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„e4' Development Services Department 240 West Huntington Drive, Post Office Box 60021 Arcadia,CA 91066-6021 PERMIT NO. $QQ_QSQ_S$( 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 6/18/2015 CM 10:05 1/19/2016 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#: 15-396 APPLICANT MAILING ADDRESS Plan#: 31826 Eco Stone Construction Inc PHONE NO. EMAIL ADDRESS: f CONTRACTORIPROFESSIONAL MAILING ADDRESS Eco Stone Construction Inc 7933 Kenyon Ave PHONE NO. (310)714-0722 FAX NO. Los Angeles,CA 90045 EMAIL ADDRESS: License No. 1005272 Type: B Expires: 7/31/2017 12:00: TENANT MAILING ADDRESS Amc Theater �I NO. FAX NO. 5 0'MEW L DESCRIPTION ADDITION OF BAR IN LOBBY AT AMC THEATER Construction Type UOM N of Units Value Construction Type UOM #of Units Value Value Value 150,000.00 $150,000.00 OCCUPANCY: Tenant Improve TOTAL VALUATION: $150,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 1,019.85 1,019.85 01-3103 PC Cal Green 101.99 101.99 01-3103 PC ADA 152.98 152.98 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 1,569.00 1,569.00 01-3104 Bldg Issue ADA 156.90 156.90 01-3104 1.00 each T.I.Fire Pkc 245.00 245.00 01-3109 SMIP Coin 42.00 42.00 14-2207 gm bldg std 6.00 6.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $3,344.32 Balance Due: $0.00 Paid Today: $2,069.50 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111643 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 1,770.25 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 14-2207 42.00 Arcadia building inspector for a period of 180 consecutive days. 714-2203 6.00 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) Of ARC A r . 4;�0.00kN,q'9 V PERMIT/PLAN REVIEW APPLICATION iv legal riii o4 Development Services Department, 240 West Huntington Drive, Post Office Box 60021 44u111,Y aLN Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION tI/ I hereby affirm under penalty of perjury that I am licensed under provision of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Busines and Professions Code my license is in full for e and effect. -7 2A, , ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class Lic se No. SIT Date !J° compensation, as provided for by Section 3700 of the Labor Code, for the �,j' � performance of the work for which this permit is issued. Signature of C for OWNER-B LD R DECLARATION have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affi 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 work s omen a insurance c ier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier QJ� demolish,or repair any structure,prior to its issuance,also required the applicant � -O�-�/r,C] `-C� for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number f��C/ provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be complete 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 � 64—, sale(Section 7044,Business and Professions Code:The Contractors License Date ` I I I�rrP Signature r 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(I)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. Na ��r vl An-, 3c9`G�(Yva✓� Title £'t'ti 'N' t RINT NAME I edify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. 'gnature - O'er T Date 1 / I 4 1 (X or ?3c5-zS- 65-0---S NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. -, 2!-1 G , I Ess F 2 !� 100. Setbacks 210. Under flr./bldg.drain 2-Z 101. Rough grade 211. Copper underslab 419 V 7.Pr?I fetiG. 102. Figs.&forms 212. Rough plumbing 2-Z^l6 P'P- 103. Pre-slab 213. Rough gas � ^ n 104. Floor joists 214. Shower pan `l-2'S--iG �"<�la'�- 41)e valo 105. Steel 215. Water heater /1,OQ1146. 2r 106. Grout lift 216. Roof drains F-77 107. Shear nailing 217. Building sewer e/i' - 0��'P t� EN4- 108. Diaph nailing 218. Water service ,�Peiu V L pa CGC v/y 109. Roof nailing 219. Final gas 110. Framing 220. Fixtures A�� 111. 0cc./Area Sept.Wall 221. Final plumbing 112. Sound walls 222. Sewer cap/demo. 113. T-bar.rid 114. Insulation-Flr. Pool Inspections Date Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. 241. Rough plumbing 117. Drywall nailing 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish grade ' 5. Gas line&test _ 121. Final building 3 i3--2-/6 246. 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 Reroof Inspections Date Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical 272. Sheathing nailing 157. Fixtures 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 2-25-I` /1-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 I 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 , - 111 i,Y Development Services Department 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. ..i Arcadia, CA 91066-6021 BOO-052-337 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 12/14/2015 CM 12:13 1/11/2016 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. Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Patrick Shanley Electric PHONE NO. IL ADDRESS: CONTRACTOR/PROFESSIONAL ' MAILING ADDRESS r CC IRE Patrick Shanley Electric 15611 Prairie A1� ONE NO. (310)427-5018 FAX NO. Lawndale, CA 90260 EMAIL ADDRESS: License No. 932148 Type: C-10 Expires: 5/31/2017 12:00: TENANT MAILING ADDRESS A M C PHONE NO. FAX NO. • , DESCRIPTION INSTALL SODA MACHINES AMC THEATER,ADD TWO SUBPANELS Construction Type UOM S of Units Value Construction Type UOM S of Units Value ;.4(/1c 3 -2-- /6 ze.... OCCUPANCY: OTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 100 Flat Elec Issue Auto 44.35 44.35 01-3105 2.00 each Distrib panel 31.10 31.10 01-3105 2 00 each Outlets 3.08 3.08 01-3105 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $79.53 Balance Due: $0.00 Paid Today: $31.10 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111557 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 31.10 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 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) 1 of ARC l C,0..1F ORA, ∎,0104‘7:1 c.,s1 REVIEW APPLICATION ail t.- o o, 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 ICENSED CONTRACTOR'S DECLARATION WORKERS' II MPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under p •.lty of perjury one of the followin_••-- 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 c- ficate of conse o self-insure for workers' License Class C () License No. ' Exp. Date compensation, as provided for by ection 37:1 of the Labor Code, for the / performance of the work for which thi 'er• it is issued. Signature of Contractor OWNER-BUILDS CLARATION ❑ I have and will maintain workers'co sensation surance,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 p formance oft work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance ca rand 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 ne : not be completed if the permit is for one h114,ed 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 certi 1 at 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. f / h amen �✓/°f L , .f L,J Title / //--- / PRINT NAME - certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. Si nature )7,,,,,--""-----..---------- Date 1—// /D Yew° `� Development Services Department ' 240 West Huntington Drive, Post Office Box 60021 Arcadia, CA 91066 6021 PERMIT NO BOO-052 478 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 1/6/2016 CM 10:01 1/11/2016 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. Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Platinum Plumbing Ca J��'I`'^',''1I}II �I PHONE NO. CONTRACTOR/PROFESSIONAL ' MAILING ADDRE3S•� lJ v uu"REE5 EMAIL ADDRESS: Platinum Plumbing Ca 31570 Railroad Canyon Road#205 PHONE NO. (951)244-0622 FAX NO. Sun City, CA 92587 EMAIL ADDRESS: License No. 458885 Type: C-16,C-36 Expires: 6/30/2016 12:00: TENANT MAILING ADDRESS . A M C PHONE NO. FAX NO. PA/DESCRIPTION )n A '� i j/�CONNECT NEW FREESTANDING SODA STATION TO EXISTING LINE 'V'1.[_ lb` Construction Type UOM #of Units Value Construction Type UOM #of Units Value 3-Z-46 ,e L /--ei-----'7 OCCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY EOM DESC AMT AMT PAID ACCT 1.00 Flat Plmbg Issue A 44.35 44.35 01-3105 1. ! 12.46 .05 01-3105 .0 e .00 each Baekflow<2" 171.05 171.05 01-3105 . . 1.00 I 00 88-3027 Total Fees: $228.86 Balance Due: $0.00 Paid Today: $171.05 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Kecetpt P: III sus 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 171.05 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 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) .. � ,of FO ARC 44, U u it PERMIT/PLAN REVIEW APPLICATION Jo*, 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 1:1 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 El I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date 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. r• me its Al V Title Iraq PRINT NAME certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Acadia to enter upon t above-mentioned property for inspection purposes. 1 /� Sign re SPial4 Date Development Services Department 5 240 West Huntington Drive,Post Office Box 60021 ' " Arcadia, CA 91066-6021 PERMIT NO. B00-052-634 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 1/27/2016 CM 10:42 1/27/2016 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. Los Angeles,CA 90025- EMAIL ADDRESS: ist-e-Akil-4-y- APPLICANT MAILING ADDRESS Platinum Plumbing r���� n �5?f�D PHONE NO. �IUII n n{ll� !u'? lJti'JUU EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS Platinum Plumbing Ca 31570 Railroad Canyon Road#205 PHONE NO. (951)244-0622 FAX NO. Sun City,CA 92587 EMAIL ADDRESS: License No. 458885 Type: C-16,C-36 Expires: 6/30/2016 12:00: TENANT MAILING ADDRESS Amc PHONE NO. FAX NO. , DESCRIPTION PLUMBING FOR TI-AMC Construction Type UOM ti of Units Value Construction Type UOM #of Units Value 2-/c � ,- r.1/4 L 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 1,00 each Lavatories 12.46 12.46 01-3105 1.00 each Kitchen sinks 12.46 12.46 01-3105 2.00 each Floor sink 24.92 24.92 01-3105 I 00 each Grease trap 12.46 12.46 01-3105 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $107.65 Balance Due: $0.00 Paid Today: $107.65 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111738 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 106.65 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) ./ G�,ov Lir'ogp�'9�! ' PERMIT/PLAN REVIEW APPLICATION 04 memo 44p, 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. have and will maintain a certificate of consent to self-insure for workers' License Class L I C " 'cense Nyi15L Exp. Date I ■ 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 i LARATION ❑ 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. y wor ers'co ens lion insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter, improve, Carrier ?UbV1 ,r t _Nr) 15 demolish,or repair any structure,prior to its issuance,also required the applicant ,t (�r����G� for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number l`W W 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 'M► in,�'� I 1 Title �� �7' _ PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date ( / 7 / %FA . GFy1FOR%i 0 ‘1 WIIIII, li it 4 2.-4':%t- ..s.vos O 4,yaityoOS MEMORANDUM Fire Department DATE: February 29, 2016 TO: BUILDING DEPARTMENT INSPECTOR Chris Ingram FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Avenue, S004 (AMC) THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: DATE / INITIAL TYPE OF INSPECTION FINAL INSPECTION FIRE SPRINKLERS FIRE ALARMS TANKS HOOD & DUCT KNOX BOX OCCUPANCY 2-25-2016 Jill Perumean COMMENTS: Emailed Bldg. Dept. 2-26-2016 RC GP-I .• i .,_ ,Z. E qc11" it, ' A 3 m O ® A ♦ I ° 71:ii ct / , 3'-3' , a �..... 41 .i. 1 tiO3 / / 4-0' / fi ¢ I (3.1 , I PROPOSED FLOOR FINISH PLAN N Y CHANGES TO APPROVER PLAN 1 BALD N PARK PLAN,criEc PROGRAM NfitiS1°DE BROUGHT TO YOUR PLAN 5050 comet RCE DRIVE CHECKERS �_.._... ..__ BAi�wrrr PARK, G€HERS ATTENTION (624)430- CA 91706 5560 • �.� ..._ ■ 1 ANAL INC ECTION final Ins k x Ifi rc4u eri p for to beginning antl aGDroV11 ': � " 'e �,_......„ the On e8mnin l'ig �� 1 , - TnfrequlreaA7gEne THREE 7"$?�: I WORKING OAYg _N�R�EE '" ... final ins FF10R notice to array f Aectlon: (pt '' ff=w ':.�R.di=L 6.P.. ham i L F:FO:` F tihF'"$G 3.--�,, I q . g'x;� Sl-ut 4-ri 00444 STARTdle'G CON'ST »tt A Building Permit RUC? �• �,,� Your Must Be Obtaine f©N,,.. Buildin d FroLnpiAlvC�atZNS � 'd r 3 BAndSafctyDepartm�nt. _� IbV lq)t� -.. _..__ t , 1 j 1 EQUIPMENT SCHEDULE 1 TAG$ CITY DESCRIPTION MODEL* _._L EQ-I /3\G) 2-DOOR BEVERAGE R�RIGERATOR BEVERAGE-AIR 48848 GY ,F EQ-3 I WALL M011NrED TV i �- Z 1 , EQ-4 I 4'-0"PAS.TABLE __ i 2 PAS.EQUIPMENT BY OWNER I EQ 6 I DUMP SINK/HAND SINK !m " -- __0 _._. �n -� I 'REAR WALL 16'-0'(8'-0"TALL) 3 B1 LOAD KINb _°_.t. EQ-b I LEFT SIDE WALL 5'-4"(8b"TALL) BY LOAD KING EQ'q LEFT SIDE LOW WALL 6'-'1"(9'-6"TALL) BY LOAD KING �. '` EQ-10 I RIGHT SIDE WALL 3'-4'(8b"TALL) BY LOAD KING i j EQ-II I RIGHT SIDE KNEE WALL 5'-1"(:Y-6•TALL) RY I non ethic :' Jan 1416 02:29p Glendora Plumbing 1.626.335-0575 p.7 f��►�_r.> BACKFLOW PREVENTER TEST REPORT ?,► �►,� City of Arcadia rt• 1 r-, �`�� P. 0. Box 60021 Arcadia, CA 9'1066402i I Assembly 1D Fealty Name G /1 A a f44 Meter `Test Report:::re: Acct Number i 1 Service Address . . ` l, /4 •d� ' Schedule Co:ii: ?'d. /A, . 9/ 4 0'7 Assembly inf:: (Replacernent/Corr ecttiion) Assy Location . 4 ,4&4 D�,4mt /t?Doo» SN t:1. i ?IWO ,mil A" di CI I. J , Tap Number I Containment loll Mfr �. < '� Contact Name • I Ph ,� Map Page � �� i' ..2--Model i` 97gICL 2'- Install Date Assy I D I I I Facility I He!. Level 1 • Line pressure at time of test REPORT OF TEST RESULT! ❑Approved BPP I Check Valve#1 , Check Valve#2 Relief Valve PVBJSVI 1 Shut Off Valves ! Held at ® O at ❑ Air inlet Opt•ad at 1#1 . #2 initial /0 . 0 PSID ❑ PSID G - 't KID -'SID l Test Closed Ti ht ❑ Did not Ope t Closed TigM I❑ ❑ Closed Tight Tight ID Check Held _': Leaked 0 ❑ an ❑ Leaked Leaked 0 Did Not Open PSID Fail I Leaked ❑ CLEANED D CLEANED ❑ C LEANED D CLEANED REDREPLACED EPLACED RtPiACEO REPLACED D Disc Disc ❑ Air inlet Die REPAIR CO ❑ R ❑ Disc I E ❑ Spring ❑ Spring ❑ Spring AM Inlet Sp rig I ❑ Diaphragm Check Disc i ii P 0 Guide 0 Sea e ❑ Seat heck Spri .1 A I ❑ Hinge pin ❑ Hinge Pin 'L7 0-Ring(s) G Float • 1 ' ❑ Module ❑ Module ❑ Module ❑ Diaphragm I Rubber Kn 0 Rubber Kit R [�j Rubber Kit Rubber Kit 0 ❑ 1 Other ❑ OthedNotes: PSID Opened at Air inlet .PSID I Final — Closed Tight i❑ .0---psro _ [0 � Pass ❑ Test ❑ Closed Tight ❑ Closed Tight _ PSID CK Valve -PSID to THE ABOVE REPORT IS CERTIFIED TO BE TRUE: N�aY Phone initial • - Certificate• ° : �PtInt�:�i3a b nee u Repair By i I I6)_Final Tsst 4y i Jan 14 16 02:27p Glendora Plumbing 1-626-335-0575 p.2 i�j Zy► SACKFLOW PREVENTER TEST RE FORT $'i "�'1 City of Arcadia •MCI N?!! ki L.-- P. 0. Box 60021 Arcadia, CA 9'1 .066-6021 !i% Assembly ID I Facility Name 1 ,4 in e Atc, ,4 "kit) Acct Number Meter A I Test Report LI,Je: Service Address yea c. 1)4/..14.4/,'„) /4'i, Schedule Co: :. l o 7 Assembly Int• (Replacement/Correction) May Location i 7 Riii, 1 . p , oo m SN ► ;f :_4f ‘. . i.- Cfc. Tap Number Co , ment O ;;MY ' r1._..: Contact Name I Ph Type :' 1 Map Page #2 Size •I i 1, z r Model .4 Mr 4, . 'Install Date i • AssylD j 1 Facility I Level I Line pressure at time of test REPORT OF TEST RESULTi> 0 Aawo1ed ei r Check Valve#1 I Check Valve#2 Relief Valve PVBISVII! Shut Off Valves O ned at ❑ Air Inlet Opt: ad at #4 #2 initialdj j ❑ Held at P� r a PSID 'SID � PSID I Did notOpe. Test , .c7, Closed Tight I A Closed Tight ❑ Closed Tight ❑ ❑ !fit ❑ Check Held ❑ Pass 1 ❑ Leaked ❑ Leaked ❑ Did Not Open PSID t � El . Fall 1 ❑ Leaked CLEANED ❑ CLEANED ❑ CLEANED 0 CLEANED CLEANED NEDV ❑ ❑ REPLACED REPLACED , REPLACED REPLACED ;� i Disc ❑ Air Inlet DIE.: ! REPAIR ❑ ❑ R i�.l DisC 0 ' C AM Inlet Sp .ng , E 1 ❑ spa ❑ Sing C❑ Spring 0 Check DSc P Guide ❑ Guide [] Diaphragm ❑ Seat C] Seat ❑ Seat C] Check Spr g A U'Hinge Pin ❑ Hinge Pin ` Module a0-Ring(8)$) ❑ Float¢hrastt� i ❑ Module ❑ Module ip Rubber Kit 9 Rubber Kit R ! Rubber Kit �t Rubber Kit L. l r"�' ' ❑ ❑ �� Other �t__: {❑ OihetrlNotes. _ -•.. ❑ i Air Inlet _PSID Closed Tight i 0 ❑ Final PSID ?siD opened at ��--tt f Test Closed Tight ❑ Closed Tight 4 PSID i CK Valve PSID Pass 0 ❑ I ?A { THE ABOVE REPORT IS CERTIFIED TO BE TRUE: - .;.omDany • Phone Initial ‘ ' Certificate M t7 p/7�� - ip. . i air By (626) 3 5-0574 Final Test ay 1 Jan 1416 02:27p Glendora Plumbing 1-626-335-0575 p.3 c.a). BACKFLOW PREVENTER TEST RE P ORT r'i`' �'''M City of Arcadia • y CA 9'I 066-6021 P. O. Box 60021 Arcadia, y Assembly ID I Facility Name l /9 C. iliPL'r/'Iy:. � ,• ' Acct Number meter Test Report P.m: Service Address lb0 - ` % ,q �r'4 /0 _- Schedule Co' I D JcA . /1 �O Assembly Int: (Replacement/Conection) Assy Location f peil Qf#fx G (/¢ •P t /`,o m SN Ili , / i/714v Tap Number Comment . Mfr Contact Name F-7-1 :1111Viffill Map Page #2 Size Model �; ! ,:. i ' Install Date i Assy I D I i-- j I Facility 1 I He° Level l Line pressure at time of tsat: REPORT OF TEST RESUL1 li 0 Apps eFP Check Valve#1 Check Valve#2 Relief Valve PVBISVi Shut Off Valves — [% 0 at ❑ Air Inlet Opt•ad at #1 #2 Iriftta! � Held at 0 Held at •4, to _PSID PSID PSID no Did not Opeil Test Closed Tight 54 Closed Tight Closed Tight ❑ ❑ ❑ Check Held-.. 1 Leaked ❑ ❑ pas 0 Leaked ❑ Leaked CJ Did Not Open PSID Fail ❑ Leaked • _ 0 CLEANED ❑ CLEANED ❑ CLEANED ❑ CLEANED CLEANED ❑ C. REPLACED REPLACED REPLACED REPLACED REPLACED ❑ ❑ Disc 0 Air Inlet Dia ' REPAIR ❑ ❑ R Li Disc ❑ �� Aid inlet Sr n9 ! .-� ,❑ Spring ❑ E �, Guide ❑ spring j❑ Diaphragm ❑ Check Disc P ❑ Sde D Seat e ❑ Seat ❑ Check Sprii i A � ❑.Hinge Pin ❑ Hinge Pin 0-Ring(s) ❑ Float I ❑ Module a Module Module ❑ Diaphragm • Rubber Kit ❑ Rubber K,t ❑ Rubber Kit Otter I❑ R Rubber Kit i 0 C ❑ ❑ I Other/Notes: • • ' Inlet ._PSID I Closed Tight ❑ ❑ Final psiD ■ PSID! ❑ Opened at I Air i ❑ Closed Tight I, PSID I CK Valve PSID 1 Pass ❑ 1 Test ❑ closed rent , 1A THE ABOVE REPORT IS CERTIFIED TO BE TRUE: i _omp�v y, o L. Je ab flea al L—. Gtendo _ T. .. Repair By .. (626 ; -. Final Teat By I i Jan 1416 02:27p Glendora Plumbing 1-626-335-0575 p.4 our trr. BACKFLOW PREVENTER TEST RE F1 ORT - i, k4 as. �" 1� 4 •:>,� City of Arcadia � �`% P. 0. Box 60021 Arcadia, CA 9'1066-6021 ID I Fadlity Name � C te , ' Acct Number i Meter Test Report I':•Je: Service Address 40 a J., gfi W;t4 4riii Schedule Co:d ft J /OD 7 Assembly Int:: (RepiacernenttCorrection) As i.ocation /eb¢R ® 4rP4 i ifdo.h SN .',C' 7f,i-}wo la A `.. gY 44 Tap Number I Containment Mfr ,� r kris' °• Ph Type i. Contact Name �� Size I. Map Page #2 Model I; Install Date Assy I D 1 I Facility He :.Level Una pressure at time of test: REPORT OF TEST RESULT it ❑Approved BFP Check Valve#1 Check Valve#2 Relief Valve PVWISVI:. Shut Off Valves Held at :far at ❑ Air Inlet OpE'' d at #1 Initial Held Id I�t PSID , ❑ PSID PSID 'SID Test ,1 nosed Tight j Closed Tight ❑ Did not Ope! o [i Closed Tight ❑ Leaked 0 Leaked ❑ Did Not Open ,❑ Check Held '•PSID Leaked Li ❑I Fall ❑ Leaked R CLEANED ❑C REPLACED REPLACED ❑REPLACED CLEANED REPLACED ❑ ❑ REPLACED R REPAIR ❑ ❑0 Swing R ❑ Disc ❑ Disc ❑ Disc ❑ Air Inlet Die Spring ❑ MI Inlet Sr tg E ! El Guide ❑ Guide ❑ Diaphragm ❑ Check Disc. P ❑ Seat ❑ Seat ❑ Seat ❑ Check Sprir li s Float A ❑ Hinge Pin 0 Hinge Pin Module Diaph Module ❑ Module [ , R ' ❑ Rubber Kit ❑ Rubber Kit R Rubber Kit •pi Rubber Kit .0 4 Other i❑ lOther/Notes: PSID�i 0 Opened at t Air Inlet .._.PSID Closed Tight l o ❑ Final PSID 1 Closed PSID Pass ❑ Test ❑ Closed Tight , [ii � PSID CK valve _ THE ABOVE REPORT IS CERTIFIED TO BE TRUE: 1A • Phone Ce# De i Company 42454,4,„_,=___ZZAY i 14 ■Print{Jam$ bi menu Repa r By 1 _ :Y . Final Test By I Jan 141602:27p Glendora Plumbing 1-626435-0575 p.5 .� ,,r BACKFLOW PREVENTER TEST RE PORT 4� "'��'=, City of Arcadia /F7 ,= r~ ,% P. 0. Box 60021 Arcadia, CA 9'1066-6021 Assembly ID 1 Facility Name j /90 4 •04414'?� – �},-� Acct Number Meter 1 Test Report f,me I /U� Service Address OF P .0 /pi.� Schedule Co. L•�-4c ,.?.' R� 14144 '7 Assembly Int- (ReplacernenUCorrection) Assy Location '44 df.7'�/a91f1 00h9 SN .1i? /711 �o/� ''�O''`['� // ' o iTAn, Tap Number Containment Mir , /CrdS Contact Name ` 4 Ph Type DI: iria t► Map Page I size i` TX2;*--- #2( Model )!.( � Install Date IAssyI0 f ( I Facility ( (Hs:.Level ( Line pressure at time of test REPORT OF TEST RESULTS ❑Appro1id ems' Check Valve#1 Check Valve#2 Relief Valve PVBISVIll I Shut Off Valves Air Inlet Ope' sd at #1 #2 /Pr HIV at 0 Held at ® p r 0 at PSID ❑ 'S►D � r d PSID PSID Test ® ❑ Did not Cops Closed Tight ❑ ❑ Closed Tight F1 Closed Csed Tight :❑ Check Held � ❑ ❑ (lb� 1 ❑ �d ❑ Leaked ❑ Did Not Open PSfD Leaked Fail (❑ Leaked - .–� 0 CLEANED ❑ CLEANED ❑ CLEANED 0 CLEANED CLEANED r ❑ REPLACED REPLACED REPLACED REPLACED REPLACED ❑ ❑ R ( ❑ Disc ❑ Disc ' ❑ Disc r Air Inlet Diu I REPAIR ❑ ❑ E I ❑ swine ❑ saving ❑ SWIM 0 Aid Inlet Sc g .ray ❑ Guide ❑ Guide ❑ Diaphragm LI Check Disc P Seat ❑ Seat [J Check Spr A A ❑ Seat ❑ B Float ❑.Hinge Pin ❑ Hinge P►n • ❑ aRing(a) i Diaphragm ; I 1 ❑ Module R ❑ Rubber Ku , D Rubber b Kit L,; Module bber Kit CI Rubber KM j Other I 0 `❑ Other/Notes: .. —r Final —oSIO _ PSID 1 ❑ Opened at Air Inlet PSID 1 Gored Tight ❑ ❑ Test I d T' ht ❑ Closed Tight I PSID (CK Valve PSID I Pass ❑ ❑ Close fig 1A THE ABOVE REPORT IS CERTIFIED TO DE TRUE: - IT t • r Certificate q / Yn :. omPanY Phone D 0f f . �, ��b�ne�u _ ..�' � Repair By — (82A Foul Test By Jan 1416 02:28p Glendora Plumbing 1-626-335-0575 p.6 ,44rro. BACKFLOW PREVENTER TEST RE PORT • .4*.�e.'AsZi.k;/ City of Arcadia `, ' P. 0. Box 6002 Arcadia, CA 9'I 066-6021 Assembly ID Facility Name e ,i,p ' ,f Acct Number ( Meter I I Test Report Due: Service Address ,(0 p 5, Ø1/d1.ii"-" 4'JL Schedule Co.1,:___E EAQ�i%9 9(Qo jMThbP1fl1: (R epiacernent1Coirection) Assy Location . R 0, C S-6e.6Iq i e 0.n iP_yi 7/b l 4 ov+•J�o1��" 'L Iii / Tap Number Contaiinment s Ph Type ii KP _ Contact Name i I Map Page 1 le l Sze I' 74. Model — i1,l /7X(.Z Install Date . i i AssylD I• I FacNity j I He:! Level Line pressure at time of test REPORT OF TEST RESULT :i. ❑Approved BFP Check Valve#1 rCheck Valve#2 Relief Valve I PVBISVI Shut Off Valves ,� Air Inlet Olx'3d at #1 #12 initial Held at PSID ❑ Held at PSID laid PSID 1 ❑ 3SI0 Test 5-4/ 0 Did not Opp t Closed Tight ❑ ❑ Gored Tight Closed Tight ❑ Check Held _: (� Leaked ❑ Leaked ❑ Did Not Open PSID Leaked 7; ❑ Fall 0 Leaked 0 CLEANED ❑ CLEANED ❑ CLEANED `❑ CLEANED CLEANED [ ❑ REPLACED REPLACED REPLACED REPLACED REPLACED ❑ ❑ R Li Disc 0 Disc ❑0 Disc�t9 ❑ Air Inlet Ds: REPAIR ❑ [i E ❑ Spdng ❑ Ong Aid inlet Sp rill ❑ Guide ❑ Diaphragm Check Disc P ' � Guide � ❑ Seat ; ❑ Seat ❑ Seat Check Spd 1 A ❑ HInge Pin ❑ Binge Pin 3 O-Ring(s) Float i O Module ❑ Module ❑ Module ❑ Diaphragm R Rubber to ❑ Rubber Kit ❑ Rubber Kit [3 Rubber Kit i Other ❑ L 0 ______---- i 0 otherfNotes: - _ Final Palo P810 I ❑ Opened at Air inlet , -,PSID I Closed Tight 1❑ ❑ Test PSID CK Valve PSiD r Pass ❑ 0 Tight I 0 Tight i IA THE ABOVE REPORT IS CERTIFIED TO BE TRUE i`` ^.omoany Phone el t , cetMlicete>Y f :� tNJ. dabineau -!D o�._- �� /(o i Glendora lumbing Repair By ! ■—7-----(626- - ---010, - `� Final Test By I 7, -- ---e - ,,, --!L— "::' ,..1_, ',1,..■., s °.' ;1 '10 1''t%,,,,,:.,i' - `•= c .,:''' '''.:.t.),`:--,-,: City ity of krcadia October 28, 2015 Ms. April Liang )evelopment ABC Beverage Control )ervices 222 East Huntington Drive, Suite 114 )cpartment Monrovia, CA 91016 Dear Ms. Liang: bon Kruckeberg The City has received a request from AMC Theatres Santa Anita 16 to 6sistant City Manager' construct a small bar area (approximately 400 square feet) within the 'eve/op/nen t Services lobby of the theatre area. This theatre is located within the Westfield hrector Santa Anita Mall at 400 South Baldwin Avenue in Arcadia. The intent of this request is to sell alcohol to patrons at the bar area, and allow patrons to consume alcohol elsewhere on the premises. This change to the existing use is being proposed along with changes to the food offerings provided at the location. As such, this proposed use is compliant with the resolution governing land use at Westfield Santa Anita Mall (Resolution No. 6199) and a Conditional Use Permit is not required for this use. Thank you very much for your time on this. Sincerely, ..... -----; Jason Kr/ckeberg Assistant City Manager/Development Services Director 164 40 Wo,t Hutrongton Dm e 'om Office Bo',.(0021 \i,actla,(,A 91066-6021 626i 57-1-541:i 626) .117-3309 l'a\ t it Nt AI Cat lia(:k.g(vs Don Stockham From: johngraf88 <johngraf88 @yahoo.com> Sent: Wednesday, March 02, 2016 11:56 AM To: Don Stockham Subject: Fwd: RE: Amc of Santa Anita Sent from my Verizon Wireless 4G LTE smartphone Original message From: Marco Espinoza<mespinoza@ph.lacounty.gov> Date: 03/02/2016 11:06 AM (GMT-08:00) To:johngraf88 <iohngraf88@,yahoo.com> Subject: RE: Amc of Santa Anita The food facility is health department approved pending Building&Safety final approval to issue the public health permit. Please submit business license,tax id, article of corporation and seller permit to process the public health permit. Please feel free to contact me if you have any question. Marco A. Espinoza, R.E.H.S Environmental Health Specialist IV Bureau of District Surveillance and Enforcement Baldwin Park—Headquater-Plan Check Office 5050 Commerce Dr., Baldwin Park, CA 917906 Tel: (626) 430-5561 Fax: (626) 813-1444 mespinoza@,ph.lacounty.gov From:johngraf88 [mailto:iohngraf88 @vahoo.com] Sent:Wednesday, March 02, 2016 10:31 AM To: Marco Espinoza<mespinoza @ph.lacounty.gov> Subject:Amc of Santa Anita