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Home My Public Portal About4929 Golden West Ave_Building_4/21/2014_r COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 5342 LT: 120 ASSESSOR INFORMATION NUMBER: 8589-018-023 0 STEVEN Y;MICHELE W 929 GOLDEN WEST AV EMP 917803938 !, TERENCE W MAIN ST #C-278 MBRA CA 91801 EC -X INC. 0 W. MAIN STREET C-278 HAMBRA, CA 91801 OR ENGINEER: TEL. NO: (626) 643 -1793 - TEL. NO: (626) 379-4900 TEL. NO: (626) 379 -4900 - LIC. NO 990915 TEL. NO: LIC. NO: MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( 3 001 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 21 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO TEMPLE CITY # 0508 BUILDING PERMIT 9701 LAS TUNAS RESIDENTIAL ADD/ALT/REP TEMPLE CITY CA 91780 BL 0508 1404140012 PHONE: (626) 285-0486 EXT: NO. OF CONST NEW BUILDING ADDRESS: SQ. FT STORIES TYPE OCCUR GROUP 4929 GOLDEN WEST AV '.UCTURE: 2150 2 V -B R-3 I TEMP CA 917803938 GARAGE: I NEAREST CROSS STREET: LOWER AZUSA OTHER: I THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY CA '.ST BLDG USE: USE ZONE: ISSUED ON: PROCESSED BY: '.ST OCC GRP: 04/21/14 SR IGS. NOW ON LOT: VALUATION: iFIDAT� FINj�I, $Y: CODE: 100,000 `lt GYn��\V/\ FEES PAID SCRIPTION OF WORK REFRAME (E) PATIO @ BACK TO MATCH THE HOUSE PITCH WITH LIGHT DESCRIPTION: QUANTITY: UOM: AMOUNT:JWEIGHT TILE (5.98 PSP) NEW INTERIOR REMODEL OF 3 1/2 BATHRM, KITCHEN, LAUNDRY RM, CONVERT (E) BEDRM TO LAUNDRY & 1/2 BATH PLANCHECK W/ENERGY 100000.00 VAL 1,211.70 BLDG PERMIT ISSUANCE 27.80 ISPECIAL CONDITIONS: STATE GREEN BLDG FEE 100000.00 VAL 4.00 STRONG MOTION RESID 100000.00 VAL 10.00 PERMIT W/ENERGY 100000.00 VAL 1,425.50 TOTAL FEES 2,679.00 (APPROVALS DATE INSPECTOR SIGNATURE I ADDITIONAL DATA ON FILE ID: DPR261 ROUTE TO: BS0508 LOCATION AND SETBACKS SOILS ENGINEER APPROVAL � FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSOLATION LET LEVEL FLOOR SHEATH 2ND LEVEL FLOOR SHEATH ROOF SHEATHING QQ//II FIRE DEPT. FRAME INSPEC' BLDG DEPT. FRAME INSPECT SHEAR PANELS ) INSULATION/WEATHER STRI P� INTERIOR LATH/DRYWALL EEXTERIOR LATH OOT DRAINAGE SMOKE DETECTION DEVICES ?IRE DEPARTMENT APPROVALI ZA OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION 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 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 Contrbr�tor pursuant ' .to the Contractors' State License Law). L): 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 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.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. License Class T i License IthlZNo. Date l Contractor Signaturetv)A WORKERS' COMPENSATION DE LARATION 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 K 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 agree that, if I should become subject to the workerQsall 'pensation visions of Section 3700 of the Labor Code, Iorthwith m ly with those provisions Signatupplicant 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 a will co e to comply therewith through the application proc s/� -WhA Cil i Appl � r t me+� C Applicantcig�24161v Company Name Date ` P Y 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 X j 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 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-identifi prope for inspection purposes. Signature Pro rty O r or Authorized Agent i Date �2 COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 5342 IT: 120 ASSESSOR INFORMATION NUMBER: 8589-018-023 TENANT OWNER: TEL. NO: LO STEVEN Y;MICHELE W (626) 643-1793- 4929 GOLDEN WEST AV TEMP 917803938 APPLICANT: TEL. NO: CHAN, TERENCE (626) 379-4900- 560 W MAIN ST #C-278 ALHAMBRA CA 91801 CONTRACTOR: TEL. NO: APEC-X INC. (626) 379-4900- 560 W. MAIN STREET #C-278 LIC. NO ALHAMBRA, CA 91801 990915 R ARCHITECT OR ENGINEER: TEL. N0: LIC. NO NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS QUALITY: 1000 FEET MATERIALS NO NO NO TEMPLE CITY # 0508 BUILDING PERMIT 9701 LAS TUNAS ALTERATION/REPAIR TEMPLE CITY CA 91780 BL 0508 1503230084 PHONE: (626) 285-0488 EXT: N0. OF CONST BUILDING ADDRESS: SQ. FT STORIES TYPE 4929 GOLDEN WEST AV STRUCTURE: V -B TEMP CA 917803938 NEAREST CROSS STREET: LOWER AZUSA THOMAS PAGE: 597 GRID: A5 LOCALITY: TEMPLE CITY 0 EXIST BLDG USE: REBID USE ZONE: R-1 ISSUED ON: PROCESSED BY: EXIST OCC GRP: 03/23/15 SR SLUGS. NOW ON LOT: VALUATION: IFINAL DATE FINAL CODE: 10,000 FEES PAID�U I T& WORK (REPLACE 21 WINDOWS WITH SAME SIZE FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: AA BLDG PERMIT ISSUANCE 27.80 AB STATE GREEN BLDG FEE 10000.00 VAL 1.00 (SPECIAL CONDITIONS: AC STRONG MOTION RESID 10000.00 VAL 1.00 D1 PLANCHECK W/O EN -HC 10000.00 VAL 184.10 D2 PERMIT W/O EN -HC 10000.00 VAL 216.60 TOTAL FEES 430.50 (APPROVALS DATE INSPECTOR SIGNATURE ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: ES0508 ON AND SETBACKS ENGINEER APPROVAL .TION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING JNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING 3HEAR PANELS FRAME INSPECTION ?IRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL RXTERIOR LATH iATED FLOOR/CEIL ASSEM. 2ATED WALL ASSEMELIES :ATED SHAFTS/OPENINGS C -BAR CEILINGS :OT DRAINAGE 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 (J) 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 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 Contrhgtor pursuant -to the Contractors' State License Law). ' U 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 which I must have resided for at least one year priori 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: htto://www.lecinfo.ca.cov/calaw.html. 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. License Class ? License No. 77 i 7�Date) Z� O Contractor Signature /, k4 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. 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 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 agree that, if I should become subject to the workers' corn ensation rovisions of Section 3700 of the Labor Code, I s II rthwith ply with those provisions Signature of/Applicant V 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 person acting on behalf of myself complied arid will continue to comply herewith through the application proces . Applicaga (Pd t f� gm) � L Applicant Signatl/_ / E( Sl l(Y Company t 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 ❑ 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 AQMD and/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 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 -!dent' grope inspection purposes. Signature bf P e O e or Authorized Agent /, Date 3 t t