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Home My Public Portal About5709 OAK AVE_Plumbing_8/22/2003_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 0308220007 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: TR: 6561 LT: 729 BL: .001 ASSESSOR INFORMATION NUMBER: 8587-005-003 TENANT OWNER: TEL. NO: GOODING KENNETH B & SHARON R (626) 287-7429- 5709 OAK AV TEMP 917802431 FEES PAID FEE DESCRIPTION: QUANTITY: UOM: 01 PERMIT ISSUANCE FEE TEL. NO: 21 HOSE BIBB(S) 1.00 FIX 25 LAVATORIES/SINKS 1.00 FIX 26 MISCELLANEOUS FIXTUR 1.00 FIX 45 WATER CLOSET/URINAL 1.00 FIX 47 WATER HEATER(S) .. 1.00.WTH 9860 LOWER AZUSA RD. TOTAL FEES UNDER SLAB WORK c s BUILDING ADDRESS: 5709 OAK AV - AMOUNT: TEMP CA 917802431 NEAREST CROSS STREET: LIVE OAK 27.75 THOMAS PAGE: 596 GRID: J3 LOCALITY:. TEMPLE CITY 16.20 16.20 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 16.20 08/22/03 JK 02/18/04 16.20 16.20 FINAL DATE FINAL B_ Y: BODE: 108.75 FI /AT E FINAL BY: DESCRIPTION OF WORK PLUMBING FOR GARAGE WITH WORKSHOP, STORAGE AND BATHROOM APPLICANT: TEL. NO: FRANK MARRONE & SONS (626) 444-2548- 9860 LOWER AZUSA SPECIAL CONDITIONS: EL MONTE 91731 CONTRACTOR: TEL. NO: APPROVALS FRANK MARRONE AND SONS (626) 444-2548- 9860 LOWER AZUSA RD. LIC. NO UNDER SLAB WORK EL MONTE, CA 91731 397884C36 WATER SERVICE PLASTIC Y/N METAL Y/N ARCHITECT OR ENGINEER: TEL. NO: R J A DESIGN (626) 705-7019- ROUGH PLUMBING 1144 N. EDENFIELD AVE. LIC. NO: COVINA, CA 91722 NONE GAS PIPING GAS VENT HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIEC CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 DATE INSPECTOR SIGNATURE f4 v C�-� 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, 9nd my license is in full force and effect d 'a Lic se ass ic. o. Z ct s ig Da OWNER -BUILDER DECLARATION I heaffirm under penalty of perjury that I am exempt from the Contr tors License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom 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).): ❑ 1 am exempt under Sec. , B.& P.C. for this reason: [ Electrical, Plumbing & Sewer Permits Only ] ❑ I, as owner of the property, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself, provided that such 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 he or she did not build or improve for the purpose of sale.). [ All Other Permits ] ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such 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 he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an uwner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law.). WORKER'S COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Carrier Policy Number -- 0 l Q2D5 ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in a manner so as to become subject to tW worker's compensation laws California, and agree that if I should ome s ject to the er' comp ation provisions of S ti 0 of t Labor C e, s I fort it comply with those ovisi 0'72, Applica ign re Da WARN NG F !LURE TO SECURE WORKER'S COMPENSATION COVE AG ! UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR1M1 A PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAN DOLLARS ($100,000), 1N ADDITION TO THE COST OF COMPENS ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. LOBBYIST ORDINANCE CERTIFICATION CComplete 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 et 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 JOB ADDRESS 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 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 (SCAQMD)? See permitting checklist for guidelines. Yes ❑ No ❑ I have read the hazardous materials information 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 SCAOMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to SCAQMD or EPA ❑ 1 declare that notification of asbestos removal is not applicable to addressed project. 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 (Sec. 3097, Civ.C.). Lender's Name Lender's Address "Qq? 1 certify that l have read this application and state under the penalty of perjury that the above information is correct. l agree to comply with all City and County ordinances and State laws relating to building construction, nd hereby authorize repZenta rues of C unty o nterupon the obme�ition pr p for i e tion purposes. Company Name (if employed by an entity/agency) Date `r A ca Owner Signature Date ,Tr Ag@nLSicJtfaTure �f Dbte c � I