The URL can be used to link to this page

Home My Public Portal About4851 FIESTA AVE - MECHANICAL_MECHANICAL__360 E. FIRST STREET TUSTIN CA 92780 EDMOND HANK KWONG (714) 293-1576- 360 E FIRST STREET #500 LIC. NO TUSTIN CA 92780 756780 ARUH1'1'ECI' UK ENGINEER: TEL. N0: DABS STRUCTURAL ENGINEERS (949) 295-7943- 1931 NEWPORT BEACH BLVD LIC. NO: COSTA MESA, CA 92627 74200 # 0508 MECHANICAL PERMIT ME 0508 1505210017 RRP RT Tn- nPR26a Rnn ' gym. nancna BUILDING ADDRESS: 4851 FIESTA AV AMOUNT: TEMP CA 917803815 NEAREST CROSS STREET: LOWER AZUSA 27.80 THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY 104.40 1 104.40 ISSUED ON: PROCESSED BY: PLAN BY: 52.20 05/21/15 SR 48.40 25.80 �FI TE 77.80 r 110.60 551.40 DSS IO OP WOR. INSTALL TWO HVAC S' COMMERCIAL HOOD FOR A NEW SINGLE FAMILY DWELLING SIGNATURE COUNTY OF LOS ANGELES` TEMPLE CITY DEPARTANT OF PUBLIC WOKS 9701 LAS TUNAS BUILDING AND SAFETY / LAND DEVELOPMENT TEMPLE CITY CA 91780 PHONE: (626) 285-0488 EXT; LEGAL ID: FEES PAID TR: 11454 LT: 34 FEE DESCRIPTION: QUANTITY: DOM: ASSESSOR INFORMATION NUMBER: 8590-020-020 O1 PERMIT ISSUANCE FEE 03 COMPRSR 101 500 EBTU 09 FURNACE 101 500 KBTU 2.00 COM 2.00 UNI TENANT: 21 FIREPLACE 101 - 500 1.00 APL 130 AIR INLETS/OUTLETS 132 APPL VENT (OTHER) 11.00 UNI 2.00 UNI OWNER: TEL. NO: KWONG, DAVID (818) 269-3868- 136 AHU 2001-10000 CFM 2.00 AHU 4845 FIESTA AV 141 VENTILATION FAN 7.00 FAN TEMP 917803815 TOTAL FEES APPLICANT: TEL. N0: KWONG, ED (714) 293-1576- 360 E. FIRST STREET TUSTIN CA 92780 EDMOND HANK KWONG (714) 293-1576- 360 E FIRST STREET #500 LIC. NO TUSTIN CA 92780 756780 ARUH1'1'ECI' UK ENGINEER: TEL. N0: DABS STRUCTURAL ENGINEERS (949) 295-7943- 1931 NEWPORT BEACH BLVD LIC. NO: COSTA MESA, CA 92627 74200 # 0508 MECHANICAL PERMIT ME 0508 1505210017 RRP RT Tn- nPR26a Rnn ' gym. nancna BUILDING ADDRESS: 4851 FIESTA AV AMOUNT: TEMP CA 917803815 NEAREST CROSS STREET: LOWER AZUSA 27.80 THOMAS PAGE: 597 GRID: AS LOCALITY: TEMPLE CITY 104.40 1 104.40 ISSUED ON: PROCESSED BY: PLAN BY: 52.20 05/21/15 SR 48.40 25.80 �FI TE 77.80 r 110.60 551.40 DSS IO OP WOR. INSTALL TWO HVAC S' COMMERCIAL HOOD FOR A NEW SINGLE FAMILY DWELLING SIGNATURE 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 (_) 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.). (_) 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 Con" ctor 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 which I must have resided for at least one year prior) to completioq of the Improvements covered by this permit, I c4nnot 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:/Avww.leginfo.ca.aov/calaw.htmi. 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 License No. _% sp❑ `� Date *t ->Contractor Signature WORKERS' COMPENSATION DEC TION 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. JOB ADDRE S 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 modiflcation 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 I hereby affirm under penalty of perjury one of the following SCAQMD permitting checklist, I understand my requirements declarations: under the Los Angeles County Code Title 2, Chapter 220, 1 have and will maintain a certificate of consent to self- Sections 220.100 through 220.140 concerning hazardous insure for workers' compensation, issued by the Director of material reporting and for obtaining a permit from the SCAQMD. Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit ASBESTOS NOTIFICATION is issued. TPoljcy No. El Notification letter sent to AQMD and/or EPA I have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for ❑ I declare that notification of asbestos removal is not the performance of the work for which this permit is issued. My applicable to addressed project. work rs' omp rlsati Ins j]nccee caller and policy number are: �,/ Carder Po��l'Icy um ei Expire— D V 7S DECLARATION REGARDING CONSTRUCTION LENDING AGENCY 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 Sa I rs Signature of Applioan 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 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 Lenders Address By my signature below, I certify to,each of the following: I am the property owner or authorized to act on the property owners 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 Ppnperty Owner or Authorized Agent Date 5 J S