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Home My Public Portal About9835 BROADWAY_Building_2/11/2015_COUNTY OF LOS ANGELES TEMPLE CITY k 0508 DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: I NO. OF CONST NEW TR: 13805 LT: 16 SQ. FT STORIES TYPE OCCUR GROUP STRUCTURE: 400 1 V -B R-3 ASSESSOR INFORMATION NUMBER: GARAGE. 8588-015-016 OTHER: TENANT: IEXIST BLDG USE: USE ZONE: EXIST OCC GRP: OWNER: TEL. NO: I BLDGS. NOW ON LOT: VALUATION KUMAR, MRSMRS DEVESH (323) 715-5485- 1 63,: 086 9835 BROADWAY TEMP 917602634 FEES PAID FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: APPLICANT: TEL. NO: O'LEARY, TOM (626) 201-1469- 181 PLANCHECK W/ENERGY 63086.00 VAL 878.50 5823 AGNES AVSNUE IAA BLDG PERMIT ISSUANCE 27.80 TEMPLE CITY CA 91780 IAB STATE GREEN BLDG FEE 63086.00 VAL 3.00 IAC STRONG MOTION ESSIG 63086.00 VAL 6.30 182 PERMIT W/ENERGY 63086.00 VAL 1,033.50 CONTRACTOR: TEL. NO: ID7 ADDNL PLANCHECK FEE 1.00 HOU 109.40 C J L CONSTRUC170N INC. (213) 392-2293- 108 CERTIF OF OCCUPANCY 101.40 801 S. GARFIELD AVE., #238 LIC. NO I TOTAL FEES 2,159.90 ALHAMBRA, CA 91801 492610 I ARCHITECT OR ENGINEER- TEL. N0: LIC. NO: I III NTaP NO: SEWER MAP HOOK: PAGE: FIRE ZONE: CMP: I I I 3 001 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 21 SCHOOL WITHIN HAZARDOUS I AIR QUALITY: 1000 FEET MATERIALS I NO NO NO I I I I i I I* ADDITIONAL DATA ON FILE I I I I IREPORT ID: DPR261 ROUTE TO: BS0508 1 BUILDING PERMIT RESIDENTIAL ADD BL 0508 1501210008 BUILDING ADDRESS: 9835 BROADWAY TEMP CA 917802634 NEAREST CROSS STREET: GOLDEN WEST THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CA ISSUED ON: PROCESSED BY: 02/11/15 SR FI, ALPrS FINAL BY: CODE: (/�ESCCl/R�IPTION OF WORK /-] ADD 400 SF. MASTER BEDROOM, BATHROOM AND 1/2 BATHROOM AND 200 SF. PATIO CONDITIONS: APPROVALS DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS I SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMSI SLAB/UNDER FLOOR RAISED FLOOR FRAMING I UNDERFLOOR INSULATION I I IST LEVEL FLOOR SHEATH i 2ND LEVEL FLOOR SHEATH ROOF SHEATHING % �� FIRE DEPT. FRAME INSPECT �Jj/� ✓ �U/ 1 BLDG DEPT. FRAME INSPECTI /_7rR SHEAR PANELS INSULATION/ HER STRI / INTERIOR LATH/DRYWALL SXTERIOR LATH17 :OT DRAINAGE SMOKE DETECTION DEVICES ?IRE DEPARTMENT APPROVAL - J OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION JOB ADDRESS I hereby affirm under penalty of perjury that 1 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 (,i) all of or (_) 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). (_) I am exemf t 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 cinnot 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: httD://www.leainfo.ca.aov/calaw.htmi. 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. Ifo License Class License No. Date r /I Contractor Signature ��_ 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. 1 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 of the 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 carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone Number ZI 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 Signature of Applicant 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 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 ❑ I 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 concerning 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 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 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 —Property Owner or Authorized Agent Date COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 13805 LT: 16 ASSESSOR INFORMATION NUMBER: 8588-015-016 TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST SQ. FT STORIES TYPE 'URE: 1100 V -B BLDG USE: REBID USE ZONE: R-1 OCC GRP: OWNER: TEL. NO: JBLDGS. NOW ON LOT: VALUATION: KUMAR, MR&MRS DEVESH (323) 715-5485- 3,000 9835 BROADWAY TEMP 917802634 FEES PAID FEE DESCRIPTION: gDANTITY: DOM: AMOUNT: I APPLICANT: TEL. NO: LEE, LEO (626) 695-9507- IAA BLDG PERMIT ISSUANCE 27.80 I 801 E GARFIELD AVE IAB STATE GREEN BLDG FEE 3000.00 VAL 1.00 ALHAMBRA CA 91801 IAC STRONG MOTION REBID 3000.00 VAL 0.50 ID2 PERMIT W/O EN -HC 3000.00 VAL 99.00 TOTAL FEES 128.30 CONTRACTOR: TEL. NO: C J L CONSTRUCTION INC. (213) 392-2293- 801 S. GARFIELD AVE., #238 LIC. NO ALHAMBRA, CA 91801 492610 ARCHITECT OR ENGINEER: TEL. NO: LIC. NO NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 OF FAMILIES: DWELLING UNITS--APT/CONDI STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS QUALITY: 1000 FEET MATERIALS NO NO NO * ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: ES0508 BUILDING PERMIT ALTERATION/REPAIR BL 0508 1503100032 BUILDING ADDRESS: 9835 BROADWAY TEMP CA 917802634 NEAREST CROSS STREET: GOLDEN WEST THOMAS PAGE: 597 GRID: A3 LOCALITY: TEMPLE CITY CA ISSUED ON: PROCESSED BY: 03/10/15 SR FINAL D TE FIN BY: CODE: /r DESCRIPTION OF WORK TEAR OFF REROOF WITH ASPHALT SHINGLES TO MATCH NEW ADDITION SPECIAL CONDITIONS: APPROVALS LOCATION AND SETBACKS FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING SHEAR PANELS FRAME INSPECTION PIRE SPRINKLER HANGERS INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. I RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T -BAR CEILINGS IAT DRAINAGE I DATE INSPECTOR SIGNATURE 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 L) 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 exemi4t 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 c 'nnot 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: httD://www.leainfo.ca.00v/calaw.htmi. 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. License Class /� License No. 7`- 72-6 t� Date Contractor Signature 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 of the 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 carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone Number U I certify that, in the performance of the work for which this permit is issued, 1 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 3l�° Ir Signature of Applicant 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 compiled and will continue to comply therewith through the application process. Applicant (Print Name) Applicant Signature Company Name Date 7 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 �20- 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 ❑ 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 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 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 Property Owner or Authorized Agent Date �i �.