HomeMy WebLinkAboutUntitled .`y' :',.. Development Services Department
•
240 West Huntington Drive,Post OfficeBox6d021
r IPERMIT NO. BOO-056-277
Arcadia,CA 91066-6021
City of (626) 574-5416,Fax(626)447-9173 e
Arcadia Permit T yp : Tenant Improve w/energ;
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
3/15/2017 CM 10:29 4/21/2017 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#: 17-72
APPLICANT MAILING ADDRESS
Plan#: 32237
J.R. Lenner Construction, Inc. PHONE NO.
EMAIL ADDRESS:
5
CONTRACTORIPROFESSIONAL MAILING ADDRESS
J.R. Lenner Construction, Inc. 73605 Dinah Shore Dr#1330 PHONE NO. (760)328-1200 FAX NO.
Palm Desert,CA 92211 EMAIL ADDRESS:
License No. 798968 Type: B Expires:. 8/31/2017 12:00:
TENANT MAILING ADDRESS
Unlg10 PHONE NO. FAX NO.
DESCRIPTION 00,111112...1
T.I FOR UNIQLO.WITH EMP ) rfpilrfJ ,
Construction Type UOM N of Units Value Construction Type #of Units Value
Value Value 600,000.00 $1,600,000.00
F" - 9 -S-0
OCCUPANCY: Tenant Improve TOTAL VALUATION: $1,600,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 7,523.10 7,523.10 01-3103 1.00 each Floor sink 12.46 12.46 01-3105
each Energy p/c fee 2,314.80 2,314.80 01-3103 52.00 each Outlets 62.80 62.80 01-3105
PC ADA 1,128.47 1,128.47 01-3103 1.00 each Ltg fixtures 1.54 1.54 01-3105
PC Cal Green 752.31 752.31 01-3103 7.00 each Misc elec 108.85 108.85 01-3105
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 1.00 each Wtr htr/vent 15.55 15.55 01-3105
each Bldg permit 11,574.00 11,574.00 01-3104 1.00 branch cin Signs elec 59.17 59.17 01-3105
Bldg Issue ADA 1,157.40 1,157.40 01-3104 1.00 each T.I.Fire Pkc 280.00 280.00 01-3109
1.00 flat Elec issue 44.35 44.35 01-3105 SMIP Corn 448.00 448.00 14-2207
1.00 Flat Mech issue 44.35 44.35 01-3105 gm bldg std 64.00 64.00 714-2203
1.00 Flat Plmbg issuance 44.35 44.35 01-3105 1.00 Flat SWMF Auto 6.25 6.25 88-3027
1.00 each Comm svc<200 a 31.43 31.43 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027
2.00 each Fum>I00,000bt 46.98 46.98 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 each Water Closet 12.46 12.46 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 each Lavatories 12.46 12.46 01-3105
4.00 each Distrib panel 62.20 62.20 01-3105
2.00 each Power 1-10 hp 31.10 31.10 01-3105
Total Fees: $25,895.11 Balance Due: $0.00 Paid Today: $13,896.43
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the 'eceipt :: ,, ,
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-310412,775.75
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 . ' 599.43
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 448.00
Arcadia building inspector for a period of 180 consecutive days. 714-2203 64.00
88-3027 9.25
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m. \'
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
OF
I PERMIT/PLAN REVIEW APPLICATION
00 j` Development Services Department,240 West Huntington Drive,Post Office Box 60021
vo Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of .
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
eby 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 5 License No.74Imo xp. Dat SPP compensation, as provided for by Section 3700 of the Labor Code, for the
!.� / '' performance of the work for which this permit is issued.
�gnature of Contractor ....—,
OWNER-BUILDER DECLARATION :Ji` 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.NJy workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier /EILA6. r M C4 i) TA.5
demolish,or repair any structure,prior to its issuance,also required the applicant .7 1t �;� @,l q G
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number ( 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 al-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
compensation,will do the work,and the structure is not intended or offered for t,y �J
sale(Section 7044,Business and Professions Code:The Contractors License tate [ l f /7 Signature
v-yR+
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.
are J t OL.)” 5 'Li Title � pe-7—
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.
'gnaturDate !
1
a . 1
gC5-6 .v4- atilSre_o
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. 1---67 f 4/ � � M,,G /S�
100. Setbacks 210. Underflr./bldg.drain (7 / 1
101. Rough grade 211. Copper.underslab /1J'' o 77kwA.‘e g/''L '3/2a--/i,k. RtM a
102. Figs.&forms 212. Rough plumbing i 'f
,......7„.
103. Pre-slab 213. Rough gas
104. Floor joists 214. Shower pan
105. Steel 215. Water heater 5---/0--17 � -G e/G A-7 7-/I-E.
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer ��'���/ �'�T- � '
_
108. Diaph nailing 218. Water service /
va-
109. Roof nailing 219. Final gas S_41.47 l�f"yW4c.c. Ar- c/f e
110. Framing 6,-/-f? ,4Y'220. Fixtureset1 Z`71-‘1'7 • I
111. Occ./Area Sept.Wall 221. Final plumbing • 5_1 t•--i 7 F /„lG ,t,. >✓
112. Sound walls iii�� _ 222. Sewer cap/demo.
113. T-bar grid &-13-'7 v7igvcT'1Z (. CA.Tt-(11'1 15
114. Insulation-Flr. Pool Inspections Date . Insp.
115. Insulation Wall 240. Excavation/steel s 5 -I? 0,-, t r i6145c1c, - c?,1
116. Insulation-Cell. 41. Rough plumbing
117. Drywall nailing 6-2.-i7 /4-.-71242. Light shell/bonding
118. Interior lath 243. Underground conduit
556-'7 �'/
119. Exterior lath 244. P-trap Pts cai-4,-- A. r fr d:x..,`
120. Finish grade 45. Gas line&test Z asi=5,LGes I-44=7Z Gni
121. Final building 5'8-17 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric 37-31-/7 . S • T /u,,!
Electrical Inspections Date Insp. 249. Final•lumbin• l
150. Power pole 250. Pool cover ,FRAJNI•*(4
151. Sales lot lighting 251. Pool final
152. Underground conduit "7-V f-? C�� c-eaz
153. Underslab conduit Reroof Inspections I Date Insp. A J C
154. UFER ground 270. Pre-reroof insp. A140 4.6R 44-619.1cir
155. Water ground 271. Roof framing
156. Rough electrical 272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E.•t.bondin• Sign Inspections I Date I Insp.
160. Service panel c-,44-/7 ' r" 80. Setback/overhang
161. Final electric 745-17 281. Footing
282. Conduit/wiring
Mechanical Inspections Date Insp. ` 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. RouchHVAC 5 S(7 ,,L -A u. . •,'' i I I. ' i
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 7-1Z-/7 rf' 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess•ool filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
�..r Ddb' t� . `t ro? ---- t 3'0ict - 4�i?'. . _-.. �,fi r 9RP, :sC
:, p t ., �.�p v� ,u°ma 1,, !x , — ._ , 0A,. .4010%._ ..„.41i
pp„,,b 4 t igi ii. �t:�r 1�� lt. e�� . ��� 1 Id,/,"k-- ilmect.-_.:___L . --,miki_.--- --,..as.,. .iitrax-ott. -- mus -- ,eimi..., _-----__Lekri-eakA%-a° s, �d� t l� lI� `fit=`� ' ,„ "-- �4__@ e . A
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1 N Acs .r • . ,,
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,,,,,,,,:„,,,g,
„) .......0.1
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11106
igff/P-
r RpORATS,'' 19. �T.� '
�rat
Certificate of Occupancy
"...-::' Irl VA
City ®f Arcadia �� f
Development Services Department - Building Division pn
a � This certificate issued pursuant to the requirements of Section 109 of the n �,NO
® Uniform Building Code certifying that at the time of issuance this structure was in ' 'Il
compliance with the various ordinances of the City regulating building construction or use. '
J
�:. 0� � � �
® Permit No. B00-056-277 . 9
r E3 ::
�+ I Building Address: 400 S Baldwin Ave,Arcadia,CA 91007 I et .1. d
® Use Classification: Tenant Improve Effective UBC: D3
® P 2016 C.B.C.
Permit Type: Tenant Improve w/ener Zone Code: ` t
a. P gY C-2 DH8 �,
�i. Occupancy Code: M Type of Construction: TYPE ITA SPRINKLERED
�y l Final Date: 9/8/2017c
,- ,,,,,.. 3.§
�� Owner: Westfield Corporation,Inc.
®" Tenant: Uniqlo
4�
wto
t(
i' 1711:1
�. �+ Don Stockham,Building Official
o1 1,—. , \---1& L'Cit.... ."''''
f I POST IN A CONSPICUOUS PLACE I�'�� p
II
d�
:� rfrl-WrTRWlttiltuLtsti, 04m0. do, � 11 �;ietvt.% t� %Itt�� t 40�� � ..*;-- ..._ e .0,,,,,,, ,
W-IMO
g t:.e �
'41.I,
LINE
• A-Line
1105 Belmont Ave. INSPECTION SERVICES Tel#562-449-7491 •
•
Long Beach, CA. 90804 Fax#562-438-5136,
REGISTERED INSPECTOR'S DAILY REPORT Permit# 5 cerLD•SC-2;7�Job# Date
TYPE OF ❑Welding 0 Reinforced Concrete ❑Quality Control
INSPECTION ❑High Strength Bolts 0 Post Tensioned Concrete
oxy
REQUIRED 0 Fire Proofing 0 Reinforced Masonry, Ot�ar
BuildingDepartment 1, D Job Address d4U. Ce L-v
Job Name Architect •
Type of Structure Engineer . •
Material Description(type,grade,source) Contractor , ✓\1 Le-'i j
Sub-Contracto..--7,91..
1 c l� �-) �r /
Fabricator •
I/ Y t P (te-ArCP- l -,
. .,
Inspector(s)Name �. ° Cl�v �' Owners Name,Address,Tel#
es •
. F • �
INSPECTION SUMMARY-LOCATIONS OF WORK INSPECTED,TEST SAMPLES TAKEN,WORK REJECTED,JOB PROBLEMS,PROGRESS REMARKS,ETC.
INCLUDES INFORMATION ABOUT-AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED,NUMBER,TYPE&IDENT.#S
OF;TEST SAMPLES TAKEN:STRUCT;CONNECTIONS(WELD MADE H.T.BOLTS TORQUED)CHECKED;KED;ETC. .
O Sc 12c%d P1/z �i'uce,_7- c :� oco-er s . .: ti 7`b 6(2--3-0-ter'
• &{,1-.Sdn! fc y Cr-V1-1i 71� � -- 6I yv� -1.2:L S 0 . "J1 p' L'f' ••Vic' T.
„,r,, 0
..
1 ,
,,/
TERMS 30 DAYS.SERVICES BILLED AT 4 AND 8 HOUR MINIMUMS,WITH A 2 HOUR CHARGE FOR CANcELLATIONS.SHOULD ALINE BE REQUIRED TO INSTITUTE LEGAL ACTIN FOR THE COLLECTION
OF A DEBT INCURRED AS THE RESULT OF THE ACCEPTANCE OF THIS SERVICE TICKET,A-LINE WILL BE ENTITLED TO'ATTORNEYS FEES AND COSTS INCURRED IN SAID SUIT.THIS FIELD REPORT
PRESENTS A SUMMARY OF OBSERVATIONS AND TESTING BY A-LINE INSPECTION PERSONNEL.OUR WORK DOES NOT INCLUDE SUPERVISION OR DIRECTION OF THE ACTUAL WORK OF THE
CONTRACTOR,HIS EMPLOYEES OR AGENTS.THE CONTRACTOR SHOULD BE INFORMED THAT NEITHER THE PRESENCE OF OUR FIELD REPRESENTATIVE NOR'THEOBSERVATIONAND TESTING,; ; ;
BY OUR FIRM SHALL EXCUSE HIM IN ANY WAY DEFECTS DISCOVERED IN HIS WORK IT IS UNDERSTOOD THAT OUR FIRM WILL NOT BE RESPONSIBLE FOR JOB OR SITE SAFETY ON THIS PROJECT.' '' .
CERTIFICATE OFCOMP LANCECONTINUES NEXT PAGED PAGE ( OFL.
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ' .
ALL OF THER' I`a SS OTHERWISE NOTED.I HAVE FOUND THIS WORK TO •
COMPLY TH APPRa .0' •NS,SPECIFICATIONS AND APPUCABLE SECTIONS
OF THE G ING:UL r ING LAW. TIME IN TIME OUT REG.HOURS O.T.HOURS SAMPLES
IMI.� � •�. _
SIGNATURE OF REGISTERED DEPUTY INSPECTOR All inspections based o • '1'„ •• '—< ours-; ours minimum
TOP.'/
I
5 ..', `�:TJ YC)r) ` CO L /� Approved by�� L� .,.. .eintAUIIIIP
SPECIAL # AGENCY
REGISTERED DEPUTY BUILDING INSPECTORS
fsk CERTIFICATE OF COMPLIANCE
�LA DBS
DEPA,9TYEET f1F BSILDITI6 MD SATM
Address of
Building 400 S Baldwin Ave#E8
Off-Site DATE OF THIS CERTIFICATE
Fabricator Simpson May 18,2017
Permit
Number B00-056-277 Year
TO THE SUPER INTENDENT OF BUILDING: CITY INSPECTOR:
I hereby certify that the following portions of the work at the above address which required continuous inspection,and
which I was employed to inspect,were inspected by me and comply with the provisions of the Building Code applicable
thereto:
Type of Inspection:
Masonry ReBar Placement Concrete or Mixer
Welding Concrete Placement Gunite
Hi-Ten bolts Tendon Placement Other
Description and Location of work completed: Observed depth and cleanness of 10 3/4"dia A307 all threaded
rods with 5"embedment for C12 attachment @ new wall opening,all set with Simpson XP epoxy.
Size of Structure Time Arrived
Number of Stories Time Left
Conc.Mix DesignNo. N/A Psi Swimming Pool N/A
I had sufficient time to inspect all materials used and placed.
I was not employed by the contractor,subcontractor,or material vendor.
P014616
Registration No.
Employed By:
Lab:
Signature Registered Deputy Building Inspector
Independent [ ] Robert Mckeehan
Print Full Name
DO NOT AMEND,ALTER, CHANGE, DELETE, OR APPEND ANY PRINTED PORTION OF THIS
CERTIFICATE AS IT WILL RENDER IT NULL AND VOID
IN.Form.07(Rev.611/2005) www.ladbs.orq
[ ] BUILDING DEPT.COPY [ ] CONTRACTOR COPY [ ] OWNERIENGINEER COPY
4-'4,- Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO. 1300-056-636
Arcadia, CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 Type:
Arcadia Permit Fire
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
4/21/2017 CM 11:29 5/4/2017 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. Plan Chk#: 17-111
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Allready Fire Sprinkler Co. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
626 NO.
Allready Fire Sprinkler Co. 818 N Grand Av PHONE ( )332-7066 FAX NO.
Covina, CA 91723 EMAIL ADDRESS:
License No. 358795 Type: C16 Expires: 7/31/2017 12:00:
TENANT MAILING ADDRESS
Uniqlo PHONE NO. FAX NO.
DESCRIPTION
FIRE SPRINKS FOR UNIQLO P
Construction Type UOM #of Units Value .onst;ucti P/�ype(.$&f Ll 1 11 ill ' #of Units Value
YP �`" V3? 'E,L e !.Liv ,ii �1'
Value Value 11,000.00 $11,000.00
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $11,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
117.00 each sprinkler pck 840.00 840.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 253.95 253.95 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $1,139.30 Balance Due: $0.00 Paid Today: $299.30
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the •ecetp ••• i
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 298.30
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 ,,,,.......s....,,,,,...„
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)
4
U �yu Rvy 9
11' PERMIT/PLAN REVIEW APPLICATION
tow, Development Services Department,240 West Huntington Drive,Post Office Box 60021
ocv Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
ICENSED 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,and6iny license is in full force and effect. ���/�❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class e` ' License No. 35-4: I/1' xp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
' performance of the work for which this permit is issued.
Signature of Contractor 1%�
ER-BUILDE' 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'com ensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier �f F '
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 _H-1I 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 5/14
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. �J
e Z` i �. Title
P'ii-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 the above-mentioned property for inspection purposes. reVi „.9—
•
Signature n lDate
tf1- .. Development Services Department
rl c 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-056-754
° ✓ Arcadia, CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 Permit Type: Fire
Arcadia
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
5/3/2017 EP 12:50 6/6/2017 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. Plan Chk#: 17-131
Los Angeles, CA 90025- EMAIL ADDRESS:
APPLICANT _ MAILING ADDRESS
Building Electronic Controls Inc. PHONE NO.
EMAIL ADDRESS:
5
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Building Electronic Controls Inc. 2246 Lindsay Way PHONE NO. FAX NO.
Glendora,CA 91740 EMAIL ADDRESS:
License No. 729905 Type: C Expires: 11/30/2018 12:01
TENANT MAILING ADDRESS
Uniqlo PHONE NO. FAX NO.
,
W't41 . Iote Storage PHONE NO. FAX NO.
FIRE DEVICES FOR UNIQLO 28 DEVICES,
Construction Type UOM #of Units Value Construction Type UOM • Hof Units Value
Value Value 13,000.00 $13,000.00
A�ril,1, fl11 a
Eig i,,,,,,,,,,,i, ,,,t0
L'e C3 Sd
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $13,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
28.00 each fire alarm pc 2 840.00 840.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 287.35 287.35 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
•
Total Fees: $1,172.70 Balance Due: $0.00 Paid Today: $332.70
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 117003
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 331.70
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
if
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m. /
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
of Anc,
1-"— ' PERMIT/PLAN REVIEW APPLICATION
0, IFFEms „I
a w j, Development Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License ClassC\0 License NO '"95 Exp. Date (-)/ jr 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 0 Or l 1
OWNER-BUILDER DECLARATION 6.1 have and will maintain workers'compensation insurance,as required by Section
IDI 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 insurancecarrierand policy numbers`/afire:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier- , � rA111 \,`\(L ��&v(G lCS
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number 3 V•PC- .2j\e5Z:57..-�
for such permit to file a signed statement that he or she is licensed pursuant to the
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ 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 ff nn
sale(Section 7044,Business and Professions Code:The Contractors License Date tk'I /�� Signature '` ....k ,i�� �'� �
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further information. + ` T/� r\ (���
IName 4 C\ \ \ \(�\ v� Title V1.1 UV
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. // ,,
Signatu' L,, �.�� ���, Ll A. j` )Date U` lY/ Vi
V ARC
ti`�4ONF ,9dr
111110111r, 7
0..
. Wijarili
"valunity ot� MEMORANDUM
Fire Department
DATE: July 26, 2017
TO: BUILDING DEPARTMENT
INSPECTOR Henry Kemich
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 400 S. Baldwin Avenue, E8 (Uniglo)
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 7-11-2017 Jill Perumean
FIRE ALARMS 7-18-2017 Jill Perumean
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 7-25-2017 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 7-25-2017 Rita