HomeMy Public PortalAbout5708 ROSEMEAD BLVD UNIT_PLUMBING_7/31/2018_P18-36514TEMPLE CITY PERMIT NO. P18-36514
City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 I (626)285-2171 I www.templecity.us
Data Inspector
Address: 5708 Rosemead Boulevard Suite 105, San Gabriel,
Parcel: 5387-013-031
Utility Cc
California 91775
CWV
GrayWater
System
Permit No: P18-36514
FINAL
Type: Plumbing Subtype:
Subtype:
Non -
Residential
Description: INSTALL GN2 SYSTEM
Special
Conditions:
Issue Date: 07-31-2018
Expire Dab: 07-31-2019 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 Chi-Peij Liu
322 Genoa Street Unit B, Arcadia, California 91006
(626) 8641170
Appkant Francisco
116 East Spruce Street, Ontario, California 91761
(909) 456-4097
Vasquez
Contractor
2eledon Design &
14037 S. Pioneer Boulevard, Norwalk, California
(562) 412-5307
554524
Development
90650
- Plumbing Details
Backwater 0
Backflow 0
Bathtub/Shower 0 Clothes 0
Dishwasher
0
Valve
Device
Washer
Drinking 0
Floor Drain 0
Floor Sink 0 Hose Bibb 0
Interceptor/Clarifier
0
Fountain
Lavatory/Sink 0
Miscellaneous 4
Pressure 0 Roof Drain 0
Solar Water Heater
0
Regulator
Pool Trap 0
Trap Primer 0
Water Closet 0 Water 0
Water Trea6nent
0
Heater
Gas: Low 0
Gas: 0
Gas Meter 0 Gas 0
Albretion/Repair
0
Press
Med/High
Regulator
Press
Greywater 0
Pipe 0
Future Branches 0 Other: 1.5 0
Other: 2-3 inches
0
System
Replacement
inches or
less
Other: over 3 0
Sewer. 0
Sewer: Manhole 0 Sewer. 0
Sewer: Private
0
inches
Connection
Addition
Connection
Sewer: -
Sewer. Pit 0
Sewer: 0 Sewer: 0
Pit/Dminfield
Extension
Alteration Tap&Saddle
Combo
Waste/Vent
Earthquake
Chemical Rainwater
Greywater
Shutoff
Waste
Fees Total
Plan Check Fess $427.08 Permit Fees $84.24
Plumbing Inspections
Approval Date Inspector
Under Slab
Work
Water Service
Plastic Y/N
Metal Y/N
Rough
Plumbing
Sewer Inspections
Approval Date Inspector
New House
Sewer
Connect Add'I
Septic Tank/Pit
Approval
Gas Piping
Gas Vent
Hot Water
Healer
Plumbing
Fixtures
Lawn Sprinklers
Date Inspector
Drval
rywell
Alter/Repair
Disconnect/Plug
Date Inspector
Approval
Data Inspector
Gas Test
Utility Cc
Notified
CWV
GrayWater
System
FINAL
Approval Date Inspector
Backfill Tank/Pit
Gray Water
System
FINAL
I
112
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 Contr9ctor pursuant:to the Contractors' State License
Law). '
U 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 whicf I must have resided for at least
one year pdorl to completion of the improvements covered by
this permit, Icannot 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: htto:l/www.leoinfo.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 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, and my
license is in full force and effegt,
44cense Class License No. sS
9Date�3r�Contractor Signature
WORKERS' COMPENSI CLARATION
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 carder and policy number are:
Carder 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
Callfomia, a d agree that, If I should become subject to the
workers' c ensation provisions of Section 3700 of the Labor
with comply with those provisions
Code, I I orth
S n re 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 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
❑ 1 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.
L*
Signatu :party Owner or Authorized Agent