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Home My Public Portal About5031 GOLDEN WEST AVE_MECHANICAL_10/26/2016_ (2)TEMPLE CITY PERMIT NO. M16-33093 - Contacts Owner Emily Phan Applicant In Huang Contractor Engineer lames Qiu Mechanical Details Compressor/Furnace /Etc up to 100k BTU Appliance Vent 0 Ventilation Fan 3 Fireplace 0 5031 Golden West Avenue, Temple City, California City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us Address: 5031 Golden West Avenue Unit A, Temple City, Parcel: 8589-018-014 (626) 720-7999 1001522 California 91780 ) / 2201 Cathryn Place, Rosemead, Califomia 91770 Permit No: M16-33093 Type: Mechanical Subtype: Subtype: Residential Description: ALTERATION OF EXIST DUCT SYSTEM, 4 AIR INLETS Special AND 3 VENTILATION FANS Conditions: issue Date: 10-26-2016 Expire Date: 04-24-2017 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 Emily Phan Applicant In Huang Contractor Engineer lames Qiu Mechanical Details Compressor/Furnace /Etc up to 100k BTU Appliance Vent 0 Ventilation Fan 3 Fireplace 0 5031 Golden West Avenue, Temple City, California (818) 286-6349 91780 243 Abogado Avenue, Walnut, California 91789 (626) 720-7999 0 H Construction and Design 488 Wrangler Way, Walnut, Califomia 91789 (626) 720-7999 1001522 Inc. ) / 2201 Cathryn Place, Rosemead, Califomia 91770 (626) 260-4600 Compressor/Furnace 0 /Etc 100-500k BTU Air Handler up to 0 2,000 CFM Ventilation System 0 -__Fees Total Plan Check Fees $0.00 PermH Fees $116.18 - Mechanical In Approval FAU/Wall 91/2kIn ecto {f[^^ Furnace Combustion Air Openings ) / Duct Work Compressor/Furnace 0 /Etc over 500k BTU Air Handler 2-10,000 0 CFM Kitchen Hood/Spray 0 Booth ApprovalDaq InspecWji AC/Compressor '6:2 - Thermostat Fire Dampers 11*5 Q�Ia�r7 -- Air Inlet/Outlet Qty Air Handler C over 10,000 CFM Fire Damper 0 OR Floor 0 Area Evaporative 0 Cooler Duct 1 Alteration Approval Dpv I Inspect r Smoke_ Detectors Commercial Hood =JL� FINAL 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 filea 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 (J) 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.). (_ 1 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 Contra or 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 which I must have resided for at least one year priorl to completior) 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: httt),/ANww.leoinfo.ca.clov/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. License lass License No. 09 Q l6 Data Lrorltrector Signature WORKERS' COMPENSATION DEC N WARNING: FAILURE TO SECURE WORKERS' COMPS TION COVERAGE IS UNLAWFUL, AND SHALL SUBJE# AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINESP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AD (TION 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 w re ' ce pens uon in ranine{ at dpolicy n 0 re� ( b Ca le Policy umber Expira0 Dat 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' compen tion provisions of Section 3700 of the Labor Code, I sh hwl h comply with those provisions 11 � -Xv gnature f i t Date LOBBYISJ ORDINANCE CERTIFICATION Comple this section for permits In Unincorpo ted Los Angeles County only 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 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 This is to certify that I, as permit applicant, am familiar with the construction. requirements of Los Angeles County Code Chapter 1 2. (relating to the Los Angeles County Lobbyist Ordinan 0 atseq., and that I authorize representatives of this county to enter the all persons acting on behalf of myself complie conti a above -identified property for inspection purposes. to comply therewith through the application pro r \10 Signature of P r or Autho ' d Agent iplicant (Pn t Name) Applicant Signa a I J- Date (1J.ra oany Name Date vj