HomeMy WebLinkAboutOld permits 1 • development Services Depart
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-• 240 West Huntington Drive,Po6,Office Box 60021 PER 'NO.
— ' Arcadia,CA 91066-6021 BOO-014-630
City of
(626)574-5416,Fax (626)447-9173 Permit Type:YPe EMP Combo
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
0 CS 11:34 1/17/2003 Issued
PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE
618 Encino Ct 5780-013-046
OWNER MAILING ADDRESS
Bone,Kenneth V Co Tr 618 Encino Ct PHONE NO. Inspector#: 205
CA - EMAIL ADDRESS:
Plan#: IN FILE
APPLICANT MAILING ADDRESS
PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
E L Payne Heating Company 23725 Roscoe Blvd PHONE NO. (818)988-8110 FAX NO.
West Hills, CA 91304 EMAIL ADDRESS:
License No. 120228 Type: C Expires: 12/31/2004 12:0(
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
REPLACE FAU/NEW AC
Construction Type UOM #of Units Value Construction Type UOM p 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 Elec issue $40.25 $40.25 01-3105
1 Flat Mech issue $40.25 $40.25 01-3105
1 each Comp 3-15hp $31.10 $31.10 01-3105
1 each Fum<100,000btu $17.00 $17.00 01-3105
1 each Power 1-10 hp $14.10 $14.10 01-3105
9 Flat Add/AlterDucts $76.50 $76.50 01-3105
Totals for: 01-3105 $219.20 $219.20
1 Flat SWMF 2 $1.00 $1.00 88-3027
I Flat SWMF 2 $1.00 $1.00 88-3027
Totals for: 88-3027 $2.00 $2.00
Total Fees: $221.20 Total Amount Paid:
$221.20 Paid Today: $221.20
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 ---'1
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. TL___)
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 i T/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
Arcadia
tiOCENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION
ereby 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 t!7..� License No. i 1--1) z t}( Exp.Date %Z.3i compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
S ignature of Contract
ave and will maintain workers' compensation insurance,as required by Section
OWNER—BUILDER DECLARATION f 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 •.ntractors issued. My workers'compensation insurance carrier and policy number are:
License Law for the following reason(Section 7031.5, Business and ' ofessions
// 77,4
Code: Any city or county which requires a permit to construct, alte improve, Carrier � l C.�
demolish,or repair any structure,prior to its issuance,also requires the•.plicant Policy Number N'.S I— /£- I G v v
for such permit to file a signed statement that he or she is licensed pursuant . .e
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 1�/7 � Applicant
Date --"'
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 r . e-c G lob Title
PRINT NAIv E"
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.
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BUILDING & SAFETY DIVISION
�•� AEAI I i tits 240 West Huntington Driv M
,ti� _, Arcadia, California 91006-3104 MPLETEU
oRl'oRAT��"
( 818 ) 574 - 5416
/ Page 1 of 1
618 E ENCINO CT 10/09/91 08 : 36
Permit No. : A9103879 Autoproj No : AU007703
Status : APPROVED Validated by : GERI
Inspector area: 205
This type : Roofing Project Applied : 10/09/91
Issued : 10/09/91
Parcel number : 5780-013-046 Finaled .
Group-occup/use: To Expire .•
Owner : BONE
Applicant : SUNSET ROOFING
Applicant Addr : 8515 FRANDSEN SAN GABRIEL, CA 91776
Job Address : 618 E ENCINO CT
Phone number : 818-451-0084
Class code .•
Valuation 10, 000
Construction : ALT
Permit to do : REROOF HOUSE & GARAGE
CONTRACTOR : SUNSET ROOFING Lic. C 603218 818-451-0084
Roofing Material > CAL-SHAKE
Fee description Units Fee/Unit Ext fee Data
Original Permit Issue Fee (YES/NO) > 33 . 15 Y
Enter Valuation > 10000 . 00
Roof Fee 3104> 195 . 25
*** Fees Required *** *** Fees Collected & Credits ***
Receipt No. Date Payment
10/09/91 228 . 40
Fees: 228 . 40
Adjustments: . 00 Total Credits: . 00
Total Fees: 228 . 40 Total Payments: 228 . 40
Balance Due: . 00
Will the applicant or future building occupant handle a hazardous material or a mixture containing a hazardous material
equal to or greater than the amounts specified on the Hazardous Materials Information Guide?
❑ YES ❑ NO
Will the proposed building or modified facility be within 1000 feet of the outer boundary of a school?
❑ YES ❑ NO
Will the intended use of the building by the applicant or future building occupant require a permit for construction or mod-
ification from the South Coast Air Quality Management District (SCAQMD)? SEE PERMITTING CHECKLIST FOR
GUIDELINES.
❑ YES ❑ NO
I have read the Hazardous Material Information Guide and the SCAQMD Permitting Checklist. I understand my re-
quirements under the Los Angeles County Code, Title 2, Chapter 2.20, Section 2.20.100 through 2.20.140 concerning
...
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