HomeMy WebLinkAboutB00-050-651 4'..'".1.:, Development Services Department -rt
' 240 West Huntington Drive,Post Office Box 60021 $QO_050_651
;4° PERMIT NO.
Arcadia, CA 91066-6021
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
8/24/2015 JB 9:40 10/7/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-32 T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CHRS
Los Angeles,CA 90025- EMAIL ADDRESS:
Plan Chk#: 15-533
APPLICANT MAILING ADDRESS
Design Tech PHONE NO. Plan#: 31746
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Design Tech, Inc. 353 S Orange Grove Ave PHONE NO. FAX NO.
Los Angeles,CA 90036 EMAIL ADDRESS:
License No. 909028 Type: B Expires: 1/31/2016 12:00:
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
TENANT IMPROVEMENT-UMEKEN
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 120,000.00 $120,000.00 W n1 .
L i yid
k7.444(- /.l--Zo --e
OCCUPANCY: Tenant Improve AL VALUATION: $120,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 885.30 885.30 01-3103
each Energy p/c fee 299.64 299.64 01-3103
PC ADA 132.80 132.80 01-3103
PC Cal Green 88.53 88.53 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 1,362.00 1,362.00 01-3104
Bldg Issue ADA 136.20 136.20 01-3104
1.00 each T.I.Fire Pkc 245.00 245.00 01-3109
SMIP Corn 33.60 33.60 14-2207
grn bldg std 5.00 5.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $3,238.67 Balance Due: $0.00 Paid Today: $1,651.27
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Kva.vipl N. 110654
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 1,406.27
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3109 245.00
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.
\r-------
(Closed on alternate Fridays)
ARe
■
c.ditiffil PERMIT/PLAN REVIEW APPLICATION
t41*' Development Services Department,240 West Huntington Drive, Post Office Box 60021
�N..,,Y vo'' 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. j ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class B Licens- •s I �0..)a Exp. Date V 6 compensation, as provided for by Section 3700 of the Labor Code, for the
-vas* 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'com ensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier The_ f o el
demolish,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 Policy Number (/tiEG /'ga f1 C?
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need of 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. - 'yam
Name S 1 v' ' . Title ��
A
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.
Signature Date e‘°�`��
60(5 .- : - c(
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp.
100. Setbacks 210. Under flr./bldg.drain J _ Al or _
101. Rough grade 211. Copper underslab it-G-15- r6elie r"Ui(� .b C (40,4�
102• Figs.&forms 212. Rough plumbing 1194 fv� ' ,�- w
103. Pre-slab 213. Rough gas '�`� �� S � � .
104. Floor joists 214. Shower pan
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing 10 A/ 220. Fixtures
111. Occ./Area Sept.Wall 221. Final plumbing k(-ea-6S
112. Sound walls 222. Sewer cap/demo.
113. T-bar'rid
114. Insulation-Fir. Pool Inspections Date Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. �,+••.� 241. Rough plumbing
117. Drywall nailing !I Z it ire.fr/241.
242. Light shell/bonding
118. Interior lath I 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 45. Gas line&test
121. Final building dl-„2c-,fir olte 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final plumbing
150. Power pole 250. Pool cover _
151. Sales lot lighting 251. Pool final
152. Underground conduit
153. Underslab conduit he- • /"Reroof Inspections Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground , / 271. Roof framing
156. Rough electrical 10.94016 /.w/ 272. Sheathing nailing
157. Fixtures fY�"11" 273. Final reroof
158. G.F.C.I.
159. E•.t.bondin• Sign Inspections Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric 0-20-1S M281. Footing
282. Conduit/wiring
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC • 4/ 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. I Date I Insp.
191. Final mechanical 11-20-15 '1074111"r 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
14,
,
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lkg Development Services Department
5 240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
' 1°f Arcadia, CA 91066-6021 800-051-904
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
10/26/2015 CM 11:31 10/26/2015 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#: CHRS
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAIUNG ADDRESS
Yeong Jo Yoo PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Yeong Yoo 331 S Gramercy PI#105 PHONE NO. FAX NO.
Los Angeles,CA 90020 EMAIL ADDRESS:
License No. 664371 Type: C20 Expires: 2/28/2017 12:00:
TENANT MAILING ADDRESS
44/4. PHONE NO. FAX NO.
DESCRIPTION
RELOCATE 12 DUCTS
Construction Type UOM #of Units Value Construction Type UOM N of Units Value
41 a g ; �1
- - k6%'v saYi LL, sL_5
,RAG/+'L- ``2ts—e c-
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Fiat Mech Issue Auto 44.35 44.35 01-3105
12.00 Flat Add/Alter Ducts 112.56 112.56 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $157.91 Balance Due: $0.00 Paid Today: $157.91
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 110864
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 156.91
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. C
(Closed on alternate Fridays)
OF ARC
LPI.tFoRry, 1,
PERMIT/PLAN REVIEW APPLICATION
Development
(626) 574-5416, Fax (626) 447.917e Box 60021
3
Arcadia, CA
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-G License No. C43`J, Exp. Date ' -,//2 compensation, as provided for by Section 3700 of the Labor Code, for the
/ performance of the work for which this permit is issued.
Signature of Contractor _t
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, Carrier
demolish,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 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
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 �
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.
❑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 /i%/ �1 0 Title
PRIN'N 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-ment'1 •- 1 •perty for inspecti n purposes.
' fSignature rz Z Date
tip' Development Services Department
240 West Huntington Drive, Post Office Box 60021
` _._,.; Arcadia,CA 91066-6021
PERMIT NO. BOO-051-908
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
10/26/2015 JB 13:03 10/26/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Rok Fire Protection PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Rok Fire Protection 4275 W Third St
PHONE NO. 213 365-8417 FAX NO.
Los Angeles,CA 90020 EMAIL ADDRESS:
License No. 539892 Type: C16C36B Expires: 8/31/2017 12:00:
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
PLUMBING FOR TENANT IMPROVEMENT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
t g
7* ■01/04'C a-2-6-e c /7-/e--;- ....
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
2.00 each Lavatories 24.92 24.92 01-3105
1.00 each Floor sink 12.46 12.46 01-3105
1.00 each Wtrhtr/vent 15.55 15.55 01-3105
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $98.28 Balance Due: $0.00 Paid Today: $98.28
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 110871
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 97.28
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
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)
%% ARC
° lg. PERMIT/PLAN REVIEW APPLICATION
-.1111'' Development Services Department,240 West Huntington Drive,Post Office Box 60021
'4.oity oil" 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 '3D License Nor:Exp. Date �//6 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 DEC RATION ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty o 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
demolish,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 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 AM)
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 . - •-71/ ,i/ 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 pro'•rty for inspection purposes.
1 p — -•//Signature ..rr�. I .W� Date
/
i, Development Services Department
I 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. B00-051-903
_••..• 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
10/26/2015 CM 10:50 10/26/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-32 T-387
OWNER MAILING ADDRESS
Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS
Los Angeles, CA 90025- EMAIL ADDRESS:
APPLICANT MAIUNG ADDRESS
A.J. Power Solution, Inc. PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
A J Power Solution Inc. 269 S Mariposa Ave
PHONE NO. (213)792-5444 FAX NO.
Los Angeles,CA 90004 EMAIL ADDRESS:
License No. 998251 Type: C10 Expires: 10/31/2016 12:0(
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
ELECTRICAL FOR UMEKEN
Construction Type UOM Hof Units Value Construction Type UOM N of Units Value
k z n
t
td:. s t 4 c ,i a(:..r.n
PLheG4 . /4"'.24.j0 -4 c —
OCCUPANCY: Tenant Improve 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
52.00 each Outlets 60.00 60.00 01-3105
101.00 each Ltg fixtures 109.00 109.00 01-3105
I.00 each SWMF 2 Auto 1,00 1.00 88-3027
Total Fees: $214.35 Balance Due: $0.00 Paid Today: $214.35
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 110862
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 213.35
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
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)
..cFFO
v9
PERMIT/PLAN REVIEW APPLICATION
A �
Development Services Department,240 West Huntington Drive,Post Office Box 60021
ceo 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. Exp Date ',r: , 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 �j
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 ins rance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 5-1-0-fe Far
demolish,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 Policy Number '/ 3 G� /
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not a 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 (D/7.-6,/ 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 AM)
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 .e13 IL— PRINT k) Title Qt.Un l/- 1/
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 arty for inspection purposes. /
Signature Date /Q/?/
5°`M.' Development Services Department
240 West Huntington Drive, Post Office Box 60021 PERMIT NO. BOO-051-
` Arcadia, CA 91066 6021 gg5
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
10/23/2015 JB 10:24 11/18/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT KG 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#: 15-686
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Building Electronoc Controls PHONE NO.
3
EMAIL ADDRESS:
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: 11/30/2016 12:01
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
FIRE ALARMS FOR TENANT IMPROVEMENT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 4,970.00 $4,970.00 151 ti,:',
, . ., ,, . : , . .
,,.. , , , .-., , ,, ;
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $4,970.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
5.00 each fire alarm pc 2 245.00 245.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 153.75 153.75 01-3112
I.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $444.10 Balance Due: $0.00 Paid Today: $444.10
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111145
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 245.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 198.10
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)
oFA•C
NoFOR.3/4
PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive, Post Office Box 60021
vo Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
Jai 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 C1assG" VC) License No. xp. Date
I 1/2-nit • 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 _A�L: __'� -. •
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 /12100 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 L pv s'e/c k,Cv1/4.4-1 ("GWN
demolish,or repair any structure,prior to its issuance,also required the applicant G \��\�
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 ,e Labo Code,I shall
IA❑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 r �� I i "4 A pg-Th
sale(Section 7044,Business and Professions Code:The Contractors License Date \ 1/ l 1C- 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 t'Y∎ i �,\ l� IN NAME
Title .. i k f'! ?\p J ►'V
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 \40-,.l Date 0 /I C6 )
i 4,9 Development Services Department
240 West Huntington Drive, Post Office Box 60021 BUS-051-921
`,•- Arcadia, CA 91066-6021
PERMIT NO.
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
10/28/2015 CM 8:03 10/28/2015 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
Hydro-Matric Fire Protection PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Hydro-Matic Fire Protection 1161 Rosedale Avenue PHONE NO. (818)247-9812 FAX NO.
Glendale, CA 91208 EMAIL ADDRESS:
License No. 718393 Type: C-16 Expires: 6/30/2015 12:00:
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
SPRINKS FOR UMEKEN
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 900.00 $900.00
x
OCCUPANCY: Fire Sprink/AIm TOTAL VALUATION: $900.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
9.00 each sprinkler pck 245.00 245.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 57.45 57.45 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $347.80 Balance Due: $0.00 Paid Today: $347.80
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the R..,;NtN. 110893
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 245.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 101.80
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'
•4`PytFOR (/�
v PERMIT/PLAN REVIEW APPLICATION
0 ick j�, 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, Carrier
demolish,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 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 Title
PRINT NAME
I certify that I have read this application an' ate t : the above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply 'th all City ordina es : 1 '':to Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter us on the abo e-menti I ed ro • , for inspection purposes.
4
Signature ••, i �� Date O Z[ , k—
g — -
/
eDevelopment Services Department
240 West Huntington Drive, Post Office Box 60021
7I CA 91066-6021 PERMIT NO. B00-051-538
..,.,.,/ Arcadia,
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
9/23/2015 CM 10:52 9/23/2015 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave #T-32 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
Design Tech PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Design Tech, Inc. 353 S Orange Grove Ave PHONE NO. FAX NO.
Los Angeles,CA 90036 EMAIL ADDRESS:
License No. 909028 Type: B Expires: 1/31/2016 12:00:
TENANT MAILING ADDRESS
Umeken PHONE NO. FAX NO.
DESCRIPTION
DEMOLISH INTERIOR SPACE IN PREPARATION FOR FUTURE TENANT IMPROVEMENT
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 2,000.00 $2,000.00
k-;/44.-- /a-t3/� Xe''"a-'
OCCUPANCY: Tenant Improve TOTAL VALUATION: $2,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 67.37 67.37 01-3103
each Energy p/c fee 22.80 22.80 01-3103
PC Cal Green 6.74 6.74 01-3103
PC ADA 10.11 10.11 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 103.65 103.65 01-3104
Bldg Issue ADA 10.37 10.37 01-3104
SMIP Com 0.56 0.56 14-2207
gm bldg std 1.00 1.00 714-2203
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $274.20 Balance Due: $0.00 Paid Today: $274.20
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Rrcetprtt. 110472
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 107.02
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 158.37
14-
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 7220 0.
714-2203 1.00 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)
Of ARC
° ii' PERMIT/PLAN REVIEW APPLICATION
, 441,j`, 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. C11 have and will maintain a certificate of consent to self-insure for workers'
License Class B License No. i 3. Exp. Date 1/30/j d compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
ignature of Contractor
OWNER-BUILDER DECLARATION El 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, Carrier �o ern IA/SAM 3'ii G?
demolish,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 Policy Number (,u E.eP/6.O Z
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need no be completed' 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'
pen lty 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 �3 f 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 lI D-V /( 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 Q Q £2 V k,1 Title W(/�G�eyAr
PRINT E (J
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 :bove-mentioned property for inspection purposes.
Signature >2/
C c de Date J J