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Home My Public Portal About5657 MCCULLOCH AVE_Plumbing_4/19/2017_ (9)TEMPLE CITY PERMIT NO. P17-34017 - Contacts Owner The Olson Company Old Ranch Parkway, Seal Beach, California 90740 Applicant Chris Borland 3010 Old Ranch Parkway, Seal Beach, Callfornia 90740 Contractor OLSON URBAN HOUSING LP 3010 Old Ranch Parkway Suite 100, Seal Beach, California 90740 Engineer Danlelian Associates 60 Corporate Park, Irvine, California 92606 Plumbing Details City of Temple City 1 9701 Las Tunas Drive I Temple City, Califomia 91780 1 (626) 285-2171 1 www.templecity.us Address: 5657 MCCulkxh Avenue Unit 104 , Temple City, California 91780 Parcel: 8573-011-029 Permit No: P17-34017 Type: Plumbing Subtype: Subtype: Residential Description: PLUMBING FOR NEW ATTACHED CONDO AND CONNECT TO Special Floor Sink 0 PUBLIC SEWER Conditions: Issue Date: 04-19-2017 Expire Date: 10.16-2017 Extension: Extension: Pressure 0 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 required v _' - inspection. - Contacts Owner The Olson Company Old Ranch Parkway, Seal Beach, California 90740 Applicant Chris Borland 3010 Old Ranch Parkway, Seal Beach, Callfornia 90740 Contractor OLSON URBAN HOUSING LP 3010 Old Ranch Parkway Suite 100, Seal Beach, California 90740 Engineer Danlelian Associates 60 Corporate Park, Irvine, California 92606 Plumbing Details 0 I`-� Ins cto Approval Date Inspector Backwater 0 Backflow 0 Bathtub/Shower 3 Valve Device Connect AdtPI Drinking 0 Floor Drain 0 Floor Sink 0 Fountain Date Inspector Under Slab Lavatory/Sink 4 Miscellaneous 0 Pressure 0 Pool Trap 0 Gas: Low 5 Press Greywater 0 System Other: over 3 0 inches Sewer: 0 Pit/Drainfield Combo Waste/Vent Trap Primer 0 Gas: 0 Med/High Press Pipe 0 Replacement Sewer: 1 Connection Sewer: Pit 0 Extension Earthquake Shutoff Regulator Water Closet 3 Gas Meter 1 Future Branches 0 Sewer: Manhole 0 Sewer: 0 Alteration Chemical Waste Clothes I Washer Hose Bibb 2 Roof Drain 0 Water i Heater Gas 0 Regulator Other: 1.5 1 inches or less Sewer: 0 Addition Sewer: TapBSaddle Fees Total 0 I`-� Ins cto Approval Date Inspector Approval Pian Check Fees $171.39 Permit Fees $428.48 Drywall Sewer Plumbing Inspections Connect AdtPI Disconnect/Plug ApprovalD Ins ctor Approval Date Inspector Under Slab Gas Piping %/ Work Water Service v _' - Gas Vent Hot Water Plastic N Metal y/N Rough % f Heater Plumbing Fixtures 11 �i `ll��Viii ```��`��,��`��' Plumbing Lawn Sprinklers Sewer Inspections 0 I`-� Ins cto Approval Date Inspector Approval New House Drywall Sewer Alter/Repair Connect AdtPI Disconnect/Plug Septic Tank/Pit (562)596-4770 (562)412-6450 (562)412-6450 939156 (949)474-6030 Dishwasher 1 Interceptor/Clarifier 0 Solar Water Heater 0 Water Treatment 0 Alteration/Repair 0 Other: 2-3 inches 0 Sewer: Private 0 Connection Rainwater Greywater Approval 0 I`-� Ins cto Gas Test (/- Utility Co Notified CWV Gray Water System / 2 FINAL Date Inspector Approval Date Inspector Backfill Tank/Pit Gray Water System FINAL OWNER -BUILDER DECLARATION 1 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 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 Contrb�tor pursuant to the Contractors' State License Law). U: I am exemdt from licensure under the Contractors' State License Law for the following reason: i By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year priorlto oompletioq of the improvements covered by this permit, Icannot 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://www.lecinfo.ca.cov/calaw.html. 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 License No. Qp3q liDb Date 1.1-L1-tl Contractor 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 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: nscc3rK.w903Z 71 t -tg Cam'0r — Policy Number Expiration 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' 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 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 ❑ No ❑ 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 �40' 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 Lenders Address By my signature below, 1 certify to'each of the following: I am the property owner or auihorized 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 of Prop 33 per or Authorized Agent Date `I-1w_�_