HomeMy WebLinkAboutUntitled AgZe, Development Services Department
ti" ri 240 West Huntington Drive,Post Office Box 60021
r,
Arcadia, CA 91066-6021 . ' PERMIT NO. BOO-053-663
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
5/17/2016 CM 8:02 8/8/2016 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#: 16-227
Los Angeles,CA 90025- EMAIL ADDRESS:
Plan#: 32007
APPLICANT MAILING ADDRESS
U R D Construction PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
PHONE NO. (310)381-9521 FAX NO.
U R D Construction 10940 Odel 4.\ / } �Su Ao ' �` EMAIL ADDRESS:
License No. 983140 Type: B e .4/3 '? '` : 0:
TENANT MAILI SS
Snow Fox PHONE NO. FAX NO.
DESCRIPTION
TI-SNOW FOX**AMEN P D 8-8-16 CHANGE OF CONTRACTOR**
Construction Type UOM N of .• Value Construction Type UOM #of Units Value
Value Value 75,000.00 $75,000.00
OCCUPANCY: Tenant Improve TOTAL VALUATION: $75,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 659.91 659.91 01-3103
each Energy p/c fee 223.36 223.36 01-3103
PC ADA 98.99 98.99 01-3103
PC Cal Green 65.99 65.99 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 1,015.25 1,015.25 01-3104
Bldg Issue ADA 101.53 101.53 01-3104
1.00 each T.I.Fire Pkc 255.00 255.00 01-3109
SMIP Com 21.00 21.00 14-2207
gm bldg std 3.00 3.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $2,494.63 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)
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• PERMIT/PLAN REVIEW APPLICATION
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
Signature of Contractor performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION :❑ I have and will maintain workers'compensation insurance,as required by Section
❑ 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 PERIVIIT 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
V. ° '"k�� Development Services Department
. ,= c, 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-053-663
Arcadia, CA 91066-6021 • •
City of (626)574-5416,Fax(626)447-9173
ArcadiaPermit Type: Tenant Improve w/energ:
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
5/17/2016 CM 10:15 7/26/2016 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. an Chk#: 16-227
Los Angeles, CA 90025- EMAIL ADDRESS:
Plan#: 32007
APPLICANT MAILING ADDRESS
I Am Interiors 13903 Artesia Bl PHONE NO. (562)926- ,:08
Cerritos, CA 90703 EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
IAM Interior Corp. 13903 Artesia Blvd PHONE NO. (56 926-2808 FAX NO.
Cerritos,CA 90703 EMAIL ADDRES-.
License No. 999414 Type: B Expires: 10/30/2016 12:0(
TENANT MAILING ADDRESS
Snow
Snow Fox °little PHON O. FAX NO. 1 br
5
DESCRIPTION l
Tl-SNOW FOX
Construction Type UOM #of Units Value Co,truction Type UO o'. its Valu
ic),
Value Value 75,000.00 $75,000.00 1111
t ' 1 y -e
\ r1
OCCUPANCY: Tenant Improve ` . To ALU,TION: �" $75,000.00 110
QTY UOM DESC AMT AMT P• D A CT 4 QTY—OM i SC AMT AMT PAID ACCT
each Plan review 659.91 • 9.91 01- 103
each Energy p/c fee 223.36 223.36 01-3 03
PC ADA 98.99 98.99 01-310
PC Cal Green 65.99 65.99 01-3103
1.00 Flat Bldg Issue Auto 44.3 44.35 01-3104
each Bldg permit 1,01 . 5 1,015.25 01-3104
Bldg Issue ADA 01.53 101.53 01-3104
1.00 each T.I.Fire Pkc 255.00 255.00 01-3109
SMIP Com 21.00 21.00 14-2207
gm bldg std 3.00 3.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $2,494.63 Balance Due: $0.00 Paid Today: $1,191.38
This pe r it/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 113737
permit is riot commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 1,161.13
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 21.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 714-2203 3.00
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. 11
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)
OV ARC
G,y1F OR,vd.i e,
11 �� I.
PERMIT/PLAN REVIEW APPLICATION
..1 r4,
. • Development Services Department,240 West Huntington Drive, Post Office Box 60021
4.4olty of 0° 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'
Li&TIPP& Lic_ens `•. "a gi p` DJ-Ted-Ver.//6 compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
Stgnatni'e ofContractor 's,d,,,
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, `awe T,4T6IMD
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 olic_y •um'er
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
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
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.
viesprvg Yo 0>. H K2- lit Civ
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
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( :Cern -. cate of Occupancyw ,
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��r� City of Acadia- �;,�,
W Development Services Department - Building Division
r .1, ' This certificate issued;pursuant to the requirements_of Section 109.of the
;e�A�
� 4 Uniform Building•Code certifyirig that at the time of issuance this structure was in �
Vi compliance with the various ordinances of.the City regulating.building construction or use. C 's
® Permit No. BOO 053=663 - ,
BuildinAddress:
g 400=5 Baldwin-Ave;Arcadia,,CA..91007
y, Use Classification: Tenant Improve Effective UBC:
2013CB'C
1, Liriti\b-.,
, 0-1
Permit Type Tenant Improve w/enel
f.:kit!
P gy:. Zone Code: - - „l
Occupancy Code:. M. ._ C 2,DH I �
-_ , ” _ Type of Construction:- 1-HR SPRINKLERED. E`-aa• '.,
TYPE LI
Final:Date: 11/10/2016 ®
VA Owner:
�I ; Westfield Gorporahon, Inc. I°
L;
ell41
_ Tenant:
Snow Fox ,
r'ittVilii.-,
x P
Don Stockham,Building Official ill i�e`�
POST IN A CONSPICUOUS PLACE
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..-g Development Services Department
t
. ' , 240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021 PERMIT NO. B00-054-560
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: EMP Combo
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
8/23/2016 CM 10:06 8/23/2016 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 - .MAIUNG ADDRESS
U R D Construction PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIO .A I GADDRESS
U R D Constructi .!'I Ili ft-11 Ave PHONE NO. (310)381-9521 FAX NO.
a`If 4'lE A 91040 EMAIL ADDRESS:
License No. 983140 Type: B Expires: 4/30/2017 12:00:
TENANT MAILING ADDRESS
Snow Fox PHONE NO. FAX NO.
5
DESCRIPTION
SNOW FOX EMP
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
f- L G``0_./C /./-15 ------- ...-,
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
3.00 each Kitchen sinks 37.38 37.38 01-3105
2.00 each Floor sink 24.92 24.92 01-3105
1.00 each Floor drain 12.46 12.46 01-3105
15.00 each Outlets 23.10 23.10 01-3105
10.00 each Ltg fixtures 15.40 15.40 01-3105
1.00 each Wtr htr/vent 15.55 15.55 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: $219.51 Balance Due: $0.00 Paid Today: $219.51
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 114010
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 217.51
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 2.00
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 ii/
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 ARO
ti 4°NuroR o,-T.AI
CIV;_ „ PERMIT/PLAN REVIEW APPLICATION
19
j• Development Services Department,240 West Huntington Drive,Post Office Box 60021
0:::,„,...., _....4,,of t" 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
rofessions Code,and/ndmy license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class J License No.7ey Exp. Date /�O�''/n compensation, as provided for by Section 3700 of the Labor Code, for the
✓✓✓ ���� / performance of the work for which this permit is issued.
' afore of ContractorLit
OWNER-BUILDER DECLARAT0 ❑ 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 is 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
1:1I, as owner of the property, or my employees with wages as their sole forthwith comply with those previsions.
compensation,will do the work,and the structure is not intended or offered for '.3 STC L,v
sale(Section 7044,Business and Professions Code:The Contractors License Date r Signature7"
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
Ir
�—' further information. 1�
Name 4 O \ IA Title y A APY
Erne
PRINT NAME .�w '
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-mentione property for inspection purposes.
Signature E.t.e �� v /
,nom
�e4Development Services Department
a 240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
Arcadia, CA 91066-6021 -} B00-054-434
City of (626) 574-5416,Fax(626)447-9173 .
ArcadiaPermit Type: Miscellaneous
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
8/8/2016 CM 8:04 8/8/2016 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 AILING ADDRESS
URD Construction PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
U R D Construction 10940 Odell Ave
PHONE NO. 310381-9521 FAX NO.
Sunland,CA 91040 EMAIL ADDRESS:
License No. 983140 Type: B Expires: 4/30/2017 12:00:
TENANT MAILING ADDRESS
Snow Fox PHONE NO. FAX NO.
,
DESCRIPTION
**CHANGE OF CONTRACTOR**
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Ft,v'4._ !!-'(5-r C7/...'''Z.V
OCCUPANCY: Tenant Improve / TOTAL VALUATION: $0.00
s
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Bldg issuance 44.35 44.35 01-3104
Total Fees: $44.35 Balance Due: $0.00 Paid Today: $44.35
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 113859
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 44.35
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. 11
(Closed on alternate Fridays)
ARe
G~4 OFF Rvi,:t,
.,; � it PERMIT/PLAN REVIEW APPLICATION
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wolittm lo
0,:z.„......01j• 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
hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
hapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. O T�3 c II I have and will maintain a certificate of consent to self-insure for workers'
License Class
Signature of Contractor License No. ), Exp. Date rip/ compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
,1/4.3-NiOWNER-BUILDER DECLAR�1'I N ❑ 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
Date _Cn j�/Oe /�
sale(Section 7044,Business and Professions Code:The Contractors License /it
Law does not apply to an owner of property who builds or improves thereon, v...--->"0 /,‘ Signature c
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.
-1
N e / A A 1010I' A A Title .0 ) . :4,- - , ,k
PRI NAME - pr
low lor
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 adia to enter upon the above-mentioned property for inspection purposes. di›-Sign ture Date 17 I �J
oc cl.-q�
NOTES
Building Inspections Date Insp. Plumbing Inspections I Date I Insp.
100. Setbacks 210. Under fir./bldg.drain c�,
101. Rough grade 211. Copper underslab ,. I---f kG A EG.EEI/eO DE'G)
102. Figs.&forms 212. Rou.h.lumbin.
103. Pre-slab 9�G 213. Rough gas Ci a PDQ i ELSE
104. Floor joists 214. Shower pan €`0 d 1 E C,c5w 6L- '
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing '--Ge-« 220. Fixtures
111. OccJArea Sept.Wall 221. Final plumbing {(10-14 •
112. Sound walls 222. Sewer cap/demo.
113. T-bar.rid
114. Insulation-Flr. Pool Inspections Date I. Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 242. Light shell bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 45. Gas line&test
121. Final building it-/0<6 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final•lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Under.round conduit
153. Underslab conduit mReroof Inspections I Date I Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical 9-6-16ie-X272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E..t.bonding --Sign Inspections I Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric /' 281. Footing
282. Conduit/wirin.
Mechanical Inspections Date Insp. 283. Disconnect
181. VentFumace/lue --284. Final sign -�
181. Furnace/A.C.
182. Rouch HVAC -- Miscellaneous Insp. I Date Insp.
183. Fire dampers 290. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Final
189. Commercial hood
190. Duct shaft -- Sewers&Offsite Insp. I Date I Insp.
191. Final mechanical --
3300. Lateral 01. addle/Y(main to P/L) --
Block Wall Inspections Date Insp. 302. Cess.00l filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
•
SNOWFOX.
CHEF-PREPARED. BEAUTIFUL.JUST HI TIME.
To whom may it concern:
1, Jaeho Choi, Vice President of Jim Kim Company, DBA 'SNOW FOX', confirm the change of
contractor for:
Space#9023 at 400 s Baldwin Ave, Arcadia CA 91007 (Westfield Santa Anita)
Existing Contractor:
1AM Interior Corp.
13903 Artesia Blvd. Cerritos, CA 90703
Phone: 562-926-2808
New Contractor:
United Real Estate Development
445 S. Figueroa ST#2700, Los Angeles,CA, 90071
Phone: 310-381-9521
Date: 8/4/2016
Signature: ..-- -- --
JimKim Company
990 Ave of the Americas,tt24H, New York, NY 10018 TEL:646.824.1755
svisr of LON, COUNTY OF LOS ANGELES• DEPARTMENT OF PUBLIC HEALTH
1 ,`
446,
8 N} ENVIRONMENTAL HEALTH
`aI - "3 SURVEILLANCE ANDENFORCEMENT
}�-,,,��I ,, � BUREAU OF SPECIALIZED SUR EI E O
Ni_ �4i Viz PLAN CHECK.PROGRAM-BALDWIN PARK
COUNTY Of LOS ANG[1E5.
C411-(600`r 5050 COMMERCE DR,BALDWIN PARK,CA 91706 Public Health
PHONE:(626)430-5560
VWVW.PUBLICHEALTH.LA000NTY.GOV/EH
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 11/10/2016 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0070631 .
PROGRAM.ELEMENT 1701 -RESTAURANT(0-500 SF)
OWNER/REQUESTER JOON KIM,AGENT
DBA • SNOW FOX
ADDRESS 400 S BALDWIN AVE,ARCADIA, CA 91007
FINAL REINSPECTION STATUS: NOT APPROVED
.� � '_ 'i ,� .�_fir ,,,,.''�ai.aj.3 ti� ,�s ya w�w r „� }: x
{CORRECTIONS REQUIRED i -NX-��3. _:.. .'' 34{7 ' a
CORRECTION CATEGORY: PLAN SUBMITTAUREMODEL IDENTIFIED: 11/10/2016
CORRECTIVE ACTION:FINAL INSPECTION CONDUCTED. ALL VIOLATIONS WERE CORRECTED.
APPROVAL TO OPERATE IS CONTINGENT UPON PROVIDING THE BLDG. FINAL APPROVAL AND
SUBMITTING PLANS FOR THE REMOTE STORAGE WITHIN 6 MONTHS.
CALIFORNIA RETAIL FOOD CODE:A person proposing to build or remodel a food facility shall submit complete,easily readable plans drawn to scale,and
specifications to the enforcement agency for review,and shall receive plan approval before starting any new construction or remodeling of any facility for use
as a retail food facility. Section#:114380, 114381
CORRECTIONS-COMPLETED 4' 1.kfe ' .' ;
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED
WAREWASHING FACILITIES 10/25/2016 11/10/2016
FOOD PREPARATION SINKS 10/25/2016 : 11/10/2016
JANITORIAL FACILITIES 10/25/2016 11/10/2016
WATER SUPPLY 10/25/2016 11/10/2016
EQUIPMENT/STORAGE 10/25/2016 11/10/2016
EMPLOYEE FACILITIES 10/25/2016 11/10/2016,
PLAN SUBMITTAUREMODEL 10/25/2016 11/10/2016
COMMENTS
NONE
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacountv.aov/eh.
EHS Signature Page 1 of 2
• PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 11/10/2016 EHS VIVIAN TAN . . . : :
.PLAN CHECK NUMBER SR0070631
PROGRAM ELEMENT : 1701 -RESTAURANT(0.-500 SF)
OWNER/REQUESTER JOON KIM,AGENT: : :
DBA' SNOW FOX
ADDRESS
400 S BALDWIN AVE;ARCADIA, CA 91007
DISCLOSURES:.
It is a misdemeanor violation to begin operatiion without a valid Public Health Permit/License..The Public Health
Permit/License will be issuedby the Los Angeles County Department:of Public Health Environmental Health Division(DPH-EH) :
Plan Check Program at the job site following final inspectionand approval by allapplicable agencies. Remodeled areas of an
existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior -
to
Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food
facility/establishment or change of menu may require plans to be submitted to the DPH EH:Plan Check Program.:Additional
approvals may be required from other enforcement agencies: . : •
• Itis improper and illegal for any.County officer,employee,or inspector to solicit bribes,gifts or gratuities:in connection with:
performing:their official duties.: Improper solicitations include requests for anything:of value suchas cash;discounts,free • .
services,paid travel:orentertainment;or tangible itemssuch as food or beverages: Any attempt by a County employee to
solicit bribes,gifts or gratuities for any reason should bereported immediately toeither the:County manager responsible for
supervising the employee or the Fraud Hotline at(800)544-6861 or www,lacountyfraud.org. YOU MAY REMAIN ANONYMOUS
Public Health Permit/License:
A separate fee is required for:the Public Health Permit/License:A billing statement will be sent to the,permit/license holder :
annually by the DPH-EH. The feeis required to be paid to:perform or carry On,conduct or engage in any mobile food facility
listed in Los Angeles County Code;Title 8,Section 8.04320.
State and Local Licenses and.Permits:
Contact the State of California and your local city.hall regarding additional license and permit requirements..
Customer may use restroom facilities if they are located in a customer area.Customers may not enter the food preparation
area,food storage area,or the utensils washing/storage areas in orderto access the.restrooins:All food,utensils and.
equipment must be protected from contamination. .
Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County, Following the
issuance of your Public Health Permitby:the Plan Check Program,an Environmental.Health Specialist from your local district
will conduct an inspection of yourfacility.:If your Business is located in a city that:has adopted the grading ordinance,the
inspector:will post a gradeor:score card at your facility. Grade/Score cards are not issued by the Plan Check Program.
Help us serve you better by completing a short survey.Visit our:website at www.publichealth.lacounty.gov/eh. '
—11 .
EHS Signature_ g
Pa e2of2 '
I1 LOS ANGELES COUNTY DEPARTMENT OF PUBLIC WORKS
II(G-1� 1u1� BUILDING&SAFETY/LAND DEVELOPMENT DIVISION
PUBLIC WORKS I
�•%i t r W,
SPECIAL INSPECTION REPORT
Each inspector must complete this report and mail it to the
District office where the permit was issued.
n DAILY n WEEKLY (FINAL
Total time on job(in days) 1/2 Day Building Permit No. B00-053-663
Job Address 400 S. BALDWIN AVE. ,ARCADIA, CA
General Contractor URD CONSTRUCTION
Size of Building No. of Stories Type of Wall
Type of Work : n Reinforced Concrete n Masonry n Hi-tensile Bolting
n_Pre-stressed Concrete Ti Welding n Gypsum conrete
n Other( EPDXY )
Discription of work inspected 1)TENANT IMPROVEMENT W/ENERGY
2) WORK DETAIL.
i) CLEANED HOLES USING COMPRESSED AIR&WIRE BRUSH.
ii) INJECTION OF EPDXY W/#4 REBARS INTO(E)CUT FACE OF SLAB(MIN.EMBED:6") @ 16"O.0
TO COVER TRENCH.(TOTAL. 44 DOWELS)
3) CHEMICAL ADHESIVE.SIMPSON SET-XP,ICC-ESR#2508. EXP.01-03-2018.
All works on this job to date has been satisfactorily completed to the approved plans and requirements
of the Los Angeles County Building Code.
C.O.L.A #P015050(W/C/M/SC/DIA)
JAYEE J. KIM L.A.COUNTY#01475(W/M/C) 9/7/2016
Special Inspector(Print) I.D. Number Date
(562)331-5700
Special Inspector(Signature) Daytime/Cell Phone Number