HomeMy WebLinkAboutUntitled CITY OF ARCADIA
t� CHECK REQUEST
Vendor No. Date MARCH 7, 2019
(for Administrative Services Only)
Pay to: HARTFIELD CONSTRUCTION CORP.
11908 CLARK ST
Arcadia, CA 91006
Account No. Amount
714-2275 $ 1,909.00
$ 1
$ , !
l
$
$ I
$ 3
TOTAL $ 1,909.00
a
1
Reason for payment. (PLEASE SUBMIT BACKUP IN DUPLICATE)
Please process a refund to the above recipient, demo bond ;x
b
DEMO-18-1890 .14
618 W LONGDEN AVE
❑ Check here if check is to be Approved by: // //
returned to Department. r
Department: Buildin. D a ent
__I
Ii City1
of Arcadia, CAPermit No.Demo 18 1890
1
Development Services Department .Permit Type:Demolition
1 240 West Huntington Drive,Post Office Box 60021 i ,. , i - WorkClossificatlon:Demo-Residential-
Arcadia,CA 91066-6021 _
(626)574-5416 - - _- - Permit Status:Issued
ARCADIA Issue bate: ll%27/zo18 Expiration: 05/26/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
618 W Longden AVE Arcadia,CA 5787001028
Contacts
WANG,FUYING Owner Hartfield Construction Corp Earthwork&Paving
1123 Sunset Blvd,Arcadia,CA 910078135 Contractor(C-12)
(626)375-0244 FUYINGWANG@QQ.COM 119085 Clark#A,Arcadia,CA 91006
(626)255-3541
aux
Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. Valuation:_ 5 0.00 Tenant
REFUND DEMO BOND TO HARTFIELD CONSTRUCTION CORP
11908 CLARK ST ARCADIA CA 91006 6262553541 Total Sq Feet: 1.909.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Bond for Demolition $1,909.00 Total Fees $2,098.28
Demo-Sewer Cap and/or Cesspool Fill $15.55 Cash/Receipt#REC-002982-2018 $2,098.28
Demolition Permit $77.78
Amount Due: $0.00
Demolition Permit Issuance Fee $44.35
Plumbing Permit Issuance Fee $44.35
Solid Waste Management Fee $6.25 /9
Solid Waste Management Fee 2 $1.00 4 COMPA /Total: $2,098.28
•
la -I g CALLS FOR INSPECTIONS
Dr_ `7 I (rte 1 I Request for einspectiondesby telephoneatd what626-574-5450.inspection
o Leaveema message
UNI (Y11./ll t I requesting the address,timeframe and what inspection item is needed.
ago) N This permit/plan review expires by time limitation and becomes null and
11% void if the work authorized by the permit is not commenced within 180 days
f�T� -I-�sb I from the date of issuance or if the permit is not obtained within 180 days
rtfrom j3t. from the date of plan submittal.This permit expires and becomes null and
� /Q void if any work authorized by this permit is suspended or abandoned for 180
I ��• ( consecutive days or if no progressive work has been verified by a City of
t ( Arcadia building inspector for a period of 180 consecutive days.
1."
7
, 24
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0(7
November 27, 2018
Issued By: Date
November 27,2018 Page 1 of 1
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1! Pal 1 PERMIT/PLAN REVIEW APPLICATION
littrtiLldr% 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 licens- is i, full force and effect.
License Class 7%. f Li.-ns0 1 have and will maintain a certificate of consent to self-insure for workers'
*,�.
Signature of Contractor • /r Exp. Date 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 DECLA' ••TION 0 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 (This section need not be completed if the permit is for one hundred dollars or less)
provisions of the Contractors License Law(Chapter 9(commencing with Section
7000) of Division 3 of the Business and Professions Code)or that he or she is
exempt there from and the basis for the alleged exemption. Any violation of I certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply 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 amnot intended or offered for. � WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within;one'0)'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 h k 14 IA W T /+�. c'ld Title (id -
PRINT NAME
I certify that I have read this application and state that the above information is cor ect and that I am the owner or duly authorized agent of the owner.
I agree to compl with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter po the above-mentioned property for inspection purposes. �1
Signatu . /1 1(Date /�//V