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Home My Public Portal About9320 Blackley St_Building_11/13/2013_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: LEGAL ID: TR: 11492 LT: 13 BL: C ASSESSOR INFORMATION NUMBER - 8590 -009-014 TENANT: UWVEH: LIU, PAUL 6159 CAMELLIA AVE TEMPLE CITY CA 91780 APPLICANT: LAI, KAMEN 8748 E VALLEY BLVD K ROSEMEAD CA 91770 P L C CONSTRUCTION INC. 6159 CAMELLIA AVENUE TEMPLE CITY CA 91780 ARCHITECT OR ENGINEER: LEE, PETER 8748 E VALLEY BLVD SUITE L ROSEMEAD CA 91770 TEL. NO: (626) 274 -7384 - TEL. NO: (626) 288 -2651 - BUILDING PERMIT NEW RESIDENTIAL BL 0508 1306100017 TEL. NO: (626) 274 -7384 - LIC. NO 944536 TEL. NO: (626) 280 -9000 - LIC. NO: 944538 MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CME: 3 01 NO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: 1 NO 01 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FEE DESCRIPTION B1 PLANCHECK W/ENERGY AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE AC STRONG MOTION REBID B2 PERMIT W/ENERGY 08 CERTIF OF OCCUPANCY * ADDITIONAL DATA ON FILE ID: DPR261 FEES PAID QUANTITY: DOM: 550090.00 VAL 550090.00 VAL 550090.00 VAL 550090.00 VAL TOTAL FEES ROUTE TO: 13S0508 IDEISCRIPTION'OF WORK V INEW 2 -STORY SFO 5 BEDROOMS, 5 BATHROOMS, 1 POWDER, WITH AMOUNT:IATTACHED 3 CAR GARAGE, COVER PORCH 83 SF. 2ND: FLOOR DEN, (STUDY RM, FAMILY RM, LIVING RM, DINING RM, WOK RM, KITCHEN 3,988.20 I 27.80 ISPECIAL CONDITIONS: 23.00 (FIRE SPRINKLERS REQUIRED 55.00 4,691.90 101.40 (APPROVALS DATE INSPECTOR SIGNATURE 8,887.30 I (LOCATION AND SETBACKS /1�iAL FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION IST LEVEL FLOOR SHEATH 2ND LEVEL FLOOR SHEATH ROOF SHEATHING FIRE DEPT. FRAME INSPEC' BLDG DEPT. FRAME INSPEC' SHEAR PANELS INSULATION/WEATHER STRI'. :RIOR LATH /I DRAINAGE / :E DETECTION DEVICES DEPARTMENT APPROVAL] r i� NO. OF CONST NEW I BUILDING ADDRESS: SQ- FT STORIES TYPE OCCUP GROUP] 9320 BLACKLEY ST 3835 2 V -B R3 j TEMP CA 917803138 �ISTRUCTURE: GARAGE: 651 1 V -B U j NEAREST CROSS STREET: OTHER: 151 1 V -B U THOMAS PAGE: 596 GRID: J4 LOCALITY: TEMPLE CITY CA USE ZONE: R-1 ISSUED ON: PROCESSED BY: j 111/13/13 SR BLnu6. NOW j ON IAT: VALUATION: 550,090 j IF$i[AL DATE F15AL AY: CODE: TEL. NO: (626) 274 -7384 - LIC. NO 944536 TEL. NO: (626) 280 -9000 - LIC. NO: 944538 MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CME: 3 01 NO. OF FAMILIES: DWELLING UNITS: APT/CONDI STAT CLASS: 1 NO 01 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO FEE DESCRIPTION B1 PLANCHECK W/ENERGY AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE AC STRONG MOTION REBID B2 PERMIT W/ENERGY 08 CERTIF OF OCCUPANCY * ADDITIONAL DATA ON FILE ID: DPR261 FEES PAID QUANTITY: DOM: 550090.00 VAL 550090.00 VAL 550090.00 VAL 550090.00 VAL TOTAL FEES ROUTE TO: 13S0508 IDEISCRIPTION'OF WORK V INEW 2 -STORY SFO 5 BEDROOMS, 5 BATHROOMS, 1 POWDER, WITH AMOUNT:IATTACHED 3 CAR GARAGE, COVER PORCH 83 SF. 2ND: FLOOR DEN, (STUDY RM, FAMILY RM, LIVING RM, DINING RM, WOK RM, KITCHEN 3,988.20 I 27.80 ISPECIAL CONDITIONS: 23.00 (FIRE SPRINKLERS REQUIRED 55.00 4,691.90 101.40 (APPROVALS DATE INSPECTOR SIGNATURE 8,887.30 I (LOCATION AND SETBACKS /1�iAL FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION IST LEVEL FLOOR SHEATH 2ND LEVEL FLOOR SHEATH ROOF SHEATHING FIRE DEPT. FRAME INSPEC' BLDG DEPT. FRAME INSPEC' SHEAR PANELS INSULATION/WEATHER STRI'. :RIOR LATH /I DRAINAGE / :E DETECTION DEVICES DEPARTMENT APPROVAL] r i� 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 (_) 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 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 c4nnot 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: http://www.leoinfo.ca.cov/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. ( r LicenVela F License No.Date Contractor Signature WORKERS' COMPENSATION DECLARATION L 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� 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 keys' co pens tion insuratace carrier and policy number are: Lam,` I�i,/`"G1�� /�� Carrier Policy Number Expiration Dat& 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 shall forth h co ply with those provisions t 1(31(3 Signa ure 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 mys f complied w' continue to ply therewith through the applica proce h 6, L"( U-XK A scant (Print N e) �rr__� A plicanij t i rrlur� C G0 w FTVC(l Ti Gly ( Company Name D to i 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). 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. Signatur of Prop `?or or Authorized Agent i Date �' 3 COUNTY OF LOS ANGELES TEMPLE CITY # 0508 DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 2BB-0488 EXT: LEGAL ID: NUMBER OF ADDED/RELOCATED TR: 11492 LT: 13 BL: C SQ. FT SPRINKLER HEADS 43 STRUCTURE: 3835 ASSESSOR INFORMATION NUMBER: 8590-009-014 TENANT: EXIST BLDG USE: IEXIST OCC GRP: OWNER: TEL. NO: BLDGS. NOW ON IAT: VALUATION LIU, PAUL 6159 CAMELLIA AVE TEMPLE CITY CA 91780 HUANG, WEI S 10105 RIO HONDO PKWY EK NIBTE CA 91733 CONTRACTOR: GF FIRE PROTECTION INC. 10105 RIO HONDO PKWY EL MONTE CA 91733 ARCHITECT OR ENGINEER (626) 274 -7384 - TEL. NO: (626) 423 -8063 - TEL. NO: (626) 350 -3196 - LIC. NO 975442 I TEL. NO: LIC. NO: MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:j 001 NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: NO 20 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO EE DESCRIPTION A BLDG PERMIT ISSUANCE B STATE GREEN BLDG FEE 0 FIRE SPRINKLER PC 2 PERMIT W/O EN -HC EPORT ID: DPR261 ROUTE TO: BS0508 BUILDING PERMIT FIRE SPRINKLER BL 0508 1409090064 BUILDING ADDRESS: 9320 BLACKLEY ST TEMP CA 917803138 NEAREST CROSS STREET: THOMAS PAGE:.596 GRID: S4 LOCALITY: TEMPLE CITY C ISSUED ON: PROCESSED BY: 09/09/14 SR F INAL DATE FIN BY: CODE: aA�T2 ION P WORK INSTALL FIRE SPRINKLER SYSTE SPECIAL CONDITIONS: APPROVALS FIRE DEPARTMENT INSPECT DATE INSPECTOR SIGNATURE I 3,500 FEES PAID QUANTITY: COW: AMOUNT: 27.80 3500.00 VAL 1.00 3500.00 VAL 98.40 3500.00 VAL 115.80 TOTAL FEES 243.00 ROUTE TO: BS0508 BUILDING PERMIT FIRE SPRINKLER BL 0508 1409090064 BUILDING ADDRESS: 9320 BLACKLEY ST TEMP CA 917803138 NEAREST CROSS STREET: THOMAS PAGE:.596 GRID: S4 LOCALITY: TEMPLE CITY C ISSUED ON: PROCESSED BY: 09/09/14 SR F INAL DATE FIN BY: CODE: aA�T2 ION P WORK INSTALL FIRE SPRINKLER SYSTE SPECIAL CONDITIONS: APPROVALS FIRE DEPARTMENT INSPECT DATE INSPECTOR SIGNATURE I 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).): (__) 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 Contractor 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 priorl 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://v w .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. -1L1censeClass 0/1� License No."f� �!DateAontractor Signature In(Arrs Vt 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 carder 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, 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 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 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 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