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Home My Public Portal About5009 Fratus Dr_Building_1/29/2015_COUNTY OF LOS ANGELES ~ DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 16475 IT: 142 ASSESSOR INFORMATION NUMBER: 8590-031-022 TENANT OWNER: SHEN SHI XIAO 5009 FRATUS DR TEMP 917803722 XYYL1l ' : SU, ANDY W 2627 DOREEN AVE EL MONTE CA CONTRACTOR: ADC CONSTRUCTION 17588 E ROWIAND STREET #A206 6117 RENO AVENUE TEMPLE CITY CITY OF INDUSTRY CA 91748 ARCHITECT OR ENGINEER: NI, ZY 8232 GARVEY AVENUE 0206 GLENDALE CA 91203 NO: SEWER MAP BOOK: PAGE: 0 SCHOOL WITHIN QUALITY: 1000 FEET NO NO 0 TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST NEW SQ. FT STORIES TYPE OCCUR GROUP STRUCTURE:.. 585 1 V -B R-3 GARAGE: OTHER: 295 1 V -B U EXIST BLDG USE: USE ZONE: TEL. NO: (626) 298 -1828 - LIC. NO: NONE FIRE ZONE: CMP: 3 00 'T/COND: STAT CLASS: NO 21 HAZARDOUS MATERIALS NO * ADDITIONAL DATA ON FILE ZD: DPR261 ROUTE T0: BS0508 BUILDING PERMIT RESIDENTIAL ADD BE 0508 1309040017 BUILDING ADDRESS: EXIST OCC GRP: 5009 FRATUS DR TEMP CA 917803722 TEL. NO: i JBLDGS. NOW ON LOT: THOMAS PAGE: 596 GRID: VALUATION: ISSUED ON: PROCESSED BY: (626) 632-8210- 1 1 FINAL FINAL q 92,310 DE CIPTION OF WORK FEES PAID LAUNDRY ROOM AND BATHROOM AND COVERED PATIO 295 SQ.FT. (FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: TEL-. NO: I (626) 542-5946- IA1 PLANCHECK W/EN-HC 25000.00 VAL 458.00 ID9 PC EXTENSION FEE 299.75 DOL 299.75 IAA BLDG PERMIT ISSUANCE 27.80 IAB STATE GREEN BLDG FEE 92310.00 VAL 4.00 IAC STRONG MOTION RESID 92310.00 VAL 9.20 TEL. NO: IBl PLANCHECK W/ENERGY 92310.00 VAL 688.90 (626) 759-6217- IB2 PERMIT W/ENERGY 92310.00 VAL 1,349.30 LIC. NO 108 CERTIF OF OCCUPANCY 101.40 692222 * I TOTAL FEES 2,938.35 TEL. NO: (626) 298 -1828 - LIC. NO: NONE FIRE ZONE: CMP: 3 00 'T/COND: STAT CLASS: NO 21 HAZARDOUS MATERIALS NO * ADDITIONAL DATA ON FILE ZD: DPR261 ROUTE T0: BS0508 BUILDING PERMIT RESIDENTIAL ADD BE 0508 1309040017 BUILDING ADDRESS: 5009 FRATUS DR TEMP CA 917803722 NEAREST CROSS STREET: THOMAS PAGE: 596 GRID: T5 LOCALITY: TEMPLE CITY ISSUED ON: PROCESSED BY: 01/29/15 SR FINAL FINAL q CODE:1/ DE CIPTION OF WORK ADD OF 585 SQ.FT. FAMILY ROOM, LAUNDRY ROOM AND BATHROOM AND COVERED PATIO 295 SQ.FT. CONDITIONS: RECORDED ON AND SETBACKS ENGINEER APPROVAL .TION/TRENCH FORMS FLOOR FRAMING 2ND LEVEL FLOOR SHEATH FIRE DEPT. FRAME INSPECT BLDG DEPT. FRAME INSPECT (SHEAR PANELS f (INSULATION/WEATHER STRIP` INTERIOR LATH/DRYWALL EXTERIOR LATH LOT DRAINAGE ISMOKE DETECTION DEVICES (FIRE DEPARTMENT APPROVAL I I I � I I DATE INSPECTOR SIGNATURE v 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) 1 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.). (_) 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). U:1 am exeml4t 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�I of the improvements covered by this permit, I c In, 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.leainfo.ca.aovlcalaw.htmi. Date: Signature of Property Owner or Authorized Agent LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that 1 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 3 License No. 6�7 zZ 7 Z Datil ontractor Signature O.cfi v 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 wo �ers' compensati n insurance carrier and policy number are: Carrier P611cy Number E*ration 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 Code, I shall forthwith comply with those provisions i moi(' /— 2� ._ZD/S Sig ture4f 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. 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 ❑ N.o ❑ i 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 -identified property for inspection purposes. Signature of Property Owner dor Authorized Agent Applicant (Print Name) Applicant Signature nib Date Company Name Date