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Home My Public Portal About5125 PAL MAL AVE_Building_10/10/2006_COUNTY OF LOS ANGELES TEMPLE CITY # 0508 BUILDING PERMIT DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS RESIDENTIAL ADD BUVZING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 BL 0508 0610100006 PHONE: (626) 285-0488 EXT: LEGAL ID: TR: 12205 LT: 8 NO. OF CONST NEW SQ. FT STORIES TYPE OCCUP GROUP STRUCTURE: 0 1 VN R3 GARAGE: 800 1 VN U1 OTHER: BUILDING ADDRESS: 5125 PAL MAL AV TEMP CA 917803434 NEAREST CROSS STREET: FREER THOMAS PAGE: 597 GRID: C4 LOCALITY: TEMPLE CITY, C ASSESSOR INFORMATION NUMBER: 8585-022-009 TENANT: EXIST BLDG USE: USE ZONE: EXIST OCC GRP: ISSUED ON: PROCESSED BY: EXPIRES ON: 10/10/06 JH 10/05/07 OWNER: TEL. NO: SANDOVAL JAIME, CHRISTIAN (626) 444-0241- 5125 PAL MAL AV TEMP 917803434 SLUGS. NOW ON LOT: VALUATION: 23,680 FINAL DATE =X4 /PI ��MO�BY: CODE: PEES PAID FEE DESCRIPTION: QUANTITY: UOM: AMOUNT: AA BLDG PERMIT ISSUANCE 27.75 AC STRONG MOTION RESID 23680.00 VAL 2.37 AX BUILDING REVIEW FEE 54.70 D2 PERMIT W/O EN -HC 23680.00 VAL 451.80 TOTAL FEES 536.62 REPORT ID: DPR261 ROUTE TO: BS0508 DESCRIPTION OF WORKG1U' BUILD DETACHED 4 CAR GARAGE APPLICANT: TEL. NO: SANDOVAL (626) 444-0241- 5125 PAL MAL AVE TEMPLE CITY CA 91780 SPECIAL CONDITIONS: CONTRACTOR: TEL. NO: SANDOVAL, JAIME (626) 444-0241- 5125 PAL MAL AVENUE LIC. NO TEMPLE CITY, CA 91780 NOME APPROVALS DATE INSPECTOR SIGNATURE LOCATION AND SETBACKS SOILS ENGINEER APPROVAL ARCHITECT OR ENGINEER: TEL. NO: LIC. NO: FOUNDATION TRENCH FORMS SLAB UNDER FLOOR RAISED FLOOR FRAMING MAP NO: SEWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 01 UNDERFLOOR INSULATION 1ST LEVEL FLOOR SHEATH NO. OF FAMILIES: DWELLING UNITS: APT COND: STAT CLASS: NO 21 2ND LEVEL FLOOR SHEATH SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO ROOF SHEATHING FIRE DEPT. FRAME INSPECT REQUIRED TOTAL SETBACK FROM EXIST SET BACK YARD: EWY: PROP LINE: WIDTH: FRONT PL- SIDE PL- BLDG DEPT. FRAME INSPECT Jl 1. SHEAR PANELS INSULATION/WEATHER STRIP INTERIOR LATH/DRYWALL EXTERIOR LATH i LOT DRAINAGE SMOKE DETECTION DEVICES FIRE DEPARTMENT APPROVAL 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 Lic. No. Contractor's Signature Date OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500).): ❑ 1 am exempt under Sec. , B.8 P.C. for this reason: [ Electrical, Plumbing h Sewer Permits Only ] ❑ I, as owner of the property, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself, provided that such 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 he or she did not build or improve for the purpose of sale.). [ All Other Permits ] ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such 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 he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law.). Owner I Date b/ WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to sell -insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carder and policy number are: Carrier Policy 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 worker's compensation laws of California. and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. pplipAp nature Da eO//� WARNING: FAILURE TO SECURE WORKER'S 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. 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 (it employed by an entity/agency) 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 ❑ No ❑ I have read the hazardous materials information guide and the SCAOMD 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 Irom the SCAQMD. ASBESTOS NOTIFICATION ❑ Notification letter sent to SCAQMD or EPA ❑ 1 declare that notification of asbestos removal is not applicable to addressed project. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that mere is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097, Civ.C.). Lender's Name Lander's Address "s`fZlj1i if certify that 1 have read this application and state under the penalty of perjury that the above information is correct if agree to comply with all City and County ordinances and State laws relating to building construction, and hereby authorize representatives of this County to enter upon the above-mentiogp,d property for inspection purposes. Applica o Agent Signature Date