HomeMy WebLinkAboutUntitled t, 1 Development Services Department
-s 240 West Huntington Drive,Post Office Box 60021
.:� Arcadia,CA 91066-6021 PERMIT NO. BOO-056-292
City of (626)574-5416,Fax(626)447-9173 Permit Type:Arcadiayp : Sign
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
3/20/2017 CM 12:05 5/1/2017 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#: 17-102
APPLICANT MAILING ADDRESS
Plan#: 32248
Evergreen Design Group PHONE NO.
EMAIL ADDRESS:
I
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Evergreen Design Group 2646 Broken Feather Ln PHONE NO. (909)802-9057 FAX NO.
Diamond Bar, CA 91765 EMAIL ADDRESS:
License No. 964592 Type: B Expires: 8/30/2017 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAXNO.
DESCRIPTION piPLE1ED 122ILLUMINATED SIGN BOARDS,INCLUDES ALL ELECTRICAL AND INSTALLATION
COED
Construction Type UOM 8 of Units Value Construction Type UOM 00 #of Units Value
Value Value 130,000.00 $130,000.00
F;A64-4-- C -2:2-t?
OCCUPANCY: Sign OTAL VALUATION: $130,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UONI DESC AMT AMT PAID ACCT
Sign plan rev 801.36 801.36 01-3103 � �?
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104 5.-11-17 °05 (&M� e-PP0 .5(7 o-cry-s
each Bldg permit 1,431.00 1,431.00 01-3104 - 5,-/a,,, 6ASer oe
1.00 flat Elec issue 44.35 44.35 01-3105 v
12.00 branch ein Signs elec 59.17 59.17 01-3105
12.00 each Sign Connection 186.60 186.60 01-3105
1.00 Flat SWMF 2 1.00 1.00 88-3027
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Total Fees: $2,568.83 Balance Due: $0.00 Paid Today: $2,568.83
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 116566
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 801.36
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 1,475.35
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 01-3105 290.12
Arcadia building inspector for a period of 180 consecutive days. 88-3027 2.00
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday K........)k..)
�
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�g ARtook,C
r � p_ PERMIT/PLAN REVIEW APPLICATION
Rik ,immirmili ..70
, Development Services Department,240 West Huntington Drive,Post Office Box 60021
m,,y o,' 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:
r.,
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 L icense No_ ti' Exp. Dat /)t'/// 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 Contrac.r //moi
OWNER-BUILDER DECLARATION ave 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
wor 'compensation nsurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier �f`� �kersyj/ -- Rlei' c,�
,
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number C17 C �3� Z/ 6 /
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.
111
compensation,will do the work,and the structure is not intended or offered for s-////2
P
sale(Section 7044,Business and Professions Code:The Contractors License Date ! Signa• 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.
�e i �� Title IL
ItINT NAME I/
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 . • above- • ioned property for inspection purposes.
/
Signature Date /��`
Deputy Inspector's Daily Field Report
Representing Inspection Firm of:
Job Name: `.,A1r>.e-,-T }P: a_. ' h,• `a
'11C11 170/_ro.Ei*5 CVOS.— Job Address: ' OO `a, ir2N1-V,W,iJ , Or ei AIN.,TT
L<fl ra›L Cr
Report Date: ,6.-`.. ►air
Inspector: &" f' `-o ( Client:
License# 91011-4-2-12- -Exp Date ' +� Contractor: EN! fe-A (-vara.,?
License Required for Inspection: E'- k f`-c. °"r D Project/Job#
ef.41,4r Permit# '00C- CTS! 7n2.- Jurisdiction: Ad.2-r-i1>:r.A
Offsite? ❑Yes � No Offsite Location:
TYPE OF WORK: (check one) ❑Reinforced Concrete ❑ Prestressed Concrete ❑ Masonry ❑Welding
e0 Other I'.`-1' ss" f U1 r
Description of Work: i \ivr-i ic,4 9)) 510; ` �r. ;10 r V1 v1-, ‘i2_ : \�� A .11-1247 :
(14-) " N-OLC`? 1f? 14'r:: J•-A"9.! I-u f- (� PI,•t,--, "i7,.. ALL 1-f G'1-[� ^�4�:(r 1� . Y"ad h f s?r�! rt-c--40r I�y
�! ca gt 9 �i - - .t'r;i�"!C 1\ C 1`1 6,1 �;�t/.'t - C-A-r Dal- "b•'bp r -3 d._,_.
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\15,./.4?rt fr. '4 f v�4 s'/ }A �i„ {a t� i E f C r 7 '1;7_,A
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eC r'-? S"��-t,=r � .�t�a�,e.r�.i � ���,Li r.'.a� t, =� ��- ,�i� �--�:�..
A LA-,-d r ft';.n L 1 +.l . t J it (�: '4 , t. ">>1 1 v`, 4r d t - 'T t: c-9 4->c,
'7-.9 76; tAr--{_ Cf.As. iP l �GdLU iI� '' _ `u 8 3r 11a7f-rr= 1 Y
$'E-"''tea?.,i.7 dA' c /71f-1r-=:t } 7 u 7_a 4 it'+:/b'7::;37 4.\1 c.-k)I1ca -P11 ,Lr' thG C-n)), T274. )
`�k1&•'i`° 1t .:�'1i',a t, .I or- N-7-0 i4-47Lt G9 'r 1 mss;sco 7 a..i 1 6'- -12>t r1 l;, e
4-Fri! {c,lM VrrAv--_ r'7` '.F `11Pr--•L.!{Fd cIL=`d icA\' G° —/
DATE TASK# REGULAR O.T. TIME IN TIME OUT
Inspector name: \`r},k•2 ,` r aSignature: —_.1.;l � ;.-- 't= `
Approved by: .-.Iln (On -ei ) Signature:
name)
Deputy Inspector's Daily Field Report
Representing Inspection Firm of: .
Job Nami: \ril r - t P-C_. r 1 k M A-I_!_
Max")" n,s(,
`2 %I t Vin"sz�1�e4r) t'.3d .s Job Address.. +fl) .�7 9 ra�� �t l f' r'b OA-
bcti-1 iA e f`'o' T 41W/o
Report Date: 5-
Inspector:
Inspector: MPP-r^x W (51 Client:
License# Exp Date• .;?"42- 31,11'Contractor: =\10,41.4- 9.9,-n1 `I". AI feu A ex,Lt
.I"
License Required for Inspections '" Project/Job# �` } kid-_
g'dWA/LC-0 GV 2'rr Permit# '%t -r)5tn-' PJurisdiction: 44.1 -'-.)►
Offsite? ❑Yes DNNo Offsite Location:
TYPE OF WORK: (check one) ❑Reinforced Concrete ❑ Prestressed Concrete ❑ Masonry ❑ Welding
❑ Other
Description of Work:
7 17. 1?U. Ff n1.6,4, f.s,1-ir, 1 60,1,1e`v r-7') ►A 1 11-Yip
1e ef.NA('- 'I Of- 't..oAki2%--'I'* 171L.t\ifirfL t7V.,7,7 L-Tr- rJ 17"a ' ' .AA tv =E Izse-,a4771 -1,A_f-
W-101,1,-)7e21 /J'/ —r7 ) -17)'6' Ai e_ 0-)NCR-P::5 (balm(.fr;() rF-r J)..s<'a'�-=-f-/
/.27(7r7i7N1 %(-71-\ - ®f 44,4P3 + s a�_ "!f3T 2, i a.t3 -1 fG1�i r '-r1-22... a�-w
DATE TASK# REGULAR ' O.T. ' • TIME IN TIME OUT
j- �� - tie-. ` A1
Inspector name: 1414144?-4:b \ !b J(5 • Signature: a4.9;1 - 1/VI.
Approved by: �0 _. Signature:
(print name)
�L �' DEVELOPMENT SERVICES „�.; :,xti :, ,v� ' A 4:-=
-' = r,' 4 DEPARTMENT ,FLAW
PI; BUILDING AND SAFETY , ? � t'tih
D ti
240 West Huntington Drive
City ®f P.O.Box 60021 ,z ,„ D D t
Arcadia,CA 91066-6021
EV T
Arcadia (626)574-5416 '-
BUILDING 400 South Baldwin Ave, Suite 231,Arcadia, CA 91007
ADDRESS
owNER Santa Anita Shoppingtown LP
MAIUNG Westfield Corporation, 2049 Century Park East, 41st Floor
ADDRESS
CITYLos Angeles sun CA 90067 TELEPHONE (310)478-4456
coNTT;acron To be provided once contractor is selected.
ADDRESS
CITY STATE ZIP TELEPHONE
STATE LIC. CITY
8 CLASSIF LIQ Na
Jose Castro & I ( s(8 -573-2./..feyD)
APPLICANT I
13400 Riverside Dr. Ste. 202
ADDRESS
Sherman Oaks CA 91423 818-574-4727
CITY STATE ZIP TELEPHONE
PROPOSED
CONSTRUCTION
Install infrastructure to accommodate the structural support, power and data for 12 floor-mounted
digital advertising screens in the public concourse areas of the mall.
REMODELED N/A NEW SOUARE FT.OF N/A
SQUARE FT. MAIN STRUCTURE
NEW SQUARE Fl OF ACCESSORY N/A NEW SQUARE FT.OF N/A
STRUCTURE(SPECIFY) PATIO(6)J PORCH(ES)
NEW SQUARE FE OF MISCELLANEOUS N/A
STRUCTURES)(SPECIFY)
OCCUPANCY Mercantile M
CLASSIFICATIONIS)
TYPE OF
CONSTRUCTION IIB VALUATION: $136,000
10/09/08
1-
t';2-.• Development Services Department •
hi���f 240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
'ate'-' Arcadia,CA 91066-6021 BOO-057-504
City of (626) 574-5416,Fax(626)447-9173
ArcadiaPermit Type: Tenant Improve w/energ:
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
8/1/2017 CM 11:33 9/27/2017 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#: OTC
APPLICANT MAILING ADDRESS Plan#: 32309
Level Construction Group, Inc. PHONE NO.
EMAIL ADDRESS:
,
CONTRACTORIPROFESSIONAL MAILING ADDRESS
Level Construction Group, Inc. 1720 E Washington Boulevard#228 PHONE NO (626)255-2038 FAX NO.
Pasadena,CA 91104 EMAIL ADDRESS:
License No. 991265 Type: B Expires: 3/31/2018 12:00:
' TENANT MAILING ADDRESS
Dl1&.SdI l PHONE NO. FAX NO.
•
DESCRIPTION
ADDING DEMIZING WALL FOR DI1, SDII. RELOCATING PANEL. ** AMENDED 9-27-17 ADDING TRANSFORMER, ELECTRICAL METER, 2
PANELS,EXTEND WASTE/WATER LINE TO DI I.
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 3,000.00 53,000.00
0/74(;4.
OCCUPANCY: Tenant Improve TOTAL VALUATION: $3,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Elan review 78.23 78.23 01-3103
each Energy p/c fee 24.07 24.07 01-3103 it"--C.,`"17 est."40 62.6r.f>'g‘k< /46-'4.'7°'
PC ADA 11.73 11.73 01-3103
PC Cal Green 7.82 7.82 01-3103 .
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
. each Bldg permit 120.35 120.35 01-3104 sopa-
Bldg Issue ADA 12.04 12.04 01-3104 .u: COMPLETED
1.00 flat Elec issue 44.35 44.35 01-3105
2.00 each Comm svc<200 a 62.86 62.86 01-3105
2.00 each Distrib panel 31.10 31.10 01-3105
1.00 each Power 10-50 hp 38.98 38.98 01-3105
2.00 Fixtures Plmbg fixture 24.92 24.92 01-3105
SMIP Corn 0.84 0.84 14-2207
grn bldg std 1.00 1.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
1.00 Flat SWMF 2 1.00 1.00 88-3027
Total Fees: $509.89 Balance Due: $0.00 Paid Today: $126.43
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 118021
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 126.43
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 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)
7.4. p 41 .°.•
,r,; •, PERMIT/PLAN REVIEW APPLICATION
0. E . Development Services Department,240 West Huntington Drive,Post Office Box 60021
044unity%INEEN 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'
1
License Class 0 License No.?7/2.6/2/ Exp. Date 6- .46
Signature of Contractor ` compensation, as provided for by Section 3700 of the Labor Code, for the
E
performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation
Code.
insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier OA' Fr •�'''—
demolish,or repair any structure,prior to its issuance,also required the applicant
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the 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
sale(Section 7044,Business and Professions Code:The Contractors License Date !�7/� 7 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.
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).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Dated7/1? 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.
\i‘i
ame fisc 1D }-� � 1) 1�/� �
PRINT NAME ,Title 4)7-----
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 corn i I s% : .= • . ,•=ances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia t • er upon the above-mention i , operty for inspection purposes.
Si: ature111.1111 .. 7/Date 7
x,•12'.• Development Services Department
I. *,11, 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-057-504
‘,..,50' Arcadia,CA 91066-6021
City of (626) 574-5416,Fax(626)447-9173 Permit Type: Tenant Improve w/energ;
Arcadia
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
8/1/2017 CM 15:08 8/1/2017 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#: OTC
APPLICANT MAILING ADDRESS
Level Construction Group, Inc. PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Level Construction Group, Inc. 1720 E Washington Boulevard#228 PHONE NO (626)255-2038 FAX NO.
Pasadena, CA 91104 EMAIL ADDRESS:
License No. 991265 Type: B Expires: 3/31/2018 12:00:
TENANT MAILING ADDRESS
D 1 1&Sd 1 1 PHONE NO. FAX NO.
DESCRIPTION
ADDING DEMIZING WALL FOR DI I,SDI].RELOCATING PANEL
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
Value Value 3,000.00 $3,000.00
51 COMPLETED
A/4'C 10-i5-0 iledir''
OCCUPANCY: Tenant Improve TOTAL VALUATION: $3,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UONI DESC AMT AMT PAID ACCT
each Plan review 78.23 78.23 01-3103
each Energy p/c fee 24.07 24.07 01-3103 q,.,` .(-/7 �j�w�I ui`�/ d�'
PC ADA 11.73 11.73 01-3103 /
PC Cal Green 7.82 7.82 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 120.35 120.35 01-3104
Bldg Issue ADA 12.04 12.04 01-3104
1.073 flat Elec issue 44.35 44.35 01-3105
1.00 each Comm svc<200 a 31.43 31.43 01-3105
SMIP Corn 0.84 0.84 14-2207
gm bldg std 1.00 1.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
1.00 Flat SWMF 2 1.00 1.00 88-3027
Total Fees: $383.46 Balance Due: $0.00 Paid Today: $383.46
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 11/Mb
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3103 121.85
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3104 176.74
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 01-3105 75.78
Arcadia building inspector for a period of 180 consecutive days. 14-2207 0.84
714-2203 1.00
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS 88-3027 7.25
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. Vi°
(Closed on alternate Fridays)
s F ARCA
4.,LIP Orgy•V
11' PERMIT/PLAN REVIEW APPLICATION
ii4itl. .r
4,411, Development Services Department,240 West Huntington Drive,Post Office Box 60021
,,mmom,Y avo 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 ISLicense No. �-u9rExp. Date ^r + compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contract
performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
El 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 ern. 4C(•-e
demolish,or repair any structure,prior to its issuance,also required the applicant n
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number t1: G - G
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 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
sale(Section 7044,Business and Professions Code:The Contractors License ate 4-�� (-O ? Signa
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 ContractoFs 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 4 u_s•Ap A CO)(At it-et n ' Titlev 7-4_ Pt Clig .r._/
AME
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.
r
Signatuell
Date 1 j-- a /_
skt ,� Development Services Department
1.4hA 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO-Q$7-744
.:� Arcadia,CA 91066-6021
City of (626)574-5416,Fax(626)447-9173 Permit Type: EMP Combo
Arcadia
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
8/31/2017 CM 15:15 8/31/2017 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.
Los Angeles, CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Level Construction Group, Inc. PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Level Construction Group, Inc. 1720 E Washington Boulevard#228 PHONE NO (626)255-2038 FAX No.
Pasadena, CA 91 104 EMAIL ADDRESS:
License No. 991265 Type: B Expires: 3/31/2018 12:00:
TENANT MAILING ADDRESS
D 11 PHONE NO. FAX NO.
jp961.3i Taiyaki Soft Serve PHONE NO. FAX NO.
PANEL RELOCATION. EXTEND WASTE I1INE
-------------- -- — -- --- ---------------
Construction Type UOM #of Units Value Construction Type UOM #of Units Value
771e..
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Elec issue 44.35 44.35 01-3105
1.00 Flat Pllnbgissuance 44.35 44.35 01-3105 UNAreet. F . &- o 41 -m adve/L l `n
1.00 Flat Corn sv 200-1000 62.13 62.13 01-3105 'L r
1.00 each unit Sewer connec 31.16 31.16 01-3105 /0_6-I? c.izi- /tr E ZC7}i�G
1.00 Flat SWMF 2 1.00 - 1.00 88-3027
1.00 Flat SWMF 2 1.00 1.00 88-3027
Total Fees: $183.99 Balance Due: $0.00 Paid Today: $183.99
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 117803
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 181.99
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 2.00
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday FridayCOI
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)
o ASC
O~4cjyteoity 6
!! PERMIT/PLAN REVIEW APPLICATION
o 2/2, Development Services Department,240 West Huntington Drive, Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia •
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. I have and will maintain a certificate of consent to self-insure for workers'
License Class '5 Lic�.VE Exp. Date Z-30-13 c mpensation, as provided for by Section 3700 of the Labor Code, for the
1
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'compansation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier / (i
demolish,or repair any structure,prior to its issuance,also required the applicant ( v t�
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
0 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 Data ( '
sale(Section 7044,Business and Professions Code:The Contractors License �Ib (1 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 '!500)5 DiveN Title 411. -ed1--
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 11J k 117
'` "'., Development Services Department
1 #
.! 240 West Huntington Drive,Post Office Box 60021
PERMIT NO. BOO-057-927
"-----z-,-----i,_!...:1Arcadia, 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
9/27/2017 CM 11:14 10/9/2017 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#: 17-337
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
Building Electronic Controls Inc. PHONE NO.
•
EMAIL ADDRESS:
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
Sd 11 PHONE NO. FAX NO.
,
DESCRIPTION
FIRE DEVICES FOR SD II.3 DEVICES
•
Construction Type UOM #of Units Value Construction Type UOM it of Units Value
Value Value 4,800.00 $4,800.00
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $4,800.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
3.00 each fire alarm pe 2 280.00 280.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 153.75 153.75 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
Eil COMPLETED
Total Fees: $479.10 Balance Due: $0.00 Paid Today: $199.10
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the •eceip •: : ,,
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 198.10
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
iliF
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�up im,ti 4,
il! PERMIT/PLAN REVIEW APPLICATION
o�2. ,� Development Services Department,240 West Huntington Drive,Post Office Box 60021
@.4.,Y a Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
12 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. CI I have and will maintain a certificate of consent to self-insure for workers'
License Class C NO.�
License N .
p. Date\L[—A
Signature of Contractor OS) 1 compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 4)\-“\e n CQ-[, Vim\ky NVt Z t `u--- Vim% •
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number6Y PstOD�-5k 0,-----0
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 `SIG,/` (o (� l .(��
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature /�1`�`Wit/'��J
Law does not apply to an owner of property who builds or improves thereon, v
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 hundredthousand 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.itr
��� Y
ame
� X ?, Title;idINNAkt —0,01( eikc —
P 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.
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 �'LX l Date VD/°I/kl
` ,;, Development Services Department
to",4 240 West Huntington Drive,Post Office Box 60021 PERMIT NO. BOO 058 000
`� • 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
10/4/2017 CM 8:28 10/4/2017 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#: OTC
Los Angeles,CA 90025- EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
F& H Fire Protection PHONE NO.
EMAIL ADDRESS:
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
F& H Fire Protection 1119 Westminster Ave PHONE No. (626)255-2312 FAX NO.
Alhambra, CA 91803 EMAIL ADDRESS:
License No. 584319 Type: C16 A B Expires: 4/30/2019 12:00:
TENANT MAILING ADDRESS
Sd 11 PHONE NO. FAX NO.
,
DESCRIPTION
ADD SPRINKS FOR SPACE SD 11 8 HEADS
Construction Type UOM H of Units Value Construction Type UOM Hof Units Value
Value Value 800.00 $800.00
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $800.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
8.00 each sprinklerpck 280.00 280.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112
each Fire Permit 53.25 53.25 01-3112
1.00 each SWMF 2 Auto 1.00 1.00 88-3027
ii COMPTD .
.. ,
Total Fees: $378.60 Balance Due: $0.00 l'aid Today: $378.60
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 118107
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3109 280.00
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3112 97.60
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 88-3027 1.00
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)
of ARC
4o14uokv, .r
7 1' PERMIT/PLAN REVIEW APPLICATION
0,6 F--
o •i41,10, � 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
1I 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 forcerand effect. (' ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C—( ' License No. Cd ( '1 Exp. Date CIA'3 50'r 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 ;. -2�� L
J
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 workerunsation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number Z/{ (,/o 7 AV Af—
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 ^ _
a.l
exempt there from and the basis for the alleged exemption. Any violation of , 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
0 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 6/G�(� 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.
ame _ P' ' 0 v Title tY)01Aa-py✓
P°I NAME (J
I certify that I have read this application and state that the above information is c I rrect 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 (b/(f/(7
ti�o� 94:5
r
rp tdd
Aueue[g.Z'�, 0
S,1907
1.
"a'`9°tom MEMORANDUM
Fire Department
DATE: October 18, 2017
TO: BUILDING DEPARTMENT
INSPECTOR Henry Kemich
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 400 S. Baldwin Avenue, SD11
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 10-16-2017 Jill Perumean
FIRE ALARMS 10-16-2017 Jill Perumean
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 10-16-2017 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 10-17-2017 Rita