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Home My WebLink AboutUntitled ,.. City of Arcadia, CA Permit NO. Demo-18-0588 * Development Services Department Permit Type:Demolition 240 West Huntington Drive,Post Office Box 60021 Work Classification:Demo-Residential Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued ARCADIA Issue Date:06/04/2018 I Expiration: 12/01/2018 , Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 911 Hampton RD Arcadia,CA 5769013037 Contacts -- BAO JIANG YANG AND MIN GAO Owner CAMARENA LAND CLEARING* Earthwork&Paving 911 HAMPTON RD Contractor(C-12) 26 Mill Valley RD,Phillips Ranch,CA 91766 (909)865-1128 Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW AND Valuation: $0.00 Tenant ADU. REFUND DEMO BOND TO:MIN GAO 305 W LE ROY AVE ARCADIA CA 91007 6263196297 Total Sq Feet: 4.055.00 Plan Check H Plan H Fees Amount Payments Amount Paid Bond for Demolition $4,055.00 Total Fees $4,275.43 Demo-Sewer Cap and/or Cesspool Fill $15.55 Cash/Receipt ft REC-001339-2018 $4,275.43 Demolition Permit $108.93 Amount Due: $0.00 Demolition Permit Issuance Fee $44.35 Plumbing Permit Issuance Fee $44.35 Solid Waste Management Fee $6.25 e4......dj !0/4 Solid Waste Management Fee 2 $1.00 Total: $4,275.43 12 COMPLETED 9,-/-43 -,x/e,i-- CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message requesting theaddress,timeframe and what inspection item is needed. eo 6tee4 1.4‘v (seeyoff cer7fi /e-ii l This permit/plan ex time limitation and becomes null and review expires b y /74 C 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 94 ` �� , adia eildin: inspector a period of 180 consecutive days. ok ."-v e.e.e,e - e.i Oft / z / FbG 1111111111 Ai --7 June 04, 2018 Issued By: Date June 04,2018 Page 1 of 1 %V A; 4 !�'± _ PERMIT/PLAN REVIEW APPLICATION 0 r� !- ! le a,41' Development Services Department,240 West Huntington Drive,Post Office Box 60021 -f" Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 0 I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and qLiceProfessions Code,and my license is in full force ai_lc ffect. nse Class C--Z Licen 0 I have and will maintain a certificate of consent to self-insure for workers' 6W Exp. Datev Signature of Contractor _I 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 demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number 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 Se 'on 37 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 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 0-1 C.--)(--, C ' _ Title �wX -e'_ PRINT NAME I certify that I have read application and state that the above information is orrect and that I am the owner or duly authorized agent of the owner. I agree to c ply with I )tY ordinances and State Laws relating to building onstruction. I hereby authorize representatives of the City of Arcadia to r upon a abe-mentioned property for inspection purposes. l I Signature ate a�Y/ 4 .'"" CITY OF ARCADIA ir Film CHECK REQUEST Vendor No. Date September 25, 2018 (for Administrative Services Only) Pay to: Min Gao 305 W. Le Roy Ave Arcadia, CA 91007 Account No. Amount 714-2275 $ 4,055.00 $ TOTAL $ 4,055.00 Reason for payment. (PLEASE SUBMIT BACK-UP IN DUPLICATE) Please process a refund to the above recipient - demo bond Demo-18-0588 911 Hampton Rd ❑ Check here if check is to be Approved by. Iie"�6 returned to Department. Building Department Department: