HomeMy Public PortalAbout5338 WELLAND AVE_BUILDING_7/3/2018_B18-36472TEMPLE CITY PERMIT NO. B18-36472
City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity. us
Address: 5338 Welland Avenue, Temple City, California 91780 Parcel: 8573-035-020
Permit No: B18-36472 Type: Building Subtype: ARAlteration
Repair
Description: RROOF(A PHALT) OLD ROOFING WILOF HOUSE AND ATTACHED LLLB GE. SHINGLE Special
REMO ED.
1400 SO Conditions:
Issue Date: 07-03-2018 Expire Date: 07-03-2019 Extension: Extension:
Permit expires on date shown it. 1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code required
inspection.
- Contacts
VOwner-Builder
Owner Ken Johnson 5338 Welland Avenue, Temple City, California 91780 (323)992-7264
Applicant Juan Cados Villaneda 5338 Welland Avenue, Temple City, Califomia 91780 (323)992-7264
Building Details
s r
Roof Sheathing
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Structure 1: Residential
2:
3:
4:
Construction Type: V -B
Sprinkler Hangars
Occupancy Group: R-3 Residential, one -and two-family
Strip
New/Added Area: 0
0
0
0
Remodel/Tl Area: 1400
0
0
0
New Dwelling Units: 0
0
0
0
Stories: 0
0
0
0
Fees Total
Valuation $8000.00
Strong Motion Fee $0.00
Building Inspections
Approval Date
Location/Setbacks
Soils Engineer
Foundation Forms
Slab/Under Floor
Raised Floor
Framing
Underfloor
Insulation
1st Floor
Sheathing
2nd Floor
Sheathing
Plan Check Fees $0.00 PermBFees $247.92
SB1473Fee $1.00 ParksDev Fee $0.00 Sewer Const Fee $0.00
Inspector Approval
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Roof Sheathing
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Fire Dept Framing
Bldg Dept Framing
Shear Panels
Sprinkler Hangars
Insulation/Weather
Strip
Interior
Lath/Drywall
Exterior Lath
Approval Date
Rated
Floor/Ceiling
Rated Walls
Rated Shafts
T -Bar
Ceilings
Lot Drainage
Smoke
Detectors
Fire Dept
Approval
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FINAL
Inspector
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OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from
the Contractors' State License Law for the reasons) 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 Conft or pursuant to the Contractors' State License
Law).
(,:I am exempt 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 whicl] I must have resided for at least
one year prior to completiorq of the improvements covered by
this permit, I nnot legally sdll a structure that I have built as an
owner -builder f 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: httD://www.leginfo.ca.cov/calaw.html.
Date:
Signatu Prop or ized 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
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 3760 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 ofthe work for which this permit is issued. My
workers' compensation insurance carder 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
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 forthyAth comply with those provisions
JOBADDRESS .
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 ❑
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 ❑ No ❑ /
i
I have read the hazardous materials information guide and the
SCAQMD, permitting checklist, I understand my requlrem@nts
under the Los Angeles County Code Title 2, Chapter 220'
Sections 220.100 through 220.140 conceming 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 owners behalf.
I have read this application and the information I have
,\t�l 1,0$BYIST ORDINANCE CERTIFICATION provided is correct.
Complete this section for permits in I agree to comply with all applicable city and county
Unincorporated Los Angeles County only ordinances and state laws relating to building
This is to certify that I, as permit applicant, am familiar with the construction.
requirements of Los Angeles County Code Chapter 2.160 at seq.,
(relating to the Los Angeles County Lobbyist Ordinance) and that I authorize representatives of this county to enter the
all persons acting on behalf of myself complied and will. continue above -identified property for inspection purposes.
to comply therewith through the application process.
Sign Of Pita rtyA /or uthorized Agent
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Applicant (Print Name) Applicant Signature
Company Name Date