HomeMy Public PortalAbout6128 RENO AVE__7/11/2017_a
TEMPLE CITY PERMIT NO.
P17-34525
City of Temple City 1 9701 Las Tunas Dnve I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us
Address: 6128 Reno Avenue, Temple City, California 91780 Parcel: 5384-004-011
Permit No: P17-34525
Type: Plumbing Subtype: Subtype: Residential
Description: CHANGE WATER
HEATER TO TANKLESS WATER HEATER, SAME Special
LOCATION UPSIZE GAS LINE Conditions:
Issue Date: 07-I1-2017
Expire Date: 01-07-2018 Extension: Extension:
Permit expires on date shown If: I) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code required
Inspection.
Contacts
Owner Michael A Janis Long 6128 Reno Avenue, Temple City, California 91780 (626) 285-8878
Applicant Raymond Barron
907 South Magnolia Avenue, Monrovia, California 91016 (626) 600-8066
Contractor
Nuquest Industnes Inc. 907 South Magnolia Avenue, Monrovia, California 91(16 (626) 600-8066 985713
- Plumbing_ Details
Backwater 0
Backflow 0 Bathtub/Shower 0 Clothes 0 Dishwasher 0
Valve
Device Washer
Drinking 0
Flour Drain 0 Floor Sink 0 Hose Bibb 0 Interceptor/Clarifier 0
Fountain
Lavatory/Sink 0
Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater 0
Regulator
Pool Trap 0
Trap Primer 0 Water Closet 0 Water 1 Water Treatment 0
Heater
Gas: Low 1
Gas: 0 Gas Meter 0 Gas 0 Alteration/ Repair 0
Press
Med/High Regulator
Press
Greywater 0
Pipe 0 Future Branches 0 Other: 1.5 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 TapWaddle
Combo
Waste/Vent
Earthquake Chemical Rainwater Greywater
Shutoff Waste
- Fees total
Plan Check Fees $113.60
Permit Fees $42.11
- Plumbing Inspections
Approval Date
Inspector Approval Date Inspector Approval Date Inspector
Under Slab Work
Gas Piping _ Gas Test
Water Service
Galva Utility Cc Notified
Plastic Y/N
Hot Water Heater CWV _
Metal
Fixtures Gray Water System
Plumbing
Rough Plumbinq
Lawn Sprinklers FINAL
WanSPlumbing Sprinklers
S_ewe_ r Ins_pec_ti_ons
Approval Data
Inspector Approval Dad Inspector Approval Data Instructor
New House Sewer
Dr}^xell Backfill Tank/%[
Connett Add9
Alter/Repair Gray Water System
Septic Tank/ Fit
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).):
(__) I, as owner of the property, or my employees with wages as
their sole compensation, will do (,/)all of or (_) portions of the
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 ClasslliaL License No.
Date %Il 1 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.
work, and the structure is not intended or offered for sale
(Section 7044, Business and Professions Code: The I hereby affirm under penalty of perjury one of the following
Contractors' State License Law does not apply to an owner of declarations:
property who, through employees' or personal effort, builds or I have and will maintain a certificate of consent to self -
improves the property, provided that the improvements are not insure for workers' compensation, issued by the Director of
intended or offered for sale. If, however, the building or Industrial Relations as provided for by Section 3700 of the
Improvement is sold within one year of completion, the Owner- Labor Code, for the performance of the work for which this permit
Builder will have the burden of proving that it was not built or is issued.
improved for the purpose of sale.).Poljcy No.
X I have and will maintain workers' compensation
U I, as owner of the property, am exclusively contracting with insurance, as required by Section 3700 of the Labor Code, for
licensed Contractors to construct the project (Section 7044, the performance of the work for which this permit is issued. My
Business and Professions Code: The Contractors' State License workers' compensation insyan�� came and policy be a e:
Law does not apply to an owner of property who builds or%Ok- Wt3U`rt/(CAh 1�ldYi33� i
improves thereon, and who contracts for the projects with a C ier Policy Numbel Expi tion pate
licensed Contra or pursuant -to the Contractors' State License t,ry " Z •600 •
DG Y.V6
(s
Law). am�of Agent Phone Number
(_): 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 priori to completionof the improvements covered by
this permit, I nnot legally sll a structure that 1 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: h_ttp://www.leainfo.ce.aov/calaw.html.
Date:
Signature of Property Owner or Authorized Agent
_ 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
Sig re efVWplicant Dattfllf— l
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 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 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 of Property Owner or Authorized Agent
Da I