The URL can be used to link to this page

Home My Public Portal AboutOAK AVE___ (3)TEMPLE CITY PERMIT NO. P17-34642 Approval Date Inspector City of Tempe City 1 9701 Las Tunas Drive I Temple City, California 91780 1 (626) 285-2171 1 www.templeclty.us Address: 9459 Live Oak Avenue, Temple City, California 91780 Parcel: 8587-010-034 Permit No: P17-34642 Type: Plumbing Subtype: Subtype: Residential Description: WATER LINE RE -PIPE - PARTIAL TO 3 FIXTURES 3/4 APPROX 90 Special FINAL SQ.FT. Conditions: issue Date: 08-01-2017 Expire Date: 01-28-2018 Extension: Extension: Permit expuw on date shown If: 1) work does net commence, or 2) work is suspended or abandoned, or 3) applicant falls to obtain code required ns,,a ion. .OIILdLI, Owner Ray Richey Applicant Brandon Ford Contractor iunrbuig Details Backwater 0 Valve Drinking 0 Fountain Lavatory/Sink 0 Pool Trap 0 Gas: Low 0 Press Greywater 0 System Other: over 3 0 inches Sewer: 0 PB/Drainneld Fees Total Mike Diamond Plumbing DBA Mike Diamond Plumbing Heating and Air Conditioning Backflow, 0 Device Floor Drain 0 Miscellaneous 0 Trap Primer 0 Gas: 0 Mad/High Press Pipe 3 Replacement Sewer: 0 Connection Sewer; Pit o Extension Combo Waste/Vent Earthquake Shutoff Plan Check Fees $113.60 Permit Fees $26.32 Plumbing. inspections Approval Date Inspector Under Slab Work Water Service Mastic Y/N Metal Y/N Rough Plumbing • Sewer Inspections Approval Date Inspector New House Sewer Connect Add'I Septic Tank/tht Bathtub/Shower 0 Floor Sink 0 Pressure 0 Regulator Water Closet 0 Gas Meter 0 Future Branches 0 Sewer: Manhole 0 Sewer: 0 Alteration 9459 Live Oak Avenue, Temple City, California 91780 3801 Unease Avenue, Culver City, California 90232 3801 Lenaw se Avenue, Culver City, California 90232 Chemical Waste Clothes 0 Washer Hose Bibb 0 Roof Drain 0 Water 0 Heater Gas 0 Regulator Other: I.S 0 Inches or less Sewer: 0 Addition Sewer: 0 Tapesaddle Rainwater (626) 285-7307 (310)838-0408 (310)838-0408 399170 Dishwasher 0 Interceptor/Clarifier ? Solar Water Heater l Water Treatment ; Alteration/ Repair 0 Other: 2-3 inches 0 Sewer: Private 0 Connection Greywater, Approval Date Inspector Approval Date Inspector Gas Piping Gas Test Gas Vent Utility Co Notified NM Water Heater Plumbing Fixturese CWV Gy Water System Lawn Sprinkles FINAL Approval Drywall Alter/Repair Disconnect/Plug Date Inspector Approval Date Inspector Backfill Took/Pit Gray Water System FINAL X_ IQ 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 filea 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 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 rce and effect. II -License Class License No. J( uateContractor Signature JOB ADDRESS r 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? WORKERS' COMPENSATION DECLARATION Yes ❑ No ❑ 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. work, and the structure is not Intended or offered for sale (Section 7044, Business and Professions Code: The I hereby affirm under penalty of perjury one of the following Contractors' State License Law does not apply to an owner of declarations: property who, through employees' or personal effort, builds or I have and will maintain a certificate of consent to self - improves the property, provided that the improvements are not insure for workers' compensation, issued by the Director of intended or offered for sale. If, however, the building or Industrial Relations as provided for by Section 3700 of the improvement is sold within one year of completion, the Owner- Labor Code, for the performance of the work for which this permit Builder will have the burden of proving that it was not built or is issued. improved for the purpose of sale.).No. Po' I have and will maintain workers' compensation U I, as owner of the property, am exclusively contracting with insurance, as required by Section 3700 of the Labor Code, for licensed Contractors to construct the project (Section 7044, the perfprmance of the work for which this permit is issued. My Business and Professions Code: The Contractors' State Licensee 1worke ainpen n insUT;ce Larjgr andtolicy u e f� Law does not apply to an owner of property who builds o r,,,1F%�f�,,(p b_ U improves thereon, and who contracts for the projects with a Caller licy Number Explrati n Date licensed Contractor pursuant to the Contractors' State License Law). Name of Agent Phone Number U I am exem(t 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 prior) 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: http://www.leginfo.ca.gov/calaw.html. Date: Signature of Property Owner or Authorized Agent 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 hall forthw'; comply wit those provisions j _/-1 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 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. Signal f Property Ow or Auth ed Agent Ali