HomeMy Public PortalAbout5721 OAK AVE_Building_1/30/2007_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT
DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD
BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0701250009
PHONE: (626) 285-0488 EXT:
LEGAL ID: N0. OF CONST NEW BUILDING ADDRESS:
TR: 6561 IT: 730 UN: .002 SQ. FT STORIES TYPE OCCUP GROOPI 5721 OAK AV
ISTRUCTURE: 695 1 VN R3 I TEMP CA 917802431
ASSESSOR INFORMATION NUMBER: GARAGE: 540 1 VN U1 NEAREST CROSS STREET:
8587-005-005 OTHER: THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY,
TENANT: JFXIST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY; EXPIRES ON:
EXIST OCC GRP: 101/30/07 JK 01/25/08
1 I
OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: IALL T FINAL �`: CODE:
CHAN, AK AV . WING - i 90,630 i/ 1 ��r/I
5721 OAK AV IIU !
TEMP 917802431 FEES PAID IPTION OF WORK
695 S.F. ADDITION FAMILY ROOM, 2 BATHROOMS, DEMO (E) GARAGE
FEE DESCRIPTION: QUANTITY: UOM: AMOUNT:IAND BUILD 2 CAR GARAGE WITH WORKSHOP 540 S.F.
APPLICANT: TEL. NO:
TOM O'LEARY (626) 287-0937- IAA BLDG PERMIT ISSUANCE 27.75 I
5823 AGNES AVENUE IAC STRONG MOTION REBID 90630.00 VAL 9.06 ISPECIAL CONDITIONS:
TEMPLE CITY CA 91780 IB1 PLANCHECK W/ENERGY 90630.00 VAL 1,128.30
IB2 PERMIT W/ENERGY 90630.00 VAL 1,327.43
I TOTAL FEES 2,492.54
CONTRACTOR: TEL. NO: (APPROVALS DATE INSPECTOR SIGNATURE
TOM O'LEARY CONSTRUCTION (626) 287-0927- I
5823 AGNES AVENUE LIC. NO I ILOCATION AND SETBACKS
TEMPLE CITY, CA 91780 489354 B-1
SOILS ENGINEER APPROVAL mxIA . Mi
ARCHITECT OR ENGINEER: TEL. NO: i iFOUNDATION/TRENCH FORKSLr IL
SAWAYA, RAMZY 7 r-
1960
1960 SANTA ANITA AVE. LIC. NO: (SLAB/UNDER FLOOR
SIERRA MADRE, CA NONE Ifly
(RAISED FLOOR FRAMING
I
MAP N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CmP:l (UNDERFLOOR INSULATION
3 DLI I 1 1
11ST LEVEL FLOOR SHEATH
NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
NO 21 1 12ND LEVEL FLOOR SHEATH
SCHOOL WITHIN HAZARDOUS I iROOF SHEATHING r� ���2- /
AIR QUALITY: 1000 FEET MATERIALS •`
NO NO NO IFIRE DEPT. FRAME INSPECTI' - r
I I
REQUIRED TOTAL SETBACK FROM EXIST I (BLDG DEPT. FRAME INSPECTI
SET BACK YARD: HWY: PROP LINE: WIDTH:
FRONT PL- i iSHEAR PANELS
SIDE PL-
'INSULATION/WEATHER STRIP(
,�% lllj�/ /y •-'l-G%j QC�Y
INTERIOR LATH/DRYWALL I"
IEXTERIOR LATH / W
ILOT DRAINAGE
(SMOKE DETECTION DEVICES
(FIRE DEPARTMENT APPROVAL
REPORT ID: DPR261 ROUTE TO: BS0508
LICENSED CONTRACTOR'S DECLARATION
I herebyalhrm 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.
and my license isinfull tome and effect.
License Class B_ _J_ Lm. No.
i
Cdnt'ca�Si e / Dat' e
OWNER -BUILDER DECLARATION
I hereby affirm under 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 live hundred dollars ($500).).
❑ 1 am exempt under Sec , SA P.C. for this reason:
[ Electrical, Plumbing & Sewer Permits Only ]
❑ 1, 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 properly, 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. 11, however, the building or Improvement is sold within
one yearof 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 contractor(s) licensed pursuant to the Contractors License Law),
WORKER'S COMPENSATION DECLARATION
I hereby affimr under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
workels 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 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 compensation insurance carder
and policy number are:
Carrier
Policy Number
❑ 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 worker's compensation laws of California, and agree that if
I should become subject to the worker's compensation provisions of
Section 3700 of the Labor Code, I shall forthwith comply with those
provisions.
Applicant Signalum r Date
WARNING: FAILURE TORE WORKER'S COMPENSATION
COVERAGE IS 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 1N SECTION 3706
OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LOBBYIST ORDINANCE CERTIFICATION
Complete this section for permits in 1
unincorporated Los Angeles County only J
This Is to certify that I, as permit applicant, am familiar with the requirements
of Los Angeles County Code Chapter 2.160 at 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 (Pont Name) Applicant Signature
Owner Signature - Date Company Name (if employed by an entity/agency) Date
JOB ADDRESS
LOCALITY
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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 an the hazardous materials information guide?
Yes ❑ No ❑
Will the intended use of the building by the applicant or tutors !wilding
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 foroblaining a permit from
the SCAOMD.
ASBESTOS NOTIFICATION
❑ Notification letter sent to SCAOMD or EPA
❑ I 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
Lender's Address
lk-p°tz?
1 certify that I 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
above-mentioned property rinspection purposes.
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plicant or Agen ignature � - Date