HomeMy WebLinkAboutUntitled - City of Arcadia, CA �§
; - �, k6� RALT 18 0889
i itrDevelopment Services Department i. ! A Permit jype Residential'Addition/Alteration
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&, Arc West Huntington Drive,Post Office Box 60021 r $ o ' 'Wrk Crass f1CGtbon Ralt Window Change Out
i - Arcadia,CA 91066-6021 r_ b ,a�.' i f � '''.-',.-:q''',.:;410..":''
(626)574-5416 - ' ; PermltStatus Issue'itd-
C DI 'Issue Date o5/3o/zols l Expiration: 11/26/2018
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
551 Fairview AVE 19 Arcadia,CA 5778004034
Contacts
HOLZER,VIRGINIA T Owner RENEWAL BY ANDERSEN* Contractor .i
551 1740 CRENSHAW BLVD,TORRANCE,CA 90501
'''''1:'.:',
(424)237-5234 akocsy@rbalosangeles.com
Description:REPLACE ONE WINDOW,RETRO-FIT 4 Valuation: $ 500.00 I 1 Tenant
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount payments Amount Paid
Building Issuing Fee $44.35 Total Fees $129.96
Building Permit Fees $40.65 Cash/Receipt#REC-001292-2018 $129.96
Building Plan Review Fee $26.43
Amount Due: $0.00
Cal Green Plan Check $2.65
Energy Plan Review Fee $8.13
Green Building Standard $1.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Res $0.50
Total: $129.96
CALLS FOR INSPECTIONS
7"Z- a Request for inspection by telephone at 626-574-5450. Leave a message
/lam requesting the address,timeframe and what inspection item is needed.
ritjtrL.
This permit/plan review expires by time limitation and becomes null and
void if the work authorized by the permit is not commenced within 180 days
from the date of issuance or if the permit is not obtained within 180 days
from 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.
1
May 30, 2018
sued By: Date
May 30,2018 Page 1 of 1
4�Fp RR^',a/d
°~ i'i.1 e" PERMIT/PLAN REVIEW APPLICATION
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0,,,....„..... • Development Services Department,240 West Huntington Drive,Post Office Box 60021
..o,.,-,' Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
v(iLICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
apter 9(commencing with Section 7000,of Division 3 of the Business and
ofessions Code,and my license is in full force and:r;ct. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class Lica: se No. 2611 I xp. Date 1-0012i.0
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 GIP A.- sZ1 _Ir
OWNER-BUILDE' DECLA' TION �, ave and will maintain workers'compensation insurance,as required by Section
ElI hereby affirm under pena'. of perj 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 so (Section 7031.5,Business and Professions is issued. 'M�y�;w� orkers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier �Y CVN k.kAck (C611C'e
demolish,or repair any structure,prior to its issuance,also required the applicant Z�WCI 2Z
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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 subj= s the
workers'compensation provisions of Section 3700 of the Labor CI.- .hall
❑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
DateC - / W,i. .�
sale(Section 7044,Business and Professions Code:The Contractors License 5 3U Signature
Law does not apply to an owner of property who builds or improves thereon, III
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' pen•.tion coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal p-'. es 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." rr
PRINT NAME
ame r(\:\,� of.A\O"\"1 Title ���
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-mentio I property for inspection purposes.
Signature - .IG,,, ( Date ---f 30 VB
l
Scope of Work: •
Job; Virginia Holzer cZo\ Replacing 1 window with no change to size or location.Ail
Address: 551 Fairview Ave.Arcadia,CA 91007 windows and doors shall have a Maximum U-Factor of
Phone: 626 446-3145 0.32&Shgc of 0.25.Replacement doors and windows will
Phon
• ( ) have Low-E glass.
Contractor: Renewal by Andersen of Los Angeles
CA Lic.#992285 I Permit: (1 By CACo.
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Job Notes: a '9.:.. 1 -- 111111111111M -----
All Windows and Doors Shall have a Maxim nn , ac Or-of-032--&-Shgc-of-0 '1;e Should-stay-on for
inspector to verify) PWS Water
i ..._.__-'-- ---------
This Project Shall Comply With: WELD ' —_ —-
Title 24&2016 California Building code(CB a)Trees ! --
2016 California Green Building Standards(C BSI-- --' -- ---------- 11111101111- ,
California Energy Code(CEC) .-..- .-_- -- - ---- •
2016 California Ener Efficienc Standards - _ _
gY. Y FEES}------- ----------- _ _
Arcadia Municipal Codes
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AFFID LIT SELF_CERTIFIC TION
Fio)R C.MPLIANCE OF SMt•KE AL M6
AND CARBON MONOXIDE ALAR ,,S .'
Property Address: ``.I rALCVle A1/&') AgCM
Permit Number: . PACT —/8--OES
Brief JOb Description:
lAJ W Dail reghtteaticr
Number of smoke alarms installed:
Number of carbon monoxide alarms installed: A
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created,
.. Smoke alarms shall be installed in each sleepingroom, and outside each separate
sleeping area in the immediate vicinity of the bedrooms, and on each 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 unitscontaining fuel burning appliances or having attached
garages,.carbon monoxide alarms shall be installed outside each separate .sleeping
: area in the immediate vicinity of the bedrooms, and on each additional story..of the
dwelling, including basements as required by Section R315 of the of the 2016 California
Residential Code (CRC).
Multi-purpose alarms (combination carbon monoxideand 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.qov/licensingliistinos/licenselistino bml searchcotest.phr
As owner of the above referenced property, I hereby certify that the smoke alarms and carbon
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•°ing is tru nd correct, and that this
declarati.rt was executed _•n (D-te) ;-(°1,i;,--. : a Arcadia, California.
Owner's Name (printed/typed): ' i 1 1_:L whi _ ,,i
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Sign-•tur<- if Owner:
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This affidavit must be returned to the City of Arcadia inspector prior to final inspection
SMOKE ALARM \NII) CAR-_,®` M.,NOXIDE .°\LARM L•CAT ONS
Noge
Guest hoof ® 30
Bathroo .
Storage
Family !ZO®m
Garage
FIRST FLOOR PLM
fli= SMOKE ALARM I m C `\r\-:BON MONOXIDE ALARM
Bath -
•
Master Bedroom
Dining Room Kitchen
!i410
ink Batt
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Hail CiCset
Nom ism -
ramily'worn mai - '1
i�Ldr�ic�a�t
�Bedroo
— — SECOND FLOOR PLAN
Sr SMOKE AL, CARt®N MONOXIDE AL=�r