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Home My Public Portal About5515 PARMERTON AVE_Building_8/1/2017_B17-34638 insulationTEMPLE CITY PERMIT NO. B17-34638 City of Temple City 1 9701 Las Tunas Drive I Temple City, Caldorr a 91780 1 (626) 285-2171 1 www.tamplecity.us Address: 5515 Parmerton Avenue, Temple City, California Parcel: 8573-009-004 91780 Permit No: B17-34638 Type: Building Subtype: AR Alteration Repair Description: BLOWN IN 1500 SQ.FT. OF R38 INSULATION IN Special 3: Structure 1: ATTIC Conditions: Construction Type: V-8 Issue Date: 08-01-2017 Expire Date: 01-28-2018 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. 1500 New Dwelling Units: _Contacts_ Stories: - Owner Cathy and Jack 5515 Parmerton Avenue, Temple ( Cascio City, California 91780 Applicant Memw 31225 La save Drive, Westlake (818) 732-7876 Eisenberg Village, California 91362 Contractor Service Champions Inc DBA Service Champions 3150 East Birch Street, Brea, (714) 777-7777 799170 Heating and Air Conditioning California 92821 Fire Dept BLulding Details 3: Structure 1: Residential Construction Type: V-8 Occupancy Group: R-3 Residential, one- and two-family New/Addeo Area: 0 Remodel/TI Area: 1500 New Dwelling Units: 0 Stories: 0 - Fees Total ��,IShams tiN oWea[her Valuation $4500.00 Strong Motion Fee 10.58 Buddinkl nspections Approval Date Location/Setbacks _ Soils Engineer _ Foundation Forms _ Slab/Under Floor _ Raised Floor _ Framing UnderRoor Insulation 1st Floor Sheathing 2nd floor Sheathing 2: 3: 4: 0 Rated 0 0 0 Floor/Ceiling 0 0 0 0 0 0 0 0 Plan Check Fees $146.80 Permit Fees 1172.71 S91473 Fee 11.00 Parks Dov Fae 10.00 Sewer Comet Fee 10.00 Inspector Approval Data Inspector Approval Data Inspector Roof Sheathing Rated Fire Dept Framing Floor/Ceiling Bldg Dept Framing Rated Walls Shear Panels Rated Sprinkler Hangars ��,IShams tiN oWea[her T Bar Ceilings Strip Strip Interior LM Drainage lath/Drywall Exterior Lath Smoke Detectors Fire Dept Approval ��ss---- FINAL IL r 3 n A Ei OWNER-BUILOER 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 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 Contra or pursuant to the Contractors' State License Law). (_) 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 whicf I must have resided for at least one year prior) to completion of the improvements covered by this permit, I connot 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: hfo://www.leginfo.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. -7 License Cl a s (� 2-,0 License No. T i Ql Date IContrector Signature WORKERS' 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 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. Labor Code, for the performance of the work for which this permit ASBESTOS NOTIFICATION is issued. Policy e5letter sent to AQMD and/or EPA I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for ❑ I declare that notification of asbestos removal is not the performance of the work for h this permit is issued. My applicable to addressed project. worAeW co nnssation ins ran '� aq li number are y, //O�' Z�-��"DECLARATION REGARDING CONSTRUCTION LENDING C rt, elicy Num r l�Mnio-,-Z- AGENCY Name of Agent hone 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 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 mg on behalf of myself complied an minue to comp) Wwith through the application pro Applicant 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 ordinances and state laws relating to building construction. I authorize representatives of this county to enter the above -identified property for inspection purposes. Signature of Property O utholzed Agent Date I I