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Home My Public Portal About6050 HART AVE_BUILDING_6/13/2016_OWNER: CHANG, EDWARD 76 W PALM DRIVE ARCADIA CA 91007 'L1lJLLY'1 ,NG, EDWARD W PALM DRIVE ADIA CA 91007 wN'1RAUIVX: TA WAY DEVELOPMENT INC. 76 W PALM DRIVE ARCADIA CA 91007 TEL. NO: (626) 512-8604 TEL. NO: (626) 512 -8604 - LIC. NO 709275 ARCHITECT OR ENGINEER: TEL. NO: CT MAX DEVELOPMENT, INC. 112 N EARLE ST LIC. NO: SAN GABRIEL CA 91775 NONE EMAP NU: SOWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 01 NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 NO O1 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO '.0 I1 tixYlliCy IOU UAYS 1F 1) WORK DOES NOT COMMENCE, OR 2) WORK IS SUSPENDED OR ABANDONED, OR 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION ON LOT: VALUATION: IFINALpr+T FINAL CODE: 444,360 1 b/._) _ / _/ FEES PAID DESCRIPTION OF WORK --- k NEW 2 -STORY SFD: 4 BEDROOMS, 4.5 BATHROOMS, WITH ATTACHED 3 FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: CAR GARAGEANDCOVERED PORCH H1 PLANCHECK W/ENERGY 994360.00 VAL 3,334.00 AA BLDG PERMIT ISSUANCE 34.40 ISPECIAL CONDITIONS: AB STATE GREEN BLDG FEE 444360.00 VAL 18.00 (FIRE SPRINKLERS REQUIRED AC STRONG MOTION REBID 444360.00 VAL 57.80 B2 PERMIT W/ENERGY 444360.00 VAL 4,913.50 1 08 CERTIF OF OCCUPANCY 125.80 (APPROVALS DATE INSPECTOR,S GMATURE TOTAL FEES 8,483.50 I •j lan ^ LOCATxoN AND SETBACKS Jit`,[ J� V/'4p•^1J{�.'�` /:�%Cy 7 7 �1(4C�`ln`l!-'` rV ` (SOILS ENGINEER APPROVAL VS FOUNDATION/TRENCH FORMS (D 1 SLAB/UNDER FLOOR 4 REPORT ID: DPR261 ROUTE TO: BSO508 JUNDERFLOOR INSULATION 1 1 1ST LEVEL FLOOR SHEATH I 2ND LEVEL FLOOR SHEATH�� ROOF SHEATHING I WA IFIRE DEPT. FRAME INSPECT, r ' FIRE COUNTY OP'LOS ANGPLgS -� TEMPLE CITY p 0508 BUILDING PERMIT '-DEPARTMENT OF PUBLIC WORKS 9701 LAS TUNAS NEW RESIDENTIAL BUILDING AND SAFETY / LAND DEVELOPMENT. TEMPLE CITY CA 91780 BL 0508 1510080083 ` •� PHONE: (626) 285-0488 EXT: ILEGAL ID: NO. OF CONST NEW I BUILDING ADDRESS: ITR: 5904 IT: 345 SQ. FT STORIES TYPE OCCUP GROUP 6050 HART AV STRUCTURE: 3023 2 V -B R-3 I TEMP CA 917801914 ASSESSOR INFORMATION NUMBER: GARAGE: O CROSS STREET: LDI AGE: I 345 1 V -B U THOMAS D; H2 THOMAS PAGE: 596 GRID: H2 LOCALITY: TEMPLE CITY GI (TENANT: I USE ZONE: R-1 ISSUED ON: PROCESSED BY: 06/13/16 SR OWNER: CHANG, EDWARD 76 W PALM DRIVE ARCADIA CA 91007 'L1lJLLY'1 ,NG, EDWARD W PALM DRIVE ADIA CA 91007 wN'1RAUIVX: TA WAY DEVELOPMENT INC. 76 W PALM DRIVE ARCADIA CA 91007 TEL. NO: (626) 512-8604 TEL. NO: (626) 512 -8604 - LIC. NO 709275 ARCHITECT OR ENGINEER: TEL. NO: CT MAX DEVELOPMENT, INC. 112 N EARLE ST LIC. NO: SAN GABRIEL CA 91775 NONE EMAP NU: SOWER MAP BOOK: PAGE: FIRE ZONE: CMP: 3 01 NO. OF FAMILIES: DWELLING UNITS: APT/GOND: STAT CLASS: 1 NO O1 SCHOOL WITHIN HAZARDOUS AIR QUALITY: 1000 FEET MATERIALS NO NO NO '.0 I1 tixYlliCy IOU UAYS 1F 1) WORK DOES NOT COMMENCE, OR 2) WORK IS SUSPENDED OR ABANDONED, OR 3) FAILS TO OBTAIN CODE REQUIRED INSPECTION ON LOT: VALUATION: IFINALpr+T FINAL CODE: 444,360 1 b/._) _ / _/ FEES PAID DESCRIPTION OF WORK --- k NEW 2 -STORY SFD: 4 BEDROOMS, 4.5 BATHROOMS, WITH ATTACHED 3 FEE DESCRIPTION: QUANTITY: DOM: AMOUNT: CAR GARAGEANDCOVERED PORCH H1 PLANCHECK W/ENERGY 994360.00 VAL 3,334.00 AA BLDG PERMIT ISSUANCE 34.40 ISPECIAL CONDITIONS: AB STATE GREEN BLDG FEE 444360.00 VAL 18.00 (FIRE SPRINKLERS REQUIRED AC STRONG MOTION REBID 444360.00 VAL 57.80 B2 PERMIT W/ENERGY 444360.00 VAL 4,913.50 1 08 CERTIF OF OCCUPANCY 125.80 (APPROVALS DATE INSPECTOR,S GMATURE TOTAL FEES 8,483.50 I •j lan ^ LOCATxoN AND SETBACKS Jit`,[ J� V/'4p•^1J{�.'�` /:�%Cy 7 7 �1(4C�`ln`l!-'` rV ` (SOILS ENGINEER APPROVAL VS FOUNDATION/TRENCH FORMS (D 1 SLAB/UNDER FLOOR 4 REPORT ID: DPR261 ROUTE TO: BSO508 JUNDERFLOOR INSULATION 1 1 1ST LEVEL FLOOR SHEATH I 2ND LEVEL FLOOR SHEATH�� ROOF SHEATHING I WA IFIRE DEPT. FRAME INSPECT, r ' FIRE 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, atter, 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.). 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 Contractor 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 which I must have resided for at least one year priorlto complebory 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. 1 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.leciinfo.ca.goylealaw.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 License No. 7o9275- C117116 Date ��G Contractor Signature v 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 I surance, as required by Section 3700 of the Labor Code, for the pert mance of the work for which this permit is issued. My yrer k com rrsatio ns r o a d policy umber are: Cl i � -1 Carder Policy piration atd 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 1 should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions ,//7 Signature of Applfi5mt 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 s 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 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. Sig` Authorized Agent DateCl/fIl6