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�� Development Services Department
1 240 W at Hirkington Drive,Post Office Box 600 1 PERMIT NO. B00-057-065
.....,./ Arcadia,.CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 • e Tenant Improvew/ener
Arcadia Permit Type:' g;
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
6/7/2017 CM 1328 1/10/2018 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. 1 1601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: HENRY
Los Angeles,CA 90025- EMAIL ADDRESS: Plan Chk#: 17-178
APPLICANT MAILING ADDRESS Plan#: 32424
Timberwolff Construction PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Timberwolff Construction 1659 W Arrow Route PHONE No. (909)945-0380 FAX NO.
Upland,CA 91786 EMAIL ADDRESS:
License No. 740882 Type: B Expires: 9/30/2019 12:00:
TENANT MAILING ADDRESS
Lids PHONE NO. FAX NO.
,
DESCRIPTION
T.I FOR LIDS.ELECTRICAL/MECHANICAL INCLUDED
Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value
Value Value 113,000.00 $113,000.00
F,A//QC_ Z-ZI-G8 P .
OCCUPANCY: Tenant Improve TOTAL VALUATION: $113,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC ANIT AMT PAID ACCT
each Plan review 853.91 853.91 01-3103 1.00 Flat SWMF Auto 6.25 6.25 88-3027
each Energy p/c fee 262.74 262.74 01-3103 1.00 Flat SWMF 2 1.00 1.00 88-3027
PC ADA 128.09 128.09 01-3103 1.00 Flat SWMF 2 1.00 1.00 88-3027
PC Cal Green 85.39 85.39 01-3103 •
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 1,313.70 1,313.70 01-3104
Bldg Issue ADA 131.37 131.37 01-3104
1.00 flat Elec issue 44.35 44.35 01-3105 1.00 Flat Meclt issue 44.35 44.35 01-3105 COPLE1'E
_
1.00 each Comp 3-I5hp 34.29 34.29 01-3105
1.00 each Air unt 10m cfm 14.11 14.11 01-3105
20.00. each Outlets 30.80 30.80 01-3105
10.00 each Ltg fixtures 15.40 15.40 01-3105
3.00 Flat Add/AlterDucts 28.14 28.14 01-3105
1.00 each T.I.Fire Pkc 280.00 280.00 01-3109
SMIP Com 31.64 31.64 14-2207
gm bldg std 5.00 5.00 714-2203
Total Fees: $3,355.88 Balance Due: $0.00 Paid Today: $1,745.75
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt P: 119009
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 1,489.42
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 211.44
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 31.64
Arcadia building inspector for a period of 180 consecutive days. 714-2203 5.00
88-3027 8.25
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)
A Oytpo G'•
I! PERMIT/PLAN REVIEW APPLICATION
E 2,, •
Development Services Department,240 West Huntington Drive,Post Office Box 60021
o�ma0 ty o[N'�` Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,an my license is in full f.r id effect. 0 I have and will maintain a certificate of consent to self-insure for workers'
L p
License Class
Signature of Contractor� C�v License N•, Exp. Date elt)?1I compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier Li D 17 ill V 7.vA-i^
demolish,or repair any structure,prior to its issuance,also required the applicant w7 /5-19 _Z
` V e G 0•- —0)
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number Co
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 t - 1r Code,I shall
❑I, as owner of the roe forthwith comply with those provisions.
property,rty, or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for r /0--(9"sale(Section 7044,Business and Professions Code:The Contractors License Date Signature r f
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of `and shall subject an employer to criminal penalties and civil fines up to one.
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as.provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
0 I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures. •
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
fslfurther information.
ame ( i lL (1e'0(ZIC (Cilli/l itle �j�74)L/l jrr�pr02v�
PRINT NAME
I certify that I have read this application and state that the above information is co ect and that I am the owner or duly authorized agent of the owner.
I agree to comply with all City 1 . 1 c ces and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the a),. • •ntioned property for inspection purposes.
Signature :/ tate ! —/ 0—l,
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp.
100. Setbacks 210. Under fir/bldg.drain //VAC 101. Rough grade 211. Copper underslab /f Y C ��G ���
102. Figs.&forms 212. Rough plumbing
103. Pre-slab Z-(-6$I4 ! 213. Rough gas
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 (-3C.5-4,8 rie 220. Fixtures
111. 0cc./Area Sept.Wall 221. Final plumbing
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid
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 245. Gas line&test
121. Final building 2-2/46 ;11246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date _ Insp. 249. Final•lumbin•
150. Power pole 250. Pool cover
151. Sales lot lighting 51. Pool final
152. Underground conduit (-3/-l�
153. Underslab conduit Reroof InspectionsDate Insp. -
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical f 5-( t;--^ ✓272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E•it.bondin• Sign Inspections I Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric %,-74-4156r70/281. Footing
282. Conduit/wirin.
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC u - . eo s In p I 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 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess•ool filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
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146;.:43('':"!. ARCAD/A 'lik J:
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„A—gCert ? [i\X"
ificate of Occupancy
; I City of Arcadia
I$0,;
Q Development Services Department - Building Division
Di;,&-:
This certificate issued pursuant to the requirements of Section 109 of the Yt
UniformBuildingCode certi 5110,11
°® Eying that at the time of issuance this structure was in
compliance with the various ordinances of the City regulating building construction or use.
011
Permit No. BOO-057-065 I
r Building Address: 0.„1,\
400 S Baldwin Ave,Arcadia,CA 91007
Use Classification: �x?,,
Tenant Improve Effective UBC: 2016 C.B.C.
Permit T
�`j, Type: Tenant Improve w/energy Zone Code: C2-DH8
fi � Occupancy Code: M 6519;15i_
Type ofConstruction: TYPE II 1 HR SPRINKLER rs-FinalDate: 2/21/2018
Owner:
f
`�F I Westfield Corporation, Inc. •
�� Tenant: r,.
® Lids
(. ..4......._,...
i'Attc4r 4
Don Stockham,Building Official �
11WI
el.4 e—P'‘t
POST IN A CONSPICUOUS PLACEgatl—4'
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krit
'"f`- TB/MEM/OUT CONSTRUCTION, INC.
��
ts59w.ArrowRte. A GRAY COMPANY
Upland.CA 91786
909-949-0380.FAX 909-949-8500
License:CA 740882
Wednesday, December 20, 2017
TO WHOM IT MAY CONCERN:
I, Moni e Iolff, Chief Financial Officer for Timberwolff Construction, Inc., hereby authorize
PPA L 5oN Mite//& -0 to obtain permits and other legal documents for the
project referenced below.
Project Name: L 10' A'--Cly
Location: V0 s f '41---P '?
If you need any further information, please contact me at 909.949.0380 x 106
Thank you,
I
Mo 'sue Wolff
ief Financial Officer
A Notary public or other officer completing this certificate verifies only the identity if the individual who signed the document to which this
certificate is attached,and not the truthfulness,accuracy,or validity of that document.
State of California
County of San Bernardino
Subscribed and sworn to(or affirmed)before me on this 20th day of December,2017 by Monique
Wolff, proved to me on the basis of satisfactory evidence to be the person who appeared before me.
G. SMITH-TREVIZO Si"
Notary Public-California •
• Ati.' San Bernardino County z
Z " 'r� } Commission #2162325 D
',r al My Comm. Expires Sep 6.2020
.t',-2-4',, Development Services Department
It MI 240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
s� ' Arcadia, CA 91066-6021 BOO 058-802
City of (626)574-5416,Fax(626)447-9173 Permit Type: Fire
Arcadia YP
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
1/18/2018 CM 9:35 1/25/2018 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th„Floor PHONE NO. Plan CHO: 18-15
Los Angeles, CA 90025.: EMAIL ADDRESS:
APPLICANT MAILING ADDRESS.
Building Electronic Controls Inc. PHONE NO.
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: 11/30/2018 12:01
TENANT MAILING ADDRESS
Lids PHONE NO. FAX NO.
DESCRIPTION
FIRE DEVICES FOR LIDS.6 DEVICES
Construction Type UOM S of Units Value Construction Type UOM S of Units Value
Value Value 6,550.00 $6,550.00
OCCUPANCY: Fire Sprink/AIm TOTAL VALUATION: $6,550.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT •
6.00 each fire alarm pc 2 700.00 700.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-31 12
each Fire Permit 187.15 187.15 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
E ED
9
Total Fees: $932.50 Balance Due: $0.00 Paid Today: $232.50
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the I eceipt ':
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 231.50
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)
�%4GA Rvy9.0
£ :(1PERMIT/PLAN REVIEW APPLICATION
.,07.„ Development Services Department,240 West Huntington Drive,Post Office Box 60021
o0\Y/, Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
4\1
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:
hapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ff ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class G O License No. 2-1/v5—Exp. Date l i;a IS, compensation, as provided for by Section 3700 of the Labor Code, for the
// •erformance of the work for which this permit is issued.
Signature of Contractor
t
have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DELLA 700 of the Labor Code,for the performance of the work for which this permit
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors /is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve, Carrier I h. U.r-`t-h @— to-i^- ,_,.� -+'�,p _k}e S
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number Gly S b. �Ci'361is%b 0
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as 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 roe forthwith comply with those provisions.
property,rty, 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 14, Signature
Law does not apply to an owner of property who builds or improves thereon, 111
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. l
Name ith L I I V l -)JL & Title Al•'C'e`
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 000.......-..r iqcDate I �
/ ,
•"-" . Development Services Department
t 2 240 West Huntington Drive,Post Office Box 60021
PERMIT NO. $00-05.8-773
Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 Permit Type: Fire
Arcadia - — — --
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
1/16/2018 EP 7:40 1/24/2018 Issued
ADDRESS NO Dir.Prefix Street Name Street Suffix UNIT '-- BLG "ASSESSORS PARCEL NO -GEO CODE -
400 S Baldwin Ave T-387
OWNER MAILING.ADDRESS - - - -- - -- ----..----- - -
Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Plan Chk#: 18-09
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT - MAILING ADDRESS - _ _ _ _ _
Allready Fire Sprinkler Co. PHONE NO.
EMAIL ADDRESS:
CONTRACTOPoPROFESSIONAL MAILING ADDRESS _ _. _ _. _ -
Allready Fire Sprinkler Co. 818 N Grand Av PHONE No. (626)332-7066 FAX NO.
Covina,CA 91723 EMAIL ADDRESS:
License No 358795 Type: C16 Expires: 7/31/2019 12:00:
TENANT MAILING ADDRESS
Lids PHONE NO. FAX NO.
,
DESCRIPTION
FIRE SPRINKS FOR LIDS 11 HEADS
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 1,100.00 $1,100.00
•
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $1,100.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
11.00 each sprinkler pck 700.00 700.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 65.85 65.85 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
I - 1 COMPLETED
Total Fees: $811.20 Balance Due: $0.00 Paid Today: $111.20
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt 4: '119114
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 110.20
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 LNSPECTION INSPECTORS'OFFICE HOURS
913'
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)
�'�oRc
V~ ``y Rvy i
• PERMIT/PLAN REVIEW APPLICATION
o\4% 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 Co e,an y license is in full rc t. 1 1 �i� ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Classy icer se xp. Dat—e71- / 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-BUILDS A TION 13 I have and will maintain workers'compensation insurance,as required by Section
0 I herebyaffirm under penaltyof perjury that I a 3700 of the Labor Code,for the performance of the work for which this permit
p j ry empt from the Contractors is issued.My workers'com nsatieirinsurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions f
Code.Any city or county which requires a permit to construct,alter,improve, Carrier .6-14) l °�
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number 1,
� 13 //1
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of 0 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 complryith ose provisions.
compensation,will do the work,and the structure is not intended or offered for a /
sale(Section 7044,Business and Professions Code:The Contractors License Date !!! 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(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
Lfurther information /,. �
arne r ; 4title U G f ' ,11/7(—
IINT NAME
I certify that I have read this appli on 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.
ignature !)'h ate / ✓, ' I
OF ARC
V4-1P-0-15"406
4-0.1FOIuI 4,
,F!
r7-4.
"airycto
°`'x MEMORANDUM
Fire Department
DATE: February 15, 2018
TO: BUILDING DEPARTMENT
INSPECTOR Henry Kemich
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 400 S. Baldwin Avenue, T46 (Lids)
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 2-15-2018 Jill Perumean
FIRE ALARMS 2-15-2018 Jill Perumean
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 2-15-2018 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 2-15-2018 Rita
~'A"\a Development Services Department
d lam PERMIT NO. BOO-057-826
240 West Huntington Drive,Post Office Box 60021
`...,' Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 Permit Type: Sign
Arcadia
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
9/13/2017 CM 13:47 9/13/2017 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
Sign Contractors/R&R Custom Sig PHONE NO.
EMAIL ADDRESS:
CONTRACTORIPROFESSIONAL MAILING ADDRESS
Sign Contractors/R&R Custom Sign:400 Foothill 135 PHONE NO. (626)335-2887 FAX NO.
Glendora, CA 91741 EMAIL ADDRESS:
License No. 740985 Type: C45 Expires: 3/31/2018 12:00:
TENANT MAILING ADDRESS
Lids PHONE NO. FAX NO.
,
DESCRIPTION
ONE ILLUMINATED CHANNEL LETTER SIGN FOR LIDS
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
Value Value 1,500.00 $1,500.00
ivipc 2-2/'-e /1.---- , --
OCCUPANCY: Sign TOTAL VALUATION: $1,500.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
Sign plan rev 46.28 46.28 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 82.65 82.65 01-3104
1.00 flat Elec issue 44.35 44.35 01-3105
1.00 each Sign Connection 15.55 15.55 01-3105
1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Ez OOMPLET
Total Fees: $235.18 Balance Due: $0.00 Paid Today: $235.18
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Kecelpt ft: 117901
permit is not commenced within 180 days from the date of issuance or if the pennit is not obtained within 180 days from 01-3103 46.28
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 127.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 01-3105 59.90
Arcadia building inspector for a period of 180 consecutive days. 88-3027 2.00
CALLS FOR LNSPECTION 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)
ARe
G~4 OFp RNy4,
g 7 PERMIT/PLAN REVIEW APPLICATION
N4,
o .ltij, 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 C
r7 Lice No. l 05(1. - Exp. Dater 3l�[�- compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor
performance of the work for which this permit is issued.
.'
OWNER-BUILDER DECLARATION 'I have and will maintain workers'compensation insurance,as required by Section
0 I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 0 \--2J `e
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 i 3 Signatu
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).
0 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 11 12.-A)1'VN, CNA- R- Title
PRINT NA E
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.
ignature / f DateV /3/1
i