HomeMy WebLinkAboutUntitled -•- Development Services Department
gsliJ 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. -
$QQ-Q52-61$
—- Arcadia,CA 91066-6021
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Tenant Improve
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
1/21/2016 SC 13:52 2/2/2016 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#: HNRY
Los Angeles,CA 90025- EMAIL ADDRESS: Plan Chk#: 16-31
APPLICANT MAILING ADDRESS Plan#: 31839
D.S. Construction S PHONE NO.
C'Hi 1 aDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
' �Oo
D.S. Construction 8521 Roland St F PHONE NO. (714)521-1213 FAX NO.
Buena Park,CA 90621 EMAIL ADDRESS:
License No. 873114 Type: B Expires: 2/29/2016 12:00:
TENANT MAILING ADDRESS
Daiso PHONE NO. FAX NO.
DESCRIPTION
TI-DAISO
st-- - -
Construction Type UOM b of Units Value Construction Type UOM N or Units Value
Value Value 10,000.00 $10,000.00
r<ot/4L- 2—<a-66 Ao4(/".. ... ....- „...,/
OCCUPANCY: Tenant Improve TOTAL VALUATION: $10,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 154.21 154.21 01-3103
PC Cal Green 15.42 15.42 01-3103
PC ADA 23.13 23.13 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 237.25 237.25 01-3104
Bldg Issue ADA 23.73 23.73 01-3104
1.00 each T.I.Fire Pkc 255.00 255.00 01-3109
SMIP Corn 2.80 2.80 14-2207
gm bldg std 1.00 1.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
/4/
2 -y—i6 wpa« ar m Cacva.,.r
Total Fees: $763.14 Balance Due: $0.00 Paid Today: $315.38
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111792
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 305.33
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 2.80
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 6.25
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)
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PERMIT/PLAN REVIEW APPLICATION
e�#*' Development Services Department, 240 West Huntington Drive, Post Office Box 60021
'0m°ally ocw- 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 Licens- . ; I Exp. Date - compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor performance of the work for which this permit is issued.
OWNER-BUILDER 1,' 1 • ' • ' ON ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perju 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 a d polity numbers are•
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 5.4'. • Glom^• �' 5� 1 ,potc,
demolish,or repair any structure,prior to its issuance,also required the applicant 9 ,! `� 1
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number d LI, `f"
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 Pr,,e7&_e:: _i)f-
PRINT NAME
I certify that I have read this application a • 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 ordi c•s and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the ab r e m• io •: I erty for inspection purposes.
Signature Date 01_ —
ti4 OAF X99 r
•
ll.ry.t 5,1903
oo�4`y MEMORANDUM
Fire Department
DATE: February 11, 2016
TO: BUILDING DEPARTMENT
INSPECTOR Chris Ingram
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 400 S. Baldwin Avenue #2145 (Daiso)
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS
FIRE ALARMS
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 2-8-2016 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 2-9-2016 RC