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HomeMy Public PortalAbout10144 LA ROSA DR_ELECTRICAL_9/6/2018_E18-36765 (2)TEMPLE CITY PERMIT NO. E18-36765 City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us Address: 10144 La Rosa Drive, Temple City, California Parcel: 8585-013-048 91780 Permit No: E18-36765 Type: Electrical Subtype: Subtype: Residential Description: REPLACE 11 LIGHT FIXTURES, REPLACE 19 Special OUTLETS AND 8 SWITCHES Conditions: Issue Date: 09-06-2018 Expire Date: 09-06-2019 Extension: Extension: Permit expires on date shown if: 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicantfails to obtain code required inspection. , Contacts Osmer Gihan 10144 La Rosa Drive, (626) 524-8584 Soliman Temple City, California 91780 Applicant Estuardo - 9575 Meridian Ave, (626)284-9000 ' Vasquez Alhambra, California 91803 Contractor Aleksa Simich Construction Inc. DBA 957 S Meridian Ave, (626) 284-9000 910946 Rainbow International of Los Angeles Alhambra, California County 91803 Engineer Hansen- Hokama Structural Engineers 180 E. Main Street, Tustin, (714)573-0073 California 92780 Electrical Details New Multilamily 0 Carnival Ride: 0 Mechanical Branch Circuit: 0 Lights Residential 0 Appliance: 3 HP or less Power Apparatus: 0 Over 100 HP Service: Over 0 1000 Amps Fees Total Plan Check Fees 80.00 New Single- 0 Family/Duplex Carnival Lighting 0 System Receptacle, 27 Switch, Lighting Outlets Non -Residential 0 Appliance: 3 HP or less Busway 0 Miscellaneous 0 Permit Fees 4103.56 Electrical Inspections Approval Date Inspector Temp Pole Underground Ufer Ground New Swimming 0 Pool Temporary 0 Power Pole Light Fixture 11 Power 0 Apparatus: 3- IOHP Sign 0 Approval Date Inspector Conduit Wiring Water Ground Spa,HotTub, 0 Alteration Temporary 0 Power System Ught Fixture: 0 Pole Mount Power 0 Apparatus: 10- 50 HP Service: Under 0 400Amps Carnival Ride: 0 Electric Branch 0 Circuit: Outlets Light Fixture: 0 Theatrical Power 0 Apparatus: 50-100 HP Service: 400- 0 1000 Amps Approval Date Inspector Utility Release FINAL 3 l 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 (_) portions of the 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 T---, License No.'tl tq Date 9 - 61 � Contractor Signature WORKERS' COMPENSATION DECLARATI 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 ATTORNEY'S FEES. work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The I hereby affirm under penalty of perjury one of the following Contractors' State License Law does not apply to an owner of declarations: property who, through employees' or personal effort, builds or I have and will maintain a certificate of consent to self - improves the property, provided that the improvements are not insure for workers' compensation, Issued by the Director of intended or offered for sale. If, however, the building or Industrial Relations as provided for by Section 3700 of the improvement Is sold within one year of completion, the Owner- Labor Code, for the performance of the work for which this permit Builder will have the burden of proving that it was not built or is Issued. improved for the purpose of sale.). Polic o. I have and will maintain workers' compensation U I, as owner of the property, am exclusively contracting with Insurance, as required by Section 3700 of the Labor Code, for licensed Contractors to construct the project (Section 7044, the performance of the work for which this permit is Issued. My Business and Professions Code: The Contractors' State License workers' cornenation Insurance carrier and policy number are: Law does not apply to an owner of property who builds or6�(ca- "�iyt N WC 1 12 Zt—jf� improves thereon, and who contracts for the projects with a Carder Policy Number Expiration Date licensed Con" �tor pursuartt.to the Contractors' State License Law). I Name of Agent Phone Number 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 whicf] I must have resided for at least one year pdoritp completiol 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: hftp://www.leainfo.ca.aovlcalaw.html. Date: Signature of Property Owner or Authorized Agent 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 tabor Code, I shall forthwith comply with those provisions -Vlk� Ct .I Signature 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 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 ❑ N ❑ i" 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 ❑ 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 toleach 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 of ProO/yy�vner or Authorized Agent 7 Date Ck - G • l y