HomeMy Public PortalAbout10212 OLIVE CT_Electrical_5/18/2017_TEMPLE CITY PERMIT NO. E17-34217
City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us
Address: 10212 Olive Street, Temple City, California Parcel: 8585-004-043
91780
Permit No: E17-34217
Type: Electrical Subtype:
Subtype: Residentia
I
Description REPLACE/UPGRADE EXISTING ELECTRIC
PANEL Special
: 200 AMP
Conditions:
Issue Date: 05-18-2017
Expire Date: 11-14-2017 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.
Contacts
Owner Karen C
8527 Sheffield Road, San Gabriel, California
(626) 616-1516
Lui
91775
Applicant Talia Lai
10212 Olive Street, Temple City, California
(626) 616-1516
91780
Contracto Wells Development and
6727 North Muscatel Avenue, San Gabriel,
(626) 926-1689 70019
r Construction Inc.
California 91775
8
Electrical Details
New Multifamily 0 New Single- 0
New Swimming 0 Spa, Hot Tub, 0
Carnival Ride: 0
Family/Duplex
Pool Alteration
Electric
Carnival Ride: 0 Carnival Lighting 0
Temporary Power 0 Temporary 0
Branch Circuit: 0
Mechanical System
Pole Power System
Outlets
Branch Circuit: 0 Receptacle, 0
Light Fixture 0 Light Fixture: 0
Light Fixture: 0
Lights Switch, Lighting
Pole Mount
Theatrical
Outlets
Residential 0 Non -Residential 0
Power Apparatus: 0 Power 0
Power 0
Appliance: 3 HP Appliance: 3 HP or
3-10 HP Apparatus: 10-
Apparatus: 50-
orless less
50 HP
100 HP
Power Apparatus: 0 Busway 0
Sign 0 Service: Under 1
Service: 400- 0
Over 100 HP
400 Amps
1000 Amps
Service: Over 0 Miscellaneous 0
1000 Amps
Fees Total
Plan Check $113.60 Permit $49.18
Fees Fees
Electrical Inspections
Approval Date Inspector
Approval Date Inspector Approval
Dat In ect
Temp Pole
Conduit Utility
Underground
Ufer Ground
Wiring Release
Water FINAL
✓G{-/-Z'hr�{l/—_L
Ground
A
OWNER -BUILDER DECLARATION
LICENSED CONTRACTOR'S DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from I hereby affirm under penalty of perjury that I am licensed under
the Contractors' State License Law for the reason(s) indicated provisions of Chapter 9 (commencing with Section 7000) of
below by the checkmark(s) I have placed next to the applicable Division 3 of the Business and Professions Code, and my
item(s) (Section 7031.5, Business and Professions Code): Any license is in full force and effect.
city or county that requires a permit to construct, alter, improve,Q
demolish, or repair any structure, prior to its issuance, also '/-License Clasoo, GzzLicense No. 7-�1
requires the applicant for the permit to file a signed statement
that he or she is licensed pursuant to the provisions of the�Date5) ontrector Signature
Contractors' State License Law (Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professions WORKERS' COMPENSATION DECLARATION
Code) or that he or ah 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 1, as owner of the property, or my employees with wages as
their sole compensation, will do IV) 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 Con" �tor pursuant to the Contractors' State License
Law).
U I 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 which I must have resided for at least
one year prior) to complefiory 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: http://www.leginfo.m.gov/calaw.htmi.
Date:
Signature of Property Owner or Authorized Agent
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' corn ensa ion insunce ca er jd po%y number ark:
l 2- (y/ 1/I :;1.
Camp Policy Number Expiration Date
'k"- (6s�
Name of A of Pho a Number
_ Ice lfy 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' mpensation provisions of Section 3700 of the Labor
CodV sh I forthwith comply with those provisions
Signature Of/Applicant Date
1 XOBBYIST ORDINANCE CERTIFICATION
U 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 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.
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, 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.
Si Siur of Pr a er or Authorized Agent
Dab i