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Home My Public Portal About8711 HERMOSA DR_PLUMBING_5/22/2017_Building Permits - TEMPLE CITY PERMIT NO. P17-34223 Page 1 of 1 City of Temple City 1 9701 las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templeoty.us Address: 8771 East Hermosa Drive, San Gabriel, California 91775 Parcel: 5306-012-060 Permit No: P17-34223 Type: Plumbing Subtype: Subtype: Residential Description: REPLACE KITCHEN SINK, REPT iCE WATER HEATER Special Conditions: Issue Date: 05-22-2017 Expire Date: 11-18-2017 Extension: Extension: Permit expires an date shown if. 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant falls to obtain code required inspection. Contacts Owner Chen Tao Chang Applicant ]ack Soong Contractor Plumbing Details Backwater 0 Valve Drinking 0 Fountain Lavatory/Sink 1 Pool Trap 0 Gas: Low 0 Press Greywater 0 System Other: over 3 0 inches Sewer: 0 Pit/Drainfield Combo Waste/Vent 8771 East Hermosa Drive, San Gabriel, California 91775 2645 Lee Avenue #3, South EI Monte, California 91733 SWM Construction Inc 2645 Lee Avenue 413, South EI Monte, California 91733 Backflow 0 Device Floor Drain 0 Miscellaneous 0 Trap Primer 0 Gas: 0 Med/High Press Pipe 0 Replacement Sewer: 0 Connection Sewer: Pit 0 Extension Earthquake Shutoff Fees Total Plan Check Fees $113.60 Permit Fees $41.01 Plumbing Inspections Approval Date Inspector Under 51ab Work Water Service Plastic Y/N Metal Y/N Rough Plumbing Sewer l llspecllcjr S Approval Date Inspector New House Sewer Connect Adi Septic Tank/Nt Bathtub/Shower 0 Clothes 0 Gas Test Washer Floor Sink 0 Hose Bibb 0 Pressure 0 Roof Drain 0 Regulator Approval Water Closet 0 Water I Heater Gas Meter 0 Gas 0 Regulator Future Branches 0 Other: 1.5 0 inches or less Sewer: Manhole 0 Sewer: 0 Addition Sewer: 0 Sewer: 0 Alteration Tap&Saddle (626) 274.9357 (626)274-9357 836333 Chemical Rainwater Waste Approval Date Inspector Gas Gas Vent Ho[ Water Heal¢r Numbing Fixtures Lawn Sprinklers _. Approval Date Inspector Dryweu Alter/Repair Disconnect/Plug Dishwasher 0 Interceptor/Clarifier 0 Solar Water Heater o Water Treatment 0 Alteration/ Repair 0 Other: 2-3 inches 0 Sewer: Private 0 Connection Greywater Approval Data Inspector Gas Test UDllty Co Notified Gray Water System FIN FTNAL Approval Date Inspector Backfill Tank/Pit Gray Water System FINAL _ https://templecity.quickbase.com/dbibkth7arp8?a=printr&rid=34223&dfid=11 5/22/2017 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 1, as owner of the property, or my employees with wages as their sole compensation, will do (J) 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 Contractor pursuant.to the Contractors' State License Law). U 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 whicil I must have resided for at least one year priorl to completion of the improvements covered by this permit, I nnot legally sell a structure that I have built as an own 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.leginfo.ca.gov/gglaw.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. / 2 Licensee�Class � B License No. 6 3 3 Date)/rL'L/ /`)Contractor Signature WORKERS' COMPENSATION ELCLARATION 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 Gartner and policy number are: Cartier 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 Cal' mia, and agree that, if I should become subject to the wo rs' compensation provisions of Section 3700 of the labor Co4f, 1 shall forthwjt9 comply with those provisions 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 ❑ N o ❑ 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 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 authoze representatives of this county to enter the above-14entified property for inspection purposes. Date ''^ Authorized Agent