HomeMy Public PortalAbout8634 Garibaldi Ave_Building_11/13/2013_ (3)011
COUNTY OF LOS ANGELES
DEPA!TMENT OF PUBLIC WORKS
BUILDING AND SAFETY / LAND DEVELOPMENT
LEGAL ID:
TR: 5903 LT: 68
ASSESSOR INFORMATION NUMBER:
5386-014-027
TENANT
OWNER:
CHI, LISA
8522 LORAS RD
SGAB 917752611
LIU, RICHARD
111 S WALNUT GROVE
SAN GABRIEL CA 91776
L PRO CUSTOM BUILDER, INC.
1 S WALNUT GROVE AVENUE #201
N GABRIEL CA 91776
CHITECT OR ENGINEER:
B HOME DESIGN, INC.
68 SAN GABRIEL BLVD #P
SEMEAD CA 91770
TEMPLE CITY # 0508 BUILDING PERMIT
9701 LAS TUNAS NEW RESIDENTIAL
TEMPLE CITY CA 91780 BL 0508 1308130043
PHONE: (626) 285-04BB EXT:
FEES PAID
FEE DESCRIPTION: QUANTITY: DOE:
TEL. NO: 1
(626) 203-9638- JB1 PLANCHECK W/ENERGY 447590.00 VAL
IAA BLDG PERMIT ISSUANCE
JAB STATE GREEN BLDG FEE 447590.00 VAL
JAC STRONG MOTION RESID 447590.00 VAL
JB2 PERMIT W/ENERGY 447590.00 VAL
TEL. NO.: 108 CERTIF OF OCCUPANCY
(626) 203-9638- 1 TOTAL FEES
LIC. NO
707609 1
TEL. NO:
(626) 279 -5657 -
LIC. NO:
NONE
N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
3 01
OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
1 NO 01
SCHOOL WITHIN HAZARDOUS
QUALITY: 1000 FEET MATERIALS
NO NO NO
ID: DPR261 ROUTE TO: BS0508
I D( iPT<tOf4 OF WORK V
[NEW 2 -STORY SFD 4 BEDROOMS, 4.5 BATHROOMS WITH ATTACHED 2
AMOUNT:JCAR GARAGE, COVERED PORCH/PATIO 0 FRONT E REAR TOTAL 587 SF
I
3,352.60 [
27.80 ISPECIAL CONDITIONS:
18.00 IFIRE SPRINKLERS REQUIRED
44.80 [
3,944.20 [
101.40 [APPROVALS DATE INSPECTOR SIGNATURE
7,488.80 [
V
LOCATION AND SETBACKS��-C
SOILS ENGINEER APPROVAL
FOUNDATION/TRENCH FORMS
SLAB/UNDER FLOOR 4
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
IST LEVEL FLOOR SHEATH
2ND LEVEL FLOOR SHEATH i�
ROOF SHEATHING J
FIRE DEPT. FRAME INSPECTMI -4
I_
BLDG DEPT. FRAME INSPECT[
SHEAR PANELS /V .
INSULATION/WEATHER STRIPINTERIOR LATH/DRYWALL Mil) Y
EXTERIOR LATH
IAT DRAINAGE l
SMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
NO. OF
CONST
NEW
I BUILDING ADDRESS:
UN: .004
SQ. FT
STORIES
TYPE
OCCUP
GROUPI 8634 GARIBALDI AV
(STRUCTURE:
3094
2
V -B
R-3
I SGAB CA 917752616
GARAGE:
448
1
V -B
U
NEAREST CROSS STREET: BURTON
OTHER:
135
1
V -B
U
I THOMAS PAGE: 596 GRID: G2 LOCALITY: TEMPLE CITY CA
(
USE ZONE: R-1
(ISSUED ON: PROCESSED BY:
111/13/13 SR
TEL. N0: JBLDGS. NOW
ON LO?:
VALUATION:
IFINAL DATE FIN BY: CODE:
- 1
447,590
1
FEES PAID
FEE DESCRIPTION: QUANTITY: DOE:
TEL. NO: 1
(626) 203-9638- JB1 PLANCHECK W/ENERGY 447590.00 VAL
IAA BLDG PERMIT ISSUANCE
JAB STATE GREEN BLDG FEE 447590.00 VAL
JAC STRONG MOTION RESID 447590.00 VAL
JB2 PERMIT W/ENERGY 447590.00 VAL
TEL. NO.: 108 CERTIF OF OCCUPANCY
(626) 203-9638- 1 TOTAL FEES
LIC. NO
707609 1
TEL. NO:
(626) 279 -5657 -
LIC. NO:
NONE
N0: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
3 01
OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
1 NO 01
SCHOOL WITHIN HAZARDOUS
QUALITY: 1000 FEET MATERIALS
NO NO NO
ID: DPR261 ROUTE TO: BS0508
I D( iPT<tOf4 OF WORK V
[NEW 2 -STORY SFD 4 BEDROOMS, 4.5 BATHROOMS WITH ATTACHED 2
AMOUNT:JCAR GARAGE, COVERED PORCH/PATIO 0 FRONT E REAR TOTAL 587 SF
I
3,352.60 [
27.80 ISPECIAL CONDITIONS:
18.00 IFIRE SPRINKLERS REQUIRED
44.80 [
3,944.20 [
101.40 [APPROVALS DATE INSPECTOR SIGNATURE
7,488.80 [
V
LOCATION AND SETBACKS��-C
SOILS ENGINEER APPROVAL
FOUNDATION/TRENCH FORMS
SLAB/UNDER FLOOR 4
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
IST LEVEL FLOOR SHEATH
2ND LEVEL FLOOR SHEATH i�
ROOF SHEATHING J
FIRE DEPT. FRAME INSPECTMI -4
I_
BLDG DEPT. FRAME INSPECT[
SHEAR PANELS /V .
INSULATION/WEATHER STRIPINTERIOR LATH/DRYWALL Mil) Y
EXTERIOR LATH
IAT DRAINAGE l
SMOKE DETECTION DEVICES
FIRE DEPARTMENT APPROVAL
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).):
L) 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 ContrbGtor 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 priorlto completions 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
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.
JOB ADDRESS
LOCALITY
-y -7 ,( HAZARDOUS MATERIAL DECLARATION
J License Class _ License No. Ger Zdf Will the applicant or future building occupant handle a hazardous
-t— // Y 9,��// material or a mixture containing a hazardous material equal to or
to L`/y .� Contractor Signatu�w ' �—�
greater
forma than the amount specified on the hazardous materials
information guide?
WORKERS' COMPENSATION DECLARATION Yes ❑ N o ❑
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.
XX 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
wori ers' co pensati insu n e carrd licy nunber are:
Carrier Policy
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 tthhro igh the application process.
p ica t Tint Name) e Applicant Signature
uCLSVI (r� t
Com any Name Da e
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.
e Sig re -e ojperty Owner pLAVe ed Agent
" "
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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 (_) 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 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 completion; of the improvements covered by
this permit, I c 'nnot 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: httn://www.leoinfo.ca.aov/calaw.htmi.
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.
License Class License No.
DatelW��ontractor Signature Wel ', '1 v" "'r1
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, 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 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 ❑ 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
❑ 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
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 Prope Owner or Authorized Agent
VV >> q 0 RoyX 9�
Date 0 / � 0 Q4'.