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HomeMy WebLinkAboutUntitled Development Services Department V 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. $QQ_044-159 'j Arcadia,CA 91066-6021 Arcadia (626)574-5416,Fax(626)447-9173 Permit Type: EMP Combo PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 23143 8/15/2013 CM 14:10 8/15/2013 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 232 Hillgreen PI 5765-010-009 OWNER MAILING ADDRESS McMeen, Herta And Roy E Trs McMe232 Hillgreen PI PHONE NO. Inspector#: JOHN Arcadia,CA 91006 EMAIL ADDRESS: Plan#: IN FILE APPLICANT MAILING ADDRESS Boston Brick& Stone General And PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Boston Brick& Stone General And N2005 Lincoln Avenue PHONE NO. (213)257-4298 FAX NO. (213)550-1212 Pasadena,CA 91103 EMAIL ADDRESS: Harley Barber authorized to sign 9/15/! License No. 783578 Type: B,C29 Expires: 8/31/2014 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION NEW OUTDOOR BBQ/KITCHEN onstruction T - ----- --_ __-_ ype UOM #of Units Value Construction Type UOM #of Units Value C COMNETED OCCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY EOM DESC AMT AMT PAID ACCT 1.00 flat Elec issue 44,35 44.35 01-3105 1.00 Flat Plmbg issuance 44.35 44.35 01-3105 1.00 Double fee 2 1.00 1.00 01-3105 1.00 each Kitchen sinks 12.46 12.46 01-3105 2.00 outlets Gas piping 15.55 15.55 01-3105 6.00 each Outlets 9.24 9.24 01-3105 3.00 each Ltg fixtures 4.62 4.62 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 /,/S"/K j/77/4(■ - , Total Fees: $132.57 Total Amount Paid: $132.57 Paid Today: $132.57 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 Receipt#: 101961 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by 01-3105 131.57 this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by 88-3027 1.00 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 11 one(1)business day in advance of the inspection 7:30 am.to 8:30 a.m. 7:30 am. to 8:30 am. 1 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) imIllik �ytpoRp��....♦i•►, . �• , PERMIT/PLAN REVIEW APPLICATION lob. 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. ry ❑ 1 have and will maintain a certificate of consent to self-insure for workers' n ZS 3�_.W Exp.Date D .131-- compensation, as provided for by Section 3700 of the Labor Code, for the License Class nt Licens o P performance of the work for which this permit is issued. Signature of Contractor Al ..... �-' •% I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER 1 CLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers'compensation insurance carrier and policy number are: License Law for the following reason(Section 7031.5,Business and Professions Carrier kr--E- /, 4-1t) Code: Any city or county which requires a permit to construct, alter, improve, G demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number Wt,L 'T 7 I I g 2--Cr for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if 1 should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of th bor Code, shall forthwith comply with those provisions. ❑ I, as owner of the property, or my employees with wages as their sole j r compensation,will do the work,and the structure is not intended or offered for Date ' I 3 Signature x 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 penalties 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 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 Signature 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 " - ( ----A2--f--- Title 377 . L— 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-mentio propert 'nspection purposes. U ` Signafttre Date S �3 ,05,1 7, Development Services Department ci 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. '� `' Arcadia,CA 91066-6021 BOO-043-575 City of Arcadia (626)574-5416,Fax (626)447-9173 Permit Type: Pool/spa (PROJECT ., TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 23143 6/17/2013 CM 10:21 6/17/2013 Issued PROJECT ADDRESS ASSESSORS PARCEL NO. GEO CODE 232 Hillgreen PI - 5765-010-009 OWNER MAILING ADDRESS McMeen, Herta And Roy E Trs McMe232 Hillgreen PI PHONE NO. Inspector#: JOHN Arcadia, CA 91006 EMAIL ADDRESS: Plan#: IN FILE APPLICANT MAILING ADDRESS Huntington Pool& Spa PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Huntington Pool& Spa 2021 E Gladstone Street#G PHONE NO. (626)332-1527 FAX NO. Glendora,CA 91740 EMAIL ADDRESS: License No. 797836 Type: D35,C53 Expires: 7/31/2013 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION 124 PF OF IN GROUND GUNITE POOL&SPA Construction Type UOM #of Units _ -- -- --- ---- - ----- - Value Construction of Units Value Pool perm ft 124.00 $28,565.55 ca PLETEO #o OCCUPANCY: Pool TOTAL VALUATION: $28,566.00 QTY UOM DESC AMT AMT PAID ACCT QTY (IOM DESC AMT AMT PAID ACCT each Plan review 350.19 350.19 01-3103 1.00 Flat Bldg issuance 44.35 44.35 01-3104 each Bldg permit 538.75 538.75 01-3104 1.00 flat Pool elec issue 44.35 44.35 01-3105 1.00 each Pool pim iss 44.35 44.35 01-3105 1.00 each Pools elec 67.65 67.65 01-3105 1.00 flat Pool piping 27.07 27.07 01-3105 1.00 flat Pool p-trap 10.86 10.86 01-3105 1.00 each Pool heater 40.74 40.74 01-3105 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 Flat SWMF 6.25 6.25 88-3027 Total Fees: $1,176.56 Total Amount Paid: $1,176.56 Paid Today: $1,176.56 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 Receipt#: 101251 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by 01-3103 350.10 this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified b 01-3105 235.12 a City of Arcadia building inspector for a period of 180 consecutive days. y 01-3105 235.02 88-3027 8.25 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) • PERMIT/PLAN REVIEW APPLICATION Alp. 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 Cod , n license is in ful -Ale ..iii. - • 7�f 3 1 f I3 ❑ I have and will maintain a certificate of consent to self-insure for workers' II compensation, as provided for by Section 3700 of the Labor Code, for the License Class License ►�•c ,,/ Exp.Da performance of the work for which this permit is issued. Signature of Contractor .//- / 'I I have and will maintain workers' compensation insurance,as required by Section OWNER-BUILDER DE' ARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty 4 perjury that I am exempt from the Contractors issued. My worke s�}c >ftpensation insurance carrier and policy number are: License Law for the following reason(Section 7031.5,Business and Professions Carrier /t/�,J1J S Code: Any city or county which requires a permit to construct, alter, improve, (��n � demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number " L for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less.) provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is ❑ I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation laws of California,and agree that if 1 should become subject to the penalty of not more than five hundred dollars($500)): workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwit co ly 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 Signature ` 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 penalties 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 Signature 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- 20000-for further information. Name I ©`�.,� Title CoitrJc N '" 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. I 01 71" Signature �� 1 Date NOTES/►/i Building Inspections Date Insp. Plumbing Inspections Date Insp. (/ / 100. Setbacks 210. Under flr./bldg.drain 23C 7 � d_ l LAC 101. Rough grade 211. Copper underslab 102. Figs.&forms 212. Rough plumbing 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan 105. Steel 215. Water heater 106. Grout lift 216. Roof drains 107. Shear nailing 217. Building sewer 108. Diaph nailing 218. Water service 109. Roof nailing 219. Final gas 110. Framing 220. Fixtures 111. 0cc./Area Sept.Wall 221. Final plumbing 112. Sound walls 222. Sewer cap/demo. 113. T-bar'rid 114. Insulation-Flr. Pool Inspections I Date I Insp. 115. Insulation-Wall 240. Excavation/steel ' 116. Insulation-Ceil. 241. Rough.lumbin. r 117. Drywall nailing 242. Light shell/bonding / j � �,. 7 506" J. 118. Interior lath 243. Underground conduit �.aiA 119. Exterior lath 244. P-tra• 120. Finish grade 245. Gas line&test ,- 20,411. l x 121. Final building 246. Fence,gates&signs .�" i 122. Final demo/lot clear 247. Pool heater 248. Final electric MIS - ElectricalInspections Date Insp. 249. Final.lumbin. 1 dir 50. Power pole 250. Pool cover / ( �? 151. Sales lot lighting 251. Pool final p/// 152. Underground conduit 153. Underslab conduit Reroof Inspections Date Insp. 154. UFER ground 270. Pre-reroof insp. 715 14 F /0165 . ,Z 15 155. Water ground 271. Roof framing (4'(S) A(r! . 4 1J3 156. Rough electrical 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. Eqpt.bonding Sign Inspections Date I Insp. 160. Service panel 280. Setback/overhang 161. Final electric 281. Footing 282. Conduit/wiring Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC Miscellaneous Insp. Date Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Fire sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. I Date Insp. 191. Final mechanical 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cesspool filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin 1•--- Development Services Department / 24:9 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-044-675 // ` •" Arcadia,CA 91066-6021 Arcadia (626)574-5416,Fax(626)447-9173 Permit T ( ) Type: SF Add/Alt + PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 23143 10/8/2013 CM 9:29 10/8/2013 Copy ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 232 Hillgreen PI 5765-010-009 OWNER MAILING ADDRESS Roy McMeen 232 Hillgreen PI PHONE NO. Inspector#: JOHN Arcadia, CA 91006 EMAIL ADDRESS: Plan#: 31046 APPLICANT MAILING ADDRESS Boston Brick&Stone Masonry PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Boston Brick&Stone General And 1v2005 Lincoln Avenue PHONE NO. (213)257-4298 FAX NO. (213)550-1212 Pasadena, CA 91103 EMAIL ADDRESS: Harley Barber authorized to sign 9/15/c License No. 783578 Type: B,C29 Expires: 8/31/2014 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION NEW POOL CABANA 435 SQ FT.,NEW MASONRY GAS FIRE PLACE Construction Type UOM #of Units Value Conslructii •• OM #of Units Value Patio so ft 435.00 $9,648.30 COMPLETED Value 500000 $5,000.00 OCCUPANCY: Dwellings TOTAL VALUATION: $14,649.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 208.49 208.49 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 320.75 320.75 01-3104 1.00 Flat Plmbg issuance 44.35 44.35 01-3105 1.00 Double fee 2 1.00 1.00 01-3105 4.00 each Outlets 6.16 6.16 01-3105 3.00 each Ltg fixtures 4.62 4.62 01-3105 1.00 outlets Gas piping 15.55 15.55 01-3105 SMIP Res 1.46 1.46 14-2207 gm bldg std 1.00 1.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 Flat SWMF 2 1.00 1.00 88-3027 Total Fees: $655.98 Total Amount Paid: $655.98 Paid Today: $655.98 This pennit/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 Receipt#: 102543 days from the date of plan submittal. This permit expires and becomes null and void if any work authorized by 01-3103 208.49 this permit is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by 01-3105 375.18 Y 01-3105 71.46 a City of Arcadia building inspector for a period of 180 consecutive days. 14-2207 1.46 CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS 88 88--330273 027 8.25 8.25 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) O A' `^ylFOkvy.I �11 PERMIT/PLAN REVIEW APPLICATION liskli, -is Development Services Department, 240 West Huntington Drive, Post Office Box 60021 -- °"°"Y°'"s Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS' COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9, commencing with Section 7000, of Division 3 of the Business and Professions Code,and my license is in full force and of ./ ❑ I have and will maintain a certificate of consent to self-insure for workers' (� C.2' C 7"/ compensation, as provided for by Section 3700 of the Labor Code, for the License Class h icense N - Exp.Date / performance of the work for which this permit is issued. Signature of Contractor 1 `y.,,, /Z 'C have and will maintain workers' compensation insurance,as required by Section OWNER—BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit is ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors issued. My workers'L compensation insurance carrier and policy number arc: ' License Law for the following reason(Section 7031.5, Business and Professions Carrier �Gte'iT ls._x.StC\e c c: ,t'r 3-r\C Code: Any city or county which requires a permit to construct, alter, improve, demolish,or repair any structure,prior to its issuance,also requires the applicant Policy Number g l 3 SO c 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 Sea, 3 00 of the Labor '.•. I shall forthwith comply with those provisions. ❑ I, as owner of the property, or my employees with wages as their sole ,��j}_' compensation,will do the work,and the structure is not intended or offered for Date CA- 03 Signature _ u �.— 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 penalties 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 Signature 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. (� I Name f�S1USN ftcl_ ) S nG `1.d L.rave! Title e 69Wtler- PreS tC('"^.1.- PRINT NAME I certify that I have read " 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 co ly , th all City ordinances • t. e laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter n t above-Tentioned . •l perty < inspection purposes. Signature /!tiT Date /`"��`/ _37 / C-------