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Home My Public Portal About5585 ROSEMEAD BLVD_BUILDING_10/19/2017_TEMPLE CITY PERMIT NO. B17-35079 City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.tempimity.us Address: 5585 Rosemead Blvd, Temple City, California Parcel: 5387-032-062 91780 Permit No: 517-35079 Type: Building Subtype: CR Commercial Alteration Description: REPAIR OF EXISTING GLU-LAM BEAM Special Conditions: Issue Date: 10-19-2017 Expire Date: 04-17-2018 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 CVS Caremark Corporation One CVS Drive, Woonsocket, Rhode Island 02895 (401) 765-1500 Applicant Jeff Mall 3000 E Miraloma Ave, Anaheim, California 92806 7 (146) 328-5333 Contractor SPS Inc. 3000 E Miraloma Ave, Anaheim, California 92806 (714) 632-8333 309472 Engineer Gregory Paviek 914 E Katella Ave, Anaheim, California 92805 (714) 385-1835 Buildiny_Details_ Structure 1: Commercial 2: 3: 4: Construction Type: V -B Occupancy Group: MMercentlle New/Added Area: 0 0 0 0 Remodel/TI Area: 0 0 0 D New Dwelling Units: 0 0 0 0 Stories: 0 0 0 0 - Fees Total Valuation $15,000.00 Plan Check Fees $333.14 Permit Feu $392.05 Strong Motion Fee $4.20 SB 1473 FN $1.00 Parks Day Fee $0.00 Sewer Const Fee $0.00 - Building Inspections Approval Date Inspector Approval Date Inspector Approval Date Inspactor Location/Setbacks Roof Sheathing Rated Soils Engineer Fire Dept Framing�)/�//� Floor/Ceiling Foundation Forms Dep[ Bldg Framing r -'Q -"1-c- Rated Walls Slab/Under Floor Shear Panels Rated Raised Floor Sprinkler Hangars Shafts Framing insulation/Weather T -Bar Underfloor Strip Ceilings Insulation interior Lot 1st Floor Ln[h/Drywdll Drainage Sheathing Exterior Lath Smoke Ind Floor Detectors Sheathing Fire Dept Approval FINAL 4 F: V OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reasons) 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).): L) I, as owner of the property, or my employees with wages as their sole compensation, will do (J) 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' 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 Contr4ctor pursuant,to the Contractors' State License Law). L): 1 am exem(4t 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 prior to completio of the improvements covered by this permit, I nnot legally sell a structure that I have built as an own 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•//www leainfo.ca.aov/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. J -/License Class � License No. 3� yl / Qate 104217 Contractor Signature '��--///"" WORKERS' COMPENSATION TION 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 workers' compensation Insurance carrier and policy number are: Cartier Policy Number Expiration Date 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' Iforr)p(jn��,tion provi ' ns of Section 3700 of the Labor Code, I s all h it connp&4th those provisions 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 acting on behalf of myself complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company 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 ❑ N o ❑ 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 checklistfor guidelines. Yes ❑ No ❑ I have read the hazardous materials information guide and the SCAQMD permitting checklisL I understand my requirements under the Los Angeles County Code Titie 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. Signature ate of P e O n r Authorized Agent _q