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Home My WebLink AboutOld permits 1 .w'•• Development Services Depa ;rit rPERT NO. $QQ-024-491 : CAyl �FOAN(l 1 , " :1 " • PERMIT/PLAN REVIEW APPLICATION Development Services Department, 240 West Huntington Drive, Post Office Box 60021 o\�j.• p 4aaeltY.f Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia ..: { � : I qM I 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. y�� ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class 0--5-3 Licen o Exp.DatZ5— (/ a; compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor performance of the work for which this permit is issued. xpOWNER-BUILDER DECLARATION have and will maintain workers' compensation insurance,as required by Section 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 1 R—Q r i /` ` Code: Any city or county which requires a permit to construct, alter, improve, Carrier ( d� demolish,or repair any structure,prior to its issuance,also requires the applicant 1 1J cr^ G�6 2� �!J for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number `�6 0� i7 G 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 b / / compensation,will do the work,and the structure is not intended or offered for Date ©F�o!D Applicant .G./ T'7/ sale(Section 7044,Business and Professions Code:The Contractors License l 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 who builds or improves thereon, and who contracts for such projects with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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 CONDJTIONS 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. The permittee may be entitled to reimbursement of the permit fees if the City fails to conduct an inspection of the permitted work within 60 days of the request for final inspection. 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. 7/ �- P ,J U 1> Name ! ttn) < �� 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 wit .11 City ordinanc , State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the . ' •-mentioned pro •• or inspection purposes. Signature II Date v V vl 06 pp w•. Development Services Depart'. �" : ow /tee 1! "1"911"1- 1,,,.; Ili PERMIT/PLAN REVIEW APPLICATION ' Development Services Department, 240 West Huntington Drive, Post Office Box 60021 ""'""`"" Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of I Arcadia 14LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION 1 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 C de,and my license is in full f•rce and effect. �j l ❑ I have and will maintain a certificate of consent to self-insure for workers' License Cla 7 is se No. / Exp.Da /7/k 7 compensation, as provided for by Section 3700 of the Labor Code, for the erformance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER ECLAR TION I have and will maintain workers' compensation insurance,as required by Section 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 insura carrier and po•' y number are,: License Law for the following reason(Section 7031.5, Business and Professions 1� 51.7471-C- P1 re I s , Code: Any city or county which requires a permit to construct, alter, improve, Carrier 4-t demolish,or repair any structure,prior to its issuance,also requires the applicant C f 1 Z 1 67 for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number ' /� (O [ provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not 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 371.! 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 0 3 Applicant ' /� sale(Section 7044,Business and Professions Code:The Contractors License P 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. ❑ 1, 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 who builds or improves thereon,and who contracts for such projects with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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. r Name i)l ,1 l ct") le_A /^ j "� N....) Title 5.2e(/PRIN NAME I certify that I have read this application and : a e • at 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 ity ordi 4 n •s a d State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon ove ntioned s '.pert for inspection purposes. 20 0 Signature Date Development Services Depart -- ' / 1 w f: 240 West Huntington Drive,}Office Box 60021 PERK. i NO. B00-016-414 4' Arcadia,CA 91066-6021 City 626) 574-5416,Fax (626)447-9173 Permit Type: Electrical •Arcadi (626) ax (' PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 10 n8/55//2003 Sc 11:12 8/5/2003 Issued PROJECT ADDRESS n /l j ASSESSORS PARCEL NO. GEO CODE ///�� 1109 Englemann Ct n T1109 OWNER MAILING ADDRESS ��O ARCADIA OAKS LLC 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 Inspector#: 206 NEWPORT BEACH,CA 92660- 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 940 sq ft New res access $279.55 $279.55 01-3105 /, A 940 sq ft New res access $37.60 $37.60 01-3105 7 /5 /�'1 each Addtl meter $14.10 $14.10 01-3105 Totals for: 01-3105 $385.60 $385.60 each SWMF 2 Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 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. Y 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) Pi* AOMIlk "(-4111111111111K7 • 011116111rLI' PERNiIT/PLAN REVIEW AEPLICATION r r 1,1101 17:4 4� j. Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °R"°"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 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 OWNER-BUILDER DECLARATION Li I have and will maintain workers' compensation insurance,as required by Section 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. ❑ 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 who builds or improves thereon,and who contracts for such projects with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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 Depart --41s, / :� 1 . 240 West Huntington Drive,l )ffice Box 60021 BOO-016-383 PERT. �NO. ' , Arcadia,CA 91066-6021 City of (626) 574-5416,Fax (626)447-9173 Permit Type: Mechanical Arcadia PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 10 8/1/2003 Sc 15:56 8/1/2003 Issued fl) /;�'j �� PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 1109 Englemann Ct a T1109 OWNER MAILING ADDRESS �� ARCADIA OAKS LLC 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 Inspector#: 206 NEWPORT BEACH,CA 92660- 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 1 Flat Mech Issue Auto $40.25 $40.25 01-3105 3 each Furn<100,000btu $51.00 $51.00 01-3105 1 each Air unt 10m dm $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 /Z ... 3 . /74'- each SWMF 2 Auto $1.00 $1.00 88-3027 1 Totals for: 88-3027 $1.00 $1.00 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 y/ 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) WO PERNi1T/PLAN REVIEW AIPLICATION 0. f/lt 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 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 OWNER-BUILDER DECLARATION ❑ I have and will maintain workers' compensation insurance,as required by Section 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 (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 contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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 TIIIS 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 Depart '"1 7 - : 240 West Huntington Drive,) Office Box 60021 PERT :NO. $QQ-Q15-343 Arcadia,CA 91066-6021 Permit Type: Plumbing City of (626) 574-5416,Fax (626)447-9173 Arcadia PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 10 c �4/f17�/2000(((3 MB 15:06 4/17/2003 Issued PROJECT ADDRESS [1\/, ""��D ASSESSORS PARCEL NO. GEO CODE 1109 Englemann Ct 'M(/ 'U� T1109 OWNER MAILING ADDRESS ARCADIA OAKS LLC 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 Inspector#: 206 NEWPORT BEACH,CA 92660- 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 a of Units Value Construction Type UOM a 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 f /' 1 each Bidet $11.30 $11.30 01-3105 ,�. / -0 L( � v 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 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 A " t. 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,w"= -� PERMIT/PLAN REVIEW APPI,ICATION Development Services Department, 240 West Huntington Drive, Post Office Box 60021 ,�c\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 m license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class k- License No i Exp.Datealde) compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor - performance of the work for which this permit is issued. OWNER—BUILDER DECLARATION ❑ I have and will maintain workers' compensation insurance,as required by Section 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, Carrief5�%//evt� p,y ,,` demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number l — � 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 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. ❑ 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 l7 sale(Section 7044,Business and Professions Code:The Contractors License Applicant 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 who builds or improves thereon,and who contracts for such projects with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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'IP/ J T .1 1 Z 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 'ty ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the ahoy: toned property�for inspection purposes.,i Signature: ►` �__ —, ` Date g/t7/0 3 w•: Development Services Departllimt ---rifts ~1•-: 240 West Huntington Drive,Fr )ffice Box 60021 PER f NO. BOO-015-699• Arcadia,CA 91066-6021 City of (626)626) 574-5416,Fax (626)447-9173 Permit Type: Fire sprinkler/alarm Arcadia , PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS I I 10 5/27/2003 [[[777(((��►►►MB 11:02 8/6/2003 Issued PROJECT ADDRESS}[1/,' �2��,"''t ASSESSORS PARCEL NO. GEO CODE 1109 Englemann Ct U 1,R1yJ/•16 11'IfJ7 i'VVU� T1109 OWNER MAILING ADDRESS ARCADIA OAKS LLC 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 Inspector#: AFD NEWPORT BEACH,CA 92660- EMAIL ADDRESS: Plan#: W128075 APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS 909 O N . Fire Sprinkler Systems 705 HARRISON ST PHONE (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 NFPAI3D $325.00 $325.00 01-3109 FIRE P/C REVIE $110.79 $110.79 01-3109 Totals for: 01-3109 $435.79 $435.79 each SWMF 2 Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 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. Y 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) r " PERMIT/PLAN REVIEW APPLICATION Rs ' fa�Q\t0.' Development Services Department,240 West Huntington Drive, Post Office Box 60021 tt�o Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia ICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ereby affirm under penalty of perjury that I am licensed under provisions of 1 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. Q ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class t .l`,Q License No.�r `lip() Exp.Date/40' i compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor .y performance of the work for which this permit is issued. OWNER-BUILDER DECLARATI have and will maintain workers' compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is ❑ e y affirm under penalty of perjury that I xempt from the Contract.rs issued. My workeys'compensation insurance carrier and policy number are License Law for the following reason(Section 7031.5,Business and Professio s Code: Any city or county which requires a permit to construct, alter, improv. Carrier demolish,or repair any structure,prior to its issuance,also requires the applicant � ""� for such permit to file a signed statement that he or she is licensed pursuant to the ' icy Number vJ bo d U rj(�uL�G� 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 ❑ I, as owner of the forthwith comply with those provisions. property, or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for Toett sale(Section 7044,Business and Professions Code:The Contractors License Applicant 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 who builds or improves thereon,and who contracts for such project with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil Code). ❑ 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 II IMa LtSa YY1a)41 Pr& Title (,►/_1241Q4✓ 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 a 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. ignature 114.1 Date S/Di( j <w•: Development Services Depart wk i"�e / :1 �: 240 West Huntington Drive,Office Box 60021 PER C NO. BOO-016-491 Arcadia,CA 91066-6021 City of (626) 574-5416,Fax (626)447-9173 Permit Type: Mechanical Arcadia PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 10 8/12/2003 MB 11:05 8/12/2003 Issued /� ASSESSORS PARCEL NO. GEO CODE PROJECT ADDRESS JIJ9Ijj I [J 1109 Englemann Ct T1109 OWNER MAILING ADDRES ARCADIA OAKS LLC 3501 JAMBOREE BLVD 2000 PHONE NO. (949)725-9570 I Inspector#: 206 I NEWPORT BEACH,CA 92660- EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS 9Q9 NO. 688-5050 FAX NO. JOHN L GINGER MASONRY INC 8188 LINCOLN AVE 100 PHONE ( ) RIVERSIDE,CA 92504 EMAIL ADDRESS: License No. 668620 Type: C Expires: 4/30/2005 12:00: TENANT MAILING ADDRESS FAX NO. PHONE 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 SWMF 2 Auto $1.00 $1.00 88-3027 Totals for: 88-3027 $1.00 $1.00 - 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. 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) i, r--, LAN REVIEW A��'T,ICATION ' Development Services Department, 240 West Huntington Drive, Post Office Box 60021 '4,,,...... _..---;:.• 'h....Tip- 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 C Z,9'039 License No. 6120t,"Z.-C7 Exp.Datey 30 -• compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor "�i„�,� performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION JA I have and will maintain workers' compensation insurance,as required by Section 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 License Law for the following reason(Section 7031.5, Business and Professions issued. My workers'compensation insura arrier and policy number are Code: Any city or county which requires a permit to construct, alter, improve, Carrier ✓irpiniGt SUIT demolish,or repair any structure,prior to its issuance,also requires the applicant r for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number `L W 560 6. �6�© 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 Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation laws of California,and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall ❑ I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for �/ ter'^ sale(Section 7044,Business and Professions Code:The Contractors License Date "/Z-%7 3 Applicant !✓�- 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 who builds or improves thereon,and who contracts for such projects with a CONSTRUCTION LENDING AGENCY contractor(s)licensed pursuant to the Contractors License Law). I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097,Civil ❑ 1 am exempt under Section 7044,Business and Professions Code,for this reason: Code). 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 l r'wt / ►/N Title AAA-VW-IC-V.- 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 S�-�Z - O 3