HomeMy WebLinkAboutUntitled e Development Services Department
11591m 240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 PERMIT NO. B00-054-869
City of (626) 574-5416,Fax(626)447-9173
Arcadia Permit Type: Tenant Improve
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
9/23/2016 CM 10:49 1/17/2017 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: HENRY
Los Angeles,CA 90025- EMAIL ADDRESS:
Plan Chk#: 16-447
APPLICANT MAILING ADDRESS
Plan#: 32162
Rutilios General Contractor PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS •
Rutilios General Contractor 4609 E Goldfield Ave PHONE NO. (562) 889-4337 FAX NO.
Long Beach,CA 90807 EMAIL ADDRESS:
License No. 741850 Type: B . . Expires: 10/3.1/2017 12:0(
TENANT MAILING ADDRESS
Piercing Prageda PHONE NO. FAX NO.
DESCRIPTION (1 ' I
� SI y
.
T.l FOR PIERCING PAGOD' IT . IEL "I! '•'.); . ERVICE
Construction Type VOM #of Units Value Construction Type UOM #of Units Value
Value Value 57,900.00 $57,900.00
F;;S/044-- /-Z5-i7 r
OCCUPANCY: Tenant Improve TOTAL VALUATION: $57,900.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 567.65 567.65 01-3103
PC Cal Green 56.76 56.76 01-3103
PC ADA 85.15 85,15 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 873.30 873.30 01-3104
Bldg Issue ADA 87.33 87.33 01-3104
1.00 Flat Elec issue 44.35 44.35 01-3105
1.00 each Comm svc<200 a 31.43 31.43 01-3105
7.00 each Outlets 10.78 10.78 01-3105
12.00 each Ltg fixtures 18.48 18.48 01-3105
1.00 each T.I.Fire Pkc 255.00 255.00 01-3109
SMIP Com 16.21 16.21 14-2207
grn bldg std 3.00 3.00 714-2203
1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $2,101.04 Balance Due: $0.00 Paid Today: $31.43
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 115555
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3105 31.43
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 Friday411,
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
. (Closed on alternate Fridays)
OF ARC
4�,LIFOR,y99dr
it
11' PERMIT/PLAN REVIEW APPLICATION
• .two • Development Services Department,240 West Huntington Drive,Post Office Box 60021
off'..,ocv, 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 Lice e No. ' Exp. Date_IO_31-n 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 :
, I
OWNER-BUILDER DECLARAT N la 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 wo kers'co pensatipn insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier S 'Lin
demolish,or repair any structure,prior to its issuance,also required the applicant (Policy p p
for such permit to file a signed statement that he or she is licensed pursuant to the Number 7�3.S�p
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code) or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further information.
(Name g.u+11, 4 - ) Fez— Title 0 u'yMM,M
INT 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. e
r r �r{
iSignatur 1 Date Q
:rte- Development Services Department
t ' 240 West Huntington Drive,Post Office Box 60021
PERMIT NO. BOO-054-869
�� Arcadia,CA 91066-6021 •
City of (626) 574-5416,Fax(626)447-9173
ArcadiaPermit Type: Tenant Improve
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
9/23/2016 CM 10:33 1/17/2017 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
400 S Baldwin Ave T-387
OWNER MAILING ADDRESS
Westfield Corporation,Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: HENRY
Los Angeles, CA 90025- EMAIL ADDRESS:
Plan Chk#: 16-447
APPLICANT MAILING ADDRESS
. Plan#: 32162
Rutilios General Contractor PHONE NO.
MAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
PHONE NO. FAX NO.
Rutilios General Contractor 4609 E G..• - � A �� (562) 889-4337
LongBeal ' 90 EMAIL ADDRESS:
License No. 741850 Type: B - Expires: is 117 12:0(
TENANT MAILING ADDRESS
•Piercing Pragada PHONE NO. FAX No. •
DESCRIPTION
T.I FOR PIERCING PAGODA.WITH ELECTRICAL
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 57,900.00 $57,900.00
NAC /-ll6?
OCCUPANCY: Tenant Improve TOTAL VALUATION: $57,900.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 567.65 567.65 01-3103
PC Cal Green 56.76 56.76 01-3103
PC ADA 85.15 85.15 01-3103 1_2,41-i ! 44`.44-6 E4.e-C-7746C 64SPec.T/a.d
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 873.30 873.30 01-3104
Bldg Issue ADA 87.33 87.33 01-3104 /el/
1.00 Flat Elec issue 44.35 44.35 01-3105
7.00 each Outlets 10.78 10.78 01-3105
12.00 each Ltg fixtures 18.48 18.48 01-3105
1.00 each T.I.Fire Pkc 255.00 255.00 01-3109
SMIP Com 16.21 16.21 14-2207
gm bldg std 3.00 3.00 714-2203
1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 Flat SWMF Auto 6.25 6.25 88-3027
Total Fees: $2,069.61 Balance Due: $0.00 Paid Today: $1,105.05
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 115551
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 1,004.98
the date of plan submittal.This permit expires:and becomes null and void if any work authorized by this permit 01-3105 . • .73.61 •
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 16.21
Arcadia building inspector for a period of 180 consecutive days. 714-220 3.00
88-30 / 7.25
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS •
Requests for inspection should be made at least Monday-Thursday Friday /
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
v~4 oFF RN.-4,o
9 PERMIT/PLAN REVIEW APPLICATION
OA 111211 'zP
o• EMI; Development Services Department, 240 West Huntington Drive,Post Office Box 60021
074%.- ----V' Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION 1 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. ElI have and will maintain a certificate of consent to self-insure for workers'
License Class License No.14 I O Exp. Dateld 3117 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 26.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.M woikers'co pensa n insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, /Carrier S"WM. 1�.1..d
demolish,or repair any structure,prior to its issuance,also required the applicant �j
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number q(' S 2.0p 7
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 ❑II 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 1
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractors License Law does not apply to an owner of property I 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 RdA.-1'i I I Q Lo re21.PRINT NAMETitle 0 UJ ACT
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.
Qgnature i. ' jetrldr, Date 01-17- 17
R�'
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