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Home My Public Portal About5837 5 KAUFFMAN AVE_BUILDING_2/7/2019_B19-37454TEMPLE CITY PERMIT NO. B19-37454 City of Temple City 19701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecityus Address: 58371/2 Kauffman Avenue, Temple City, California Parcel: 8587-021-009 91780 Permit No: B19-37454 Type: Building Subtype: ARAKeration Repair Description: COVER IRREGULAR PLASTER WALL WITH DRYWALL Special ON DEN Conditions: Issue Date: 02-07-2019 Expire Date: 02-07-2020 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 ,eOwner-Builder Owner Jinjan Development LLC ApPdicart Building Details Structure l: Residential Construction Type: V -B OccupancyGroup: R-3 Residential, one -and two-family New/Added Area: 0 RemodeVn Ana: 0 New Dwelling Units: 0 Stories: 0 458 Sharon Road, Arcadia, California 91007 9 (496) 360.7777 2: 3: 4: 0 0 0 0 0 0 0 0 0 0 0 0 - Fees Total Date Inspector Rated Valuation $400.00 Plan Check Fees $0.00 Permit Fees SF4.68 Strong Motion Fee $0.50 SB 1473 Fee $1.00 Parks Dev Fee 50.00 Sewer Const Fee 50.00 - Building Inspections T -Bar Approval Date Inspector Approval Date Inspector Location/Setbacks Lot Drainage * oke Roof Sheathing Soils Engineer Fire Dept Framing Fire Dept Approval FINAL Foundation Forms Bldg Dept Framing Slab/Under Floor Shear Panels J Raised Floor Sprinkler Hangars Framing Insulation/Weather Underfloor Insulation Strip Interior 1st Floor lath/Drywall Sheathing Exterior Lath 2nd Floor Sheathing Approval Date Inspector Rated Floor/Ceiling Rated Walls Rated Shafts T -Bar Ceilings Lot Drainage * oke Dettectors ect Fire Dept Approval FINAL / -.J J PC 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 Ilcensure 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 Contractor 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 whicf' I must have resided for at least one year pdorlto completiorryy of the improvements covered by this permit, I nnot legally a [I 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://www.leclnfo.ce.cov/calaw.html. ate: Signature of Property Own Authorized Agent �/ 7 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 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. 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: Caller 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' compenyya4`on provisions of Section 3700 of the Labor Code, I shall fo Swith comply with those provisions Signature of p ' t 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 acti o shelf of myself complied and will continue It with th to comply gh the application process. Apolican'AjPriniiNarfie) Applicant Signature Date . JOB ADDRESS LOCALITY HAZARDOUS MATERIAL DECLARATION Will the applicant or future bullding 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 checkllstfor guidelines. Yes ❑ No ❑ i I have read the hazardous materials Information guide and the SCAQMD, permitting checklist, I understand my requiremgnts under the Los Angeles County Code Title 2, Chapter 220' Sections 220.100 through 220.140 concerning hazardous material reporting and for obtaining a pernhfrom 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 penalfy of perjury that there is a ConsWction 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 cartify.to;each of the following: I am the property owner or auNlohzed 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 constructlon. I authorize representatives of this county to enter the above -identified property for inspection purposes. Signature of Property Own or Authorized Agent