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HomeMy WebLinkAboutUntitled •tWrt Development Services Department 240 West Huntington Drive,Post Office Box 60421 " PERMIT NO. $QQ-053-116 .....,•• Arcadia,CA 91066-6021 City of (626) 574-5416,Fax(626)447-9173 Arcadia Permit Type: Tenant Improve wienerg: PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 3/22/2016 CM 14:45 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#: 16-121 Los Angeles,CA 90025- EMAIL ADDRESS: Plan#: 32028 APPLICANT MAILING ADDRESS RP Z r s?ti'']-,4 Master Enterprises, Inca ' ,5{,y. F il, PHONE NO. IS' FJ t tl l EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS 626 NO. 442-1821 FAX NO. Master Enterprises, Inc. 2025 N Lee Avenue PHONE ( South El Monte,CA 91733 EMAIL ADDRESS: License No. 622619 Type: B C20 HIC Expires: 7/31/2017 12:00: TENANT MAILING ADDRESS Backhouse Yakitori PHONE NO. FAX NO. DESCRIPTION T.I.FOR BACKHOUSE YAKITORI Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 300,000.00 $300,000.00 OCCUPANCY: Tenant Improve TOTAL VALUATION: $300,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 1,692.60 1,692.60 01-3103 each Energy p/c fee 572.88 572.88 01-3103 PC ADA 253.89 253.89 01-3103 PC Cal Green 169.26 169.26 01-3103 1.00 . Flat Bldg Issue Auto 44.35 44.35 01-3104 each Bldg permit 2,604.00 2,604.00 01-3104 Bldg Issue ADA 260.40 260.40 01-3104 1.00 each T.I.Fire Pkc 255.00 255.00 01-3109 SMIP Corn 84.00 84.00 14-2207 grn bldg std 12.00 12.00 714-2203 1.00 Flat SWMF Auto 6.25 6.25 88-3027 Total Fees: $5,954.63 Balance Due: $0.00 Paid Today: $3,011.00 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the ` Receipt#: 113870 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 2,908.75 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 84.00 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 714-2203 12.00 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) / U�4�FRe F sv0.6f Y� PERMIT/PLAN REVIEW APPLICATION oj` Development Services Department, 240 West Huntington Drive,Post Office Box 60021 ''.flt,Y of V" 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 my license is in full orce a 1 d effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License No. -Z - Exp. Date 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 � ! OWNER-BUILDER DECLARATION 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' coensation insurance carrierand policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier I` �I�t4///e-- 44i 1 /r -g----, srilt. t f-ac_ ix, demolish,or repair any structure,prior to its issuance,also required the applicant 1 for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number � (/V 0 0 � -'J provisions of the Contractors License Law(Chapter 9(commencing with Section (T ' section need not b completed if the permit is or 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 for92-----6/"--) .."-______ 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 6 i►01Zv Title w1'irr_y:,�' Ad i ' 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 Arcadia to enter upon the above-mentioned property for inspection purposes. Signature elate 64 -t)' -- - 0/I `_ J f3cs15- 0-53 -((G NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. -/1�/G I�($ ;d. .f i lC�+/ CTS Z- 100. Setbacks 210. Under ft./bldg.drain 101. Rough grade 211. Copper underslab 7 vGTS / 102. Figs.&forms 212. Rough plumbing 1(-!-/(e ^(° C ' .---r-L A.j'E/� fll2c7K(4.ST 103. Pre-slab 213. Rough'as 1 Z 7-/(o t..... 1--/ 104. Floor joists 214. Shower pan a7A. 2- /And) 0 0-0-5 _ *--7:// 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 19. Final gas `2-L(,460 110. Framing 11- -siC e--4! 20. Fixtures l43-47 111. Occ./Area Sept.Wall 221. Final plumbing I-63-/7 112. Sound walls 222. Sewer cap/demo. 113. T-bar grid C2-lc 4/1/C 114. Insulation-Flr. Pool Inspections Date Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. /k•--47"242. ��.-��241. Rough plumbing 117. Drywall nailing 1(-346, 4 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish grade 6. Gasline&test 121. Final building I-17-i? 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final slumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Underground conduit 153. Underslab conduit Reroof Inspections I Date Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical 1O-25IC72. Sheathing nailing 157. Fixtures 1-11-17 - 73. Final reroof 158. G.F.C.I. (-I/-/? �- 159. Es it.bondin. Sign Inspections Date Insp. 160. Service panel (2.-"Zi-1- ' 280. Setback/overhang 161. Final electric p Jf-17 ' ---, "281. Footing 282. Conduit/wiring Mechanical Inspections Date Insp. ` 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC .1-i- , l�12 Miscellaneous Insp. I Date I 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 setback95. Final 189. Commercial hood (-/3-/7 190. Duct shaft 7 Sewers&Offsite Insp. Date I Insp. 191. Final mechanical r/3r17 �'11"1"' 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess tool filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin oft 1\ f ,-- ''+ A h�4� fiat r ,16 9 2 .__ ;9 . 10,* .r- r :,� ����I�� q��1 ` ; � .��-' �r''''.4'‘'''-'1., ..I�,� orb l,./,! - r�,' - '��, l�f� ��� {,,+t,�/? � �`�����i.,, /°;:,-- .: CaltWiPkW ietlk "LtVdtf"titt0.ilo"iv-vga:',M.Atiikhrj'Alaviaitit,'W',. .t.WenEML. lik. :.. M*Alts...g-.1.:.:', .44v o � x il litij "AP4 _ ;K. AI'W',,i,,t4 c.,--'-'-:.--5,;v Rs1^ Mil\\\ ��!% f )41 esti irate o :ccupancy ��� City of Arcadia � . ` � Development Services-Department - Building-Di-Vision . } � �t y' This certificate issued pursuant to the requirements of Section 109 of P' t9, Uniform Building Code certifying that at the time of issuance this structure was in Fi compliance with the various.ordinances of the City regulating building construction or-use. Permit No. B00=053'"-1 16 rlLt? itilult • Building Address: 400 S Baldwin Ave,Arcadia,CA`91007 : I0`!, ® ved Use Classification: Tenant-Im rove Effective UBC p CBC2013 % i Permit Type. Tenant Improve w/energy- _ Zone Code 4, - DHB. Q Occupancy Code: $ Type of Construction: i r' C2 - -. TYPE II 1HR SPRINKLERED -,721011,1 Final Date: . 1/17/2017 'y.,,4 Owner: Westfield Corporation,Inc. M '431, Tenant: Backho se (. itori SI • i r:,:/, rc,„ 6'.-4- � Don Stockham,Building Official V-z ki , .rf" nl POST IN A CONSPICUOUS PLACE Ib � = � ;� � �� � � � .=,.,� �vt �„ . LTJ �,�--� gym. _�,� -� � , ��,�". �`®F 4iiiiimosnis0'1 Esklm!ic,2en met iii .. � C'J 'mtasz .L© _�•,� K�a� g� ��77q a pig _moo ,... ,q,,.� i ��°9� =�.A � ���� �t� .44/11115'',6:� � :off m ��ti�d�:_1��,-;,1;41,,m _��,�_ �_�- l�, � � Lt���-� `al' �,. a B►A\o, �� }.1,�,. 1 tf6��ISy . ki �ikt �li 0,4 4,,, ��+ ur ,) �'Z Development Services Department ;;6240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021 PERMIT NO. BOO-054-598 City of (626) 574-5416,Fax(626)447-9173 ArcadiaPermit Type: EMP Combo PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 8/26/2016 EP 13:25 8/26/2016 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. Los Angeles, CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Master Enterp tat C. PHONE NO. COMP[EIEO EMAL ADDRESS: CONTRACTOR/PROFE ADDRESS 626 NO. 442-1821 FAX NO. Master Enterprises,Inc. 2025 N Lee Avenue PHONE ( South El Monte,CA 91733 EMAIL ADDRESS: License No. 622619 Type: B C20 HIC Expires: 7/31/2017 12:00: TENANT MAILING ADDRESS Back House Yakitori PHONE NO. FAX NO. DESCRIPTION EMP FOR BACK HOUSE YAKITORI Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value • Aici„... .. V 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 40.00 each Outlets 48.00 48.00 01-3105 1.00 Flat Mech issue 44.35 44.35 01-3105 50.00 each Ltg fixtures 58.00 58.00 01-3105 1.00 Flat Plmbg issuance 44.35 44.35 01-3105 1.00 each Wtr htr/vent 15.55 15.55 01-3105 2.00 each Furn<100,000btu 37.48 37.48 01-3105 1.00 each Misc elec 15.55 15.55 01-3105 2.00 each Water Closet 24.92 24.92 01-3105 1.00 branch circ Signs elec 59.17 59.17 01-3105 2.00 each Lavatories 24.92 24.92 01-3105 1.00 Fixtures Urinal 12.46 12.46 01-3105 3.00 each Hood 42.33 42.33 01-3105 1.00 Fixtures Plmbg fixture 12.46 12.46 01-3105 10.00 each Kitchen sinks 124.60 124.60 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 5.00 each Distrib panel 77.75 77.75 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 each Fan-vent single 9.38 9.38 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 each Dishwashers 12.46 12.46 01-3105 1.00 each Comp 3 hp 18.74 18.74 01-3105 9.00 each Floor sink 112.14 112.14 01-3105 3.00 each Floor drain 37.38 37.38 01-3105 5.00 each Power 1-10 hp 77.75 77.75 01-3105 1.00 each Air untl0m cfin 14.11 14.11 01-3105 5.00 outlets Gas piping 15.55 15.55 01-3105 Total Fees: $986.75 Balance Due: $0.00 Paid Today: $986.75 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 114062 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 983.75 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 3.00 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 . 1 Requests for inspection should be made at least Monday-Thursday Friday i 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) U~4 o Fr RviC9di �' PERMIT/PLAN REVIEW APPLICATION 410,) 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 f rce and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class 57) C17.0 License No. bZL6 g Exp. Date7(� /7 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'coensation insurance cam r and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier f>I/6. �Ll/� demolish,or repair any structure,prior to its issuance,also required the applicant 6/6 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 on 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 ose 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. ❑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 Osk.. Development Services Department 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. Arcadia, CA 91066-6021 BOO-054-804 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 9/20/2016 CM 10:16 9/22/2016 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#: 16-440 Los Angeles, CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS United Fire Service,Inc. PHONE NO. EMAIL ADDRESS: CONTRACTORIPROFESSIONAL. ..MAILING.ADDRESS. ,nes _ :,. • - , United Fire Service,Inc. 811'. " 3 PHONE NO. (818)346-2499 FAX NO. C. 'OA. k,_0,Z, 0 EMAIL ADDRESS: License No. 822177 Type: C Expires: 7/3 /2017 12:00: TENANT MAILING ADDRESS - Backhouse Yakatori PHONE NO. FAX NO. , DESCRIPTION FIRE SUPPRESSION SYSTEM FOR BACKHOUSE YAKATORI Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 2,250.00 -$2,250.00 OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $2,250.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 17.00 each Fire Ext.Sys. 765.00 765.00 01-3109 1.00 Flat Fire Issue Auto 44.35 44.35 01-3112 each Fire Permit 120.35 120.35 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $930.70 Balance Due: $0.00 Paid Today: $165.70 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 114335 permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 164.70 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 1.00 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days._ CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS / Requests for inspection should be made at least Monday-Thursday Friday one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) or ARC y._ IJAV0$y,''91r Li9 PERMIT/PLAN REVIEW APPLICATION i o O• Development Services Department,240 West Huntington Drive,Post Office Box 60021 °..a,.,°iN 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 pay license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C` (' (0 Signature of Contractor Lice.ns o. g22 7 7it-/7 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. WNER-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 V c-v demolish,or repair any structure,prior to its issuance,also required the applicant tAMIC'32 O 15c 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 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. (Name A Q1\ r 1 k- (Title f•r^t_ 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. �ignature ®� `rte - Late q.,?,-?.-I6 rr , Development Services Department r , 240 West Huntington Drive,Post Office Box 60021 %-1:-09 Arcadia,CA 91066-6021 ;PERMIT NO. B00-054-768 ArcadiaCity of (626) 574-5416,Fax(626)447-9173 Permit Type: Fire PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/15/2016 CM 13:52 9/22/2016 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#: 16-433 Los Angeles,CA 90025- EMAIL ADDRESS: APPLICANT MAILING ADDRESS Building Electronic Controls Inc. PHONE NO. EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRES- Building Electronic Controls Inc. 2246 Lind , ;,, :'- ` h PHONE NO. FAX NO. Glendora, '� 41. I 1 p 'IL ADDRESS: License No. 729905 Type: C Expires: - i 01.=t `i t,� • TENANTMAILING ADDRESS - Backhouse Yakitori PHONE NO. FAX NO. DESCRIPTION - BACKHOUSE YAKITORI 18 FIRE DEVICES Construction Type UOM N of Units Value Construction Type UOM If of Units Value Value Value 9,860.00 $9,860.00 OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $9,860.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 18.00 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 237.25 237.25 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 • Total Fees: $920.10 Balance Due: $0.00 Paid Today: $282.60 . This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 114346 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 281.60 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) ("S4 Nor Rvt 1, If PERMIT/PLAN REVIEW APPLICATION o ; /• Development Services Department,240 West Huntington Drive,Post Office Box 60021 "'4A,,Y,,,tv 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' ( icense Class C.lb tc nse No. �I'2 Exp. Date l�'3b'i compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor �Vl__�a 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 _L 'r'C-1.--•— v ,- R,;.-N MLA.% • demolish,or repair any structure,prior to its issuance,also required the applicant GP Cc, i ' l C-4-- 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 nat 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. e...,„,,,,,,-_,A , (Name CSS L0®� C:4-j 1 --elk 1.-, Title ''.r trv`L PRINT NAME I ce tify that I ha • rea 8,this application and• at:that the above information is correct and that I am the owner or duly authorized agent of the owner. I .gree to corn s.y with all City ordinances :nd '\.to Laws relating to building construction. I hereby authorize representatives of the City of A cadia t• • upon the above-mentioned p opert for inspection purposes. C v,...),_(Signature 1 ` ( Date 2�' rhe`' Development Services Department \� ;t- 240 West Huntington Drive,Post Office Box 60021 � i Arcadia, CA 91066-6021 L MIT NO. $QQ-054-914 City of (626) 574-5416,Fax(626)447-9173 Arcadia it Type: - Fire PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 9/28/2016 CM 13:03 10/10/2016 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#: 16-456 Los Angeles, CA 90025- EMAIL ADDRESS: APPLICANT .. ...',MAILINGADDRESS ? . . _ _ Allready Fire Sprinkler Co. PHONE NO. EMAIL ADDRESS: , CONTRACTORIPROFESSIONAL, ,. MAILING ADDRESS " Allready Fire Sprinkler Co. 818 N Grand Av PHONE NO. (626)913-6720 FAX NO. Covina, CA 91723 EMAI DRESS: License No. 358795 Type: C16 Expires: 7/31/ 1 :0 TENANT MAILING ADDRESS Backhouse Yakitori NE NO. FAX NO. DESCRIPTION FIRE SPRINKS FOR BACKHOUSE YAKITORI 19 HEADS Construction Type UOM #of Units Value Construction Type UOM #of Units Value Value Value 4,000.00 $4,000.00 OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $4,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT 19.00 each sprinkler pck 637.50 637.50 01-3109 1.00 Flat . Fire Issue Auto 44.35 44.35 01-3112 • each Fire Permit 137.05 137.05 01-3112 1.00 each SWMF 2 Auto 1.00 1.00 88-3027 Total Fees: $819.90 Balance Due: $0.00 Paid Today: $182.40 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 114588 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 181.40 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 �'/J 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. I (Closed on alternate Fridays) 1`J, OF ARO Q O,,,,wo iv,-4,, Cl ; ,,,\ V6. 0' PERMIT/PLAN REVIEW APPLICATION " 00›.....„ j�, Development Services Department, 240 West Huntington Drive,Post Office Box 60021 .„,,y°{N° Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia iWORKCONTRACTOR'S DECLARATION ERS'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: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Cod an y license is in full o • .is e s ect. I�) 1 ❑ I have and will maintain a certificate of consent to self-insure for workers' LicenseClass�Li -n.e 9. 'xp. Dat"e7-3/ / 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-BUILDE' ARA ION Ir 1 have and will maintain workers'compensation insurance,as required by Section 4❑ I hereby affirm under pe 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.M'/workper�s'com-13— en�”s9ati n��/tnsurance1'QIcarri�e9r d policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier V)i+'ldi5 Jv� f� ) demolish,or repair any structure,prior to its issuance,also required the applicant" U� 3 -) 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 roe forthwith comply with those provisions. property,rty, or my employees with wages as their sole /D r w� 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' Jl 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 PER1vIIT 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 .i-- --r-- u` X0(0.E.cf\q (Title �� PWIT NAME l 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. ( ignature , / D ate ID ✓io—1' 46‘ OF ARC G L • '`3neorPoe+ted ctteo Aary.t 5,1903 *1yaityataMEMORANDUM Fire Department DATE: January 19, 2017 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Avenue, M 10 (Backhouse) THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION - FIRE SPRINKLERS 12-5-2016 Jill Perumean FIRE ALARMS 1-13-2017 Jill Perumean TANKS HOOD & DUCT 1-13-2017 Jill Perumean KNOX BOX OCCUPANCY 1-13-2017 Jill Perumean COMMENTS: Emailed Bldg. Dept. 1-13-2017 Rita f ,l BUSINESS NAME fl ' 1NTo r'`''i'� � ''' / COUNTY OF LOS ANGELES DEPT OF PUBLIC HEALTH ADDRESS Vg") {/ • Vti-rf. F�,, A y/ /�;/. A Public Health Programs—Environmental Management COMPUTER NO. ` ``'r;�J'?C 0 2 OFFICIAL INSPECTION REPORT HEALTH DISTRICT Continuation Sheet DATE / . xr / .,.trjr' 7 ' • / / i / '`f �.! ."5 �.. A rr •f i!%a -`/ �!,• /I t i 7 fi'!'trrd. �` ���..� �.r^.' •/�'• =y/L.-�• ° . Y,Q • • • Tel: 714-333-8382 • Fax: 714-521-7622 • CAL TECH Inspection. Services 7784 La Casa Way, Buena Park, CA90620 • • rDate Day of Week REGISTERED INSPECTOR'S DAILY REPORT I /o ht/&:b. TYPE OF 0 Reinforced Concrete 0/Structural Steel Welding ❑ Quality Control INSPECTION ❑ Post Tensioned Concrete ig Fire Proofing 0 Epoxy. • REQUIRED 0 Reinforced Masonry ❑ High Strength Bolts 0 Others Job Address 4100 S. /,4LDl JAI AVE &f1"T 1,4 10 1U cI,Dh4 Job Name Permit No. T. L hak. Ririfl (A iT©12 i �� ou .5 3 -- _► 16 Owner Address Tel Contractor � qq y� Address Tel Sub Contractor Architect Tel I.4 TEC r l iE fgooF Jai garrloRI - 1 16.1 Inspector NameEngineer y Tel 1‘,1l i_ 9 JD ADJw- AA ( 5uLT TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES • INSPECTION SUMMARY: • B5 aVE-h ` 1 PATr_i1+k\ ""-Sr VA's OF FI I'Pc6OF/J MA-Mk) \L_. CA-FCC �o 'a 12 'c a 5/46 �. � fit-- t ��'�- � �=F'�T� � , f ll�� 1 ON' T` C& . RP AT poo---R c 1+ rorEs. ARIA pAT o65-1 CD.t F C dpi V • • •All inspections are based on a minimum of 4 hours.if over 4 hours or after 12:00 noon an 8 hour minimum will be billed and past 12:00 midnight 8 hour minimum at time and half will be billed except Saturday,Sunday 8 Major Holiday. "ATTORNEY'S FEES-If any action at law or in equity is brought to enforce or to interpret the terms of this contract,the prevailing party shall be entitled to reasonable attorney's fees cost and necessary disbursements in addition to any other relief to which such party may be entitled. CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE ❑ • PAGE I OF I I HERE BY CERTIFY THAT I HAVE OBSERVED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED.I HAVE FOUND THIS WORK TO COMPLY WITH THE TIME IN TIME OUT REG.HOURS O.T.HOURS SAMPLES APPROVED PLANS,SPECIFICATIONS,AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. TOO ri(jk 241 m t f All inspection based on a minimum of 4 hours and over 4 hours-8 hour minimum. In addition,any inspect on extending past noon hour will be an 8 hour minimum. SIGNATURE OF REGISTERED INSPECTOR SF pili ILC. Approved Lic.Type Lic.No. AGENCY y Property er or Owner's Agent WHITE&CANARY(OFFICE), PINK(INSPECTOR), GOLDEN ROD(SUPER INTENDENT) N).1-Z4,4- tt,),ct • City of 54A- Los Angeles Uniform Code Program Uniform Procedure I-7: Special Inspections Special Inspection Report • DISCREPANCY -tCONFORMANCE 1 M discrepancies shall be brought to the immediate attention 6f If worts conforms to approved design and code requirements,submit I the Contractor for correction. If corrections are not made in a this report to Building Department and copies to Contractor,Engineer/ Ii timely manner,this report shall be used as a discrepancy notice. Architect of record and Owner no later than the business day following . Submit the original to Building Department and copies to " ttie conclusion of the special Inspection, For inspections greater than 5 . Contractor,Engineer/Architect of record and Owner. days duration,submit a conformance report at least once every week. Act 16.10 t5 . yAki To4J •This Is a: v Progress Report • Final Report Report No.j Page No: . 1 of 1 Pnlect Address: Desai of Pro/ &��/AJ /. ro�/�1� (/'��Sii Permit Number: Owner; Amhitect/Engineer of Record: Contractor: jr-�'r • 6-at .—.0,._s-3-�/ "�/�r 4-? Full Name of Special Inspection: City Registration Number: Company: /y, e� Phone Number: Huan Van But P013049 e/ 4 VanBui Inspection j14-345-8266 Type of Inspection: —.— a Reinforced Concrete a Stryctural Masonry a Piling,Piers&Caissons a Smoke Control a Prestressed/Oost-tensioned a Bolts in Concrete/Masonry a Excavation and Fills a Compliance a Shotcrete/Gunite .ef Structural Wing . a Spray-Applied Energy Reports a Insulating Concrete/Gyperete a High Strength Fire Proofing a Testing Reports • IgBolting o Other Time Time Date Arrived Departed Description and Location of Work Inspected e`/r3lra. q:#1 /®r i- 0/4Com, e77C C,2 /tA . 4, tea, 7�- t � 7pJ775 J/ '0 , /4 /1 4Stru .T; V r/lc-f-r i N_ . '` I Remarks: I HEREBY DECLARE THAT THE FOLLOWING IS TRUE TO THE BEST OF MY KNOWLEDGE: `.. :AM,OR MY COMPANY IS,-RETAINED BY THE OWNER OR THE ARCHITECTJENGINEER OF RECORD TO PROVIDE SPECIAL INSPECTION FOR THE WORK COVERED IN THIS REPORT. 2. I HAVE PERFORMED THE REQUIRED INSPECTION DURING THE TIME PERIOD AS STATED ABOVE. 3. THE WORK COVERED IN THIS REPORT IS IN CONFORMANCE TO THE APPROVED PLANS,SPECIFICATIONS AND APPLICATION WORKMANSHIP PROVISIONS OF THE CODE,EXCEPT AS INDICATED OTHERWISE. Signature: Date i// f f _ Huan Van But, Deputy Inspector r 1=-` -a LVNfadERGN[iENELOF'Mf:NDf S•tKVIG • r„�,' .A..WILrrLe.reeeu.e esting a ee;nnut:lan • UYf{ t�, 1 , No: 7206 : • THIS IS TO CERTIFY THAT: Gr""de 1 , `r ��, ` ;'rod JUSTIN M. CARR • �1'p R P. CITY OF LONG BEACH CALIFORR N A • JUSTIN CARR CERTIFICATION NO. . - ' . MASONRY 0 REINFORCED CONCRETE® GRADING 0 Certification ID#0101401. •i 14 STRUCTURAL STEEL&WELDING ►:4' WOOD SHEAR in • Expires ont 10/17/2020 : - - : RESTRESS 0 FIREPROOFING® DRIVEN PILE® - P®XY ifi . • �� Verify at CheekACl org .TEs 6-30-15 EXPIR. h-30=1:6 (CJC:I" " .r +� ertificatio J • f�l/1� I�J'Y4iT7 • . • `BL-350 _ BUILDING OFFICIAL. Justin Can 5228550 JueUn'Cerr 5228550 1. �•;, v Building inspector=•Exp.0 3/1 012 01 5 i' € Reinforced =Ex Concrete Special Inspectorp:04/2612016 l } N Spray-applieieprooling Special Inspector-Exp.04126/2016',: ".: Structural Steel&Welding Special Inspector-Exp.07/2112017 ► d Flc,.:.:s 14: y. . --- .. ` pJp t r t } c s! ii' ', `-' C'{it L s A Fw... • . DEPUTY BUILDING-INSP D P• U�Y BU LDING )NSP . License#:'P023381.. Expires: 102012016 • License#: P023381 Expires:11/2112017: : • • . JUSTIN-M. CAR`t:',; .' CONCR TI SII; C/6•UCT .. CONCRETE CONSTRUCTION • .STEEL CONSTRUCT,(OAI .. • • �t • . Issued City of Los An , :'' 1''^ Issued by City of Los Angelas; --.-i• • --:' v' . . by gales. r;1,i , y )..Department of Building and Safety . . •' . +� ) Department of Building and:Safely - - � -- . DEPUTY BUILDING:N G N SP - � � .License# P023381 Expires 10/2612 0 16 . JUSTIN M CARR..: '.11,:c- i ;' .. _ . . � . 'DRILLEDIN ANCHORS • Justin•M Carr • . 0.i . C W l Has complied with the requirensest of.4 WS QCl.' a Standard for AWS Certification of Welding Inspectors if `,, Issued by C• ity of Los Angeles• , r,. Fta ` 09110041 aws Pre:Naem• I t`i.) Department'of Building and Safety Exp.1 Nov 2018 ,s • ...a With Eye Correction : ,2 _'as . .. : . • aws eniscau&id a r - D�' S'_ . /der//rJr�esh . or��h • Glork