HomeMy WebLinkAboutB00-050-645 ,u ` Development Services Department
240 West Huntington Drive,Post Office Box 6001_ PERMIT NO.
Arcadia, CA 91066-6021 BOO-050-645
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Tenant Improve w/energ;
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
6/24/2015 CM 14:46 9/22/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan Chk#: 15-411
Los Angeles, CA 90025- EMAIL ADDRESS: ++��
APPLICANT MAILING ADDRESS 3 ' 7OC
R.S.I. Group(Preet) PHONE NO. (714)609-7882
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
H.A. Builders, Inc. 14796 Wild Colt Place PHONE NO. (619)669-1183 FAX NO.
Jamul, CA 91935 EMAIL ADDRESS:
License No. 816820 Type: B Expires: 4/30/2016 12:00:
TENANT MAILING ADDRESS
California Pizza Kitchen PHONE NO. FAX NO.
DESCRIPTION
TENANT IMPROVEMENT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 350,000.00 $350,000.00 ', s
Eil
^- --- /1-19---1 S 47
OCCUPANCY: Tenant Improve TOTAL VALUATION: $350,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 1,916.85 1,916.85 01-3103
each Energy p/c fee 648.78 648.78 01-3103
PC ADA 287.53 287.53 01-3103
PC Cal Green 191.69 191.69 01-3103
100 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 2,949.00 2,949.00 01-3104
Bldg Issue ADA 294.90 294.90 01-3104
1.00 each T.I.Fire Pkc 245.00 245.00 01-3109
SMIP Corn 98.00 98.00 14-2207
gin bldg std 14.00 14.00 714-2203
100 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $6,696.35 Balance Due: $0.00 Paid Today: $3,406.50
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the 114,,c,..4.4-0. 110463
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 3,288.25
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 98.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 88-3 88-30273 027 6.25
16.00
Arcadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
(........{.../
Requests for inspection should be made at least Monday-Thursday Friday
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)
mwlltl imuk
of AR
4 GT,A,FORivz.?� .
Cil fiefst i' PERMIT/PLAN REVIEW APPLICATION
Ei;*. Development Services Department,240 West Huntington Drive,Post Office Box 60021
°°'emu„+,Y„0” 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 licen e is in full force and effect. p ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class Li nse o_gi�j a F�ep. Date ' 0 !— compensation, as provided for by Section 3700 of the Labor Code, for the
��V /`// performance of the work for which this permit is issued.
Signature of Contractor
OWNER-BUILDER DECLARA ION 1'1 I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I am exempt fro::2niractors 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'c( pensation rn urance carrier_a�d Po �cyr numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier sr r """ p v 5 1/0 ►`� 7 L
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number g®O►��®O
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000) 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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree th if I should become subject to the
workers'compensation provisions of Sectio 3700 of the Labor Co 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
a(440 , ..1
sale(Section 7044,Business and Professions Code:The Contractors License Date 9'Z J Signature
Law does not apply to an owner of roe who builds or improves thereon,
PP Y property rtY
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 unlaw 1,
sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
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 CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPOR'T'ANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE, FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for
further formation.
Name HMSM � Title ,J' ID
PRINT NA
I certify that I ha 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 ent u on the above-rr3gntioned pro ty for inspection purposes.
ri a
el Signature q/ 9 1 AC
Date
5 6 0 -0 - CYi
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp.
4-2=1-IC Fi4AI-t(n!6 <3. ' (A sA'O'100. Setbacks 210. Under r./bldg.drain
101. Rough grade 211. Copper underslab d-i 5 , --�La�7, / ,,16,
102. Figs.&forms 212. Rough plumbing U ••=0Z-- /- �g- r.
103. Pre-slab 213. Rough gas � f
104. Floor joists 214. Shower pan &/c > ,4 7 72 PG-,“.)0 o 6,.t
105. Steel 215. Water heater
106. Grout lift 216. Roof drains o I- 5//PG O1= C.J 4.G L I
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
(�!L` 5'/ 4 ~ Vet s�
109. Roof nailing 219. Final gas
110. Framing '1 2."I /1 . / 220. Fixtures Pink nf}r 1 puti,..6o0 F714saty„e'
111. 0cc./Area Sept.Wall I "("i✓���/ 221. Final plumbing RSA-RSA- 4L ?�
112. Sound walls 222. Sewer cap/demo. .9 �/9�ilfj U t
113. T-bar.rid
114. Insulation-Flr. Pool Inspections Date Insp. W-Sf A2 PAP-10 4--
115. Insulation-Wall 240. Excavation/steel �^``'' In" �
116. Insulation-Ceil. 241. Rough plumbing YAW I.1/NK . D '^, I0-S-1S di
117. Drywall nailing }I-3-15, 242. Light shell/bonding 1
118. Interior lath 243. Underground conduit (-1/41A-400 ( �'10•(� d),9_ 10 O
119. Exterior lath 244. P-trap ��11 0 1
120. Finish grade 245. Gas line&test -
8-(5 // /
121. Final building /)' 6 4/ 246. Fence,gates&signs f 6,�/
122. Final demo/lot clear 247. Pool heater
248. Final electric FrAfril"C.Y or
" -'"IM"( -725 FAT'T'O
Electrical Inspections Date Insp. 249. Final plumbing A,`° A� c ouA r� c, .. l o- 7J V t
)
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Underground conduit I° A-6.4.- , 1 arJ
153. Underslab conduit Reroof Inspections Date Insp. _
154. UFER ground 270. Pre-reroof insp. oy 04',1(, outer 4.^t) 10-2415
155. Water ground 271. Roof framing
156. Rough electrical 11-2 /��/ 272. Sheathing nailing
157. Fixtures �I' 273. Final reroof
158. G.F.C.I.
159. E..t.bondin. Sign Inspections Date Insp.
160. Service panel 280. Setback/overhang
161. Final electric 1 11245-f 281. Footing
282. Conduit/wiring
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC Miscellaneous Insp. Date Insp.
183. Fire dampers 290. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Final
189. Commercial hood
190. Duct shaft Sewers&Offsite Insp. Date Insp.
191. Final mechanical 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cesspool filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
9`M \ Development Services Department
240 West Huntington Drive, Post Office Box 60021
Arcadia, CA 91066-6021 PERMIT NO. BOO-051-666
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: EMP Combo
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
10/6/2015 CM 10:39 10/6/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave 115-U T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
H.A. Builders, Inc. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
H.A. Builders, Inc. 14796 Wild Colt Place PHONE NO. (619)669-1183 FAX NO.
Jamul,CA 91935 EMAIL ADDRESS:
License No 816820 Type: B Expires: 4/30/2016 12:00:
TENANT MAILING ADDRESS
C.P.K. PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL AND PLUMBING FOR CPK
Construction Type UOM #of Units Value Construction Type UOM Hof Units Value
INI... F�� "
P
S
,' r i
[, ¢s a x x � r'i and
671 N4Z.-- 11-I9 -f5 4/
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 flat Elec issue 44.35 44.35 01-3105
1.00 Flat Plmbg issuance 44.35 44.35 01-3105
3.00 each Water Closet 37.38 37.38 01-3105
4.00 each Lavatories 49.84 49.84 01-3105
45.00 each Ltg fixtures 53.00 53.00 01-3105
1.00 Fixtures Urinal 12.46 12.46 01-3105
1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 Flat SWMF 2 1.00 1.00 88-3027
Total Fees: $243.38 Balance Due: $0.00 Paid Today: $243.38
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the R..“..;Pt#• 110637
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 241.38
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 2.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
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)
ik,
' OF"
4 �� PERMIT/PLAN REVIEW APPLICATION
Office Box 60021
��;j Development Services Department,240 West Huntington Drive, Post 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 m y li•-nse is in full force and effect. / ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class icense No.g168 xp. Datef-7//1.) compensation, as provided for by Section 3700 of the Labor Code, for the
k A Orr performance of the work for which this permit is issued.
Signature of Contractor •
OWNER-BUILDER DECLARAI ON 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'co/m�pens�ation insurance carrier and olicy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier -s74 16 63--714 compensation
i r �r
demolish,or repair any structure,prior to its issuance,also required the applicant 2-'2:7° 0 Lit
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as 'o become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree .t if I should become subject to the
workers'compensation provisions of S cti.n 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 // _ ( rte
sale(Section 7044,Business and Professions Code:The Contractors License Date (0 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,
sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
1]I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work f w ich this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for
further information. ��
Name / • +�'� Title ' ' A---S 1 ��
'RINT NAME
I certify that I hav 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 ent u n the a ve-mentioned prope for inspection purposes. r
�. Date 10 `
Signature
, "" Development Services Department
-' 240 West Huntington Drive,Post Office Box 60021
� . Arcadia,CA 91066-6021 PERMIT NO. BOO-048-194
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: Fire
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
10/13/2014 CM 8:37 10/13/2014 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan#: OTC
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Hydro-Tech PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Hydro Tech Plumbing Corp 2609 Strozier Avenue PHONE NO. (626)216-9110 FAX NO.
El Monte,CA 91733 EMAIL ADDRESS:
License No. 725263 Type: C36 Expires: 7/31/2006 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
SPRINTS FOR EXTRANCE CALIFORNIA PIZZA KITCHEN
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 700.00 $700.00
i
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $700.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
7,00 each sprinklerpck 235.00 235.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 49.05 49.05 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $329.40 Balance Due:
$0.00 Paid Today: $329.40
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 106668
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3109 235.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 93.40
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Ar- 88-3027 1.00
cadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(l)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)
lam.
v.oF[Ivc,„
RENEE
PERMIT/PLAN REVIEW APPLICATION
E Development Services Department,240 West Huntington Drive,Post Office Box 60021
--' F` Arcadia,CA 91066-6021, (626)574-5416,Fax(626)447-9173
„un ,nt No
City of
Arcadia
0 LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury that 1 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 CA c)rmy license is in fu� ��l ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No. 43i/io xp. compensation, as provided for by Section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
Signature of Contractor
/have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors 700 of the Labor Cod ir the rformance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions
is issued.My workers' . •�e n n i sur nce carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,de- Carrier �1
Y Y Y q P P 941
/DI
mulish,or repair any structure,prior to its issuance,also required the applicant for .4
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.1 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 subje o the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I show II r e subject to the
workers'compensation provisions of Secti'n 700 0 �.o,or Code, I shall
I, as owner of the property, or m em to employees with wages as their sole forthwith comp with those provisions.
❑ my P 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
I
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 �Q 0.—%C_ V rn • i5I71 Title COnt:
RI AME
I certify that I have rea this a!, i . o' 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 i all • ty i di a s and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter the . i ov e • ne property for inspection purposes.
Signature Date 10 13 1f
I
° \ Development Services Department
P P
240 West Huntington Drive,Post Office Box 60021
` `.J Arcadia, CA 91066-6021 PERMIT NO. BOO_Q51-664
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Fire
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
10/6/2015 CM 10:04 10/6/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: OTC
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
B.E.C. PHONE NO.
EMAIL ADDRESS:
f
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Building Electronic Controls Inc. 2246 Lindsay Way PHONE NO. FAX NO.
Glendora, CA 91740 EMAIL ADDRESS:
License No. 729905 Type: C Expires: 11/30/2015 12:01
TENANT MAILING ADDRESS
California Pizza Kitchen PHONE NO. FAX NO.
DESCRIPTION
FIRE ALARMS FOR CALIFORNIA PIZZA KITCHEN
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 13,650.00 3,61X 3 = I
s
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $13,650.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
33.00 each fire alarm pc 2 735.00 735.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 304.05 304.05 01-3112
1.00 each SWIvIF 2 Auto 1.00 1.00 88-3027
Total Fees: $1,084.40 Balance Due: $0.00 Paid Today: $1,084.40
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt 4: 110°35
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3109 735.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 348.40
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 88"3027 1.00
Arcadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
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 A
PERMIT/PLAN REVIEW APPLICATION
4 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
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 t-O License No. a,. '11°'` xp. Date \.k13Cj(1 ` 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►�_.��= �t:SIA#4, AAA
`a•
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 a1ndn olicy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier SIC)( �vY ce' 1�'r ` `�� f 0,10(
demolish,or repair any structure,prior to its issuance,also required the applicant Q
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 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
0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. ` ,J�
compensation,will do the work,and the structure is not intended or offered for Date / P 5 Signature �\�'"
sale(Section 7044,Business and Professions Code:The Contractors License Si nature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
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 CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
w,
Date / I lS Signature !.• . VA'tOi�a 'i Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further information �-y-
Name -)•1)(r‘0(�` � � Title 1/4\ \'—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 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 �y,V� .��1� a: Date 0/ it S
e"" Development Services Department
5* 240 West Huntington Drive, Post Office Box 60021 PERMIT NQ.
Arcadia, CA 91066-6021 BOO-051-482
City of (626) 574-5416,Fax (626)447-9173
Arcadia Permit Type: Fire
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
9/17/2015 CM 16:58 10/5/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: FIRE
Los Angeles, CA 90025- EMAIL ADDRESS:
Plan#: 15-595
APPLICANT MAILING ADDRESS
Allready Fire PHONE NO.
.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Allready Fire Sprinkler Co 818 N Grand Ave PHONE NO. (626)913-6720 FAX NO.
Covina,CA 91723 EMAIL ADDRESS:
License No. 358795 Type: C16 B Expires: 7/31/2017 12:00:
TENANT MAILING ADDRESS
California Pizza Kitchen PHONE NO. FAX NO.
DESCRIPTION
SPRINKS-4 HEADS-CALIFORNIA PIZZA KITCHEN
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
Value Value 950.00 50.0 . > r. ,:,- E
OCCUPANCY: Fire Sprink/AIm TOTAL VALUATION: $950.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
4.00 each sprinkler pck 245.00 245.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 61.65 61.65 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $352.00 Balance Due: $0.00 Paid Today: $107.00
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the • • i s i
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 106.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 1.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday -
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�ivoxRy�g9�
PERMIT/PLAN REVIEW APPLICATION
•
t> *� Development Services Department,240 West Huntington Drive,Post Office Box 60021
q„yofv, Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Cod and jm license is in full force an. of ect. r ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class �--/ Licens No. � xp. Date 7N-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 /
OWNER-BUILDER LZLA ATION ❑ 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
is issued.M worke=pratioq insurance) ar ie and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions ,� ff�(_
Code.Any city or county which requires a permit to construct,alter,improve, Carrier
demolish,or repair any structure,prior to its issuance,also required the applicant 5 3 0 000 a 5 J T,
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 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,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
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 CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for
further information.
Name 111 7MEREM Title Q 'S 12
PRINT NAM
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.
J
Signature f - Date f,
ytt'�`` Development Services Department
I 240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021 PERMIT NO. $QQ_051-385
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Comm Add/Alt
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
9/8/2015 JB 15:42 9/8/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave #115-U T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS
Los Angeles, CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
H.A. Builders, Inc. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
H.A. Builders, Inc. 14796 Wild Colt Place PHONE NO. (619)669-1183 FAX NO.
Jamul, CA 91935 EMAIL ADDRESS:
License No. 816820 Type: B Expires: 4/30/2016 12:00:
TENANT MAILING ADDRESS
California Pizza Kitchen (C.P.K.) PHONE NO. FAX NO.
DESCRIPTION
DEMOLISH INTERIOR IN PREPARATION FOR FUTURE TENANT IMPROVEMENT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 16,000.00 $16,000.00
i
hi ■"t--- //'--/12 5/
OCCUPANCY: Tenant Improve TOTAL VALUATION: $16,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
I.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 337,45 337.45 01-3104
Bldg Issue ADA 33.75 33.75 01-3104
SMIP Corn 4.48 4.48 14-2207
gin bldg std 1.00 1.00 714-2203
100 each SWMF 2 Auto 1.00 I.00 88-3027
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $428.28 Balance Due: $0.00 Paid Today: $428.28
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt A: 110312 '
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 415.55
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 4.48
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 714-2203 1.00
Arcadia building inspector for a period of 180 consecutive days. 88-3027 7.25
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m. to 4:30 p.m.
(Closed on alternate Fridays)
1f ARC.
4.`rY(Fortvii •
V PERMIT/PLAN REVIEW APPLICATION
oil r-,.
ti
"mM.ol,Yof0" 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. 0 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 IJ I have and will maintain workers'compensation insurance,as required by Section
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, Carrier 9 q 4- 6.0(17 e lrj.i'ioiN I f15.'ArU/1 re fu nd
demolish,or repair any structure,prior to its issuance,also required the applicant go /210 8-I Li-
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)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 ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 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
0 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 [, J
sale(Section 7044,Business and Professions Code:The Contractors License Date ®CI 0 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,
sale. If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
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 CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures..
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further information. Moo Name P(ee'4- Rc4-e / Title Pli V1 PC-4- /V lG o G q rr
PRINT NAME *J iJ
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 gi(42(211-- Date 0 R" O$ - (3
Wit-NALTIONS 'ENS 1NMALS:
CORRECTED: PLAN CHECK OFFICIAL INSPECTION REPORT
COUNTY OF LOS ANGELES 0 DEPARTMENT OF PUBLIC HEALTH
ENVIRONMENTAL HEALTH
OPERATOR '
iiiTIALS' Illr RETAIL INSPECTION III WHOLESALE INSPECTION—-- ' —
SECTION I: TYPE OF INSPECTION
Preliminary Inspection III 90-Day Evaluation
iu Follow Up Inspection III Equipment Evaluation
i E .._ . .
p
Final Inspection-___NEW Revocation Evaluation
o
--
t-. - Final Inspection-REMODEL
k II Other:
p SECTION II: STATUS OF PERMIT I LICENSE
s A Rii r-PROVED:The facility/establishment Is approved to operate pursuant to the following contingencies:
111111•■ ..., _
DENIED:The facility/establishment is NOT approved to operate.To obtain approval,the requirements needed are:
\ild
N ' (s ) Q v Couttic.,76-1) /37 -7-0 13t:10 r
44-
.„,,....t.\
41 -.
Vi ati IV J;L V G— G44. OKIL, ri1c4t4zif_LS11 ilp rio V 61-3 70
-..........x. I i 5:6' ..... .... • * •
.... 0
fal •
\%4 I ,.. .: 1, NW 4 II a
< 0
6 0 w i liC
o
W ,,..T 4E01 -T14e etiv-raii-e-Tot„PA.qt-IVN ... '• t *, I
I----. i
0 Z-i V) 0 Ul 5P.
W! 1. ei -eij 6,-A4 VM7.1k4 -I1+6 tit5141-71-1 Aityov.44). -7 wet( rote. u t utiotf ,
co o I i z in
3. o w E w co
.._
ah . ,,... . a .— •.... II CI i• A i' ... is 1 ,,, S , . ....
41111Y
• '8 — 'i
o w
0 p. IN --tç t6 gs-73—iwi Qv,—ro ivT 1.61.1.3—EJ S s c-opil)s Fri P-Oo kur?V
I
. ., . L QuironE ii—T 7iftc- AF-1. MArti -=- 1106g-
...,
Submit 3 sets of detailed plans:See Cons ruction Requirement Guidelines at www.publithealth.lacounty.govieh 1
7 ft 4
Z Obtain local Building&Safety,Fire Department and other agency permits and approvals
0
ti 41 if- SECTION III: LIMITS & RESTRICTIONS
I.-izt .W- .c‘•N, 2 6
1-- w
..;)...° .t.. -*.1
L it The approved facility/establishment may engage in the processes I activities marked below:
--,......ci if._.
5 > '';. m ,111' ......tt Train Employees Use Multiservice Utensils
.,I '4q .t.. g:2.■ _ .,....
%.-Jil MI Stock Prepackaged/Non-Potentially Hazardous Foods Serve Alcoholic Beverages
a aal
z...-- ,....0 L...4.- --.
le Stock Perishable I Potentially Hazardous Foods May NOT Se Alcoholic Beverages On-Site Consumption
Serve everages For— 1
Food Preparation Food Preparation-LIMITED FOOD PREPARATION Wholesale Food Processing tion Food Demonstration
6
I Food Preparation-NO COOKING PERMITTED Food Market,Wholesale
-]
z .3 ri lz: .9.._?. ...-5 4_; 6 tj Food Market Retail,Prepackaged Foods Only
Other i
z '--
g F:1 off, hi ,,,,°- 5
ri
cc ,-,i o. SECTION IV: FEES I ADMINISTRATIVE ACTIONS
A fee in the amount of$ must be paid prior to the next field inspection.
X , .."1- thrr--9:40:111.4
CLOSURE:Operating without final approval and/or without Public Heath Permit OR License
--I
-I
"
al Administrative Review I Office Hearing has been scheduled on: ,at am./p.m.(Provide Valid Photo Identification)!
W ...q., > r■:-`•
I
SECTION V: DISCLOSURES
.J ,‘„ ‘••• " .44 et-J
,--• ---, i--t , - ' It is a misdemeanor violation to begin operation without a valid Public Health permit I license.The Public Health permit/license wit be
c.) ,C),
kr) 81 Issued by the Plan Check Inspector at the job site following final inspection and approval by all applicable agencies Remodeled areas of
ian existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies poor to use
aILI ri'L'"?' F_,..'-',, ,,,,, a-3 , Fi; , 1 Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food facility/
-i."*1' '''', establishment or change of menu may require plans to be submitted la the Health Department Plan Check Program Additional approvals
L :,.1 may be required from other enforcement agencies
CI '.;:,_' It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or on
gratuities in connection with performing
,e4 their official duties.Improper solicitations include requests for anything of value such as cash,discounts,free services,paid travel or
4 c--- r-: .
Ay) entertainment,or tangible items such as food or beverages.Any attempt by a County employee to solicit bribes,gifts or gratuities for any
Z CIO*,• .. 't; :,',131 reason should be reported immediately to either the County manager responsible for supervising the employee or the Fraud Hotline at
w 1 41 Lt.t (800) 544-6861 or wvvw.lacountvfraud.orq.YOU MAY REMAIN ANONYMOUS
. ■
ri '
1 i f1.4 7 e; r SEE REVERSE SIDE FOR ADDITIONAL CRITERIA
H-3•14- ..0,14
ORIGINAL
IMIIIMIIIIR,
•FAR
41.00,11F014,41-4. .I
i' w".e s.iws
4onityo11" MEMORANDUM
Fire Department
DATE: November 9, 2015
TO: BUILDING DEPARTMENT
ATTN: INSPECTOR Chris Ingram
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 400 S. Baldwin Avenue, E04 (CPK)
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 11-5-2015 Jill Perumean
FIRE ALARMS 11-3-2015 Jill Perumean
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 11-5-2015 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 11-5-2015 RC
OF
engineering group , inc . DAILY FIELD REPORT
SEG Project Number: PENDING Site Contact: Ralph Quinonez
Project Name: California Pizza Kitchen Project Location: 400 S Baldwin Ave#115,Arcadia,CA
Date: 10/26/15 Day: Monday Weather: Night
❑ Sample ❑ Tagging ❑ Pick-Up El Delivery El Soil ❑ Aggregate
El Concrete ❑ Rebar ® Steel ❑ CMU ❑ Bolts
❑ Other
Description of Work XI Inspected ❑ Performed ❑ Attended
Report:Observed the final field welding of the Trellis Steel Support Assembly by Certified Welders with the FCAW process(E71T-8/NR232)wire using
proper welding procedures and techniques.All completed welds are visually acceptable in accordance with AWS D1.1.The work is complete.
Set(s)of Concrete/Mortar/Grout Prisms/Other 7/e)4000K Time In Time Out Regular Time Over Time Travel Time A ge
11 PM 7 AM 8 rA
To the best of my knowledge,the abovXWas/Was NOT performed in accordance with the approved plans,specific eons, ;nd _n1. ory r:.uirements.
Superintendent/Representative: Technician: 1
Ralph Quinonez ,, d �i spo or Jose D.Gutierrez ■ f ' I
Geotechnical • Inv°ironmental • Geology • \laterials Iesting& Inspection • Inrensic • IaburatorN
Corporate Office 2809 Unicorn Rd., 11650 Mission Park Dr., 3850 N.Wilcox Rd., 2211 Fortune Dr., 3420 C Street NE,
4729 W.Jacquelyn Ave. Suite 103, Suite 108,Rancho Suite F, Suite C, Suite 304,
Fresno,CA 93722 Bakersfield,CA 93308 Cucamonga,CA 91730 Stockton,CA 95215 San Jose,CA 95131 Auburn,WA 98002
(559)271-9700 (661)393-9711 (909)980-6455 (209)931-2226 (408)577-1090 (253)737-5992
(559)275-0827 Fax (661)393-9710 Fax (909)980-6435 Fax (209)931-2227 Fax (408)577-1099 Fax (253)929-6094 Fax
01 SALEM
engineering group , inc . DAILY FIELD REPORT
SEG Project Number: PENDING Site Contact: Ralph Quinonez
Project Name: California Pizza Kitchen Project Location: 400 S Baldwin Ave#115,Arcadia,CA
Date: 10/25/15 Day: Sunday Weather: Night
❑ Sample ❑ Tagging ❑ Pick-Up ❑ Delivery ❑ Soil ❑ Aggregate
❑ Concrete ❑ Rebar ® Steel ❑ CMU ❑ Bolts ❑ Other
Description of Work 50 Inspected ❑ Performed ❑ Attended
Report:Observed the ongoing field welding of the Trellis Steel Support Assembly by Certified Welders with the FCAW process(E71T-8/NR232)wire using
proper welding procedures and techniques.All completed welds are visually acceptable in accordance with AWS D1.1.The work remains ongoing.
Set(s)of Concrete/Mortar/Grout Prisms/Other (Circ •••)
Time In Time Out Regular Time Over Time Travel Time •e
1 PM 7AM 8 „4 ��r /
1
To the best of my knowledge,the abovXWas/Was NOT performed in accordance with the approved plans,specific. io-r., : • gu . ory••uirements.
Superintendent/Representative: Technician:
Ralph Quinonez . ��sp, - Jose D.Gutierrez I I I
GeotechnicaI • Environmental • Geolog. • Materials resting& Inspection • IOretSic • IaboratorN
Corporate Office 2809 Unicorn Rd., 11650 Mission Park Dr., 3850 N.Wilcox Rd., 2211 Fortune Dr., 3420 C Street NE,
4729 W.Jacquelyn Ave. Suite 103, Suite 108,Rancho Suite F, Suite C, Suite 304,
Fresno,CA 93722 Bakersfield,CA 93308 Cucamonga,CA 91730 Stockton,CA 95215 San Jose,CA 95131 Auburn,WA 98002
(559)271-9700 (661)393-9711 (909)980-6455 (209)931-2226 (408)577-1090 (253)737-5992
(559)275-0827 Fax (661)393-9710 Fax (909)980-6435 Fax (209)931-2227 Fax (408)577-1099 Fax (253)929-6094 Fax
oi SALEM
engineering group , inc . DAILY FIELD REPORT
SEG Project Number: PENDING Site Contact: Ralph Quinonez
Project Name: California Pizza Kitchen Project Location: 400 S Baldwin Ave#115,Arcadia,CA
Date: 10/24/15 Day: Saturday Weather: Night
❑ Sample ❑ Tagging ❑ Pick-Up ❑ Delivery ❑ Soil ❑ Aggregate
❑ Concrete ❑ Rebar ® Steel ❑ CMU ❑ Bolts ❑ Other
■
Description of Work lJ Inspected ❑ Performed ❑ Attended
Report:Observed the ongoing field welding of the Trellis Steel Support Assembly by Certified Welders with the FCAW process(E71T-8/NR232)wire using
proper welding procedures and techniques.All completed welds are visually acceptable in accordance with AWS D1.1.The work remains ongoing.
Set(s)of Concrete/Mortar/Grout Prisms/Other (Cir• - • e
Time In Time Out Regular Time Over Time Travel Time , 4111011r
11 PM 7 AM 8 ''/
To the best of my knowledge,the abovXWas/Was NOT performed in accordance with the approved plans,specific. ions, , d gul. ory::uirements.
Superintendent/Representative: Technician:
, i i I
Ralph Quinonez uI ?y no .ir Jose D.Gutierrez
(;eotechnical • 1 environmental • (,eulog■ • Materials Testing& Inspection • I orensic • I aboratorN
Corporate Office 2809 Unicorn Rd., 11650 Mission Park Dr., 3850 N.Wilcox Rd., 2211 Fortune Dr., 3420 C Street NE,
4729 W.Jacquelyn Ave. Suite 103, Suite 108,Rancho Suite F, Suite C, Suite 304,
Fresno,CA 93722 Bakersfield,CA 93308 Cucamonga,CA 91730 Stockton,CA 95215 San Jose,CA 95131 Auburn,WA 98002
(559)271-9700 (661)393-9711 (909)980-6455 (209)931-2226 (408)577-1090
(559)275-0827 Fax (661)393-9710 Fax (909)980-6435 Fax (253)737-5992
(209) Fax (408) Fax (253)929-60094 94 Fax
wrww
SALEM 0
DAILY FIELD REPORT
engineering group , inc .
SEG Project Number: PENDING Site Contact: Ralph Quinonez
Project Name: California Pizza Kitchen Project Location: 400 S Baldwin Ave#115,Arcadia,CA
Date: 10/23/15 Day: Friday Weather: Night
❑ Sample ❑ Tagging El Pick-Up ❑ Delivery ❑ Soil ❑ Aggregate
❑ Concrete ❑ Rebar ® Steel ❑ CMU El Bolts
❑ Other
Description of Work J Inspected El Performed ❑ Attended
Report:Observed the initial field welding of the Trellis Steel Support Assembly by Certified Welders with the FCAW process(E71T-8/NR232)wire using
proper welding procedures and techniques.All completed welds are visually acceptable in accordance with AWS D1.1.The work remains ongoing.
Set(s)of Concrete/Mortar/Grout Prisms/Other (Circle ►' e) /
Time In Time Out Regular Time Over Time Travel Time /1'1 �'/,
11PM 7AM 8
To the best of my knowledge,the abovXWas/Was NOT performed in accordance with the approved plans,specifications, , d gul. ory..uirements.
Superintendent/Representative: , Technician:
Ralph Quinonez SSA 7 L _ - Jose D.Gutierrez i I .
Geotechnical • t nvironmental • (,eolog■ • Materials I esting& Inspection • forensic • I ahuratory
Corporate Office 2809 Unicorn Rd., 11650 Mission Park Dr., 3850 N.Wilcox Rd., 2211 Fortune Dr., 3420 C Street NE,
4729 W.Jacquelyn Ave. Suite 103, Suite 108,Rancho Suite F, Suite C, Suite 304,
Fresno,CA 93722 Bakersfield,CA 93308 Cucamonga,CA 91730 Stockton,CA 95215 San Jose,CA 95131 Auburn,WA 98002
(559)271-9700 (661)393-9711 (909)980-6455 (209)931-2226 (408)577-1090 (253)737-5992
(559)275-0827 Fax (661)393-9710 Fax (909)980-6435 Fax (209)931-2227 Fax (408)577-1099 Fax (253)929-6094 Fax
• engineering group , inc . DAILY FIELD REPORT
SEG Project Number: PENDING Site Contact: Ralph Quinonez
Project Name: California Pizza Kitchen Project Location: 400 S Baldwin Ave#115,Arcadia,CA
Date: 10/27/15 Day: Tuesday Weather: Night
❑ Sample ❑ Tagging El Pick-Up ❑ Delivery ❑ Soil
❑ Aggregate
❑ Concrete ❑ Rebar ® Steel ❑ CMU XI Bolts
❑ Other
Description of Work RI Inspected ❑ Performed ❑ Attended
Report:Observed the proper installation of all wedge anchors,epoxy anchor rods,securing columns to floor and all new steel to CMU block wall.Verified
holes size,diameter and cleanliness of holes prior to installation of Hilti 200 epoxy.All work is complete accordance with code and approved drawings.
THIS IS A FINAL REPORT
Set(s)of Concrete/Mortar/Grout Prisms/Other (Circl• '■ e)
401°P.
Time In Time Out Regular Time Over Time Travel Time "•it►'
11 PM 7AM 8
To the best of my knowledge,the abovXWas/Was NOT performed in accordance with the approved plans,specific it , ,nd gul. ory r: uirements.
Superintendent/Representative: Technician: %
Ralph Quinonez _.r/ :7y A ' ., Jose D.Gutierrez .;:i....._ i i I
(.eotechnical • I-_nv iron men tal • (",colop • Materials Testing& Inspection • Iorensic • I aborator■
Corporate Office 2809 Unicorn Rd., 11650 Mission Park Dr., 3850 N.Wilcox Rd., 2211 Fortune Dr., 3420 C Street NE,
4729 W.Jacquelyn Ave. Suite 103, Suite 108,Rancho Suite F, Suite C, Suite 304,
Fresno,CA 93722 Bakersfield,CA 93308 Cucamonga,CA 91730 Stockton,CA 95215 San Jose,CA 95131 Auburn,WA 98002
(559)271-9700 (661)393-9711 (909)980-6455 (209)931-2226
(559)275-0827 Fax (661)393-9710 Fax (909)980-6435 Fax (209)931-2227 Fax (408)571019 Fax (253)9-6094 F
( ) (408)577-1099 Fax (253)929-6094 Fax