HomeMy WebLinkAboutUntitled alligROOF-18-,0951
City of Arcadia, CA k.:: ,,„, f ” ,
(, .i Development Services Department .f Permit Type Roof,'
240 West Huntington Drive,Post Office Box 60021
" i , Work Classification Residential Reroof`.
+ Arcadia,CA 91066-6021
> `" , ° Permit Status:,Issued':
(626)574-5416 ,_� -
A CADItIssue Date 06/06/2018' Expiration:ration: 12 03 2018
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
509 W Duarte RD Arcadia,CA 5778008068
-,.S.ac R'm..,i,ni..,t a4.II'. J.re m..•.,'.KYR q�.,aY�.'2"tlffiRb1 V.XK�.e'."ae^vMa.4, 4 .AtiF Mall':.,�ti'rP�."ALN`.'4E?W...:'P- 'A^""5'+SKaWk..- 6. "' ....z.rt.6'.,AP. a.,..2k StA'.'lR� �fl4L'.`�d'•A'25+:?'w'kM..x•11,F ':'.'X..R _ .+:c'V7�
Contacts
CANDET PROPERTIES Owner . Park's Roofing* Roofing Contractor(C-39) 3
3806 Riverside DR,Chino,CA 91710
(909)455-3566 (909)455-3566 4
,,! ...5""L..a- ,y.r'w.•.y..1b.'._1..111% -,�.,.,..,Ly_... .4M4. ten^ � W 4.-.. e,.a"q_,.Ol , 1*X..a , ...... .. - - „x.]F.!Rw._
Description:T/0 AND REROOF ATMENT BUIL-BING WITH r
PAfiValuation: $ 14.000.00 Tenant ,
MBN TORCH DOWN,COLOR:WHITE,CLASS A WITH GRAVEL t
4Total Sq Feet: 0.00 Plan Check# Plan#
LA_•1 ' �_.
_-.�y��suc•*ava��e+.�x•. � .w.:�x.rzr,�.:�'�,w�,v ,.x..��h. ..:dw-:�,n ,..,�z .
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $354.65
Building Permit Fees $304.05 Cash/Receipt#REC-001371-2018 $354.65
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $354.65 1,
•
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,thfsL //tise6--e_r/oee /7"te*""77-1
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
CARBONvoid if the work authorized by the permit is not commenced within 180 days
MONOXIDE from the date of issuance or if the permit is not obtained within 180 days
AND SMQcToRs from the date of plan submittal.This permit expires and becomes null and
SHALL BE
void if any work authorized by this permit is suspended or abandoned for 180
-RE
QUIRED consecutive days or if no progressive work has been verified by a City of
PURSUANT TO Arcadia building inspector for a period of 180 consecutive days.
CRC AND ( BC
i,
cfri COMPLETED
CM
June 06, 2018
Issued By: Date
June 06,2018 Page 1 of 1
A
�4. FF" 96 ,
a�'*z .ly,i PERMIT/PLAN REVIEW APPLICATION
0 C.
r
• `,i Development Services Department,240 West Huntington Drive,Post Office Box 60021
0„7.2„..„Y% Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
ICENSED 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:
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.-Sq License No. ej((D�g9 Exp. Date c7;i/Iq 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 I)1--i41._
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 workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 'i'TiATr Pu 1.1
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 9D )-3
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
1:1I, 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 '
Date i6( I Signature `�
sale(Section 7044,Business and Professions Code:The Contractors License
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 I 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 \/O N % RAP--11_ Title
PRINT NAME
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.
` ( l
ignature� 1 Date ��� D
5-( q
l ("/ ut42.i
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp.
100. Setbacks 210. Under fin/bldg.drain
101. Rough grade 211. Copper underslab 6.-13-16 .-15-z5-2=.- poa .
102. Figs.&forms 212. Rough plumbing 52 b,Gr 6 vl,Dkias
103. Fre-sl 214. Rough
104. Floor joists 214. Shower pan
105. Steel 215. Water heater --e' 5.
/1 ,1‘ g=9,2.
106. Grout lift 216. Roof drains a�V�
107. Shear nailing 217. Building sewer uglT 3�
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing 220. Fixtures
111. 0cc./Area Sept.Wall 221. Final plumbing
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid
114. Insulation-Fir. Pool Inspections Date . Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 245. Gas line&test
121. Final building 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final slumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Underground conduit
153. Underslab conduit Reroof Inspections Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical 272. Sheathing nailing
157. Fixtures 273. Final reroof .
158. G.F.C.I.
159. Eqpt.bonding Sign Inspections I Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric 281. Footing
282. Conduit/wirin.
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC u . •1. 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. Date I Insp.
191. Final mechanical 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess.00l filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
City of Arcadia, CA ROOF 18-1051
9 d
Development Services Department ' Permit Type.Roof
:. 240 West Huntington Drive,Post Office Box 60021
9 ; etWork Classification Reroof=Residential
t „ 1 Arcadia,CA 91066-6021
' (626)574-5416 y •� 1.s PermrtStatus Issued
ARC DIA ;, Issue Date 06/19/2018;1 Expiration: 12/16/2018
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
i
509 W Duarte RD Arcadia,CA 5778008066
i......A5:.''.h.a..4,#{..'1'M!k: �.:WX':6^'4 fi.,:NW:+.•.•.'Yh�4;roVYiTia'4F.`R' `^>::fF'�S
Contacts
CANDET PROPERTIES Owner Park's Roofing* Roofing Contractor(C-39)
3806 RIVERSIDE DR 3806 Riverside DR,Chino,CA 91710
(909)455-3566 t
Description:T/O AND REROOF UNIT 5 WITH TORCH DOWN TO Valuation: S 2,400.00 1 Tenant
MATCH EXISTING,COLOR WHITE
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $170.95
Building Permit Fees $120.35 Cash/Receipt#REC-001486-2018 $170.95
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $170.95 -
ice"-7../
cii<44e- C—za....tia,
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.
(127\\]N— _--
June 19, 2018
Issued By: Date
June 19,2018 Page 1 of 1
ti�oFp �'9di
CA 'r' ` • ' PERMIT/PLAN REVIEW APPLICATION
�1 e•i�FJF'E
'E ' Development Services Department,240 West Huntington Drive,Post Office Box 60021
o00°alt,ofN°mArcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of
Arcadia
,I LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
0 I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
I,Chapter 9(commencing with Section 7000,of Division 3 of the Business and
U,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 (39 License No. �`Dv9'7 Exp. Date �(3ol/v� compensation, as provided for by Section 3700 of the Labor Code, for the
(Signature of Contractor` /�L r
performance of the work for which this permit is issued.
1 ")zi I have and will maintain workers'compensation insurance,as required by Section
` OWNER-BUILDER DECLARATION I ^3700 of the Labor Code,for the performance of the work for which this permit
affirm I hereby under penalty of perjury that I am exempt from the Contractors ,/ is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions 6 t i
Code.Any city or county which requires a permit to construct,alter,improve,c I (I Carrier e-/TA-TX- Po DP)
demolish,or repair any structure,prior to its issuance,also required the applicant ' t 'i!
for such permit to file a signed statement that he or she is licensed pursuant to the i I(Policy Number C0S1? ).3
provisions of the Contractors License Law(Chapter 9(commencing with Section 1i J(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 0,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 il,'I'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 l
compensation,will do the work,and the structure is not intended or offered for 1 y,
sale(Section 7044,Business and Professions Code:The Contractors License Date
I 6 f`� !� Signature
Law does not apply to an owner of property who builds or improves thereon, �''11
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
7-• further information.
. 1
7 ,,
/ ame /0/.)(-1 �/-f21Title AiAR,--. -
i
PRINT NAME
I ,�
T 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
,1 1,cadia to enter upon the above-mentioned property for inspection purposes.
`Signature (7.--z--t-Al Date t //CI/13(
JUN. 21. 2018 4:57PM CANDET 6262815689 NO. 3441 P. 1
Jun 1318,07;33e Parka Roofing 9085901873 p.2
-
•
•
;'
'u y •
APFtDAVl7$CLF-CERTiFlCA7iO l
FOR COMPLIANCE OF SMOKE ALARMS
•
AND CARSON MONOXIDE ALAR S .
fr
Property A y Address: /cbq � ' 10' der)
Permit Number: L)V
Brief.Job •Descripfion; '
Number of smoke alarms installed: p UJ rhe Can
Number
of-carbon monoxide alarms installed.t 6 t
C - ) co Cf( CW-0-\S
When alterations, repairs or addition requiring a permit occur,or sleeping moms 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 2018
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 g315 of the of the 2016 California
Residential Code(CRC).
Multi-purpose alarms(combination carbon monoxide and snnoica alarms)may be used.
Ail alarms shall comply with requirements for listing and approval by the Office of the State Fire •
Marshal. h_tt�_ //osfm.ti%e,ca.govJ jitaAlgiesligtg
• 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 end in
compliance with the code sections referenced above,
t declare under penalty of perjury that the foregotn la true and connect, and that this
declaration was execrated on (Date) at Arcadia,California.
O eatr°a Name(printer /iy d); re
SUgna tune of Owner: „(6.2 . A .t
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Jun tuJUN. 21. 2018 4: 57PWootinCANDET 6262815689 yuaoyu•itSrs N0. 3441 P. 2: •
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AFFIDAVIT SELF-CERTIFICATt®fit
FOR COMPLIANCE OF WOKE ALARMS
•
AND CARBON MONOXIDE ALARMS //
Property Address: go-Y . 7kar Ref 4r2- irea.di'e CA -(007
Permit Number: .,
Brief Job Description: - eze T ,4r,
�
Number of smoke alarms installed:
Number of carbon monoxide alarms In alled: 2
•
When alterations, repairs or additions requiring a permit occur, or steeping 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. htipJlosfm.fIt cutov/!trans l s nc stiicenseiisting bml search
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 troregofnrg is true and correct, and that this
declaration was executed on (Date) 0 6 g at Arcadia, California.
Ownec`�l''eme(printed/typed): _. . Xcotosof/�(,� 1-0-1A
•r
sig attire of Owner: • ' _....• -•" 11.1.,
of ifs`Tiffliigvir treat' ii{uiriea ca C1tof�Atoadia i4p_eoortpriciiiiikarawic !'
Vii!‘ 10JUN. 21. 2018 4:50PM.uuiii'ICA NDET 6262815689 • '•''' NO. 3440 P. 3 b*8_
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A IDAVI1 SOLI.CESITtFICA'1 iON. .
FOR C RIIPL{APtCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: 509 W Duarte Rd#3 Arcadi _
Permit Number: __
Brief Job Description: ,,,.,. _ •
Number of smoke alarms installed: 6 _
Number of carbon monoxide alarms installed: 0
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 2018
California Residential Code (CRC) and•California Health and Safety Code Section 1311 3.7,
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://osfm.fire.ca;Dov/lice;nsinnllsiingsillcenselisting_burl ,searchcotelLan
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 tender penalty of perjury that the foregoing is true and correct, and that this
declaration was executed on Pate) 06/14/2018 _ at Arcadia, CailfOrra€a.
Owner's Name (minted/typed): _ slew low
SIgutaatureof Owner: , _.._... _�...._..,,_.___. .. �,�.._....._ . _...-w
' ht1 14a •ra�u�t:b® returned to the City of Arcadia inspector prior to final lnspeotion
jun14JUN. 21. 2018 4: 58PMtaotrnt(ANDET 6262815689r 'v�"u'r'�' NO. 3441 P. 4
'AFFIDAVIT SCLF-CERTIFiCA'FtOM
FOR COMPLIANCE OF attlIOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: . .ce,/t''�• 6
Permit Number:
Brief Job Description:
Number of smoke alarms installed: 64'
.
Number of carbon monoxide alarms installed,
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created,
Smoke alarms shalt be installed in each sleeping room, and outside each separate
stpeptng area in the Imirtediate vicinity of the bedrooms, and on each additional story of the
dwa1ling, Including basements and habitable attics as required by Section R314 of the 2016
California Residentiai Code (CRC) and California Health and Safety Code Section 131131,
For dwellings or sleeping units containing fuel burning appliances or haViag attached
• garages, carbon monoxide alarms shall be Metalled 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 shell comply with requirements for listing and approval by the Office of the State Fire
Marshal, ..11$ imam ca..ov/iic,erls'n±.is n 51ire sef.sti bi I s=:r. G* :.- �tR
As owner of the ebore 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 sectlena referenced above,
t declare under penalty of perjury that the gore o rrg to true and correct, and trate thisv
declaration was executed oa(Date)��e� ' . -�-�-�-at Arcadia,California.
Owner's'
rr's' Esta (prt;F �Eyi*d): L '_ �
Signature of Owner:,......,,...r.�.�. ..- •
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JUN. 21. 2018 4: 58PM CANDET 6262815689 �. NO. 3441 P. 5
Jun t3 tile 67:33a Parks Roofing 908E901673 pit •
i, •
411P •
AFFiDAVIT SELF.CERrIFiCATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
property a C (01
Permit Number:
Ogef'Job'Description: -
Number of smoke alarms Installed:
Number of carbon monoxide alarms installed:,
When alterations,repairs or additions requiring a permit occur, or sleeping rooms are creeted,
Smoke alarms shall be installed in each sleeping room, and outside each separate
steeping area'in the Immediate vicinity of the bedrooms, and on each additibnel 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 ss required by Section R31.5 of the of the 2016 California
Residential Code(CRC).
Mull-purpose alarms(combination carbon monoxide and.smoke alarms)may be used.
All alarms shall comply with requirements for listing and approval bythe Office of the State Fire
Marshal. _ ►s' �_., -...v1l :: 3. . ® Ii 1
AgmbolegcN
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 reference above.
1 declare under penalty of perjury thata !Dreg t g I true and corrects and that this
declaration was executed on Mete). ob' t t • at'Arcadla,California.
miners Name(printed/typed: _ A.R4 p
- E a
Signature of Hamer: :.• •
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JUN. 21. 2018 .4: 58PM CANDET 6262815689 NO. 3441 P. 6 •
Ju.n 1•� a, Roofing • rg'n5901573 N.6
•
v, 6
4AFFIDAVIT` ELF-:EE TlFlCATtON' .
FOR COMPLIANCE OF SMOKE.AL ARMS
AND CARBON.MONOXIDE ALMS
Property Address; 5 4` ._ _ :� -
Permit Number. Rano - S -
Brief Job Description: fZ®o , ceLCtNl'_li'"r
Number of smoke alarms installed: 5.
Number of carbon monoxide alarms installed: 2.
When alterations., repairs or additions requiring a.peirriil occur, or sleeping roarFfs are created.
Smoke alarms shall be installed in each. sleeping room, and outside each separate
sleeping area in the irrfinediate 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 (CIBC) and California Health-and Safety Code Section 13113.7.
For dwellings or sleeping units containing fuel burning appliances of 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.
Ail alarms shall comply with.requirements for listing and approval by the Office of the State Fire
Marshal. ht' ://osfrn.1tre.ca.g v/I'censi'n tstirr s llcer�sefisfirra brei search•ooiest,oh •
As owner of the above referenced property, I hereby cer'ti'fy that the smoke alarms and carbon
monoxide alarms have been installed in accordance with the manufacturer's instructlons.and iii
compliance with the code sections referenced above.
E declare under penalty of perjury that the foregoing Is true and correct,.and that this
declaration was executed on ,Gate)--12%„,.. .11_,... .142 �__ st Arcadia, California.
C:Wr er'& Name.(printed/typed):....16.____Vjaka2�.. .
Signature co Cpmum - �...�__
•
This affidavit must be returned to the City'of Arcadia inspector prior to final inspection
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JUN. 21. 2018 4: 58PM CANDET 6262815689 ( NO. 3441 P. 7
Jun 9318,07:33a Park's Roofing •
X873 p.2
A PI'1DAVLF BE L,F4ERTIFICATION.
FOR COMPLIANCE OF SliIlOKE. RNI •
AND CARBON MONOXIDE ALARMS p q
Property,Address: 5-09 W, Du,o,r e 1`d. 41 �rrw �a Irl r i�'Q
Permit Number:
Beief Job Description:
Number of smoke alarms installed:;2...
Number of carbon monoxide alarms lnekalled:, I
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created,.
Smoke alarms shall be installed in each sleeping room, end outside each separate
sleeping area in the immediate vicinity of the bedrooms', and on each addiitionat story of the
tics as
uired
Californiag (Residential'Cade (CRC) andbasements and tableCalif Orinla Health and SSafely Code Section
Section 13113.7.
For dwellings or sleeping unite 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 8315 of the of the 2016 California
Residential Code (CRC).
Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used.
Ail alarms shall comply with requirements for listing and approval by the Office of the State Fire
Marshal. lam://tlefm.fire. a av gasnsin�glistin eilicenselis se•archcoiest. g
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.
decls;t'e•eider penalty of perjury that the foregoing is true and correct, and that this
-13 - a-s{$ et Arcadia, California.
(factional=was executed ei9 Gate) ._..._��T - —
Owrie.r's Name(printed/typed): 'guy Lee. .
This.lacklaNritl tat be rat rfredaobe-061.0.Atottaltar.s00 ;r.i rlar to' Ek l°in,s,.p tibigi. ,f