The URL can be used to link to this page

Home My Public Portal About5060 SULTANA AVE_PLUMBING_10/16/2017_P17-35061 (2)TEMPLE CITY PERMIT NO. P17-35061 City of Temple City 19701 Las Tunas Drive I Temple City, CaTharma 91780 1 (626) 2854171 1 www.templecity.us Address: 5060 Sultana Ave, Temple City, California 91780 Parted: 5388-017-028 Permit No: P17-35061 Type: Vlumung Subtype: Subtype: Resderoal Description: PLUMBING FOR NEW DETACHED CONDO AND CONNECT TO Special PUBLIC SEWER Conditions: Issue Date: 10-16-2017 Expire Date: 04-14-2018 Extension: Extension: Permit expires on date shown it: 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant falls to obtain code required Inspection. - Contacts Owner Sultana Highland Villa LLC 5922 North Burton Avenue, San Gabriel, CalMomue 91775 (626) 922-7373 Applicant len Holopain in 1227 W Valley Blvd 9109, Alharnlxa, California 91803 (626) $23-7070 Contractor Boomerang Engineering Inc. 1227 W Valley Blvd #109 - 115, Alhambra, California 91803 (626) 780-6694 861501 Architect ARC Design 1227 West Valley Boulevard, Alhambra, California 91803 (626) 715-7222 • Plumbing Details Backwater 1 Backflow 0 Bathtub/Shower 3 Clothes 1 Dishwasher 1 Valve Device Washer Drinking 0 Floor Drain 0 Floor Sink 0 Hose Bibb 2 Interceptor/Clariter 0 Fountain Lavatory/Sink 4 Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater 0 Regulator Pool Trap 0 Trap Primer 0 Water Closet 3 Water 1 Water Treatment 0 Heater Gas: Low 5 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 inches or Tess 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 Sewer: Pit/Drainfield Extension Alteration TapASaddle Combo Waste/Vent Earthquake Chemical Rainwater Greyweter Shutoff Waste -ees Total Plan Check Fans ;200.44 Permit Fees $501.09 PI,.-' , lnspections Approval Ins or Approval xDvrt,• ns or Approval U'der Slab Work Gas Piping Gas Tat water Service r Gas Vent IIII err` SCC` ------ 7�7TT�� Milky Co NotlBed Mastic y/N Hot Water Heater CWV Metal Y/N q Fixtures Gey Water System ingFibrFINAL Rough Plumbing Lavin Sprinklers; Lawn - Sewer Inspections _ Approval _ Ogty ns Approval Date Inspactor Approval Date 4up•ctor New Ifouse Sewer /y�rH� Dryweil Connett Add'I Alter/Repmr Gray Water System Septic Tank/Nt Disconnect/Plug RML Xf 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 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 Contrhor pursuant to the Contractors' State License Law). (_) I am exemdt 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 prion to completion of the improvements covered by this permit, I "rinot 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: hftt),//www.leainfo.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 JOB ADDRESS LOCALITY Division 3 of the Business and Professions Code, and my I icense is in full ford and effect. HAZARDOUS MATERIAL DECLARATION L ic e Class Ula` License No. the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material equal to or Date Contractor Signature greater than the amount specified on the hazardous materials information guide? WORKERS' COMPENSATION DE LARATION 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 workers' compensation Insurance carrier and policy number are: Cartier Policy Number Expiration Date 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 soas to be me subject to the workers' compensation laws of California agree that, f I should become subject to the worker ' c pensation provisions of Section 3700 of the Labor Code, Vkall forthwith comply with those provisions 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 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 (SCAQMO)? 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). Lenders 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 owners 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 represen 'ves of this county to enter the above -identified pr9W9dy for inspection purposes. Signature of ProjyFty Owner or Authorized Agent Date