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Home My Public Portal About9525 GIDLEY ST_Plumbing_8/28/2014_COQNTY OF LOS ANGELES TEMPLE CITY # 0508 PLUMBING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS PL 0508 1405140021 BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: FEES PAID BUILDING ADDRESS: TR: 12998 LT: 56 9525 GIDLEY ST _ FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: TEMP CA 917804214 ASSESSOR INFORMATION NUMBER: NEAREST CROSS STREET: TEMPLE CITY 8592-002-057 OW PLANCHECK FEE 0.00 164.10 THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY CA 01 PERMIT ISSUANCE FEE 27.80 TENANT: 17 FLOOR DRAIN (S) 2.00 FIX 32.40 ISSUED ON: PROCESSED BY: PLAN BY: 21 HOSE BIBB(S) 2.00 FIX 32.40 08/28/14 SR 25 LAVATORIES/SINKS 2.00 FIX 32.40 OWNER: TEL. N0: 41 TRAP PRIMERS) 2.00 SYS 32.40 FINAL DATE F HAL CODE: HONG JIE PAN (626) 823-8968- 45 WATER CLOSET/URINAL 2.00 FIX 32.40 2209 KINGSBRIGE CT 47 WATER HEATER(S) 2.00 WIN 32.40 0 SAN DIMAS CA TOTAL FEES 386.30 -lk tfl# POF O PLUMBING FORWWAREHOUSE/OFFICE SPACE APPLICANT: TEL. N0: PERFECT DESIGN, RAYMOND ZHONG (626) 289-8808-`..11�-y��rly 2416 W VALLEY BLVD l Y7 H �l. F"1� )✓J -1 PECIAL CONDITIONS: ALHAMBRA CA 91803 CONTRACTOR: TEL. NO: APPROVALS DATE INSPECTOR SIGNATURE 882- 2227HOME INC. B HUNTINGTON DR. #559 )626) LIC. 75NO UNDER SLAB WORK SAN MARINO CA 91108 972462 e WATER BEVICE r\ PLASTIC N METAL I�N\ 1 ARCHITECT OR ENGINEER: TEL. N0: PERFECT DESIGN AND DEVELOPMENT (626) 289-8808- ROUGH PLUMBING 2416 E. VALLEY BLVD. LIC. NO: ALHAMBRA, CA 91803 NONE GAS PIPING GAS VENT HOT WATER HEATER , PLUMBING FIXTURES LAWN SPRINKLERS GAS TEST UTILITY COMPANY NOTIFIED CWV GRAY WATER SYSTEM REPORT ID: DPR263 ROUTE TO: BS0508 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).): U I, as owner of the property, or my employees with wages as their sole compensation, will do (J) all of or (_) portions of the 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 licenseis in full for and eIf ct '%/ License Class License No. q ntractor Signature 45 �ORKERVCOMPENSATION 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. 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 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 i�sued. improved for the purpose of sale.). Pglic, 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 performance of the work for which this permit is i ued. My applicable to addressed project. Business and Professions Code: The Contractors' State Licen ork�rs�cop��eq¢�tign ir}s}�@npe/ der and policy er are: I Law does not apply to an owner of property who builds i J6 W W I1V L,lj Y.N1I \l �,f1j i _ DECLARATION REGARDING CONSTRUCTION LENDING improves thereon, and who contracts for the projects with a arner ' " o icy u her Expir ion D to AGENCY licensed Contrb?Wr pursuant Ito the Contractors' State License ,J) f -� I g, Law). N'a gent " I"' " �Phbne Number I hereby affirm under penalty of perjury that there is a Construction lending agency for the performance of the work for (_): I am exemplt from licensure under the Contractors' State — I certify that, in th performance of the work for which this which this permit is issued (Section 3097, Civil Code). License Law for the following reason: permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Lenders Name California, and agree that, if I should become subject to the wArr ers' romnensation oAnNisions of Section 3700 of the Labor , 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: hfto://www.leeinfo.ca.eov/calaw.html. 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 ❑ N o ❑ 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. Date: Signature of Property Owner or Authorized Agent ode. I shall forthwithTPl/with those prg��App i to e o )leant 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 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 cc truction. I thorize representatives of this county to enter the ove-identified propo inspection purposes. ig ture of Property Ow o Author' gent Uo.t,t Date,:,-?/ V