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Home My Public Portal About5334 Encinita Ave_Electrical_12/1/2006_T '-COUNTY OF, LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMEN�f LEGAL ID: TR: 11492 LT: 22 BL: A ASSESSOR INFORMATION NUMBER: 8590-001-026 TENANT: OWNER: TEL. NO: SALDIVAR, DANIEL (6261 614-1044- 5334 ENCINITA AV TEMP 917803114 APPLICANT: TEL. NO: SAME AS OWNER CONTRACTOR: TEL. NO: SAME AS OWNER LIC. NO ARCHITECT OR ENGINEER: TEL. NO: LIC. NO: TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: FEES PAID PEE DESCRIPTION: QUANTITY: DOM: Al PERMIT ISSUANCE FEE LB 200 AMP PANELS, MCC 1.00 PAN TOTAL FEES REPORT ID: DPR265 ROUTE TO: BS0508 ELECTRICAL PERMIT EL 0508 0612010015 SPECIAL CONDITIONS: APPROVALS DATE TEMPORARY POWER POLE UNDERGROUND CONDUIT OPER GROUND ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED 1 INSPECTOR SIGNATURE C BUIL➢ING ADDRESS: 5334 ENCINITA AV AMOUNT: TEMP CA 917803114 NEAREST CROSS STREET: 27.75 THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY, C 38.85 66.60 ISSUED ON: PROCESSED BY: PLAN BY: EXPIRES ON: 12/01/06 JK 05/30/07 7�\/A1l�ww. %{+ BY: PINAL DATEArl CODE: fl LL IIVV.. DESCRIPTION OF WORK ELECTRICAL METER UPGRADE TO 200 AMP SPECIAL CONDITIONS: APPROVALS DATE TEMPORARY POWER POLE UNDERGROUND CONDUIT OPER GROUND ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED 1 INSPECTOR SIGNATURE C 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 lull force and effect License Class Lic. No. Contractor's Signature Dale OWNER -BUILDER DECLARATION I hereby affirm under penally of perjury that I am exempt from the Contractors License Law forthe following reason (Sec.7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to Isle a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500) ) ❑ 1 am exempt under Sec. , B & P.C. for this reason [ Electrical, Plumbing & Sewer Permits Only ] ❑ Las owner of the property, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). [ All Other Permits ] ❑ [,as owner of the property, or my employees with wages as their sol@ compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such 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 he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractors) tic setl our; ant to the Contractors License Law) Owner Signal re Date G / WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 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: Carder 7Policy umber 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. Appli nt ioatureat> e WARNING: FAILURE TO SECURE WORKER'S 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. 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 seg , (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 (if employed by an entity/agency) Date JOBADDRESSI LOCALITY f 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 (SCAOMD)? See permitting checklist for guidelines. Yes ❑ No ❑ I have read the hazardous materials information guide and the SCAOMD 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 Irom the SCAOMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to SCAOMD or EPA ❑ 1 declare that notification of asbestos removal is not applicable to addressed project. CONSTRUCTION LENDING AGENCY I hereby all irm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Cw.C.). Lenders Name Lenders Address 190°1q? I certify that I have read this application and state under the penalty of perjury that the above information is correct. t agree to comply with all City and County ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter upon the above-mentioned property for inspection purposes. Applicant or gent Signature COUNTY OF IAS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 11492 IT: 22 BL: A ASSESSOR INFORMATION NUMBER: 8590-001-026 TENANT OWNER: SALDIVAR, DANIEL 5334 ENCINITA AV TEMP 917803114 BUD VILLALOBOS 11606 E WASHINGTON WHITTIER CA 90606 CONTRACTOR: B M VILLALOBOS INC. 11606 E WASHINGTON BLVD WHITTIER CA 90601 OR ENGINEER: TEL. NO: (626) 234 -1608 - TEL. NO: (323) 781 -8983 - TEL. NO: (323) 447 -1836 - LIC. NO 872939 TEL. NO: LIC. NO: REPORT ID: DPR265 ROUTE TO: BS0508 ELECTRICAL PERMIT EL 0508 1406170065 BUILDING ADDRESS: 5334 ENCINITA AV AMOUNT: TEMP CA 917803114 NEAREST CROSS STREET: 27.80 THOMAS PAGE: 596 GRID: S4 LOCALITY: TEMPLE CITY, C 121.10 40.00 JISSUED ON: PROCESSED BY: PLAN BY: 34.00 106/17/14 SR 11.00 1 11.00 Q ��AT FI CODE: 11.00 11.00 1266.90 SPI OF WORK NEW ELECTRICAL BY PLANS LIGHT FIXTURES, OUTLETS AND 1SWITCHES FOR KITCHEN, 1/2 BATHROOM AND LAUNDRY AREA CONDITIONS: MALS DATE �RARY POWER POLE I I :GROUND CONDUIT GROUND CONDUIT WIRING WATER LINE / 'IC YIN METAL YIN 1 TY COMPANY NOTIFIEDI TEMPLE CITY N 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: FEES PAID FEE DESCRIPTION: QUANTITY: DOM: Al PERMIT ISSUANCE FEE F1 120V, 15/20A BR CKTS 7.00 BR G1 OUTLETS-LGT,SW,RECP 20.00 OUT G2 LIGHTING FIXTURES 17.00 LGT H2 RES GRBG DISP IT 3HP 1.00 DIS H3 RES DISHWASHR LT 3HP 1.00 DIS H4 RES RANGE HUE LT 3HP 1.00 ROD HE RES WASH MACH IT 3HP 1.00 WAS TOTAL FEES REPORT ID: DPR265 ROUTE TO: BS0508 ELECTRICAL PERMIT EL 0508 1406170065 BUILDING ADDRESS: 5334 ENCINITA AV AMOUNT: TEMP CA 917803114 NEAREST CROSS STREET: 27.80 THOMAS PAGE: 596 GRID: S4 LOCALITY: TEMPLE CITY, C 121.10 40.00 JISSUED ON: PROCESSED BY: PLAN BY: 34.00 106/17/14 SR 11.00 1 11.00 Q ��AT FI CODE: 11.00 11.00 1266.90 SPI OF WORK NEW ELECTRICAL BY PLANS LIGHT FIXTURES, OUTLETS AND 1SWITCHES FOR KITCHEN, 1/2 BATHROOM AND LAUNDRY AREA CONDITIONS: MALS DATE �RARY POWER POLE I I :GROUND CONDUIT GROUND CONDUIT WIRING WATER LINE / 'IC YIN METAL YIN 1 TY COMPANY NOTIFIEDI 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 Contractor pursuant .to the Contractors' State License Law). Up I am exem�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 whicl1 I must have resided for at least one year prior) to completion of the improvements covered by this permit, I c�'nnot legally sdll 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:/Iwww.leciinfo.ca.aov/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 fo� and effect. License Class License No. (, r Date VJontractor Signature /WS' 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. Py No. V 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 w s' c mpen ion insur ce a and policy n ber 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' c pensation provisions of Section 3700 of the Labor Code WofApplicant th co ply " h se provisions iiia D e 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, I understand my requirements under the Los Angeles County Code Title 2, Chapter X20' 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. 1 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-identi 'fi property for inspection purposes. Sign t f Prop Owner �%�f{ 'gent _ - // C� Date �/ COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT 3AL ID: : 11492 IT: 22 BL: A SESSOR INFORMATION NUMBER: 90-001-026 VAR, DANIEL ENCINITA AV 917803114 AS OWNER 41 .Y*TilliH[i OR ENGINEER: TEL. NO: (626) 234-1608 TEL. NO: TEL. NO: LIC. NO TEL. NO: LIC. NO: TEMPLE CITY # 0508 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0468 EXT: FEES PAID FEE DESCRIPTION: QUANTITY: UOM: JAI PERMIT ISSUANCE FEE IG2 LIGHTING FIXTURES 2.00 LGT TOTAL FEES I REPORT ID: DPR265 ROUTE TO: BS0508 ELECTRICAL PERMIT EL 0508 1400060003 BUILDING ADDRESS: 5334 ENCINITA AV AMOUNT: TEMP CA 917803114 NEAREST CROSS STREET: 27.80 THOMAS PAGE: 596 GRID: S4 LOCALITY: TEMPLE CITY, C 4.00 31.80 ISSUED ON: PROCESSED BY: PLAN BY: 08/06/14 SR FIAL 'dAE F;NAL BY: CODE: R Ir �OF WORK CHANGE OUT 2 LIGHT FIXTURES ON BATHROOM #2 SPECIAL CONDITIONS: APPROVALS DATE TEMPORARY POWER POLE UNDERGROUND CONDUIT i IUFER GROUND - ROUGH CONDUIT ROUGH WIRING MAIN WATER LINE I PLASTIC YIN METAL YIN UTILITY COMPANY NOTIFIED 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).): 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 Contra or pursuant.to the Contractors' State 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 which I must have resided for at least one year priori to completion, of the improvements covered by this permit, Innot legally sell a structure that I have built as an If 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.leoinfo.ca.cov/calaw.html. Date: " —1 Signre of Pro e r 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. 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 Code sal hw omply ith those provisions �-/�-lei Sig ur ant Ddt€ LOBBYIST ORDINANCE CERTIFICATION Complete this section for permits in Unincorporated Los Angeles County only This is to certify that 1, 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 JOB DRESS 33y 67-el"74 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 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 conceming 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 prope for inspection purposes. Sign of Pro arty ner r Authorized Agent Date — �7