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HomeMy WebLinkAboutOld permits 1 Development Services Departme ei1 :- 240 West Huntington Drive,Post u.iice Box 60021 PERMI O. B00_015-342 ,/ Arcadia,CA 91066-6021 Arcadia (626) 574-5416,Fax (626)447-9173 Permit Type: Plumbing PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 4/17/2003 MB 15:04 4/17/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct T1107 OWNER MAILING ••.. li 111 1 'ARCADIA OAKS LLC l�1 - PHONE NO. Inspector#: 206 EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS CASA PLUMBING INC 856 ELM ST L PHONE NO. (714) 771-6073 FAX NO. ORANGE,CA 92867 EMAIL ADDRESS: License No. 809831 Type: C Expires: 6/30/2004 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION FIXTURES FOR NEW HOUSE Construction Type UOM #of Units Value Construction Type UOM #of Units Value OCCUPANCY: Dwellings TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT Flat Plmbg Issue A $40.25 $40.25 01-3105 each SWMF 2 Auto $1.00 $1.00 88-3027 4 each Bathtub $45.20 $45.20 01-3105 Totals for: 88-3027 $1.00 $1.00 2 each Shower $22.60 $22.60 01-3105 6 each Water Closet $67.80 $67.80 01-3105 7 each Lavatories $79.10 $79.10 01-3105 1 each Bidet $11.30 $11.30 01-3105 I I 2 each Kitchen sinks $22.60 $22.60 01-3105 2 each Dishwashers $22.60 $22.60 01-3105 2 each Garbage Disp $22.60 $22.60 01-3105 FI ' l!^' I ��'‘ 2 each Bar sink $22.60 $22.60 01-3105 1 each Lndry trays $11.30 $11.30 01-3105 1 each Clothes wsh $11.30 $11.30 01-3105 1 each Wtr htr/vent $14.10 $14.10 01-3105 8 outlets Gas piping $22.50 $22.50 01-3105 1 each unit Sewer connec $28.25 $28.25 01-3105 Totals for: 01-3105 $444.10 $444.10 Total Fees: $445.10 Total Amount Paid: $445.10 Paid Today: $445.10 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday-Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) • A l� t • �w PERIviIT/PLAN REVIEW APPLICATION rroA Development Services Department, 240 West Huntington Drive, Post Office Box 60021 "'°�T• Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and effect. �/ ❑ I have and will maintain a certificate of consent to self-insure for workers' License Clas License No%il 41, Ex..Day F compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor If ❑ I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers' comlen ati• insurance carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Carrier 7 "YAP/ A. , / 044-, ✓r - •- 1-° 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 /;`a� Policy Number t/ for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comp) with those provisions. ❑ 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 Date Applicant sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(I)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further /��err information. Name 414,41) 01 e Title PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the abov -mentioned property for inspection purposes.• Date fhil°Signature nt By: ; 9497259322; Sep-4-01 11 : i4AM; Page d/ 05-14-0' 02:05pm From-CDD 6264479173 335 P.02/02 F-664 i4 .;y' • -al f� - " CITY OF ARCADIA 240.West Huntington Drive Arcadia, CA 91007 . ROUGH GRADING VERIFICATION ATTENTION: Community Development Administrator. . SUBJECT: Grading Verification for Project No f rac...-i- .. Rip S Z 7 cL\ Address: 70 _ - , • L;'�1 i&ii1 1i Areccr(c .ce.. Q1000 , Gentlemen: //O 7 &N/k� rv,,,a,w Coo r-vt-.. Rough grading operations have been completed for Project No 2 for Lo through (if applicable) and has been inspected _...by the undersigned Registered Civil Engineer or Licensed Architect.. Based upon the observations, the rough grading of the lot(s) listed above have been ,completed in conformance with plans marked "APPROVED" by the City. The work includes but is not limited to the following: grading to approximate final .elevations; staking of.property lines; location and gradient of cut and fill slopes; .location, cross- sectional configuration and flow-line.gradient of drainage swales and terraces; berms - installed where indicated; and required drainage slopes provided on building.pads. Enclosed herewith is a Soil and Compaction Report for the Building Division which is required on all new construction sites prior to footing inspection: QikOFESS H /1 l` - .�4`- V MqN '4!� 'Engineer(Sign•tore) .`Z>oj. •' .ape 'yam rchitect (Signature)'. •. R.C.E. No. f X703 II W No.13703 ` y.`P.A. No. - Exp. 3/31/05 Date: C//(c/p'-5 *k * Received and approved` ` ,A C i V 1 �►,; OF CALF' Date: C.D.D./Plaru ing cc: C.D.D./Maint. Ser. C.D:D./Building • jok March 24, 2005 Building Department CITY OF ARCADIA 240 West Huntington Drive Arcadia, CA 91007 RE: 1107 Englemann Court Attention Building Department: This letter serves as written authorization to remove the following company as the currently listed contractor relating to my property: TNT Plumbing & General Contracting 2601 North Del Rosa Avenue, Suite 220 San Bernardino, CA 92404 License# 399291 Kindly replace this information with my name as OWNER/BUILDER and provide Greg Caraveo with a new job card. Thank you for you immediate attention to this matter. uiz Ignacio 240 WES']'HUNTINGTON D171vg j 1.`',RC:ADIA,(;A 91007 13UlI,DING BFRVl3!.ES (626)574-`JIG Application is hereby mode to the Building Ofrioinl for A permit subject to the enndltlohs I hereby affirm under penalty of p nju[yth am exempt from tlOaf OO,trnctor'a License Zacj fOr Mid restrictions set torch ont ib application.—— Urc following rant= (saes 7031,5 Business and Professions Code: Any city or county wtielt • --— ——. — -- requires n permit to construct, altar, improve, demolish. or repair any snucturo, f orkers'COtnprnrarOpDecforatiDn issunnae,also requires the applicant for such permit to file n Signed PR or tc :i I hereby affirm under penalty ofperjury one of the following; (check nppro rinte line Bred�'tpem9rit that en i w h _rhave and will maintain a certificate of consent to self insure for workers'compensation, Section 7000)of Division n3 of the Bhn Connector's Licence Co or that h(o or sho is ex mpt as provided for by geetlon 3700 of the Labor Code,for tho performance of the work for which therefrom and the basis for the alle rcexemption. Anny vi Code or Se he or shu 3 exempt this ctm,t is issued. 6 Any violation of Section 7031,5 by ai?' EIPPliant I have and will maintain workcre compenaation insuranc0.tie required by section 3700 of 5300.00)for a penult subjects the applicant to civil penalty of not moro than five hundred delis;. Mc Labor Code,for the performance of the work for which this permit is issued. ley werltnrs oompensation manna=carrier and policy number;are_ 0 L as owner of the properr ,or nu'amployoos vzith wages y,their note aornpcnsat on,will do a 11,005'40q, the work and flay structure re not intended oJ'offered for sale(Sc e.70d4 Business and Professions Carrier polioyd 2 Codc:The Contractor's License Law don,rot apply to act owner of ptoperty who builds or improves thereon,or who does such work himself or herself or through his or her own employees, CLRTIFICATE OF EXEMPTION FROM WORCtiIERS' provided that such improvements are not intended or offered for sole, If,however.the building or COMPENSATION INSURANCE improvement is sold within ono 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 sole). I certify that in the performance of the work for which this permit is issued.I shall not employ 0 T.ss owner of the property,am en.Clusivcly.eouttneting with liaxtseci coos-notary to construct any person in any mckrttor so as to become subject to workers compensation Laws of California. the project(Sec.7044 Business and Professions Code:The Contractors License Law does not and agree that if I shculd become subject to the workers'compensation provision,of gcetiou apply to an owner of property who builds Or improves thereon and who contracts for:ach 3700 of the Labor Code,I t3hadt forthwith comply with those provisions. projects with a contract(s)licensed pursuant to the Contractor's License Law), Applicant: .. 0 T tmr exempt under Section _ �,B.h E.C.for sirs WARNING: Failure to scotue workers compensation insurance is unlawful and shall subject an r'18°L1:—_ employer to criminal penalties and civil lines of up to One hundred thousand dollars($1 00,000), "�— in Addition to the cost of compensation,damages as provided for in tho Labor Code,interest and OwNLR: — DATE: =windy fees.=windy I.10ENSED CONTRACTOR'S'DECLARATION f hereby attinu under penalty of pemuy that I stn licensed under provisions of Chapter 9 t certify that I have read this applic flan and mate that the nbo've information is confect and : (commencing with Section 7000)of Dr vision 3 of the Business and Professions si Code,and Ins rem the owner or a duly authorized agent of the owner.I agree to comply with all city,rid r license is in full force and ofl'eat, laws relating to building construction and hereby autheri- represcnlativcs of the City of Arco:,,_ T^r7 r] r to enter u on the cr e-atimbauCd prop qy for inspect purpose*. License Number .41?!��/!�32;2-- License Glass ('J �_ �/, /� Ezparuuon Date of Contractor's License I-" I ( 1 t• re o ow •, agent or contractor p;c r_,u,( xk} LLC ELECTRICAL PERMIT ,.'1:�,.,t.1 iu�L„iii�. ......}} .Irki;1q 7,ti{�i';n.:,:yi:,,,IIJilP.,..,...>i,: nia•'33,3 1'.>a,I;lktii•:..::i'.:}}}�sr`.3u>t> w Diu ._• ,., ... f ff •c ,�.t•.. ,.•ant 1. }q;r.'.,.} 11 fail ,: ,;tJ•,, ,....:,•,,, .., it, :c.,,, 6. lift,:, t f 1 1 jAi3 ',.iN Y - 1f'a.1'•.�„,,1,l 1 0” l ' 'lil.l;,;isi,�:fir 1, CAI— Ei .... .... ,•• r ii liij i, . • fir- rj } . • , :- r ., �.i,••r � `, '' l sST� ;,; 13 . .. .,,, 77-. t , 1 I 1 it 1 �r•• ,,,y ,7., WI•1 J .:J1 :; „ii 11!;17,1)33,:1. 4 71 i I1 1 :';;-;p 7 i :a,] . •3'•:,- 1(1,•1;1'l Berner Elect f 4J 3 ,7- 44. 3 , it.;37t,»c'.:..,::. 711 ., d.,,�,i.• ;}• , Inc. ' ',: 'l,.11.� ,." t•. ii 255 Citation ii>: ' : qrc ,:, '• :.11i;i i� fy?d�lless tl.n Circle c ��} � Qy�17 "f.":1°•n r.'l.i i:, 'iF^,.J)cl �C�'�;� } a!Li 333 3ii>:"u:•;)i'i J' ► Corona CA 92 m3;.:31,,,:;,,,.,.r'a)i111.'ill'', 11'1J4LYi� ll I11J 311:1 to 33f p•P) 880-2523 .il'll'I,,,.�.,i, I,....! '�h•.)„t,'a 31e 7��' ',1'11!.3,'' 'ql,: ll.l;3l~ H p kiii;::.1.::. ' : J,i,;:lll,, , �'i.i 3,1:3?t d ..,... J„ ',”: i 1. ... ...3•11:;,33::33 3,- ..0..,:77.....!A;3. 33.N;3 43))ii.::,i.,;]1a..rL1:3'i. �'��• c' i ;)1 3 ,� �rte `/'y� ...4-49(.0-C7 ,,c. J '1: ,3�°,iii:°''foe•1!�,t a.i.J..., r i 3 i33. u.g�. Description� `��-"�' ' �''1•T '�';�3• 1�• —yr'1,/ l,, ,is p)�:,;:4'111'r.''.t;:'"i':()li I:ill.'>':.3i3''>}; :i+Ipiltri,,,1 t'n 311),;':':J5-:i'�'i-'l y•�t I i.•,,,c; •t .t.,J� __ 13 'i:.) F11-,,1314:7:,''Ili.:::l• tJ i,:JZ •13�3�i.1,.:. '137f'tni'ii' ,1,1'311 . ,1 -„t,, .•.,. .all Ilir ).,,P,lt11L ,f,.1.,:3tl.. 1:I,,l S�l"%:,,•,•:I 1, )Isi10.".• .. J II){:1,3, ' rf:;'. ufaF{l Fee No. �3)lI'.. li i 33. if.1,i1 . i°�Itpl .�:3 fly'' i'`..,!'1.1;Ali Description Fee No. Amt. Power Schedule for Equipment Rated in m,KV ,, KW or KVAR 1-20 receptacle,switch or lighting outlets 1.40 etas 11111111111.111 Over 0,not over 1.eacll t Each additional switch,receptacle or outlet 0.90 6.)0 Over 1,not over 10,each 14,10 I-20 lighting fixtures or lamp devices 1,40 ca. Over 10,not over 50,each Each additional lighting fixture or lamp 0.90 �J.5 M; Uver 50,not over 100.each 70.55 5 N MEM ew residential constriction 0.05 ps MIMEO Over 100,each New assessory structure w/new dwelling 0,04 pa! � 400 11 . 00 A 00 amp or less res.idenlial service ' Residential appliances not exceeding 1 HP 5.65 ea. 14.1) �►" 200 amp or lass eorxlmcrcial.service I9.10 220 or240 volt receptacles 5.65 ea_ iiiiing. 20lamp to 1000 amp commercial service 5 Swimming pool and/or spa 56.35 Over 100()amp commercial service 141.35 Branch circuit for one sign 56,35 NM Each additional motel' For ecch additional sign branch circuit 5-65 14-10 �� vliscel.laneous Dishibulionpanai_each 14.10 6........ Temporary power pole w/service panel :Tull Description of Work; Each additional power pole w/panel 14.10 MI Solid Waste Management(SWA'1F)and 47.25 • Processing fee Total fee.including Processing and SWlv-IF „, `? r Price per square foot 4 i i OPIN 11 09:0Tam From-CDD 6264479173 %"�9. T-617 P.01/01 F-897.:: :240 west Huntington Drive ELECTRICAL:'- MECHANICAL -:PLUMBING � j '•Arcadia,CA. 9t006-6021 PERMIT"WORKSHEET (626)•5745416 BUILDING ADDRESS . rJ DESCRIPTION OF WORK • ELECTRICAb • '` SQU4RB'FEET ' ±5561. F—� .TYPE OF CONSTRUCTIQN W ALUATION • A.RCAD•IA OAKS,'' LLC 9 . . OWNER NAME•' ;.• ......... •• .:35'01 JAM,BO1 EE ROAD,' SUITE .2000 • Cry NEWPORT >•3ECAH STAYE:..0 - •zIP 12660 '-'. ADDRESS ' . • BERNER ELECTRIC.,' INC.: '' '9b9-x73`4 -31.71:>° PHONE . APPLICANT.NAME: . • •• •• • •,2:55 •.CITATION CIRCLE'. IRCLE' ciTY CORONA STATE CA ,f• .p 9.2$81) ADDRESS 949-Z? -.9�oa O • CONTRACTR;:. 'CAL METRO BUILDERS .' INC.• ••PHONE,.;.„-• ADDRESS'"., '3.501 . JAMBOREE `ROAD; SUITE. 2000 C1.i,NEWPOR'r.BEACH ,.STATE ' CA Zp . 6O ' , 4 8 5'32 2 2 Cl.n•. EXPIRATION DATE 10 31 f,o 'CITY.LICENSE_NO •�r� , . STATE LiC*- ''N0. l ICENSE CLASS ,- 7..:.7 t. ,,.y,,,! ...... 1 PLll,tlyl8Il�l�c0..s STEM . ....,......4t.:).2.,.:.•,, J,• •#of Units I Description . ;:(Additions.Commercial Industriap #of.Units• .Description• ! • ' Temporary Power_Pole #of.Panels:__._n_... ._____. _ ;aam�ubs ..,.- ,, ,. • 1. I Services'- ., •. , Size:_•4 00 AMP. .... . .. -. , Showers . ---- `.7'Outlets(Receptacles Switc tes) :. ..._ j Water Closets - — �'FIxtures: ., ,, _-. _. . . ._...... Lauatatles , ' •S�bpanel: 2o©. AMP Size: . .. __... • . , ........ - .K1t�..e^Sink . _ ,.;Sign BranchCirc. , „ _._ _ . . ._ . __. _�, , ;Dishwashers :: ..: )• I Miscellaneous. Garbage D sposi�is' u 3 Sq. Ft;Area New s, .:.....::..,. q,'Ft ilras N9w Res:Bldg. / Floor Sink Bldg., Accessory ,_.: Floor.Drain '• -r*4- #.of Units Reecription .._•.•..•:.____ . ., 'Laundry Trays FAU'to and including 100,000 BTU .«_n _ r ,,,-"...,•Y1 ..L t "2;,1 m - - Cibthe's,'Wash®r� FAU • , over.100,000 8'TU _ •• • ..-� -. Grease Trap '• • : -• • �• Floor/Wall I SUS.P:/Heater. •---- • • Gs's Systems-#,outlets Pre-Fab Flreplacei . .. __ ., .. ..... .SSh o er Pan Ra lacement • ;�•:•' Kitchen Exhaust Hood .' w ^ ,;, .• • • � � con Fan nduding duc t(COM•and IND only). - • wim'rbfria Pool•Piping "p"-gip , �• s ,' ' Boller./Cornpressor'to and Includin9:3HP Po'b1.Water Heater� ,�• �'' bolter/Compressor ressor over 3HP to 11H1' ,-_. Boller./oompreisor over 1'6HP'to 3OHP :Sewer-Connections• ....,:4,:s..;• !, �-;;.• • ..',Boiler.I Compressor Over 3OHP to 50HP •'Boiler./Compressor over 50HP to 1,75HP” 4a'wn Sprinkler System , 'Air-'Ffandler to end.inoludli 9 10,000'CFM . •Micellaneous.. ' -F. andler over 10 000 CFM I:, F;• to/Add Registers or Ducts • • 1'; ' /3db -o /to - 3gy •/4i-use%o ip//, 3 P/4)-) 2A //0 7 1.-?:-A). 4 Cae,s,rt' YE I - - - - - - -.- _ - . - ;- - -�� _ Iv ; i , I ir • . • . III 1 ... , WI, , • ' B. t, , • . . p fr, i 1 ,,. , /: „i , 1 !- •� ifs' `�' ' 1 ii • r �+ oda�a C PAD MO I 1 , 1 a n , ?!. - i.,,1 ': k):I ; ‘9.> :P4X. , 4. ) / ,�.+►- - .. e., ` � /�' i,/ 1• (� 1..`467 �^ r 4 :' `. 1 k: " ' . ;.,- II , : .. 1:.1 2' .4 . I -•••-••••• LI ell, It r■ ■ 1.59 7," - , 1.24;,, - / ti ROUTING pate and i AC---- t ;; ç ,* Ser Initial::. ! ' <�� �r I Notes sheett/. PI inning 7iS CA/ A.R.A. , Enq. _ ,._ Bui1din Fire «.. ' _ PWS Water 1.....H., P W S-NPQES= , _ _`i~ �_ _. .. r It JUN-26-2003 09:07 0,0iQST INC. 714 4468689 P.02/02 ostsk„ . - 2 .i.,4_4.41'•,4 ' : 1. ' ,i . , 11.111316Z.H.L. 2...1-76-rthe.i.■ TUNE 26,2003 .. . CITY OF ARCADIA,„,... .- . . 240 W.HUNTIN9TON Dit 1 - i . 1.•'-i„s : . ARCADIA,CA?"91066 , 1 . ... . . , ATTENT , Bull DING 0EPARTMENli . . .,.. ? . . . 1 \ . . REFERENCE: ARCADIA OAKS PRO : —TRACT 52745 !, LOT 9- 1107 ENGLE 1' ).''COURT , - . - TEES LETTER SERVES AS MY VERIFICATION OF BUILDDIG FOR.M BOARD 1.: • . . ' SETBACK LOCATION&F.F.ELEVATIO$PER THE PRECISWGRADRIO ht. BUILDING ENVELOPE PLAN PREPAREUY KEITH&ASSOCIATES.,TRE FORM BOARDS ARE IN qUBSTANTIAL NFORNIANC,E WITH THE REVISED FINISHED FLOOR.OF 660.58 AS SHOWN ON ItEVISILINDATE,111:2-61737'THISVEItIFICATIONISEASEfre14,21/411E11,-elfMt ON 6-26-03. t •., 't 1 . , SINCERELY, 4r-it".' 4.0lioe . 1 1 : I i ...„..1.4.....:... RON POST 11 PRESIDENT • : -. . • " 1 . Nfri, . . ..... • li . , ...... . . . -- ' ' ' s - • . - * • .d1411115 ' ''''''-- I 1 A ,. V • ..-' - : — ,• , • . , . . . . • ., . . LAND SURVEYING . a C014S1IR a AtA1014G ' :' 2524 FENDER AVE.UNIT G • FULLERTON,CA 92831 • (714) 446($964 * FAX(714)-44.5,8o8C • ' . TOTAL P.02 /7"U 4/4 e527211-55 , //U 7 ?AJ &/114 Aix) Cep,---1 r 1 •- \Iti 66-4.— 7-1e14- -..,,-,- — — ---1- —,- •:--- :-- --..' - , t ,...,______66e......_____ ./- ‘1 )pt!// i 1 i .______6(1.0_,.,,..._._ 1 I i> I . • /1/ 84.1 ' \'"6 I I ° � I � 1 ,i : I 1 , :, so. ,i osp ‘ ei.--1-- I I 1 1 • ' ' I ! pt . ! I i . i� I v 1 I : t1 N c J i G• \-$. P AD 601 o :_t_ 1 i 1. 0 ( I i k:. I! II 0'5)". ," ' .14' .....4:1.'11 / . i 1,V \, 1 C , :rti,„,,ii,,A471 cm_ ....;,..k.f., _,. .(..\.4 . •g:/_.1 4.6 4 . .4 .-. -4. ( ..1 T . 70 4, °I' k: 1 ' 1 1`'s 131g e - - . - :.„. .. , ,it. 441-. , : .. . ____ „ :,_ ,t2, ,--- S9 'v y1 ■ / 4- ,. `YnC �.-r 4 / ,V,- a "i`.. + ' ��.a�\ ,.04 p y�vy� iD'19 . ..... :ko\ ,r // -at " 24 EST HUNTINGTON DRIVE ( r F OF A R CA D IA-4'N BUILDING SERVICES ARCADLA,CA 91007 (626)574-5416 * 4 '•OWNER-BUILDER DECLARATION"" Application is hereby made to the Building,Official for a permit subject to the conditions I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for and restrictions set forth on this application. the following reason(Sec.7031.5 Business and Professions Code: Any city or county which _—__—______—_________—________-- — _-- -- requites a permit to construct, alter, improve, demolish, or repair any structure, prior to its Workers'Compensation Declaration issuance,also requires the applicant for such permit to file a signed statement that he or she is I hereby affirm under penalty of perjury one of the following: (check appropriate line) licensed pursuant to the provisions of the Contractor's License Law(Chapter 9(commencing with I have and will maintain a certificate of consent to self insure for workers'compensation, Section 7000)OF Division 3 of the Business and Professions Code or that he or she is exempt as pro tied for by Section 3700 of the Labor Code,for the performance of the work for which therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any this t is issued. applicant for a permit subjects the applicant to civil penalty of not more than five hundred dollars I have and will maintain workers'compensation insurance,as required by Section 3700 of ($500.00): the Labor Code,for the performance of the work for which this permit is issued. My workers' ❑ 1,as`owner of the property, compen anion insuranc carrier and oli• numb are: p perty,or my employees with wages as their sole compensation,will do it .' the work and the structure is not intended or offered for sale(Sec.7044 Business and Professions �` � �) ! '� y, V\!L'9 iILiI 'l 1 ' -- Code:The Contractor's License Law does not apply to an owner of property who builds or Cartier 1 111 I III I1e II VV `� �t improves thereon,or who does such work himself or herself or through his or her own employees, CERT ATE OF EXEMPTION FROM WORKERS' Li( provided that such improvements are not intended or offered for sale. If,however,the building or COMPENSATION INSURANCE 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 certify that in the performance of the work for which this permit is issued,I shall not employ ❑ I,as owner of the property,am exclusively contracting with licensed contractors to construct any person in any manner so as to become subject to workers compensation Laws of Califomia, the project(Sec.7044 Business and Professions Code:The Contractor's License Law does not and agree that if I should become subject to the workers' compensation provisions of Section apply to an owner of property who builds or improves thereon, and who contracts for such 3700 of the Labor Code,I shall forthwith comply with those provisions. projects with a contract(s)licensed pursuant to the Contractor's License Law). ❑ I am exempt under Section ,B.&P.C.for this Applicant: WARNING: Failure to secure workers compensation insurance is unlawful and shall subject an reason. employer to criminal penalties and civil fines of up to one hundred thousand dollars($100,000), OWNER: in addition to the cost of compensation,damages as provided for in the Labor Code,interest and DATE: attorney fees. LICENSED CONTRACTOR'S DECLARATION I certify that I have read this application and state that the above information is correct and that I I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 am the owner or a duly authorized agent of the owner.I agree to comply with all city and state (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my laws relating to building construction and hereby authorize representatives of the City of Arcadia license is in full force and effect. License Number 52 to enter upon the above-mentioned property for inspection purposes. Licens lass _ Expiration Data of Contractor's License .�.) 5/ c=: Signature of owner,owner's agent or contractor Date MECHANICAL PERMIT T3ulhkwg ez (,7��,�st�p or:. i jjjj//qq "rT?. i� ? :.1...;1; I. '* + f,i0:11!tfry) '3413 F UIItTfl,,,0, fop nl1GtfIl 1} ?i,{ l, i i :t!i! 1? + � dre $ t i? It. t ! .i i� i i {*. 31 t 3 t: F1 ,.g i .? r ,,,,••,7,,, ;;;,,,.•;,„:,i s. 11 355'-. .i 1 ?i :1 i f 'autl� i- ,tom" ? tt } z i ,1 i i { i i i , { l..‘,.i.,,,:: 3?i=ill t tll33Jli ii?� 1'..1 i1ii 314.i 1 i 1 3 i 1 !i i ,,,ggyay 3?3 } 1 i s is, t 11 y R'd • i ,{: 5 ?{ � i? i t i 113351}� �'s li +i� Is� t1i1 fii tt �1i3 i 3 � 1 �'�-' �#!l:'3 t 5#{if.i ��• e f nbC'1 '.,,,t'nl i !{ - 5 a. °i li? ?t i 1+ i :5?:?;?:,,,i:t .W,,31111}1i ? ` !1 {- l; a 'i d� l It F I i 1 n: Rte..: i -- :AN(t,. 1 } i . 11 ) 1 it j 1 1F/ '1,,,!,,K3 ....,. ...: {ii i st 5 1 ?i 13 3sj1t s i, i; ,, ,, :? ,,, .. fine L be Description Fee No. Amt. ...... :?i:�i!.?.i1 3i.;:: , 5. }m 5.�. •i'.y.is}.»: .,..-' .. I Description Fee No. AmtInstallation or relocation of compressor or 17.00 Li, ie- boiler to&including 3 HP or 100,000 BTU l Installation or relocation of each forced air 17.00 / Installation or relocation of compressor or 31.10 or gravity furnace to 100,000 BTU, 3 I e boiler over 3 HP or 100,000 BTU to and including ducts and vents attached thereto including 15 HP or 500,000 BTU Installation or relocation of each forced air 21.30 Installation or relocation of compressor or 42.50 or gravity type furnace,incbttling ducts and boiler over 15 HP or 500,000 BTU to and vents attached thereto,over 100,000 BTU including 30 HP or 1,000,000 BTU Installation/relocation of each floor furnace 17.00 Each ventilation fan connected to a single 8.50 installation or relocation of each suspended, 17.00 duct and not located within a dwelling unit wall,or floor mounted unit heater Each air handling unit to 10,000 CFM 12.80 1 ` M Repair or alteration of an appliance vent 8.50ea. Each pre-fabricated fireplace 12.80 Repair,alteration,or addition to existing 17.00 Each evaporative cooler 12.80 heating,cooling,or absorption unit Each kitchen grease hood 12.80 Full Description of Work: Miscellaneous Solid Waste Management(SWMF)and 41.25 Processing fee Total fee,including Processing and SWMF 1j /rim 1 C Aficate No. 2002408 — 24 9 ARCADIA UNIFIED SCHOOL DISTRICT 234 Campus Drive, Arcadia, CA 91007 •• (626) 821-8300 Ext. 6732 (Certificate of Compliance with Fee Provisions of Government Code Section 65995) This new Fee Schedule is effective April 8,2002. Any Developer Fee worksheet brought in on or after this date will be charged at the new rate. Address of Development: 1107 Englemann Ct. , Arcadia, CA 91006 Number of Buildings in Project: One Plan Check Number: 03-84 [ ] Exempts 500 sq. ft. or less. Future k Residential2 [ I Commercial/Ind.2 [ ] Com/Ind Parking2 additions chargeable at regular rate. $2.14/sq. ft. $0.34/sq. ft. $0.17/sq. ft. Area in Sq. Ft.: A developer may request refund of fees to the 5,591 District within twelve months of payment of fees, in the event the Building Permit expires or the Developer Fee: $ ..11 ,964.74 project is canceled. The refund will be reduced by a $100 administrative fee. The refund check will Receipt No. kX I I N/A be issued in the name of the original payee and mailed to the address of payee, as shown on the 2 2 0 7 7 7 original Certificate of Compliance. Part of Phase III , Anoakia Estates Owner: Arcadia Oaks, LLC Developer: Mark Smith, Hover Dev. Co. Address: 3501 Jamboree Rd. #2000 Address: Newport Beach, CA 92660 Home Phone: Business Phone: 949-725-9600 Pager/Cell Phone: ! Pager/Cell Phone: 1This is to certify that the above-described development has been determined to be exempt from the developer fees of Government Code Section 65995 and a Building Permit may be issued therefor. 2This is to certify that all fees due to the Arcadia Unified School District, under provision of Government Code Section 65995, as a prerequisite to the issuance of a Building Permit by the Building and Safety Division of the Planning Department, have been received. Based on the information presented above, this Certificate of Compliance is hereby executed. ➢ The District charges a $100 fee to process reinstatement of the Certificate of Compliance resulting from an "insufficient funds" check in addition to a$20 fee for the bounced check. Only cash or a Cashiers' Check will be accepted as payment thereafter. The District charges a $100 fee for any amendments to or cancellation of a Developer Fee Certificate of Compliance issued on any type of development. Said request for refund of fees paid to the District must be made within twelve months of payment of fees. No refunds will be issued on fees paid prior to the twelve- month limit for any reason. Applicant confirms that he/she is authorized to ig. on behalf of the owner/developer and that the information he/she provid-- er-in is rue d ate to the best of his/her knowledge. Signature of Applicant: k Approved: . A ♦ 111 April 7, 2003 Assistant Superintendei Business Services Ate,6 CO OT7 G WHITE—Applicant YELLOW—Accounting Dept. PINK—Business Office GOLDENROD—Chrono DevFeeForm:4-08-2002 Amok .04, • I! itARCADIA r,,,cQ\ii�a� MEMORANDUM Fire Department DATE: December 31, 2003 TO: BUILDING DEPARTMENT ATTN: INSPECTOR Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 1107 Englemann Ct THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: DATE /INITIAL TYPE OF INSPECTION PERMIT NO. FINAL INSPECTION FIRE SPRINKLERS B00-015-698 10/24/03 M Krikorian FIRE ALARMS TANKS HOOD & DUCT KNOX BOX OCCUPANCY COMMENTS: Emailed Bldg Dept 10/27/03 - E Massey tk4�Cr; CITY OF ARCADIA -; � DEVELOPMENT SERVICES DEPARTMENT ., Inter-Departmental Inspection Request Date: i I y -U To: Public Works Inspector / From: Oitej Address: I I U n L h9 k Imo i 61 Permit No.: 1300-014 - 66 Contractor: Cam, I e I vU Phone No.: / G, Owner: 1-I Liver ) eve !o, v c hT Phone No.: ( °i jc ) Please inspect the following items to ensure that the contractor/developer is in compliance with all conditions of approval established for the project, and that the work performed meets the City's standards for Public Works construction: Type of Inspection Date & Initial Date &Initial Final Approval Drainage � Grading Erosion Control Offsite Improvements Construction Bin(s) Street Improvement(s) _ (conduit, curb/curb & � gutter, curb nos., driveway approach, I 1 parkway planting, sidewalk, street light, traffic flow, etc.) Sewer(s) (lateral, grease/sand interceptor, saddle, wye, etc.) Comments: -?(jikJ cc: Public Works Services Department— Sewer Inspector Rev. 1 1/9/99 '^' PLANNING SERVICES "•""'` ATTENTION: (Ov /i%` ' DATE: , f 3 ` 03 FROM: BUILDING SERVICES INSPECTOR: 6VC PROPERTY ADDRESS:' I ' U � l., �!� �� y�c h l C t PERMIT# J: 1 O d - 01 y-F6 6 PLAN#: ) TO 7 5 CONTRACTOR: CU 1 fr`-G r✓'U PHONE#: OWNER: /1 etr_s_tfAioc, KS L L C. PHONE #:8 ) -2) 176 PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE PLANNING REQUIREMENTS. ITYPE OF INSPECTION DATE & INITIAL DATE & INITIAL FINAL APPROVAL ' LANDSCAPING/IRRIGATION m44,4 Cazsayt. , "° TRASH ENCLOSURES ,,��� e.o r mea PARKING/DRIVEWAYS C drwrIcie -10 Am. toll] STORAGE AREAS ..�. 4 MECHANICAL EQUIPMENT WALL HEIGHT LIGHT HEIGHTS BACKFLOW SCREENING GRADING COMMENTS: I I f Jb3 O 3/5/97 1 I j ' I PAoSY I ' \ ` / ti C� i'b�� tom' ■ $, n87 (� 6 �" .�a� _ yU(a f � � t l''.... I ' > '1 t f$ . _ , ® b66 r ; / �58/S^ .� j 4i #1 A o • i l it M : 6� ' ,Y j •Y ' j�. trdf5 i .. 4.,,y \,,,, __ Igo; illit.x. a' A ,'''` —"s' :' ---- --- ... 1;---„..14 : --- -aslarallil_LIr. OL,2"/I . Ao _---666 -�_ sss. I F�5JS p'/ iii.."--. . ,. / Stiiiiira,MOINI111110111111111111 ," -wr -- --:,w-,rA _ --..\\* / i % :-.:43Z - . 1 ,,, ! =60— —0. Hp\ t0 . • 66 as �s • q ' 1 �� 14 ,.‘s,,. -,,, IFF F7-1 6``u I y� n ( ' — A Y . `4 / I 1 I a / I *�,4' • Zs �'� 0 6 eke A .1 41 If.- ' l 4 4 4' --v G of:// ,PAD tI60.0 a : o '� ro fj.F ~ _},...__ __\z-- — �R�. a A 4 -58/' e / l gs P E S - !�� �' ,�Z �r ter) I �'. .x.67 I$ I� �g1 FS X821 a " - b IL �,,.;,e a I' •,-.; ..,. $ 656 1. _ :�5 --— 6 L. r._,• _ 1 I it I i�`!111:1314:' s >--wow: —� 8 5 8.0 1 FC i ` .o o •h• :r. Fse.a / n — k: N� / i J �v , 't — . •= 4► ,fir 42,13,----- •► , _''� I 15147,/! 'i ;�✓ .'mil+ `� ,'i ��'F' ,rte`, °° r 1\ f� �, / l -J I,' / ) �i• <653.3 �--w— ANOAKIA ESTATES Arcadia, CA '� -` TREE LEGEND 1 AIN WATER RECLAMATION COUNTY SOLID WASTE MANAGEMENT SANITATION DISTRICTS OF LOS ANGELES COUNTY 1955 Workman Mill Road, Whittier, CA 90601-1400 Mailing Address: P.O. Box 4998, Whittier, CA 90607-4998 JAMES F. STAHL Telephone: (562) 699-741 1, FAX: (562) 699-5422 Chief Engineer and General Manager Counf'ei ttiYrCil: 7:00 a.m. - 4:00 p.m. Mon. -Thurs. 7:00 a.m. - 3:00 p.m. Fri. Account No.: ', 0406380 SEWERAGE SYSTEM CONNECTION FEE District No.: 15 Date: June 28, 2002 Property Owner: ARCADIA OAKS LLC Address of Property: 701 W FOOTHILL BOULEVARD ARCA DIA, CA 91006 Thomas Guide Page: Contact: GARY PETERS, SUPERINTENDENT Phone: 626-836-6589 Mailing Address: 3501 JAMBOREE RD., #2000 NEWPORT BEACH, CA 92660 County Assessor Map Book, Page, and Parcel Number: 5769-009-003 Structure is Proposed. User Category and Units of Usage: Category: O 1 A Number of Units: 31 Square Footage: CONNECTION FEE CALCULATION 31.00 X $1,250.00 = $38,750.00 Number of Units of Usage Connection Fee Per Unit of Usage Connection Fee SPECIAL CREDITS: DEMOLITION CREDIT $38,750.000R Demolition Credit COMMENTS: $0.00 Connection Fee Due AiOr! DL`'TRiCT Fee Payment Received From: Processed by: MLH LOS ANGELES COUNTY ° N/A Approv d,by: APPROVED Amount: $0.00 Ck. No.: . D.C.: Date: June 28,2002 JAMES F.STAHL CHIEF ENGINEER&GEN.MGSb BUILDING DEPT COPY VALID ONLY WHEN STAMPED 0 Recycled Paper »r. 03AT 4* WATER DIVISION ATTENTION: I 0 1^"1. H i 5 c..r►-, DATE: I I_ 3 `' U 3 FROM: BUILDING DIVISION INSPECTOR: Gvr&j PROPERTY ADDRESS: 1 0 PERMIT NUMBER: J7g 0 O 0 I L F�6 6 PLAN NUMBER: ' F C 7 5_ CONTRACTOR: (761 M .61- v 0 PHONE # OWNER: /1✓G h e4 t c2c4 Ks L LC PHONE# (Oj ki c) —7 ) Gj S 7 U PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT OF PUBLIC WORKS REQUIREMENTS. TYPE OF T DATE & DATE & FINAL INSPECTION INITIAL _ INITIAL APPROVAL METER LOCATION I t(3 l0 3 L/1 -. BACKFLOW DEVICES Lib/63 VI-- IRRIGATION SYSTEM FIRE SP.SYSTEM t(72 /0'i METER CLEAR.A.P.P. // GW(3/0j --. SWIMMING POOL COMMENTS: C Worddata/Waterdivision9-28-01 yi 9/28/01 w Ea PATRELL ENGINEERING GROUP, INC. 751 Sunny Grove Ln. • Glendora, CA 91741 • PH: (626) 335-4362 • FAX (626) 963-4812 ENGINEERING CALCULATIONS AND DETAILS FOR SURCHARGE DUE TO FREESTANDING BLOCK WALL ON SPA BOND BEAM (BLOCK BY OTHERS) RUIZ RESIDENCE 1107 ENGLEMAN COURT ARCADIA, CA ( . 2994 r * Exp. 6106 ‘0CF 1 V IL * ryF Jo/S SF' OF1,". SH CL BF A CALF Norte, s)gn e �1UtA T O FLO DATE: JULY 26, 2004 °R.ST,4r �Apf ENGINEER: DOUGLAS R. FERRELL RCE # 32994, CALIFORNIA 651 E. NORTHRIDGE AVE. GLENDORA, CA 91741 (626) 335-4362 0 Project: \7c 2- V.. -_-3eA.V2 PATRELL c)1 ' E t■AAN COOCz-t- AcC2L,FVi.A■ ENGINEERING Client: C "2COL 17 = GROUP, INC. Engineer: '= F +-V 651 E. Northridge Ave. PH: (626) 335-4362 Glendora, CA 91741 FAX: (626) 963-4812 Date: �`��-�-t 04 Sheet of L"\- ` vow y C_r {ate v r 71,.. Q ------------- _______ I yvr2 ` I ` i fiat" J .. .._..—_- 1 7' { . • // I 2! r,.\ 'GCL 0,.14-LC, TO r I. lr t0 A. c Ar rQ,p1 ESSi 1, =' J m m 1. l is--X rti LA -> : E{" '. ' W O No. 32994 rr- m �'J J'FL COT-U,1/4"6' ' ( ?• (x�F =: F�s °c Exp. 6106 * 1 110E CA\-- Project: FLAT-. S\Mn.: t PATRELL \ -1 E r1(A.K.t4\F N G7 rektzL44 (-A ENGINEERING Client: c-- c GROUP, INC. Engineer: -7 -t 651 E. Northridge Ave. PH: (626) 335-4362 Date: -1 -1-Le LO`4 Sheet 2' of Glendora, CA 91741 FAX: (626) 963-4812 Cs siA N W AG 92A, 'L J`.c.A4Q,1 --r • ''‘'1 ‘a't,ac�L.r-- 'c;tA.4);;F.o Cou (fro-6e4,-t-ittNotrAct) /he 4.4-6‘(c'(It)-c. lit-1 t: EXIT— W s - !pc c3 l.. IZA I 1 L.. int I u w' P_�l'O�. E_..v:- r �c _:_t„4,,,, . _ 3144...ust_ A9 NIT,11111 ilil let — , i .,,,s 111-M411 i.-3e tev-e, Hit III 1- I') * e.,iz`ty-c- 1,1 'r->_. 6T7•A VONE Et c. ( .01,4 7,, C'lam '• P4TM Pc — �►� , Cl 40 Y co n�1C ' �e-- ` 2,C�UO TC.-k. , 2 b. n P4-I5 �1.t� _ 4 J(9� /� z g t� m Lcu, I p No.C2994 r- * Exp. 6/06 q OF CAt.\FOQ� ON 0 Project: �'l& t - 'c&ec iv'i.E-iJc • PATRELL l l o rJ i ENGINEERING Client: C- ,V, LL, GROUP, INC. Engineer: ‘ 0,--"v ,.L, 651 E. Northridge Ave, PH: (818) 335-4362 Glendora. CA 91740 FAX: (818) 963-4812 Date: 117(..e(0 4 Sheet 27 of A' FP. ,-.'‘ 1 It\.] wc,! \LA L! 1--).-T-------, ,�;. CA L�c?_ Fob F STPtJt74.14 1 14zo - CO 2. 4 pc4 ( -3 . )2 = J CJ2 !I: 3 P-.01 L = 45 ( s p � - -2_7(0 ik, 2 vlsoiL. = 27Co i b ( 3 - 5' ) _ 321 ' ;x' 3 . q x 2(3, Cc x ' As 3f;'‘L" = 322 ' i X ; _ - x 20c ;, ,, � a '7 " OC A.5 --- i \ Gr Lj' .....D. J _: oil 4, 4-0 .,,, -p -... 10 rn ;- E VE_F-:--7, , ig Q Iii+.02394 ,— A * Exp. 6106 ,* • Project: Clot 2 7.-C---0t C — — 1I � � � t.�1,orP4-.1 Cam 4/L t.A.- PATRELL ENGINEERING Client: - cs GROUP, INC. Engineer: 1k7 651 E. Northridge Ave. PH: (818) 335-4362 /�, Glendora, CA 91740 FAX: (818) 963-4812 Date: �(Z-u(W "1 ( Sheet of 1 MOMENT CUE TO SOIL_ PREP U2.E SUtMMED AC':0OT CR17 Pptn!T < OrJ RA U EN N QIS. COO C� -CC) CAI GHT WALL a- v O -CAM TAKEN A6OUT T1-11.5 Pal �1T m u < N1 PRWG a ' 1 33 GoDR�Ir\IA-rFS X = R - R 33° = R ( co 33` cr R - X 3•-0" 2,_0„ _O° . 455 . 839 2. 4 . 59 3'CD" Z,_(o„ 1'0" .• 455 83c: 3.34 . 54 ._0„ 3,_0•, 455 839 3,84 _5a- 5,_0„ 5' _Cf,„ -Co„ , C - I.2 4.7CQ ,82 (r),_0„ 3'CD" 2'-Cp., 1 138 2,Og7 5,CDO 1.3(0 -7. _O„ 3'-Co" 3'-Co ? 1. 5(14 2,05 (9. 44 1.`=11 5f g,_ „ , 3'_CD' 4' -(z)" i 2.04q 3.74 7 • 27 2,45,�',c0 ESS/p k 9-'0" 3'-69, 5,_(r)„ 2. 504 4,c�i3 8, 11 3.!at', • FR�F 0q JO' c" 3Co1' Co' -Co" 2, G(DO 545■ S.q5 t.' ■ m `4 q^ No.C:2994 rr * Exp. 6106 * ,el�oF CA``�pQ� AiIt Development Services Depart it 4 240 West Huntington Drive,1 )ffice Box 60021 PERK:'NO. BOO-015-698 o Arcadia, CA 91066-6021 City Arcadia (626) 574-5416,Fax (626)447-9173 Permit Type: Fire sprinkler/alarm PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 5/27/2003 MB 11:03 8/6/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct T1107 OWNER MAILING A HOVER DEVELOPMENT ��p� PHONE NO. Inspector#:���D p : AFD EMAIL ADDRESS: Plan#: W/28075 APPLICANT MAILING ADDRESS FIRE SPRINKLER SYSTEMS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Fire Sprinkler Systems 705 HARRISON ST PHONE NO. (909)915-3473 FAX NO. Corona, CA 92879 EMAIL ADDRESS: License No. 684600 Type: C Expires: 2/29/2004 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION SPRINKS Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 5,546.00 $5,546.00 OCCUPANCY: Fire Sprink/alm TOTAL VALUATION: $5,546.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT Flat Bldg Issue Auto $40.25 $40.25 01-3104 each Bldg permit $170.45 $170.45 01-3104 Totals for: 01-3104 $210.70 $210.70 57 heads NFPA13D $325.00 $325.00 01-3109 . FIRE P/C REVIE $110.79 $110.79 01-3109 F f N Totals for: 01-3109 $435.79 $435.79 1 each SWMF 2 Auto $1.00 $1.00 88-3027 //,' /, E Totals for: 88-3027 $1.00 $1.00 I I— U t_I —V 3 (J Total Fees: $647.49 Total Amount Paid: $647.49 Paid Today: $211.70 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by (� a City of Arcadia building inspector for a period of 180 consecutive days. , / �/ CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS V Requests for inspection should be made at least Monday—Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) g loom, 11; PERNIYT/PLAN REVIEW APPLICATION it rrAiril rig ,..¢$j• Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °L=• Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia CENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisio s of 1 hereby affirm under penalty of perjury one of the following: hapter 9, commencing with Section 7000, of Division 3 of the Busine- and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class ` License No. ��/� �� compensation, as provided for by Section 3700 of the Labor Code, for the G t(� �l lJ Exp.Dat02 4 / --ww performance of the work for which this permit is issued. Signature of Contractor It Ai • Y/ di" _ have and will maintain workers' compensation insurance,as required by Section OWNER—BUILDER DECLARATION • 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exemp Tom the Co tractors issued. My woylfgrs'Fompens on,insurance carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Pro -ssions Carrier 11g17,1•Yn/4( ci Code: Any city or county which requires a permit to construct, alter, i .rove, demolish,or repair any structure,prior to its issuance,also requires the app cant S1" 6/Od 0Ogg Policy Number ✓ for such permit to file a signed statement that he or she is licensed pursuant to e (This section need not be completed if the permit is for one hundred dollars or less.) provisions of the Contractors License Law(Chapter 9(commencing with Sectio 7000) of Division 3 of the Business and Professions Code)or that he or she is • - 1 y that in the performance of the work for which this permit is issued,1 shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ I, as owner of the property, or my employees with wages as their sole 4 compensation,will do the work,and the structure is not intended or offered for Date , Applicant fi (� sale(Section 7044,Business and Professions Code:The Contractors License ■ Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further information. p L_ Name Mt r� Z Title �"C✓.th te PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature b 'Is:i 1 ` WY Date (6 I l.Q j ac w• a 1; Development Services Depart t •. I-1 • 240 West Huntington Drive,Fr Vice Box 60021 PER NO. B0O-016-490 City of Arcadia,CA 91066-6021 y Arcadia (626)574-5416,Fax (626)447-9173 Permit Type: Mechanical PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 8/12/2003 MB 11:03 8/12/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct T1107 OWNER MAILING ADD T HOVER DEVELOPMENT 1 �},r�{plait:EINE NO. Inspector#: 206 u�� P EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS JOHN L GINGER MASONRY INC 8188 LINCOLN AVE 100 PHONE NO. (909)688-5050 FAX NO. RIVERSIDE, CA 92504 EMAIL ADDRESS: License No. 668620 Type: C Expires: 4/30/2005 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION 3 PREFAB FIREPLACES Construction Type UOM 8 of Units Value Construction Type UOM #of Units Value OCCUPANCY: Dwellings TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT Flat Mech Issue Auto $40.25 $40.25 01-3105 3 each Firepl pre-fab $38.40 $38.40 01-3105 Totals for: 01-3105 $78.65 $78.65 each SWMF2Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 / i-- I , 6. G- I Total Fees: $79.65 Total Amount Paid: $79.65 Paid Today: $79.65 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. A CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS \()( Requests for inspection should be made at least Monday—Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) Ygt!1. K' PERMIT/PLAN REVIEW Al-PLICATION 14p, . Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °''°••*' Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class(.Zq —(.�3VLicense No. 64`a 6w. Exp.Date 4:1-30 compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers'compensation insurance+carrier and policy number are: License Law for the following reason(Section 7031.5,Business and Professions Carrier Ui✓ i v�i a� NY �7-y 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 Policy Number / e--"/5450 6 3600 for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ 1, as owner of the property, or my employees with wages as their sole Q ----- compensation,will do the work,and the structure is not intended or offered for Date[)—«-03 Applicant ✓= sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000�for'further information. p Name —.17:1/4 - l fG`yp en Title ^kA-Y".ti^e r PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date l Z^03 `ice• Development Services Depart • 240 West Huntington Drive,Pl lffice Box 60021 PER. NO. B0O-016-384 City of Arcadia,CA 91066-6021 / Arcadia (626)574-5416,Fax (626)447-9173 Permit Type: Mechanical PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 8/1/2003 SC 15:58 8/1/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct u T1107 OWNER MAILING v i E ITEEJ PHONE NO. Inspector#: 206 EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS ALISO AIR 29736 AVE DE LAS BANDERAS PHONE NO. (949)589-2021 FAX NO. RANCHO SANTA MARGARITA, ,EMAIL ADDRESS: License No. 526420 Type: C Expires: 3/31/2004 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION HVAC FOR NEW RESIDENCE Construction Type UOM #of Units Value Construction Type UOM #of Units Value OCCUPANCY: Dwellings TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT I Flat Mech Issue Auto $40.25 $40.25 01-3105 3 each Fum<100,000btu $51.00 $51.00 01-3105 1 each Air unt 10m cfm $12.80 $12.80 01-3105 4 each Comp 3 hp $68.00 $68.00 01-3105 Totals for: 01-3105 $172.05 $172.05 I each SWMF 2 Auto $1.00 $1.00 88-3027 F i y H Totals for: 88-3027 $1.00 $1.00 6 I I - 9 Total Fees: $173.05 Total Amount Paid: $173.05 Paid Today: $173.05 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday—Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m. to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) �". PER1\1�T/PLAN REVIEW Ai-PLICATION 1K+' „4 r-,a Development Services Department, 240 West Huntington Drive, Post Office Box 60021 4.0�"r��*� Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp.Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor ❑ I have and will maintain workers' compensation insurance,as required by Section OWNER—BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers' compensation insurance carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, Carrier demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number 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 (This section need not be completed if the permit is for one hundred dollars or less.) 7000)of Division 3 of the Business and Professions Code)or that he or she is ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ 1, 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 Date Applicant sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further information. Name Title PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date w•. Development Services Departrtlrl, ''� 4l�hl 1� 240 West Huntington Drive,Pdl�r ffice Box 60021 PERT NO. BOO-016-415 / City of Arcadia,CA 91066-6021 Arcadia (626) 574-5416,Fax (626)447-9173 Permit Type: Electrical PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 8/5/2003 SC 11:15 8/5/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct T1107 OWNER MAILING ADDRESS O CMPIETED PHONE NO. Inspector#: 206 EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Berner Electric,Inc. 255 CITATION CIRCLE PHONE NO. (909)734-3171 FAX NO. Corona,CA 92880 EMAIL ADDRESS: License No. 485322 Type: C Expires: 1/31/2004 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION ELECTRICAL FOR NEW RESIDENCE Construction Type UOM #of Units Value Construction Type UOM #of Units Value OCCUPANCY: Dwellings TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 1 flat Elec Issue Auto $40.25 $40.25 01-3105 1 each Res service $14.10 $14.10 01-3105 5,591 sq ft New res elec $279.55 $279.55 01-3105 940 sq ft New res access $37.60 $37.60 01-3105 . 1 each Addtl meter $14.10 $14.10 01-3105 / Totals for: 01-3105 $385.60 $385.60 I— t n '.' each SWMF2Auto $1.00 $1.00 88-3027 — L' — V 3 I Totals for: 88-3027 $1.00 $1.00 1 6 . G Total Fees: $386.60 Total Amount Paid: $386.60 Paid Today: $386.60 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday–Thursday Friday `Y/ one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) � PERNIIT/PLAN REVIEW ArPLICATION 101 urrAby 4p,, Development Services Department, 240 West Huntington Drive, Post Office Box 60021 ° °s•=• Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No Exp.Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor ❑ I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers' compensation insurance carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Carrier 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 Policy Number for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ 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 Date Applicant sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers' compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further information. Name Title PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date Development Services Departmti' / -•, 240 West Huntington Drive,Post.. dice Box 60021 PER `� M'+ 0. B0O-014-866 ryof Arcadia,CA 91066-6021 Arcadia (626) 574-5416,Fax (626)447-9173 Permit Type: SFNew PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 2/27/2003 MB 14:18 4/11/2003 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Englemann Ct T1107 OWNER MAILING ADDR.` , Ili IV IARCADIA OAKS LLC "E NO. Inspector#: 206 EMAIL ADDRESS: , Plan#: 28075 APPLICANT MAILING ADDRESS HOVER DEVELOPMENT 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 School Dist#: 249 NEWPORT BEACH,CA 92660 EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS CAL METRO BUILDERS INC 3501 JAMBOREE ROAD 2000 PHONE NO. FAX NO. NEWPORT BEACH,CA 92660 EMAIL ADDRESS: License No. 783497 Type: B Expires: 8/31/2004 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION LOT 9, 4 BEDROOMS,4 1/2 BATHROOMS, KITCHEN W/MORNING RM, DINING RM, LIVING RM, LIBRARY,LIBRARY LOFT, FAMILY RM,CRAFT RM,LAUNDRY RM,BONUS RM,ENTRY PRCH,PORTE COCHERE,CARRIAGE ENTRY,BALCONIES,3+1 ATTACHED GARAGE Construction Type UOM #of Units Value Construction Type UOM #of Units Value Air Conditioning Res sq ft 5,591.00 $19,009.40 Patio/Porch sq ft 343.00 $5,680.08 Sprinkler System sq ft 5,591.00 $14,536.60 Type V Wood Frame Good sq ft 5,591.00 $506,544.60 Sprinkler System sq ft 940.00 $2,444.00 Wood frame garage sq ft 940.00 $22,372.00 OCCUPANCY: Dwellings TOTAL VALUATION: $570,587.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT Flat Bldg Issue Auto $40.25 $40.25 01-3104 each Bldg permit $4,473.90 $4,473.90 01-3104 Totals for: 01-3104 $4,514.15 $4,514.15 1 housing u Park Rec Fee $185.00 $185.00 07-3509 Totals for: 07-3509 $185.00 $185.00 1-/ U 7 SMIP Res $57.06 $57.06 14-2207 _� I /— l J Totals for: 14-2207 $57.06 $57.06 ' t ' Flat SWMF Auto $6.25 $6.25 88-3027 .2 6.25 G Totals for: 88-3027 $6.25 $6.25 - Total Fees: $4,762.46 Total Amount Paid: $4,762.46 Paid Today: $4,762.46 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday—Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) • 4 soul 1 i PERi iIT /PLAN REVIEW APPLICATION . r—* ,N /,. Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °'•t` Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Co d my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' icense Class nse N li'l 9.31.0 compensation, as provided for by Section 3700 of the Labor Code, for the xp.Date performance of the work for which this permit is issued. Si lure of Contractor ❑ I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers'compensation insurance carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, arrier demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number 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 (This section need not be completed if the permit is for one hundred dollars or less.) 7000) of Division 3 of the Business and Professions Code) or that he or she jal I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violatio • not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a compensation laws of California,and agree that if I should becom- bject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of th- abSide, I shall forthwith comply with those provision ❑ I, as owner of the property, or n1y employees with wages as their sole I _ /�O 1. compensation,will do the work,and the structure is not intended or offered for ,• Gf Applican I .■1 / / -.fin sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. lf,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further i� io information. ,�.�w Name ilia 14K- J !I h/ Title iltr • PRINT NAME I c tify that I have read this applicatio• an e that the above information is correct and that I am the owner or the duly authorized agent of the o ner. I agree to comp with all C' o es and State laws relating to building construction. I hereby authorize representatives of the City of T".cadia to a po above- •nti i y,. property for inspection purposes. S ature //, Date (�..„e3 l•� wI Development Services De •knent .' ,I: BOO-019-623 , 24�West Huntington Driv, ost Office Box 60021 PEI NO. City of Arcadia,CA 91066-6021 Arcadia (626,474-5416,Fax (626)447-9173 Permit Type: Pool/spa • PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 7/29/2004 JB 11:27 7/29/2004 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1107 Engleman Ct OWNER MAILING ADDRESS ExpIR Ruiz,Ignacio PH 1 Inspector#: JOHN •DRESS: Plan#: IN FILE APPLICANT MAILING ADDRESS California Pool&Spa 3104 E Garvey Avenue B , • PHONE NO. (626)2$ 12261 West Covina,CA 91791 EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS California Pool&Spas 3104 E Garvey Avenue B PHONE NO. (626)285-2261 FAX NO. West Covina,CA 91791 EMAIL ADDRESS: License No. 185102 Type: C , ' ' a ' t Expires: 2/28/2005 12:00: TENANT MAILING ADDRESS ' PHONE NO. FAX NO. DESCRIPTION 152 PF OF IN GROUND POOL AND SPA Construction Type UOM #of Units Value Construction Type UOM #of Units Value Pool perim ft 152.00 $31,760.40 OCCUPANCY: Pool TOTAL VALUATION: $31,761.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review $375.05 $375.05 01-3103 Totals for: 01-3103 $375.05 $375.05 each Bldg penult $577.00 $577.00 01-3104 Totals for: 01-3104 $577.00 $577.00 , 1 flat Pool issue $40.25 $40.25 01-3105 I flat Pool elec issue $40.25 $40.25 01-3105 1 each Pool plm iss $40.25 $40.25 01-3105 1 each Pools elec $61.35 $61.35 01-3105 I flat Pool piping $24.55 $24.55 01-3105 I flat Pool p-trap $9.85 $9.85 01-3105 I each Pool heater $36.95 $36.95 01-3105 Totals for: 01-3105 $253.45 $253.45 I each SWMF 2 Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 Total Fees: $1,206.50 Total Amount Paid: $1,206.50 Paid Today: $1,206.50 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced vyithin 180 days from the date of issuance or if the permit is not obtained within 180 ' days from the date of plan submittal. This permit expires and becomes null and void if any work authorized,by kp,.... . this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday—Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for ons'Ite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) ek Few., 1 PERMIT/PLAN REVIEW APPLICATION ,, 4 j,. Development Services Department, 240 West Huntington Drive, Post Office Box 60021 . °"'°mot' Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: '7�• Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Cod- a 6 y license is in full filly and gf ct. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class , License N V K Exp.Date compensation, as provided for by Section 3700 of the Labor Code, for the / performance of the work for which this permit is issued. Signature of Contractor , 'I I have and will maintain workers' compensation insurance,as required by Section OWNER—BUIL I R DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers'cskripensation- uran carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Carrier GGVV- 11•UU�alljj((e��j ``LL LI Code: Any city or county which requires a permit to construct, alter, improve, I�V'�� demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number 1 for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if 1 should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ 1, 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 p Date 29' com Applicant l sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that,such improvements are not intended or offered for WARNING: Failure to secure workers' compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 2000 for further information. Name I • iS I i (III .t4 Title __Citiflada/ PRINT -ME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. 9 Signature Date 72 • Development Services Depart nt —�"� ' :11 1:` 240 West Huntington Drive,]office Box 60021 PER i NO. B0O-019-265 Arcadia,CA 91066-6021 City of ` Arcadia (626) 574-5416,Fax (626)447-9173 Permit Type: Garden wall PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS W 14:35 6/23/2004 • Issued PROJECT ADDRESS SESSORS PARCEL NO. GEO CODE 1107 Englemann Ct 1107 OWNER MAILING ADDRESS Ruiz, Ignacio 1107 Englemann Ct PHONE NO. (626)222-0737 Inspector#: JOHN Arcadia,CA 91006 EMAIL ADDRESS: Plan#: IN FILE APPLICANT MAILING ADDRESS T N T PLUMBING&GENERAL PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS T N T Plumbing&General Contract 2601 N Del Rosa Ave Suite 220 PHONE NO. (909)306-9124 FAX NO. San Bernardino,CA 92404 EMAIL ADDRESS: License No. 399291 Type: B Expires: 2/28/2005 12:00: TENANT MAILING ADDRESS PHONE NO. 7 FAX NO. DESCRIPTION 261 LF OF GARDEN AND/OR RETAINING WALL AT HEIGHTS VARYING FROM 18 INCHES TO 7 FT 9 IN HIGH. AND 13 PILASTERS VARYING 2 FT TO 7 FT 9 IN HIGH AND 12 TO 16 INCHES AROUND. Construction Type UOM #of Units Value Construction Type UOM #of Units -Value Wall Masonry sq ft 1,029.00 $5,145.00 Wall Masonry sq ft 76.00 $380.00 OCCUPANCY: Wall Masonry TOTAL VALUATION: $5,525.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT Flat Bldg Issue Auto $40.25 $40.25 01-3104 each Bldg permit $170.45 $170.45 01-3104 Totals for: 01-3104 $210.70 $210.70 each SWMF 2 Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 ti Total Fees: $211.70 Total Amount Paid: $211.70 Paid Today: $211.70 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS YilliF4. Requests for inspection should be made at least Monday–Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 9:00 a.m. 7:30 a.m.to 9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) Z t5 II PERMiT/PLAN REVIEW Al JI LICATION Development Services Department, 240 West Huntington Drive, Post Office Box 60021 '34,....T.9- Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION AI hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and d effect. 2/21/CS ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class ense Nom I L.7� Exp.Dat compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor � - ■r have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER ECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My v,, s'compensation insura a carrier and policy number are: License Law for the following reason(Section 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, Carrier demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number ! 7 /q 3!3 eV 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 (This section need not be completed if the permit is for one hundred dollars or less.) 7000)of Division 3 of the Business and Professions Code) or that he or she is ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. ❑ 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 Date t 3 f 4/ Applicant `r-- sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure workers'compensation coverage is unlawful, sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalities and civil fines up to one completion,the owner—builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest,and attorneys fees. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Owner Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 4. 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required. A Certificate of Occupancy must be obtained prior to use and oc:upancy of new buildings and structures. ti 3. Per South Coast Air Quality Management District (AQMD) regulations, renovation and remodeling work that results in the removal, stripping, or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396- 20a'cr 00 for further information. Name c /inl ff j c) S2 Title 5`)r'rr;..t 4 en e/-/#1" PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or the duly authorized agent of the owner. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature —7. ----- Date yg O •