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HomeMy Public PortalAbout9450 Las Tunas Dr_Building_4/28/2015_COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: BK: 21349 LOT 1 PG: PC: ASSESSOR INFORMATION NUMBER: 8587-009-024 TENANT: RIDE AID CORPORATION OWNER: TEL. NO: THRIFTY PAY -LESS (714) 883-9092- 320 GODDARD WAY #125 IRVINE CA 92618 APPLICANT: TEL. NO: POUR, MEGAN (949) 752-9333- 15 HUBBIE SUITE 200 IRVINE CA 92618 CONTRACTOR: TEL. NO: ROCON GROUP, INC. (951) 653-9992- 14340 ELSWORTH ST STE 101 LIC. NO MORENO VALLEY,CA 92553 845912 ARCHITECT OR ENGINEER: TEL. NO: JAG ARCHITECTURE (949) 752-9333- 15 NUBBLE SUITE 200 LIC. NO: IRVINE CA 92618 NONE MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: 0 NO 22 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO THIS PERMIT EXPIRES 6 MONTHS FROM DATE OF ISSUANCE OR FROM DATE OF LAST VALID INSPECTION. TEMPLE CITY 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST SQ. PT STORIES TYPE STRUCTURE: 0 1 V -B EXIST BLDG USE: COMM EXIST OCC GRP: M BLDGS. NOW ON LOT: DESCRIPTION PLANCHECK W/EN-HC BLDG PERMIT ISSUANCE STATE GREEN BLDG FEE STRONG MOTION OTHER PERMIT W/ENERGY-HC CERTIF OF OCCUPANCY # 0508 USE ZONE BUILDING PERMIT TENANT IMPROVEMENT BL 0508 1503030080 NEW BUILDING ADDRESS: OCCUP GROUP 9450 LAS TUNAS DR M I TEMP CA 91780 NEAREST CROSS STREET: OAK THOMAS PAGE: GRID: LOCALITY: TEMPLE CITY I : ISSUED ON: PROCESSED BY: j04/28/15 SR I VALUATION: FINAL ATE FI BY: CODE: 30,000 i FEES PAID QUANTITY: UOM: 30000.00 VAL 30000.00 VAL 30000.00 VAL 30000.00 VAL TOTAL FEES IV D)SCRIPTION OF WORK 1) T.I. PROVIDE NEW FULL HEIGHT WALL ADJACENT TO (E) PHARMACY AMOUNT: AREA TO CREATE A CONSOLATION RM, NEW IOW WALL TO CREATE A NEW WAITING AREA, NEW SOFFIT ABOVE COOLER, NEW FIXTURES WI' 525.00 1 27.80 ISPECIAL CONDITIONS: 2.00 6.30 617.60 101.40 1,280.10 APPROVALS DATE LOCATION AND SETBACKS TOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS 9LAB/UNDER FLOOR ?AISED FLOOR FRAMING 7NDERFLOOR INSULATION FLOOR SHEATHING lOOF SHEATHING 'HEAR PANELS FRAME INSPECTION ^IRE SPRINKLER HANGERS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL iXTERIOR LATH IATED FLOOR/CEIL ASSEM. iATED WALL ASSEMBLIES IT -NAR CEILINGS + ADDITIONAL DATA ON FILE SLOT DRAINAGE REPORT ID: OPR261 ROUTE TO: BSO508 I INSPECTOR SIGNATURE RATED 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 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 Contr9?tor pursuant.to the Contractors' State License Law). 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. Q License Class_ License No. V Date '2�_1, 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 w kers' cope t' ryinsurance carrier and p licy number are: C 'er / ,, A Policy NumWr Expiration Date %r rl/•r /✓/tt. 7_0. %S/- 76N-03// Name of gent Phone Number U I am exempt from licensure under the Contractors' State — I certify that, in the performance of the work for which this License Law for the following reason: 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 By my signature below I acknowledge that, except for my workers' compensation provisions of Section 3700 of the Labor personal residence in which I must have resided for at least CodeZ?/Ar all forthwith comply with those provisions one year priori to completiory of the improvements covered by / this permit, I cannot legally sell a structure that I have built as an of 4, yic. lT' e /S owner -builder If it has not been constructed in its entirety b Signature of Applicant Date 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://wvnv.leeinfo.ca.eov/calaw.html. Date: Signature of Property Owner or Authorized Agent 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 JOB ADDRESS 6 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 ❑ 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 Lenders 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 Property r or Authorized Agent t nwy, / r/ -G, Date 11-g 00-C3-