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Home My Public Portal About5341 SANTA ANITA AVE_PLUMBING__8/29/2017_TEMPLE CITY PERMIT NO. P17-34804 Date Inspector Gas Piping City of Tempe City 1 9701 Las Tunas Drive I Temple City, Cakfomia 91780 1 (626) 285-2171 1 www.templecity.us Address: 5341 Santa Anita Avenue, Temple CRY, California 91780 Parcel: 8573-018-045 Hot Water Heater _ Plumbing Fixtures Permit No: P17-34804 Type: Plumbing Subtype: Subtype: Residential Description: REPLACE WATER LINES ON 12 FIXTURES ON THE HOUSE. REPLACE Special Date Inspector DRAIN LINES ON 8 FIXTURES ON THE HOUSE Conditions: Alter/Repair Issue Date: 08-29-2017 Expire Date: 02-25-2018 Extension: Extension: Permit expires on date shown if. 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant falls to obtain code recollect inspection. Contacts Owner Donna Owens 5341 Santa Anita Avenue, Temple City, California 91780 (626) 443-9630 Applicant Criman Torres 3183 Wilshire Boulevard 196-K29, Los Angeles, California 90005 (818) 462-3699 Contractor Arco Plumbing Inc. 3183 Wilshire Boulevard 196-K29, Los Angeles, California 90005 (818) 462-3699 993603 Pwmbing 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 Reef Drain 0 Solar Water Heater 0 Regulator Pool Trap 0 Trap Primer 0 Water Closet 0 Water 0 Water Treatment 0 Heater Gas: Low 0 Gas: 0 Gas Meter 0 Gas 0 Alteration/Repair 8 Press Mad/High Regulator Press Greywater 0 Pipe 12 Future Branches 0 Other: 1.S 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: 0 Sewer: 0 Pit/Drainfield Extension Alteration Tap&Saddle Combo Waste/Vent Earthquake Chemical Rainwater Greywater Shutoff Waste F 7, L- z'. Iota1 Plan Check Fear $113.60 Permit Fees $273.73 Plumbing Inspections Approval Date inspector Under Slab Work Water Service Plastic YIN Metal YIN Rough Plumbing Sewer inspections Approval Data Inspector New House Sewer Connect Add'I Septic Tank/Pit Approval Date Inspector Approval Date Inspector Gas Piping Gas Test Gas Vent — Utility Cc Nohfied Hot Water Heater _ Plumbing Fixtures CWV Gray Water System Lawn Sprinklers FINAL Approval Date Inspector Approval Date Inspector Drywall _ Backfill Tank/PI( Alter/Repair Gray Water System Disconnect/Plug 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 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 (_) 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 Contrt~ or pursuant .to the Contractors' State License Law). U: 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 whlcfl I must have resided for at least one year pdorl to complego 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: hftp://www.leciinfb.ca.aov/calaw.html. Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I ano licen ed under provisions of Chapter 9 (commencing with ction 000) of Division 3 of the Business and Profession Code, nd my license Is in full force and effect. ^>< C Icense Class License No. ate Z�ontractor Signature WORKERS'COMPENSATION DECLARATI N 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. 0' have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance o(eff the ��work for which this permit is issued. My rle' pe� _'on Inss policy m r : Carder Po cy Number Expiretion IXte Name of gent Phone Number I certify #121INin the performance of the work for which this permit is issuLena ll not employ any person in any manner so as to bec'act to the workers' compensation laws of California, anthat, If I should become subject to the workers' cornprovisions of Section 3700 of the Labor Code, I shall_ Rtg(ywith those provisions -/D—ate LOBBYIST OROWANCE 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 I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirem@nts 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 teach of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this applicatio nd the information I have provided is correct. I agree to comply with ap icable city and county ordinances and state ws relating to building Construction. I authorize reps above -identified Signature of Property f ,Date to enter the