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Home My Public Portal About9525 GIDLEY ST_Electrical_8/28/2014_' COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: PR: 12998 LT: 56 ASSESSOR INFORMATION NUMBER: 3592-002-057 DWNER: TEL. NO: RUNG JIE PAN (626) 823-6968 2209 KINGSBRIDGE CT SAN DIMAS CA APPLICANT: TEL. NO: PERFECT DESIGN, RAYMOND ZHONG (626) 289-8808- 2416 W VALLEY BLVD. ALHAMBRA CA 91803 CONTRACTOR: TEL. NO: VIA HOME INC. (626) 575-8882- 2275 HUNTINGTON DR. #559 LIC. NO SAN MARINO CA 91108 972462 ARCHITECT OR ENGINEER: TEL. NO: PERFECT DESIGN AND DEVELOPMENT (626) 289-8808- 2416 E. VALLEY BLVD. LIC. NO: ALHA4BRA, CA 91803 NONE TEMPLE CITY # 0508' 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: FEES PAID DESCRIPTION: QUANTITY: DOM: AMOUNT: PC CITY $109.35 MIN 0.00 630.20 PERMIT ISSUANCE FEE 27.80 120V, 15/20A BR CKTS 45.00 BR 670.40 OUTLETS-LGT,SW,RECP 50.00 OUT 79.30 LIGHTING FIXTURES 22.00 LGT 41.70 N -RES EX FANS LT 3HP 2.00 EX 30.60 HEAT PUMPS +3-10HP 2.00 HT 39.40 200 AMP PANELS, MCC 1.00 PAN 38.90 n TOTAL FEES 1,558.30 a-0 jvo REPORT ID: DPR265 ROUTE TO: BS0508 ELECTRICAL PERMIT EL 0508 1405140038 BUILDING ADDRESS: 9525 GIDLEY ST TEMP CA 917804214 NEAREST CROSS STREET: TEMPLE CITY THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY CA ISSUED ON: PROCESSED BY: PLAN BY: 08/28/14 SR FINAL D TE FINAL B CODE: DESCRIPTION OF WORK ELECTRICAL FOR A NEW WAREHOUSE/OFFICE SPACE SPECIAL CONDITIONS: DATE INSPECTOR SIGNATURE TEMPORARY POWER POLE UNDERGROUND CONDUIT LIFER GROUND ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE 111 PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED i,/w/w 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 I, as owner of the property, or my employees with wages as their sole compensation, will do (,/) all of or U portions of the I hereby affirm under penalty of perjury that I am licensed under I LOCALITY provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full fort nd effect. �� HAZARDOUS MATERIAL DECLARATION license Class � License No. Will the applicent or future building occupant handle a hazardous '� ��Fhnnr aterial or a mixture containing a hazardous material equal to or DaC tractor Si nature, t _ �reater than the amount specified on the hazardous materials zs�� 9 (fUl//�� mformationguide? W K S' COMPENSATION DE LARATION Yes ❑ No ❑ 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. work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The I hereby affirm under penalty of perjury one of the following Contractors' State License Law does not apply to an owner of declarations: property who, through employees' or personal effort, builds or 1 have and will maintain a certificate of consent to self - improves the property, provided that the improvements are not insure for workers' compensation, issued by the Director of 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)7 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. Intended or offered for sale. If, however, the building or Industrial Relations as provided for by Section 3700 of the Improvement is sold within one year of completion, the Owner- Labor Code, for the performance of the work for which this permit ASBESTOS NOTIFICATION Builder will have the burden of proving that it was not built or is iss ed. improved for the purpose of sale.). li No. ❑ Notification letter sent to AQMD and/or EPA I have and will maintain workers' compensation U I, as owner of the property, am exclusively contracting with insurance, as required by Section 3700 of the Labor Code, for ❑ I declare that notification of asbestos removal is not licensed Contractors to construct the project (Section 7044, the pertormance of the work for which this permit Is is5te applicable to addressed project. Business and Professions Code: The Contractors' State Licens kers' tom a sett oli nu P cY Law does not apply to an owner of property who builds or I DECLARATION REGARDING CONSTRUCTION LENDING improves thereon, and who contracts for the projects with a ' r �C [icy nrr 1_, ( xpireti AGENCY licensed Contractor pursuant .to the Contractors' State License ` _ �/I tG Law). Na e o gent Fjhone Number I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for I certity that, in the pe ormance of the work for which this which this permit is issued Section 3097, Civil Code U I am exemdt from licensure under the Contractors' State permit is issued, I shall not employ any person in any manner P ( ). License Law for the following reason: so as to become subject to the workers' compensation laws of 1 P Lenders Name .. Cali ia, and agree t at, if I should become subject to the By my signature below I acknowledge that, except for my wor a s' compensation ov' ' ns of Section 3700 of the Labor personal residence in which I must have resided for at least one year prion to completioq 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.lecinfo.ca.cov/calaw.html. Date: Signature of Property Owner or Authorized Agent `Co e, I shall forthwith co I wi those provision y w/ Lender s Address \1 1 n n � /� ��l UU I By my signature below, I certify uteach d the following: Si at e o pplicant Date I op the property owner or authorized to act on the property owner's behalf. LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits in Unincorporated Los Angeles County only This is to certify that 1, 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 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 authode representatives f this county to enter the abgve;identified property for i spj6d1ion purposes._ SignQur.Q of Property Owner or o etl Age Date U4 /�t i r/