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Home My Public Portal About6229 OAK AVE_Mechanical__COUNTY OF LOS ANGELES' ' DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: ON FILE ASSESSOR INFORMATION NUMBER: 5385-001-018 TENANT: OWNER: TEL. NO: TAI, FIONA (626) 283-1932- 1842 S CALIFORNIA ST SAN GABRIEL CA 91776 APPLICANT: TEL. NO: SAME AS OWNER - CONTRACTOR: TEL. N0: SAME AS OWNER - LIC. NO ARCHITECT OR INGINEER: TEL. NO: SON, STEVE (626) 262-9668- 4028 ROSEMEAD BLVD. #35 LIC. NO: PICO RIVERA CA 90660 NONE PERMIT EXPIRES 180 DAYS IF 1) WORK DOES NOT COtM1ENCE, OR 2) WORK IS SIIS PENDED OR ABANDONED, OR 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION ID: DPR264 ROUTE T0: 850508 MECHANICAL PERMIT ME 0508 1604270011 6229 OAK AV TEMP CA 917801656 NEAREST CROSS STREET: THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY ON: PROCESSED BY: PLAN BY: 16 SR AIR CONDITIONING AND HEATING SYSTEM AFIRE DAMPERS � � SMOKE DETECTION DEVICES I�/A_// �-1 I TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: FEES PAID FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: O1 PERMIT ISSUANCE FEE 34.40 03 COMPRS 101- 500 KBTU 1.00 COM 65.00 09 FURN/HEATER 100-500 1.00 UNI 65.00 30 AIR INLETS/OUTLETS 12.00 IN/ 63.60 41 SINGLE REGISTER FANS 3.00 FAN 59.40 TOTAL FEES 287.40 ID: DPR264 ROUTE T0: 850508 MECHANICAL PERMIT ME 0508 1604270011 6229 OAK AV TEMP CA 917801656 NEAREST CROSS STREET: THOMAS PAGE: 596 GRID: J2 LOCALITY: TEMPLE CITY ON: PROCESSED BY: PLAN BY: 16 SR AIR CONDITIONING AND HEATING SYSTEM AFIRE DAMPERS � � SMOKE DETECTION DEVICES I�/A_// �-1 I 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).): (, 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.). (, 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). ": I am exemdt from licensure under the Contract ors' 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 priorito completiory of the improvements covered by this permit, I gnnot 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: htto://www.leginfo.ca.gov/r law.htmi. 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 Class License Date Contractor Signature WORKERS' COMPENSATION DECLARATION WARTfING: FAILURE TO SECURE WORKERSCOMPENSATION 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 carrier and policy number are: Cartier Policy Number Expiration Date Agent Phone Number I certify that, in the perf ormance 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'riomia, 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 _- L°' Signa ire of Applicant Data 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 WiII 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? 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 El No ❑ i I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirements under the Los Angeles County Code Titie 2, Chapter 220' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a pernitirom 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 ce tify to each of the follow ng: 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 properly for inspection purposes. Signature of Propert y Owner or Authorized Agent Dated "LEi 6