HomeMy Public PortalAbout___COUNTY OF LOS ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING AND SAFETY / LAND DEVELOPMENT
LEGAL ID:
BK: 30 PG: 4 PC: 3
ASSESSOR INFORMATION NUMBER:
5385-026-033
OWNER: TEL. NO:
CHONG, JOHN (626) 383-7733-
9816 PLA14ERTY ST
TEMP 917801710
APPLICANT: TEL. NO:
SAME AS OWNER
CONTRACTOR:
TEL. NO:
SAME AS OWNER
BUILDING PERMIT
-
9701 LAS TUNAS
LIC.
NO
ARCHITECT OR ENGINEER:
TEL. NO:
TEMPLE CITY CA 91760
LIC.
NO:
MAP NO: SEWER MAP BOOK: PAGE:
FIRE ZONE:
CMP:
3
00
NO. OF FAMILIES: DWELLING UNITS:
APT/COND: STAT
CLASS:
0
NO
21
SCHOOL WITHIN HAZARDOUS
OCCUP
AIR QUALITY: 1000 FEET
MATERIALS
900 1
NO NO
NO
I TEMP CA 917801710
FEES PAID
FEE DESCRIPTION: QUANTITY: DOM
B1 PLANCHECK W/ENERGY 120960.00 VAL
AA BLDG PERMIT ISSUANCE
AB STATE GREEN BLDG FEE 120960.00 VAL
AC STRONG MOTION AESID 120960.00 VAL
B2 PERMIT W/ENERGY 120960.00 VAL
OB CERTIF OF OCCUPANCY
TOTAL FEES
REPORT ID: DPR261 ROUTE TO: BSO508
DE CI i OF WORK 1II\\\\1
EXPAND FAMILY ROOM, ADD MASTER BEDROOM, MASTER BATHROOM,
AMOUNT:IW.I.C., ENCLOSED (E) FRONT PORCH W/INTERIOR REMODEL AND
REPLACE ALL (E) WINDOWS & EXTERIOR DOORS
1,334.60
27.80 SPECIAL CONDITIONS:
5.00
12.10
1,570.10
101.40 JAPPROVALS DATE INSPECTOR SIGNATURE
3,051.00 1
LOCATION AND SETBACKS /� j
SOILS ENGINEER APPROVAL 4V\ /IY
FOUNDATION/TRENCH FORMS�{,f )
SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
DIST LEVEL FLOOR SHEATH
12N0 LEVEL FLOOR SHEATH
ROOF SHEATHING
FIRE DEPT. FRAME INSPECT" 1 V
BLDG DEPT. FRAME INSPECTr
S
SHEAR PANELS
INSULATION/WEATHER STRIP•/(/7',
(INTERIOR LATH/DRYWALL
1
1EXTERIOA LATH
LOT DRAINAGE
(SMOKE DETECTION DEVICES
IFZAE DEPARTMENT APPROVAL
TEMPLE CITY
N 0508
BUILDING PERMIT
9701 LAS TUNAS
RESIDENTIAL ADD/ALT/REP
TEMPLE CITY CA 91760
BL 0508 1406120080
PHONE: (626) 285-0488
EXT:
NO. OF
CONST
NEW
BUILDING ADDRESS:
SQ. FT STORIES
TYPE
OCCUP
GROUP 9816 FLAHERTY ST
STRUCTURE:
900 1
V -S
R-3
I TEMP CA 917801710
GARAGE:
I NEAREST CROSS STREET: GOLDEN WEST
OTHER:
I THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY
(EXIST BLDG USE:
USE ZONE:
(ISSUED ON: PROCESSED BY:
EXIST OCC
GRP:
108/11/14 SR
I
BLOBS. NOW ON LOT:
1
VALUATION:
120,960
FI AL DAT FI AL BY: CODE:
FEES PAID
FEE DESCRIPTION: QUANTITY: DOM
B1 PLANCHECK W/ENERGY 120960.00 VAL
AA BLDG PERMIT ISSUANCE
AB STATE GREEN BLDG FEE 120960.00 VAL
AC STRONG MOTION AESID 120960.00 VAL
B2 PERMIT W/ENERGY 120960.00 VAL
OB CERTIF OF OCCUPANCY
TOTAL FEES
REPORT ID: DPR261 ROUTE TO: BSO508
DE CI i OF WORK 1II\\\\1
EXPAND FAMILY ROOM, ADD MASTER BEDROOM, MASTER BATHROOM,
AMOUNT:IW.I.C., ENCLOSED (E) FRONT PORCH W/INTERIOR REMODEL AND
REPLACE ALL (E) WINDOWS & EXTERIOR DOORS
1,334.60
27.80 SPECIAL CONDITIONS:
5.00
12.10
1,570.10
101.40 JAPPROVALS DATE INSPECTOR SIGNATURE
3,051.00 1
LOCATION AND SETBACKS /� j
SOILS ENGINEER APPROVAL 4V\ /IY
FOUNDATION/TRENCH FORMS�{,f )
SLAB/UNDER FLOOR
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
DIST LEVEL FLOOR SHEATH
12N0 LEVEL FLOOR SHEATH
ROOF SHEATHING
FIRE DEPT. FRAME INSPECT" 1 V
BLDG DEPT. FRAME INSPECTr
S
SHEAR PANELS
INSULATION/WEATHER STRIP•/(/7',
(INTERIOR LATH/DRYWALL
1
1EXTERIOA LATH
LOT DRAINAGE
(SMOKE DETECTION DEVICES
IFZAE DEPARTMENT APPROVAL
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).):
U I, as owner of the property, or my employees with wages as
their sole compensation, will do (,J) 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 Contrb?tor pursuant -to the Contractors' State License
Law). '
U 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 whicf I must have resided for at least
one year prior) to completioq of the improvements covered by
this permit, Icannot 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://www.lecinfo.ce.cov/celaw.html.
Date: �( I Y
Signature of Property Owner r Au ri ed Agent
1 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
WAi�MNG: 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:
Carder 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, 'rf I should become subject to the
workers' compensation provis'ons of Section 3700 of the Labor
Code, 1 shall forthwith -comp ith those provissiiio''lonns�
Is
Signature of pp cant , Dae I
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 ❑ IJ.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 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 inspegtion purposes.
Signature
Date J(up �..
A
COUNTY OF LOS ANGELES
DEPARTMENT OF PUBLIC WORKS
BUILDING AND SAFETY / LAND DEVELOPMENT
LEGAL ID:
BK: 30 PG: 4 PC: 3
ASSESSOR INFORMATION NUMBER:
5385-026-033
TENANT
OWNER:
CHONG, JOHN
9816 FLAHERTY ST
TEMP 917801710
4PPLICANT:
SAME AS OWNER
AS OWNER
OR ENGINEER:
TEMPLE CITY # 0508
9701 LAS TUNAS
TEMPLE CITY CA 91780
PHONE: (626) 285-0488 EXT:
NO. OF CONST
SQ. FT STORIES TYPE
STRUCTURE: 1700 V -B
EXIST BLDG USE: REBID
EXIST OCC GRP:
TEL. NO: ELUDE. NOW ON LOT:
(626) 363-7733- 1
FEE DESCRIPTION:
TEL. N0:
- IAA BLDG PERMIT ISSUANCE
JAB STATE GREEN BLDG FEE
JAC STRONG MOTION REBID
ID2 PERMIT W/O EN -HC
TEL. NO:
LIC. NO
TEL. NO:
LIC. NO:
NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP:
3 00
OF FAMILIES: DWELLING UNITS: APT/COND: STAT CLASS:
NO 21
SCHOOL WITHIN HAZARDOUS
QUALITY: 1000 FEET MATERIALS
NO NO NO
REPORT ID: DPR261
BUILDING PERMIT
ALTERATION/REPAIR
SL 0508 1411180086
BUILDING ADDRESS:
9816 FLAHERTY ST
TEMP CA 917801710
NEAREST CROSS STREET: GOLDEN WEST
THOMAS PAGE: 597 GRID: A2 LOCALITY: TEMPLE CITY CA
USE ZONE: R-1 ISSUED ON: PROCESSED BY:
11/18/14 SR
VALUATION: INAL DATE FI By. CODE:
5,000 1\�/ I
FEES PAID SCRilN OF WORK
TEAR OFF REROOF AND INSTALL ASPHALT SHINGLES TO MATCH NEW
QUANTITY: DOM: AMOUNT:JADDITION
27.80
5000.00 VAL 1.00 SPECIAL CONDITIONS:
5000.00 VAL 0.50
5000.00 VAL 132.60
TOTAL FEES 161.90
APPROVALS DATE INSPECTOR SIGNATURE
LOCATION AND SETBACKS
ISOZLS ENGINEER APPROVAL
FOUNDATION/TRENCH FORMS
JSLAB/UNDER FLOOR
RAISED FLOOR FRAMING
UNDERFLOOR INSULATION
FLOOR SHEATHING
]ROOF SHEATHING
SHEAR PANELS
FRAME INSPECTION
FIRE SPRINKLER HANGERS
JINSULATZON/WEATHER STRIP
INTERIOR LATH/DRYWALL
EXTERIOR LATH
RATED FLOOR/CEIL ASSEM.
RATED WALL ASSEMBLIES
(RATED SHAFTS/OPENINGS
IT -BAR CEILINGS
LOT DRAINAGE
ROUTE TO: BS0508
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 L) 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 Contr9ctor 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 whicl1 I must have resided for at least
one year prion to completioq 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: httD://www.leainfo.ca.aov/calaw.html.
Date: 1 I I I
Signature of Property wner or Au o 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
WARMNG: 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:
Carder 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 th workers' compensation laws of
California, and agree that, 4f I should become subject to the
workers' compensation provisions of Section 3700 of the Labor
Code, I shall fop—with fop—withcomply with thos rovisions
S1gnaTurjy tce'gt//" / Date r
LL LOBBYIST O/ORDINANgbI/E CERTIFICATION
Complete this secti n 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
1
JOBADDRESS '
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 requiremgnts
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 1 have
provided is correct.
I agree to comply with all applicable city and county
ordinances and state laws rel Ing to building
construction.
I authorize representatives oihi county to enter the
above -identified propp,prty-for 1r pection purposes.
Signature of P pe OVQzer or
I
Date II I r �-
�' I