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Home My Public Portal About9861 VAL ST_Grading_7/22/2020_G20-39754TEMPLE CITY PERMIT NO. G20-39754 City of Temple City 1 9701 Las Tunas Drive 1 Temple City, California 91780 I (626) 285-2171 1 www.templecity.us Address: Permit No: Description: Issue Date: Contacts 9861 Val Street, Temple City, California 91780 Parcel: 5383-025-011 G20-39754 Type: Grading Subtype: Subtype: Non - Residential COMPACTED BACK FILL SWIMMING POOL Special Conditions: 07-22-2020 Expire Date: 07-22-2021 Extension: Extension: 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 inspection. Owner Wei Yan 9861 Val Street, Temple City, California 91780 Applicant Roger Li 2702 Denton Avenue, Rosemead, California 91770 (626) 716-0621 4 (626)378-8031 Contractor Roger Li Construction 2702 Denton Avenue, Rosemead, California (626) 378-8031 - 962953 Inc. 91770 Architect Johnny 2585 South 10th Avenue, Arcadia, California (626) 548-0037 Yu 91006 Engineer WPH Engineering LLC 333 Santa Anita Avenue, Arcadia, California (626) 658-7974 91006 Grading Details Supervised Grading Cut 50 Fill Over Excavation Total Volume 50 Fees Total Plan Check Fees $0.00 Permit Fees $224.28 Grading Inspections Approval Date Inspector Initial Grade Prep Compaction Report Recd Sup Eng Cert Recd Approval Date Inspector Approval Date Inspector Rough Surety /• f//j/ Grading Bond �� )v71� " / Planting Released t/�!S/// & FINAL Irrigation Sup Eng Final Cert OWNER -BUILDER DECLARATION I hereby affirm under penalty of p erjury that I am exempt fr om the Contractors' State License Law for th e rea son(s) indi cat ed below by the checkmark(s) I h ave placed n ext to the applic abl e item(s) (Section 7031 .5, Busi ness and Prof essions C od e): Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structur e, prior to its issuance, also requires the applicant for the permit to file a signed statement tha t he or s he is licensed pursuant to the provisions of the Contra ctors' State License Law (Chapter 9 (comme ncing with Se ction 7000) of Division 3 of the Business and Pr ofession s Code) or that he or she is exempt from li censure a nd the basis for the alleged exemption. An y violation of Section 7031.5 by any applica nt for a permit subje cts the applicant to a civil penalty of n ot mo re than five hundred dollars ($500) .): (_) I, as owne r of the pro perty, or my e mployees with wages as their sole co mpen sa tio n, will do (I) all of or L) portions of the work, a nd the structure is not intended or offered for sal e (Section 7044, Business and Professions Code: The Con tracto rs' State License Law does not apply to an owner of property who, through employees' or persona l effort, builds or improves the property, provided that the improv ements are not intended or offered for sale. If, however, the building or improvement is sold within one yea r of comple tio n, the Owner - Builder will, have the burden of provin g that it was not built or improved for the purpose of sale.). L I, as own er of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State Lice nse Law does not apply to an owner of property who builds or improves thereon, and who contra cts for the proje cts with a licensed Contractor pursuant to the Contra ctors ' State License Law). 0: I am e xempt from licensure under the Contractors' State License Law fo r the following reason: By my signature below I ackn owledge that, except for my personal residence in whict? I must hav e resided for at least - one yea r prior to co mpletio rt of the improvements cov ered by this permit, I cannot le gally sell a structure that I have built as an owner -bu ilde r If it has not been constructed in its entirety by license d contractors. I understand that a copy of the applicable law, Section 7044 of 'the Business and Professio ns Code, is available upon request when this application is submitte d or at the following Web site: http://www.leginfo.ca .00v/calaw.html. Date: Signa ture of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLAR ATION I hereby affirm under penalty of perjury that I am licensed under pro visions of Chapter 9 (commencing with S ection 7000) of Division 3 of .the Business and Professi o s Code, and my license is in full force and effect. icense Clas_ ._._"ri Lic ense No. ntractor Signa RICERS' COMPENS ATION DE CLAR ATION W AfZ)GING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN AL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENS ATION, DAM AGES AS P RO VIDED FO R IN SECTI ON 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S , FEES. I hereby affirm under penalty of p erjury one of the following decl ar ations: _I ha ve and will mai ntain a certificate of consent to self - in sure for workers' c ompensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the L abor Code, for the performance of the work for which this permit is issued . Policy No . I have and will maintain w orkers' c omp ens ati on insurance, as required by S ecti on 3700 of _the Labor Code, for the performance of the w ork for hich this permit is issued. My worke rs', pomp- nsation 'nsura c ca 'er- d _•11 7umber are: Cam piration Date Name of Agent Phone Number I ce rtify that, in the performance of the work for which this pe rmit is iss ued, I sha ll not employ any person in any manner So as to become subject to the workers' compensation laws of C alifornia, and a gree that, if I should become subject to the wo rke rs' co mpensation provisions •f Section 3700 of the Labor Code, I sha ll fo rthwith comply 'ose provisions Signat of Ap- -nt Date LOBBYIST O RDINA NCE CER TIFICATION Complete this section for permits in Uninc orpo ra te d Los Ange le s Coun ty on ly This is to certify tha t I, as permit applicant, am familiar with the requireme nts of Los An gele s Coun ty Code Chapte r 2.160 et se q., (relating to the Los A ngeles Co unty Lo bbyist Ordina nce) a nd that all persons acting on behalf of myself complied and will continue to comply therewith through the application process. A pplicant (Print Name) A pplicant Signature Company Name Date JOB ADDRESS LOCALITY HAZARDOUS M ATERIAL DECLARATION Will th e applicant or future building. occup ant h andle a hazardous m at erial or a mixture containing a ha zardous mat erial equ al to or greater than the amount specified on the hazardous materials information guide? Yes ❑ N o ❑ Will the intended use of the building by the applicant or future building occupant r equire a p ermit for constructi on or modification from the South Coast Air Qu ality M anag em ent District (SCA QMD)? See permitting checklist for guid eli nes. Yes 0 N.o 0 I ha ve read the hazardous materials information guid e and the SCAQMD , permitting checklist, I understand my r equirements und er th e Los Angel es County Code Title 2, Chapter 320' Sections 220.100 through 220.140 concerning hazardous material reporting and for obt aining a permit from the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to AQMD and/or EPA ❑ I declare that notification of asbe stos remov al is not applicable to addressed project. DECLARATION REGARDING CONSTRUCTION LENDING AGENCY I hereby affirm under p en alty of p erjury that there is a Construction lending agency forthe performance of the w ork for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my sign ature below, I certify .toeach of the following: I am the prop erty ow ner or auth ori zed to act on the property owner's behalf . I have re ad this application and th e informati on I have pr ovided is c orrect. I agree to comply with all applic able city and county ordinances • and state laws r elating to building c onstruction. I authori ze representatives of this county to enter the abo ve -identified property for inspection p Signature of bate—