HomeMy Public PortalAbout9065 RANCHO REAL RD_BUILDING_2016-08-15_B16-93TEMPLE CITY PERMIT NO. B16-93
City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us
Address: 9065 Rancho Real Road, Temple City, Parcel: 5388-002-028
California 91780
Permit No: B16-93 Type: Building Subtype: RA
Residential
Addition
Description: 360 Square Foot addition, extend living Special
room, bedroom, relocate kitchen. Remodel Conditions:
existing master bedroom and replace roof
structure.
Issue Date: 08-15-2016 Expire 02-11-2017 Extension: Extension:-
Date: u
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 Inc
9065 Rancho Real Road, Temple City,
(626) 375-8628
Wong
California 91780
R-3 Residential, addition under 600 s.f.
Applicant Jin
243 Abogado Avenue, Walnut, California
(626) 720-7999
Huang
91789
0
Contractor J H Construction and
488 Wrangler Way, Walnut, California
(626) 720-7999 1001522
Design Inc.
91789
Buildinq Details
Structure 1:
Residence 2:
Construction Type:
V -B
Occupancy Group:
R-3 Residential, addition under 600 s.f.
New/Added Area:
360
Remodel/TI Area:
1486
New Dwelling Units:
0
Stories:
0
Fees Total
3: 4:
0 0 0
0 0 0
0 0 0
0 0 0
Valuation $100,000.00 Plan Check Fees $0.00 Permit Fees $1762.07
Strong Motion Fee $13.00 SB 1473 Fee $4.00 Parks Dev Fee $0.00 Sewer Const Fee $0.00
Building Inspections
Approval Date Inspector
Location/Setbacks
Soils Engineer
Foundation Forms Z
Slab/Under Floor
Raised Floor
Framing
Underfloor
Insulation
15[ Floor
Sheathing
2nd Floor
Sheathing q
Roof Sheathing 12
Fre Dep[ Framing
Bldg Dept �
Framing
Approval Date Inspector
Shear Panels
Sprinkler Hangars A AF
Insulation/Weather
Strip /�
Interior Q
Lath/Drywall
Exterior Lath ZZ 115�
Rated Floor/Ceiling 4-01
Rated Walls S#O.;
Rated Shafts
T -Bar Ceilings
Lot Drainage n
Smoke Detectors s
Fire Dept Approval �F A 7 Q
FINAL
A
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 Contractor pursuant to the Contractors' State License
Law).
L) 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 completion of the improvements covered by
this permit, I gnnot 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.leoinfo.ca.gov/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.
vLicense Class License No.
��ate Contractor Signature
WORKERS' COMPENSATION DEC ON
WARNING: FAILURE TO SECURE WORKERS' COM ENSATION
COVERAGE IS UNLAWFUL, AND SHALL SU ECT AN
EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FI S 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
wo cars' c pe ation insura oe raeb ntt policy nu ber are:
Ca i t Poli u
ft V Expi e 1�
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' codon provisions of Section ions of the Labor
Code, I she fo ' h comply with those provisions
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 11N o [I
Wi0 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 1:1
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 conceming hazardous
material reporting and for obtaining a permit from the SCAQMD.
ASBESTOS NOTIFICATION
El Notification letter sent to AQMD and/or EPA
El 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).
Lenders Name
Lenders Address
TL-,� By my signature below, I certify to each the following:
v I am the property owner or authorized
to act on the
property owner's behalf.
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.
4l i Applicant (Print Name) Applicant Signature
.4. Company Name
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 roperty for inspection purposes.
Signature of re^ Wner or Authorized Agent
V
ate ;"
-O�