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Home My Public Portal About6156 Kauffman Ave_Building_11/24/2014_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 1410300019 PHONE: (626) 285-0488 EXT: LEGAL ID: NO. OF CONST NEW BUILDING ADDRESS: ON FILE SQ. FT STORIES TYPE OCCUP GROUPI 6156 KAUFFMAN AV ]STRUCTURE: 224 1 V -B R-3 I TEMP CA 917801743 ASSESSOR INFORMATION NUMBER: GARAGE: NEAREST CROSS STREET - 5385 -020-002 OTHER: THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CA TENANT: EXIST BLDG USE: PHOTO ISSUED ON: PROCESSED BY: IEXIST OCC GRP: R-3 111/24/14 SR OWNER: TEL. NO: SLUGS. NOW ON LOT: VALUATION: I ]FINAL TE FINAL BY: CODE: QUACH, MOSES (626) 257-0415- 8,300 ]L)r1 6156 KAUFFMAN AVE i L)AR TEMP 917802239 ] FEES PAID ] CR iON F WORK I ] 13.57 KW PV SYSTEM (14) MODULES IFEE DESCRIPTION: QUANTITY: DOM: AMOUNT:] APPLICANT: TEL. NO: MORA, STEPHANIE (310) 955-6576- IAA BLDG PERMIT ISSUANCE 27.80 1 5374 W SAN FERNANDO IAB STATE GREEN BLDG FEE 7700.00 VAL 1.00 ISPECIAL CONDITIONS: LOS ANGELES CA 90039 IP1 RES PV PC<IOKW 153.90 1 IP2 INSPCT RES PV <10KW 138.00 ] TOTAL FEES 320.70 ] CONTRACTOR: TEL. NO: ]APPROVALS DATE INSPECTOR SIGNATURE SOLARCITY CORPORATION (323) 899-7400- ] 1 1 5375 W SAN FERNANDO ROAD LIC. NO ] ]LOCATION AND SETBACKS 1 LOS ANGELES CA 90039 888104 ] ISOILS ENGINEER APPROVAL ] ARCHITECT OR ENGINEER: TEL. NO: i (FOUNDATION/TRENCH FORMS ] LIC. NO: ] ]SLAB/UNDER FLOOR ] I IRAIS ED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:( ] ]UNDERFLOOR INSULATION 3 00] FLOOR SHEATHING NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: I I] ] 1 NO 20 IROOF SHEATHING I I ] SCHOOL WITHIN HAZARDOUS ] (SHEAR PANELS AIR QUALITY: 1000 FEET MATERIALS ] NO NO NO 1 ]FRAME INSPECTION I 1 ]FIRE SPRINKLER HANGERS ( ] I I ] INSVLATION/WEATHER STRIP( I] ] (INTERIOR LATH/DRYWALL ] ] ] l 1EXTERIOR LATH ] 1 ] FLOOR/CEIL ASSEM. 1 I iRATEO 1 (RATED WALL ASSEMBLIES 1 (RATED SHAFTS/OPENINGS T -BAR CEILINGS ]LOT DRAINAGE ] IREPORT ID: DPR261 ROUTE TO: BS0508 1 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 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 pursuanLto the Contractors' State License Law). (_) I am exeQt from licensure under the Contractors' State License Law for the following reason: By my signature below 1 acknowledge that, except for my personal residence in which I must have resided for at least one year priorlto 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.00v/calaw.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. License Class % C'UNTY OF LOS ANGELES ` DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT 1G1i ll: ON FILE ASSESSOR INFORMATION NUMBER: 5385-020-002 TENANT OWNER: QUACH, MOSES 6156 KAUFFMAN AVE TEMP 917802239 APPLICANT: SAME AS OWNER CONTRACTOR: SAME AS OWNER ARCHITECT OR ENGINEER: TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: BUILDING PERMIT ALTERATION/REPAIR BL 0508 1311140110 IVV. V[ � tlV1LU 11V li FWUKGJJ: SQ. FT STORIES TYPE 6156 KAUFFMAN AV STRUCTURE: 1800 V -B TEMP CA 917801743 NEAREST CROSS STREET: EXIST BLDG USE: RESID EXIST OCC GRP: TEL. NO: BLDGS. NOW ON LOT: (626) 257 -0415 - FEE DESCRIPTION: TEL. NO: - AA BLDG PERMIT ISSUANCE AB STATE GREEN BLDG FEE AC STRONG MOTION RESID D2 PERMIT W/O EN -HC TEL. NO: LIC. NO TEL. NO: LIC. NO: EMAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO IRE PORT ID: OPR261 THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CA USE ZONE: R-2 ISSUED ON: PROCESSED BY: 11/14/13 SR VALUATION: FINAL DATE FI AL CODE: 3,500 �VA� FEES PAID ISESL I ON WORK RE -ROOF OVER EXISTING LAYER WITH COMPO SHINGLES QUANTITY: DOM: AMOUNT: 27.80 3500.00 VAL 1.00 SPECIAL CONDITIONS: 3500.00 VAL 0.50 3500.00 VAL 115.80 TOTAL FEES 145.10 APPROVALS DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS 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 FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T CEILINGS -BAR LOT DRAINAGE ROUTE T0: 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 (,/) 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 Contrba for pursuant.to the Contractors' State License Law). ' U I am exempt 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 completiorq 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: / / 1/Q 1/ 3 Signature of Prop O ner or Authorized Agent 7-- /.. 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. 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 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' compensation provisions of Section 3700 of the Labor 7Z7 comply with those provisions %` 1111 el -113 ignature 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 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 _ r 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 ❑ 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 ❑ 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). 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 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 P pe Owner or Authorized Agent