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Home My Public Portal About5933 AVON AVE_PLUMBING__4/24/2017_P17-34074TEMPLE CITY PERMIT NO. P17-34074 Contacts Owner Sharon City of Temple City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templecity.us Address: 5933 Avon Avenue, San Gabriel, California 91775 Parcel: 5386-012-043 Permit No: P17-34074 Type: Plumbing Subtype: Subtype: Residential Description: SHOWER, CLOTHESWASHER, LAVATORIE, SINK, WATER CLOSET, Special (818) 987-7863 TANKLESS WATER HEATER AND WATER HEATER Conditions: Issue Date: 04-24-2017 Expire Date: 10-21-2017 Extension: Extension: Plumbing Details Permit expires on date shown If: 1) work does not commence, or 2) work Is suspended or abandoned, or 3) applicant fails to obtain code required a� Hot Water �[ inspection. Metal Y/N Rough Y/N Rough Contacts Owner Sharon 5933 Avon Avenue, San Gabriel, California 91775 - Applicant Eliad Dorfman 2373 Westwood Boulevard, Los Angeles, California 90064 (818) 987-7863 Contractor Cielo Construatlon Company 1053 Colorado Boulevard, Los Angeles, California 90041 (800) 897-3114 983179 Plumbing Details Water Service a� Hot Water �[ CWV Metal Y/N Rough Y/N Rough Heater l "'��'GGG "` Plumbing �/S//A Fixtures `l ��• ___LLL ---___ Backwater 0 Backflow 0 Bathtub/Shower 1 Clothes 1 Dishwasher 1 Valve Device Washer Drinking 0 Floor Drain 0 Floor Sink 0 Hose Bibb 0 Interceptor/Clarifier 0 Fountain Lavatory/Sink 2 Miscellaneous 0 Pressure 0 Roof Drain 0 Solar Water Heater 0 Regulator Pool Trap 0 Trap Primer 0 Water Closet I Water 1 Water Treatment 0 Heater Gas: Low 1 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 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: 0 Sewer: Pit 0 Sewer: 0 Sewer: 0 Pit/Drainfield Extension Alteration TapBSaddle Combo Waste/Vent Earthquake Chemical Rainwater Greywater Shutoff Waste - Fees Total Plan Check Fees $113.60 Permit Fees $164.02 Plumbing Inspections Approval Date Inspector Approval Da Ins Approval Under Slab I/ Gas Piping N - Gas Test Work Gas Vent Notified Water Service a� Hot Water �[ CWV Metal Y/N Rough Y/N Rough Heater l "'��'GGG "` Plumbing �/S//A Fixtures `l ��• ___LLL ---___ Gray at Gray Water System FINAL Plumbing lawn Sprinklers Sewer Inspections — �7 Date Inspector Approval Data Inspector Approval Date Inspector Approval Date New House Drywell Backfin lank/Pit -_ Sewer Alter/Repair Gray Water Connect Add'1 Disconnect/Plug system Septic Tank/Pit FINAL Inspector OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION JOB ADDRESS 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 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). U:I am exemi;jt 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 which I must have resided for at least one year priori to completion 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: htti)�//www.leoinfo.Ga.gov/calaw.html. ce 0ov/calaw html/www leoinfo ca cov/calaw html Date: Signature of Property Owner or Authorized Agent 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 _-a— License No. 1 Date i 3 yontraator Signature WORKERS' COMPENSATION LARATION 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: 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 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 s ome subject to the workers' compensation provisions of ion 3700 of the Labor Code, I shall forthwith comply wit se provisions SignaU&`5f 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 actingon behalf of myself complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company Name Date 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 specked on the hazardous materials information guide? Yes ❑ N o ❑ 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 SCAQMD permitting checklist, I understand my requiremernts 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 Lenders 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 identified property for inspection pur Signature of Prop�y Owner orized Agent Date