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Home My Public Portal About6127 CAMELLIA AVE_PLUMBING_4/9/2018_P18-35924 (2)TEMPLE CITY PERMIT NO. P18-35924 City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626)285-2171 1 www.templecity.us Address: 6127 Camellia Avenue, Temple City, California Parcel: 5385-015-012 Earthquake 91780 Utility Co Notified Shutoff Waste Fees Total Permit No: P18-35924 r Type: Plumbing Subtype: Subtype: Residential Description: RE -PIPE MAIN WATERLINE INTOTHE HOUSE Special Conditions: Approval Date Inspector Issue Date: 0409-2018 Date Inspector Expire Date: 0409-2019 Extension: Extension: Permit expires on date shown 8:1) work does not commence, or 2) work is suspended or abandoned, or 3) applicant fails toobtam code required inspection. Hot Water PI Y/N eta /N Heater - Contacts System Plumbing s FINAL VOwner-Builder (� Lam am Ss Lawn Sprinklers Owner Steve Hang 6127 Camellia Ave, Temple City, California 91780 (626)688-3731 Approval Date Inspector Applicant Date Inspector New House Drywall 792204 Architect Alter/Repair Connect Add'I 792204 Plumbing Details Septic Tank/Pit Backwater 0 Backflow 0 Bathtub/Slower 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 0 Pressure 0 Roof Drain 0 Solar Water Heater 0 Regulator Pool Trap 0 Trap Primer 0 Water Closet 0 Water 0 Water Treatment 0 Heater Gas: Low 0 Gas: 0 Gas Meter 0 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 leu Other: over 0 Sewer: 0 Sewer: Manhole 0 Sewer: 0 Sewer: Prtvate 0 inches Connection Addition Connection Sewer: 0 Sewer: Pit 0 Sewer: 0 Sewer: 0 Pit/Drainfield Extension Alteration Tap&Saddle Combo Date Inspector Waste/Vent Earthquake Chemical Utility Co Notified Shutoff Waste Fees Total r Plan Check Fees 4148.65 Permit Fees $21.06 - Plumbing Inspections Approval Date Inspector Approval Date Inspector Under Slab Gas Piping Wort' Gas Vent Water Service Hot Water PI Y/N eta /N Heater er4 System Plumbing s FINAL Fixtures (� Lam am Ss Lawn Sprinklers Sewer Inspections Approval Date Inspector Approval Date Inspector New House Drywall Sewer Alter/Repair Connect Add'I Disconnect/Plug Septic Tank/Pit Rainwater Greywater 9 Approval Date Inspector Gas Test Utility Co Notified CWV r Gray Water System FINAL 1 ` Approval Date Inspector Backfill Tank/Pit Gray Water er4 System s 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 (J) 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 Con" or pursuant to the Contractors' State License Law). (_): I am exemiJt 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 priorl to completion of the improvements covered by this permit, I cannot legally sdll 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: http,//www.leginfo.ca.cov/calaw.htmi. Date: O A Signature of Property Owner oXAx r rid 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 rJOB AIIDRESS CALITY 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? WORKERS' COMPENSATION DECLARATION Yes ❑ 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 shallnot ploy any person in any manner so as to become subject to he workers' compensation laws of California, and agreet, I should become subject to the workers' compen*tio ' 'ons of Section 3700 of the Labor Code, I shall forth t with those provisions x 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 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 ❑ No ❑ i I have read the hazardous materials Information guide and the SCARMD 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 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 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 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-identiroperty for inspection purposes. Owner or Authorized Agent 61�