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Home My WebLink AboutUntitled rjDevelopment Services Department 11 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 PERMIT NO. BQQ=051-516 City of (626) 574-5416 Fax(626)447-9173 Arcadia Permit Type: Tenant Improve w/energ: PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/21/2015 SC 11:38 10/7/2015 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-387 OWNER MAILING ADDRESS Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CHRS Los Angeles,CA 90025- EMAIL ADDRESS: Plan Chk#: 15-621 APPLICANT. -MAILING ADDRESS Plan#: 31748 Westfield Corporation,Inc. PHONE NO. EMAIL ADDRESS: ' CONTRACTOR/PROFESSIONAL MAILING ADDRESS Owner PHONE NO. FAX NO. EMAIL ADDRESS: License No. Type: Expires: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION `� I 'woveV Construction Type UOM #of Units /// TI FOR LANE WAY (AO. EMValue Construction Type UOM #of Units Value Value value 675,000.00 $744,187.50 ��C !-s-�7 r OCCUPANCY: Mixed Use TOTAL VALUATION: $744,188.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 3,688.43 3,688.43 01-3103 each Energy p/c fee 1,248.39 1,248.39 01-3103 PC ADA 553.26 553.26 01-3103 PC Cal Green 368.84 368.84 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 5,674.50 5,674.50 01-3104 Bldg Issue ADA 567.45 567.45 01-3104 1.00 each T.I.Fire Pkc 245.00 245.00 01-3109 SMIP Corn 208.37 208.37 14-2207 gm bldg std 30.00 30.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $12,634.84 Balance Due: $0.00 Paid Today: $7,453.02 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt ft: 110666 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 922.10 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 6,286.30 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 208.37 Arcadia buildinginspector foraperiod of 180 consecutive days. 88-30273 36.25 PY 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 . ��yIFORH�99�j' 11' PERMIT/PLAN REVIEW APPLICATION j• Development Services Department,240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION '❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: ' Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ._Signature of Contractor OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section 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 demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers' Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attomey's fees. 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law), for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures.. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for further information. Name SUM to Title �f CO-0 f Cin "^ 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. { 19/ 1(7Oi5.i Signature Date (( N N N NW CO O O O O CO CO OD CO CID OD C7D CA Oo CO OD CA M CA O ) 01 01 CT CT 01 01 Co 01 j CT C19 N y N O O O O O O O O O O PNP O CO co V O) U) A W N O CO CO V 01 A W N n N O O CO W V 2 2 A W N 7` O CO 2 V 2 2 A W N O - o 37 T < T CO T O T 37 * C C C Cn "O n T T T El 0 g j j -1 Co O T 33 _p Cn (.) cn T T T 37 Cn S N O N .0.. DO N v a 0 CD O 3 3 N c 3 a w Z '.CD . ._,„• C c w fil O. O. CwD * d N w a)• CD N• 0 C C czr 0 C •CO) N o w N p CD oii.' m C CD Ca 1( fn 0 -0 °—) T` Cr w 0- w w C) • CO CD 37 CD CCD fn 0 S O. o N w w w O S d w m _ S. f0 Cr =..., • C/ — al CO 3 S T7 CD c O w O C0 CD O 0- _ CD S y _ = O_ Q• O . f0 O. D j O — w Re S 0 fQ w .T" , fn 7 co w — m O. .y-. 0 3 S CD .-.. 0 O Cn co CO C0 W o -O N co 0. CO o O O * CD Co w O O O CT CO 7r a W a S 0=co o Q. O co j• O N D N Cn • w 0= n c c CSS (O CD CCDD 0 — d N_ S w > >, . o_ d w = w w cn 2 w y o .O-u n' O (yD CO O �. v 0 n O (7D d d j o_ .Si. .Oi. 0 Co CD S tD N C T CA CO Cn Co 0 co O o CD n 0- s fn o- o m c 6 fn m `' w N c coo y c y d N , 0 0 _1 - o 1 d E CD 1111, e cT 7 7 0 N co W co co co co co .y) N N N N Cl) N N Cl) N) N Co N N N N N N N N N N N N N N N N .0 N N N Na N N N N N N N N O O O O O IO O CD CO CO CO CO CO CO OD CO CO CO CO V V V V CD 01 C71 A A A A A Cl .Cl. A . A 0 N ND N O) 0) A W N O * CS) C. C) N O (7). .Cl. W N O Ca CO N O O CO OD V CO Vl -Cl- W N O l7 N O CO O V CP OI A W N O C 1• co C) C7 C1 CO O co f— y ?1 2 T C -Ti T O l7 T Cn 7 T Cn 37 T T T T T T T O •O C r 37 T 7 cf.) T T T7 co 37 Cn 37 37 C7 C co o a w c a Co w w O o O O G) O m O O co N O S O O O O 7 O co w « O co O X N CD 0 X j c O S O O O > 0 < 0 Cn O. 0 RD w O O N C1 CD C� 7 O a fD O (D O O O 7 O w w O' N O. 0. to [D w f=9 °� O • CD ID w Cn w w O s N CD CO w N N 0 N c1 2- O0 N 0 co co v O. CT (D w O N W G Q O v co N o V) O C f0 O C7 N S 3 a ? 00 . (D S (D = •'O f-. co O- < .0.w '0 fD f0 7 d CD S 7• C0 -O .0 7C• O N �. 0 O = l0 N �' 3 O 0 co < c CD N C0 N 7' -O O c y w m (0 N O- -O .z N m •< Dr c H 7 µ o 0 0 o m 3 w Re fD c o B. w 3 m fD co o jcD v T.- c a o W O fn O E CD< 7 O O. m C 7 7 U ? N w rn O Q co d O CD (D CD W C1 N = 3• in N f0 f0/l c = n foil Q IJ- Cn Q toN O Q 0a aUa C = CO N R= C7 N O O an N _O. 7 • '< t0 CO CL CO cc S ,-,3 y fn .=.• O I= v o o m �, ynm m m � \CD D 9 D CCD coC S. • Nk. 1\o = o 0 0 v 1 t -N `11 tk, t 1•,' ck) p t t.a (NI 9... 4 5 1 kZ )«6 1 1 C 34..._ .... - , 5r, , , ..,,, , ,, , c., a ", ,..., e t.-, --?. c... (.. 7% r• 'C\ s ,..... i g D zi t. .k i t) ?:6) 111 (6° b `'N' I "1"1 )71 .7?\s\-."-V, P 9. ct) 15 cj V 4\ i) ,.., g , f > Z k., A I 1 1 V,, & 'i P C t )q I A A Z c. 16 -v I �, "P .. , , t t., k It --- w '� cry D� v1 g I' ; m t t ,,„ k GN * ; • a ir• --..§: IN ... r,,, W It 1 cr.. \ tillr Building Inspection NOTES 6--2--16 /4 1 A < E. D s,,e 0#�-`- 6-3-1C fAkr� i�vos` t� 2-51.9/u6 5 ./s,r Soir.'�Esr, 0- 15--/4 f R/,w.i.4! A-T 7-Weir Ykycd oor A r- ^Ge- 1v6-Wri.# dkD cr - 7/+- Wr+c.Kwp.r. i » 64S-6G I:2045V DA-SewAc.c. Scez-kyk[.6 Ari oaRTi 5—!<)'G/6I17 fAe...t-P ' 6-'2-1746 dr:-.4,6-67-geG ./ iceAr PT' , TO,e$ i2.771-5711 Z 3 JOB NO: 10/ Building gs of `34L`- l� CITY OF A' 1f P 119" Off-Site DEPARTMENT OF Fabricator BUILDING AND SAFETY ``-- BUILDING INSPECTION Permit va Number ..D.W— �. — 1 ?.c Year. DATE OF CERTIFICATE 1__ REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: ❑ Masonry 0 ReBar Placement 0 Concrete or Mixer ❑ Welding 0 Concrete Placement Gunite h •� 0 Hi-Ten Bolts 0 Tendon Placement Other.�"-�.Uf�1 t•!s) 1 Description and location of work completed: _ ��A . IA rcP .li ... Ft... K ... .11?� . ..> 07 '1• Com" 3 STEEL..• • ... ..1.4 6A.KI. WA1 S-SO1 :& 12.P0-1 [► WEST -- f flo p'.1. . ..... ?ML- As a .Arfu.c .t PAT C 1t 6-1 . W& 5S E-c-U' $4...0at Pap Pal Fid ') -11;1/ k P 4L : CO co 300 lksD Size of Structure Time Arrived ......• ••,•�( ...�r� No. of Stories Time Left Job t QQ 1 Conc.Mix Design No Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,/' subcontractor or material vendor. Registration No. Employed By: Lab. .t....1 }•-4. Signature-Registered Deputy Building Inspector. Independent 1LS - S of'0 B&S B-94(R.10/86) 1A I Prirtt Full Name .tateitti.t Development Services Department , AGI 240 West Huntington Drive,Post Office Box 60021 � � PERMIT NO. BOO-053-133 �t i Arcadia, CA 91066-6021 CiArcadia (626) 574-5416,Fax(626)447-9173 Permit Type: Tenant Improve PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 3/24/2016 CM 15:57 4/27/2016 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. Inspector#: HNRY , Gd f s A 90025- EMAIL ADDRESS: Plan Chk#: 16-127 APPLICANT 4 r h ,1KAILIN r.:: _i,:,.t e � Plan#: 31925 Westfield Corporation PHONE NO. EMAIL ADDRESS: f CONTRACTOR/PROFESSIONAL MAILING ADDRESS Westfield Corporation 11601 Wilshire Blvd 12 Floor PHONE NO. FAX NO. Los Angeles,CA 90025 EMAIL ADDRESS: License No. Type: Expires: TENANT MAILING ADDRESS PHONE NO. FAX NO. DESCRIPTION ADD UNISEX RESTROOM TO LANEWAY Construction Type UOM N of Units Value Construction Type UOM #of Units Value Value Value 15,000.00 $15,000.00 I OCCUPANCY: Tenant Improve TOTAL VALUATION: $15,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 208.49 208.49 01-3103 PC Cal Green 20.85 20.85 01-3103 PC ADA 31.27 31.27 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 320.75 320.75 01-3104 Bldg Issue ADA 32.08 32.08 01-3104 SMIP Com 4.20 4.20 14-2207 gm bldg std 1.00 1.00 714-2203 1.00 .Flat SWMF Auto 6.25 6.25 88-3027 -23-ed .144.c ��4ec‘./t-O 7.5/46v#4°- ,-1/2 .sr .P614141‘7714'671/r A P l'izoVAsc-c /.67 -/ Total Fees: $669.24 Balance Due: $0.00 Paid Today: $669.24 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt 4: 112743 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 260.61 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 397.18 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 4.20 Arcadia building inspector for a period of 180 consecutive days. 714-2203 1.00 88-3027 6.25 CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday-Thursday Friday C.................. 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) C~4 ,fes oFp 2v�cd. PERMIT/PLAN REVIEW APPLICATION 014 WEI! , ; Development Services Department, 240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9 (commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for y sale(Section 7044,Business and Professions Code:The Contractors License Date— (TV/ Signatilre 1 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- 4i,7��`(' 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 � ec4l!4 v, f'=Title 1)la c+G/ 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. Sig Date yl/ Z-7/70(b .fd> t Development Services Department • 240 West Huntington Drive,Post Office Box 60021 t PERMIT NO. BOO-050-448 � Arcadia, CA 91066-6021 City of (626) 574-5416,Fax(626)447-9173 Permit Type: EMP Combo Arcadia yP : • PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 6/4/2015 CM 16:46 6/23/2016 • 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 PHONE NO. 1�1�1'1�1�1'��------,,'��'^^��----��''�� .;3 0 M pFmFDEMAIL ADDRESS: CONTRACTOR/PROFESSIOC ESS PHONE NO. FAX NO. EMAIL ADDRESS: License No. Type: Expires: TENANT MAILING ADDRESS Din Tai Fung PHONE NO. FAX NO. DESCRIPTION LANDLORD WORK:UTILITIES FOR FUTURE DIN TAI FUNG RESTAURANT Construction Type UOM #of Units Value Construction Type UOM N of Units Value F,V,¢L G -713 -/6- OCCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 1.00 flat Elec issue 44.35 44.35 01-3105 1.00 Flat Plmbg issuance 44.35 44.35 01-3105 1.00 each Distrib panel 15.55 15.55 01-3105 2.00 each unit Sewer connec 62.32 62.32 01-3105 2.00 Fixtures Plmbg fixture 24.92 24.92 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 Flat SWMF 2 1.00 1.00 88-3027 Total Fees: $193.49 Balance Due: $0.00 Paid Today: This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 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) Ane G~4 No Rv,'9di ._ PERMIT/PLAN REVIEW APPLICATION 04o- qv," Development Services Department, 240 West Huntington Drive,Post Office Box 60021 oA'4Y4lty oitt" Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date- compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance;as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own -- -employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures.. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. Name Title PRINT NAME I certify that I have read this application 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 }; u. Development Services Department 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. $QQ-050_392 Arcadia, CA 91066-6021 City of (626) 574-5416,Fax(626)447-9173 Arcadia Type:Permit T e Comm Add/Alt PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 5/28/2015 CM 16:46 6/23/2016 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave M-5 T-387 OWNER MAILING ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS Los Angeles, CA 90025- EMAIL ADDRESS: Plan#: 31592 APPLICANT MAILI 8.ADDRESS Westfield Ken Huan C'rf PHONE NO. (310)575-5976 EMAIL ADDRESS: CONTRACTORfPROFESSIONA MAILING ADDRESS Owners Agent PHONE NO. FAX NO. EMAIL ADDRESS: ' License No. Type: Expires: TENANT MAILING ADDRESS Din Tai Fung PHONE NO. FAX NO. f DESCRIPTION LANDLORD SHELL WORK FOR FUTURE T.I.DIN TAI FLING Construction Type UOM #of Units Value Construction Type UOM N of Units Value Value Value 10,000.00 $10,000.00 _F;;44-c_ 4_Z3—// 717f.:7.16,,,°°. 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 each Energy p/c fee 52.20 52.20 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 SMIP Corn 2.80 2.80 14-2207 grn bldg std 1.00 1.00 714-2203 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $561.34 Balance Due: $0.00 Paid Today: This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 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) G~,OFpo R,c9`j. PERMIT/PLAN REVIEW APPLICATION • °Ei '' • Development Services Department, 240 West Huntington Drive,Post Office Box 60021 oA°uo+r ocve Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Date Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures.. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for further information. Name Title PRINT NAME I certify that I have read this application 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 4k Development Services Department It ! 0 240 West Huntington Drive,Post Office Box 60021 ` ' PERMIT NO. BOO-051-552 'O Arcadia,CA 91066-6021 CiArcadia of (626) 574-5416,Fax(626)447-9173 Permit Type: Comm Add/Alt PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/24/2015 CM 10:26 9/24/2015 Issued ADDRESS NO. Dir.Prefix Street NameSt a ix , (..., .._:.: UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Bal it Y.`:`a T-387 OWNER �VAILINGADOIL Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: CRIS Los Angeles, CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Westfield Corporation(Steven Char PHONE No. (310)261-3764 EMAIL ADDRESS: , CONTRACTOR/PROFESSIONAL MAILING ADDRESS Owner PHONE NO. FAX NO. EMAIL ADDRESS: , License No. Type: Expires: TENANT . MAILING ADDRESS Laneway Project PHONE NO. FAX NO. DESCRIPTION DEMOLISH INTERIOR IN PREPARATION FOR FUTURE LANEWAY PROJECT Construction Type UOM b of Units Value Construction Type UOM S of Units Value Value Value 78,000.00 $78,000.00 OCCUPANCY: Tenant Improve TOTAL VALUATION: $78,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 676.20 676.20 01-3103 each Energy p/c fee 228.87 228.87 01-3103 PC Cal Green 67.62 67.62 01-3103 PC ADA 101.43 101.43 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 1,040.30 1,040.30 01-3104 Bldg Issue ADA 104.03 104.03 01-3104 SMIP Com 21.84 21.84 14-2207 gin bldg std 4.00 4.00 714-2203 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $2,295.89 Balance Due: $0.00 Paid Today: $2,295.89 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the R,.ee:pt N. 110487 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 1,074.12 01the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207-207 1,188.68 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified bya Cityof 14- 21.844 p y p � 714-2203 4.00 Arcadia building inspector for a period of 180 consecutive days. 88-3027 7.25 CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday-Thursday Friday one(1)business day in advance of the inspection 7:30 a.m. to 8:30 a.m. 7:30 a.m.to 8:30 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) G~� d OFF Rv�C9i Il PERMIT/PLAN REVIEW APPLICATION 'ii 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 0 I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall 0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for 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 5-1 /ol-#1, Title ?'i Li/P7F64-b , I' 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 t Arcadia to enter upon the above-mentioned property for inspection purposes. j i Signature Date `7 Z`�- 1 ) �' / Awkw Development Services Department :71 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-052-530 `•M Arcadia,CA 91066-6021 City of 626 574-5416,Fax(626)447-9173 ArcadiaPermit Type: Mechanical PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 1/12/2016 CM 15:15 1/12/2016 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: APPLICANT MAILING ADDRESS Western Allied PHONE NO. EMAIL ADDRESS: E : CONTRACTOR/PROFESSIONAL ;LOGIPELETE D 213 NO. 685-4050 FAX NO. Western Allied 12046 Florence Ave PHONE � Santa Fe Springs,CA 90670 EMAIL ADDRESS: License No. 198821 Type: Expires: 5/31/2016 12:00: `TENANTMAILING ADDRESS Qaneway Project 1 PHONE NO. FAX NO. DESCRIPTION DUCT WORK FOR LANEWAY PROJECT Construction Type UOM N of Units Value Construction Type UOM N of Units Value F.;.444.6- 4 _zz`G OCCUPANCY: TOTAL VALUATION: $0.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 1.00 Flat Mech Issue Auto 44.35 44.35 01-3105 1.00 Flat Add/Alter Ducts 9.38 9.38 01-3105 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $54.73 Balance Due: $0.00 Paid Today: $54.73 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt FF: 1 fi593 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 53.73 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) OF ARC CPLIF ORA,1, °~ 9 PERMIT/PLAN REVIEW APPLICATION Development Services Department,240 West Huntington Drive,Post Office Box 60021 `,,..,,,ofN°°` Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION T 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 Cop,and my license is in ful ect. G ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class L-2C •cense No. Exp. Date 3(4 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 DE ARATION Til I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'co ensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier Zv C. /rte demolish,or repair any structure,prior to its issuance,also required the applicant PolicyNumber 1) 27 7 4. ` L V 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 C■ 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 IDI, 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 I-- 1 l I / sale(Section 7044,Business and Professions Code:The Contractors License Date Signature .i Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, 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. N me _ L, Title is PRINT • E I ertify 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 gree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of A cadia to ente u on the above-mentioned property for inspection purposes. F / j Signature // NIL__ Date ` 2 �` mss% Development Services Department 240 West-Huntington Drive,Post Office Box 60021 r Arcadia,CA 91066-6021 1.--; ' - PERMIT NO, BOO-051-862 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 10/27/2015 JB 12:21 12/15/2015 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT -BLG - ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin AveT-387 (/_l/��!t,'-� OWNER MAILING ADDRESS '" — Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: Los Angeles,CA 90025- EMAIL ADDRESS: Plan Chk#: 15-696 APPLICANT MAILING ADDRESS Plan#: 31805 Daniel Camin (Westfield Rep) PHONE NO.FAEMAIL ADDRESS:(213)2489403 CUP1ETED CONTRACTOR/PROFESSIONAL , MAILING ADDRESS PHONE NO. FAX NO. EMAIL ADDRESS: License No. Type: Expires: I TENANT - MAILING ADDRESS - - Laneway Project PHONE NO. FAX NO. DESCRIPTION LANEWAY PROJECT Construction Type UOM 8 of Units Value Construction Type UOM 8 of Units Value Value Value 600,000.00 $1,600,000.00 „,/4-G i-5.---1 7 /` - ''' OCCUPANCY: Tenant Improve TOTAL VALUATION: $1,600,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 7,523.10 7,523.10 01-3103 PC Cal Green 752.31 752.31 01-3103 PC ADA 1,128.47 1,128.47 01-3103 1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 11,574.00 11,574.00 01-3104 Bldg Issue ADA 1,157.40 1,157.40 01-3104 1.00 each T.I.Fire Pkc 245.00 245.00 01-3109 SMTP Corn 448.00 448.00 14-2207 grn bldg std 64.00 64.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $22,942.88 Balance Due: $0.00 Paid Today: $13,294.00 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111392 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 12,775.75 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 448.00 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 714-2203 64.00 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) v~4°FF Rw,49d' � 9 PERMIT/PLAN REVIEW APPLICATION ot ." 0.>„.„:".-,...„--:, .. Development Services Department, 240 West Huntington Drive, Post Office Box 60021 .,.,,r of 4° Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION D 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 El I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil , not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole f rthwith 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 ate 1Zf Irl Signature L(4.. 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: (15-(IC Lender's Name ,.......... i )Date `�1 l 5-r I C Signature Lender's Address PORTANT: APPLICATION IS HEREBY MA E 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. N e---7. ani'li1 COM lit Title-- 711tc4'o1I CO/154 i.C-(r . PRINT NAME I c rtify 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 gree 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 the above-mentioned property for inspection purposes. Si naure� Date 114 i 415 5 66 - 05t- a 62 NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 100. Setbacks 210. Under fir./bldg.drain 101. Rough grade 211. Copper underslab 102. Figs.&forms 212. Rough plumbing 6-23-a 103. Pre-slab 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 110.1FramOcc/Ag 220.1Fixturesall 111. Occ./Area Sept.Wall 221. Final plumbing 6-z3-/G 112. Sound walls 222. Sewer cap/demo. 113. T-bar grid 'p-2j-/6 114. 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 grade245. Gas line&test 121. Final building -c-17 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final ulumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Underground conduit 153. Underslab conduit Reroof Inspections Date I 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. Eqpt.bonding Sign Inspections Date I Insp. 160. Service panel 280. Setback/overhang 161. Final electric 281. Footing 282. Conduit/wirins Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC _ -A Miscellaneous Insp. Date Insp. 183. Fire dampers -- 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Fire sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Final . 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. I Date I Insp. 191. Final mechanical 622,4• Arr011iwr 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 t��T. Development Services Department I i,1 M 11 r. 240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021 PERMIT NO. BOO-052-266 City of (626) 574-5416,Fax(626)447-9173 Arcadia Permit Type:`' Fire PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 12/7/2015 CM 11:19 1/14/2016 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- B.E.C. PHONE NO. EMAIL ADDRESS: , CONTRACTORIPROFESSIONAL MAILING ADDRESS Building Electronic Controls Inc. 2246 Lindsay Way PHONE NO. FAX NO. Crle a ra, EMAIL ADDRESS: License No. 729905 Type: C pir;s: ill •Oil 2 TENANT A, DDR- S A IB is B Laneway Project PHONE NO. FAX NO. DESCRIPTION FIRE ALARMS FOR LANEWAY PROJECT . Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value Value Value 25,420.00 $25,420.00 OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $25,420.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 42.00 each fire alarm pc 2 735.00 735.00 01-3109 1.00 Flat Fire Issue Auto 44.35 44.35 01-3112 each Fire Permit 500.50 500.50 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $1,280.85 Balance Due: $0.00 Paid Today: $1,280.85 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 111611 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3109 735.00 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 544.85 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 88-3027 1.00 Arcadia building inspector for a period of 180 consecutive days. CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday-Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. ..---------........'7 (Closed on alternate Fridays) X14 oFF `'9di 1,7 PERMIT/PLAN REVIEW APPLICATION o j`a Development Services Department,240 West Huntington Drive,Post Office Box 60021 .nnl,y do 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:Glass G`� License No - ' -I�J Exp a etD I 174---74/4 l 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 cr ail � Dt- 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_--2 ) ' Q VI l°Cv•r\eArkc .r` demolish,or repair any structure,prior to its issuance,also required the applicant ` . V v G (1 1 1 1 o 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 sectio`d 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. T Na � - f.' e me—�-�t�l � -'J _.i ii � l"e=� � QCt3Y PRINT NA', 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'''..---toenter upon the above-mentioned property for inspection purposes. Signa�trrre (xi I� Dam to t/\ /t IP fi' , Development Services Department . 1 * 240 West Huntington Drive,Post Office Box 60021• = PERMIT NaNO. BOO-054-262 •-` 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 7/19/2016 CM 16:32 7/21/2016 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. Plan Chk#: 16-343 Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAI DDR J PHONE NO. Building Electronic Controls In EMAIL ADDRESS: CONTRACTORIPROFESSIONAL MAILING ADDRESS Building Electronic Controls Inc. 2246 Lindsay Way PHONE NO. FAX NO. Glendora,CA 91740 EMAIL ADDRESS: License No. 729905 Type: C Expires: 11/30/2016 12:0( TENANT MAILING ADDRESS Laneway PHONE NO. FAX NO. , DESCRIPTION ADD 7 DEVICES TO NEW SYSTEM(B00-052-266 Construction Type UOM #of Units Value Construction Type UOM N of Units Value Value Value 25,420.00 $25,420.00 OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $25,420.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 7.00 each fire alarm pc 2 637.50 637.50 01-3109 1.00 Flat Fire Issue Auto 44.35 44.35 01-3112 each Fire Permit 500.50 500.50 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $1,183.35 Balance Due: $0.00 Paid Today: $545.85 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the xecetpr if: 113o84 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 544.85 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. ---"7 CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS (.7„/- 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 PERMIT/PLAN REVIEWTION 0,4 OiROiRaMI • 010' • Development Services Department,240 West Huntington Drive, Post Office Box 60021 '44nicy of IV' 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- y-li e•- • -in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' c-L-icens`e Class t'i icense- o: Z 0Exp._Date t L•�J'1- compensation, as provided for by Section 3700 of the Labor Code, for the - _• _ '- A performance of the work for which this permit is issued. Signage:of Contiactor-_-- \- �►`o 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, C --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 Number9(o(mss l 41 l d provisions of the Contractors License Law(Chapter 9(commencing with Section (Ts sectionneed-not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall 0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for 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 rt -r information. 0 Name CSG bA • —Title —i:t 0.l^ C�r CS • PRINT NAME • I cer y that ave read this application . +.state that the above information is correct and that I am the owner or duly authorized agent of the owner. ✓ reeto_c,mply with-all_City_ordina es d State Laws relating to building cost ruction. I hereby authorize representatives of the City of cadia_ti - ler upon the above-mention d pr`perty for inspection purposes. cL � A � I 1 Signature - A. A V Lam_ Date 1 2� ` 6 OV air ARC,' "incotponted Aosnrt 5.1903 4.1 c° "Unity 0116P ,0 MEMORANDUM Fire Department DATE: September 1, 2016 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Ave., Laneway THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 8-16-2016 Jill Perumean FIRE ALARMS 7-25-2016 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY 8-30-2016 Jill Perumean COMMENTS: Emailed Bldg. Dept. 8-30-2016 jp ov ti4. f '9r �� :":Iveory.r.[d Aaurt 5.190) 0044 �"ai`y°s�� MEMORANDUM Fire Department DATE: July 29, 2016 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemich FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Ave. (Laneway Unisex Restroom)PC #16-127 THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 7-25-2016 Jill Perumean FIRE ALARMS 7-25-2016 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY 7-25-2016 Jill Perumean COMMENTS: Emailed Bldg. Dept. 7-26-2016 jp AuSv.S.ff6f OV opproniv, A. % July 26,2016 `"y++1ty oto Mr.Ryan O'nan Westfield Tenant Coordinator 400 South Baldwin Avenue Arcadia,CA 91006 City of Dear Mr.O'nan: Arcadia As discussed during our recent construction walkthrough,it has been brought to our attention that the Westfield Santa Anita's Emergency Responder Radio System has not been maintained in an operable condition.Per the California Fire Code,sections 510.6 and 510.6.2,Westfield is responsible for both Fire maintaining and improving the system as necessary to provide an acceptable minimum level of life and safety to the building's occupants.Therefore,the Arcadia Fire Department will not approve a certificate of Department occupancy for the Laneway project until proof of intent(i.e.a signed contract with an acceptable vendor) has been provided.We appreciate your cooperation with this matter. Sincerely, 4IL Mike Lang Mark Krikorian Fire Chief Fire Marshal 710 South Santa Anita Avenue Arcadia,CA 91006 (626)574-5100 (626)446-7410(fax) www.arcadiaca.gov Cern .icate:'o Flame Resistance :. :Noo , c)i-j,545'l. . . Firetect's . ISSUED TO: DIGBAR Interiors&.Architecture APPLICATION 0TH Corporate Seal of.:'' ADDRESS Deborah Gregory • Authenticity INVOICE: 2+1I4Z+1�3:. - . . . . . . .12030 Washington.Blvd:#3 . : '. ' :'. ': : . :' - - Los Angeles,CA 90066. Certificate of Compliance is issued to verify that the itemsor areas described.on the reverse side of this certificate have been treated with our chemicals: This original certificate contains.Firetect's Corporate.Seal of Authenticity:.Copies of this certificate.hold novalidity:.Our flame- : :retardant chemicals pass the following highlighted tests. Application date is indicated: • NFPA 701 Small Scale&Test.No..1.,*0 5/16'** •'..CA Title 19 Public Safety_See:1237 **07!/25/16 ' •. NFPA 701•Large.Scale/Test No. 2 ___ .: •. 'ASTM E-84-14a* *0,7125/16 * -.'•. BS.476:.Part 7:1987.(wood) : . : •. 'BS.5867: Part2:1980(fabric)' -.. . ' • UBC.8-2 (ICC 803.5.1)NFRA•265,:02' • -.NY.Cart'No.5069,Code 27-4266;.3RCNY19-01 . • Name of Chemical Used FIRE=POOF:&FR-10 • Registration No.: C-2.6501.&C-10003. °'-- -7''. . . • _Batch No.: E -. 4i.` .CALP . '®, . 4.7-4.,----..\-, ..a I .9yd • : . � ' am!.- 3'4... . ;. . . . . . : Flame Retardants. , - ..�'1, � �; . www.Firetect.:com .'��4e *��q�. . 2 . . : , . . . . . . , ciat CA 91355 ad. . . 98C Valen A1248.01 r . • • • • . . 661 259-FIRE Fax 661 295-3880 5/zawiteic, www.fretect.com Signature.of Certified Applicator,Kathleen Newman,01712516' : .WARRANT YAND DISCLAIMER: :'. : _ _. Sellers and Manufacturers only obligation shall be to replace such quantity of the product:proved to be defective. Neither seller nor.manufacturer • ' . shall be liable for an:injury,loss or damage,direct or consequential,arising out of the use of or inability to,use the product Deterioration of'coatings : : 'applied.to interior.finishes.can occur due to atmospheric conditions,repeated cleaning of the surface or.painting over.applied coating s: lre Retardants shall possess the desired degree of permanency and shall be maintained so as to retainthe effectiveness of the treatment under:the service. :. conditions encounteredin actual use: Periodic testing by trained and inspection bytrained officials should be performed to ensure flame-retardancy: : . DESCRIPTION'OF MATERIAL TREATED FOR ,'0. iI 01545. FLAME.RETARDANCY This original certificate contains Firetect's Corporate Seal of.Authenticity.:Copies of this Certificate holdno validity: This Certificate must,be available for review by the Fire.Authority: Reproductions of this Certificate can not be produced without re-treatment. QUANTITY***************DESCRIPTION=INV#711421.3 DATED07/2:51116********************** ***40 YARDS*************NATURAL.BURLAP:FABRIC, 48" WIDE***"************************ ***176 EACH*************FABRICATED RAW WOOD.CRATES, 12"x12"x19:5"******************* ***38 EACH**************FABRICATED RAW WOOD CRATES, 17"x17fx24"********************. ******FLAME RETARDANT APPLIED AT: FIRETECT 28298 CONSTELLATION ROAD, VALENCIA, CA 91355***** ***ABOVE TREATED ITEMS ARE TO BE.USED AS INTERIOR DECORATIVE:MATERIAL S.ONLY*** I CARE INFORMATION: I See Warranty information on the front of this certificate: These fabrics and/or materials have been treated to comply with the Requirements for Fire Retardancy as required by Federal, State and Local Authorities having jurisdiction. Never allow decorative material to come in contact with any liquids. This fabric ordecorative material should be periodically re-tested toensure compliance. Dry cleaning of fabric is recommended and flame-retardant may be removed by washing or.dry cleaning. Periodic testing and inspection should be performed by trained officials to ensure flame-retardancy. Re-treatment is recommended every 36 monthsafter application. i ,,,,,rttpr-7117:4---p— . Iiii i i4r4P,r:441.,i14*..;'1-4'rillei./r;h1rtiirfk7-. 4,4 `, 'yam s c.,fir. iYC- ,4,7 ' , =-arm r,Y c;` `' ;_ftet�4.i9 cdr `te *"''r i, a` Ftp Vr.i,-,ki,. -,., ,YAIfv*E;� �a '�., %i ail"# ,c+ t O9 ' ,� ) �� . � ,,, Q�;r`�`"Qac ` .._ ,„, _. _, Ny , , ECT® E �F� 1�= o ., 5 9 } www.firetect.com IMPORTANT INFORMATION ABOUT YOUR CERTIFICATE OF , FLAME RESISTANCE. Enclosed is your Certificate of Flame Resistance; This must be kept with your decorative material in a safe place: The Fire Authority may ask you for this Certificate and it must be kept on-site at all times with:.the decorative. j materials described on thereverse side of the Certificate of Flame Resistance. i Please DO NOT misplace this Certificate: Additional copies CANNOT be issued. Copies are not valid and usually are not accepted by the Fire Authority, If article is cleaned, then dry-cleaning method is -preferred: : Various atmospheric and other elements can change the flame-spread :rating. Do not allow flame retardant to.come in contact with liquid as it may deter the flame resistance. Flame retardant articles must be maintained. Re-treatment is recommended if article comes in contact with liquids or every 3-4 years, whichevercomes first. Thank you for working with Firetect, we appreciate your business: 28298 Constellation Rd. Valencia, CA 91355 (661)295-FIRE(3473)Fax(661)295-3880 www.firetect.com 04/15 i REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COIVI 'MANCE Address of i Building ' r.:Z? . Ariz 1 • Off-Site l , J,� DATE OF THIS CERTIFICATE Fabricator v:',:>�� .;T� rY'.F' !s A% 9 -1. ,e" J j Permit Number e.1c..) Year TO THE SUPERINTENDENT OF BUILDING: CITY`INSPECTOR: ,>:.�=fr I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer [ ] Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement IX] Other dc-Ag.� Description and location of work completed: r ✓�� -�. ss-7-7e.A-r:4._ A (79,65.57z ,l ,4". .`,V2 J-Y.e1 � /7`�. /ioiLr ys�.0>: • ,Csa'_4.r 10 c.):=".5 a a A/6 .7 C J s 57 I 1 "0 f 7;(/';', ../1" A nn,,,e) C.+�d°�J'�J .�'?,�^.Zl,/� A i'* r'�..r__=u` ... :+'tw f_�. 9 -i-" r' 4,1-7-. A /Ix> AO .11A/4 ,...o 7- 7,74717 : D17 ra"..v , r ,?,,.f ." f`✓ 417Z 724' c G Size of Structure -==4'='C %-"`V" - 'DD` (7%gC1" ,?/4 f Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi, Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. S $"'2 c', /C r: ' . Registration No. Employed By: Lab. j _% /--0).'-.7 , Signature-Registered Deputy Building Inspector Independent [ ] / .%�i`L..ts• `i�! r:� -'r` : `tip art.! Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form:07 (Rev.6/1/2005) roshanian &associates MEP ENGINEERING I TECHNOLOGY I LEED I COMMISSIONING I ENERGY January 5, 2016 Inspector Henry Kemick Plumbing Inspector Building Inspection Office 240 West Huntington Drive Arcadia, CA 91007 Subject: Westfield Santa Anita; Laneway Sanitary Sewer Slope Dear Inspector Kemick, We hereby making a request to have .a 1% slope for underground sanitary sewer piping in the lower parking garage, in lieu of 2%, due to field condition (Per 2013 CPC. Section 708.1). Thank you for your consideration. Respectfully, • / ° fps ESSIoiy, ., r4 t oos ang i!�.,affari, MSME, P:E., LEED AP, CxA • e4� No. ay 289 1� 33 `° . . * EXP. !•'-314.' * A: 6404 Wilshire Boulevard, Suite 610 Los Angeles, California 90048 T: (323) 933-5252 F: (323) 933-5589 E: info@roshanian.com W: roshanian.com r BUILDING INSPECTION NOTICE Development Services ,wio e`i• Department �``•»•"" Building Inspection Office City of 240 West Huntington Drive Arcadia,CA 91007 Arcadia (626)574-5416 Address: Date: Time: The building inspector was here to inspect r7biltrp 4.67737( nouPt TA//04. huerA-zr#0-we40,,,tovms. %If box is checked, please schedule an inspection by calling (626) 574-5416 at least one (1) business day in advance of the inspection. Appointments may be made by calling the building inspector between 7:30-8:30 a.m. on the morning of the scheduled inspection. City Hall Office Hours: Monday-Thursday: 7:30 a.m. to 5:30 p.m. Alternate Fridays: 7:30 a.m. to 4:30 p.m. Closed Alternate Fridays Thank You Inspector: 14 Apey due` aroshanian &associates MEP ENGINEERING I TECHNOLOGY I LEED I COMMISSIONING I ENERGY Inspector Henry Kemick Plumbing Inspector Building Inspection Office 240 West Huntington Drive Arcadia, CA 91007 Subject: Westfield Santa Anita; Laneway Sanitary Sewer Slope Dear Inspector Kemick, We hereby making a request to have a 1% slope for underground sanitary sewer piping in the lower parking garage, in lieu of 2%, due to field condition(Per 2013 CPC Section 708.1). Thank you for your consideration. Respectfully, lanill OFESSIOt"` 1 ....,�oo7s ozaffari, MSME, P.E., LEED AP, CxA ,-1 v r ,- • i 22289 1 0 • * E 12-31- l * ,. 61 4FCHAt103 : '�OF QPa.03 ROUTING ACTION Date and =a �O,\ �,�o<� 'See Initials of /QIP/Go�,o.0)_/Qe, Notes Checker F on Sheet# Planning Enq. _ Build - ing ` y�i ►,. 1 Fire — — PWS-Water WELD Trees A: 6404 Wilshire Boulevard, Suite 610 Los Angeles, California 90048 T: (323) 933-5252 F: (323) 933-5589 E: info@roshanian.com W: roshanian.com r._ „ roshonion &associates MEP ENGINEERING I TECHNOLOGY I LEED I COMMISSIONING I ENERGY Inspector Henry Kemick Plumbing Inspector Building Inspection Office 240 West Huntington Drive Arcadia, CA 91007 Subject: Westfield Santa Anita; Laneway Sanitary Sewer Slope Dear Inspector Kemick, We hereby making a request to have a 1% slope for underground sanitary sewer piping in the lower parking garage, in lieu of 2%, due to field condition(Per 2013 CPC Section 708.1). Thank you for your consideration. Respectfully, i),F - OFESSIp. $„.‘ oos an JIozaffari, MSME, P.E., LEED AP, CxA f45a _ 4., . ( z 22299 kk * E 12-31- : * ', u> d/FCHA!WW* ,, OF CANg° I ROUTING ACTION /4.- 7c0/Uate and �� VSee Initials of4EonSheet#1 R,z, .,,,,, ,,c- Notes _ Che_cicer [Planning -II ------ — - — Eng.—_ i _ _ 1 Buildino I_ _G V7t_ _ i Fire ,---------_-- PWS-Water -_i _ -- — [WELO — —. _ - Trees I — I r A: 6404 Wilshire Boulevard, Suite 610 Los Angeles, California 90048 T: (323) 933-5252 F: (323) 933-5589 E: info@roshanian.com W: roshanian.com L 4(0URY KOURY ENGINEERING 14280 EUCLID AVE CHINO,CA91710 ENGINEERING (24 Hour)Cell:(310)713-4005 \TESTI N G, INC. Office:(909)606-6111 IFax:(909)606-6555 DSA File No. OSA App No. GEOTECHNICAL DAILY TESTING REPORT Project No. Date 12-21-15 Day 15-0961 (Final Amendment) Mon Job Address City 400 S. Baldwin Ave. Arcadia Job Name Permit No. Issued By Westfield Santa Anita-Laneway utility trench Type of Work Weather Temperature Density testing Cool/Clear sky 64 F - 69 F Geotechnical Personnel Contractor Superintendent Toto Rojo Westfield Jack-818-472-2093 SUMMARY-LOCATIONS OF WORK MONITORED,TESTS TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS,ETC. Surface Conditions I i I Dry ri Moist ri Wet [ 1 Tao Wet to Compact Failed with Probe On site as requested to conduct density testing on the subgrade of the 4"grease waste pipe line utility trench, about 50'long and 2'wide, located on the Lane Way,2nd floor of the building. Fill was placed and compacted prior to my arrival on site. The Contractor indicated that the trench was about 4 feet deep; However no test pits were performed for deeper testing. Collected-1 bag soils sample to establish the maximum dry density and optimum moisture content. The result of Lab test indicates that the subgrade compaction did not meet the minimum of 95%relative compaction. However the revised(see Structural Engineers's Bulletin#3)minimum required compaction of 90%was achieved at the surface. Moisture content of subgrade material was also low. Max.Dry Field Relative Compaction(%) Remarks Test Elevation/ Test No. Date Depth Test Location Density Dry Density M.C. Min. Method (pcf) (Pcn (Y) Field Required Soil Type Lab No. 1 12-21-15 +/-0' Subgrade, utility trench 134.9 126.4 5.8 _ 93.6 90 SM 3918 Nuc 2 " " " 122.5 5.4 90.8 3 " " " 122.5 7.2 90.8 " " " " 4 " " " 125.8 5.6 93.2 " " " II 5 " " " " 128.0 4.6 94.8 " " " " 6 " " " " 121.9 4.8 90.3 " " " " Lab No. Soil Description Soil Type Max Density Opt Moisture(%) 3918 Brown silty sand with gravel SM 134.9(Corrected) 7.9 ALL FIELDS MUST BE COMPLETED/DENSITY UNITS ARE LBS/FT.3 No Lunch Half Hour Lunch Nuc Gauge On Site • CERTIFICATION OF COMPLIANCE ALL WORK LISTED ABOVE WAS OBSERVED AND/OR TESTED AS REQUIRED BY THE APPROVED PLAN,SPECIFICATIONS AND GOVERNING CODE CONTINUED ON NEXT PAGE 1 1 PAGE OF • WORK COMPLIES AS NOTED ■ WORK DOES NOT COMPLY TIME IN TIME OUT TRAVEL R.T. REG O.T. TIME MILEAGE HOURS HOURS WTH THE REQUIREMENTS•F�� •OCUMENTS. 10 am 2 pm 1.5 88 4 SIGNATURE n r-_ Jack EC 8002974 I Approved By: PROJECT SU �� LICENSE / PERI TENDE - CC:Architect,Engineer,Project Inspector,DSA Regional Office www.kouryengineering.com FORM FR-20003 06/05-2013 KOURY ENGINEERING 11 :3-1 � URY 14280 EUCLID AVE CHINO,CA 91710 ENGINEERING (24 Hour)Cell:(310)713-4005 • & TESTING, INC. Office:(909)606-6111 Fax:(909)606-6555 • DSA File No. DSA App No. GEOTECHNICAL DAILY TESTING REPORT Project No. Date Day 15-0957 12-17-2015 Thursday Job Address City ' 400 South Baldwin Arcadia .Job Name Permit No Issued 13y Westfield Mall Typo of Work Weather Temperature Field Observation and testing Geotechnical Personnel Contractor Superintendant Matin.Noorzay Jack 818-472-2093 SUMMARY-LOCATIONS OF WORK MONITORED,TESTS TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS,ETC. I Surface Conditions 0 Dry El Moist 0 Wet 0 Too Wet to Compact E Failed with Probe Arrived on site to observe the competency of the subgrade(Bellow the bottom of Grease interceptors).There are two grease interceptor tanks at the P-2 level parking structure.The tanks are about 17 feet by 8 feet and about 10 feet in depth(5,000 Gallons) and 17 feet by 6 feet and about 9 feet in depth(2,500 Gallon).Both of the tanks are resting on competent,firm and unyielding native material which consists of Silty Sand.The quality of work was observed and found in general compliance and acceptable level of soils engineering practice. Recommend to backfill the sides of the tank with minimum two sack slurry instead of soils backfill. • Max,Dry Field Relative Compaction(%) Remarks Test Date Elevation! Test Location Ocnsdy Test No. Depth WO Dry Density M.0 Field Min. Method Soil Type Lab No, • Oct) I%) Required No tests taken Lab No, Soil Description Soil Type Mao Density Opt Moisture(%) • ALL FIELDS MUST BE COMPLETED/DENSITY UNITS ARE LBS/F7.3 No Lunch a Half Hour Lunch ❑ Nuc Gauge On Site ri CERTIFICATION OF COMPLIANCE ALL WORK LISTED ABOVE WAS OBSERVED AND!OR TESTED AS REQUIRED BY THE APPROVED PLAN,SPECIFICATIONS AND GOVERNING CODE CONTINUED ON NEXT PAGE1=1PAGE 1_OF 1 0 WORK COMPLIES AS NOTED ❑ .VW-. = NOT COMPLY TIME IN TIME WI TRAVEL P,T REG OT. rIME MILEAGE HOURS HOURS VMTHTH• 'EQUI?AE. OF VSAApPRO U..D000M, . 12:00 1:00PM 2 2 0 'CIT t5Sr ' .�- / .- Approved By - PROJECT SUPERINTENDENT,TOR LICENSE I/ CC:Architect,Engineer,Project Inspector,DSA Regional Office www.kouryengineerfng.com FORM FR-20003 06105-2013 I \ KOURY ENGINEERING , 1KOURY 14280 EUCLID AVE CHINO,CA 91710 ENGINEERING (24 Hour)Cell:(310)713-4005 TESTING, INC. Office:(909)606-6111 I-- Fax:(909)606-6555 OSA File No. DSA App No. GEOTECHNICAL DAILY TESTING REPORT Project No. Date Day 15-0961 1-19-16 Tue Job Address City 400 S.Baldwin Ave Arcadia Job Name Permit No. Issued By Westfield Santa Anita-Laneway Utility Type of Work Weather Temperature Observation and Density Testing Cloudy 68 F.- 72 F Geotechnical Personnel Contractor Superintendent Toto Tojo Westfield const./Accurate conc. Jack-818-472-2093 SUMMARY-LOCATIONS OF WORK MONITORED,TESTS TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS,ETC. Surface Conditions n Dry Moist Ii Wet I I Too Wet to Compact I 1 Failed with Probe On site,as requested to observe and conduct density testing on the 4"water line trench,size about 80'L x 2'W x 2'depth on top of the pipe up to the designed subgrade, located on the driveway of the basement parking lot, west of the Westfield(Macy)bldg. Fill was placed on proper size lift, moisture conditioned and compacted by two(2) jumping walkers. The density testing results passed the required relative compaction of 95%. As requested also, I conducted density testing on the subgrade, beside the grease interceptor tank, located on the lower basement of the Westfield bldg. Fill was placed and compacted prior to my arrival on site.The density testing result passed the required relative compaction of 95%. Max.Dry Field Relative Compaction(%) Remarks Test Elevation/ Test No. Date Depth Test Location Density Dry Density M.C. Min. Method (pcf) (pcf) (%) Field Required Soil Type Lab No. 1 1-19-16 -1' Water trench • 134.9 128.6 8.4 95.4 95 SM 3918 Nuc 2 +/-0' S.G.Water trench " 128.4 8.2 95.2 3 II -1' Water trench " 129.0 8.5 95.7 " " " " 4 " +/-0' S.G.Water trench " 128.8 7.8 95.5 " " " " 5 " +/-0' Subgrade, beside of the II 128.4 7.6 95.2 " " •. " " trash enclosure tank Lab No. Soil Description Soil Type Max Density Opt Moisture(%) 3918 Brown silty sand with gravel SM 134.9 7.9 ALL FIELDS MUST BE COMPLETED!DENSITY UNITS ARE LBS/FT.3 No Lunch Half Hour Lunch Nuc Gauge On Site III CERTIFICATION OF COMPLIANCE ALL WORK LISTED ABOVE WAS OBSERVED AND/OR TESTED AS REQUIRED BY THE APPROVED PLAN,SPECIFICATIONS AND GOVERNING CODE CONTINUED ON NEXT PAGE PAGE 1 OF 1 • WORK COMPLIES AS NOTED ■ WORK DOES NOT COMPLY TIME IN TIME OUT TRAVEL R.T. REG O.T. TIME MILEAGE HOURS HOURS WITH THE REQUIREMENT-OF�P� •OCUMENTS. 9 am 3 pm 1.5 hrs 88 6 '7 SIGNATURE r7 / EC 8002974 Al Approved By: Jack- ' PROJECT SUPERIN DENT IOR LICENSE# CC:Architect,Engin r,Project Inspector,DSA Regional Office www.kouryengineering.com FORM FR-20003 06/05-2013 KOURY ENGINEERING 1 14280 EUCLID AVE ,..� CHINO,CA 91710 't0URY (24 Hour)Cell:(310)713-4005 Office:(909)606-6111 ENGINEERING Fax:(909)606-6555 8. TESTING, INC. Date<2' ;-2-:—)I t 'i f REGISTERED INSPECTOR'S DAILY REPORT Project No. S 5— Oct l,o `. Reinforced Concrete Structural Steel ❑ Batch Plant TYPE OF INSPECTION I I Prestressed Concrete I I Fire Proofing Drilled in Anchors PERFORMED Reinforced Masonry Shotcrete Other Project Address City Project Name _. Permit No. Issued By: s (_ Lk) -:", 1 \1 '\ C)s>-. ='>c. \: 'i%• ,-, ,'\. •7 f"i( - c):'--'`t- f b:-,, c t` t',45 i',-J'. :".,t.., Type of Structure,_• \ Architect •- r t 1 _ Material Description(Type,Grade,Source,Etc). Engineer ,,, _ �' I '4r' Contractor i' =>-. LA- . 12\ Z 1 '4v :,\C-.%,{..() L. t,. ° !Y i. t �J f,;f Inspector's Name I - Subcontractor r� I- . --- .,i 1 C ( r.,�,i t C.L=. •.1 6,.-,v,} ca'. C_;:,. � _.. TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES INSPECTION SUMMARY- LOCATIONS OF'WORK INSPECTED,TEST SAMPLES TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS,ETC.INCLUDE INFORMATION ABOUT AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED,NUMBER&TYPE.OF TEST SAMPLES TAKEN,STRUCTURAL CONNECTIONS(WELDS MADE,BOLTS TORQUED)CHECKED,ETC. • ,, .,f•1\i', ,'r 1,. . ~\i \ ,' e, , , `1 ,r -\ -1 r S! _>.' r` . i 1 : .. .. . , , .'1': cy. ,,i :;_ t�S _•J tO t‘ [� (';; K.'.,C,./ -_.,,,i•, „\' \--.),',`.-, tt)':.C,-,�1t, , - . : jr :(r. ... t r, i C..r .r - / � C_r (L1').,U. C1--,i I' ; f .,\, V.. '... ... f t l it ,t . _` ; I t • ! )) -r t y .,i .: -r•i. . t . t. ._ ..v, .,� •1. i r -. ,. rt '/; .. `f ) '-r i.. \' , !{- V. 7 ? 4 . !-) ;' ,, . t /f •,(•- 1 . ri _ r r.' t : t0, / ,,i CA 11-0 i.;•1,;jt. ;"•...' L. I I.:. :) 0;a I t.',/ IC f 'v-, t.J. ..'J s (i.' -•.,5 t`s I.2/l,-s- f yr•, 1 1 . .. r.1 1 1 '-:% . C: ,- 'IV) , t. i( . 1 ,.• 5.. ' — t r. . 5 ,. .. ; \,. ,. ; t-i-(1 f C. . r' , , , i! L'i - f ,...-1 11 L'r,-• l,! i- ...1 . ,.'t F. Li, - .,: , t.,• f t i i. - c , L L./ r.” I. 72,,. ,/:.i'i ,-- -__.i -i "r r M_ .) ❑ CHECKED IN WITH CITY ❑ REVIEWED APPROVED PLAN ❑ TESTS PERFORMED PER SPECS. ❑ CALLED IN SAMPLES FOR PICK UP QUALITY CONTROL ❑ ON TIME TO JOB ❑ REVIEWED SPECIFICATIONS ❑ CORRECT NO.OF SAMPLES ❑ ALL DEFICIENCIES NOTED CHECKLIST ❑ CHECKED PERMIT ❑ REVIEWED PREVIOUS REPORTS ❑ SAMPLES STORED SAFELY ❑ OTHER CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE❑ PAGE / OF I ALL WORK LISTED ABOVE WAS INSPECTED AS REQUIRED BY THE APPROVED PLAN,SPECIFICATIONS,AND GOVERNING CODE TIME IN TIME OUT HOURS HOURS SAMPLES IWORK COMPLIES WITH WORK DOES NOT COMPLY \APPROVED DOCUMENTS t,j(1.: i j t All inspections based on a minimum of 4 hours and over 4 hours-8 hours minimum.If the inspector is called to a project and no work is performed a two hour minimum charge will be applied.Please verify Q.C.Checklist. Signature of Registered Inspector f Speciality , No. Agency . Project Superintendant\ CC:Owner,Architect,Engineer,Building Official www.kouryengineering.com ' .- - FORM FR-20003 10/30/13 KOURY ENGINEERING � i 1CHINO,CA91710 / '�0�� 4280 (24 Hour)Cell:(310)713-4005 Office:(909)606-6111 ENGINEERING Fax:(909)606-6555 TESTING, INC. Date p i I i z_i')! i i� REGISTERED INSPECTOR'S DAILY REPORT Project No. , r_„ `, Reinforced Concrete I I Structural Steel Batch Plant TYPE OF INSPECTION I I Prestressed Concrete Fire Proofing Drilled in Anchors PERFORMED Reinforced Masonry Shotcrete Other Project AddressCity , 7 'C r_ I'r." e,La E.l r :"t :: !�(.r' \ , Project Name , Permit No. \, ., Issued By: t iA)C. _?..•'\ �' .. ., .,} (.-', t''4 . , ,. .c-^, Y1(,(J _Q '...3`, ...[}'i !d._ - . " s' , '•L ^ _ _\ . r Architect t Type of Structure ....5"j .. . 4. �, 1',\. '' \l.,,.„. ,..\ .4. is � I'` , Material Description(Type,Grade,Source,Etc). Engineer \ _ ! i I-',1'.+t— '-f- i \. ..7:-.'.-':_”, _ `, i.; \Contractor t . Inspector's Name • ( S Subcontractor _'1.. . • \ ._ .-� .i.':\‘, (.(1_ \\ . I `r TESTS PERFORMED TYPE OF SAMPLE -SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES INSPECTION SUMMARY- LOCATIONS OF WORK INSPECTED,TEST SAMPLES TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS,ETC.INCLUDE INFORMATION ABOUT AMOUNTS OF MATERIAL.PLACED OR WORK PERFORMED,NUMBER&TYPE OF TEST SAMPLES TAKEN,STRUCTURAL CONNECTIONS(WELDS MADE,BOLTS TORQUED)CHECKED,ETC. • ! 1 " f-` : 4,eADM REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE (.ry A- 22-'f_? 7N�� AC/-ri'�.I � c 'Trr/'i`LV 64AlevE EAT /Ao - T 4ddress of .� 3uilding d saaryl f 'A) Dff-Site DATE OF THIS CERTIFICATE =abricator C) AIv,4.- VAyc)J 'ermit 6%25'—25'— \lumber R ©$+6 s SAC Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: • ,VA'd/ 1(-'4-11-^"G1< I hereby certify that the following portions bf the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer (>4 Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: ( / . -.e-) r/e./A) O1 Ae_z- A27I2 O CCA4 c r-b/✓l 9c.-6-4'.S-r% - g 7® AC4s AI4 z -% Z✓.✓lt 2Z a 23 ['W6,/A"Z—♦ $44°A ,-.0 00dAL tIPP.C<r'z ��i-J4M/dP/'sem ./.~..Qr.O "AM i1/. 7,3 An.,6V,,V.C'r 5 Son" A14%0/A-,z- Wipe .66-104, 7.44-rd- deirelc///ppi...".ir 447-rQ (.lJ3. i) /i..CC 13.456,4n- io-r 9 r%- 3 oc rk/ Dv R 4:74r RA,9177)44,1 geleAr p i/Ni, , c a''irtai€cfO 422. Size of Structure ski.sT//e )I C - Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: Lab. • Signature'-Registered Deputy Building Inspector Independent [ ] Print Full Name PO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) Aec'a©'x REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE. W ry/d D - A.v43`wA y "Ca oirc - address of 3uilding 4"DO 5 19,4€.J, )ff-Site DATE OF THIS CERTIFICATE =abricator / AAi VA (>0.4.._ Der mit \lumber Bar,-06-S— 0, Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: 2V 1C-- .1'i°4 I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: F'A'A /V011T Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer [> Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: 5 r'' gr. .67. 2-1.-VidSY-,az4a r�.4.. .30 &4/G- '�c�i&,-rxi �✓,��c 4A rd A -c../a. 37 r,i34'..7 A Aizta,A41 dA✓ 6/1c111-74 .o "Oa.j 51. A /�I/srz P -d "La S 1e'/+•gw, ✓"ver,ed 76 A.81 Rd-AM f2s e?i, .s/A/F • �. 2 y S'�.rp7 -16 c7..v& 41M7.00 . Joyce frev.rdev4 pax. dlrr 7/6-7-A & rr 4 e aas c 6 �,•P�� 1./ /�G►.h<G g 3i S•e 3 Ac_r eoz_(<.754,/? 5i.c .44e 37 `/ TO /Cane) 4514P-Arris- fdre.j1 E'T A - L✓S6.o.s /.e<cLG7?SG7a /` �.C` �/�1rT .F-®-�G�r .✓ Zti -60,0,07t_ f✓.c c X.4-4-t' dams' A'r a is 9'-. a 2 sa&s.��Ne Pte- nom-/CJs T3 a i/✓S%e 44„4-7-141.. of/VG'S 1-24-C*4 V/A SdpPa/Lrs A6aad- 'FO,cat ,IavoF ��1�sez- z.•Adz /4 L' Tie rAl4.s.W.51T2 ,:7414.eA.- Palo 23 FAL. Le?kdaQ7 AeAF ( sS/ 5•1e1.a<yr Evsial ..0 7 <3aLrr 1P4<OG.S A1-72/4 P./L.oelv .414 Ta A LJ&L,p</VU GaA'1, . Tiie/d 44e ID Size of Structure A.Z. Xa 5 ' S-5•'6"ro70 Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: Lab. Signature-Registered Deputy Building Inspector Independent [ ] AiE{v/A- -A! de /??akega-/t/rcf•A/ Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) Cr9 dF A•ec4Di,4 REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE sviejliCArer A d/.o 2 Q. `. a./7-4,0 20c^-2/ es7/=46.rhe 'e%l'wr9 y Ateua74ZT 4ddress of 3uilding off-Site DATE OF THIS CERTIFICATE :abricator VA 10/:- 'ermit ‘Jumber k, Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: -*A-A/o Y k'4""z.°`'/ A" I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: F/tidy 4 /.�4i aiz.:TS'k�47� e`r'.� Ls dye- DO -Cc_ 2.oyc to l/ Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] 'Other Description and location of work completed: ;Arts e/e►ez.Ai-14%N" ¢ 677 - .,.a -d1�.�✓� P_cs �� Pas'L / ' ? 44.7402- A.A..-o %CA' 1z Issue. AS /dam lotbodprity r rrr.0 12.40;/ 5240 e S e2•( £t :-74 'i-*ed 3 7 //gS ..4 7 . o /are eanoa..we'rleAldo t9691--- L? ,d rG, 7 /3.1`V/ST-y -7;r0/61*-- RdiyF,-,.,2 dn.v- A.r.D hexa.✓ f a7L 2 ft'7�IC-Cr4l I i iAr-' 4,14-C 77 ,o2--f t.�J�z O G feket De-To r0' $fa -7 4 +',_G. .-Pori-�7o,. 'rS Y aF/4 r Tib FL 141249&•^A0 .64 Sr l .q ea.Gzi►rs a.G' 1791' ""-'44 Raor i-GYk2 C6'v, 7'o4,, PA'S<YST9 Ott J's Prx .l A-m,,, A I t #T ,A€944 P s ,AktzWbdr' ///5-7-2 e47G��rS 4/5-' 4j Jafi,cl✓moo £d.r..3 /17aO7 Size of Structure - 's - Z ' Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: l� Lab. Signature-Registered Deputy Building Inspector Independent [ ] . . 'iv,✓ ,U Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07 (Rev.6/1/2005) 009.1ecilom REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE kddress of 3uilding )fF-Site DATE OF THIS CERTIFICATE =abricator CgAA1 1/A Dermit dumber — 6� '--y g/‘ Year • TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: ii./6-41 ��''-d"/1' I hereby certify that the following portions of the work at the above address which required continuous inspection, and Nhich I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: &"f L RERCai 1 (.4.Jc=s i Skrzrati1 VP Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer [5.411 Welding [ ] Concrete Placement [ ]. Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: eo." ". .a-J - v J',0 aa.I'.0vn✓ Aek/O 44/s`I"40 i✓Z 0 de d1S AD®CD sTn-tz. 1a,/1— rvv'sl SA-* /6W 4/.v41;-5 4-� 7.top G•�40s 22 70220 3 D;wihtas'/0 /S.,? APD v®®•vx. 5 uD 444 .:46,4eere DC1all-M17 ,1h -i1 G_'/oy+/0"40 s-..W/114 40''1/y jzr,10n4-- "earl_ 2.frr 9 .415101,,x-- 1--A.iaT Z3 4 za%.2 4)490 .va-AJ A774e;anerivr Bc1Gsrs' -z g �i ac - ./_,,v0-42 Gr/24 `7.4"45.7-/A/G. g°6< 130-0?-1" P Df7$6/- /3/.57' e? ,%sr /0-r,1 SPS ear zA4-10 A 'xr.i 74cyi' 1z e" P 6.%?%17r-tv/z--- cam'S•41- ? r app,,, �ri2 p. ,40 Dar-J, .04,11 fc�,a D 1 ;diti r £2c e £• Size of Structure £ Y/ST./AlG '‘201P Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: Lab. Signature-Registered Deputy Building Inspector Independent [ ] .kecr'A/A/cr-! / R Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07 (Rev.6/1/2005) G e /Q/1C-AD/74 REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE F/Neva.. 1Peiaolvr .51er ,45cri 610 4400 Aer-aSs L'*'arOD iia kddress of 3uilding Y.00 So m )ff-Site DATE OF THIS CERTIFICATE =abricator CAA4lA- VA_Va 2 permit Dumber / - r"--O..5 d 67,4 Year ro THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: /116Av2y J ' ' ' 4t I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: . Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer f Welding [ ] Concrete Placement [ ]. Gunite ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: CO 2-raD sLre L- .41.4.1) �✓��a�i�' Or Alex-3 5 / i'7 01"0AM V/J A SVD l/,& 797' z./A,tr Di) GLe9 Zd 1^�ars As g'r✓ f�/SS la-r‘ ry wry! i? ZZ ..e Z. .vew -yi, 4/0,04-fioodve R409,19,5- Se-z-Der Vat"' Jens. per S/` 2 o.. s/A, ASS.�t�t%- Cob a.r, �a l Bolus Sac- Dom.A7/613 _r/sS v...4‘7,43;"‘ , tsw,o- 15/57 51 4L /0 G AS. C5044,445-4- 1-40.0 /WO BeVt,frP,45:4440e f✓l$.r�rl L✓ �Oa/ 1)D 20?0 Zi_ Paw_ '> Jq/ 7q Al'!) 5L-r 9- G"oAiT /4/57,0„e- y m //sT , A77.44-11Raor Ad' Lasjp 1122nd Pak- Sc iie--v/76,a s//(7--1 Az /.acs/-D f/vG. Cami s/l.r PAA ADD422A .' S v.G �Lj!-rs .43, A.vp ASS+ z' ®ev f'/46 ADZ Alt B Y 14 e.0)-7'r.0,dJ i412#.el f !/.Shue 47-7/77 /ivev237L-CA/a-dr�f Size of Structure EXiCrin/G /?ooh' Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. /CC U7 '9 Registration No. Employed By: Lab. • - Signature-Registered Deputy Building Inspector Independent [ ] iracovzs-7// A cf ��A./ Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) ; wc 4/74' REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE s�1=vc�� LAN 4-1-4)01'7 pc.rA-c-T address of 3uilding 4'O2 6-04/7/4 13A4D G✓s.V )ff-Site DATE OF THIS CERTIFICATE :abricator 6-"-Ayo/t- Dermit dumber 01300 —d SSG-- 4 Year • TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: #49/4-V ft6?2n/)C K I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: FlA4,,A- . L'1i0.0 9C)i pG deoA {3�ria1- AT Ave ARrd- Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer [>4 Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: td, 9P.4.A-r--L-f, ao:s0,qv ,s04,11 X16' D D,' P--.ori--r F,' i NA'S izea goer /)corj'✓� v rim LJ/De- F.IA1✓G4- )woac,e 841-.arms . Ca val4-c T!oat/ A 4i11 £1iJZO,,i,G P"2 pe7 - 7/sr- elf' Afifeleoz 117,44.vr & A/' - �� /�•S J%Z.t�T 13cP4A.s.a+) e7zer ti r7-0 3&&r' sX 27 5 /2-r ( .2/4/41-5 DD G Ar,F.eo./.5'2l AFAAV#Al Als s`/2i1C*' &7t•Jazw .Z,.✓z's Dt7 To 4c JA-e-4,017, af c 76-21A i' on-02h' /VSS/2-i e-s D A/4*.,. £iva$ 1)D77 ee. SA-extra-4 2e, 7.a i©c� iJe261I,-L By c_c�� cam- IrA4z o ( 6-7i7-7 ni .,4for.rac- er.,/ F1ACC 1067.W A.{IG-ye Size of Structure 6kiSTsN' /loo' Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. k Yee— Registration No. ' Employed By: • Lab. « L ,// Signature- Registered Deputy Building Inspector Independent [ ] JPAovs14r.I /2 , 142'NAA/ Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) A/Z c/ /'g REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE \ddress of 3uilding Cer )ft-Site DATE OF THIS CERTIFICATE :abricator L'�A/J I/A G'® 5- 1- / • permit Dumber 84e)--/5.4f- 5/G Year r0 THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: -4A-2114-1 1k A/2-/VA�A- I hereby certify that the following portions of the work at the above address which required continuous inspection, and Nhich I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer .7.] Welding [ ] Concrete Placement [ ] Gunite ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: Ca' P.zz-r -O u/&2/J,"it /Ass y4 4-121,12! A evL! NSs �1 et-:e 5S..0P->�'L.�s' Pte— i7 %o r -sed E-2`y/ 'II 14 . St Sr it $/M- .CO�✓r� P/Cl1 B k!-• /4H7- / np. c7 - c . yvL , .fCI�I YG aQQ.4 i.') UCi de `f IYrS' 5-T 5-4- v C'cr�.um.( r-a.sL Racal' .t34-At/ J 2 ' 2 eAdn_ 'T lMvaz. /discs /d 4 Gx J r 2 L OTA/Z S '.s i r ire ?o P 130-7767/1-7 4J/J. .4t'/m'i - .ea-)c Z&ssL 4 - s a00,0 o rA/4- AA To A Gesso 'J - s Farm_ //.s-rr✓ S4--9L/4'lr £-A"Ck el A/6-0 JY//L G E' z S A.4/ 4/4-1l0 i.a+2- -3" r"3�/ �_/r.4- Size 7L"Size of Structure Eer/S 7-111.41-. /Zoe lc S r "'WWI Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. 0T-1S Rerq Registration No. Employed By: Lab. ' ' --- Signature- Registered Deputy Building Inspector Independent [ ] ike-A/A43-771 A AT /04 Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07 (Rev.6/1/2005) AxeAoo4 REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE Al)aS:Fi ArLO .%.,aNar r r/A y fir-e1/474-c-t— kddress of 3uilding '/OO Sou rW 134401-4 N )ff-Site DATE OF THIS CERTIFICATE =abricator (EAAJ il/A 1� 'ermit Jumberr —O$ /� ,r/ Year 10 THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: //AA8 /("e I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer Welding [ ] Concrete Placement [ ] Gunite ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: 60,49:e-07-20 £ -O,,1,G -0q4y•r s'4 NQS CwasJ- s -e yS/..‹C GL l P.c Pe-TA/6S k/►9i Al itty.r >4. y'oL c X 4 A3&.--7 �oYJ 7.4 L L,c1-f i p,s. grit//A 4./ ,.Q rive"— 116-5/2Ar L•r f3E,A07 7# B✓ '2/.r$'tom A s•4404#2." AloeAsti G/tcQ al A„iA 444'24/- e•IL AT D1) 21 4J20 'e 07, - p z De-7-7/5'7' ht/sS 1.O,GL,A 7704/ A A,D cony. O E NSS ` /IX /3 PA/2- fLn. Ret 4' F/« 4 .epi, • 4.%)4:74 0 60i/v€- Size of Structure , ')'/cR4V- ' Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: Lab. Signature-Registered Deputy Building Inspector Independent [ ] m e � 4 Print F611 Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07 (Rev.6/1/2005) REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE 4ddress of 3uilding 9 c Sear/ )ff-Site DATE OF THIS CERTIFICATE =abricator a gA,u6 ermit p�.,� Dumber 453e -ó5/b- 0./4 Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: f°V2Y '=°171-41/ 1( I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer (x] Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: /t.r 7 4./)17704,/ Off' '� ASS /t-re 73aa j' `Pe-P,A4.1..-s drJA/y 71Wir.&.urss de-ea-0 / Ad%.O /,.J LO 0a SivGivd.r Ar 2 dr ‘2419Q Fed/ 76, 5 S d'-"c la -Z-! CM 6 nar.,m,e 5 )./ V4 41./ .Ar/(TA TA Al f5-r .'/S5 C/_,o /96rAarvs 4T /7 AC4 t 70 Comfy ;to f' 7- , .Pxr--'7p ly Q 19 iii/1711)Z L As i7- / A•^,0 /c16 l/A4./ or a /OA- Cj'Ata/.t.trz.. -ro A.n p7cM �I#67-ierar ®t ' .1'/s;l/Va..1? VC B c o.? A ff ��et/t' bTD :,c I o So ra zt iA..t CgrA/ 6f16 o ' GdB--46S C 'i- C 7A-/ zJS/A-.6 e-717-g %/7/�L Gdx rs O"/ S/t' Size of Structure 4 J/sT/A1C /Sat"( Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool _ I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. og?sKc' Registration No. Employed By: Lab. Signature- Registered Deputy Building Inspector Independent [ ] Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) / RC 4D`,4 REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE 4ddress of 3uilding It DO- . E3A140 s/1J Dff-Site yib, DATE OF THIS CERTIFICATE =abricator (27.�.-I.4.1 VA 5't' _. `Z -� 'ermit \lumber $O J -0 5/ 5/‘ Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: AizrWA )41e'" - I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer [ ] Welding [ ] Concrete Placement [ ] Gunite Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: ' ip c..=r' .Ai' "ia "Ass. /a4.46 • 8 7 4447),__ oC/ev ;"/1 C—.r pp A7 7 pp etc- r2rasz co.A.4%,,e,c_7-e,12A/s' 7747 4i7e' ,q4=---,4.79 D 7/67-4/ iS"i/r, c'4' . /A4.57-Aft-4-10 i7. -J tr W.C.S. 12a' tbsz S.Ffryi,i c Ni GvT or,aT 4tr,2KPQaI��e /iA f JDL-z A Ti et", Oil #056-S.P.-t- 6 x Bpi /71 J ?G G'C_ .20 76 oto-T PsdL De-7,6 7fs/ T CeraVi Jar-4O.ease CC i /7,Ape o-t- 5/ S-t +' h(5-3- ()/'I'Pt Co..4eAr4/ts r F00001 r awxx AP-64.2 p��. ;o cies/ ty f1Pii,x ,,J !/.v1 ex5-,77P, �. 5 ev c,4 £7,77 ,/n: L r Caere r�- Size of Structure :r/.r/N12-eratC Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. /cc asp7.( .7 Registration No. Employed By: Lab. Signature-Registered Deputy Building Inspector Independent [ ] Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07 (Rev.6/1/2005) „09. c',lpm,i REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE p/EI O -LANE/44O y P20,7a-ear” 4ddress of Building /S4LAOLAJ,1i Dff-Site f/ 171,„0 DATE OF THIS CERTIFICATE 1�. =abricator 4W — r,E jun ��LA -0 /7 / rmit ,"� Number sU�- � 057 Year TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: •rz9V2 X6 44/ I hereby certify that the following portions of the work at the above address which required continuous inspection,and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: [ ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer >1 Welding [ ] Concrete Placement [ ] Gunite [ ] Hi-Ten Bolts [ ] Tendon Placement [ ] Other Description and location of work completed: ,s7v.. /4® Ti? UP .A/LAO 7 Cot ig P..a cx OJ / £k'i` i 5,hr.t.1‘,41'7' e Ivo G -/Of CG vr-a 40 22. 7 ?d 12- 1.4"x A'2.49/v'we 1-hi-5-s' iz r c-e A774 el//12A--r /,l.2y.rC,� aAtb FID 21.3 �f.vi :es V•W ?> .13,goi»p411- 4,,,z. T it1 t>+i/7.sY A r C.Pa✓.✓t=-°7-/c.v f l',7,1:C,C�,l fir VA .o.0 , a s c,C -4,v O c 9 /'CS' fa r ms r% 3 .-,a.s .O 7- .rvsv OP,eav,.<Na. AR. / ? S''D y . tate-10; - /liar Co/nP , se OAI e OS74.0C /4 0.-727—fA;e2/ iA/ 47/ ,V,,1-of rAr o eii C�L"TS l/Gn-s%s.4-- oil AV O AZ .6-2-7 te' 45-7,97 c.ci R Ar.9.46 Size of Structure `'/S 4N0 12O0-P Time Arrived 7 DO No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. I was not employed by the contractor,subcontractor or material vendor. Registration No. Employed By: j Lab. O If�f S _ � �/ A"' Signature-Registered Deputy Building Inspector Independent [ ] Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) ,4O'f REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFICATE OF COMPLIANCE 12e-sr f/Ard-p 44n,jk-, y P�J4-eT address of s'r e 3uilding 9'00 5 .?.44Z Dff-Site DATE OF THIS CERTIFICATE =abricator_/Y�rJ/uo.�'v'T� /� permit tf --/� dumber 6(40 — SG— vr/G Year FO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: /" : Y �cC'�2/v�czc I hereby certify that the following portions of the work at the above address which required continuous inspection, and Nhich I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable :hereto: Type of inspection: ] Masonry [ ] ReBar Placement [ ] Concrete or Mixer ] Welding, [ ] Concrete Placement [ ] Gunite ] Hi-Ten Bolts [ ] Tendon Placement ] Other Seamy I ,'.'Ae it /e.,a73 ,(,e.•/0 Description and location of work completed: ,r', Ac-J Sc✓es7247-4 Ad/4 466'zvznv p4:f.c� pal' iii17z,45 ,a? 5.(--.9,L/G w7 .eye ez,r 6.e/D Z-,,k,44' Rid rte- /3 _5'.vcr-r- / !J,Tyr "Pk).n.e.1„e::P.7Z- jt./ 'd Na 7- Dov - 1 V'i AtrieaiiT' �cra.urPvd .A/- 37A4 "le 43B Axa-T" I�.✓tr- _ Le.z. sv w 4 Xao{ ./4 V/-A / '4'aa l2 �Q�O:s4-� Pi c S/✓ T ,4O•r 11410-6"- 7 Size of Structure 4I'/4f %/,VG. A2 ��fd/6'7 Time Arrived No.of Stories Time Left Job Conc.Mix Design No. Psi Swimming Pool I had sufficient time to inspect all materials used and placed. • I was not employed by the contractor,subcontractor or material vendor. os7$goI /e-C. . Registration No. Employed By: Lab. Signature-Registered Deputy Building Inspector Independent [ ] !!id/l4•7"efijv lja c --Axvt/ Print Full Name DO NOT AMEND, ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. IN.Form.07(Rev.6/1/2005) KOURY ENGINEERING URY 14280 EUCLID AVE '�® CHINO,CA 91710 (24 Hour)Cell:(310)713-4005 ENGINEERING Office:(909)606-6111 . 8 TESTING, INC. Fax:(909)606-6555 • Date REGISTERED INSPECTOR'S DAILY REPORT Project No. Reinforced Concrete I I Structural Steel I J Batch Plant TYPE OF INSPECTION Prestressed Concrete I 1 Fire Proofing o74..;,,Drilled in Anchors PERFORMED - II Reinforced Masonry I I Shotcrete Other / f' ° 'Project Address 47.70: .-- . Aa 1.4'4 i`2i. - CityZe. a,' _ tt T` ter: y; . Project Name 1 )r.r{": 1f%='' 1'+.,'.z•-'e}' ,, i.i.7, C..:✓f°‘. Permit No. x;.'•..,,. , -) /c� - Issued By: 1- ,,,-2.41i'.47,.-1.f / a ' . v��s/1... ' b' Type of Structure "^" Architect y 5 ;.;"4... . .• _• t '- - i Material Description(Type,Grade,Source,Etc). Engineer .I'g., . P'",;1•, - - A d Contractor L,?�'�,s- :,,,,?�.r,`� Inspector's Name FJ V V"'aro . Z'j , --•j—v s., f(;',r�i)o,�c- Subcontractor r� � I r ^---- ---. l va Tests Performed • • TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES INSPECTION SUMMARY- LOCATIONS OF WORK INSPECTED,TEST SAMPLES TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS,REMARKS;ETC.INCLUDE INFORMATION ABOUT AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED;NUMBER&TYPE OF TEST SAMPLES TAKEN,STRUCTURAL CONNECTIONS(WELDS MADE,BOLTS TORQUED) CHECKED,ETC. +moi', ,6'i+....f..,,,, .f_.r.,:'I J 1�-,'`•�`'2 'ref,-'v' �? a.`*.G..;•' '``'"4..✓1 _ f '�.2'=- <01,:f2,-,..e.— -Y .s.,-. s—: N i_,✓ - tom::. �-.G .i.-:�'" /s -a.. .. fr. 1').? ) r / r 7 /2 yr • i5:".•••=4',�o 1,'.. - ? I.. ''.r%''t; ;:1�4...,d-"-d-d" /e1.-//' ,-?4\ r` ,r--•-Ti;k-'1',—:r''.*. 1 .--:Z '.f1.'i.{x,14,, • 7 -',,, -,/,':"aft G>: ..,./0 W i+e.{ t-Y/' f "t=r,_ i ',,,C--- / - a7k�C,� c -j • �'ii':f+.� �^ i ,.7/ft -E 'r` 4 —.",".---.:—",3.-6'-,-E • 1 f F Y / / • • • QUALITY CONTROL ❑ DSA-5 FORM COMPLETED ❑ REVIEWED APPROVED PLAN ❑TESTS PERFORMED PER SPECS. ❑CALLED IN SAMPLES FOR PICK UP CHECKLIST ❑ ON TIME TO JOB ❑ REVIEWED SPECIFICATIONS ❑CORRECT NO.OF SAMPLES ❑ALL DEFICIENCIES NOTED . . ❑ CHECKED APPLICATION/FILE NO. ❑ REVIEWED PREVIOUS REPORTS ❑SAMPLES STORED SAFELY ❑OTHER . CERTIFICATIONS OF COMPLIANCE . CONTINUED ON NEXT PAGE PAGE OF A PROVED DOCUMENTSHE I I WORK DOES NOT A PROVED DOC MEN TCOS WITH ALL WORK LISTED ABOVE WAS INSPECTED AS REQUIRED BY THE TIME IN TIME OUT HOURS HOURS SAMPLES APPROVED PLAN,SPECIFICATIONS,AND GOVERNING CODE.., ,, / i e i....' (- 1,/,r,' "--1:Tt Z-,•! All inspections based on a minimuni�f 4 hours and over hours hours minimum.If the inspector Is called to a project and no work is performed a two hour•tninimum charge will be applied.Please verify Q.C.Checklist. SIGNATURE OF SPECIAL INSPECTOR r / Approved B ( -I ` , , C = ir' ','..,=.7-2',";,-",,,7,;:"..2 _'(7 PP Y:'' SPECIALITYNO. ' ,t AGENCY ' PROJECT SUPERINTENDANT /")/ 'e Y4: ' CC:Owner,Architect,Engineer,Building Official www.kouryengineering.com FORM FR-20003 10/30/2013 iIOURY \ KOURY ENGINEERING 113219 14280 EUCLID AVENUE CHINO,CA 91710 • ENGINEERING (24 Hour)Cell:(310)713-4005 \ & TESTING, INC. 7®� Office:(909)606-6111 \ I Fax:(909)606-6555 Date 03/22/16 REGISTERED INSPECTOR'S DAILY REPORT Project No. 15-0961 TYPE OF Reinforced Concrete ❑ Structural Steel ❑ Quality Control INSPECTION 0 Prestressed Concrete 0 Fire Proofing ❑ Drilled In Anchors REQUIRED 0 Reinforced Masonry . 0 Shotcrete ❑ Other Project Address City 400 S Baldwin Ave Santa Anita Project Name Permit No. Issued B' Westfield Santa Anita LUTSI B00-051-516 city of Arcadia Type of Structure Architect II N Stenfors&Architects Material Description(type,grade source,etc.) Engineer Simpsons set XP ex 12/08/17#4 ASTM 615/60 ANF&Associates Contractor Inspectors Name Subcontractor James Mc Callick TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES INSPECTION SUMMARY- LOCATIONS OF WORK INSPECTED.TEST SAMPLES TAKEN.WORK REJECTED.JOB PROBLEMS.PROGRESS.REMARKS. ETC.INCLUDE INFORMATION ABOUT AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED.NUMBER&TYPE OF TEST SAMPLES TAKEN.STRUCTURAL CONNECTIONS(WELDS MADE.BOLTS TORQUED)CHECKED.ETC. Provide deputy inspectionfor the placement of #4 dowels 12 inch on center 4 inch inbed per RFI 34(ssk4 01/29/16) @ 6"curb (Simpson set xp) between linesBB to CC/38 to 37&EE/36 to the best of my knowledgethe work inspected was in accordance with the city approved designed drawing in the provisions of the current building code with no corrections ❑ CHECKED IN WITH CITY ❑ REVIEWED APPROVED PLAN ❑ TEST PERFORMED PER SPECS. ❑ CALLED IN SAMPLES FOR PICKUP QUALITY CONTROL ❑ ON TIME TO JOB ❑ REVIEWED SPECIFICATIONS ❑ CORRECT NO.OF SAMPLES ❑ ALL DEFICIENCIES NOTED CHECKLIST ❑ CHECKED PERMIT ❑ REVIEWED PREVIOUS REPORTS ❑ SAMPLES STORED SAFELY ❑ OTHER: CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE 0 PAGE 1 OF 1 ALL WORK LISTED ABOVE WAS INSPECTED AS REQUIRED BY THE APPROVED PLAN,SPECIFICATIONS,ANDGOVERNING CODE TIME IN TIME OUT REG.HOURS O.T.HOURS SAMPLES 11.WORK COMPLIES WITH ❑ DOES NOT COMPLY 700am 900am 4.0 APPROVED DOCUMENTS All inspections based on a minimu f 4 hours and over 4 hours-8 hours minimum.If the inspector is called to a project no work is performed a two hour minimum charge will be applied. eri .C.Checklis SIGNATURE OF REGISTERED INS' • •R ✓ Approved by concrete 080835 county Los Angeles Project Superintendent SPECIALTY - NO AGENCY • ) •f. REVIEWED CC:Architect,Engineer,Building Official www.kouryengineering.cc By/ainies at 9:32 am, Mar 24,2016 :R-2000303/1/2015 ;; Department Of Building &-Safe f- Material Control Section 1 : IA ` 221 N. Figueroa' , 4th Floor 61 '0,71 X • Los Angeles, CA 90012 �:r0: '.--07' Tel. (213)482-0315 FAX (213)482-7318 www.LADBS.org FABRICATOR CERTIFICATE OF APPROVAL Shop Location Craneveyor Corporation Gregory Bischoff Gregory Bischoff P. O. Box 3727 1524 North Potrero Ave. South El Monte, CA 91733 South El Monte, CA 91733 Approval No: FB00827 Branch No: N/A Expiration Date: 2/1/2017 Approval Type: USS/HSS/AL/RB/STNSTL You are herby notified that your certificate of approvalis valid until the expiration date shown above under the provisions of the City Of Los Angeles Municipal Code, section 96.204 (g) and, Information Bulletin P/BC 2002-042 (Part I) Renewal. ../.., ''-fh, "ichdd For man 4001" Principal Inspector Materials Control Section (213) 482-7097 ' ' r 0 •1: 0 II.5 . I r •- "4"--"?.. My Professional Information: Last, First MI: McKeehan,Kenneth R Certified under this name: Kenneth R McKeehan City, State Zip: Lancaster, CA 93535-4822 (te1:93535- 4822). Certification Type(s) : Structural Masonry Special Inspector(expires 06/20/2018) Structural Steel &Welding Special Inspector(expires 06/20/2018) Spray-applied Fireproofing Special Inspector(expires 06/20/2018) Reinforced Concrete Special Inspector-Legacy(expires 06/20/2018) RECEIVES MEMBER BENEFITS? NO Upload your imqg „ kKggrjla )Your Photo' link on the left side menu. Back to Top(http://iccstaff.iccsafe.org/Resources/member- lookup.cfm#top) QUICK LINKS Log in to myICC (https://ay.iccsafe.org/eweb/DynamicPage.aspx? WebCode=LoginRequired&Site=ICC&URL_success=http://www.iccsafe.org/myicc/%3fusertoken Renew my Membership (http://www.iccsafe.org/Membership/Pages/RenewReinstateMembership.aspx) Renew my Certifications (http://www.iccsafe.org/Certification/Pages/renew.aspx) ICC Online Campus (http://campusonline.iccsafe.org/) http://verify.iccsafe.org/875809 2/3/16,10:54 AM Page 1 of 1 .. I • . , . • - 111 . , , : . . .. . • • •—- . . ._ .. ; . ...7,, . , dr • 1 . ,. • • ._ , .H: ' ... .., . . • .. ., . . , ., . .- .. ... ._ .. .. . . . . . . _ .., ....,....45...Hx : ... . . .. . . ....._ ir .___ ... •.' • . 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Tel: (620 448-8182JOB NO./ !Z—A a ANF & ASSOCIATES Fax: (626)448-8092 L ill- ( / +S adA By © Consulting Structural Engineers E-mail: anf1688pacbell.net '1 `' - 1 1 s� �r'rlN .4 A i P 7A DATE + f � '"� +G 9420 Telstar Avenue,Suite 118, El Monte,CA 91731 61.—eV Art I O(J 'G li t SH. / OF . . ' ii ' .._,.. , t ir . , , , . : , . . . , . „ ‘,.; , . . . 1 , , , , , •, ,, . . ; ./ • . ;,II' , . . . , , ,:- t . , ,, , .: _ .: ... . . , f : ,, , f rum...." I 1 r-- -H. . • ,.' i, t ii..,i . - 1qm-A ', Tel: (626)448-8182 JOB NO. ANF & ASSOCIATES Fax: (626) 448-8092 / q �/ p I Consulting Structural Engineers E-mail: anf1688 ,pacbell.net / By �-�`�f f 16-1-0l47 f�A DATE O" - °C? - I Co ; 9420 Telstar Avenue,Suite 118, El Monte,CA 91731 SH. Z OF I (11.7e: HA-Y 1 M t#1.°M ' IA'n C5T. 1 432izet, ! . tolik $0.[Lf toArt an.,4 1 1 ' 4;s5 / SNA pckwr :'SIAr�t� ..$E L eoy 01 e7 i yA� j ..mmax.< 4 1 - 7, -To 41...0 i,....-" 1'1( f) 1 t (E &� A-L 4a4,6 �. � ,....., .,,,, . ,,I , , , , . .4 4_.... _ -_ _ ._ _......._.. _ .. _ .-.. .. _ _ _ _ -. r � 770,1. ,.16,..., ',v. gii q.:,, ,, /4" L.,t b ...___ _ ,, No. 2588 1, B ► [ 17E � r. Tel: (626)448-8182 JOB No.I GI ( 2.. -A il ANF & ASSOCIATES Fax: (626)448-8092 j. .E-mail: anf1688t A)Ay Consulting Structural Engineers paebell.net BY 1 4-Ni I IA DATE 4brrA t(- -- 9420 Telstar Avenue,Suite 118, El Monte,CA 91731 51.f I SU-) 54 SH. 08i-oi - ico i 3 OF 5 • . . , . , 1 , 1 I , . , i . ; . 1 , . f , , r , . % t _ i.. . . t. . , , [ Wseld From: Hooshang Mozaffari fmailto:Hooshang@roshanian.com] Sent:Thursday,June 16, 2016 11:07 AM To: Daniel gamin<dcamin@Westfield:com> Subject:Westfield SA Mall Laneway Domestic Cold Water Pressure Regulating Station NDan ela Asirequeste, the follow ung Dom stic ColdrWa er,Pr sure Regulating�Stafio installed ° cans rov!de 1 p ' The;needed domestic wa�ter need of 200 gpm as follow(see attachmentd;and thegr�aph`belowr)' -te, ` -'� Hope this helMnswer water utility s4question value prouides�50 �, � ,✓,� '� � �� :, valve provides # gpm ands h= valve prpyjc.es:-120 . � Totals 245tigpm;whicheexceedst�taeaneedi WILKINS MODEL 500 YSSR • 1/2', 50. GPM S.., 6) 80:.P,S.J d 0.04 r< . 70GPM, . :. SET. &J. P.S..I 2-1/2", .1 10 CPN1 N. :SET ASO P.5,1 . STATION .. DETAIL."A" 2 • • WILKINS MODEL 500 YS8R ..8 04 ►.4 ►t -1/2", 50 GPM S_, i' 80 P,5_1 v1 ►•4 ►4 " 70 GPM SET 71 80 P.S.i 4" 2-1/2", 1 10 GPM � . SET 1 80 P.5.I P.R.V. STATION SCALE: N,T,S, DETAIL "A" MODEL SOW/SIM 142"THAW 3"(STANDARD&METRIC) FLCt'3 RALES(E 3t 3.2 6.3 9.5 12.6 15.8 18.9 0 15 164 i Pt-- 1$ �– 69 35 zi •_ —�.. . — u. o so 75 100 120 150 200 250 300 PLOW RATES(GPM `c,Axv curvets are based sn a so psi ptesssIto ciftertntiiU' Regards, Hooshang Mozaffari, MSME, PE, LEED AP,CxA Principal r� roshonian & ssocv-_: es 6404 Wilshire Blvd., Ste. 610 Los Angeles . CA 90048 1: (323) 933-5252 F: (323) 933-5589 www.roshanian.Corn This e-mail and any attachments contain Roshanian and Associates confidential information that may be proprietary or privileged. If you receive this message in error or are not the intended recipient,you should not retain,distribute,disclose or use any of this information and you should destroy the e- mail and any attachments or copies.Thank you 2 URN® Model500VSBR Water Pressure Reducing Valve WILKINS with Integral By-pass Check Valve Application I Designed for installation on water lines to reduce high inlet 1 pressure to a lower outlet pressure.The high flow capacity makes this device most suitable for industrial water lines and commercial irrigation systems.The direct acting integral by- .,_.,__.,,„ pass design prevents buildup of excessive system pressure caused by thermal expansion.The balanced piston design • enables the regulator to react in a smooth and responsive r' manner to changes in system flow demand,while at the same time, providing protection from inlet pressure changes. Options(Suffixes can be combined) ❑ - standard with single union FNPT inlet x FNPT Standards Compliance outlet(1/2"thru 2")and less union(2 1/2"&3") •ASSE®Listed 1003(1/2"thru 2'h") Includes in-line bronze"Y"type strainer with • IAPMO®Listed(1/2"thru 2") 20 mesh stainless steel screen • City of Los Angeles Approved(1/2"thru 2 1/2") ❑ C - copper sweat connection valve only 1/2"thru 2" • CSA®Certified(1/2"thru 2") copper sweat strainer 3/4" &1" only All other strainers are FNPT Materials ❑ HR - 75 psi to 125 psi spring range,factory set Main valve body Cast bronze ASTM B 584 at 85 psi Access covers Cast bronze ASTM B 584 ❑ HLR - 10 psi to 125 psi springe range,factory set Brass ASTM B 16 at 50 psi Fasteners Stainless steel,300 series ❑ HT - 180°F maximum temp Stem&plunger Cast bronze ASTM B 584 ❑ LPV - 180°F maximum temp with 10 psi to 35 psi Brass ASTM B 16 spring range,factory set at 20 psi Elastomers Buna Nitrile(FDA approved) ❑ LPC - 140°F maximum temp with 10 psi to 35 psi EPDM (FDA approved) spring range,factory set at 20 psi Cap gaskets Natural vulcanized fibre ❑ SC - sealed cage bell housing and stainless steel Acetal(DelrinTM 500), NSF Listed adjustment screw Springs Oil tempered wire,ASTM A 229 ❑ SW - made for salt water service Strainer screen Stainless steel,300 series ❑ 510 - 400 psi inlet rating and 75 psi to 125 psi (20 mesh standard) spring range,factory set at 85 psi Seat Stainless steel,300 series ❑ P - tapped and plugged for gauge ❑ G - tapped and plugged with gauge Features Sizes: 1/2",3/4", 1", 1 1/4", 1 1/2",2",2 1/2",3" Accessories Maximum working water pressure 300 psi ❑ Repair kit(rubber only) Maximum working water temperature 140°F D Reduced pressure range 25 psi to 75 psi Factory preset 50 psi ��• Threaded connections(FNPT) ANSI B1.20.1 . • Copper connections(FC) ANSI B16.22 __M B rT At 0WILKINS soo C i A Dimensions&Weights(do not include pkg.) E DIMENSIONS(approximate) SIZE WEIGHT CONNECTIONS A B C D E in. mm in. mm , in. , mm in. mm in. mm in. mm lbs. kg. 1/2 15 SINGLE UNION 4 1/2 108 6 152 3 76 2 3/4 70 8 1/4 210 5 2.3 3/4 20 SINGLE UNION 4 5/8 118 6 152 3 1/2 89 2 3/4 70 9 1/8 232 6 2.7 1 25 SINGLE UNION 5 1/8 130 6 7/8 175 4 102 3 5/16 84 10 254 7 3.2 1 1/4 32 SINGLE UNION 6 5/16 160 7 1/4 184 4 3/4 121 4 102 13 1/8 333 9 4.1 1 1/2 40 SINGLE UNION 8 5/16 211 10 254 5 127 5 127 17 5/8 448 16 7.3 2 50 SINGLE UNION 9 1/2 241 10 3/4 273 6 152 6 1/2 165. 18 5/8 473 24 10.9 2 1/2 65 LESS UNION 10 254 _ 14 1/2 368 7 1/2 _ 191 8 203 19 3/8 492 43 19.5 3 80 LESS UNION 11 1/8 283 16 406 8 1/2 216 8 203 25 635 60 27.2 Zurn Industries,LLC I Wilkins Rev.A 1747 Commerce Way,Paso Robles,CA U.S.A.93446 Ph.855-663-9876,Fax 805-238-5766 Date:4/13 In Canada I Zurn Industries Limited Document No.REG-500YSBR 3544 Nashua Drive,Mississauga,Ontario L4V 1 L2 Ph.905-405-8272,Fax 905-405-1292 Product No.Model 500YSBR .zurn.corra Page 1 of 2 Flaw Characteristics MODEL 500YSBR 1/2"THRU 3"(STANDARD&METRIC) FLOW RATES Ws) 20 3.2 6.3 9.5 12.6 15.8 18.9 _— 1/2" = 3/4" ��,,,,��! 11/4" 11/2" 2 21/2• 3", /138 15 15mm" 20mm ,,,dim 40mm 50mm)—�65mm 80mm)// 104 a G. x �- 1 LO• 69tit Ru.I5 LCMIII=_ —-.-.---..M 35 ,y��_ — _ u_ 00 �5 100 120 150 200 • 250 300 FLOW RATES(GPM) "Flow curves are based on a 50 psi pressure differential" Typical Installation Local codes shall govern installation requirements. Unless otherwise specified,the assembly shall be mounted in accordance with the manufacturers'instructions and the latest edition of the Uniform Plumbing Code.The assembly shall be installed with sufficient side clearance for testing and maintenance.The Model 500YSBR may be installed in any position. If installed in a pit or vault,specify the"SC"sealed cage option. Multiple installations are recommend for wide demand variations or where the desired pressure reduction is more than 4 to 1 (ie:200 psi inlet reduced to 50 psi outlet).Caution:Anytime a reducing valve is adjusted,a pressure gauge must be used downstream to verify correct pressure setting. Do not bottom adjustment bolt on bell housing. OPTIONAL PRESSURE i GAUGE i. „olio 'll l e O `■III-111_ II _ I'm i 1—I I I_I I • iI l—VIII—Ill—Ill- �ioo i� o�ol, „, , Z Ilyilly_1171' iililiEi OPTIONAL I — ■ 111 PRESSURE GAUGE ,=: cc ill B :0 MODEL DU MODEL 850 rs: DIELECTRIC UNION =� SHUT-OFF VALVE e ...._ . a •■ -111-111- IT-IIF 111=111111E.1 -alia 17-,-TrEL-111_7�I-I I L- IlEll 1=111- lln �1•fail Ti= =111 �TIJ' • DIRECTION OF FLOW �olr Horizontal Installation Vertical Installation Specifications The Pressure Reducing Valve shall consist of a bronze body and bell housing, a separate access cover for the plunger and a bolt to adjust the downstream pressure.The bronze bell housing and access cap shall be threaded to the body and shall not require the use of ferrous screws.The assembly shall be of the balanced piston design and shall reduce pressure in both flow and no-flow conditions.The assembly shall be accessible for maintenance without having to remove the body from the line. The Pressure Reducing Valve shall be a ZURN WILKINS Model 500YSBR. Zurn Industries,LLC I Wilkins 1747 Commerce Way,Paso Robles,CA U.S.A.93446 Ph.855-663-9876,Fax 805-238-5766 In Canada I Zurn Industries Limited 3544 Nashua Drive,Mississauga,Ontario L4V 1L2 Ph.905-405-8272,Fax 905-405-1292 www.zurn.com Page 2 of 2