The URL can be used to link to this page

Home My Public Portal About5909 CLOVERLY AVE_Building_4/30/2015_COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT L ID: 8526 IT: 10 BL: .001 SSOR INFORMATION NUMBER: -008-017 OWNER: TEL. NO: TED CHAD - PO WEI (626) 572-7442- 616 N GARFIEL AVENUE MONTEREY PARK 91755 APPLICANT: TEL. NO: MAKARENA, MANUEL (323) 855-6669 4823 ROWLAND AVENUE EL MONTE CA 91731 CONTRACTOR: TEL. NO: GOLD STAR ROOFING (323) 855-6662- 4425 ROWLAND AVE LIC. NO UNIT A 741676 C39 EL MONTE CA 91731 ARCHITECT OR ENGINEER: TEL. NO: LIC. NO MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 22 SCHOOL WITHIN HAZARDOUS QUALITY: 1000 FEET MATERIALS NO NO NO PERMIT EXPIRES 6 MONTHS DATE OF ISSUANCE OR DATE OF LAST VALID INSPECTION. TEMPLE CITY M 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST SQ. FT STORIES TYPE STRUCTURE: 80 V -B EXIST BLDG USE: COtM1E USE ZONE: C-1 EXIST OCC GRP: SLUGS. NOW ON LOT: VALUATION: 20.000 FEES PAID FEE DESCRIPTION: QUANTITY: UOM: AMOUNT AA BLDG PERMIT ISSUANCE 27.80 AB STATE GREEN BLDG FEE 20000.00 VAL 1.00 AS STRONG NATION OTHER 20000.00 VAL 4.20 D2 PERMIT W/0 EN -HC 20000.00 VAL 384.60 ia.FEES 417 60 (REPORT ID: DPR261 ROUTE TO: BS0508 n BUILDING PERMIT ALTERATION/REPAIR BL 0508 1504300074 BUILDING ADDRESS: 5909 5927 CLOVERLY AV TEMP CA 917802126 NEAREST CROSS STREET: THOMAS PAGE: 596 GRID: J3 LOCALITY: TEMPLE CITY ISSUED ON: PROCESSED BY: 04/30/15 SR FINAL ATE FINAL B CODE: d`1 DES C PTI(iti OF WORK TEAR OFF AND RECOVER USING A 30 YR DEMENTIONAL SHINGLES CONDITIONS: APPROVALS DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS 1 SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING SHEAR PANELS FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOA/CEIL ASSEM. RATED WALL ASSEMBLIES T -BAR CEILINGS LOT DRAINAGE Y IPATEL 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 (✓) 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 1, 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 ContractorsState License Law). (_) I am exemdt 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 whicf I must have resided for at least one year priori to completion; of the improvements covered by this permit, I c'Prot 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: hfD://www.leainfb.m.aov/mlaw.html.. 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. / � )4censsee Class y (6'rG 34 License No. —,i- 6 -/Bate Date �b Contractor Signa ure WORKERS' COMPENSATION DECLARATION WANING: 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 ffirm under penalty of perjury one of the following decla Ions: 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 whichthis 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 wo com ensati n insurance m r a lic number ar sr'�`A = ��v �-FIs � Carrier Po icy 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 ree that, if 1 should become subject to the workers' corn sation provisions of Section 3700 of the Labor Code, I sha o wi those provisions r - 30 Igna re of Applicant Date LOBBYIST ORDINANCE CERTIFICATION Complete this section forpennits 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 complied and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company Name 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 ❑ N o ❑ 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 requiremgnis 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 AQMD and/or EPA ❑ 1 declare that notification of asbestos removal is not IS 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). Lenders Name Lender's Address By my signature below, I certify to'each of the following: I am the property 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-identifiedproperty for inspection purposes. Signatw;&Vfty6wner or Authorized Agent Date% �� lJ