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Home My Public Portal About5605 __4/25/2018_TEMPLE CITY PERMIT NO. E18-36022 City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecity.us Address: 5605 Clovedy Avenue, Temple Parcel: 8588-004-022 Archbishop of LA City, California 91780 Multifamily Permit No: E18-36022 Type: Electrical Subtype: Subtype: Nom Angeles Orozco California 90806 Residential Description: 1 GENERATOR AND 12 CARNIVAL Special Construction Inc. RIDES Conditions: - Issue Date: 04-25-2018 Expire Date: 04-25-2019 Extension: Extension: System Permit expires on date shown if. l) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to Power System obtain code required inspection. Branch Circuit: 0 Contacts Owner Roman Catholic 3424 Wilshire Boulevard, Los (818) 291-5900 Archbishop of LA Angeles, California 90010 Multifamily Applicant Maria De Los 2661 Golden Avenue, Long Beach, (310) 748-6809 Angeles Orozco California 90806 Contractor Ronald Electric & 2661 Golden Avenue, Long Beach, (310) 947-5863 793754 Construction Inc. California 90806 Temporary Electrical Details New 0 New Single- 0 New 0 Spa, Hot Tub, 0 Carnival Ride: 12 Multifamily Family/Duplex Swimming Alteration Electric FINAL Pool Ground Carnival Ride: Carnival Lighting 0 Temporary 0 Temporary 0 Branch Circuit: 0 Mechanical System Power 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 0 Power 0 Power 0 Appliance: 3 Appliance; 3 HP Apparatus: Apparatus: 10- Apparatus: 50 - HP or less or less 3-10 HP 50HP 100 HP Power 0 Busway O Sign 0 Service: Under 0 Service: 400- 0 Apparatus: 400 Amps 1000Amps Over 100 HP Service: Over 0 Miscellaneous 0 1000 Amps - Fees Total Plan Check Feas $424.28 Permit Foes $606.12 Electrical Inspections Approval Date Inspector Approval Date Inspector Approval Date Inspector Temp Pale Underground Conduit Wiring Utility Release Ufer Ground Water FINAL Ground 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 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 7144, 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 Contraor 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 whic.� I must have resided for at least one year prior to completions of the improvements covered by this permit, Innot legally sell a structure that I have built as an owner -builder f 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: hdp://ww ,leninfo.m.gov/calaw.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. _ I License WARNING: IFAILURE TO SECURE WORKEBIS' ATION COVERAGE IS UNLAWFUL, AND SH B E AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FIN 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. 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 carrier and policy number are: Carder Policy Number Expiration Date Phone Number f I certify that, in the performance of the work for which this issued, I shall not employ any person in any manner as to Dpcome subject to the workers' c9mpensation laws of ifomia, and agree that, if I should oma sppppppbject to the rkers' mpensation provision action 37O the Laboy JA I shlill forthwith comph4with those orovision r r LOBBYISTORDINANCE CERTIFI ATION I Complete this section for pe Its In Unincorporated Los Angeles Co my only This is to certify that I, as permit applicant, am mi r with the requirements of Los Angeles County Code Cha r 60 at seq., (relating to the Los Angeles County Lobbyist In ce) and that all persons acting on tt((ehalf of myself compli an will conti to GPmply therewith thrNgh th&applic 'on s IllA r.. f I\\ ��1. JOB ADDRESS �� LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant, or future building occupant handle a hazardous material of ure containing a hazardous material equal to or Brea an the amount specified on the hazardous materials _Arrformation guide? Yes ❑ No ❑ WIII 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 Lender's Address By my signature below, I certify tol,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 my ordinances anal state laws relatin uilding construction. 1 Coma y Name V Da Date LIU of JW county to enter the lild5pection purposes.