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Home My Public Portal About10120 LA ROSA DR_BUILDING_1/3/2019_B19-37306 (2)TEMPLE CITY PERMIT NO. B19-37306 City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecity.us Address: 10120 LaRosa Drive, Temple City, California 91780 Parcel: 8585-013-008 Permit No: B19-37306 Type: Building Subtype: RR Residential Alteration Description: REPLACE(E)TUB W/ACRYLIC SHOWER WALLS AND PAN. Special Construction Type: V -B REPLACE VALVE TRIM, SHOWER, HEAD AND SHOWER DOOR. Conditions: R-3 Residential, one -and two-family New/Added Area: TUB TO PAN CONVERSION. ALL OTHER PLUMBING AND Remodel/11 Area: 0 FIXTURES TO REMAIN. (HALL BATH) 0 Issue Date: 01-03-2019 Expire 01-03-2020 Extension: Extension: Approval Date Date: Date Inspector Approval 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 Location/Setbacks inspection. - Contacts Owner Helen Hu 10120 La Rosa Drive, Temple City, California 91780 (626) 755-1699 Applicant Emily Batioff 2981 E La Palma Avenue, Anaheim, California 92806 (714) 507-1674 Contractor Reborn Bath Solutions 2981 La Palma Avenue, Anaheim, California 92806 (714) 630-2220 443682 Building Details Stnrcbrre l: Residential Construction Type: V -B OccupancyGroup: R-3 Residential, one -and two-family New/Added Area: 0 Remodel/11 Area: 0 New Dwelling Units: 0 Stories: 0 - Fees Total Approval Date 2: 3: 4: 0 0 0 0 0 0 0 0 0 0 0 0 Valuatbn $5500.00 Plan Check Fees $189.17 Permit Fees $222.55 strong Motion Fee $0.71 SB1473Fee $1.00 Parks Dev Fee $0.00 Sewer Const Fee $0.00 - Building Inspections Approval Date Inspector Approval Date Inspector Approval Date Inspector Location/Setbacks Roof Sheathing Rated Soils Engineer Fire Dept Framing Floor/Ceiling Foundation Forms Bldg Dept Framing Rated Walls Slab/Under Floor Shear Panels Rated Shafts Raised Floor Sprinkler Hangars T -Bar FramingCeilings Insulation/Weather Underfloor Strip Lot Drainage Insulation Interior k�a Smoke 1st Floor Lath/Drywall / Detectors Sheathing 2nd Floor Exterior Lath Fire Dept Approval Sheathing FINAL ILI r w 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 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 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 Contritor pursuant to the Contractors' State License Law). U: I am exemi4t from licensure under the Contractors' State License Law for the following reason: i By my signature below I acknowledge that, except for my. personal residence in which I must have resided for at least one year pdorl to completions of the Improvements covered by this permit, Icannot 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.lecinfo.ca.aov/calaw.htmi. 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 ClassB Clc License No. L1431o62 Date 1131WContractor Signature WORKERS' COMPENSATION C TION WARNING: FAILURE TO SECURE WORKER 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. aPolic No. I have and will maintain workers' compensation conte, as required by Section 3700 of She Labor Code, for the performance of the work for which this permit is issued. My workers' cornRQe�n��s��aUon Insurpnce� ppaa��rrtter and ppolicy n mbar,are: BetkS(n�retPrFaW-k) Q�WC,811'119. 1130 Carrier Policy Number Expiration Date Name of Agent Phone Number I certify that, In the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, ti I hould become subject to the workers' compensation provl sof Section 3700 of the labor Code, I shallAorthwith-co7npl those provisions 0-; 1,g Date NL.0BEll[YIST 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 IOt20 �q-�2oSa Df• 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 <T} 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 permittingist for guidelines. Yes ❑ Ko i I have read the hazardous materials information guide and the SCAQMD_ permitting checklist, I understand my requirem@nts 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 +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. Signature Agent