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HomeMy WebLinkAboutUntitled ;., City of Arcadia, CA Permit No. EIec-18-1353 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:07/31/2018 Expiration: 01/27/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1325 S Baldwin AVE Arcadia,CA 5383038027 Contacts �____ BALDWIN ARCADIA CENTER LP Fire Contractor(C-16) FIORE ELECTRICAL INC* Electrical Contractor 815 W NAOMI AVE A (C-10) 3509 SUNNY HILLS DR, NORCO,CA 92860 (951)833-6127 Description:MOVING 4 CIRCUITS FOR LA FITNESS GYM Valuation: S 0.00 Tenant TRICYCLES Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Electrical Permit Issuance Fee $44.35 Total Fees $51.51 Outlets-Receptacles&Switches $6.16 Cash/Receipt#REC-001884-2018 $51.51 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $51.51 F;,44_c_ COtiiiiiTED 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. July 31, 2018 Issued By: Date July 31,2018 Page 1 of 1 k ! PERMIT/PLAN REVIEW APPLICATION 0" - .0 40 b' 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. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C.\Ci ' . e No.84? al-k Exp. Date °II 1 tcompensation, as provided for by Section 3700 of the Labor Code, for the •' performance of the work for which this permit is issued. Signature of Contractor 0,1 OWNER-BUILDER DECLARATION ❑ 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 carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier - �� 11.uC1(01 demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number I ~lXn 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($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for Date 3 t 1 l$ 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. 'n q �/(��c r �`( � nI /�( ,(�Q�/��,( ame Y {\Y '�1J vv V J Title \�Y1� (, i ,YNr`�W "' PRINT NN 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 buildin construction. I hereby authorize representatives of the City of rcadia to enter upon ti :al ,v -mentioned property for inspection purposes. ignature Ilse Date 1 1 '9'l 1 t 7-31 -18 To Arcadia Building Dept. To whom it may concern: I authorize my daughter Shannon Ontiveros to act as my agent to pull a permit to relocate circuits at the LA Fitness located at 1325 South Baldwin Avenue Arcadia, CA 91007 Regards, � � ex'' Anthony Fiore Owner Fiore Electrical Inc. F_ LURE 4114.Tel 951-833-6127 3509 Sunny Hills Dr. www.fioreelectricalinc.net Fax 951-444-6571 Norco, Ca 92860 Fioreelectricalinc@gmail.com FURNI: ::,..nrcc==ec SDA TURE«....m.,............ s.'.,uo .o.....,....., PARTNERSHIP - PROJECT AMP O,QIIF04k1EZiB Arcadia,CA • AAA,ATAE55 _• ••=r teVA 4_i O O O O © ® O © ® 0 0 0 ® 0 �z_-_ SCOPE OF WORK ISSUED FOR < ,DATE OPSCPATTOP AMA P.,,ma Pa* .art © 1 OO m.n 1 I P.O.RECTIOMMORIWASCP OM mn o wn «� I tri 1 �•• _ .,,.■ VIA PEP.LEES Pm/ u •I_ —.-0 tel' �.i� rm�� o moon ti c t ,... 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