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Home My Public Portal About5325 GLICKMAN AVE_Building_12/1/2015_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS ALTERATION/REPAIR BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 SL 0508 1512010069 PHONE: (626) 285-0468 EXT: LEGAL ID: NO. OF CONST BUILDING ADDRESS: TR: 10558 LT: 27 BL: .001 SQ. FT STORIES TYPE 5325 GLICKMAN AV ISTRUCTURE: 17 V -B I TEMP CA 917803329 ASSESSOR INFORMATION NUMBER: I NEAREST CROSS STREET: 8585-003-006 I I THOMAS PAGE: 597 GRID: B4 LOCALITY: TEMPLE CITY TENANT: EXIST BLDG USE: RESID USE 20NE: R-1 I TISSUED ON: PROCESSED BY: (EXIST OCC GRP: (12/01/15 SR OWNER: TEL. NO: IBLDGS. NOW ON LOT: VALUATION: (FINAL DATE F NAL CODE: KOO, JAMES I 7,800 I 5325 GLICKMAN AVESPT�N(/(/- {/�/ TEMPLE CITY CA 91780 FEES PAID DE 0 F WORK IT/O EXISTING ROOF MATERIAL INSTALL NEW 7/16" OSB PLYWOOD. IFEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IINSTALL NEW GAF CLASS "A" COMP SHINGLES. SRAKEWOOD COLOR APPLICANT: TEL. NO: I ION HOUSE TA, DAVID (909) 598-8980- IAA BLDG PERMIT ISSUANCE 34.40 1 20300 E CARREY ROAD IAB STATE GREEN BLDG FEE 7800.00 VAL 1.00 ISPECIAL CONDITIONS: WALNUT CA 91789 IAC STRONG MOTION REBID 7800.00 VAL 1.00 1 ID2 PERMIT W/O EN -HC 7800.00 VAL 228.40 1 TOTAL FEES 264.80 CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE SUNSHINE ROOFING, INC. (909) 598-8988- 1 1 516 N DIAMOND BAR BLVD #183 LIC. NO ]LOCATION AND SETBACKS DIAMOND BAR CA 91765 755126 * I ] ISOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: I (FOUNDATION/TRENCH FORMS LIC. N0: (SLAB/UNDER FLOOR I I I (RAISED FLOOR FRAMING I I MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:I (UNDERFLOOR INSULATION 3 001 SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: I ] NO 21 I R00F iROOSHEATHING r� ♦� SCHOOL WITHIN HAZARDOUS 1 1SHEAR PANELS 1 AIR QUALITY: 1000 FEET MATERIALS NO NO NO i (FRAME INSPECTION I I ] IFIRE SPRINKLER HANGERS I I I I I I ]INSULATION/WEATHER STRIP, 1 I (INTERIOR LATH/DRYWALL (EXTERIOR LATH I (RATED FLOU A/CEIL ASSEM. I ] I ] RATED WALL ASSEMBLIES ] PERMIT EXPIRES 100 DAYS IF 1) WORK DOES NOT COMMENCE, OR I IRATED SHAFTS/OPENINGS 2) WORK IS SUSPENDED OR ABANDONED, OR I I 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION IT -BAR CEILINGS ADDITIONAL DATA ON FILE I ILOT DRAINAGE IREPORT ID: DPR261 ROUTE TO: 050508 I I I 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).): (_,) 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 Contractor pursuant Ito the Contractors' State License Law). LICENSED CONTRACTOR'S DECLARATION JOB ADDRESS I hereby affirm under penalty of perjury that I am licensed under LOCALITY provisions of Chapter 9 (commencing with Section 7000) of I Division 3 of the Business and Professions Code, and my license is in full force and effect. HAZARDOUS MATERIAL DECLARATION License Class License No. ,y� J 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 Date ontractor Si�,ture- i// information guide? WORKERS' COMPENSATION 6ECLARATION Yes ❑ No ❑ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION Will 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 FORIN SECTION 3706 OF THE LABOR CODE, INTEREST, AND Yes ElN o ❑ ATTORNEY'S FEES. i 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. PNo. :olicy/ 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 y✓o ers' aompensation sura licy numib>ert Carrier Po cY Number Expiration Date Name of Agent Phone Number (_) I am exempt from licensure under the Contractors' State (— I certify that, in the performance of the work for which this License Law for the following reason: 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 By my signature below I acknowledge that, except for my !workers'com sation provisions o999fsssSeeeection 3700 of the Labor personal residence in which I must have resided for at least ode�lshal rthwith comply with th wsions one year priorlto completion of the improvements covered by this permit, I cannot legally sell a structure that I have builjAsZr /� /� 12 owner -builder if it has not been constructed in its entirety by Sig atur ot'A�cant L Date licensed contractors. I understand that a copy of the applicable law. Section 7044 oftheBusiness and Professions Code, is I have read the hazardous materials Informatlon guide and the SCAQMD permitting checklist, I understand my requirements 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). Lenders Name Lender's 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 available upon request when this application is submitted or at LOBBYIST ORDINANCE CERTIFICATION provided is correct. the following Web site: htto://www.fecinfb.ca.aovlcalaw.htmi. Complete this section for permits in I agree to comply with all applicable city and county Unincorporated Los Angeles County only ordinances and state laws relating to building This is to certify that I, as permit applicant, am familiar with the construction. Date: requirements of Los Angeles County Code Chapter 2.160 at seq., (relating to the Los Angeles County Lobbyist Ordinance) and that I authorize representatives of this county to enter the Signature of Property Owner or Authorized Agent all persons acting on behalf of myself compiled and will continue above -identified property for inspection purposes. to comply therewith through the applicatifl ass. �=� Signature of Pro arty Owner_or-P, oozed Agent �IAp}p- ica, t Print Na / Apprpntgn tura / � . fn fi � I VX,—' "tet .�' , // `� Date 12— Company - Name _J D5.e /(((