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yr fir'• Development Services Department • S ' 240 West Huntington Drive,Post Office Box 60021 �`v% Arcadia,CA 91066 6021 PERMIT NO. BOO-047-166 City of (626)574-5416,Fax(626)447-9173 Arcadia Permit Type: Tenant Improve w/energ; PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 6/19/2014 CM 12:26 9/3/2014 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT 8LG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-387 OWNER MAILING ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan Chk#: 14-360 Los Angeles,CA 90025- EMAIL ADDRESS: Plan#: 31354 APPLICANT MAILING ADDRESS Kamus&Keller(Marcia!) PHONE NO. (323)490-9757 EMAIL ADDRESS: CONTRACTORIPROFESSIONAL MAILING ADDRESS 702 NO. 891-0479 FAX NO. K R Construction 4110 W Dewey Dr PHONE ( Las Vegas,NV 89118 EMAIL ADDRESS: License No. 981156 Type: B Expires: 2/28/2015 12:00: TENANT MAILING ADDRESS A T&T PHONE NO. FAX NO. , DESCRIPTION TENANT IMPROVEMENT Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 50,000.00 $50,000.00 n COMPLETED ., _b_,___,„„,,____a__,____ts__ 3_,/ OCCUPANCY: Tenant Improve TOTAL VALUATION: $50,000.00 QTY DOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 524.23 524.23 01-3103 each Energy p/c fee 177.43 177.43 01-3103 PC ADA 78.63 78.63 01-3103 PC Cal Green 52.42 52.42 01-3103 100 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 806.50 806.50 01-3104 Bldg Issue ADA 80.65 80.65 01-3104 1.00 each T.1.Fire Pkc 235.00 235.00 01-3109 SMIP Corn 14.00 10.50 14-2207 gm bldg std 2.00 2.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $2,021.46 Balance Due: $3.50 Paid Today: $950.25 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 106212 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 931.50 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 10.50 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 714-2203 2.00 cadia building inspector for a period of 180 consecutive days. 88-3027 6.25 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) I mow 1 PERMIT/PLAN REVIEW APPLICATION qv,. Development Services Department,240 West Huntington Drive,Post Office Box 60021 ,-t''''' Arcadia,CA 91066-6021,(626)574-5416,Fax(626)447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 o,the Business and Professions Code,and my licen is in full force and effept! ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class B ' ense NoV it 5G, atee_ /2�r�,� 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 DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier molish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less) of 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 Da,I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to be o - subject to the workers' by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I she Id become .oIect to the workers'compensation provisions of Section 3711 of the Labe Code, // ❑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 sale(Section 7044,Business and Professions Code:The Contractors License Date;7�f03�� Signature - �_ ��. 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,and sale.If,however,the building or improvement is sold within one(1)year of 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 did hundred thousand dollars($100,000),in addition to the cost of compensation, not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's 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 CONSTRUCTION LENDING AGENCY builds or improves thereon,and who contracts for such projects with a contras- I hereby affirm under penalty of perjury that there is a construction lending agency tor(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 RE- STRICTIONS 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 fur- ther information. Name 4) L Title o//'eGi -.t....'4 PRINT NAME I certify that I have re is application and star at the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply ith City ordinances,.and tate Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to entpon above-mentioned'prop ty fo inspection purposes. / Signature I �.—... / Date 0 Ve.) ./ ;NO OPERATION NO OPERATION NOTES Building Inspections Date Insp. Plumbing inspections Date Insp. 100. Setbacks _ 210. Under flrjbldg.drain 101. Rough grade 211. Copper underslab 102. Figs.&forms 212. Rough plumbing �i J�/ v ) 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 nailin(gr 219. Final gas 110. Framing ilw-`li �� / 220. Fixtures 111. Occ./Area Sep.Wall 4/ 221. Final plumbing A jf( d 112. Sound walls 222. Sewer cap/demo. 113. T-bar grid 114. Insulation-fir. Pool Inspections Date Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. 241. Rough plumbing 117. Drywall nailing 10-6-tl( Ail 242. Light shelVbonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish grade 245. Gas line&test 121. Final building f--�t-' 246. Fence,gates&signs 122. Final demo/lot clear 1 ' 247. Pool heater 248. Final electric Electrical inspections Date I Ins'. 249. Final Plumbing 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Under.round conduit 153. Underslab conduit Reroof Inspections Date Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical ° if v 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. Eqpt.bondin. .Sign Inspections Date I Insp. 160. Service panel 280. Setback/overhang 161. Final electric $044 281. Footing 282. Conduit/wirin. Mechanical Inspections ( Date Ins.. 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 MM,Sewers 8OffsiteInsp. . Date Insp. 191. Final mechanical 1 5-i ✓r 300. Lateral(main to P/L) 301, Saddle/Y Block Wall Ins ectians Date • 302. Cesspool filled 200. Footings 303. Sidewalk 201. Steet/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin a . wry‹r __-_,,...---"..„4.,t,,p11 /'�`P' .1,;-:. .' i``°`_._ ,,,r'r®4s'` �•7" fi:*s —'v�\� :' --,,. '� l„ t°d"W' .... �i "' dry "v ,,\ �. "°pas a a•r a\. - ,. � ..� i " `' " " ., ,. I > �5°l 4 4'y (irr' �alk -a-,E�i is d 1i �: �,i i ,��'t a , y'I,T ,4 r_ �� `.F r -w. 4-,--1;:;-1'.7.-"'-241 r .+ P.A u ,xr :,=*- •i ...vl '� ( ' "` s,,r f ;� --v k c ai€ ./'''."- s5 + x h ","<- L 1,"--•7 ". s � ' 1 3 k e r1 '^G rt..- , <7f':.; ,,,,,„ „- "^„,„„,,',,,,: ,,,,'' „, ,, ' ,, _ ,,r3 = - ",a �,PA,, s xr;; , •u2re"5r�y+ ',,,,,, ,,,xz.,i+ 'en gx,,uz c^:-,---, t',1/ 7-6:4-;;;'''''1\ ` Y 3 tti Iy` + f/,,. h d A O p m a r,5 o A m (f,.',. ..-,,. "\r? 1 to , > cD I 4:e6 O • a F'i do y a -i A ° C er a n 1 / 1�- I a• o o $ 5 a a .o , _, CD CD//� 5 a .1 IV 0. 07 �• > ., � / ''', CD �CDD C G. v' �1 \ 1 i 1' `+ ° co " co a et ° mob �� ( I i �.�,. n n 0 C O o *�� t /,.,: b �p coo H a `M i jps / / °e O ° Q r c CCD i,V7``'1 i Irw„• b © C O 0 ^� 0 O °'f'Y. I, � D : ' a E 3 ,'_ C 3, n e 01 E. 2 O. f a � ` e ' c m o n Q �' C! ' �' / , g n C g. 0 , - b ' • C I �F j. • W p0 I O C1 N 1 1U ,! ' O .p i N "' Y� << 14 x I--- I (\n 'El i -v x t f i _ k . i Mfg rP �,✓1? /�![� : 2 .. " �f1Q`�/�� ��` wgra �� ��-�f�l �x fi' ���'��1��' ��`� � � � �'�' �� r'+:, � 1�f � / p�� � , . IC� ��i) � Iry Vim; \� VI A / \� = mil,I, �/ \ r/ \ V // \� V // •ti�oFFi r II!C) 1111411111 117 wAvry.i 5,1901, 1110 launitY°tea MEMORANDUM Fire Department DATE: November 12, 2014 TO: BUILDING DEPARTMENT ATTN: INSPECTOR Chris Ingram FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Avenue, T6 (AT&T) THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 10-20-2014 Jill Perumean FIRE ALARMS 11-5-2014 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY 11-10-2014 Jill Perumean COMMENTS: Emailed Bldg. Dept. 11-10-2014 RC C v' rli 'egg€ "C: --_ 1jJflhi 2.ra= 21 ❑XE:1 8!! k Y _ n { ! • arc 'fig # . / d• 0 , N CO N- 5 • • J 0 CD 0 CD N. 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APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/25/2014 JB 13:26 9/25/2014 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-6 T-387 OWNER MAILING ADDRESS I Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. I Inspector#: CRIS Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS PHONE NO. K.R.Construction EMAIL ADDRESS: , CONTRACTORIPROFESSIONAL MAILING ADDRESS K R Construction 4110 W Dewey Dr PHONE NO. (702) 891-0479 FAX NO. Las Vegas,NV 89118 EMAIL ADDRESS: License No. 981156 Type: B Expires: 2/28/2015 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. A T&T DESCRIPTION ELECTRICAL AND MECHANICAL FOR TENANT IMPROVEMENT N of Units Value Construction Type MP1ED Value ....firL'- /l''''I vj_q_lel/ Construction Type UOM Co L OCCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 1.00 flat Elec issue 44.35 44.35 01-3105 1.00 Flat Mech issue 44.35 44.35 01-3105 1.00 Flat Add/Alter Ducts 9.38 9.38 01-3105 32.00 each Outlets 40.00 40.00 01-3105 43.00 each Ltg fixtures 51.00 51.00 01-3105 100 Flat SWMF 2 1.00 1.00 88-3027 100 Flat SWMF 2 1.00 1.00 88-3027 Total Fees: $191.08 Balance Due: $0.00 Paid Today: $191.08 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt tt: 106482 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3105 189.08 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 2.00 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- cadia 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) k ∎F A; 1 11901 r' PERMIT/PLAN REVIEW AP • 1-, APPLICATION a�41*,, Development Services Department,240 West Huntington Drive,Post Office Box 60021 ""''r°`' Arcadia,CA 91066-6021, (626)574-5416,Fax(626)447-9173 City of Arcadia � .ICENSED 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 Chapter 9(commencing with Se 'on 7000,of Division 3 of a Business and of perjury one of the following: Professions Code,and my licens is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class 13 cense No. 0.//5- , . Dat`� fkr compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor / . performance.N ` 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 ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier molish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less) 11 of 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall 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 sale(Section 7044,Business and Professions Code:The Contractors License Date Signature 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 sale.If,however,the building or improvement is sold within one 1 WARNING:Failure to secure Workers'Compensation coverage is unlawful,and ( )year of 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 did hundred thousand dollars($100,000),in addition to the cost of compensation, not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and ❑I, as owner of the property, am exclusively contracting with licensed attorney's fees. contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who CONSTRUCTION LENDING AGENCY builds or improves thereon,and who contracts for such projects with a contrac- I hereby affirm under penalty of perjury that there is a construction lending agency tor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Civil Code). 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 RE- STRICTIONS 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 fur- ther information. Name J/� / ` I Aral, PRINT NAME Title Lt II-C-1-.• I certify that I have this application and s : • at the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply;t'i all City ordinance :nd .tate Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter u the above-mention•, pro,•rt�, ins•ction purposes. Signature / D i Date 9/0.0i0/X' °r--,. Development Services Department p P y 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. s,% Arcadia,CA 91066-6021 BOO-047-998 City of (626)574-5416,Fax(626)447-9173 Arcadia Permit Type: Fire • PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/22/2014 CM 16:34 9/30/2014 Issued ADDRESS NO. Dlr.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-387 OWNER MAILING ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan Chk#: 14-546 Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS T.R.L. Systems PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS T.R.L. Systems 9531 Milliken Avenue PHONE NO. (909)456-2651 FAX NO. Rancho Cucamonga, CA 91730 EMAIL ADDRESS: License No. 413747 Type: C-10 Expires: 11/30/2014 12:01 TENANT MAILING ADDRESS At&T PHONE NO. FAX NO. DESCRIPTION FIRE ALARMS FOR AT&T Construction Type UOM #of Units Value Construction Type UOM Of of Units Value Value Value 2,000,00 $2,000.00 n COMPLETED OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $2,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 6.00 each fire alarm pc 2 587.50 587.50 01-3109 1.00 Flat Fire Issue Auto 44.35 44.35 01-3112 each Fire Permit 103.65 103.65 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $736.50 Balance Due: $0.00 Paid Today: $149.00 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 106535 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 148.00 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 1.00 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- cadia 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) P 1 PERMIT/PLAN REVIEW APPLICATION 119111r4 1 /�' Development Services Department,240 West Huntington Drive,Post Office Box 60021 �'"'°^;;,z,,,,.' 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 C y license is in R ect. ( ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class o ens N J� Exp. Dat+I INK compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor ,i r rformance of the work for which this permit is issued. OWNER-BUILD' ' t 1 aCM iI ON I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code, or the rformance the work for which this er ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers ensatio inran c er and policy numbers are. Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier (Is 2‘.134,1? molish,or repair any structure,prior to its issuance,also required the applicant for 1, G , such permit to file a signed statement that he or she is licensed pursuant to the pro Policy Number l� I visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less) of 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' by any applicant for a permit subjects the applicant to a civil 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 Se ion 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply wi those provisions. compensation,will do the work,and the structure is not intended or offered for 9 ''�`� sale(Section 7044,Business and Professions Code:The Contractors License Date • gnature ,��,,= 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,and sale.If,however,the building or improvement is sold within one(1)year of 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 did hundred thousand dollars($100,000),in addition to the cost of compensation, not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's 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 CONSTRUCTION LENDING AGENCY builds or improves thereon,and who contracts for such projects with a contrac- I hereby affirm under penalty of perjury that there is a construction lending agency tor(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 RE- STRICTIONS 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 fur- ther information. Name ■IJ, ■ Title W,,ii[aifI1 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 duly authorized agent of the owner. I agree to comply with all City dinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above entio d property for inspection purposes. Signature Date 9)301 ,5w1' Development Services Department 240 West Huntington Drive,Post Office Box 60021 � s PERMIT NO. rs Arcadia,CA 91066-6021 BOO-048-025 City of (626)574-5416,Fax(626)447-9173 Arcadia Permit Type: Fire PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/24/2014 JB 15:41 9/30/2014 Issued ADDRESS NO. Dlr.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-6 T-387 OWNER MAILING ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan Chk#: 14-551 Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Already Fire Sprinkler Company PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Allready Fire Sprinkler Co. 818 N Grand Av PHONE NO. (626)913-6720 FAX NO. Covina,CA 91723 EMAIL ADDRESS: License No. 358795 Type: C16 Expires: 7/31/2015 12:00: TENANT MAILING ADDRESS A T&T PHONE NO. FAX NO. , DESCRIPTION SPRINKS FOR T.l. Construction Type UOM N of Units Value Construction Type UOM #of Units Value Value Value 3,200.00 $3,200.00 4 COMPLETED OCCUPANCY: Fire Sprink/AIm TOTAL VALUATION: $3,200.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 21.00 each sprinkler pck 587.50 587.50 01-3109 I.00 Flat Fire Issue Auto 44.35 44.35 01-3112 each Fire Permit 137.05 137.05 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $769.90 Balance Due: $0.00 Paid Today: $769.90 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 106533 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3109 587.50 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 181.40 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 88-3027 1.00 cadia 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) t,,,,,F..„,,, I l PERMIT/PLAN REVIEW APPLICATION i ' Development Services Department,240 West Huntington Drive,Post Office Box 60021 \y/.• 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,an my license is in full or..- .. `-t ct. ❑ I have and will maintain a certificate of consent to self-insure for workers License Class Lice e No. _1 I b Exp. Date. 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 CLARATION [ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.rwo �n�t �su ap _ �polity numbers are Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier �/�-1-� molish,or repair any structure,prior to its issuance,also required the applicant for 5�� • ►'t x3 a. •)�/ such permit to file a signed statement that he or she is licensed pursuant to the pro- (This Number (T!I�� visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less) of 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall 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 sale(Section 7044,Business and Professions Code:The Contractors License Date Signature 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,and sale.If,however,the building or improvement is sold within one(1)year of 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 did hundred thousand dollars($100,000),in addition to the cost of compensation, not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's 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 CONSTRUCTION LENDING AGENCY builds or improves thereon,and who contracts for such projects with a contrac- I hereby affirm under penalty of perjury that there is a construction lending agency tor(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 RE- STRICTIONS 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 fur- ther information. /, /�f�,/ Name 4 K ' Title _S i Cam— POI( - PRI NAME I certify that I have read this application and state that the above information is correct and that I am the owner or 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 a ve-mentioned property for inspection purposes. Signature h1t1 Date l (// '''' Development Services Department 240 West Huntington Drive,Post Office Box 60021 .::,':, Arcadia,CA 91066 6021 .► • PERMIT NO. BOO-047-412 City of (626)574-5416,Fax(626)447-9173 Arcadia Permit Type: Sign PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 7/16/2014 CM 12:15 7/16/2014 Issued ADDRESS NO Dlr.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave 706-L T-387 OWNER MAILING ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS Los Angeles,CA 90025- EMAIL ADDRESS: Plan#: IN FILE APPLICANT MAILING ADDRESS , Mall Sign Service PHONE NO. EMAIL ADDRESS: , CONTRACTOR/PROFESSIONAL MAILING ADDRESS Mall Sign Service 12439 Magnolia Boulevard Ste 113 PHONE NO. (818)764-1909 FAX NO. N. Hollywood, CA 91607 EMAIL ADDRESS: License No. 811074 Type: C45 Expires: 7/31/2014 12:00: TENANT MAILING ADDRESS A T&T PHONE NO. FAX NO. DESCRIPTION ONE ILLUMINATED CHANNEL LETTER SIGN FOR AT&T Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 1,800.00 $1,800.00 QOOMPt1Ib 1 ‘....01-1____ )a- p.-Ii( 4,, OCCUPANCY: Sign TOTAL VALUATION: $1,800.00 QTY UOM DESC AMT AMT PAID ACCT QTY (TOM DESC AMT AMT PAID ACCT Sign plan rev 53.34 53.34 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 95.25 95.25 01-3104 1.00 flat Elec issue 44.35 44.35 01-3105 1.00 branch cin Signs elec 59.17 59.17 01-3105 1.00 each Sign Connection 15.55 15.55 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $314.01 Total Amount Paid: $314.01 Paid Today: $314.01 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 Receipt#: 105718 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3103 53.34 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 01-3104 139.60 cadia building inspector for period of 180 consecutive days. 01-3105 119.07 g p p y 88-3027 2.00 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) to PERMIT/PLAN REVIEW-APPLICATION *4 11 :111 le , 4.411,*. , Development Services Department,240 West Huntington Drive,Post Office Box 60021 m°"''Y avv. Arcadia,CA 91066-6021,(626)574-5416,Fax(626)447-9173 City of Arcadia �SED 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 C4-5 License Na •S I low-Exp. Date?`.3I-I¢ compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor • ' a �f Ct... ■ performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued. orkers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier .` 'pocr ;NI 0 molish,or repair any structure,prior to its issuance,also required the applicant for Policy Number 9 07-7S p D Q such permit to file a signed statement that he or she is licensed pursuant to the pro- Q V visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed if the permit is for one hundred dollars or less) of 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' by any applicant for a permit subjects the applicant to a civil 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 Date' 1 -j b - 14- sale(Section 7044,Business and Professions Code:The Contractors License 1 Signature Law does not apply to an owner of property who builds or improves thereon,or T V V — — 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,and sale.If,however,the building or improvement is sold within one(1)year of 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 did hundred thousand dollars($100,000),in addition to the cost of compensation, not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's 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 CONSTRUCTION LENDING AGENCY builds or improves thereon,and who contracts for such projects with a contrac- I hereby affirm under penalty of perjury that there is a construction lending agency tor(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 RE- STRICTIONS 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 fur- ther information. Name `^ E ' \ t-t C r1 PRINT NAME Title �C7T' r( I certify that I have read this application and state that the above information is correct and that I am the owner or 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 1- l e - i 4-- t..