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Home My Public Portal About4939 HELEO AVE_PLUMBING_1/30/2018_P18-35612 (2)TEMPLE CITY PERMIT NO. P18-35612 Plumbing Details Backwater 0 City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecity.us Bathtub/Shower 5 Address: 4939 Heleo Avenue, Temple City, California 91780 Parcel: 8590-023-029 Device Permit No: PIS -35612 Type: Plumbing Subtype: Subtype: Residential Description: PLUMBING FOR NEW SINGLE FAMILY DWELLING AND Special Hose Bibb 2 Interceptor/Clarifier 0 CONNECT TO PUBLIC SEWER Conditions: Issue Date: 01-30-2018 Expire Date: 01-30-2019 Extension: edension: Pressure 0 Permit expires on date shown 8:1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code required Inspection. Regulator Contacts Pool Trap 0 Trap Primer 0 Water Closet 5 Owner S.D. Construction 2662 River Avenue, Rosemead, California 91770 Applicant Shui Gen 2662 River Avenue #A, Rosemead, California 91770 (626) 586-6668 Gas: Low 6 Ding Gas Meter 1 Gas 0 Contractor Green Center Construction 2662 River Ave#A, Rosemead, California 91770 (626)586-6668 915286 Regulator Inc. Press Engineer Peter Lee Engineering Inc. 8748 East Valley Boulevard Suite L, Rosemead, California (626)628-0900 Pipe 0 Future Branches 0 91770 Other: 2-3 inches 0 Plumbing Details Backwater 0 Backflow 1 Bathtub/Shower 5 Clothes I Dishwasher I Valve Device Washer Drinking 0 Floor Drain 0 Floor Sink 0 Hose Bibb 2 Interceptor/Clarifier 0 Fountain Lavatory/Sink 8 Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater 0 Regulator Pool Trap 0 Trap Primer 0 Water Closet 5 Water 1 Water Treatment 0 Heater Gas: Low 6 Gas: 0 Gas Meter 1 Gas 0 Alteration/Repair 0 Press Med/High Regulator Press Greywater 0 Pipe 0 Future Branches 0 Other: 1.5 1 Other: 2-3 inches 0 System Replacement inchesor less Other: over 3 0 Sewer: 1 Sewer: Manhole 0 Sewer: 0 Sewer: Private 0 inches Connection Addition Connection Sewer: 0 Sewer: Pit 0 Sewer: 0 Sewer0 Pit/Drainfleld Extension Attaration Tap&Saddle Combo Waste/Vent Earthquake Chemical Rainwater Shutoff Waste Fees Total Plan Check Fees $253.54 permit Fess $633.86 Plumbing Inspections Greywatef Approval ate 1 sp o Approval to I Approval In pec - Urger Slab Gas Piping Gas Test Work Gas Vent Utility Co Notified Wafer Service Hot Water CWy Metal Y/N Heater Gray Water Rough Plumbing System ` Plumbing Fixtures FINAL Lawn Sprinklers Sewer Inspections 51V&wA $1-49Aj 7I jd/i? "41 Approval ate Insp o Approval Date Inspector Approval Date Inspector New House Drywall Backfill Tank/Pit Sewer Alter/Repair Gray Water Connect Add'I Disconnect/Plug System Septic Tank/Pil 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 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 Contr9�or pursuant to the Contractors' State License Law). (_) 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 priorl to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner -builder H it has not been constructed in its entirely, 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: http•//www leoinfo ca oov/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. JOB ADDRESS LOCALITY , HAZARDOUS MATERIAL DECLARATION G_'� Will the applicant or future building occupant handle a hazardous License Class License No. mate ,a[ r a mixture containing a hazardous material equal to or /-Date Contractor Signature �,�.9 an the amount specified on the hazardous materials 9 0' inrf�o�rn guide? WORKERS' COMPENSATION DECLARATION Yes ❑ No ❑ 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. 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 vers' corn ensatio insu re carrier and poll cy nu tier IL -f Jo Cartier P Icy Number i ti Da s� SrirFP LrK�,mniy N me of Agent Phone Wml5er 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 Labor Code, I shall forthwith comply with those provisions sw �RA D >7 1-- 13e / g 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 lathe 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 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 o ❑ i 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 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 of j3 operty�OerLw r or Auth� led A t 5 C(��^ a 00/a,