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City Of Arcadia, CA �;' Permit NO.'ROOF-18-1179
g Development Services Department Permit Type Roof
�� �, 240 West Huntington Drive,Post Office Box 60021 l
y I ,i ,Work Classification Reroof Residential
��� �', Arcadia,CA 91066-6021 a.. c r � r •.;
INLVAIlt
(626)574-5416 a t •3 Permit Status Issued
ARCADI Issue Uafe 07/09/2018,1 Expiration: 01/05/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
375 W Longden AVE Arcadia,CA 5785022010
Contacts
PAMELA MARKESE Owner SHARP REMODELING INC Roofing Contractor(C-39)
375 LONGDEN AVE 23801 CALABASAS RD,CALABASAS,CA 91302
(818)652-2138
Description:PARTIALT.O REROOF BACK OF HOUSE TO MATCH ��, Valuation: S 3,000.00 Tenant
EXISTING OWENS CORNING 15 SQ.
Total Sq Feet: 0.00 Plan Check# Plan#
-==..._.....-7,..,....=+= .. ' =,---. ._"1.1,1.:F: +Y; 4,, 4%*W 111h.40..: Q.:,l•'A.MA"X:'. R..:.,.:H4�..'.. t6dHWgk... 'A°n:.6'M1`°SMm.. a .40.CY r
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $170.95
Building Permit Fees $120.35 Cash/Receipt#REC-001643-2018 $170.95
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $170.95 -,
44,- i'{!piETED
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
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.
li, .
July 09,2018
Issued By: Date
July 09,2018 Page 1 of 1
of Ark,
i' PERMIT/PLAN REVIEW APPLICATION
E, Development Services Department,240 West Huntington Drive,Post Office Box 60021
\y% 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 C J�
Signature of Contractor Lic32ense No./01G S2 Exp. Date. 31'c�O 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 D CLARATION ❑ 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.M�^workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier S -1—e W)CJ
demolish,or repair any structure,prior to its issuance,also required the applicant (g p l,{
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number 9
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 foror
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
l
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
furtherAhinformation.
[Name /"l CNC " 3(1 (Title / +-
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 el../s6 /l/IJ (Date .1 -Cl ' J B
4
l>, ,.) i7i 'Permit NO ROOF 18-1179:
City of Arcadia, CA ,
1; Development Services Department ) rte, rr , x-g Permit Type•Roof.
3 240 West Huntington Drive,Post Office Box 60021 ' ' V. I r
k„5----;:i i # t i l work Classification Reroof Residential
Arcadia,CA 91066-6021
�` (626)574-5416 ', '"' s PerinitStatus Issued
.ARCADIA Issue Date 07/09/2018.1 Expiration: 01/05/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
375 W Longden AVE Arcadia,CA 5785022010
Contacts
•
PAMELA MARKESE Owner SHARP REMODELING INC Roofing Contractor(C-39)
375 LONGDEN AVE 23801 CALABASAS RD,CALABASAS,CA 91302
(818)652-2138
Description:REROOF REAR ACCESSORY STORAGE cf Valuation: 5 3.000.00 Tenant
STRUCTURE/OLD STABLE WITH OWENS CORNING 15 SQ.
APPROVED BY PLANNING,PETER a Total Sq Feet: 0.00 3 Plan Check# Plan#
4...w'fiz:.�it�rtM�`..tlY+ _ •fi y¢m.+S4C.':a_..4--xLtr".. •x....:m /.�..W.,.. ;'. 'c;Y,tA45`.A'.5 .+••'"..':49 ...
' Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $170.95
Building Permit Fees $120.35 Cash/Receipt#REC-001643-2018 $170.95
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $170.95 DeiI J l
7:.—:-,-;4 /4- .-2-/a---isii,(----- „,,,i ---
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
49- COMPLETEDrequesting the address,timeframe and what inspection item is needed.
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.
July 09,2018
Issued By: Date
July 12,2018 Page 1 of 1
U�4OFp " ; Z
7 PERMIT/PLAN REVIEW APPLICATION_
ofill Development Services Department,240 West Huntington Drive,Post Office Box 60021
-unity°fN 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 License No. Exp. 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
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
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 property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
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
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 Title
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
y
0 6/FORA,,,9%
:-
AFFIDAVIT SELF-CERT FICATI N
F R COMPLIANCE OF SW.KE ALARMS
AND C '.,I N Me NOME AL , ,-'ISS:
Property ddress'. / G P �Xl C =(✓/1'� r / I,1/ '
P y . . .
Permit Number: R o„S- 1$. ) 1 i-`2N ,
Brief Job Description Pim—P. �-�C
Number of smoke alarms installed: .
Number of carbon monoxidealarms installed: , 5
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are.created,
Smoke alarms shall be installed in each sleeping room, and outside each separate
sleeping area in the immediate vicinity of the bedrooms, 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 units containing 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 monoxide and smoke alarms) may be used.
All alarms shall comply with requirements for listing and approval by the Office of the State Fire
Marshal. http://osfrmfire.ca:qov/licensinglistingSIlicenselistinq bml searchcotest.dho
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 ._f perjury that the for going is true and correct, and that this
declaration was executed' on (Date) / i a • at -.rcadia, Californina:
0 . 41
Own:_is Name (printed/1wd): %/'_ s- mit .A K es -
Signature of Owner
_/),Zel'Ic 44.,ieka,12---
.
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
•
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