HomeMy WebLinkAboutUntitled fi
r IPermitNO.ROOF'S-0057•
) City of Arcadia, CA ,
Report Text Library:Municipality_Address } Permit Type ROOf
,
9 ''''''4''''I'f ( d Work Classification:Residential Rei oof
` .:', >Permit •Status.Issued
ARCAD�� Issue Date ,02/05/2018„1 Expiration: 08/04/2018
Location Address Parcel Number
1748 Orangewood LN,Arcadia,CA 91006 5766013006
Contacts
MICHAEL RAUCH Owner Always Reliable Roofing Roofing Contractor(C-39) Z
1748 ORANGEWOOD LN,ARCADIA,CA 91006 14410 Crystal Latern DR,Hacienda Heights,CA 91745
(626)836-6948 mr@ciw.edu (626)723-9536 alwaysreliableroofing@verizon.net
Description:T.O.REROOF HOUSE/ATACHED GARAGE WITH Valuation: $ 13,500.00 Inspection Requests:
afi
OWENS CORNING DURATIONS WITH SHASTA WHITE CLASS A (626)574-5416
38 SQ(JC) Total Sq Feet: 0.00
Fees Amount Payments Amt Paid Available Inspections:
Building Issuing Fee $44.35 Total Fees $354.65 Inspection Type I IVR
Building Permit Fees $304.05 Cash $354.65
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $354.65
COMPLETED
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February 05, 2018
Issued By: Date
Page 1 of 1
Monday,February 5,2018
OF AR
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•
°~ • PERMIT/PLAN REVIEW APPLICATION
44.1 Development Services Department,240 West Huntington Drive,Post Office Box 60021
'°'�°al�Y°t% Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
0 I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class e.--11License+�No. 0317° Exp. Date -)O' V compensation, as provided for by Section 3700 of the Labor Code, for the
i/ performance of the work for which this permit is issued.
Signature of Contractor T I
WNER-BUILDS' I L TION C'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 S 1-.4-G- F' /(
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number 3 003`1 7-6
for such permit to file a signed statement that he or she is licensed pursuant to the (This section need not be completed if the permit is for one hundred dollars or less)
provisions of the Contractors License Law(Chapter 9(commencing with Section
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 orthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License ate a S-t SS Signature jficit-
Law does not apply to an owner of property who builds or improves thereon, \))
or who does such work himself or herself or through his or her own `
employees,provided that such improvements are not intended or offered for , WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). • damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
0 I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044, Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
0 I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for
further(information. q - — r
Name v e- x- �v t-- Title CD 1'"/
PRINT NAME
I certify that I have read this application and state that the above information is coilrect and that I am the owner or duly authorized agent of the owner.
agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentioned property for inspection purposes.
2.--C.T ('
Signator Date
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y
Auu�,S,150,
AR�
AFF@B�t.•,!/BT.SELF-CE-TlF DOA`B'B®i�{� .. .
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FORCOMPLIANCE OF SMOKE ,,,
ND C%1/4r;BON MONOXIDE ALARM
Pro pertyAddress: . OgA1 .
Permit Number:
0 /R de57
Brief Job Description:
Number of smoke alarms installed:'
Number of.carbon monoxide alarms installed:
When alterations, repairsor additions requiring a permit occur, or sleeping rooms are.created,
Smoke alarms shall be installed 'in each sleeping room, and outside each separate
sleeping area in the immediate vicinity of the bedrooms, andoneach additional story.of the
dwelling, including basements and habitable attics as required by Section R314 of the 2016
California Residential Code(CRC) and.California.Health and Safety Code Section 13113.7.
For dwellings or sleeping units containing fuel burning appliances or havingattached
garages,.carbon monoxide alarms shall be. installed outside each separate.' sleeping
area in the immediate''vicinity of the bedrooms, and on each additional story ofthe
dwelling, including basements as required by •Section. R315 of the of the 2016 .California
Residential Code (CRC).
Multi-purpose alarms (combination carbonmonoxide and smoke alarms) may be used.
All alarms shall. comply With requirements for listing and approval by the Office of the State Fire
Marshal. http://osfm.fire.ca:gov/licensinglistings/licenselistinq brill searchcotest.php
As owner of the above referenced property, I hereby certify that the smoke alarms andcar on
monoxide alarms have been installed in accordance with the manufacturer's instructions and in
Compliance with the code sections referenced above:. _
I declare under penalty of:perjury that the foreg,. ng is !i.e and correct, and that this
decl ratiil n was .•xecuted on (D::te)'pr . • d 0 ' (d' at Arcadia, Californi...
e ner'sName (printed/typed):41 CkA—z-
i</(G
Signatureof..Owner: _ ----
This affidavit must be returned to the City.of Arcadia inspector prior to final inspection
S' ALARM.AND CARz,ONI M.NOX0®E ALARM LOC .TIONS
-
Guest Room1'
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Storage
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Room
Garage
FIRST.FL®.eTR PLAN
Or. SMOKE
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Bath
Master Bedroom
Dining I ooni Kitchen , 411‘ —
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Closet I
, Closet
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' Bedroont :T::
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SECOND FLOOR ULAN
SMOKE ALARI 111. - o C '.`.r>ON MONOXIDE AL=\=VI •