HomeMy Public PortalAbout5472 ENCINITA AVE_MECHANICAL_11/6/2018_M18-37069 (2)TEMPLE CITY PERMIT NO. M18-37069
City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecity.us
Address: 5472 Encinita Avenue, Temple City, California 91780 Parcel: 8588-030-057
Permit No: M18-37069 Type: Mechanical Subtype: Subtype: Residential
Description: REPLACE EXISTING A/C -HEAT SYSTEM &3NEW Special
DUCTS Conditions:
Issue Date: 11-06-2018 Expire Date: 11-06-2019 Extension: Extension:
Permit expires on date shown if: l) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails to obtain code
required inspection.
- Contacts
Owner Remedios Aquino 5472 Encinita Avenue, Temple City, California 91780
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Applicant Carra Contreras 4931 Encinita Avenue, Temple City, California 91780 (626)286-3157
Contractor Connor Air Conditioning 4931 Encinita Avenue, Temple City, California 91780 (626)286-3157 403735
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Mechanical Details
Compressor/Fursce/Etc 2 Compressor/Wmace/Etc 0
Compressor/Furnace/Etc 0
Air 3 OR Floor 0
upto 100k BTU 100-5001k BTU
over 500k BTU
Inlet/Outlet Am
Ory
ApplianceVent 0 Air Handlerupto2,000 0
Air Handler2-10= 0
Air Handler 0 Evaporative 0
CFM
CFM
over 10,000 CooMr
CFM
Ventilation Fen 0 Ventilation System 0
IOtcsrr Hood/Spray 0
Fire 0 Drax 0
Booth
Damper AReradon
Fireplace 0
Fees Total
Plan Check Fees $0.00 PermRFees $90.48
Mechanical Inspections
Approval Data lnsPfctorA Approval
Furnace v/ /h /.y/✓_�/_ AC/Compressor son
D/a�q �,p
"i�`r' kc
'b/••//e,8,y
Approval Date kspeemr
Smoke
CombusFAU/Wation
Combustion Air • r -'„ Thermostat
Openings
Detectors
Commercial
Fire Dampers
Duct Work L1,ZL� µ�s
Hood
AfA�
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 Contr9cior pursuant to the Contractors' State License
Law). 1I
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 which I must have resided for at least
one year priorlto completiotp of the improvements covered by
this permit, I cannot 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 appllcation is submitted or at
the following Web site: htto://www.lecinfo.ca.cov/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 (pommencing with Section 7000) of
Division 3 of the Business and Professions Code, and my
license is in full force and effect.
License Clas Icense N
Date `\ ontractor Signature
T103:5�
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 3700 of the
Labor Code, for the performance of the work for which this permit
is Issued.
Policy No.
have and will maintain workers' compensation
in ur I ce, as required by Section 3700 of -the Labor Code, for
the performance of theworkfor which this permit is issued. My
worker ' compen tLt � ( d licy qumbe r
'701 diner Policy Number Expiration
Name off Agent Phone Number
1-I certify that, In the performance of the work for which this
pgrrNt 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_§bduld become subject to the
workers' compens latiIii of Section 3700 of the Labor
Code, I shall forth comgly wi a provisions
Signature ohCppllcant 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) a
all persons acting on behalf of myself complied and continue
toymmoly therewith thmuch the aoDlication Proo"s 41
JOB ABDRESS
LOCALITY
HAZARDOUS MATERIAL DECLARATION
Will the appllcant 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
WIII the intended use of the buildinot 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 ❑ Ro X t
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 penult from the SCAQMD.
ASBESTOS NOTIFICATION
❑ Notification letter sent to AQMD and/or EPA
declare that notification of asbestos removal Is not
ppiicable 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 is county to enter the
;aboferidentitie inspection purposes.
Date
Agent