HomeMy WebLinkAboutUntitled (2) ...IP.. City of Arcadia, CA
Permit NO.11-18-0462
Development Services Department Permit Type:Tenant Improvement
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Tenant Improvement
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:05/29/20181 Expiration: 11/25/2018
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
400 S Baldwin AVE Arcadia,CA 5775031043
1
Contacts _
SANTA ANITA BORROWER LLC C/0 � Owner JACOB WEBSTER Applicant
WESTFIELD SANTA ANITA 1236 POTOLA AVE,TORRANCE,CA 90501 )
400 (310)702-7852 WEBSTERJACOB@AOL.COM
ELDER-JONES General Contractor(B) i
1120 80th ST, Minneapolis,MN 55420
(612)854-2854
Description:INTERIOR T.I FOR MOTHERHOOD MATERNITY. Valuation: S 200,000.00 Tenant MOTHERHOOD MATERNITY
Total Sq Feet: 0.00 Plan Check#18-462 Plan#32520
Fees Amount Payments Amount Paid
Accessibility Plan Check $186.62 Total Fees $4,437.93
Accessiblity Building Permit $191.40 Cash/Receipt#REC-001257-2018 $2,220.00
Building Issuing Fee $44.35 Cash/Receipt#REC-000726-2018 $2,217.93
Building Permit Fees $1,914.00
Amount Due: $0.00
Building Plan Review Fee $1,244.10
Cal Green Plan Check $124.41
Commercial T.I.Fire Plan Chk. $280.00
Energy Plan Review Fee $382.80 /V4L - ,
Green Building Standard $8.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Corn $56.00 CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
Total: $4,437.93 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
'
Cufk;4' 1 a from the date of issuance or if the permit is not obtained within 180 days
,.
R11:11
., from the date of plan submittal.This permit expires and becomes null and
"� lit 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 29, 2018
Iss •d By Date
May 29,2018 Page 1 of 1
A;
00.001044
4 PERMIT/PLAN REVIEW APPLICATION
Q`E 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
[l-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
LProfessions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
icense Class 43 Li o. Exp. Date_J�/3//l? 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 C TION ❑ 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'compe ation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier Co/2
demolish,or repair any structure,prior to its issuance,also required the applicant
— 0 /
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number f�' d�/�
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 Secti. 700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for /
sale(Section 7044,Business and Professions Code:The Contractors License Date 5/1/4 Signature /Air
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.
13 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 fr¢tzr//ii(/ 5 itc/41•, Title -cup
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 wi • , City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter u s• above- s • p 'oned property for inspection purposes.
Signature I/ Date .5/2-0
1
4/00 aca I I1'/o7' IAM*
NOTES
Building Inspections Date Insp. Plumbing Inspections I Date I Insp. � fee-,ttipAr i1
100. Setbacks --210. Under flr./bld•.drain �I
101. Rough grade 211. Copper underslab
102. Figs.&forms 212. Rough plumbing -16-C
103. Pre-slab 213. Rough gas 2
yr
104. Floor joists 214. Shower pan 7•
105. Steel 215. Water heater pot f ,* fuser l
CO�/T
106. Grout lift 216. Roof drains l��
107. Shear nailing 217. Building sewer �T Na�c'• N" ��� nE•
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing 220. Fixtures
111. Occ./Area Sept.Wall 221. Final plumbing ►`�3�$
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 sole 250. Pool cover --
151. Sales lot lighting �uni 251. Pool final
152. Under.round 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 I Date I Insp.
160. Service panel :0. Setback/overhang
161. Final electric - 281. Footing
282. ConduiVwirin.
Mechanical Inspections Date Insp. 283. Disconnect --
180. Venting/flue --284. Final sign --
181. Furnace/A.C.
182. Rouch HVAC -- Miscellaneous Insp. I Date I 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 -WM Sewers&Offsite Insp. I Date I Insp.
191. Final mechanical jr, 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
(-------
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Certificate of Occupancy ;
City of Arcadia ,..., i
Development Services Department—Building Division `.
I
, This certificate issued pursuant to the requirements of the
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.
,'� Permit No. TI 18-0462 i
Building Address: 400 S. BALDWIN AVE ARCADIA,CA 91006
i.
` Permit Type: TENANT IMPROVEMENT Effective CBC: 2016. C.B.0 \\/:
Occupancy Code: M Zone Code: C2-DH8 / \
" r Final Date: 8-14-18 Type of Construction: TYPE II 1 HR SPRINKLERED ,�\
owner: WESTFIELD S NTA ANITA Tenant: MOTHERHOOD MATERNITY
\ a
..L.A . 514
Don Stockham,Building Official
Post in Conspicuous Place
I \ '\ '
'i
Y
A A A�
�/
„ ( 7--- . 04
/ ,`,i\s ,,;':;---,.. : c. f� \
r
Certificate ofOccupancy %
11--- City of Arcadia
�
� \�' Development Services Department—Building Division \
` j This certificate issued pursuant to the requirements of the . -:-...)
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.
Permit No. TI-18-0462 s, ,
Building Address: 400 S Baldwin Ave,Arcadia,CA 91007 ,
�\ it
I' � Permit Type: Tenant Improvement Effective CBC: 2016 C.B.0 -'1
11
y � Occupancy Code: M Zone Code: C2-DH8 —..,i
/ ���.
I Final Date: 08/13/2018 Type of Construction: TYPE II, 1-HR SPRINKLER -..-,,,/
'7,
I
��/
\-' owner:Westfield Corporation,Inc. Tenant: Motherhood Maternity -1 I
r i
0 *- 0ti ;.'7' �- 1�
\I/
.• tockham,B 'ring Offic.1 ` 1
' Post in Conspicuous Place �� �
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-- 4
V �4 V
•• City of Arcadia, CA Permit NO. EIec-18-1069
Development Services Department Permit Type:Electrical
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Electrical Commercial
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:06/21/20181 Expiration: 12/18/2018
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/O Owner PACIFIC WINDS BUILDING INC Electrical Contractor
WESTFIELD SANTA ANITA (C-10)
400 19 HAMMOND STE 504,IRVINE,CA 92618
(949)916-8137
,err.. -.;.
Description:ELECTRICAL FOR T.I FOR MOTHERHOOD Valuation: S 0.00 Tenant MOTHERHOOD MATERNITY
MATERNITY.
Total Sq Feet: 0.00 ! Plan Check#18-462 Plan#32520
Fees Amount Payments Amount Paid
Electrical Permit Issuance Fee $44.35 Total Fees $275.21
Light Fixtures $66.80 Cash/Receipt#REC-001511-2018 $275.21
Outlets-Receptacles&Switches $38.80
Amount Due: $0.00
Sign and Branch Circuit $124.26
Solid Waste Management Fee 2 $1.00
Total: $275.21
tiA CALLS FOR INSPECTIONS
tot?Liii
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.
June 21, 2018
Issue By: Date
June 21,2018 Page 1 of 1
F AR
`,•%FOR
Al .011411111-01 li PERMIT/PLAN REVIEW APPLICATION
tt 4 -0i� 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
CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
fENSED
ereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
apter 9(commencing y Iec • 7000,of Division 3 of the Business and
fessions C°�e,and m'`t1 - e i full fo a and e'ect. I have and will maintain a certificate of consent to self-insure for workers'
ense Class VLi isse I A Exp. Date 3�/' compensation, as provided for by Sect 3700 of the Labor Code, for the
j-rformance of the work for which this rmit is issued.
nature of Contractor `�141k
OWNER-BUILDER DE►ill;
• • 1 ION I �A I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of. at 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 - tion 7031.5,Business and Professions is issued.My workers'compensation• urance c • r and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier
demolish,or repair any structure,prior to its issuance,also required the applicant -Ir.,
On
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 •ch 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‘4. ome subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,an•it...un that i hould become subject to the
workers'compensation provisions of .• I f the Labor Code,I shall
y w
forthwith mplith those provisiI� . 41 r .
❑I, as owner of the property, or my employees with wages as their sole1
compensation,will do the work,and the structure is not intended or offered for 21 1 ..._,,p
sale(Section 7044,Business and Professions Code:The Contractors License D,eSignature
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'C.. pen ion coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal pe • ,es and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
0 I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature_ _ Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further information.
e Title ��A
PRINT NAME
Irtify th. :ve r 4' • this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
ee to c. . y wit. City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
dia o -•t• p. . •: bove-mentioned property for inspection purposes.
to
— Z � ~ � �
ature ` • y- Date
41cil a: City of Arcadia, CA
Permit NO. FIRE-18-1071
,,I!i/ Development Services Department Permit Type:Fire
3<i i 240 West Huntington Drive,Post Office Box 60021 Work Classification:Fire Alarm
CA 91066-6021
4- Arcadia,
(626)574-5416 Permit Status:Issued
A RCA IA Issue Date:07/17/2018 1 Expiration: 01/13/2019
,
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 Building Electronic Controls Inc* Applicant
WESTFIELD SANTA ANITA 2246 Lindsay WAY,Glendora,CA 91740
400 (909)305-1600 ext 100
Description:FIRE ALARM 6 DEVICES MOTHERHOOD Valuation: $6.000.00 Tenant MOTHERHOOD MATERNITY
MATERNITY1
Total Sq Feet: 0.00 Plan Check#18-1071 Plan tf
Fees Amount Payments Amount Paid
Fire Alarm Plan Check $700.00 Total Fees $915.80
Fire Issuance $44.35 Cash/Receipt II REC-001727-2018 $215.80
Fire Permit Fees $170.45 Cash/Receipt tt REC-001513-2018 $700.00
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $915.80
CALLS FOR INSPECTIONS
se- COWILE1ED 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.
July 17, 2018
Issued By: Date
July 17,2018 Page 1 of 1
�yroR,y,
ill ! PERMIT/PLAN REVIEW APPLICATION
:: ,_, .
l I ' 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
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C 1 0License No.72J Exp. Date ` j
Signature of Contractor compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
��
OWNER-BUILDER 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 pwrorkeers'compensation insurance carrier and poli.�j numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier \Y' ) a,Y\� C,Q. 6-F - t \N
_ Ole
demolish,or repair any structure,prior to its issuance,also required the applicant \N S S�'g gal U2 �7
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
CII, 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 1/ V]/ QL 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 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 tr &t IS /Title I i♦1//, 1111), - .I 4 6 ( i I, �v
Tr, 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-menti' ed property for inspection purposes.
ignature�� I iB I.'V Date 7/t-1/ IF)
045
City of Arcadia, CA Permit NO. FIRE-1 -1
Development Services Department Permit Type:Fire
/ 240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Fire Sprinkler
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:07/03/2018 Expiration: 12/30/2018
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 *Allready Fire Sprinkler Co. Fire Contractor(C-16)
WESTFIELD SANTA ANITA 818 N Grand,Covina,CA 91723
400 (626)332-7066
Description:MOTHERHOOD MATERNITY FIRE SPRINKLERS.19 Valuation: S 2.600.00 1 Tenant MOTHERHOOD MATERNITY
HEADS
Total Sq Feet: 0.00 Plan Check#18-1045 Plan#
Fees Amount Payments Amount Paid
Fire Issuance $44.35 Total Fees $865.70
Fire Permit Fees $120.35 Cash/Receipt#REC-001479-2018 $700.00
Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-001620-2018 $165.70
Sprinkler Heads $700.00
Amount Due: $0.00
Total: $865.70
�I I CALLS FOR INSPECTIONSCOMPLETED
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.
July 03, 2018
Issued By: Date
July 03,2018 Page 1 of 1
.
00 PERMIT/PLAN REVIEW APPLICATION
,
iv, e • ~ I)evelupment Services Department,240 West Huntington Drive,Post Office Box 60021
•\r•N Arcadia, CA 91066-6021,(626)574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C I 6 License No. 3 57793- Exp. Date O7'3/VI'
Signature of Contractor
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
OWNER-BUILDE CLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under nalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.M, workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier t(1.t2 d¢S# XJ0,1,'O71 o.__' 1-5.49, 'a„cp
demolish,or repair any structure,prior to its issuance,also required the applicant �.y,�� /e-',Z
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number V wvO Z $, ,
provisions of the Contractors License Law(Chapter 9(commencing with Section (T�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 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
0 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 forQ' ,
sale(Section 7044,Business and Professions Code:The Contractors License Date 7.-3-/ D- 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 W.kers'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.
fame 1:4240( pi mac/ 01 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.
Signa ����� Date 7^ 3 — /
11
Permit NO. Plum-18-1181
City of Arcadia, CA
Development Services Department Permit Type:Plumbing
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Work Classification:Plumbing Commercial
)' . (626)574-5416 Permit Status:Issued
ARCADIA Issue Date:07/09/20181 Expiration: 01/05/2019
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 ART ARGIL PLUMBING* Plumbing Contractor
WESTFIELD SANTA ANITA (C-36)
400 1811 Iowa ST,Costa Mesa,CA 92626
(818)469-4301
Description:PLUMBING FOR RESTROOM AT MOTHERHOOD Valuation: $ 0.00 Tenant MOTHERHOOD MATERNITY
MATERNITY
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Floor Drain Fee $12.46 Total Fees $110.74
Laundry Trays $12.46 Cash/Receipt#REC-001645-2018 $110.74
Lavatories $12.46
Amount Due: $0.00
Plumbing Permit Issuance Fee $44.35
Solid Waste Management Fee 2 $1.00
Water Closet $12.46
Water Heater and/or Vent $15.55
Total: $110.74
CALLS FOR INSPECTIONS
131
COMPRequest for inspection by telephone at 626-574-5450. Leave a message
l 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.
July 09, 2018
Issued By: Date
July 09,2018 Page 1 of 1
r.aUi;
kl . Li PERMIT/PLAN REVIEW APPLICATION
:: IL.. x '10
two Development Services Department,240 West Huntington Drive,Post Office Box 60021
o Arcadia,CA 91066-6021, (626) 574-5416,Fax(626)447-9173
City of
Arcadia
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 d
Professions Code,and my license is in full force and effect. �i 4 ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C--. t License No. 5 AL,w Exp. Date 7� , 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 DECLA' ,TION ❑ 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'gompen on ins ce carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 57�J /
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 ri J EN MMYii
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 37 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 Bions.
compensation,will do the work,and the structure is not intended or offered for
sale(Section 7044,Business and Professions Code:The Contractors License Date Signature
Law does not apply to an owner of property who builds or improves thereon,
or who does such work himself or herself or through his or her own
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑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 -'' �P )4A j Title 041J 294
RI NAM
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.
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 abov mentioned property for inspection purposes.
L
Signature Date 7 /),'
/9
Permit No. Mech-18-1041
• City of Arcadia, CA
Development Services Department Permit Type:Mechanical
240 West Huntington Drive,Post Office Box 60021
''I, Arcadia,CA 91066-6021 Work Classification:Mechanical,Commercial
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:06/18/2018 Expiration: 12/15/2018
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 ALLIANCE HEATING AND AIR HVAC Contractor(C-20)
WESTFIELD SANTA ANITA CONDITIONING INC*
400 324 E DYER RD B,SANTA ANA,CA 92707
Description:REPLACE DUCT WORK FOR MOTHERHOOD Valuation: $0.00 Tenant
MATERNITY. Total Sq Feet: 0.00 Plan Check# Plan#
ti
Fees Amount Payments Amount Paid
Add/Alter Ducts $121.94 Total Fees $181.40
Air Handling Units<=10,000 cu ft per min. $14.11 Cash/Receipt H REC-001474-2018 $181.40
Mechanical Permit Issuance Fee $44.35
Amount Due: $0.00
Solid Waste Management Fee 2 $1.00
Total: $181.40
tIEITEO CALLS FOR INSPECTIONS
Request for inspection bytelephone at 626-574-5450. Leave a message
q P P
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.
June 18, 2018
Issued By: Date
June 18,2018 Page 1 of 1
CA,.1P04044•4
4 ! I� PERMIT/PLAN REVIEW APPLICATION
e\ Development Services Department,240 West Huntington Drive,Post Office Box 60021
*a' �t.>'e
oArcadia, CA 91066-6021,(626) 574-5416,Fax(626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affum 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
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 G/!� ken o.SIOVr Exp. Date__/_f/fS 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
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
is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve, Carrier F1/er,P Pot r /)4 5- CP•
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number i04907)/ f j'7 1 7 I
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 ❑ 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 3 00 of the Labor Code,I shall
IDI, 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 forp
sale(Section 7044,Business and Professions Code:The Contractors License Date �I I!� 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 /
ame 11S I44 Gly ide Praj -eC'� -"C)-440°/V�li`f-VV
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
rcadia to enter upon th ve-mentioned property for inspection purposes. 1 I
gnature� Date CO ( t F
seaisi City of Arcadia, CA
i' + Permit NO.SIGN-18-1044
Development Services Department Permit Type:Sign
240 West Huntington Drive,Post Office Box 60021
I '' Arcadia,CA 91066-6021 Work Classification:Sign-Illuminated
-_, r— (626)574-5416 Permit Status:Issued
ARCADIA Issue Date:06/18/2018 I Expiration: 12/15/2018
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
x400 S Baldwin AVE Arcadia,CA 5775031043
I
Contacts
SANTA ANITA BORROWER LLC C/0 Owner R N F SIGNS INC* Contractor
WESTFIELD SANTA ANITA 330 E NEWMARK AVE,MONTEREY PARK,CA 91755
400 (626)445-3116
Description:LED ILLUMINATED SIGN FOR MOTHERHOOD Valuation: S 2.000.00 Tenant MOTHERHOOD MATERNITY
MATERNITY
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-001478-2018 $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
Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
8-la-68
j(14e-- 5‘4/a. This permit/plan review expires by time limitation and becomes null and
*.....7, 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
L?L7
Arcadia building inspector for a period of 180 consecutive days.
orixttt
O
4
June 18, 2018
Issued By: Date
June 18,2018 Page 1 of 1
`',ti�roR,yi••
ii4 100.1 h PERMIT/PLANREVIEW APPLICATION
.+ ,tt * Development Services Department,240 West Huntington Drive,Post Office Box 60021
00.,.tlalry of 0.0 Arcadia, CA 91066-6021,(626)574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
`f•' I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C`"4ed 4 License . Exp. Date 7-
Signature of Contractor
compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
OWNER-BUILDER 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 c
. 2 s.3i 4
demolish,or repair any structure,prior to its issuance,also required the applicant p 1 3 1c Q .ZQ1
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less)
7000)of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for
Date C— \B ^l D Signa —Ar (
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.
0 I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further information.
Name Ware-1"z-dqv t (Title 1Z n v.,ilM..Jk
P NAME
I certify that I have read this application and state that the above information is rrect and that I am the owner or duly authorized agent of the owner.
I agree to comply with all _' , ordinances a 1 State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upo I e above-me +'1 ned p•, rty for inspection purposes. t
Signature t� }�Date \V ^\�Q p