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Home My Public Portal About9814 BROADWAY_BUILDING_2/9/2017_ (3)TEMPLE CITY PERMIT NO. B16-33136 City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templeMy.us Address: 9814 Broadway, Temple City, California 91780 Parcel: 8588-016-003 Permit No: B16-33136 Type: Building Subtype: RA Residential Addition Description: 1 -STORY ADDITION (499 SQ.FT) 2 NEW BEDROOM WITH ONE Special BATHROOM AND TEAR OFF AND REROOF WITH ASPHALT TO MATCH Conditions: NEW ADDITION Issue Date: 02-09-2017 Expire 08-08-2017 Extension: Extension: Date: 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 Richard Wong 9814 Broadway, Temple City, California 91780 Applicant Michael Liu PM Design 2550 West Main Street Unit 211, Alhambra, California 91801 (626) 642-8909 Contractor ADC Construction Company 17588 Rowland Street, City of Industry, California 91748 (626) 759-6217 692222 Building Details Structure 1: Residential Construction Type: V -B Occupancy Group: R-3 Residential, addition under 600 s.f. New/Added Area: 499 Remodel/TI Area: 1885 New Dwelling Units: 0 Stories: 1 Fees Total Valuation $75,000.00 Strong Motion Fee $9.75 Building Inspections —_Approval D�.a,��_- In pe< r Location/Setbacks 3/�� % /,�_ Soils Engineer Foundation Form: Slab/Under Floor Raised Floor Framing Underfloor Insulation 1st Floor Sheathing 2nd Floor Sheathing 2: 3: 4: 0 0 0 0 0 0 0 0 0 0 0 0 Plan Check Fees $0.00 Permit Fees $1453.06 SB 1473 Fee $3.00 Parks Dev Fee $0.00 Sewer Const Fee $0.00 Approval ID tq Ins Roof Sheathing Z Fire Dept Framing Bldg Dept Framing Shear Panels Sprinkler Hangars p,__/�� Insulation/Weather Strip r7 Interior Lath/Drywall Exterior Lath Approval Ratad Floor/Ceiling Rated Walls Rated Shafts T -Bar Ceilings Lot Drainage Smoke Detectors Fire Dept Approval FINAL Date Inspector OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLAW16, V I 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 b the checkmark(s) I have laced next to the applicable Division 3 of the Business and Professions Code and my JOB ADDRESS •� ' LOCALITY Y P item(s) (Section 7031.5, Business and Professions Code): Any license is in full force and effect. HAZARDOUS MATERIAL DECLARATION city or county that requires a permit to construct, alter, improve, [ Will the applicant or future building occupant handle a hazardous demolish, or repair any structure, prior to its issuance, also License Class License No. L6 72-2, Z 7i requires the applicant for the permit to file a signed statement material ora mixture containing i hazardous material equal 2 - or QZ greater than the amount specified on the hazardous materials that he or she is licensed pursuant to the provisions of the \,/ Date —/ Contractor Signature information guide? Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions WORKERS' COMPENSATI DECLARATION Yes ❑ No ❑ 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 L) 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.). L) 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 exemlit 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 priorl to completion of the improvements covered by this permit, Innot legally sell a structure that I have built as an owner -builder 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: hnp://www.leginfo.ca.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 ATTORNEYS 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. INo. 1 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 work e s' 'Zpe tion i sura a cern r policy umber are: Cartier Policy -Number Etpirallon 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 G4 OZ-�_2oi SlIr 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 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 ❑ N o ❑ i 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 ❑ Notficabon 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. Signatur of Property Owner or Authorized Agent �y I� / Oat D2 — 7-2o/)