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Home My WebLink AboutB00-050-040 U•j Development Services Department 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 PERMIT NO. City of B00-050-040 Arcadia (626)574-5416,Fax(626)447-9173 Permit Type: Plumbing PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 0015 4/29/2015 JB 9:27 4/29/2015 Issued ADDRESS NO. Dlr.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 502 W Pain Dr 5787-013-014 OWNER MAILING ADDRESS Danvershooker, Donna& Dan 502 W Palm Dr PHONE NO. Inspector#: CRIS Arcadia, CA 91007 EMAIL ADDRESS: APPLICANT MAILING ADDRESS Bashford Enterprises PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Dba: Bashford Ent. 12155 Pineville PHONE NO. (626)443-4833 FAX NO. El Monte,CA 91732 EMAIL ADDRESS: License No. 319112 Type: B Expires: 8/31/2016 12:00: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION WATER CLOSET REPLACEMENT Construction Type UOM if of Units Value Construction Type UOM #of Units Value COMNIETED OCCUPANCY: TOTAL VALUATION: $0.00 QTY IIOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 100 Flat Plmbg Issue A 44.35 44.35 01-3105 100 each Water Closet 12.46 12.46 01-3105 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $57.81 Balance Due: $0.00 Paid Today: $57.81 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#: 108738 rm the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 56.81 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) O1 A' I, PERMIT/PLAN REVIEW APPLICATION IMF, meg t2. rat Development Services Department,240 West Huntington Drive,Post Office Box 60021 ^tw nity 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. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class icense No I! Exp. Date 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 t/ 1=11 I have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DEC ARATIO 3700 of the Labor Code,for the performance of the work for which this permit ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My worke s'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions y�q Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier "` u/ir molish,or repair any structure,prior to its issuance,also required the applicant for Policy Number /6q/5 `2Z7 May 5/—1_5 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 hundr d 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. Name 2v/ Title ��9! �/ tNT NA( 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. Signatu ' z,✓ ��`�/.C.i/ Date i522.41'/ ! c 1/ /