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`'�'"' Development Services Depart-worm -.► 240 West Huntington Drive,: isi Office Box 60021 1'ERI ' N( BOO-036-931 City of Arcadia,CA 91066-6021 Permit Type: Plumbing Arcadia (626) 574-5416,Fax(626) 447-9173 PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 25340 4/7/2011 JB 15:49 4/7/2011 Issued ADDRESS No. Dir.Prfia Street Name Street Suffix Project ASSESSORS PARCEL NO. GEO CODE 625 Encino 41*. c-f- 5780-013-048 OWNER MAILING ADDRESS Rodney&Karen Johnston 625 Encino Court PHONE NO. Arcadia,CA 9 •4• - •DRESS: Insnector#: JEFF L A 1, 1 I l Plan Chk#: APPLICANT MAILING ADDRESS ^,� ,!\/1 - I , � Plan#: Rodney&Karen Johnston 625 Encino Cou t t'I' School Dist#: Arcadia, CA 91006 EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Owner PHONE NO. FAX NO. EMAIL ADDRESS: License No. Type: Expires: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION INSTALLATION OF NEW DISWASHER Construction Type UOM #of Units Value Construction Type UOM #of Units Value //NAL 4 14-- 11 I[i\ CCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 1 Flat Plmbg Issue A 42.25 42.25 01-3105 1 each Dishwashers 11,87 11.87 01-3105 1 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $55.12 Total Amount Paid: $55.12 Paid Today: $55.12 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the R«.v pt a• 93767 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 01-3105 54.12 180 days from the plan application date. This permit expires and becomes null and void if any work 88-3027 1.00 authorized by this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by the 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 8:30 a.m. 7:30 a.m. to 8:30 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) C. I.' iPi 76- , do _ ...... c, z ,. i • W ,-, LU! ( h( Cu) a 0 ed }{iJ CI >,.... a < lc66-4-144"- .,.... , ( ili 0 . 1 ,,t . , I I d, L . , < t N > r �2' � a[ a A , 4 vc til N . ? t AO LL- N J W W • 0 O0 Qrz • i W � � oz 8 f ` V7 C ewe wee.•.».l } Y W ~ 7-- 'G C—q I K. Z tn m0 ;Z ^_ aU In tn w S ' Z Ei a> ":-.( < O � ‹ k 0 to c4 �O � p z7-et.i . _ LL� z rA a i)-. ■■■.. L. y gl pv,O c(� a -; F- v_) t_ � f¢ `OOAr zl_ ca ,, •- \1 A . I- -....I LL J LLI i. ,, , t 0 4 • Ai N ' LU ui H '-f - - 0 L'A )... V) r -- .r -; . „e • R \ . 4144% 1 Mi • 00 4,...4 A,... : k .sw.+^.. . .. .1•1$47? ('%J-B3222) 97,3c71q gI u7.71 '9913 xoPuTA Jo '$J 'Sg 95, -R J007_ a313ga IIn L =a u o uo ;9T i>Z;z 29T g '9 }=3D 00 i M ; - i9 u8 S/9%J23 'g i}9aa uo "9T 9%QTo 9UTTTa0 119X11 '9 S.1991Ig i i# =9q.=90 U0 u9I 2$=Tor Jooli 119X lI9 TJ i9V119T g9 Tgoo k tx„8T luoTq pun Z '2 tmeaq paa71 Ao ,10Izu> 'M-1957 9X1 Jn k fato39T« 'I 2}p-3or `4in 9 ouToug gag =o guoTvloTJToae3 uoTTTD0V lar BUILDING AND SAFETY DIVISION 00-, '^* BUILDING City of Arcadia lobt 37_., PERMIT 240 W. HUNTINGTON DR., ARCADIA, CA 91006 • TEL. (213) 446-4471 Building 625 0 e 0 C'P. U.B.C. Type Occ. Address Edition I Const. Group Lot Block Tract Occ. F. D.Appr. Date H. D. Appr. Date No. _Load Required Required Owner Use Zone Special Case No. S Mailing 625 k IP cr. Homeowners Association Approval I Date Address City ARCADIA Zip91 6 I Tel. Lot Contractor Special alIIrF Conditions Ad NOTE: Include: C'150.00 S. nalan DR. VALUATION Labor,Material, Plumbin., Etc. $ Cite % r T I# Misc. FEE 80 540 5404 State Lic. �d City •Private &Classif. 3795143 B _Lic. No.0"11768—I Swimmin• Pool/S.a ■Public Arch., Engr., Sign-Pole ❑ Wall ❑ Designer Address Tel. F Temporary❑ Projecting❑ City Zip State E Fee Based on Total Sq.Ft. Lic. No. E Construction . 40.6.°1 S PLAN CHECKING FEE squares. I 3409. iY S.M.LP. 40 a�1�"r Permit Fee 19 Floor Main Accessory Total Processed by Area TOTAL 107 74 New❑ Add.❑ Alter.❑ RepairVf Demolition❑ Permit No. Plan No. Date LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION III: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section I hereby affirm that I have a certificate of consent to self-insure,or a certificate of I t t)of Division 3 of the Business and Professions Code,and my license is in full force and Worker's Compensation Insurance,or a certified copy thereof.(Sec.'3800,Labor Code.) effect. Policy No. _.�L.L3rB.6 Company_AIM. OWNER-BUILDER DECLARATION ® Copy is filed ❑Certified copy is Exp.Date with the City. hereby furnished. I 10/85 l I hereby affirm that I am exempt from the Contractor's License Law for the following CERTIFICATE OF EXEMPTION FROM reason:"Sec.7031.5.Business and Professions Codes.Any city or county which requires a WORKERS'COMPENSATION INSURANCE permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance (This section need not be completed if the permit is for one hundred dollars($100)or less.) also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law,Chapter 9(commencing with El certify that in the performance of the work for which this permit is issued,I shall not Section 7000)of Division 3 of the Business and Professions Code, or that he is exempt employ any person in any manner so as to become subject to the Workers'Compensation Law therefrom,and the basis for the alleged exemption.Any violation of Section 7031.5 by any of California. applicant for a permit,subjects the applicant to a civil penalty of not more than five hundred NOT/CE TO APPLICANT:If,after making this Certificate of Exemption you should become dollars($500).'' subject to the Workers' Compensation provisions of the Labor Code,you must forthwith comply with each provisions or this permit shall be deemed revoked. I.as owner of the property,or my employees with wages as their sole compensation,will CONSTRUCTION LENDING AGENCY o the work,and the structure is not intended or offered for sale."Sec.7044,Business and I hereby affirm that agency performance of the work Professions Cade:The Contractor's License Law does not apply to an owner of property who rm at there is a construction lendin g B enc Y for the P builds or improves thereon and who does such work himself or through his own employees, for which this permit is issued.(Sec.3097,Civil Code.) provided that such improvements are not intended or offered for sale. If, however, the Lender's Name building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale.'' Lender's Address ❑ I, as owner of the property, am exclusively contracting with licensed contractor to construct the project."Sec.7044,Business and Professions Code:The Contractor's License I certify that I have read this application and state that the above information is correct.I Law does not apply to an owner of property who builds or improves thereon,and who con- agree to comply with all city and county ordinances and state laws relating to building tracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law.'' construction,and hereby authorize representatives of this city to enter the above-mentioned property for inspection purposes. ❑ I am excempt under Sec._ ,B.&P.C.for the reason Signature of Applicant Date Mailing Address _ Date ___________ _Owner City,State,Zip This is a building permit when.properly filled our signed and validated, ASSESSOR COPY and is subject to expiration if work thereunder'is suspended for 180 days. .* CITY OF ARCADIA / r--'T \ Development Services I�tment $00-011-569 tY 240 West Huntington C.,. •P.O. Box 60021 PER NO. M�' ye!!a�:17� !II ens• Arcadia,CA 91066-6021 �..ocoso- (626)574-5416 Permit Type: Plumbing PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 1/10/2002 CS 15:08 1/10/2002 Issued PROJECT ADDRESS - ASSESSORS PARCEL NO. GEO CODE 625 Encino Ct (� �nH ��((�7� [a, 5780-013-048 OWNER MAILING ADD �'' EH{�Johnston,Rodney M And Karen L 625 Encino t YYY L`i ONE No. Inspector#• 205 Arcadia,CA 91006 EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Masterserv,Inc P.O. Box 483 PHONE NO. (800) 806-7374 FAX NO. Verdugo City,CA 91046 EMAIL ADDRESS: License No. 580017 Type: C Expires: 10/31/2003 12:0( TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION COPPER RE-PIPE Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 5,800.00 $5,800.00 OCCUPANCY: Dwellings TOTAL VALUATION: $5,800.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Bldg permit $170.45 $170.45 01-3104 Totals for: 01-3104 $170.45 $170.45 /-, `4 7 Flat Plmbg Issue A $40.25 $40.25 01-3105 �! Totals for: 01-3105 $40.25 $40.25 i each SWMF 2 Auto $1.00 $1.00 88-3027 b.; i et, /08- - /, Totals for: 88-3027 $1.00 $1.00 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 ARE Requests for inspection should be made at least Monday-Thursday Fridays one(1)business day in advance of the inspection 7:30 a.m.-9:00 a.m. 7:30 a.m.-9:00 a.m. by telephone at(626)574.5416 for onsite work. 4:00 p.m.-5:30 p.m. 4:00 p.m.-4:30 p.m. CLOSED ON ALTERNATE FRIDAYS DEVELOPMENT SERVICES DEPARTMENT•FORM#6600•ARCADIA PRINTING SERVICES City of Arcadia rr it, Development Services ..apartment _, • •'. " 240 West Huntington Drive- Post Office Box 60021 i rt• Arcadia, CA 91066-6021 (626) 574-5416 PERMIT / PLAN REVIEW APPLICATION 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 Busines and Professions Co license is in full ( d e /t. 7 I have and will maintain a certificate of consent to self-insure for License CIas�Lice -e h `�i r .. , d / 3 workers' compensation, as provided for by Section 3700 of the Labor � ,��� Code, r the performance of the work for which this permit is issued. Signature of Contractor: i�I - 's 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 issued. My worker's compensation insurance OWNER - BUILDER DECLARATION carrier and policy nu r are: O I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5, Business and Carrier: Professions Code: Any city or county which requires a permit to (a construct, alter, improve, demolish, or repair structure,any structure, prior to its issuance, also requires the applicant for such permit to file a signed Policy Number: statement that he or she is licensed pursuant to the provisions of the (This section n not be completed if the permit is for one hundred dollars or Contractors License Law (Chapter 9 (commencing with Section 7000) of less). Division 3 of the Business and Professions Code or that he or she is exempt there from and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant 0 I certify that in the performance of the work for which this permit is for a permit subjects the applicant to a civil penalty of not more than issued,I shall not employ any person in any manner so as to become subject five hundred dollars($500): to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation • I, as owner of the property, or my employees with wages as their sole provisions of Section 3700 of the Labor Code, I shall forthwith comply compensation, will do the work, and the structure is not intended or with those provisions. offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who Date: Applicant: 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 sale. If, however, the building or improvement is sold within one (1) year of completion, the owner - builder will WARNING:Failure to secure workers'compensation coverage is unlawful,and shall have the burden of proving he or she did not build or improve for the subject an employer to criminal penalties and civit fines up to One Hundred Thousand purpose of sale). Dollars($100,000),in addition to the cost of compensation,damages as provided for in • I, as owner of the property, am exclusively contracting with licensed contractors to Section 3706 of the Labor Code,interest and attorneys fees. construct the project (Sec. 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 contractor(s) licensed pursuant to the Contractors License Law). CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction ❑ lending agency for the performance of the work for which this permit I am exempt under Sec. ,B.&P.C.for this reason: is issued (Sec. 3097, Civ.C.). 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.Construction activity is prohibited between the hours of 7:00 p.m.and 7:00 a.m.and on Sundays and Holidays. 2.The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 3. 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. NAME: vF.,211....►J/ A TITLE: e/la 0 ,a `r/ P-NT • E I certify that I have read this application and state that the above informatio •rrect 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 ating • building construction.I hereby authorize representatives of the City of Arcadia to ente upon above-me • :pr:pliegirosof insp. to ores. —1117—SIGNATURE: ' DATE: ///:A.7 (.1 Qi CITY OF ARCADIA Development Services C `tment PERINO. 240 West Huntington Dr P.O. Box 60021 BOO-009-273 Arcadia, CA 91066-6021 Permit Type: Electrical (626)574-5416 PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS I 4/30/2001 CS 7:55 4/30/2001 Issued PROJECT ADDRESS �I y j �{ r PIIJE1i1EIL ASSESSORS PARCEL NO. GEO CODE 625 Encino Ct U iYJ 5780-013-048 OWNER MAILING ADDRESS Johnston,Rodney M And Karen L 625 Encino Ct PHONE NO. Inspector#: 207 Arcadia, CA 91006 EMAIL ADDRESS: APPLICANT MAILING ADDRESS JOHNSON, RODNEY PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS PHONE NO. License No. EMAIL ADDRESS: Type: Expires: TENANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: DESCRIPTION UPGRADE SERVICE TO 200 AMP 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-Po 1 Totals for: 01-3105 $54.35 $54.35 each SWMF 2 Auto $1.00 $1.00 88-3027 Fputt, invecno v . e Ix.... 4 Totals for: 88-3027 $1.00 $1.00 Or 4 Total Fees: $55.35 Total Amount Paid: $55.35 Paid Today: $55.35 This permit/plan revievv 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 ARE Z:)/ , Requests for inspection should be made at least Monday-Thursday Fridays one(1)business day in advance of the inspection 7:30 a.m.-9:00 a.m. 7:30 a.m.-9:00 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.-5:30 p.m. 4:00 p.m.-4:30 p.m. CLOSED ON ALTERNATE FRIDAYS DEVELOPMENT SERVICES DEPARTMENT•FORM#6600•ARCADIA PRINTING SERVICES .-4k , City of Arcadil "'` "N 1r - y; Development Services Department _'0 7 240 West Huntington Drive - Post Office Box 60021 , Arcadia, CA 91066-6021 o.„„0 (626)574-5416 PERMIT / PLAN REVIEW APPLICATION LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION O 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. 1 I have and will maintain a certificate of consent to self-insure for License Class License No. Exp.Date workers' 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: O 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 issued. My worker's compensation insurance OWNER - BUILDER DECLARATION carrier and policy number are: I I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5, Business and Carrier: Professions 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 for such permit to file a signed Policy Number: statement that he or she is licensed pursuant to the provisions of the (This section need not be completed if the permit is for one hundred dollars or Contractors License Law (Chapter 9 (commencing with Section 7000) of less). Division 3 of the Business and Professions Code or that he or she is exempt there from and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant O I certify that in the performance of the work for which this permit is for a permit subjects the applicant to a civil penalty of not more than issued, I shall not employ any person in any manner so as to become subject five hundred dollars($500): to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation I, as owner of the property, or my employees with wages as their sole provisions of Section 3700 of the Labor Code, I shall forthwith comply compensation, will do the work, and the structure is not intended or /with those provision . offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who Date: L!/3 b( Applicant 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 sale. If, however, the building or improvement is sold within one (1) year of completion, the owner - builder will NG:Failure to secure workers'compensation coverage is unlawful,and shall have the burden of proving he or she did not build or improve for the subject purpose of sale). an em ployer to criminal penalties and civil fines up to One Hundred Thousand Dollars($100,000),in addition to the cost of compensation,damages as provided for in I, as owner of the property, am exclusively contracting with licensed contractors to Section 3706 of the Labor Code,interest and attorneys fees. construct the project (Sec. 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 contractor(s) licensed pursuant to the Con ctors License Law). CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction I am exempt under Sec. B.&P.C.for this reason: lending agency for the performance of the work for which this permit i t.'^ 111 h fce A Co•1TraCr,/ is issued(Sec. 3097, Civ.C.). Lender's Name: ufk �f Date: —1 b °Al Owner: ' �` Lender's Address: fte 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.Construction activity is prohibited between the hours of 7:00 p.m.and 7:00 a.m.and on Sundays and Holidays. 2.The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 3. 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. ME: Q'" ©D ft/' -' `r, h TQrtN 5 t HIV TITLE: 0`4"4(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. L / SIGNATURE: ^`��� gkie--.=-----N DATE: i / 7°%/ w:, CITY OF ARCADIA I.6�. Development Servicepartment . � \M .. .n 240 West Huntington ,-P.O. Box 60021 PI ZIT NO. BOO-004-108 •-: r-d,',, • �:i Arcadia, CA 91066-6L_ (626)574-5416 Permit Type: Mechanical PROJECT LETIj I J. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS CO,„, +�' 11/8/1999 CS 10:27 11/8/1999 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 625 Encino Ct 5780-013-048 OWNER MAILING ADDRESS Johnston, Rodney M And Karen L 625 Encino Ct PHONE NO. Inspector#: 205 CA - EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Air-Tro Heating&A/C 1630 Myrtle Av PHONE NO. (626)357-5311 License No. 258228 Monrovia, CA 91016 EMAIL ADDRESS: Type: C Expires: 12/31/1999 TENANT MAILING ADDRESS PHONE NO. EMAIL ADDRESS: DESCRIPTION HVAC CHANGEOUT Construction Type UOM #of Units Value Construction Type UOM #of Units Value OCCUPANCY: Dwellings TOTAL VALUATION: $0.00 OTY UOM DESC AMT AMT PAID ACCT OTY UOM DESC AMT AMT PAID ACCT 1.00 each Furn<100,000btu $17.00 $17.00 01-3105 1.00 each Comp 3 hp $17.00 $17.00 01-3105 it`/1 T/ 1.00 Flat Mech Issue Auto $40.25 $40.25 01-3105 ( Totals for: 01-3105 $74.25 $74.25$1.00 f� /OA' 1.00 each SWMF 2 Auto $1.00 $1.00 88-3027 1iN Totals for: 88-3027 $1.00 $1.00 Total Fees: $75.25 Total Amount Paid: $75.25 Paid Today: $75.25 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 ARE Requests for inspection should be made at least Monday-Thursday Fridays one(1)business day in advance of the inspection 7:30 a.m.-8:30 a.m. 7:30 a.m.-8:30 a.m. by telephone at(626)574-5416 for onsite work and 4:30 p.m.-5:30 p.m. 4:00 p.m.-4:30 p.m. at(626)574-5490 for offsite work. CLOSED ON ALTERNATE FRIDAYS —L_ •? City of Arcadia "� • Development Services Departi■,.nt 4 ill 240 West Huntington Drive-Post office Box 60021 �� .: iy, t<• Arcadia,CA 91066-6021 � (626)574-5416 t` PERMIT / PLAN REVIEW APPLICATION LIC SED CONTRACTOR'S DECLARATION WORKERS COMPENSATION DECLARATION ereby affirm under penalty of perjury that I a licensed under provisions of I hereby affirm under penalty of perjury one of the following. m 7 Chapter 9 (commencing with Section 7000) of Division 3 of the Busi ss nd Professions cod�lannd�my license is in full force a�: effec r? ❑I have and will maintain a certificate of consent to self-insure for License Class 1.�H1 License No. /_71I �Exp. to l 31 2"0 workers compensation as provided for by Section 3700 of the Labor r• Code , for the performance of the work for which this permit is issued. Signature of Contractor: . ,d - _.. OWNER - BUILDER DECLARATION have and will maintain workers compensation insurance,as required I hereby affirm under penalty of perjury that I am exempt from the by Section 3700 of the Labor Code, for the performance of the work Contractors License Law for the following reason (Sec. 703 1.5, Business and for which this permit is issued. My workers compensation insurance • ns Code: Any city or county which requires a permit to carrier and number are: construct, alter, improve, demolish, or repair any structure, prior to its / ' ( f / / J r issuance also requires the applicant for such permit to file a signed Carrier: V(, N statement that he or she is licensed pursuant to the provisions of the + n 77 �� I Contractors License Law (Chapter 9, commencing with section 7000 of J (-� Policy Number: (This section need not be completed if the permit is for one hundred ($100) or less). El I, as owner of the property, or my employees with wages as their sole ❑ I certify that in the performance of the work for which this permit is compensation, will do the work, and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The issued, I shall not employ any person in any manner so as to become Contractors License Law does not apply top an owner of property who subject to the workers compensation Laws of California, and agree builds or improves thereon, and who does such work himself or herself or that if i should become subject to the workers compensation through his or her own employees, provided that such improvements provisions of Section 3700 of the Labor Code, I shall fortwith comply are not intended or offered for sale. If, however, the owner-builder or with these provisions. improvement is sold within one(1)year of completion,the owner-builder will have the burden of proving he or she did not build or improve for the Date:_ Applicant: purpose of sale). with licensed con- y in wth c exclusively cont act WA tilt G F ilu to "' ;.':<::;:n; ;i>:;: owner of the property, am R N a re "`'`.'�``'�� '?`�` ?� ��"��`�''�'�� I, a_ owne o P P Y, 9 siC#:::,.+a�t�l���rrtl� ;.�r ..�� .."f8 r the project Sec. 7044 Business and unlawful ent ll:#a tiof;.t se et p1 .. .. .tilmlj :> I(t ('td tractors to construct p J Professions Code:The Contrators License Law does not apply to an owner Clvll#lam Up J:#Onif•tlle0t 0#01. llll ,'t rP .fin fth' of property who builds or improves thereon, and who contracts fr ? $ pf. !ij !! #r, j, ii r licensed pursuant to the 3y4 >h :..'.. .:" ! 1 t r,.'r•:; :�,�>� : .sm for such projects with a contractor(s) P :. .::::,�::::::::::::::::::::.: ::::::.�::::::::::>.: :.:,..:.....z:...,..•...:>::�,• Contractors License Law). :: •:;. ;::: : : :;::::: :..::.:.......:. :...:::. ,•:: ...........:: CONSTRUCTION LENDING AGENCY I am exempt under Sec. ._. , B. &P.C.for this reason: 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 ( Sec. 3097, Civ.C.). Lenders Name: Date: Owner: , Lenders 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. Construction activity is prohibited between the hours of 7:00 a.m. and on Sundays and Holidays. 2. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 3. 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,structures and remodeling work. p� NAME: L� ___��—'_y TITLE:— �. PRINT AhAE 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 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.If,Afetr making the certificate of Exemption from the Worker's Compensation provisions of the Labor Code, I should become subject to such provisions, I will forthwith comply. In the event I do not comply with Worker's Compensation la this permit shall be deemed revoked. J� SIGNATURE:_ / /1-/) -- DATE: /1 // 2 BUILDING AND SAFETY DIVISION — BUILDING City of Arcadia job# 3736 PERMIT 240 W. HUNTINGTON DR., ARCADIA, CA 91006 • TEL. (213) 446-4471 AIIN Cciing Address 625 ENCINO CT. U.B.C.Edition 'Type Occ• Const. Group _ Lot Block Tract Occ. F. D.Appr. Date H. D.Appr. Date No. _ Load Required Required Owner Use Zone Special Case No. Mailing ' ,T FT ,IS Homeowners Association Approval Date Address ENCINO CT. City AKUADJA Zir1006 Tel. Size Contractor Special CAT1-PAC ROOFING _ ___ Ad NOTE: Include: 6150.00 20 S. DUPONT DR. @eL _VALUATION Labor, Material, Plumbing, Etc. $ Cit IE V2 Misc. FEE 806• T b0 548 5404 State Lic. City ❑Private &Classif. 279503 B Lic. NoO-11768-L Swimming Pool!Spa [�Public Arch., Engr., Sign-Pole ❑ Wall ❑ Designer Address Tel. F Temporary❑ Projecting❑ City Zip State E Fee Based on Total Sq.Ft. Lic. No. E Proposed REROOF WITH DECRA TILE. 40.65 S PLAN CHECKING FEE Construction — - squares. ICBO#3409. SINGT,R FAMILY S.M.I.P. 1.4.19.mn DWELLING Permit Fee 101 75 r Floor Main Accessory Total Processed by Area TOTAL 102 24 New❑ Add.❑ Alter.❑ RepaiI Demolition❑ Permit No. Plan No. Date LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION P.:1 I hereby affir, m licensed under provisions,f C apter 9(commencing with Section I hereby affirm that I have a certificate of consent to self-insure,or a certificate of I rr)of Div is' usines nd Pro essions ',e/.id m license is in full force and Worker's Compensation Insurance,or a certified copy thereof.(Sec.-3800,Labor Code effect. �/ `�_ -' ✓A `_/ Policy No. PCS137886-- Company ROYAL ' OWNER-BUILDER I CLARATION ®Copy is filed ❑Certified rn sh is Ex .Date with the City. hereby furnished. 1�/R� ❑ 1 hereby af fir at lam exempt from the Contractor's License Law for the following CERTIFICATE OF EXEMPTION FROM reason:''Sec.703!. .Business and Professions Codes.Any city or county which requires a WORKERS'COMPENSATION INSURANCE permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance (This section need not be completed if the permit is for one hundred dollars($100)or less.) also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law,Chapter 9(commencing with ❑ I certify that in the performance of the work for which this permit is issued,I shall not Section 7000)of Division 3 of the Business and Professions Code, or that he is exempt employ any person in any manner so as to become subject to the Workers'Compensation Law therefrom,and the basis for the alleged exemption.Any violation of Section 7031.5 by any of California. applicant for a permit,subjects the applicant to a civil penalty of not more than five hundred NOTICE TO APPLICANT:!f,after making this Certificate of Exemption you should become dollars($500)." subject to the Workers' Compensation provisions of the Labor Code,you must forthwith comply with each provisions or this permit shall be deemed revoked. I,as owner of the property,or my employees with wages as their sole compensation,will CONSTRUCTION LENDING AGENCY o the work,and the structure is not intended or offered for sale."Sec.7044,Business and 1 hereby affirm that there is a construction lending agency for the performance of the work Professions Code:The Contractor's License Law does not apply to an owner of property who for which this permit is issued.(Sec.3097.Civil Code.) y P builds or improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the Lender's Name building or improvement is sold within one year of completion,the owner-builder will have —the burden of proving that he did not build or improve for the purpose of sale.'' Lender's Address ❑ I, as owner of the property, am exclusively contracting with licensed contractor to construct the project."Sec.7044,Business and Professions Code:The Contractor's License I certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordi noes and state laws relating to building Law does not apply to an owner of property who builds or improves thereon,and who con- g P y Y e I' B tracts for such projects with a contractor(s)licensed pursuant to the Contractor's License Law.'' construction,and he thorize representat• of this city to enter the above- entioned property for insp e / i / ❑ I am excempt under Sec. ____,B.&P.C.for the reason __. / / _ Signature of •i.. /LLl-♦� i � --- Mailing Address ���-'' � � ��� - e _ i • Vute _ Owner City,State,Zip �� — This is a building permit when properly filled out, signed and validated, INSPECTOR COPY and is subject to expiration if work thereunder is suspended for 180 days. + INSPECTION RECORD FOUNDATION: (Gr. Certif. Comp. Tests, Set- backs,Forms,Reinf.Steel,Excavation. INSPECTION NOTES FLOOR SLAB/JSTS., GIRDERS: Mesh, Vap. • Barrier,Blkg.,Spans,Access,Vents,Tr.Lmbr. MASONRY: Reinf., Mortar Jts., Grout Lifts, Clean-Outs,Bolts. ROOF SHTG.:Nailing,Diaph.Blocking,Material Grade and Thickness,Roof Drains. FRAMING:Walls,Raft.,Jsts.,Blocking,Bracing, Nailing,Backing,Diaphr.Draft Stops. INSULATION: Thickness, R-Values, Piping, Sound Caulking. , • FIREWALLS: Material, Thickness, Dampers, Doors,Closers,Fusible Links. INTERIOR:LATH/DRY WALL:Nailing,Supports, Laps,Joint Reinf. EXTERIOR LATH/SIDING: Mesh, Fasteners, Laps,Paper,Thickness,Backing. FINAL INSPECTION: Finish Grading Certif., Slope Plant., Energy Compl. Card Posted, • Pkg. Access, Fire Doors, Exit, Locking De- vices, Landings, House Numbers, Weather Stripping, PI./Engr.Clear. SWIMMING POOL/SPA EXCAV. REINF.SETBACKS:Radius Stl.,Bond- ing,Exp.Soil, Ramp Loc.,Surcharge. — FENCE/GATES: Height, Closers, Accessibility, Latches,Stability. FINAL INSPECTION: MISC. SIGNS: RE ROOF. .1 7 INSPECTION DATE INSP. SIGN. A • 6frgC,A/fcaa//:etCOMPLETED ;: ' , . . BUILDING & SAFETY DIVISION w- 'AE ARCADIA % 240 West Huntington Drive 0 Arcadia, California 91006-3104 400R�'oRATEO',0 ( 818 ) 5 7 4 - 5 4 1 6 page o 625 E ENCINO CT 01/11/89 13 :02 Permit No : A8900104 Autoproj No : AU002125 Status : APPROVED Validated by : CP Inspector area: 205 This type : Single Family Project Applied : 01/11/89 Issued : 01/11/89 Parcel number Finaled • Group-occup/use: To Expire .• Owner : ELLIS, JAMES Applicant : ELLIS, JAMES Applicant Addr : 625 ENCINO CT ARCADIA, CA 91006 Job Address : 625 E ENCINO CT Phone number : 818=445=3182 Class code . Valuation 12 , 726 Construction : OTH Permit to do : BED & BATH/PER REAL ESTATE INSPECTION Fee description Units Fee/Unit Ext fee Data Dwelling(Enter Square Footage) 3104> 228 . 00 . 00 Accessory Blding(Enter Sq Ft) 3104> 54 . 00 . 00 BATH/EX Building Permit Fee 3104> 196. 55 S.M. I.P. Fee 714-2207> . 89 *** Fees Required *** *** Fees Collected & Credits *** Receipt No. Date Payment 01/11/89 197 .44 Fees: 197 . 44 Adjustments: . 00 Total Credits: . 00 Total Fees: 197 . 44 Total Payments: 197 . 44 Balance Due: . 00 I CALL FOR INSPECTION DECLARATIONS Requests for inspections should be made at least In accordance with Health & Safety Code, Section twenty-four hours in advance by telephone at 19825,all required declarations on the reverse side of 574-5416, 8:00 A.M. - 5:00 P.M. this form have been properly signed and dated by the permittee. Inspectors office hours are: Verified by: 8:00-9:00 A.M.; 1:00- 1:30&4:30- 5:00 P.M. 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T T 13 C 2 G) r 33 m T T 3) (n co (n T 33 co ?1 C (n T 3) C) (n (� O co m o > > ° m m (o o x > > o w w c. m x o o c m 5 T c x o o coo -10 a m w a m m m w y m Z w d o m ° m a F m (o a z °-' m <. c ,o a m f m () m m m j < y -o G) C co -3 m m D 5 0 m m m a c m C) RI 3 c 0 R° o m 7, o m c y y g ; (o m c) -D Co Z cmi p y (m-� C 0 o z D �1 m y m - 3 _� v ° < v a 3 O y c 0 , r m mo -I -1 a° f w. o ci a a (n n "° °-' w C) m m 0 co m CD my m w a ° m n 0 to 0 IC m y 3 (o n w t D Z to ° a o -I o m • a O N c m z a Z cn to ° ° 0 0 > > > m m m m E z z z 0 0 0 0 7 5 . . • _ 1 - • - . \ • - - 1 I \ I - ♦ - . - . z 0 —I m N 6 fr y c a ey<*ct BUILDING & SAFETY DIVISION ag ARCA;;D A�� e7k, 240 West Huntington Drive ,cea Arcadia, California 91006-3104 PORATED ( 818 ) 574 - 5418 rage 1 of 1 625 E ENCINO CT 01/11/89 13 : 05 Permit No : A8900105 Autoproj No : AU002125 Status : APPROVED Validated by : CP Inspector area: 205 This type : Electrical Project Applied : 01/11/89 Issued : 01/11/89 Parcel number Finaled • Group-occup/use: To Expire • Owner : ELLIS, JAMES Applicant : ELLIS, JAMES Applicant Addr : 625 ENCINO CT ARCADIA, CA 91006 Job Address : 625 E ENCINO CT Phone number : 818=445=3182 Class code Valuation • 0 Construction : OTH Permit to do : WIRING FOR BED & BATH/PER R.E. INSPECTION Fee description Units Fee/Unit Ext fee Data Original Permit Issue Fee (YES/NO) 27 . 55 Y Outlets 3105> 16. 00 15. 20 *** Fees Required *** *** Fees Collected & Credits *** Receipt No. Date Payment 01/11/89 42 .75 Fees: 42 . 75 Adjustments: . 00 Total Credits: . 00 Total Fees: 42 . 75 Total Payments: 42 . 75 Balance Due: . 00 CALL FOR INSPECTION DECLARATIONS Requests for inspections should be made at least In accordance with Health & Safety Code, Section twenty-four hours in advance by telephone at 19825,all required declarations on the reverse side of 574-5416, 8:00 A.M. -5:00 P.M. this form have been properly signed and dated by the permittee. Inspectors office hours are: Verified by: 8:00- 9:00 A.M.; 1:00- 1:30&4:30-5:00 P.M. Signs� 4r_. R I ciFi g��Q m m . 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BUILDING & SAFETY DIVISION *►- AREnDIA 240 West Huntington Drive C \7111 Arcadia, California 91006-3104 + TES"��o ( 818 ) 5 7 4 - 5 4 1 6 Page 1 of 1 625 E ENCINO CT 01/11/89 13 : 07 Permit No : A8900106 Autoproj No : AU002125 Status : APPROVED Validated by : CP Inspector area: 205 This type : Mechanical Project Applied : 01/11/89 Issued : 01/11/89 Parcel number Finaled . Group-occup/use: To Expire .• Owner : ELLIS, JAMES Applicant : ELLIS, JAMES Applicant Addr : 625 ENCINO CT ARCADIA, CA 91006 Job Address : 625 E ENCINO CT Phone number : 818=445=3182 Class code . Valuation 0 Construction : OTH Permit to do : REGIS. & DUCT/PER R.E. INSPECTION Fee description Units Fee/Unit Ext fee Data Original Permit Issue Fee (YES/NO) 27 . 55 Y Piece of Equip. not covered above> 1. 00 8 . 70 8 . 70 *** Fees Required *** *** Fees Collected & Credits *** Receipt No. Date Payment 01/11/89 36. 25 Fees: 36. 25 Adjustments: . 00 Total Credits: . 00 Total Fees: 36. 25 Total Payments: 36. 25 Balance Due: . 00 CALL FOR INSPECTION DECLARATIONS Requests for inspections should be made at least In accordance with Health & Safety Code, Section twenty-four hours in advance by telephone at 19825,all required declarations on the reverse side of 574-5416, 8:00 A.M. -5:00 P.M. this form have been properly signr and dated by the permittee. Inspectors office hours are: Verified by: - 8:00- 9:00 A.M.; 1:00- 1:30&4:30-5:00 P.M. 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BUILDING & SAFETY DIVISION ig ARCADIA 240 West Huntington Drive /, Arcadia, California 91006-3104 *C°A�'ORATED'��o ( 818 ) 5 7 4 - 5 4 1 6 Page 1 or 1. 625 E ENCINO CT 01/11/89 13 :08 Permit No : A8900107 Autoproj No : AU002125 Status : APPROVED Validated by : CP Inspector area: 205 This type : Plumbing Project Applied : 01/11/89 Issued : 01/11/89 Parcel number Finaled .• Group-occup/use: To Expire .• Owner : ELLIS, JAMES Applicant : ELLIS, JAMES Applicant Addr : 625 ENCINO CT ARCADIA, CA 91006 Job Address : 625 E ENCINO CT Phone number : 818=445=3182 Class code .• Valuation 0 Construction : OTH Permit to do : PLUMB BATH/PER R.E. INSPECTION Fee description Units Fee/Unit Ext fee Data Original Permit Issue Fee (YES/NO) 27 . 55 Y Showers 3105> 1. 00 7 . 75 7. 75 Water Closets 3105> 1. 00 7 .75 7 .75 Lavatories 3105> 2 . 00 7 .75 15. 50 *** Fees Required *** *** Fees Collected & Credits *** Receipt No. Date Payment 01/11/89 58. 55 Fees: 58 . 55 Adjustments: . 00 Total Credits: . 00 Total Fees: 58 . 55 Total Payments: 58 . 55 Balance Due: . 00 CALL FOR INSPECTION DECLARATIONS Requests for inspections should be made at least In accordance with Health & Safety Code, Section twenty-four hours in advance by telephone at 19825,all required declarations on the reverse side of 574-5416, 8:00 A.M. -5:00 P.M. this form have been properly signed and dated by the permittee. Inspectors office hours are: Verified by: ' 8:00-9:00 A.M.; 1:00- 1:30&4:30-5:00 P.M. 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BUILDING & SAFETY DIVISION 4: ARC CbIA 240 West Huntington Drive -fif ' Arcadia, California 91006-3104 f4'cORpORATVD-s � ( 818 ) 574 -5416 Page 1 of i 625 E ENCINO CT 01/09/89 16: 19 Permit No : A8900059 Autoproj No : AU002125 Status : APPROVED Validated by : CP Inspector area: 205 This type : Miscellaneous Projects Applied : 01/09/89 Issued : 01/09/89 Parcel number Finaled . Group-occup/use: To Expire . Owner : ELLIS, JAMES Applicant : ELLIS, JAMES Applicant Addr : 625 ENCINO CT ARCADIA, CA 91006 Job Address : 625 E ENCINO CT Phone number : 818=445=3182 Class code .• Valuation 0 Construction : OTH Permit to do : REAL ESTATE INSPECTION (BDRM & BATH) Fee description Units Fee/Unit Ext fee Data Enter Route Inspection Amount 3107> 38 . 65 38. 65 *** Fees Required *** *** Fees Collected & Credits *** Receipt No. Date Payment 01/09/89 38 . 65 Fees: 38 . 65 Adjustments: . 00 Total Credits: . 00 Total Fees: 38 . 65 Total Payments: 38 . 65 Balance Due: . 00 CALL FOR INSPECTION DECLARATIONS Requests for inspections should be made at least In accordance with Health & Safety Code, Section twenty-four hours in advance by telephone at 19825,all required declarations on the reverse side of 574-5416,8:00 A.M. -5:00 P.M. this form have been properly signed and dated by the permittee. _ Inspectors office hours are: Verified by: 8:00-9:00 A.M.; 1:00- 1:30&4:30-5:00 P.M. 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