HomeMy WebLinkAboutMEP PERMITS FOR MF/NEW 2015 Development Services Department
+mow 240 West Huntington Drive, Post Office Box 60021 $QQ-049-106
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Arcadia,CA 91066-6021 PERMIT NO.
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 JB 9:03 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
506-88 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
A-Co Temp Power Pole •-) (��1��UJ U u J 2
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
A CO Temporary Power P.O. Box 16843 PHONE NO. (818)255-3560 FAX NO.
North Hollywood,CA 91615 EMAIL ADDRESS:
License No. 777790 Type: C Expires: 4/30/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ONE 200-AMP SUB METER AND 19 100-AMP SUB POLES FOR CONSTRUCTION OF MF/RESIDENCES
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
OCCUPANCY: TOTAL VALUATION: $0.00
QTY 11OM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 flat Flee Issue Auto 44.35 44.35 01-3105 j — 1 1.00 each 0-400 Res Ser 15.55 15.55 01-3105 Z'1 2
19.00 each Addtl meter 295.45 295.45 01-3105 l j C}� ]
100 each SWMF 2 Auto 1.00 1.00 88-3027 F'/VAV ��yC"- L/V (A L^-S ■
Total Fees: $356.35 Balance Due: $0.00 Paid Today: $356.35
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107737
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 355.35
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)
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PERMIT/PLAN REVIEW APPLICATION
rib
�; E .sta Development Services Department,240 West Huntington Drive,Post Office Box 60021
�,,,.nC W 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 Busi ss a d
Professions Cod]_and my lic se is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. Exp. Date ��Q 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
OWNER-BUILDER DECLARATION M I have and will maintain workers'compensation insurance,as required by Section
El 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 wo kers'co 'ensafon insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier aV AOKi
molish,or repair any structure,prior to its issuance,also required the applicant for �}C1::/21-1--
IS—
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number C 1
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 t .t if I should become subject to the
workers'c mpensation provisions of Sect/n 3700 of the Labor Code,I shall
1, as owner of the property, or my employees with wa es as their sole forthwith mp y with those provisions ,
❑ P P Y> Y g s—
compensation,will do the work,and the structure is not intended or offered for , / 0
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature �La/
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(I)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:
I. 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.
ja
Name 24 it t Title /; . /I /t/
' `T 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 comp with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to • t/upon the above-mentioned property for inspection purposes.
Signaturet i,�4 I Date Li ���
" Development Services Department
' 240 West Huntington Drive,Post Office Box 60021
"t' Arcadia,CA 91066-6021 PERMIT NO. B00-050-046
City of (626)574-5416, Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:04 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
506 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. (l n ri HONE NO.
4�U�UVU lr LL MAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona,CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
4.,\A.. ‘
r1AL ( 0 -
CUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Flee Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15,55 15.55 01-3105
2,390.00 sq fl New res elec 167.30 167.30 01-3105
418.00 sq ft New res access 25.08 25.08 01-3105
I.00 each Power 1 hp 7.62 7.62 01-3105
1.00 each Power 1-10 hp 15.55 15.55 01-3105
I 00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $276.45 Balance Due: $0.00 Paid Today: $276.45
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#: 108745
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 27 1.00
88-3027 1
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)
iti 7CRC,�
PERMIT/PLAN REVIEW APPLICATION
1" 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Classj& License N.! 7 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 Contract° /,N:/
OWNER-BUILDER DECLARATION 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
❑
I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
LCode.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 forT�1.-�/� ��
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 El 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 1.1-��_�� 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(I)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:
I. 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 /I"1 16 81�,x/rlr j9 Title 15 1i]
P NT 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 above-mentioned property for inspection purposes.
Signatureaerd e me C�Date I /5
,,,,s,`':' '' .it Development Services Department
> 240 West Huntington Drive,Post Office Box 60021
,`- Arcadia,CA 91066-6021 PERMIT NO. BOO-050-047
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:06 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
508 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. ^ PHONE NO.
1 dalO L1EEIMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS vV
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
FLECTRIC Al.FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
I, L `d kr c1141
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY IIOM MSC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Elec Issue Auto 44.35 44.35 01-3105
100 each 0-400 Res Ser 15.55 15.55 01-3105
2,113.00 sq Il New res elec 147,91 147.91 01-3105
397.00 sq II New res access 23.82 23.82 01-3105
1.00 each Power I hp 7.62 7.62 01-3105
1 00 each Power I-10 hp 15.55 15.55 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $255.80 Balance Due: $0.00 Paid Today: $255.80
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#: 108746
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 25
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City ofAr-
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)
i pF ARn
'Q`P.,!er-y�-•4
PERMIT/PLAN REVIEW APPLICATION
C\�,`., jzA Development Services Department,240 West Huntington Drive,Post Office Box 60021
%..,,.of ' Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
' '1 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 6^q0 License No. 5 Exp. Date_WLT 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 Contract
OWNER-BUILDER DECLARATION g 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions �� ����
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 /}S}.�l�v�j�r
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number/-�/W 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
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
Date / (/21 15 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,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.
0 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 /MX/.:. &LK/L111P Title
Pin
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 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. G�
Signature �,/�, Date Z[--)S
Development Services Department
r
240 West Huntington Drive,Post Office Box 60021
"rtr�"
�•���„ Arcadia,CA 91066-6021 PERMIT NO. B00-049-996
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/24/2015 CM 15:07 4/24/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
510 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lie 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Tipping Development Inc. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRE n.ri D
Tipping Development Inc. 911 S Primth�� �D PHONE NO. (626)303 5547 FAX NO.
Monrovia,CA 91016 EMAIL ADDRESS:
License No. 960202 Type: B Expires: 11/30/2015 12:0(
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ONE PEDESTAL.HOUSE METER FOR MF DEVELOPEMT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1,00 Flat Elec Issue Auto 44.35 44.35 01-3105
1.00 each Addtl meter 15.55 15.55 01-3105 g--t 7- is-
1.00 each SWMF2Auto 1.00 1.00 88-3027
Sek vice a —WSe
Total Fees: $60.90 Balance Due: $0.00 Paid Today: $60.90
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#: 108685
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 59.90
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)
`gy----6;t3- ,
'
f_ PERMIT/PLAN REVIEW APPLICATION
1
ll\\n;.. rz.
f*, h Development Services Department,240 West Huntington Drive,Post Office Box 60021
',4n,,r�•�°�` 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 License No. 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
❑ I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
0 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 ❑ 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:
I. 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. �j
Name A AO . .c�.r4 Title \
l ' //2-1-..
if 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 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.
/gArL 14--) `4—i T.
Signature Date
Development Services Department
s ,' 240 West Huntington Drive,Post Office Box 60021
,.rfrr '' Arcadia,CA 91066-6021 PERMIT NO. B00-050-048
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:08 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
516 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. ^}co FA fil-),n � oNE NO.
UUU AIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: CIO Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM 8 of Units Value Construction Type UOM #of Units Value
MANE /c-f-- C" Ji
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Elec Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,390.00 sq ft New res elec 167.30 167.30 01-3105
418.00 at fl New res access 25.08 25.08 01-3105
100 each Power I hp 7.62 7.62 01-3105
1.00 each Power 1-10 hp 15.55 15.55 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $276.45 Balance Due: $0.00 Paid Today: $276.45
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#: 108747
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 275.45
suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar-
cadia 88 8-3-30027 27 1.40.00
1
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)
�LA_Rp�� ►� PERMIT/PLAN REVIEW APPLICATION k
E ; 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
a 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 G/o License No. Exp. Date2//7 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 DECLARATION 51 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.jl y workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions (1 ���
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 /� ra —,rv�/�l�7_��
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number v wl
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 wa es as their sole forthwith comply with those provisions.
❑ P P Y� Y g � i"
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 "L�� Signature �i� c
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. A/
Name A/K6. ✓L 4' P NAME 13 DAI .
PRINT 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� 1�C/ Date 11-0?---✓15
"" Development Services Department
vis6 '' 240 West Huntington Drive,Post Office Box 60021
'`�> Arcadia,CA 91066-6021 PERMIT NO. B00-050-049
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 12:08 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
518 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
^� (�L ,R il n IL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS + I Iv„O �bu a �EL
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C l0 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION MFR New
FREE STANDING CONDO
Construction Type UOM Of of Units Value Construction Type UOM #of Units Value
r"J' ( — 1c PANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Elec Issue Auto 44.35 44.35 01-3105
I.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,1 13.00 sq fl New res elec 147.91 147.91 01-3105
397.00 sq ft New res access 23.82 23.82 01-3105
I.00 each Power I hp 7.62 7.62 01-3105
1.00 each Power 1-10 hp 15.55 15.55 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $255.80 Balance Due: $0.00 Paid Today: $255.80
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#: 108763
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 254.80
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)
„,,bF ARC
PERMIT/PLAN REVIEW APPLICATION
�:L„--__, E ,,*Y Development Services Department,240 West Huntington Drive,Post Office Box 60021
''' ,,,,,i,m e' Arcadia,CA 91066-6021,(626)574-5416,Fax (626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
rgi 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 4^1Q License No.1 1 Exp. Date 7”!7 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
OWNER-BUILDER DECLARATION q 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions XU 1r'�
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 �T1aY,f6G�7_0
such permit to file a signed statement that he or she is licensed pursuant to the pro-
(This Number I rl/��/
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 ❑ 1 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
forthwith comply 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 £.4—ZG� Signatur �_
sale(Section 7044,Business and Professions Code:The Contractors License Date
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:
I. 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 //lJJ`/V ,&e4e,:wipPRtHT NAME Title /3 0
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.
/
Signatur - Date 41i'l
" t: Development Services Department
,, ' 240 West Huntington Drive,Post Office Box 60021
" , PERMIT NO. BOO-050-052
Arcadia,CA 91066 6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:12 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
526 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
p,(,rp,D 11
Schamber Electric, Inc. 1674 Railro ca IJUJ Il IEHONE NO. (951)739-0497 FAX NO.
Corona,CA 8 EMAIL ADDRESS:
license No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM N of Units Value Construction Type UOM N of Units Value
•
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
ChA.
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Elec Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,390.00 sq ft New res elec 167.30 167.30 01-3105
418.00 sq ft New res access 25.08 25.08 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $253.28 Balance Due: $0.00 Paid Today: $253.28
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 108749
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 252.28
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)
al r r.r v1,11,,
J PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
'�4,, of l'" Arcadia, CA 91066-6021,(626)574-5416,Fax (626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
ki 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'g
License Class tom^10 License Nog 5 1 Exp. Dato2,71 7 compensation, as provided for by Section 3700 of the Labor Code, for the
e, 4r(__ ._____._
performance of the work for which this permit is issued.
Signature of Contractor
pif I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
❑ hereby affirm under penalty exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
I hb y fd lt p y of perjury that I am exem p is issued.My worker compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions r ��
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 l_r1�(i 7-0-2--
such permit to file a signed statement that he or she is licensed pursuant to the pro-
Policy Number flV K.'
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 Li 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
❑ 1, 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 ) ^may __
sale(Section 7044,Business and Professions Code:The Contractors License Date`T�/f� Signatures ^� _-
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 ,0 0 0 1 D K Title BCI 7
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 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 ,/ Zi Date Li` 1'15
,• "k` Development Services Department
5 k 240 West Huntington Drive,Post Office Box 60021
``tt ' Arcadia, PERMIT NO. B00-050-054
cadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:19 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
528 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. (�n n P ONE NO.
O "I'','I I JLE� IL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS ����u�l)II
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C 10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
rigokb 1 c-7-- 'r it_,(2)
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
I.00 flat Elec Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,1 13.00 sq fl New res elec 147.91 147.91 01-3105
397.00 sq 11 New res access 23.82 23.82 01-3105
1.00 each Power I hp 7.62 7.62 01-3105
1.00 each Power I-10 hp 15.55 15.55 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $255.80 Balance Due: $0.00 Paid Today: $255.80
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#: 108752
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105
254.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 88 8 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)
/OF ARC
!P�,�f�Uk.V���I
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 and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class 16 License No. � Exp. Date 21/7 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
OWNER-BUILDER DECLARATION In 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
❑
I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
�� ���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 CO 7 a_
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 ❑ 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
❑1, 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 /�1 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(I)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 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.
/! /K(.
Name : Bai �,PRINT NAME Title 13Of
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
Ul. ,
. , Development Services Department
S t 240 West Huntington Drive,Post Office Box 60021
off"-" Arcadia,CA 91066-6021 PERMIT NO. BOO_050_056
City of (626)574-5416,Fax(626)447-9173
Arcadia
Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:21 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
536 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
AIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS r*vu I U ll USchamber Electric, Inc. 1674 Railroad...Sr
PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C 10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELEC'TRICAI.FOR MF/NEW
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
A. 4 ID-S--
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 flat Elec Issue Auto 44.35 44.35 01-3105
100 each 0-400 Res Ser 15.55 15.55 01-3105
2,930.00 so ft New res elec 205.10 205.10 01-3105
418.00 so ft New res access 25.08 25.08 01-3105
1.00 each Power I hp 7.62 7.62 01-3105
1.00 each Power I-IO hp 15.55 15.55 01-3105
I.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $314.25 Balance Due: $0.00 Paid Today: $314.25
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 Receipt#: 108753
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 8 313.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 88 8-3 30027 27 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)
1
vti`oFc. 9
PERMIT/PLAN REVIEW APPLICATION
E ; Development Services Department,240 West Huntington Drive,Post Office Box 60021
" ��_,.ot%` 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 C---/0 License 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
OWNER-BUILDER DECLARATION c23 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 703 I.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier RE-p001.4 �.--
molish,or repair any structure,prior to its issuance,also required the applicant for
Policy Number/J/ /6� .�
such permit to file a signed statement that he or she is licensed pursuant to the pro- nn//vv
visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed i t /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
❑1, 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 -- G
sale(Section 7044,Business and Professions Code:The Contractors License Date Z [� 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(I)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:
I. 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. / / yJ yo n7
Name Aii . Sif-/-1 'v"�PRINT NAME Title 8Dn
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. q
Signature ;i„�/" Date /—15
, "`ItDevelopment Services Department
1 240 West Huntington Drive,Post Office Box 60021
y`T`x Arcadia,CA 91066-6021 PERMIT NO. $00_050_057
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:22 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
538 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. (� (� PHONE NO.
�ja� n�nll It,��D EMAIL ADDRESS:
n lly 1L1�1�(
CONTRACTORIPROFESSIONAL MAILING ADD^''�fii/Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C 1 0 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
iN L Lb -g Lr NI
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 flat Elec Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
4,644.00 sq 0 New res elec 325.08 325.08 01-3105
752.00 sq Il New res access 45.12 45.12 01-3105
2.00 each Power 1 hp 15.24 15.24 01-3105
2.00 each Power I-10 hp 31.10 31.10 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $477.44 Balance Due: $0.00 Paid Today: $477.44
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#: 108755
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01'3105 476.44
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)
�, PERMIT/PLAN REVIEW APPLICATION
c\� F Development Services Department,240 West Huntington Drive,Post Office Box 60021
,,,,,,i�.of•' 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 0 License No' ,/0j. Exp. Date2/7 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 Contract°
OWNER-BUILDER DECLARATION Y"' 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
I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier AN R1P/(,)'t i/�
molish,or repair any structure,prior to its issuance,also required the applicant for Policy Number �rz c—�l b�7 �
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 ❑ 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 � )C'
sale(Section 7044,Business and Professions Code:The Contractors License Date Z J 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:
I. 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 /24W__ gi e44rol trr i
rxnME Title gA
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. �{ 7�f
Signature _ Date ( �G` 45
,45.4.7':." Development Services Department
4 ' 240 West Huntington Drive,Post Office Box 60021
,•rit, PERMIT NO. B00-050-058
-- Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:25 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
556 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lle 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS: .
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
et\j''l� —, EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADD SS i- LE DJ IJ 95]NO.
Schamber Electric, Inc. 1674 Railroad t PHONE (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: Cl0 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM N of Units Value Construction Type UOM #of Units Value
ftJ-L to-k-(r c,
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
Q`I'Y UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
I (10 Hal Flee Issue Auk) 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,930.00 sq tt New res elec 205.10 205.10 01-3105
418.00 sq It New res access 25.08 25.08 01-3105
I,00 each Power I hp 7.62 7.62 01-3105
I.00 each Power I-10 hp 15.55 15.55 01-3105
1.00 each SWMF 2 Auto 1.00 I.00 88-3027
Total Fees: $314.25 Balance Due: $0.00 Paid Today: $314.25
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the
Receipt#: 108756
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from
Receipt
313.25
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)
/pF A'C
. .r�‘ari"'ra9
(` PERMIT/PLAN REVIEW APPLICATION
f #p'' 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class " it License N.. " l Exp. Date /7 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 Contract°
OWNER-BUILDER DECLARATION [p 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 /Zff18 U 6.
molish,or repair any structure,prior to its issuance,also required the applicant for 4 Policy Number � -ool f7/
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 ❑ 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 p
sale(Section 7044, Business and Professions Code:The Contractors License Date��Z �� 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:
I. 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/ / Din_
Namei�1� 1"1/1 E. pic�Cjt,O Title IJ // 1
PRI TNAM_E
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. q
Signature//��� /e - Date Z/-LS
'`"
Development Services Department
5 IOW ' 240 West Huntington Drive, Post Office Box 60021
..crt= Arcadia,CA 91066-6021 PERMIT NO. B00-050-060
City of (626)574-5416,Fax(626)447-9173
Arcadia
Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 12:09 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
566 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lie 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
MAIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS crot �i. I 1
��,�� — D NE NO. (951)739-0497 FAX NO.
Schamber Electric, Inc. 1674 Railroad
Corona,CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
M,L t °~7 / '4)4
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Flee Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,423 00 sq ft New res elec 169.61 169.61 01-3105
418.00 sq fl New res access 25.08 25.08 01-3105
1.00 each Power 1 hp 7.62 7.62 01-3105
1.00 each Power 1-10 hp 15.55 15.55 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $278.76 Balance Due: $0.00 Paid Today: $278.76
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#: 108764
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 277.76
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)
■oww.
� F"A'RC,
O
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 and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class G 0 License No. I I Exp. Date 2J/7 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
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
License Law for the following reason(Section 7031.5,Business and Professions workers'compensation insurance carrier and policy numbers are:
kkers
Code.Any city or county which requires a permit to construct,alter,improve,de- ACarrier Re f of34'G
molish,or repair any structure,prior to its issuance,also required the applicant for (�T? d
such permit to file a signed statement that he or she is licensed pursuant to the pro-
(This 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 ❑ 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 wa es as their sole forthwith comply with those provisions.
❑ P P Y, Y g �
compensation,will do the work,and the structure is not intended or offered for 4-2-1 Date _ 5 Si gnatur ���'�
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,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.
Ell, 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.. �) w d Phi
-Name M// 131/1 A 1 PRINT NAME Title 8 N
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 .-0""-- Date �Z�45
Development Services Department
at�,;.s.--,'''''.t:.',` 240 West Huntington Drive,Post Office Box 60021
y `t„.' Arcadia,CA 91066-6021 PERMIT NO. $00_050_061
tee.;
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:30 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
568 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia,CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. (� ��� PHONE NO.
0 CC 1!!III D4 ri FAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS IU, U L�U
Schamber Electric,Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
I[L.ECTRICAI,FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Flee Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,069.00 sq II New res elec 144.83 144.83 01-3105
396.00 sq Ii New res access 23.76 23.76 01-3105
1.00 each Power I hp 7.62 7.62 01-3105
1.00 each Power 1-10 hp 15.55 15.55 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $252.66 Balance Due: $0.00 Paid Today: $252.66
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#: 108758
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 251.66
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)
OF`°RC9i
�`�! ~ PERMIT/PLAN REVIEW APPLICATION
,i, a
T.1171,"4 y Development Services Department,240 West Huntington Drive,Post Office Box 60021
",z �a� Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173
�uo�,.otH�
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
51 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 /b License N1577041 Exp. Date— compensation, as provided for by Section 3700 of the Labor Code, for the
f -
performance of the work for which this permit is issued.
Signature of Contractor f2/,.–
i �r
OWNER-BUILDER DECLARATION y° 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
❑ 1 hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions ���������
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 /��`^--(1,1617 7
such permit to file a signed statement that he or she is licensed pursuant to the pro-
(This Number /t/ t'V �C��
visions of the Contractors License Law(Chapter 9(commencing with Section 7(X)0) (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
CI 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 / G rI J7 �S 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,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:
I. 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 1 " i/fv1 ? lj?/4INT Title v17 z' I _
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 above-mentioned property for inspection purposes.
Signature 6 Date L, `1 5
" Development Services Department
5 40 4014011 - 240 West Huntington Drive,Post Office Box 60021
' Arcadia,CA 91066-6021 PERMIT NO.
City of B00-050-062
Arcadia
(626)574-5416,Fax(626)447-9173
Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:32 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
576 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. /�p^1F rO(l (��( J PHONE NO.
,
UVu L LL=LC u EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: CIO Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
11 L L D--7-Ir
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
I.00 flat Elec Issue Auto 44.35 44.35 01-3105
100 each 0-400 Res Ser 15.55 15.55 01-3105
2,190.00 sq ft New res elec 153.30 153.30 01-3105
390 00 sq fl New res access 23.40 23.40 01-3105
1.00 each Power 1 hp 7.62 7.62 01-3105
100 each Power I-10 hp 15.55 15.55 01-3105
1 00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $260.77 Balance Due: $0.00 Paid Today: $260.77
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#: 108759
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 25 1.00
88
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City ofAr-
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)
ipF ARC
/4 �r: , d f
PERMIT/PLAN REVIEW APPLICATION
E ; y 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
aI 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 L'Ig License Exp. Date/�7 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 DECLARATION A 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier pePliow L
molish,or repair any structure,prior to its issuance,also required the applicant for 111/-49107-02--
such permit to file a signed statement that he or she is licensed pursuant to the pro-
(This Number/7
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 El 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
El 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 �� Signatur•/- y/a!9
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 441 �i-' 5L-'Oz/1,19e Title 1.3 Pfil
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 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 ,441.411P Date W-2`/-) 5
:Ik Development Services Department
240 West Huntington Drive,Post Office Box 60021
.
,,tt Arcadia,CA 91066-6021 PERMIT NO. _ _
����°�'' o• B00 050 063
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:35 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
578 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
EMAIL ADDRESS:
'
CONTRACTOR/PROFESSIONAL MAILING AD ES D
r 1 t I'LE o ( )
Schamber Electric, Inc. 1674 Rai an i't'LI u PHONE No. 951 739-0497 FAX NO.
Corona,CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
r1M1
tb �-i'
OC ANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 tlat Elec Issue Auto 44.35 44.35 01-3105
1.00 each 0-400 Res Ser 15.55 15.55 01-3105
2,069.00 sq ti New res elec 144.83 144.83 01-3105
396.00 sq ti New res access 23.76 23.76 01-3105
100 each Power I hp 7.62 7.62 01-3105
100 each Power I-10 hp 15.55 15.55 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $252.66 Balance Due: $0.00 Paid Today: $252.66
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#: 108760
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 251.66
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)
,iQF A._R
(� ~
%,'"------,.. q PERMIT/PLAN REVIEW APPLICATION
ig • Development Services Department,240 West Huntington Drive,Post Office Box 60021
„„y of- Arcadia, CA 91066-6021,(626)574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
g 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&/b Licen No. a Exp. Date2/27 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 e....-"`
OWNER-BUILDER DECLARATION X 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued. y workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions (�� � �
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier �5
molish,or repair any structure,prior to its issuance,also required the applicant for '�'�(,jai/Cf7 �"7
such permit to tile a signed statement that he or she is licensed pursuant to the pro- Policy Number %Y7 J( G--
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 Date �_ ,_I5 Signatur o^�
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,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:
I. 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. ""���Q ��J�yy�
Name /" )Rt Q 49 Title J-/')1//
IIRNT 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 above-mentioned property for inspection purposes.
Signature f,g Date j--/— q—15
-,.':,:l'`"� Development Services Department
'1 ' 240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 PERMIT NO. $QQ-05Q-064
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:37 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
586 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220
PHONE NO. Inspector#: JEFF
Arcadia,CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. PHONE NO.
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Q cf A Ur��� t AIL ADDRESS:
._....
,,J
Schamber Electric, Inc. 1674 Railroad t PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
f 1b - 8,1r +,L\
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat 0lec Issue Auto 44.35 44.35 01-3105
2.00 each 0-400 Res Ser 31.10 31.10 01-3105
4,250.00 sq ft New res elec 297.50 297.50 01-3105
794.00 sq ft New res access 47.64 47.64 01-3105
2.00 each Power I hp 15.24 15.24 01-3105
2.00 each Power I-10 hp 31.10 31.10 01-3105
I.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $467.93 Balance Due: $0.00 Paid Today: $467.93
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 108761
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 01-3105 466.93
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)
%C4 C
PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
of Arcadia,CA 91066-6021, (626)574-5416,Fax (626)447-9173
City of
Arcadia
�7}LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
I1 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 G • License N.t 91O° Exp. Date� 7 compensation, as provided for by Section 3700 of the Labor Code, for the
"ire"--- performance of the work for which this permit is issued.
Signature of Contractor
OWNER-BUILDER DECLARATION I have and will maintain workers'compensation insurance,as required by Section
❑ 1 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'cormpensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de-
molish, Carrier ����
�
or repair any structure,prior to its issuance,also required the applicant for /1 tom,,a.•1n1
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number/`1 fV t/�/
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
Date J Si gnature
_ e
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,and
sale.If,however,the building or improvement is sold within one(I)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. ��77 n
Name �� D �G JL/Z?4( Title /3 6/7 7
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 ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter/u/ppoonn the above-mentioned property for inspection purposes.
Signaturis/% t 'i �+� � " Date f'2'7'_15
" i,
Development Services Department
- 240 West Huntington Drive,Post Office Box 60021
"` Arcadia,CA 91066-6021 PERMIT NO. $00_050_005
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:39 4/29/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
588 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc.
r*t U•�u�Ir���n n PHONE NO.
ED EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING Au6REJ u
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona, CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C I0 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
rO CUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 flat Elec Issue Auto 44.35 44.35 01-3105
2.00 each 0-400 Res Ser 31.10 31.10 01-3105
4,060,00 sq IS New res elec 284.20 284.20 01-3105
914.00 sq ft New res access 54.84 54.84 01-3105
2.00 each Power 1 hp 15.24 15.24 01-3105
2.00 each Power 1-10 hp 31,10 31.10 01-3105
I.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $461.83 Balance Due: $0.00 Paid Today: $461.83
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#: 108762
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 460.83
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)
pF..A1?_,D
µ.�rokNagd
PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
may Arcadia, CA 91066-6021, (626)574-5416,Fax(626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
cif 1 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 License No.r / Exp. Date, j_•_ 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 ,P0"" _
OWNER-BUILDER DECLARATION VA 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 Jb..7pVt
molish,or repair any structure,prior to its issuance,also required the applicant for jj�7 A
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number i Tn1/00 ro
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,1 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
forthwith comply 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 lC
sale(Section 7044,Business and Professions Code:The Contractors License Date�� _/✓ Signatur 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- 1 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-
therrjjinformation
Name jn1;1 ggi'
nP Title $12
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 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/6� ��� Date
"r Development Services Department
5 240 West Huntington Drive,Post Office Box 60021
.rtr, , Arcadia,CA 91066-6021 PERMIT NO. $00_050 059
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Electrical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/29/2015 JB 11:27 4/29/2015 Issued
•
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
558 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Schamber Electric, Inc. r n n��+I�DPHONE NO.
rJUC,� 1 Il}� EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Schamber Electric, Inc. 1674 Railroad St PHONE NO. (951)739-0497 FAX NO.
Corona,CA 92880 EMAIL ADDRESS:
License No. 957709 Type: C10 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR MF/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
NAL to -12 --(r ik,\-\
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY COM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1,00 flat Flee Issue Auto 44.35 44.35 01-3105
2.00 each 0-400 Res Ser 31.10 31.10 01-3105
4,644.00 sq fl New res elec 325.08 325.08 01-3105
752.00 sq fl New res access 45.12 45.12 01-3105
2.00 each Power 1 hp 15.24 15.24 01-3105
2 00 each Power 1-10 hp 31.10 31.10 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $492.99 Balance Due: $0.00 Paid Today: $492.99
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#: 108757
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 491.99
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)
6—_ARC
�- �~› - PERMIT/PLAN REVIEW APPLICATION
w# ' Development Services Department,240 West Huntington Drive,Post Office Box 60021
f"m�.„.ofN„ Arcadia,CA 91066-6021,(626)574-5416,Fax (626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
El 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 G'1d License Noe Exp. Date 2/17 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 r�/
OWNER-BUILDER DECLARATION I have and will maintain workers'compensation insurance,as required by Section
Ei 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.M workers' insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier g oat)L_
molish,or repair any structure,prior to its issuance,also required the applicant for ��Adlif? i f
such permit to file a signed statement that he or she is licensed pursuant to the pro- Policy Number/r�I� Gam/ "lei.
visions of the Contractors License Law(Chapter 9(commencing with Section 7000) (This section need not be completed i 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 El 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
Ej 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 q—'Date 2 J.)G
sale(Section 7044,Business and Professions Code:The Contractors License 1 /J 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.
❑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:
I. 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. Q
Name /I1J,k P Title 13Dn1
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 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. 'v(J-Z
Signature ///:, _Z- Date �/�
Development Services Department
It
,-.4
240 west Huntington Drive,Post Office Box 60021 PERMIT NO $QQ-049-090
, ,,.,, Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:04 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
506 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing PHONE NO.
r v o} p `�En EMAIL ADDRESS:
CONTRACTORIPROFESSIONAL MAILING ADDRESS.
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
I L t -k4S ,fi A t
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 Flat Plmhg Issue A 44.35 44.35 01-3105
3 00 each Bathtub 37.38 37.38 01-3105
200 each Shower 24.92 24.92 01-3105
400 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1 00 each Lawn spmkler 18.74 18.74 01-3105
100 each SWMF 2 Auto I.00 1.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107721
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 349.63
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 )•\ki
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)
,, ARC
r�,[oky�
'; �' PERMIT/PLAN REVIEW APPLICATION
c f, Development Services Department,240 West Huntington Drive,Post Office Box 60021
�'m4n,ls°C'' 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 force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class '7 License No.4 Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
��g ��� /� performance of the work for which this permit is issued.
Signature of Contractor + V(/�✓ y-_
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
❑
y is issued.My workers'corn ensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier 0 '
mulish,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 i__, 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 C
sale(Section 7044,Business and Professions Code:The Contractors License Date >'/ l Signature ',�
Law does not apply to an owner of property who builds or improves thereon,or r {{{
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. l '
Name b kr `'-i:ar NAME Title jN itZ./i
PRINT 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 ` 0 . ,i 4 All_ Date 7.1 G ,.
's"" Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
`�"' Arcadia,CA 91066-6021 BOO-049-103
.IP'
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:22 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
508 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing P • NO.
1CFR 1 LtDDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS �✓
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM N of Units Value Construction Type UOM 8 of Units Value
•
10- 8'- /,c (PA
f-f1(J4L
UPANCY:
TOTAL VALUATION: $0.00
QTY IIOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
100 each Shower 12.46 12.46 01-3105
400 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
100 each Kitchen sinks 12.46 12.46 01-3105
100 each Dishwashers 12.46 12.46 01-3105
1 00 each Garbage Disp 12.46 12.46 01-3105
1 00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkier 18.74 18.74 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107734
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 337.17
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)
PERMIT/PLAN REVIEW APPLICATION
maim .41
s Development Services Department,240 West Huntington Drive,Post Office Box 60021
n,}.ooc Arcadia, CA 91066-6021, (626)574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ 1 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 License No. 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
OWNER-BUILDER DECLARATION Li 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 Li 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
❑1, 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:
❑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 Title
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 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 )4 51 0 r
,,.*,` N Development Services Department
240 West Huntington Drive, Post Office Box 60021 PERMIT NO BOO-049-091
7
Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:05 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
516 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing c p(Ti�II �� I ENO.
J� Uu u J V- ENt ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91 733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM Of of Units Value
� L /0-8---/r d
OCCUPANCY: TOTAL VALUATION: $0.00
QTY EOM DESC AMT AMT PAID ACCT QTY IJOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
2.00 each Shower 24.92 24.92 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
100 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
100 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkler 18.74 18.74 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107722
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 349.63
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)
i ARC
c, VI( PERMIT/PLAN REVIEW APPLICATION
I,00 Development Services Department,240 West Huntington Drive,Post Office Box 60021
;;;;,,,<a-f Arcadia,CA 91066-6021, (626) 574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
0 1 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 have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
OWNER-BUILDER DECLARATION ❑ 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
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 ❑ 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,1 shall
I. as owner of the property, or my employees with wa es as their sole forthwith comply with those provisions.
❑ P P Y. Y g
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).
❑ 1 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.
N e Title
PRINT NAME
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.
agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upon the above-mentioned property for inspection purposes.
r' / ,
ignature r' (� Date .4 f ! r
o x''12 Development Services Department
r 240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 PERMIT NO. $QQ-049-101
City 4 (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:20 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
518 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing �� nnR a No.
1JVdu �
ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
license No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type 1.1OM #of Units Value Construction Type UOM #of Units Value
rii\lilL 0-8"--a-CUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
I.00 each Shower 12.46 12.46 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
100 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.0(1 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
100 each Lawn sprnkler 18.74 18.74 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107732
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 337.17
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 K%,.._... .,
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)
1-1 ARQ
,iii,
PERMIT/PLAN REVIEW APPLICATION
e 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
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 ❑ 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.lf,however,the building or improvement is sold within one(I)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.
0 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-
k 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 Title
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 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
Signature ( Date 2 1/A
" Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
.r r B00-049-092
?' Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:07 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
526 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lie 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing 1 PHONE NO.
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS r ADDRESS:
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
rmiki, C�✓V��\
CUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
2.00 each Shower 24.92 24.92 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
100 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn spmkler 18.74 18.74 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107723
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 349.63
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.
..1 .1' *.-}
(Closed on alternate Fridays)
7,--0,ARC ARC.
PERMIT/PLAN REVIEW APPLICATION
E 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
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 703 L5,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 D. 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 Title
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 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 ( V a Date >'/ / /cr
j'` Development Services Department
240 West Huntington Drive,Post Office Box 60021 BOO-049-102
`�`
� Arcadia,CA 91066-6021
PERMIT NO.
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:21 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
528 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing PHONE NO.
(J EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING AD n n 'I ��ED
D.N.C. Plumbing 2627 L u d IILa PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM N of Units Value Construction Type UOM #of Units Value
pSAL uo--7-it ct-A)
CCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37,38 37.38 01-3105
I.00 each Shower 12.46 12.46 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
500 each Lavatories 6230 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1 00 each Dishwashers 12,46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5 00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtrhtr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkler 18.74 18.74 01-3105
100 each SWINE;2 Auto 1.00 1.00 88-3027
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107733
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 337.17
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
lf..),\\Q. ..../
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)
/F ARC
4�Po,`v��gdr
(� . ., ► PERMIT/PLAN REVIEW APPLICATION
#�' Development Services Department,240 West Huntington Drive,Post Office Box 60021
\'��,,'.C'''' 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. Li I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
OWNER-BUILDER DECLARATION ❑ 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier
coolish,or repair any structure,prior to its issuance,also required the applicant for
such permit to tile 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 ❑ I certify that in the performance of the work for which this permit is issued,l 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- 1 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 Title
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 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 ->/ 5_ A '
x`'t� Development Services Department
z 240 West Huntington Drive,Post Office Box 60021 PERMIT NO $QQ_049_093
.�rrr' Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:07 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
536 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS _
D.N.C. Plumbing j )11,11'
pi
5 PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte,CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM N of Units Value Construction Type UOM N of Units Value
0 i■IA L i t,-8---L(
(tIA\
OCCUPANCY: TOTAL VALUATION: $0.00
QTY 1.10M DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
2 00 each Shower 24.92 24.92 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
100 each Lawn sprnkler 18.74 18 74 01-3105
1 00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107724
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 349.63
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 NA
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)
ARC
RVl,
PERMIT/PLAN REVIEW APPLICATION
c Eli• Development Services Department,240 West Huntington Drive,Post Office Box 60021
gt 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 License No. 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
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
y p y p y p is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5, Business and Professions
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 ❑ 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 Title
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 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 �1
"I Development Services Department
.' 240 West Huntington Drive,Post Office Box 60021 PERMIT NO BOO-049-096
^ r °% Arcadia,CA 91066-6021
City of (626)574-5416 Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:12 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
538 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIe 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing 0 Cn' 1 1 F S1I1E1ONE NO.
AI L ADDRESS:
f
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Fl MA.st, Lb4- 4r thA.,\.
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY [IOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
6.00 each Bathtub 74.76 74.76 01-3105
6.00 each Shower 74.76 74.76 01-3105
8.00 each Water Closet 99.68 99 68 01-3105
1000 each Lavatories 124.60 124.60 01-3105
2.00 each Kitchen sinks 24.92 24.92 01-3105
2.00 each Dishwashers 24.92 24.92 01-3105
2.00 each Garbage Disp 24.92 24.92 01-3105
2.00 each Clothes wsh 24.92 24.92 01-3105
10.00 outlets Gas piping 31.00 31.00 01-3105
2.00 each Wtrhtr/vent 31.10 31.10 01-3105
2.00 each unit Sewer connec 62.32 62.32 01-3105
2.00 each Lawn spmkler 37.48 37.48 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $680.73 Balance Due: $0.00 Paid Today: $680.73
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107727
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 679.73
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)
ARpFO
PERMIT/PLAN REVIEW APPLICATION
C. 04 f
-M' Development Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021, (626)574-5416,Fax(626)447-9173
mYni,y of
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 License No. 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 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 ❑ 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(I)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 Title
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 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 f �iLnv Date
,� '""� Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO B00_049-094
'',,,L„, ,,,, Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:08 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
556 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lie 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing Cnp n ( ( PHONE NO.
4 J )1 U110 I�)� �j D EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS v
(626 NO. 216-91 10 FAX NO.
D.N.C. Plumbing 2627 Loma Ave PHONE
South El Monte,CA 91733 EMAIL ADDRESS:
l.icense No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM if of Units Value Construction Type UOM N of Units Value
F.i/4kL 1c &-ir 44\
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1 00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
2.00 each Shower 24.92 24.92 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
100 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
I.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtrhtr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
I.00 each Lawn spmkler 18.74 18.74 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107725
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 349.63
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)
OF AtC
l:�,-u�eq�9
r 7 PERMIT/PLAN REVIEW APPLICATION
OMEN -41
t # ' Development Services Department,240 West Huntington Drive,Post Office Box 60021
.,Y'�L 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 License No. 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 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 ❑ 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
❑1, 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(I)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 Title
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 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 1 A , . Date -)12-/ 4'_
"' Development Services Department
i-iW 1 240 West Huntington Drive,Post Office Box 60021
-, Arcadia,ca 91066 6021 PERMIT NO BOO-049-095
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:09 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
566 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing PHONE NO.
�r� �I'7 MAIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESr ! ',! n n I
D.N.C. Plumbing 2627 Loma ATe `J "�L HONE No. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT • MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
rI L I t - v.,
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
2.00 each Shower 24.92 24.92 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
I.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5 00 outlets Gas piping 15.55 15.55 01-3105
1 00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkler 18.74 18.74 01-3105
1.00 each SWMF 2 Auto 1.00 I.00 88-3027
Total Fees: $350.63 Balance Due: $0.00 Paid Today: $350.63
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt/4: 107726
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 349.63
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)
/p6 ARC.
/`t`„,1POK,y,�■
,, '�- I' PERMIT/PLAN REVIEW APPLICATION
r 1>r*' Development Services Department,240 West Huntington Drive,Post Office Box 60021
�''%.,.,of ' Arcadia, CA 91066-6021,(626) 574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ 1 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 License No. 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 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 he 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. 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 Title
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 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 V Date >1 5-1 /
Development Services Department
t.' ' 240 West Huntington Drive, Post Office Box 60021
.,Itx. PERMIT NO BOO-049-099
Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:18 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
568 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRE CI_ Irk n n r, 9 1 779 D.N.C. Plumbing 2627 Lom Li ,'�,'J PHONE No. (626)216 9110 FAX NO
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM 8 of Units Value Construction Type UOM #of Units Value
fSkL ib-'7-'L
O
ilA
CCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY IJOM DESC AMT AMT PAID ACCT
100 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
1.00 each Shower 12.46 12.46 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
I00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5 00 outlets Gas piping 15.55 15.55 01-3105
100 each Wtrhtr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkler 18.74 18.74 01-3105
100 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107730
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 337.17
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 Q
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)
oF,AR,
ig ._ li PERMIT/PLAN REVIEW APPLICATION li
c� flk Development Services Department,240 West Huntington Drive,Post Office Box 60021
�m4 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 License No. 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
❑ I 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors
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 ❑ I certify that in the performance of the work for which this permit is issued,1 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 wa es as their sole forthwith comply with those provisions.
❑ P P Y� Y g
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(I)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 Title
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 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.<7—.4-Signature ati(.4-1.i Date >I z' 7,I
s`' " Development Services Department
./Ifx
240 West Huntington Drive,Post Office Box 60021 PERMIT NO B00_049_098
Arcadia,CA 91066-6021
City of (626)574-5416 Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:16 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
576 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
ONE NO.D.N.C. Plumbing 0 COn 1' [ U AIL ADDRESS:
RESS:
'
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM U of Units Value Construction Type UOM N of Units Value
r1 <L is-7 L cA
CUPANCY: TOTAL VALUATION:
$0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 Flat Pltnbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105 N1 mil/ '
1.00 each Shower 12.46 12.46 01-3105
4.00 each Water Closet 49.84 49.84 01-3105 tlLy7"'
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105 ( I
1.00 each Clothes wsh , 12.46 12.46 01-3105 L,�
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtrhtr/vent 15.55 15.55 01-3105 SZ6
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn sprnkler 18.74 18.74 01-3105 ) '�
100 each SWMF 2 Auto 1.00 1.00 88-3027
lM t
S Nt' AVE.)
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107729
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 337.17
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 100
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)
■
/OF-ABC
PERMIT/PLAN REVIEW APPLICATION
r.
y E *• 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
OWNER-BUILDER DECLARATION ❑ 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
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
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 ❑ 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 wa es as their sole forthwith comply with those provisions.
❑ P P Y. Y wages
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:
I. 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 Title
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 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 ,/ V Date / 7
u`"" Development Services Department
240 West Huntington Drive,Post Office Box 60021
,,.,,,, Arcadia,CA 91066-6021 PERMIT NO BOO-049-100
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:29 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
578 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lie 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing 7671 ENO.
✓�V ell a LE, !Pm ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
D.N.C. Plumbing 2627 Loma Ave PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM 8 of Units Value Construction Type UOM N of Units Value
pmAL ib---t-IS kv"...
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
100 Flat Plmbg Issue A 44.35 44.35 01-3105
3.00 each Bathtub 37.38 37.38 01-3105
1.00 each Shower 12.46 12.46 01-3105
4.00 each Water Closet 49.84 49.84 01-3105
5.00 each Lavatories 62.30 62.30 01-3105
1.00 each Kitchen sinks 12.46 12.46 01-3105
1.00 each Dishwashers 12.46 12.46 01-3105
1.00 each Garbage Disp 12.46 12.46 01-3105
1.00 each Clothes wsh 12.46 12.46 01-3105
5.00 outlets Gas piping 15.55 15.55 01-3105
1.00 each Wtr htr/vent 15.55 15.55 01-3105
1.00 each unit Sewer connec 31.16 31.16 01-3105
1.00 each Lawn spmkler 18.74 18.74 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $338.17 Balance Due: $0.00 Paid Today: $338.17
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107731
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 337.17
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)
pF ARe
` PERMIT/PLAN REVIEW APPLICATION
Mt, l-
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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
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
y p y p y p is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
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 ❑ 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(I)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 exertrt 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 Title
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 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 r L�/{/�'1/ Date
-"x"'' Development Services Department
e 240 West Huntington Drive,Post Office Box 60021 PERMIT NO B0O-049-104
Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:25 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
586 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, LIc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS /�► n r
♦ 11'1 n nl r I-bIV NO.
D.N.C. Plumbing ..� ..fiikUtl LL-11u
. ..ADDRESS:
f
CONTRACTORIPROFESSIONAL MAILING ADDRESS
626 NO.
D.N.C. Plumbing 2627 Loma Ave PHONE )216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
r1t4L 1D'g' IX k"-IA-
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
600 each Bathtub 74.76 74.76 01-3105
2.00 each Shower 24.92 24.92 01-3105
8.00 each Water Closet 99.68 99.68 01-3105
10.00 each Lavatories 124.60 124.60 01-3105
2.00 each Kitchen sinks 24.92 24.92 01-3105
2.00 each Dishwashers 24.92 24.92 01-3105
2.00 each Garbage Disp 24.92 24.92 01-3105
2.00 each Clothes wsh 24.92 24.92 01-3105
10.00 outlets Gas piping 31.00 31.00 01-3105
2,00 each Wtrhtr/vent 31.10 31.10 01-3105
2.00 each unit Sewer connec 62.32 62.32 01-3105
2.00 each Lawn spmkler 37.48 37.48 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $630.89 Balance Due: $0.00 Paid Today: $630.89
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107735
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 629.89
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)
pF ARC
kq PERMIT/PLAN REVIEW APPLICATION
17.727» Development Services Department,240 West Huntington Drive,Post Office Box 60021
o 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 License No. 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 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 tile 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 ❑ 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,1 shall
❑1, 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 Title
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 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 1 Date ,�
Q
i/
Development Services Department
jez,
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 PERMIT NO. B00-049-105
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:26 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
588 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Lk 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
D.N.C. Plumbing PHONE NO.
//� C-1 AIL ADDRESS:
CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS( 1 CO�y i I l
D.N.C. Plumbing 2627 Loma Ave U U l�l� PHONE NO. (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
rIL lb--1-'
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
600 each Bathtub 74.76 74.76 01-3105
4.00 each Shower 49.84 49.84 01-3105
8.00 each Water Closet 99.68 99.68 01-3105
10.00 each Lavatories 124,60 124.60 01-3105
2.00 each Kitchen sinks 24.92 24.92 01-3105
2.00 each Dishwashers 24.92 24.92 01-3105
2.00 each Garbage Disp 24.92 24.92 01-3105
2.00 each Clothes wsh 24.92 24,92 01-3105
10.00 outlets Gas piping 31.00 31 00 01-3105
2.00 each Wtr htr/vent 31,10 31.10 01-3105
2,00 each unit Sewer connec 62.32 62.32 01-3105
2,00 each Lawn sprnkler 37.48 37.48 01-3105
1 00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $655.81 Balance Due: $0.00 Paid Today: $655.81
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107736
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 654.81
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 100
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)
pF Alt`\
/.y 4- rr '9\I
(‘ 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 and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 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
OWNER-BUILDER DECLARATION ❑ 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
[] I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
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 ❑ 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 wa es as their sole forthwith comply with those provisions.
❑ P P Y. Y g
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 ANI)RE-
STRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
I. 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 Title
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 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 V Gti1.�' ' Date >1 7 j �
"`. Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
� � , BOO-049-097
.
.►r=<N,., Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Plumbing
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
2/2/2015 CM 8:13 2/2/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
558 S Second Ave A-B 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO.
Arcadia, CA 91006- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
r (r..11 EE
D.N.C. Plumbing J LOU� L, PHONE NO.
J ' uuuil
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
(NO. 626
D.N.C. Plumbing 2627 Loma Ave PHONE (626)216-9110 FAX NO.
South El Monte, CA 91733 EMAIL ADDRESS:
License No. 969825 Type: C-36 Expires: 2/28/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR MFR/NEW
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
AlkL /o-1�-it" d'
'OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg Issue A 44.35 44.35 01-3105
6.00 each Bathtub 74.76 ' 74.76 01-3105
6.00 each Shower 74.76 74.76 01-3105
8.00 each Water Closet 99.68 99.68 01-3105
10.00 each Lavatories 124.60 124.60 01-3105
200 each Kitchen sinks 24.92 24.92 01-3105
2.00 each Dishwashers 24.92 24.92 01-3105
2.00 each Garbage Disp 24.92 24.92 01-3105
2.00 each Clothes wsh 24.92 24.92 01-3105
10 00 outlets Gas piping 31.00 31.00 01-3105
2.00 each Wtrhtr/vent 31.10 31.10 01-3105
2.00 each unit Sewer connec 62.32 62.32 01-3105
2.00 each Lawn sprnkler 37.48 37.48 01-3105
100 each SWMF 2 Auto I.00 1.00 88-3027
Total Fees: $680.73 Balance Due: $0.00 Paid Today: $680.73
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 107728
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 679.73
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 0
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)
.ARC
�°~ � PERMIT/PLAN REVIEW APPLICATION
c�, j, Development Services Department,240 West Huntington Drive,Post Office Box 60021
\'''unit,at"° 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 License No. 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 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 ❑ 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 Title
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 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 :-3 Date 4 / /cr-
" Development Services Department
'� 240 West Huntington Drive,Post Office Box 60021
''�f" ° Arcadia,CA 91066-6021
PERMIT NO. BOO-049-785
:.
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Mechanical
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/6/2015 JB 12:21 4/6/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
506 S Second Ave 5779-008-024
OWNER MAILING ADDRESS
Dexter 2nd Ave, Llc 255 E Santa Clara St 220 PHONE NO. Inspector#: JEFF
Arcadia, CA 91006- EMAIL ADDRESS: ,
APPLICANT MAILING ADDRESS
20th Century Air PHONE NO.
�^'unnI� MIL ADDRESS:
CONTRACTORIPROFESSIONAL ' MAILING ADDRESS 0 V V�UUPL.�E11:1
20th Century Air P O Box 638 PHONE NO. (714)777-6641 FAX NO.
Earp, CA 92242 EMAIL ADDRESS:
License No. 511598 Type: C-20,B Expires: 6/30/2015 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
MECHANICAL FOR 20-UNIT CONDO PROJECT
Construction Type UOM #of Units Value Construction Type UOM S of Units Value
��I�L l�0-(2 - r r cft.od
OCCUPANCY: Dwellings TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Mech Issue Auto 44.35 44.35 01-3105
20.00 each Furn<100,000btu 374.80 374.80 01-3105
20.00 each Comp 3 hp 374.80 374.80 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $794.95 Balance Due: $0.00 Paid Today: $794.95
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 108437
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 793.95
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)
,---o-F ARC
°'9� PERMIT/PLAN REVIEW APPLICATION
ON
E #�` Development Services Department,240 West Huntington Drive,Post Office Box 60021
,....„yo,..- 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 C-Z 0 License No.Da l t Exp. Date 6.30-(f 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 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'comsaion insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier on 6 f/
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 ❑ 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
❑1, 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.lf,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).
❑ 1 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 ,' 0 M..(
s�-°`�- PRINT k�E Title w
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 q` & f c