Loading...
HomeMy WebLinkAboutUntitled •._ Development Services Department 14I""t Ill 240 West Huntington Drive, Post Office Box 60021 - ~ IF---, ` PERMIT NO. B00_058_6$0 .":---4' Arcadia,CA 91066-6021 City of (626)574-5416,Fax(626)447-9173 Permit Type: Tenant Improve w/energ; Arcadia PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS 12/21/2017 CM 10:33 3/8/2018 Issued ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE 400 S Baldwin Ave T-387 OWNER MAIUNG ADDRESS Westfield Corporation, Inc. 11601 Wilshire Blvd. 12th Floor PHONE NO. Inspector#: HENRY Los Angeles,CA 90025- EMAIL ADDRESS: Plan Chk#: 17-480 APPUCANT MAIUNG ADDRESS PHONE NO. Design Tech, Inc. Plan#: 32465 EMAIL ADDRESS: CONTRACTOR/PROFESSIONAL MAILING ADDRESS 714 NO. Design Tech, Inc. 353 S Orange Grove Ave PHONE (714)290-7711 FAX NO. Los Angeles,CA 90036 EMAIL ADDRESS: License No. 909028 Type: B Expires: 1/31/2020 12:00: TENANT MAILING ADDRESS Holy Roly PHONE NO. FAX NO. DESCRIPTION T.I.HOLY ROLY WITH EMP Construction Type UOM N of Units Value Construction Type MOM N of Units Value Value Value 100,000.00 $100,000.00 C COMPLETED OCCUPANCY: Tenant Improve TOTAL VALUATION: $100,000.00 QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT each Plan review 795.60 795.60 01-3103 1.00 each Wtr htr/vent 15.55 15.55 01-3105 each Energy p/c fee 244.80 244.80 01-3103 1.00 each T.I.Fire Pkc 280.00 280.00 01-3109 PC ADA 119.34 119.34 01-3103 SMIP Corn 28.00 28.00 14-2207 PC Cal Green 79.56 79.56 01-3103 grn bldg std 4.00 4.00 714-2203 I un Flat Bldg Issue Auto 44.35 44.35 01-3104 1.00 Flat SWMF Auto 6.25 6.25 88-3027 each Bldg permit 1,224.00 1,224.00 01-3104 1.00 Flat SWMF 2 1.00 1.00 88-3027 Bldg Issue ADA 122.40 122.40 01-3104 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 Flat Elec issue 44.35 44.35 01-3105 1.00 Flat SWMF 2 1.00 1.00 88-3027 1.00 Flat Mech issue 44.35 44.35 01-3105 1.00 Flat Plmbg issuance 44.35 44.35 01-3105 (�-2S-ttr 1.00 each Distrib panel 15.55 15.55 01-3105 (L� �/ 8.00 each Kitchen sinks 99.68 99.68 01-3105 pot 1t4 4/V 2.00 each Floor sink 24.92 24.92 01-3105 �(M��/ Z44,1 2.00 each Floor drain 24.92 24.92 01-3105 e. 22.00 each Outlets 32.80 32.80 01-3105 V� 23.00 each Ltg fixtures 33.80 33.80 01-3105 6.00 Flat Add/Alter Ducts 56.28 56.28 01-3105 Total Fees: $3,387.85 Balance Due: $0.00 Paid Today: $1,868.55 This permit/plan review expires by time limitation and becomes null and void if the work authorized by the •ec.16 •. • permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 1,390.75 the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 436.55 is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 28.00 Arcadia building inspector for a period of 180 consecutive days. 714-2203 4.00 88-3027 9.25 CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS Requests for inspection should be made at least Monday-Thursday Friday 411 . one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m. by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m. (Closed on alternate Fridays) uskilip PERMIT/PLAN REVIEW APPLICATION Ell*' Development Services Department,240 West Huntington Drive,Post Office Box 60021 %.0.a,iY a'4a4. 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, . d my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class Signature of Contractor N i.�i , fr Exp. Date 2,,,b2-0 compensation, as provided for by Section 3700 of the Labor Code, for the r�1 performance of the work for which this permit is issued. WNER-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 ge 1/-e--- 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 I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall 0 I, as owner of the property, forthwith comply with those provisions. or my employees with wages as their sole .c.....„_____0,7 compensation,will do the work,and the structure is not intended or offered for g. sale(Section 7044,Business and Professions Code:The Contractors License Date g Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044, Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. çme IOe C�_ ( lc • e • a PRI 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 pliw S, h44.,y l�oc y ''s d 1'3M-1>w t.-' NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 100. Setbacks 210. Under fir./bldg.drain I 101. Rough grade 211. Copper underslab -Z5 '- $ 7 � G cT c /,,/ 102. Figs.&forms 212. Rough plumbing (1-Z5-125 / / S DSL y 103. Pre-slab 213. Rough gas 4/11.-/-4 104. 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 nailing 19. Final gas 110. Framing c(2S s 220. Fixtures 111. 0cc./Area Sept.Wall 221. Final plumbing 6-7-f g 112. Sound walls 222. Sewer cap/demo. 113. T-bar arid 5 '-I$4A 114. Insulation Flr. Pool Inspections Date Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. ,241. Rough plumbing 117. Drywall nailing 1-36-18,f 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish.rade 245. Gas line&test 121. Final building 6.267 i - 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 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. E..t.bondin. Sign Inspections Date I Insp. 160. Service panel 280. Setback/overhang 161. Final electric 6-7-(b 281. Footing 282. Conduit/wirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC 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 a Sewers&Offsite Insp. I Date I Insp. 191. Final mechanical G-Z-l S ' 300. Lateral(main to P/L) - 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess.so'filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin �' COUNTY OF LOS ANGELES • DEPARTMENT OF PUBLIC HEALTH w„+ ENVIRONMENTAL HEALTH } 'P� ©; SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH PLAN CHECK PROGRAM-BALDWIN PARK COUNTY OF Los ANGELES * %°1!uvo1iY0' 5050 COMMERCE DR,BALDWIN PARK,CA 91706 Public Health PHONE:(626)430-5560 WVVW,PUBLICHEALTH.LA000NTY.GOV/EH PLAN CHECK OFFICIAL INSPECTION REPORT DATE 06/20/2018 EHS VIVIAN TAN PLAN CHECK NUMBER SR0128768 PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF) OWNER/REQUESTER KEVIN BAIK,ARCHITECT DBA HOLY ROLY ADDRESS 400 S BALDWIN AVE 2220,ARCADIA,CA 91007 FINAL REINSPECTION STATUS: NOT APPROVED CORRECTIONS REQUIRED CORRECTION CATEGORY: PLAN SUBMITTAL/REMODEL IDENTIFIED:06/13/2018 CORRECTIVE ACTION: 1. PROVIDE A 12"TOP RETURN AT THE SNEEZE GUARD IN THE SERVICE AREA. 2. PROVIDE AN APPROVED CEILING IN THE SERVICE AREA. 3. INSTALL THE DIPPER WELL AT THE FREEZER FOR SCOOPING ICE CREAM(AS PER PLAN). 4. PROVIDE THE ANSI CERTIFICATION FOR THE ESPRESSO MACHINE. 5. SECURE THE LOCKERS TO THE WALL. 6. SEAL THE HOLES AROUND PIPING IN THE STORAGE ROOM. 7. SUBMIT THE PHP APPLICATION ALONG WITH THE FOLLOWING DOCUMENTS: -ARTICLES OF INCORPORATION -OWNER'S DRIVER'S LICENSE -SELLER'S PERMIT/BUSINESS LICENSE -EIN 8. PROVIDE A COPY OF THE BLDG. FINAL. CAUFORNIA RETAIL FOOD CODE:A person proposing to build or remodel a food facility shall submit complete,easily readable plans drawn to scale,and specifications to the enforcement agency for review,and shall receive plan approval before starting any new construction or remodeling of any facility for use , as a retail food facility Section# 114380, 114381 CORRECTION CATEGORY: PLAN SUBMITTAL/REMODEL IDENTIFIED:06/20/2018 CORRECTIVE ACTION: RE-INSPECTION CONDUCTED;VIOLATIONS ON REPORT DATED 6/13/18 WER CORRECTED. THIS FACILITY IS HEALTH DEPARTMENT APPROVED; OK TO STOCK AND TRAIN. V APPROVAL TO OPERATE AND ISSUANCE OF PUBLIC HEALTH OPERATING PERMIT IS CONTINGENT UPON PROVIDING A COPY OF THE BLDG. FINAL. THE AIR CURTAIN SHALL COVER THE ENTIRE OPENING OF THE FRONT DOOR. (TO BE VERIFIED BY THE DISTRICT INSPECTOR). CAUFORNIA RETAIL FOOD CODE:A person proposing to build or remodel a food facility shall submit complete,easily readable plans drawn to scale,and specifications to the enforcement agency for review,and shall receive plan approval before starting any new construction or remodeling of any facility for use as a retail food facility. Section it:114380, 114381 Help us serve you better by completing a short survey.Visit our website at www publichealth lacounty goy/eh. Operator Signature Page 1 of 3 • —171 •fljJHiJetJq.4(; 11431111r.-1,:, ' 2.0.11C YTi'Lf0;) .-7)11\4143 e;e )114 V(' 'sra Aq -A"VC A., '1:0 '' 1VY.t40') 0,0r4a.1}1140183931/11 .it\131ii0313 i4A-1 ) • 31-A0 7-#3.9k11_.”1 '.eD3H.:"/ _ „.. ____ • _ _ •••• - Tift4T413J.7-1 MAROOPel ; '.13TT;i1;CY:354 /4;411 . 4 r.F."...,;:704• ' 1 3%aEt'ife,..Hi TA\vtqt;C:1") 9)..." . 140 ;‘), 13vogq2A, ..10‘,„-)F h,PA3c1.7 A -"A! 7 J..' cL1 ; ..t.'!;',1;:• 1,-.1)-'.7 C. _T 7-..-;;_, VO•• ' .1% !I-NV 3!-FT Tit,IP.t.!:'7", 7 I -A- .7', 2 -"1j .1'510',.)A "7,3100"r: ,N3Q3 -•••••-••• 133n11.,43(71 .1'JGC)%/ V/. • •Yq00 al. ri A ?1-., A;'3: a.31-7-,1 'T ) ••(", ; 71'.1 "'.. -71'1: HT (IA ','.')A"; 4'41 • -. ..:-)1•111V 1'1'; r" ":; :0 T.; r :13.1A(.1?'"(.114A tlJif it)00 TV(P i C 1 1 711-11 m ) 1,41 ' ,11) •`• V 7. . 7 , ' ', ,rk 9(i0,,) • • tyit, t.'az • : ; •'• •"'. ••• • 411' !,! PLAN CHECK OFFICIAL INSPECTION REPORT DATE 06/20/2018 EHS VIVIAN TAN PLAN CHECK NUMBER SR0128768 PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF) OWNER/REQUESTER KEVIN BAIK,ARCHITECT DBA HOLY ROLY ADDRESS 400 S BALDWIN AVE 2220,ARCADIA, CA 91007 COMMENTS NONE Help us serve you better by completing a short survey.Visit our website at www publichealth.lacounty.gov/eh. Operator Signature Page 2 of 3 PLAN CHECK OFFICIAL INSPECTION REPORT DATE 06/20/2018 EHS VIVIAN TAN PLAN CHECK NUMBER SR0128768 PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF) OWNER/REQUESTER KEVIN BAIK,ARCHITECT DBA HOLY ROLY ADDRESS 400 S BALDWIN AVE 2220,ARCADIA,CA 91007 DISCLOSURES It is a misdemeanor violation to begin operation without a valid Public Health Permit/License.The Public Health Permit/License will be issued by the Los Angeles County Department of Public Health Environmental Health Division(DPH-EH) Plan Check Program at the job site following final inspection and approval by all applicable agencies. Remodeled areas of an existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior to use. Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food facility/establishment or change of menu may require plans to be submitted to the OPH-EH Plan Check Program. Additional approvals may be required from other enforcement agencies. It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or gratuities in connection with performing their official duties. Improper solicitations include requests for anything of value such as cash,discounts,free services,paid travel or entertainment,or tangible items such as food or beverages. Any attempt by a County employee to solicit bribes,gifts or gratuities for any reason should be reported immediately to either the County manager responsible for supervising the employee or the Fraud Hotline at(800)544-6861 or www.lacountyfraud.org. YOU MAY REMAIN ANONYMOUS Public Health Permit/License: A separate fee is required for the Public Health Permit/License.A billing statement will be sent to the permit/license holder annually by the DPH-EH. The fee is required to be paid to perform or carry on,conduct or engage in any mobile food facility listed in Los Angeles County Code,Title 8,Section 8.04.720. State and Local Licenses and Permits: Contact the State of California and your local city hall regarding additional license and permit requirements. Restrooms: Customer may use restroom facilities if they are located in a customer area.Customers may not enter the food preparation area,food storage area,or the utensils washing/storage areas in order to access the restrooms.All food,utensils and equipment must be protected from contamination. Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County. Following the issuance of your Public Health Permit by the Plan Check Program,an Environmental Health Specialist from your local district will conduct an inspection of your facility. If your Business is located in a city that has adopted the grading ordinance,the inspector will post a grade or score card at your facility. Grade/Score cards are not issued by the Plan Check Program. Help us serve you better by completing a short survey.Visit our website at www publichealth lacounty qov/eh Operator Signature Page 3 of 3 T540q3P. 1401T33claioll JA10f140 )i33H314A-lq ,;- ! .":11,3t0 1 — I — . - $4.0'41;st.;14.}1031-40 IAA_P2: I r • - 10 A.:1 _ . . • tt •,•A fr j . ,VP, I 0•••••••....,11-..•=•,••••••.-.. • - . . 't 7 t .• '.!' !*'1,-) t' ' t., :•• 1. t ; ••: ;!113'.' 41.40 I;:t - ' , 0•ricfmr. • 4; (•.,- ••• fr;:) • ^ •• 1 : ; 41'1', 4t14 03 b'..33 :70 1' Vein tif;',.'.4 'Ii? ' .1' .•5 • •,4 1. •• zrir, •. . • . t'. ' •..• 1- k v i ; 110.,lq:4•1'. . •., . )C.:rri!- , • 7 ' ' 411:42, .; ")f • • , 0.4"j AA‘.1!At• ! tt, ' = !Ito' !i-•• )611,: • • t • , prolF.he.. ,Mm '• 4'1,4; ' ,• . ••,.f ,r1• bis .1,.• . - - h111 ,.• - ' r. ?rr riC., -4 • • ic..tfp••,;) 7(--. -----, -2--- ----- -/---------c- .„ --,, :--,=-------A „ „-------..„N ,,,, ., .,,,, N --, , 4_ , ,,_ „ , , , , ________, , ....___ _______„. .,.. ,,, „,,.. , , ,...., r• ...,..---;-.1 7-------,,,,-------,.. ./----„,.„---- ----... .,..---;..-- \ /----__ .,. .----7 \ Certificate of Occupancy _" City of Arcadia eel: Development Services Department - Building Division y 7 -11 This certificate issued pursuant to the requirements of Section 109 of the Uniform 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.( 'a 7-//:\_-:://:—/: C�P/_ Permit No. BOO-058-650 �� Building Address: 400 S Baldwin Ave,Arcadia,CA 91007 � Use Classification: Tenant Improve Effective UBC: C.B.C.2016 Permit Type: Tenant Improve w/energy Zone Code: C-D,DH8 I l/' Occupancy( ‘..; Code: B Type of Construction: TYPE II, 1 HR SPRINKLERED ` Final Date: 6/25/2018 '< Owner: Westfield Corporation,Inc. ,\./7,.,, ,_ ,_) Tenant: Holy Roly . , S� — `,4, i• f II on Stockham, i'Iding Official (7';;„, �POST IN A CONSPICUOUS PLACE . ----- --- — — ---_ �. — _ �' ....y City of Arcadia, CA Permit NO.SIGN-18-0731 Development Services Department Permit Type:Sign 240 West Huntington Drive,Post Office Box 60021 Work Classification:Illuminated Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued ARCADIA Issue Date:05/03/2018 I Expiration: 10/30/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number i400 S Baldwin AVE Arcadia,CA 5775031043 Contacts _ SANTA ANITA BORROWER LLC C/0 Owner Chae Yong Kwak Electrical Contractor WESTFIELD SANTA ANITA (C-10) 400 3620 W Pico BLVD,Los Angeles,CA 90019 (213)820-0044 Description:I LED ILLUMINATED SIGN AND 1 BLADE SIGN FOR Valuation: $2.000.00 Tenant HOLY ROLY HOLY ROLY Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Building Issuing Fee $44.35 Total Fees $329.10 Building Permit Fees $103.65 Cash/Receipt#REC-001080-2018 $329.10 Electrical Permit Issuance Fee $44.35 Amount Due: $0.00 Sign and Branch Circuit $62.13 Sign Connection $15.55 Sign Plan Review $51.82 Solid Waste Management Fee $6.25 Solid Waste Management Fee 2 $1.00 Total: $329.10 CALLS FOR INSPECTIONS b-25.1T Request for inspection by telephone at 626-574-5450. Leave a message S requesting the address,timeframe and what inspection item is needed. pot, h,Pd-e-r-ov This permit/plan review expires by time limitation and becomes null and r 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 ISconsecutive days or if no progressive work has been verified by a City of Ulla/ Arcadia building inspector for a period of 180 consecutive days. 4 May 03, 2018 Issued By: Date May 03,2018 Page 1 of 1 • A. ill !IF '± PERMIT/PLAN REVIEW APPLICATION I4 • 4411.-b, Development Services Department,240 West Huntington Drive,Post Office Box 60021 oft,et w' � Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 1D 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 License Class & - Licen ❑ I have and will maintain a certificate of consent to self insure for workers' s S 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 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'c pens on insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, - Carrier ,,-�G ' ' demolish,or repair any structure,prior to its issuance,also required the applicant t{b 3 7 1 for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number j S provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is fo one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is 4 exempt there from and the basis for the alleged exemption. Any violation of IDI 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 Sectionthe Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. i 7, -- ---- S compensation,will do the work,and the structure is not intended or offered for AI, - - sale(Section 7044,Business and Professions Code:The Contractors License Date 3/s/� Signa r Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑ I, as owner of the property, am exclusively contracting with licensed - contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909)396-2000 for further information. Name r'\ Title 4,,H---- 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 'ty ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon th i 9• • entioned property for inspection purposes. 4.519, I . 3 )sinature Pr f: Front Dimension OB TITLE ,a-5'VIE _ -- 1 9ft—Oin x 30in Cabinet with Illuminated individual channel reverse letters FN,vNT STORE FRORT-T8.0c- TE PIASTER \\\` HOLY ROLY ICE CREAM i, - ' " 400 S. Baldwin Ave., #2220 $ ;T Arcadia, CA 91007 'N2,, $_- ' ,,-a. tli I - < 917-355-2793 3'40' 1 7-10" HOLY ROLY 6-2- 1 4'-2" 4-2" WINDOW— ICE CREAM �� �` �` LANI)LORI) GLASS DOOR !a! 4 1 • d „—____ --tom • . • • Total Sq. Footage: 9ft—Oin SIGN:22.5sq.ft / t X_ 10inHOLY ROLY 30in 7` ONTRACTOR t . CREAM 10in Idon ban sign C E 71, g � g / - 3620 W. Pico Blvd. Los Angeles, CA 90019 213-385-3344 . 1110111Mip Installation Dimension 1.25in 9ft-Oin x 30in Cabinet with +-2.5in 4 °'—4in —k Illuminated individual 063 Aluminum reverse channel letters channel reverse letters face & returns gray color powder coating finish _ 1/2"x1-1/4" Aluminum spacer with 1/4"x2" Machine Bolt (min. 4 per LET.) Low Voltage Wiring form LED to LED t. P5co ve ? ENANT Class 2 Power supply (12VDC,5x100W) HOLY ROLY ICE CREAM 1/8x1/2" Hold for letters & screws S. Baldwin Ave., #2220 (min 4 per LET.) €, 1/8" Lexan polycarbonate clear A , C 917-355-2793rcadiaA91007 ` ). Alternate Attachment Methods: LANDLORD I Building Construction: '•-• y 1 --• ofrll) Botts Sample: H I P-- 1-) Minimum Fastners: .. r» ter-•�-•- •••••�•----•+ ) I Illuminated Channel Letters 0 080 Aluminum Cabinet White This sign is intended to be installed in accordance with the requirements of Article color powder coating finish 600 of the National Electrical Code and/or other applicable local codes.This'mcludes proper grounding LISTED and bonding of the spn. 4° °� Total Sq. Footage: SIGN:22.5sq.ft HOLY RoLy .... X ONTRACTOR 3/8"x 4" Toggle Bolt • '44 ICE CREAM 4,._ • dong bang sign 3620 W. Pico Blvd. Los Angeles, CA 90019 — — 213-385-3344 A` OB TITLE Front Dimension ,8-, _ _ _ , _ >>_'�'��_ _____ __ 2ft-5in x 2ft-5in Non Illuminated Blade sign \ ENANT STORE FRITE ASTER HOLY ROLY ICE CREAM #II- ' -, 400 S. Baldwin Ave., #2220 y 'P) Arcadia, CA 91007 i• 11 1T-8ti ., !ct - ., 917-355-2793 -10'---I 3-10- HOLY ROLY ICE CREAM STOREFRONT :1/ - - LANDLORD GLASS DOOR m 9 ..... -r / 10-Off / . a i 4 --kr., 6! Total Sq. Footage: oak wood panel with 1/2"PVC letters cut painted logo color :-,o SIGN:5.9sq.ft oak wood panel 3/8"x 4"Toggle Bolt X Hou gold aluminum cablirct 011iI ONTRACTOR IR'WC kners cut painted kgo cob, Front Back dong bang sign 3620 W. Pico Blvd. Los Angeles, CA 90019 213-385-3344 Site Plan OB TITLE HOLY ROLY ICE CREAM 400 S. Baldwin Ave., #2220 _ Arcadia, CA 91007 B --A NN \ \\- 1111 71- II 1111 ,,•* - • - -:--- ---, ;5; / ENANT \\ J.# 1 / HOLY.ROLY ICE CREAM • ^// //' NORDSTROM (HHN/A r 400 S. Baldwin Ave., #2220 ® a •�— )1/ Arcadia, CA 91007 \- INA J ,r � �ir � 917-355-2793 It� wa , w 1 - - X07 ,� �„ g I' r_ ,!?��-� i • - . *so LANDLORD .l _I Fiiiiiimillialiiiiii.,47ii.. tLA �, Low- __ \ EJi4 '1■ 1 i5 Gp �. Nip Total Sq. Footage: SIGN:5.9sq.ft HOLY ROLY ONTRACTOR ICE CREAM • Bong bang sign 3620 W. Pico Blvd. Los Angeles, CA 90019 213-385-3344 1 RSC UTING ACTION Date and off' `See Initials of QQo°��,oA�°arAO: � Notes Checker CA P� G°P on Sheet# Planning Ni it b _ Eng. -- — - Building 5.7.-ffpfrt = Fire _ PWS-Water WELD � - -- -- - --- Trees _ 1� Permit NO. FIRE-18-0479 _ � City of Arcadia, CA 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:In Review ARCADIA Issue Date: Expiration: 09/30/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 400 5 Baldwin AVE Arcadia,CA 5775031043 Contacts SANTA ANITA BORROWER LLC C/0 Owner Allready Fire Sprinkler Co. Applicant WESTFIELD SANTA ANITA 818 N Grand,Covina,CA 91723 400 (626)332-7066 Description:FIRE SPRINKS FOR HOLYROLY ICE CREAM .9 HEADS Valuation: S 1.900.00 Tenant HOLYROLY ICE CREAM Total Sq Feet: 0.00 Plan Check#18-0479 Plan# Fees Amount Payments Amount Paid Fire Issuance $44.35 Total Fees $424.80 Fire Permit Fees $99.45 Cash/Receipt#REC-000744-2018 $280.00 Solid waste Management Fee 2 $1.00 Cash/Receipt#REC-000854-2018 $144.80 Sprinkler Heads $280.00 Amount Due: $0.00 Total: $424.80 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 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. IS COMPLETED Issued By: Date April 11,2018 Page 1 of 1 A• PERMIT/PLAN REVIEW APPLICATION ce`� Development Services Department,240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021,(626)574-5416,Fax(626)447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class3St-?qr. Licens o. C--/.6 Exp. Date 0 7-3/-Ar 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 C /'"� OWNER-BUILD ;''ECLARATION I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit I hereby affirm unde • nalty of perjury that I am exempt from the Contractors is issued.M workers'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions a / Code.Any city or county which requires a permit to construct,alter,improve, Carrier VC fC S'_ ,�o•- demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number J 7 S 'j�QO(� Z 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 i % Z(/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 ate �f— 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 Wo ers'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. 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 u the above-mentioned property for inspection purposes. Age Date Sign• g• —// -� � Yg•. City of Arcadia, CA Permit NO. FIRE-18-0512 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:Issued ARCADIA Issue Date:04/24/2018 I Expiration: 10/21/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 400 5 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 HOLY ROLY .5 DEVICES Valuation: S 2.800.00 Tenant HOLY ROLY Total Sq Feet: 0.00 Plan Check#18-512 Plan# 1 , Fees Amount Payments Amount Paid Fire Alarm Plan Check 5280.00 Total Fees $445.70 Fire Issuance 544.35 Cash/Receipt#REC-000781-2018 $280.00 Fire Permit Fees $120.35 Cash/Receipt#REC-000976-2018 $164.70 Solid Waste Management Fee 2 $1.00 Amount Due: $1.00 Total: $445.70 - 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. ,. � COMPLETED April 24, 2018 I ued By: Date April 24,2018 Page 1 of 1 4 ! PERMIT/PLAN REVIEW APPLICATION 4416, Development Services Department,240 West Huntington Drive,Post Office Box 60021 00z.„....... a 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 �l V License No. 72i 4Qr Exp. Date 1/ /it 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 DECLAIATION I 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 can9er'and�polic�y numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier r kksibQx_ ji _- Wt.44 demolish,or repair any structure,prior to its issuance,also required the applicant 01 f1 y for such permit to file a signed statement that he or she is licensed pursuant to the olicy Number U-`� provisions of the Contractors License Law(Chapter 9(commencing with Section s 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 of employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): tompensation Laws of California,and agree that if I should become subject to the t 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 �/ ° 0 sale(Section 7044,Business and Professions Code:The Contractors License Date IZl Signature Law does not apply to an owner of property who builds or improves thereon, -- or who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and attorney's fees. ❑I, as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). ❑ I am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date Signature Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING: 1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel. 2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings and structures. 3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. , /(, �� jie ��u vll,€c ,U &A 4 7��`+ Title ____Prirfrt 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 it !.n4/18' 4.1 of ARC ‘), PIII9M 7 t 5r� Aury1�901 00› °'u,,,cyice MEMORANDUM Fire Department DATE: June 11, 2018 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemich FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 400 S. Baldwin Avenue #2220 (Holy Roly) THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 5-22-2018 Jill Perumean FIRE ALARMS 6-6-2018 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY 6-6-2018 Jill Perumean COMMENTS: Emailed Bldg. Dept. 6-6-2018 Rita