HomeMy Public PortalAbout9617 BROADWAY_PLUMBING_10/12/2017_P17-35037 (2)TEMPLE CITY PERMIT NO. P17-35037
City of Temple City 1 9701 L Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 vnvw.templecity.us
Address: 9617 Broadway, Temple City, California 91780 Parcel: 8588-009-016
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Permit No: P17-35037 Type: Plumbing Subtype Subtype: Residential -
Description: PWMBING FOR NEW DETACHED CONDO AND CONNECT TO Special
PUBLIC SEWER Conditions:
issue Date: 10.12-2017 Expire Date: 04-10-2018 Extension: Extension: r
Permit expires on date shown H: 1) work tices not commence, or 2) work is suspended or abandoneQ or 3) applicant fails to obtain code required
inspection.
owner E -Highland (US) Corp 5003 Golden West Avenue, Temple City, California 91780 (626) 226-8864
Applicant John Hua 3534 Hawkwood Rd, Diamond Bar, California 91765 (626) 731-5406
Contractor John Hua General Contractor 3514 Hewkwood Rd, Diamond Bar, California 91765 (626) 731-5406 751479
Architect
Engineer T 6 W Consulting Engineers 1168 San Gabriel Boulevard, Rosemead, California 91770 (626) 288-0708
-arq Details
Backwater 0 Backflow, 0 Bathtub/Shower 3 Clothes 1 Dishwasher 1
Valve Device Washer
Drinking 0 Floor Drain 0 Floor Sink 0 Hose Bibb 3 Interceptor/Clarifier 0
Fountain
Lavatory/Sink 4 Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater 0
Regulator
Pool Trap 0 Trap Primer 0 Water Cluset 3 Water 1 Water Treatment 0
Heater
Gas: Low 4 Gas: 0 Gas Meter 1 Gas 0 Alteration/Repair 0
press Med/High Regulator
Press
Greywater 0 Pipe 0 Future Branches 0 Other: 1.S 1 Other: 2-3 inches 0
System Replacement inches cur
less
Other: over 3 0 Sewer: 1 Sewer: Manhole 0 Sewer: 0 Sewer: Private 0
inches Connection Addition Connection
Sewer: 0 Sewer: Pit 0 Sewer: 0 Sewer: 0
Pit/Drainfeld Extension Alteration TapBSaddle
Combo
Waste/Vent Earthquake Chemical Rainwater Greywater
Shutoff Waste
Fees Tota;
Plan Check Face $184.44 Permit Fees $461.11
Plumbing Inspections
Approval Date f insp o Approvalat /��Itr �f/toa Approval Date Inspector
Under SWO Woh Gas Piping Casten
Water Service Gas Van[ Gray Ca Notified
Plastic Y/N Hot Water Heater CWV
Metal Y/N Plumbing fixtures Gray Writer System
Rough Mumbinq Lawn Spnnklers FINAL
Sewer Inspections
Approval ��D% t�o .v �I�n/s✓pj4(�{ o�r� Approval Data Inspector Approval Data Inspector
New House Sewer Is' Drywall Backfill Tank/Fa
Correct Addy Alter/Repair Gray Water System
epocjack/At OisconneNPlug FINAL
cp.pq' a, 6�%r�alt
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 acid the basis
for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicanf 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 pdorl to completion) of the improvemepts covered by
this permit, Icannot 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: htto•/ANww.IeQlnfo.ca.aov/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 effect.
cense Class 724 License No.
?1—rlate 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 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:
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
California, and agree that, if I should become subject to the
workers' compensation provisions of Section 3700 of the Labor
Code, 1 shall forthwith comply with those provisions
10 11'2,112
Signature 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 et seq.,
(relating to the Los Angeles County Lobbyist Ordinance) and that
all persons acting on behalf of myself compiled and will continue
to comply therewith through the application process.
Applicant (Print Name) Applicant Signature
Company Name Date
JOB ADDRESS I
LOCALITY
HAZARDOUS MATERIA- 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.o ❑ %
i
I have read the hazardous materials Information guide and the
SCAQMD_ permitting checklist, 1 understand my requirem@nts
under the Los Angeles County Code Tule 2, Chapter 2?0'
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).
Lender's Name
Lender's Address
By my signature below, I certify toeach 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.
Signature of Property Owner or Authorized Agent
ate�C., 4 12, /