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Home My Public Portal About9165 BIDWELL ST_Plumbing_11/22/2011_COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT GAL ID: : 12977 LT: 18 BL: .001 SESSOR INFORMATION NUMBER: 87-017-034 OMER: TEL. NO: GARCIA SANDY - 9165 BIDWELL ST TEMP 917802447 APPLICANT: TEL. NO: 1 SASSON BEZALEL (310) 433-2066- 1 224 S. TOWER DR. #A 1 BEVERLY HILLS 90211 1 CONTRACTOR: TEL. NO: PARADISE BUILDERS (800) 710-4237- 137 N. LARCHKONT BLVD. #691 LIC. NO LOS ANGELES, CA 90004 583918 ARCHITECT OR ENGINEER: TEL. NO: LIC. NO TEMPLE CITY DATE # 0508 .r(A PLUMBING PERMIT 9701 LAS TUNAS PLASTIC Y/N METAL Y/N 1 PL 0508 1111220010 TEMPLE CITY CA 91780 GAS PIPING PHONE: (626) 285-0488 EXT: HOT WATER HEATER PLUMBING FIXTURES FEES PAID LAWN SPRINKLERS BUILDING ADDRESS: GAS TEST UTILITY COMPANY NOTIFIEDI 9165 BIDWELL ST BE DESCRIPTION: QUANTITY: DUN: AMOUNT:1 TEMP CA 917802447 I NEAREST CROSS STREET: 1 PERMIT ISSUANCE FEE 27.80 THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY, C 7 BATHTUBS/SHOWERS 2.00 FIX 32.50 1 5 LAVATORIES/SINKS 1.00 FIX 16.30 (ISSUED ON: PROCESSED BY: PLAN BY: 5 WATER CLOSET/URINAL 1.00 FIX 16.30 111/22/11 SR TOTAL FEES 92.90 1 FINAL DATE FINAL BY: CODE: SPORT ID: DPR263 ROUTE TO: SS0508 ON OF WORK FOR NEW BATHROOM CONDITIONS: APPROVALS DATE INSPECTOR SIGNATURE UNDER SLAB WORK .r(A WATER SERVICE PLASTIC Y/N METAL Y/N 1 ROUGH PLUMBING GAS PIPING GAS VENT I HOT WATER HEATER PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIEDI CWV I I GRAY WATER SYSTEM 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 (_I 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.) (_) 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.). (_) 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 completion 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: hllp.-LAvwwP-_Ap mfo_c _ v6calaw.hlml- Date: Signature of Property Owner or Authorized Agent 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, and my license is in full force and effect. pr License Class11.� License No. �3 / Date '7.L-�Gontractor Signature l a WORKERS' COMPENSATION DECLARATIO 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 penally 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. ZP i No. I have and will maintain workers' compensation Z, uranbe, as required by Section 3700 of the Labor Code, for the performance of thAwork for whkch this permit is issued. My wort r ' ompe do nsurance carrier and policy m er are: V1�J`r t. 577 t Z Carrier Policy Num Expi ti n 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 act he workers' compensation laws of California, and ag e t t, i I should become subject to the workers' compens i provisions of Section 3700 of the Labor Code, I shall forth omply with those provisions 1 zz- I I Signature of Applican 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 et seq., (relating to the Los Angeles County Lobbyist Ordinance -and that all persons acting on behalf of myself comp) nd ill continue to comply therewith through the application pr . 1�-v 2, ApplicanPrint N�fnnt Sign t e) ApplicauraZ Av7, \Z Company oma Date 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 SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to SCAQMD or EPA ❑ 1 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 Lender's Address By my signature below, I certify to each of the following: I am the properly owner or authorized to act on the property owners 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-ide ed roperty for inspection purposes. Signature o party Owner or Authorized Agent Date rl'�Z-II