626) 720-7999 1001522 New Swimming 0 Pool Temporary Power 0 Pole Light Fixture 1 Power Apparatus: 0 3-10 HP Sign 0 Approval Date Inspector Conduit Wiring '"sly Water Ground Spa, Hot Tub, 0 Alteration Temporary 0 Power System Light Fixture: 0 Pole Mount Power 0 Apparatus: 10-50 HP Service: Under 0 400 Amps Carnival Ride: 0 Electric Branch Circuit: 0 Outlets Light Fixture: 0 Theatrical Power 0 Apparatus: SO - 100 HP Service: 400- 0 1000 Amps Approval Date Inspector Utility Release zI 1 FINAL 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 Cade): 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).): L) I, as owner of the property, or my employees with wages as their sole compensation, will do (✓) all of or U 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 Contr9�tor pursuant to the Contractors' State License Law). L): I am exempt 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 priorl to completionr-1 of the Improvements covered by this permit, I cannot legally sdll a structure that I have built as an owner -builder fl 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 thefollowing,We she:htto:l/www.ledinfo.ce.covlcelaw.html Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION JOB ADDRESS I hereby affirm under penalty of perjury that I am licensed under LOCALITY provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full for nd effect. HAZARDOUS MATERIAL DECLARATION License Class License No. ZL Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or L'7/olreater than the amount specified on the hazardous materials Date�)I II Ili/ rTt,act rSignature information guide? WORKERS' COMPENSATION IDECLARA IOPV Yes ❑ No ❑ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION Will the intended use of the building by the applicant or future COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN building occupant require a permit for construction or EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO modification from the South Coast Air Quality Management ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION District (SCAQMD)? See permitting checklist for guidelines. 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 perforance of the work for which this permit is issued. My workers' compensation Insurance carder and policy number are: Yes ❑ No ❑ I have read the hazardous materials Information guide and the SCAQMD permitting checklist, I understand my requiremernts under the Los Angeles County Code Title 2, Chapter 220' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a perk 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. Carrier Policy Number Expiration Date DECLARATION REGARDING CONSTRUCTION LENDING AGENCY Name of Agent Phone Number I certify that, in the perforance 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 sti f rt w''11 omply with those provisions 2 I L -2,71? SlarctureVAppildant Date 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 ac' b he f myself complied and will continue to comply therm pplication process. Applicant (Print Name) Applicant Signature Company Name Date 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 certity 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 pro rtylfor inspection purposes. Signature of Porized Agent Dat