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Home My Public Portal About6029 Agnes Ave_Building_8/25/2014_COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: ITR: 6561 LT: 58 UN: .002 (ASSESSOR INFORMATION NUMBER 15385-027-008 TEMPLE CITY 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONS SQ. FT STORIES TYPE 2300 V -B # 0508 I TENANT: IEXIST BLDG USE: RESID IEXIST OCC GRP: USE ZONE: R-1 OWNER: TEL. N0: JBLDGS. NOW ON LOT: VALUATION: IPERFETTO JOHN J CO TR PERFETTO TRUS - 1 8,000 16029 AGNES AV I TEMP 917801708 1 FEES PAID FBE DESCRIPTION: QUANTITY: DOM: AMOUNT: APPLICANT: TEL. NO: I 1FRUTOS, JIM (626) 393-2117- IAA BLDG PERMIT ISSUANCE 27.80 1732 N HARTLEY STREET IAB STATE GREEN BLDG FEE 8000.00 VAL 1.00 I WEST COVINA 91790 IAC STRONG MOTION RESID 8000.00 VAL 0.80 I ID2 PERMIT W/O EN -HC 8000.00 VAL 183.00 1 TOTAL FEES 212.60 CONTRACTOR: TEL. NO: ITOP CHOICE ROOFING (626) 393-2117- 1 1732 NORTH BARTLEY ST. LIC. NO 1 IWEST COVINA, CA 91790 928190 ` 1 IARCHITECT OR ENGINEER: TEL. NO LIC. NO: I MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 N0. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS (AIR QUALITY: 1000 FEET MATERIALS I NO NO NO ADDITIONAL DATA ON FILE PORT ID: DPR261 ROUTE TO: BS0508 BUILDING PERMIT ALTERATION/REPAIR. BL 0508 1408250001 nuiuuiiw ewurccaa: 6029 AGNES AV TEMP CA 917801708 NEAREST CROSS STREET: LAS TUNAS THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CA ISSUED ON: PROCESSED BY: 06/25/14 SR wue: REMOVE EXISTING ROOFS - 30 LB FELT UNDERLAYMENT AND 30 YR DIMENSIONAL ASPHALT SHINGLES SPECIAL CONDITIONS: APPROVALS DATE INSPECTOR SIGNATURE (UNDERFLOOR INSULATION I 1FLOOR SHEATHING 1 1 ROOF SHEATHING / SHEAR PANELS 1 IFRAME INSPECTION 1RATED WALL ASSEMBLIES (RATED SHAFTS/OPENINGS ) 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).): (.j 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 Contrdotor 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 priorl to completions 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 application is submitted or at the following Web site: htto://www.leginfo.ca.gov/calaw.htmi. 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. JOB ADDRESS LOCALITY KALAKUVUJ MAI LKIAL UIZU NI IVK Tcense Clas ("L License No. S Will the applicant or future building occupant handle a hazardous -----material or a mixture containing a hazardous material equal to or Date Contractor Signature greater than the amount specified on the hazardous materials information guide? WORKERS' COMPENSATO DEC0-OMMPEN-SATION ON Yes E]N o El WARNING: FAILURE TO SECURE WORKERSWill the intended use of the building by the applicant or future COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN building occupant require a permit for construction or EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO modification from the South Coast Air Quality Management ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION District (SCAQMD)? See permitting checklist for guidelines. 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 nsurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My wo co ens ns ra0 carder an otic umber am: Carrier 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 1 should become subject to the workers' compensationpprovisions of Section 3700 of the Labor CodeJ1 shall forthwith cloly with those Drovisions Date I., I LO YIST RDINANCE CERTIFICATION �f Cohvplete 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 Name Date Yes ❑ N o ❑ r 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 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-idVtified property fqr inspection purposes. of Property OwneAror Authorized Agent