HomeMy Public PortalAbout9120 EMPEROR AVE_Building_3/23/2015_COUNTY OF LOS ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING AND SAFETY / LAND DEVELOPMENT
LEGAL ID:
JTR: 14396 IT: 4
1
ASSESSOR INFORMATION NUMBER:
15382-015-004
TENANT:
OWNER:
ITRAN, MICHAEL
19120 EMPEROR AV
ISGAB 917752019
APPLICANT:
!BALLESTEROS, RON
10927 DOWINEY AVE p0
]DOWNEY CA 90241
CONTRACTOR:
EDMCND HANK KWONG
360 E FIRST STREET #500
TUSTIN CA 92780
ARCHITECT OR ENGINEER:
ALVAREZ DESIGN STUDIOS INC.
10927 DOWNEY AVE., SUITE D
DOWNEY, CA 90241
TEMPLE CITY M 0508
9701 LAS TIBIAS
TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
BUILDING PERMIT
NEW RESIDENTIAL
BL 0508 1408260010
TEL. NO:
(562) 861 -3883 -
TEL. NO:
(714) 293 -1576 -
LTC. NO
756780
TEL. NO:
(562) 861 -3883 -
LIC. NO:
NONE
NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
3 01
OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS:
1 NO O1
SCHOOL WITHIN HAZARDOUS
QUALITY: 1000 FEET MATERIALS
NO NO NO
B1 PLANCRECX .W/ENERGY 390050.00 VAL 3,000.80
AA BLDG PERMIT ISSUANCE 21.80
AB STATE GREEN BLDG FEE 390050.00 VAL 16.00'
AC STRONG MOTION RESID 390050.00 VAL 39.00
B2 PERMIT W/ENERGY 390050.00 VAL 3,530.30
08 *C
EER�1T��IJJF 1yO(FF'�OCCUPANC//Y�Q .]�Ipy]'�AL �(^ ,E//,�7��/�jj� 101.40
�f"'✓`r'_ �� i��'t'1• '/"V-✓�'{I.N"�' 6 15�. ,30
OP (4) 411efic,
G$ri2i�'rj �NLF✓�f%d ,1i� C4tG%1/dCq'L-0�i�FJG)A71�
c
TD: DPR261 ROUTE TO: BS0508
AL CONDITIONS:
SPRINKLERS REQUIRED
APPROVALS DATTEE'� INSPECTOR SIGNATURE
LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL �
FOUNDATION/TRENCH FORMS
LH/UNDER FLOOR �1
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
IST LEVEL FLOOR SHEATH
—_
2ND LEVEL FLOOR SHEATH
ROOF SHEATHING
FIRE DEPT. FP.AME INSPECT
BLOC DEPT. FRAME INSPECT
SHEAF. PANELS 1
INSULATION/WEATHER STRIP,
INTERIOR LATH/DRYWALL
EXTERIOR LATH
SMOKE DETECTION DEVICES
FIRE
NO OF
CONST NEW BUILDING ADDRESS:
SQ. FT
STORIES
TYPE
OCCUP GROUPI 91.20 EMPEROR AV
ISTRUCTURE:
2634
2
V -B
R-3 I SGAB CA 917752019
GARAGE:
641
1
V -B
U I NEAREST CROSS STREET: LOMA
OTHER:
245
1
V-6
U I THOMAS PAGE: 596 GRID: H1 LOCALITY: TEMPLE CITY
USE ZONE: A-1 ISSUED ON: PROCESSED BY:
03/23/15 SR
,
TEL. NO: BLDGS. NOW
(626) 298-9079-
ON LOT:
VALUATION: FINAL ATE p F NAL CODE:
390,050 q Z(`
FEES
PAID IDES IPTION �F WORK
Wn-H
INEW 2 -STORY SFD: 4 BEDROOMS, 4.5 BATHROOMS ATTACHED 3
FEE DESCRIPTION:
QUANTITY:
QOM: AMOUNT:JCAR GARAGE, PATIO AND BALCONY 100 SQ. FT.
TEL. NO:
(562) 861 -3883 -
TEL. NO:
(714) 293 -1576 -
LTC. NO
756780
TEL. NO:
(562) 861 -3883 -
LIC. NO:
NONE
NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
3 01
OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS:
1 NO O1
SCHOOL WITHIN HAZARDOUS
QUALITY: 1000 FEET MATERIALS
NO NO NO
B1 PLANCRECX .W/ENERGY 390050.00 VAL 3,000.80
AA BLDG PERMIT ISSUANCE 21.80
AB STATE GREEN BLDG FEE 390050.00 VAL 16.00'
AC STRONG MOTION RESID 390050.00 VAL 39.00
B2 PERMIT W/ENERGY 390050.00 VAL 3,530.30
08 *C
EER�1T��IJJF 1yO(FF'�OCCUPANC//Y�Q .]�Ipy]'�AL �(^ ,E//,�7��/�jj� 101.40
�f"'✓`r'_ �� i��'t'1• '/"V-✓�'{I.N"�' 6 15�. ,30
OP (4) 411efic,
G$ri2i�'rj �NLF✓�f%d ,1i� C4tG%1/dCq'L-0�i�FJG)A71�
c
TD: DPR261 ROUTE TO: BS0508
AL CONDITIONS:
SPRINKLERS REQUIRED
APPROVALS DATTEE'� INSPECTOR SIGNATURE
LOCATION AND SETBACKS
SOILS ENGINEER APPROVAL �
FOUNDATION/TRENCH FORMS
LH/UNDER FLOOR �1
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
IST LEVEL FLOOR SHEATH
—_
2ND LEVEL FLOOR SHEATH
ROOF SHEATHING
FIRE DEPT. FP.AME INSPECT
BLOC DEPT. FRAME INSPECT
SHEAF. PANELS 1
INSULATION/WEATHER STRIP,
INTERIOR LATH/DRYWALL
EXTERIOR LATH
SMOKE DETECTION DEVICES
FIRE
OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION I JOB ADDRESS
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).):
U t, as owner of the property, or my employees with wages as
their sole compensation, will do (✓) all of or U 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 to'the Contractors' State License
Law).
U I am exempt from licensure under the Contractors' State
License Law for the following reason:
By my signature below I acknowledge that, except for my
personal residence in which I must have resided for at least
one year prior) to complefiory of the. improvements covered by
this permit, I cannot legally sell a structure that I have built as an
owner -builder If it has not been constructed in its entirety, by
licensed contractors. I understand that a copy of the applicable
law, Section 7044 of'the Business and. Professions Code, is
available upon request when this application is submitted or at
the following Web site: htto://www,leain(o.ca.cov/calaw.html.
Date:
Signature of Property Owner or Authorized Agent
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, and my
license is in full force and effect.
License Class�L License No.
Date % I7Cvonlmctor Signature /Z X
V
WORKERS' COMPENSATION DECLARATION
WARNING: FAILURE TO SECURE WORKERS' 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 IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
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 ofthe
-
Labor Code, for the performance of the work for which this -permit
is issued.
Policy No.
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 Expiration Date
Name of Agent Phone Number
I 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 with those provisions
3 /a3(IS
Signature of Applies Date
LOBBYIST ORDINANCE CERTIFICATION
Complete 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 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 (Print Name) Applicant Signature
Company Name Date
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 ❑ N o ❑
1 have read the hazardous materials information guide and the
SCAQMD permitting checklist, 1 understand my requirements
under the Los Angeles County Code Title 2, Chapter 220'
Sections 220.100 through 220.140 conceming 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).
Lender's Name
Lenders Address
By my signature below, I certify to each of the following:
I am the property owner or authorized to act on the
property owner's behalf.
I have read this application and the information I have
provided is correct.
I agree to comply with all applicable city and county
ordinances and state laws relating to building
construction.
I authorize representatives of this county to enter the
above -identified property for inspection purposes.
Signature of.Rroerty Owner or Authorized Agent
Data
3 a 3 rs