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Home My Public Portal About9828 Garibaldi Ave_Building_2/9/2015_ (3)COUNTY OF LOS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT L ID: 6561 LT: 55 UN� .003 BECK INFORMATION NUMBER: -027-003 TEL. NO: �R. AN CHAD 9828 GARIBALDI AV TEMP 917801712 APPLICANT: TEL. NO - CHARLES SLAUGRUND, AIA (805) 529-1979- 14994 MARQUETTE ST 9701 LAS TUNAS �OORPARK CA 93021 CONTRACTOR: TEL. NO: RP ASSOCIATES, INC. (818) 879-5002- 1351 TOTTENHAM CT LIC. NO INK PARK CA 91377 740238 - kRCHITRCT OR ENGINEER: TEL. NO: ZHARLES 131AUGPUND (805) 529-1979- L4994 MARQUETTE STREET LIC. NO- �OORPARK CA 93021 C25792 �P NO: SEWER MAP BOOK; PAGE: FIRE ZONE: CMP: V-13 3 00 qO. OF FAMILIES: DWELLING UNITS: APT/COND : STAT CLASS: 0 NO 21 SCHOOL WITHIN HAZARDOUS %IR QUALITY: 1000 FEET MATERIALS NO NO NO FEES PAID FEE DESCRIPTION; QUANTITY: UOM BI PLANCHECK W/ENERGY TEMPLE CITY VAL AA BLDG PERMIT ISSUANCE 9701 LAS TUNAS AB STATE GREEN BLDG FEE TEMPLE CITY CA 91780 VAI, AC STRONG MOTION REBID PHONE: (626) 285-0498 EXT: VAL B2 PERMIT W/ENERGY NO. OF CONST NEW SQ. FT STORIES TYPE OCCUP GROUP JSTRUCTURE- 44 - 8 1 V-13 R-3 GARAGE: OTHER: EXIST 13LDG USE: USE ZONE: IEXIST OCC I GRP: SLUGS. NOW ON LOT: VALUATION i 30,000 FEES PAID FEE DESCRIPTION; QUANTITY: UOM BI PLANCHECK W/ENERGY 30000.00 VAL AA BLDG PERMIT ISSUANCE AB STATE GREEN BLDG FEE 30000.00 VAI, AC STRONG MOTION REBID 30000.00 VAL B2 PERMIT W/ENERGY 30000.00 VAI, TOTAL FEES - ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: ES0508 AMOUNT: 502.20 27.80 2.00 3.00 590-70 1,125.70 I BUILDING PERMIT RESIDENTIAL ADD/ALT/REP BL 0508 1501050025 BUILDING ADDRESS: 9828 GARIBALDI AV TEMP CA 917801712 NEAREST CROSS STREET: GOLDEN WEST THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CA ISSUED ON: PROCESSED BY: 02/09/15 SR FI4AL DATE Pi By� CODE: ED 'f7��F 6 WORK REPAIR FIRE DAMAGE TO SINGLE EMILY DWELLING. REPAIR ROOF STRUCTURE AND MINOR WALL FRAME DAMAGE- REPLACE INTERIOR SURF ACES, REPLACE ELECTRICAL AS NEEDED, REPLACE FAU, REPLACE SPECIAL CONDITIONS: DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS SOILS ENGINEER APPROVAL FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION 1ST LEVEL FLOOR SHEATH 2ND LEVEL FLOOR SHEATH ROOF SHEATHING FIRE DEPT. FRAME INSPECTP BLDG DEPT. FRAME INSPECI;r3,ft SHEAR PANELS INSULATION/WEATHER STRIP INTERIOR LATH/DRWALL EXTERIOR LATH LOT DRAINAGE 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).): 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 Contrbctor pursuant .to the Contractors' State License Law). U. 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 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: http://www.leainfo.ca.aov/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. License Class 6 License No. Date YfWContractor Signature WORKERS' COMPENSATION DECLARATION 11 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 performa ce of the work for which this permit is issue . My wor a ation insur nce carri41t V�T er and policy be are'" Carrier I Policy Number Expiration ate 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' compe sation provisions of Section 3700 of the Labor Code, I shc3ll fqA with comply with those provisions Signatti a 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 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 ❑ 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 constructi I author' e r presentatives of this county to enter the above -i enti ed property for inspection purposes. Signatur of erty Owner or Authorized Agent i' Date ti C COUNTY OF IAS ANGELES DEPARTMENT OF PUBLIC WORKS BUILDING AND SAFETY / LAND DEVELOPMENT LEGAL ID: TR: 6561 LT: 55 UN: .003 ASSESSOR INFORMATION NUMBER: 5385-027-003 TENANT OWNER: TEL. NO: MR. AN CHAO AS STATE GREEN BLDG FEE 3000.00 9828 GARIBALDI AV VAL AC STRONG MOTION REBID TEMP 917801712 VAL APPLICANT: TEL. NO: PARTON, BRUCE (818) 879-5002- TOTAL FEES 1351 TOTTENHAM CT OAK PARK CA 91377 CONTRACTOR: TEL. NO: HP ASSOCIATES, INC. (818) 879-5002- 1351 TOTTENHAM CT LIC. NO OAK PARK CA 91377 740238 ARCHITECT OR ENGINEER: TEL. NO: LIC. NO MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 00 NO. OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS: NO 21 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO TEMPLE CITY 9701 LAS TUNAS TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT: NO. OF CONST SQ. FT STORIES TYPE STRUCTURE: 15 V -B # 0508 EXIST BLDG USE: REBID USE ZONE: R-1 EXIST OCC GRP: SLOGS. NOW ON LOT: VALUATION: 3,000 FEES PAID FEE DESCRIPTION: QUANTITY: DOM AA BLDG PERMIT ISSUANCE AS STATE GREEN BLDG FEE 3000.00 VAL AC STRONG MOTION REBID 3000.00 VAL D2 PERMIT W/O EN -HC 3000.00 VAL TOTAL FEES • ADDITIONAL DATA ON FILE REPORT ID: DPR261 ROUTE TO: BS0508 AMOUNT: 27.80 1.00 0.50 99.00 128.30 BUILDING PERMIT ALTERATION/REPAIR BL 0508 1503300100 BUILDING ADDRESS: 9828 GARIBALDI AV TEMP CA 917801712 NEAREST CROSS STREET: GOLDEN WEST THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY C ISSUED ON: PROCESSED BY: 03/30/15 SR F1/I/WWTT"E, FIN CODE: D $F WORK TEAR OFF REROOF WITH COMPOSI ION SHINGLES SPECIAL CONDITIONS: DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS FOUNDATION/TRENCH FORMS SLAB/UNDER FLOOR RAISED FLOOR FRAMING UNDERFLOOR INSULATION FLOOR SHEATHING ROOF SHEATHING SHEAR PANELS FRAME INSPECTION FIRE SPRINKLER HANGERS INSULATION/WEATHER STRIP L INTERIOR LATH/DRYWALL EXTERIOR LATH RATED FLOOR/CEIL ASSEM. RATED WALL ASSEMBLIES RATED SHAFTS/OPENINGS T -BAR CEILINGS LOT DRAINAGE OWNER -BUILDER DECLARATION LICENSED CONTRACTOR'S DECLARATION . JOB ADDRESS by affirm under penalty of perjury that I am exempt from mtractors' State License Law for the reason(s) indicated by the checkmark(s) I have placed next to the applicable (Section 7031.5, Business and Professions Code): Any county that requires a permit to construct, alter, improve, ish, or repair any structure, prior to its issuance, also as the applicant for the permit to file a signed statement e or she is licensed pursuant to the provisions of the actors' State License Law (Chapter 9 (commencing with n 7000) of Division 3 of the Business and Professions or that he or she is exempt from licensure and the basis alleged exemption. Any violation of Section 7031.5 by pplicant for a permit subjects the applicant to a civil V of not more than five hundred dollars ($500).): is owner of the property, or my employees with wages as ole compensation, will do (,i) all of or (_) portions of the and the structure is not intended or offered for sale m 7044, Business and Professions Code: The actors' State License Law does not apply to an owner of ty who, through employees' or personal effort, builds or ,es the property, provided that the improvements are not ed or offered for sale. If, however, the building or ,ement is sold within one year of completion, the Owner - r will have the burden of proving that it was not built or ,ed for the purpose of sale.). is owner of the property, am exclusively contracting with ►d Contractors to construct the project (Section 7044, :ss and Professions Code: The Contractors' State License oes not apply to an owner of property who builds or tes thereon, and who contracts for the projects with a )d Contrb�tor pursuant .to the Contractors' State License m exem�t from licensure under the Contractors' State ;e Law for the following reason: signature below I acknowledge that, except for my ial residence in which I must have resided for at least .ar prion to completion; of the improvements covered by rmit, I c 'nnot legally sell a structure that I have built as an builder If it has not been constructed in its entirety by :d contractors. I understand that a copy of the applicable action 7044 of 'the Business and Professions Code, is ole upon request when this application is submitted or at owing Web site: http://www.leainfo.ca.00v/calaw.html. ure 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 l / License No� V 413 Date4� 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 perfgqnance of the work for which this permit is issued. My worker p ation inqolicy [ r� e� car�ier aAd policy � are, Carrier 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 ❑ N.o ❑ ,i' I have read the hazardous materials information guide and the SCAQMD permitting checklist, I understand my requirem�nts under the Los Angeles County Code Title 2, Chapter 2220' 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 toeach 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 authori rep sentatives of this county to enter the above -i fled roperty for inspection purposes. Signatur Ir 7 el Owner or Authorized Agent �„n I Date ` l