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HomeMy WebLinkAboutUntitled s : A• 4 !�',,, PERMIT/PLAN REVIEW APPLICATION 0+ t �IIEN � Development Services Department,240 West Huntington Drive,Post Office Box 60021 \,r ° Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173 City of Arcadia 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: Chapter 9(commencing with Section 7000,of Division 3 of the Busi ss d Professions Code�and my license is in full force and pe t. p / ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License o. Date/ compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION ialorhIvnd will maintain workers'compensation insurance,as required by Section IDI hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier I®G \ demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number Wa ?"- , -,,,z3 D� ""©r J 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 cemfy 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 c pl 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 SignatureeV ....., 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). 0 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 Ail — 4 /i l SI Title .I- s -,_ r PRINT N i certify that I have read this application and state that the above information is co rect and that I am the owner or duly authorized agent of the owner. I agree to comply with all City o nances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon th ve- tioned property for inspection purposes. Signature Date 9//9/ a NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 100. Setbacks 210. Under flr./bldg.drain .5.-/-/$ , "'IOW t v 101. Rough grade 211. Copper underslab -�-<S iN/1 u F/�/hit `' 102. Figs.&forms 212. Rough plumbing 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan 105. Steel 215. Water heater 106. Grout lift 216. Roof drains 107. Shear nailing 217. Building sewer 108. Diaph nailing 218. Water service 109. Roof nailing1 219. Final gas 110. Framing S$-fig /A'.07". 220. Fixtures _ 111. 0cc./Area Sept.Wall 221. Final plumbing 112. Sound walls 222. Sewer cap/demo. 113. T-bar.rid 114. Insulation-Flr. Pool Inspections Date Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. 241. Rough plumbing 117. Drywall nailing 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish grade 245. Gas line&test 121. Final building 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final.lumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Underground conduit 153. Underslab conduit Reroof Inspections Date Insp. 154. UFER ground ' /Q 270. Pre-reroof insp. 155. Water ground /', ( 1 vv 271. Roof framing 156. Rough electrical y 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. E..t.bondin. Sign Inspections I Date I Insp. - 160. Service panel 280. Setback/overhang 161. Final electric 281. Footing 282. Conduit/wirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC -$-(a l% • •I I I Date Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Fire sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. I Date Insp. 191. Final mechanical 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess...l filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin ' '^/,% \, /\'. j \ ,/ - �^ \ / \A \ ( ^ \ // ^(�j \ / _ . A--'.-/--*,- — ——i F —--.----- -- /1 ,f� ;�` r,., tip; )" ) 4'-'Ar . lr . `,fie% /" \\'uraidite. r-.411 .\\( ��- , Certificate of Occupancy City of Arcadia Development Services Department—Building Division il c /Y' .' This certificate issued pursuant to the requirements of the a California Building Code certifying that at the time of issuance this structure was in "\ compliance with the various ordinances of the City regulating building construction or use. f Permit No. TI 18-0279 V1 .� Building Address: 400 S BALDWIN AVE ARCADIA CA 91006 f I Permit Type: TENANT IMPROVEMENT Effective CBC: 2016 C.B.C. - Occupancy Code: M Zone Code: C-2 DH8 ( " li Final Date: 6-1-18 Type of Construction: TYPE IIB 1 HR aC , i\; Owner: WESTFIEL S NTA ANITA Tenant: SUGARFINA 7-D.Pit /. \ ` Don Stockham,Building Official Post in Conspicuous Place L/' / : ,______i / / �/ / / /_,/ / }� / \ �/ � 1, \�� � �/ v �—=� „, ., City of Arcadia, CA Permit NO.FIRE-18-0575 Development Services Department Permit Type:Fire 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Fire Alarm (626)574-5416 Permit Status:In Review ARC. I)1 Issue Date: I Expiration: 10/04/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number a 400 S Baldwin AVE Arcadia,CA 5775031043 Contacts SANTA ANITA BORROWER LLC C/0 Owner Building Electronic Controls Inc. Applicant WESTFIELD SANTA ANITA 2246 Lindsay WAY,Glendora,CA 91740 400 (909)305-1600 ext 100 Description:FIRE DEVICES FOR SUGARFINA.4 DEVICES Valuation: S 4.130.00 Tenant SUGARFINA Total Sq Feet: 0.00 Plan Check#18-575 Plan# Fees Amount Payments Amount Paid Fire Alarm Plan Check $280.00 Total Fees $479.10 Fire Issuance $44.35 Cash/Receipt#REC-000978-2018 $199.10 Fire Permit Fees $153.75 Cash/Receipt#REC-000867-2018 $280.00 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $479.10 CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message n 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. Issued By: Date April 24,2018 Page 1 of 1 i11 ' 1 PERMIT/PLAN REVIEW APPLICATION +' I" r** E41,b' Development Services Department,240 West Huntington Drive,Post Office Box 60021 °'wl,7 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: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' C License Class /t(0 License No. -?gyps- Exp. Date I/07 compensation, as provided for by Section 3700 of the Labor Code, for the 111 I performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION have and will maintain workers'compensation insurance,as required by Section 0 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 carrieranJd_poli�cy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier !rtC�-L(,ratkeL, 4L,i_'e ., demolish,or repair any structure,prior to its issuance,also required the applicant i .-6t,j0..„. 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 O I, as owner of the property, or my employees with wages as their sole forthwith comply 'th 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 ate 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). 0 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 Y1.CE.'j Lt , -) Title q 'r--r4--- PP T 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. It agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. 1- Cumt.r 1(2, nature Date .•, City of Arcadia, CA Permit NO. FIRE-18-0641 Development Services Department Permit Type:Fire 240 West Huntington Drive,Post Office Box 60021 Work Classification:Fire Sprinkler Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued ARCADIA Issue Date:05/02/2018 I Expiration: 11/02/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 400 S Baldwin AVE Arcadia,CA 5775031043 Contacts SANTA ANITA BORROWER LLC C/0 Owner Aliready Fire Sprinkler Co. Applicant ' WESTFIELD SANTA ANITA 818 N Grand,Covina,CA 91723 400 (626)332-7066 Description:FIRE SPRINKS FOR SUGARFINA Valuation: S 900.00 Tenant SUGARFINA Total Sq Feet: 0.00 Plan Check#18-641 Plan# ti Fees Amount Payments Amount Paid Fire Issuance $44.35 Total Fees $382.80 Fire Permit Fees $57.45 Cash/Receipt U REC-001053-2018 $102.80 Solid Waste Management Fee 2 $1.00 Cash/Receipt q REC-000955-2018 $280.00 Sprinkler Heads $280.00 Amount Due: $0.00 Total: $382.80 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 bythe is not commenced within 180 da s CIP*Igt: permitY 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. May 02, 2018 Issued By: Date May 02,2018 Page 1 of 1 . 4 ! 1 PERMIT/PLAN REVIEW APPLICATION rr+ j r� 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 D 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. 1:1 I have and will maintain a certificate of consent to self-insure for workers' icense Class C. I t License No,35X1 f) Exp. Date 562G compensation, as provided for by Section 3700 of the Labor Code, for the signature of Contractor l''/ f Wt Gt GV 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 VVer P.S+ /As C a ,C1/1 demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number 55000°474/,,, 7 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 C3I 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 hot 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 tha if I should become subject to the workers'compensation provisions of Sectio' 3700 of the Laboode,I shall ❑I, as owner of the property, or my employees with wages as their sole fprthwith comply with �thoose provisions. compensation,will do the work,and the structure is not intended or offered for date 5�� -/ o Si airi i�.�.. sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon, i' 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 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. er e Title c./ vL C T _ ••i NAME _---- (S rtify 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. gree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of dia to enter n the above-mentioned property for inspection purposes. rr c/ S a _, �� - --� Date % - , - / .S - ------- V 01111.,q41 117 Au{u.[5,1901 oo\ j� �u�i`yo MEMORANDUM Fire Department DATE: June 4, 2018 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemich FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Avenue (Sugarfina) THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 5-30-2018 Jill Perumean FIRE ALARMS 5-30-2018 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY 5-30-2018 Jill Perumean COMMENTS: Emailed Bldg. Dept. 5-30-2018 Rita City of Arcadia, CA Permit NO.SIGN-18-0719 Development Services Department Permit Type:Sign 240 West Huntington Drive,Post Office Box 60021 Work Classification:Illuminated Arcadia,CA 91066-6021 Permit Status:Issued (6261574-5416 ARC.AI)](A Issue Date:05/03/2018 Expiration: 10/30/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 400 S Baldwin AVE Arcadia,CA 5775031043 Contacts SANTA ANITA BORROWER LLC C/0 Owner TAKO TYKO* Electrical Contractor WESTFIELD SANTA ANITA (C-10) 400 5010 VENICE BLVD,LOS ANGELES,CA 90019 (323)516-4096 • Description:ONE LED ILLUMINATED SIGN FOR SUGARFINA& 2 Valuation: S 1.600.00 Tenant SUGARFINA NON ILLUMINATED SIGNS 1 Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Building Issuing Fee $44.35 Total Fees $303.90 Building Permit Fees $86.85 Cash/Receipt U REC-001065-2018 $303.90 Electrical Permit Issuance Fee $44.35 Amount Due: $0.00 Sign and Branch Circuit $62.13 Sign Connection $15.55 Sign Plan Review $43.42 Solid Waste Management Fee $6.25 Solid Waste Management Fee 2 $1.00 Total: $303.90 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. r;#11141& 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 (�I COMPiEIEOvoid if any work authorized by this permit is suspended or abandoned for 180 IiP consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. May 03, 2018 Issued By: Date May 03,2018 Page 1 of 1 sfA• ` iFORt.,4:i 4 ! PERMIT/PLAN REVIEW APPLICATION II.+ !` EDevelopment 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 No. — /ii Ex.. Date a /fr compensation, as provided for by Section 3700 of the Labor Code, for the f, performance of the work for which this permit is issued. Signature of Contractor __ �/ iiiii OWNER-BUILDER D LARATION AMP" 21 I have and will maintain workers'compensation insurance,as required by Section i3 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.Myworkers'corn n insurance er and c nu j are: Code.Any city or county which requires a permit to construct,alter,improve, arrier (� "Y5 SIiG� y_►� 1/ demolish,or repair any structure,prior to its issuance,also required the applicant olicy Number �J�7 7T Z �'�' for such permit to file a signed statement that he or she is licensed pursuant to the 's section need not be completed if the permit is for one hundred dollars or less) provisions of the Contractors License Law(Chapter 9(commencing with Section 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 ith 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 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 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. l Name /i r A /, Title ___,, ,1222 .e.,Z 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 . i i ,bove-mention p rty for inspection purposes. Signature / 41--z------ Date ��k S 3/4"-1._0" A -...„.. ALL CHEMICAL/CLEANING SUBSTANCE WILL 1 MS-1 BE STORED ABOVE MOP SINK 6.-0" MIN. AFF AND AWAY FROM ANY FOOD RELATED MH-1 PRODUCTS L Li .e5i) ELECT. MOP SINK 4 11106, 4 L ••••4=, - Yol0e,Cer'‹ 01, 1I1 aciii m,r1, 8 1f .,„ .•\-\6 41 IIF—X-I F1X5-i L-1 13 1 0 ! ) (62E)430-5560 M -a 6 WDT-3 \ , 1 I WDT-2 Bill -----..........,1wp., FX-8F :8 • I 1FX-15 I • 0 I 18 2'. . e -J I WDT-1 Esa ..., \ ) -, 6 1 \ \ \ \\\\\ \ i NI 1 / I — —Ea FX-15 / WDT-2 III • 1.— TRAVEL PATH 4T-0” FX-7-36.2 1 CVI-1.3 CASH WRAP IF 0 li b Cif A*44 I ,:1 1 1 \• -----..-•. S IC 0 S SSLES-kat FX-7-36.2 ' - Ar.)EGUME r-rei' - - - ir '''S FALILITI - r- ,LA - •-i.iL-" -•, ' WRAP TO HAVE 36" MIN. „,,slit ,Ny".4 WIDE ACCESSIBLE SURFACE AREA — ^,05-0 Cu" VSAA. ---. FX-14 FOR FULL DEPTH OF COUNTER AT # 0`" , ..,•,':.• ,•1'" 34" A.F.F MAX -SEE DETAIL 1/A1.1 ,, o ' ...--,•-•"4-.:;',.14 I FX-8 E-----IFla ....-, ,„:,,-,-c- --. CISONS'UtA4110it G-E ALCOHOLIC BEVERAGES '''''-------, , • -*I ,.„,,oaao 3 ____ 4.40., City of Arcadia, CA Permit NO. Demo-18-0574 Development Services Department Permit Type:Demolition 240 West Huntington Drive,Post Office Box 60021 Work Classification:Demo Commercial t Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued A RCA 0 I A Issue Date:04/12/2018 Expiration: 10/09/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 400 S Baldwin AVE Arcadia,CA 5775031043 Contacts SANTA ANITA BORROWER LLC C/0 Owner TIMBERWOLFF CONSTRUCTION INC* General Contractor(B) WESTFIELD SANTA ANITA 1659 W 1659 ARROW RTE,UPLAND,CA 91786 400 (909)949-0380 Description:INTERIOR MISC DEMO ONLY FOR SUGARFINA T.I Valuation: . S 500.00 Tenant SUGARFINA Total Sq Feet0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Demo-Sewer Cap and/or Cesspool Fill $15.55 Total Fees $111.50 Demolition Permit Issuance Fee $44.35 Cash/Receipt#REC-000865-2018 $111.50 Plumbing Permit Issuance Fee $44.35 Amount Due: $0.00 Solid Waste Management Fee $6.25 Solid Waste Management Fee 2 $1.00 Total: $111.50 Si �� CALLS FOR INSPECTIONS P`� Request for inspection by telephone at 626-574-5450. Leave a message M inspection item is needed. CO he address timeframe and what requesting t 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. ir / April 12, 2018 Issued By: Date April 12,2018 Page 1 of 1 F - i% PERMIT/PLANN REVIEW APPLICATION A�t*' Development Services Department,240 West Huntington Drive,Post Office Box 60021 . t, Arcadia, CA 91066-6021,(626) 574-5416,Fax (626)447-9173 City of Arcadia JIICENSED 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 Busin s d 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 V nse�Aj . Ex . Date compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor ..4-- 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 w kers'compensati insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier Cj demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number '' ' 41'17-4C1) ""'°2g/b�c.� — .0 7 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 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 e Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith c mply with those provisions. compensation,will do the work,and the structure is not intended or offered for ii -- sale(Section 7044,Business and Professions Code:The Contractors License Date l 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 furtherrtyerAinformation. / ame /'`/G�1_ $0 ii T C itle — 41 .....-.....„ 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 ab -mentioned roperty for inspection purposes. 4nature )Date 7///. / /J