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Home My Public Portal About5720 OAK AVE_Swimming Pool_10/15/2001_' COUNTY OF LOS ANGELES TEMPLE CITY # 0508 COMBINATION SWIMMING POOL PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS CP 0508 0110120003 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: POOL TYPE: RESIDENTIAL/SPA BUILDING ADDRESS; TR: 6561 LT: 727 UN: .002 SIZE: 392 SQ.FT CONST TYPE: VN 5720 OAK AV TEMP CA 917802430 ASSESSOR INFORMATION NUMBER: USE ZONE: R-1 NEAREST CROSS STREET: WORKMAN/LAS TUNAS 8587-010-024 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY VALUATION: TENANT: 17,500 ISSUED ON: PROCESSED BY: EXPIRES ON: 10/15/01 JK 04/13/02 FEES PAID OWNER: TEL. NO: FINAL D TE FINAL BY: CODE: BATEMAN ROBERT E;PATRICIA A (626) 285-8782- FEE DESCRIPTION: QUANTITY: UDM: AMOUNT:-- 5720 OAK AV -' TEMP 917802430 02 PERMIT ISSUANCE FEE 27.75 UWRIPTION OF WORK 04 COMB POOL STD PC 17500.00 VAL 233.85 NEW GUNITE SWIMMING POOL WITH ATTACHED SPA 06 COMB POOL PERMIT 17500.00 VAL 776.10 STD PLAN #26077 APPLICANT: TEL. NO: 08 STRONG MOTION RESID 17500.00 VAL 1.75 SWAN POOLS (626) 966-8631- 16 POOL BARRIER - FENCE 92.25 961 N. AZUSA AVE TOTAL FEES 1,131.70 SPECIAL CONDITIONS: COVINA, CA CONTRACTOR: TEL. NO: - APPROVALS DATE INSPECTOR SIGNATURE SWAN POOLS COVINA (626) 966-8631- 961 AVE LIC. NO SPA/POOL LOCATION COVINAACAS91722 477968 C53 _ HEATER LOCATION ARCHITECT OR ENGINEER: TEL. N0: _ i �I OVERHEAD CONDUCTOR CLEAR LIC. NO: LIGHT CONDUIT ELECTRICAL BONDING G�- MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: FIRE DEPT HYDRANT APPROV 150H265 3 STEEL 5 FORMS NO. OF FAMILIES: DWELLING UNITS: APT/CONO: STAT CLASS; 'q NO 31 _ GAS LINE L SCHOOL WITHIN HAZARDOUS CONDUIT/ELECTRICAL AIR QUALITY: 1000 FEET MATERIALS NO NO NO SEWER - REQUIRED TOTAL SETBACK FROM EXIST ANTI-SYPHON VALVE SET BACK YARD: HWY: PROP LINE: WIDTH: i / FS�DNT PL-E "1 - � • V' FENCING AND GATES I$I�, fv PL- �..�- �..-�.._�•-'- //.; GAS TEST Poo/ u 5'%-OL FLa-CLb�.oTL� No? SAP/BACKWASH RECEPTOR SPA/POOL COVER FINAL FIRE DEPT APPROVAL i FINAL ELECTRICAL REPORT ID: DPR268 ROUTE TO: BS0508 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 Profession((/ss Code, and my license is in full force and effect. L¢ a Class` Lic. No X -Mom o'f\ Io-tS U 1 Contractor's Signature Date OWNER -BUILDER DECLARATION I hereby affirm untler penalty of perjury that I am exempt from the Contractors 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.8 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 o7 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 at her own employees, provided that such improvements are not intended or uttered 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 owner of property who builds or improves thereon, and who contracts for such projects with a contractors) licensed pursuant to the Contractors License Law.). WORKER'S COMPENSATION DECLARATION I hereby affirm underpenalty of perjury one of the following declarations. ❑ 1 have and will maintain a certificate of consent to self -insure for workers compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. CVfhave and will maintain workers compensation insurance, as required y Section 3700 of the Labor Cotle, for the performance of the work for which this permit is issued. My workers compensation insurance carrier and policy numb rare: n• /� 1 �y Carrier 0, \ 0lN\.D 1 kE )\Policy Number L ❑ 1 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 should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply -th those provisions. Applicant Signature Date WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE /S 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 LOBBYIST ORDINANCE CERTIFICATION r Complete this section for permits in L 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 el 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 Owner Signature Date Company Name (it employed by an entity/agency) Date 11011 ADDRESS I 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 (SCAOMD)? See permitting checklist for guidelines Yes ❑ No ❑ I have read the hazardous materials information guide and the SCAOMD 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 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.). Lenders Name Lenders Address 90°q? I certify that 1 have read this application and state under the penalty of perjury that the above information is correct. I agree to comply with all City and County ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter upon the ab -mentionedproperty for inspection purposes. �-n� ID-Icrd Applicant or Agent Signature Date