HomeMy WebLinkAboutB00-049-301 Development Services Department
5 240 West Huntington Drive,Post Office Box 60021
j PERMIT NO.
Arcadia,CA 91066-6021 BOO-049-301
,
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
2/23/2015 CM 13:28 2/23/2015 Issued
ADDRESS NO. Dir.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. Inspector#: cris
Los Angeles,CA 90025- EMAIL ADDRESS:
Plan#: in file
APPLICANT MAILING ADDRESS
Success Sign Inc. PHONE NO.
EMAIL ADDRESS:
'
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Success Sign Inc. 2812 Peck Road PHONE NO. (626)444-8181 FAX NO.
El Monte,CA 91731 EMAIL ADDRESS:
License No. 896068 Type: C45 Expires: 5/31/2015 12:00:
TENANT MAILING ADDRESS
Gemorie PHONE NO. FAX NO.
DESCRIPTION
one LED illuminated sign for Gemorie
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
Value Value 1,000.00 $�0 1000. 0
✓ PLETED
3- It- $
64,1
OCCUPANCY: Sign TOTAL VALUATION: $1,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY IIOM DESC AMT AMT PAID ACCT
Sign plan rev 34.52 34.52 01-3103
1.00 Flat Bldg Issue Auto 44.35 44,35 01-3104
each Bldg permit 61.65 61.65 01-3104
1.00 flat Elec issue 44.35 44.35 01-3105
1.00 each Sign Connection 15.55 15.55 01-3105
I.00 Flat SWMF 2 1.00 1.00 88-3027
I.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $202.42 Balance Due: $0.00 Paid Today: $202.42
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107958
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 34.52
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 106.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 01-3105 59.90
cadia building inspector for a period of 180 consecutive days. 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)
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PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
° ,. Arcadia,CA 91066-6021,(626)574-5416,Fax(626)447-9173
City of
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 an effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C License No.g Vol Exp. Date '. 24/ 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
❑ I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
❑ 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 worke om sation insurancerrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier I C..�
molish,or repair any structure,prior to its issuance,also required the applicant for
Policy Number B 0
such permit to file a signed statement that he or she is licensed pursuant to the pro-
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 m
e
'`t 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 cwt 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 compl with those provisions.
compensation,will do the work,and the structure is not intended or offered for
(Section 7044,Business and Professions Code:The Contractors License Date 23 !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.
NgC y�/(� Title 1,(n/40,—
// PRINT NAME
I:edify 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
cadia to enter upon the above-mentioned property for inspection purposes.
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