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Home My Public Portal About5514 MCCULLOCH AVE_Mechanical_8/5/2019TEMPLE CITY PERMIT NO. M19-38328 City of Temple City 19701 Las Tunas Drive 1 Temple City, California 91780 I (626) 285-2171 I www.templecity.us Address: 5514 Mcculloch Avenue, Temple City, California Parcel: 8573-013-038 91780 Permit No: M19-38328 Type: Mechanical Subtype: Description: APPLIANCE VENT AND VENTILATION FAN Special Conditions: Issue Date: 08-05-2019 Expire Date: 08-04-2020 Extension: Contacts Subtype: Residential 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 Michele Chimienti Applicant Alex Sordo Contractor Engineer Mechanical Details Compressor/Furnace/Etc 0 up to100kBTU Appliance Vent 1 Ventilation Fan 1 Fireplace 0 Fees Total Alexander Sordo Brian Arthur Noteware Architect 5514 Mcculloch Avenue, Temple City, California 91780 (562) 477-9385 13708 Boston Court, Fontana, California 92336 13708 Boston Court, Fontana, California 92336 2850 Ocean Park Boulevard #315, Santa Monica, California 90405 Compressor/Furnace/Etc 0 100-500k BTU Air Handler up to 2,000 0 CFM Compressor/Furnace/Etc 0 over500kBTU Alr Handler 2-10,000 0 CFM Ventilation System 0 Kitchen Hood/Spray 0 Booth Plan Check Fees $0.00 Permit Fees $40.08 - Mechanical Inspections Approval Date Inspector FAU/Wall Furnace Combustion Air Openings Duct Work Approval Date Inspector AC/Compressor Thermostat Fire Dampers (310) 930-3269 (310) 930-3269 673274 (310) 452-6500 Alr 0 OR Floor 0 Inlet/Outlet Area Qty Alr Handler 0 Evaporative 0 over 10,000 Cooler CFM Fire 0 Duct 0 Damper Alteration Approval Date Inspector Smoke Detectors Commercial Hood 774/7— t ' L l�"',' '._._... FINAL ��f OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that l am exempt from the Contractors' State Licens e Law for th e reason(s) indicated below by the checkmark(s) I h ave placed next to the applicable item(s) (Section 7D31.5, Business and Professions Code): Any city or county that requires a permit to construct, alter, improve, demolish, or re pair any structure, pri or to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursua nt to the pr ovisions 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 fo r a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compe nsation, will do (,r) all of or L) portions of the work, and the structure is not inte nde d or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does no t apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improv ements are not intended or offered for sale. If, howeve r, 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 purpo se of sale. ). L) I, as owner of the property, am exclusive ly con tracting with licensed Contra cto rs to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does no t a pply to an owner of pro perty who builds or improves thereon, and who contracts for the proje cts with a licensed Contractor pursuant to the Contractors' Sta te License Law)_ 0; I am exempIt fro m licensure under the Contractors' State License Law for the following reason: By my signature below 1 acknowledge that, except for my personal residence in which i must have resided for at lea st one year pricrl to compietionl of the improvements covered by this permit, I *not legally sell a structure that I have built as an owner -builder If it has not bee n constructed in its entirety by licensed contractors. I understand tha t a co py of the applicable la w, Section 7044 of 'the Business and Professions Code, is available upon request whe n this applicatio n is submitted or at the following Web site : htto://www.leoinfo_ca. gov lcalaw.html. Date: Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECL ARATION 1 hereby affirm u nder penalty of perjury th at I am licensed under. provisions of Ch apter 9 (commencing with Section 7000) of Division 3 of the Business and Pr ofessions Code, and my license is in full force and effect. License Class 1?"") License No. ' 1 Date gI I Contractor Signatur%�, WORKERS' CO MPENSATI ON DECL ARATION WARNING: FAILURE TO SECURE WORKERS' C OMPENS ATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI VIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF C OMPENSATION, D AMAGES AS P ROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES . I h ereby affirm under pen alty of perjury o ne of the following declarations: i have and will maintain a certificate of consent to self - insure for workers' compensation, iss ued by the Director of Industrial Relations as provided for by Section 3700 of th e Lab or Code, for the performance of the work for which this permit is issued. Policy No. I have a nd 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' compens ation insurance carrier and__polic{y num er are: fjC SS•fL� ACW Carrier Policy Number Expire on Date Name of A gent / Phone Number I certify tha t, in the perf ormance of the work for which this permit is issue d, l 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, l sha ll forthwith comply with those pro visions _. . si Signature of A pplicant Date LOBBYIST OR DINANCE CERTIFICATION Comple te this section fo r permits in Un inc orpo ra ted Lo s A ngeles County only This is to certify tha t I, as permit applicant, am familiar with the requirements of Los Angeles County Code Chapter 2.160 et seq., (relating to the Los A ngeles Co unty Lobbyist Ordina nce) a nd that all persons acting on behalf of myself complie d and will, continue to comply therewith through the application pro cess. Applica nt (Print Name) A pplica nt Signature JOB ADD RESS LOCALITY HAZARD OUS MATERIAL DECLAR ATION Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous materi al 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 (SCAQ MD)? See p ermitting ch ecklist for guidelines . Yes ❑ N .o ❑ I have read th e hazardous materials information guide and the SCAQMD permitting ch ecklist, I understand my requirements under the Los Angeles County Code Title 2, Ch apter 220' Sections 220.100 through 220.140 concerning ha zardous material reporting and for obtaining a permit from the SCAQ MD. ASBESTOS NOTIFICATI ON ❑ Notification letter sent to AQMD and/or EPA D I declare that notification of asbestos removal is not applicable to addressed project. DECL AR ATION REG ARDIN G CONSTRUCTI ON LENDING AGENCY I hereby affirm under penalty of perjury that there is a Construction lending agency for the p erformance of the work for which this permit is issued (S ection 3097, Civil Code). Lender's Nam e Lender's Address By my signature below, I certify toeach of the following: I am the property owner or authori zed to act on the prop erty owner's behalf. have read this applicatiory'and the information I have provided is correct. 1 agree to comply with all applic able city and county ordinances " and state l aws rel ati ng to building construction. " I authorize representatives of this county to enter the above -identified property for inspection purposes. Sign at f e"of Property Owner or Authorized Ag ent Company Na me Date Date