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HomeMy WebLinkAboutUntitled — 4\1 Permit NO TI-18-1,40!, . oCity of Arcadia, CA ' _�' � riS� -(1' , Development Services Department ( �> t t ' '" -"t � Permit Type Tenant Imov prement r 240 West Huntington Drive,Post Office Box 60021 f" f r+ i + C41 e )j . I ; .F AR gcw.�o.u.4`t MO PERMIT/PLAN REVIEW APPLICATION ski s cm � Ii iDevelopment 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 5 I p Licens . hf 107 Exp. Date ` 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 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.M¶workers'c mpensation insurance^ carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve,' Carrier F-`'IR-(Z �YZ. _./yLJ .C, demolish,or repair any structure,prior to its issuance,also required the applicant policy Number 1 2 W L l4 k f 2-1-r 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 kindred 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($500)): • compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor dz i shall 0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those$rovisions. compensation,will do the work,and the structure is not intended or offered forpp Q` sale(Section 7044,Business and Professions Code:The Contractors License Date 57-1t5—7.19t� 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 shallsubject 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: I. 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 11 furtherinformation.information.mattion. � (Name W t (Ly e u}'1(�-� Title SOy-ud` I iC-tt 9hJ - -€1, � 1\ PRINT ME Sof I certify that I have read this application and state that the above information is cors ct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances +nd-State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon t. . above-mentio. •/ property for inspection purposes. R ignamre Date --/g.-- . 2°/` NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 56gf it:GRA Ti -/s-icfo6 100. Setbacks 210. Under flrJbldg.drain r/C�77 101. Rough grade 211. Copper underslab 102. Figs.&forms 212. Rough plumbing /0 1111 103. Pre-slab Itoett 419,1 213. Rough gas �,r Rate 104. Floor joists 214. Shower pan ' /roa"i""v�/ `� 7/^Rate 105. Steel 215. Water heater P# yE / yew ewer /�74t-T5 106. Grout lift 216. Roof drains 107. Shear nailing 217. Building sewer ,�,,pper�# //ren iw W/PlelM24, 11,a4- 108. Diaph nailing 218. Water service 109. Roof nailing 219. Final gas j0'221 t Dk��` �,Y 110. Framing 220. Fixtures 111. Occ/Area Sept.Wall 221. Final plumbing whit 1112.12. Sound walls 222. Sewer cap/demo. it 4 ,,ps„i a,�_„( s r rid 114. Insulation-Flr. Pool Inspections Date I. Insp. t ( riti 'r'Vb l�ry�"`�(yU c n asp 115. Insulation-Wall 240. Excavation/steel 40bE. OK WP N.i D 116. Insulation-Cell. 241. Rough plumbing 1L. 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. Anal building 2021-1 9 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Anal electric Electrical Inspections Date Insp. 249. Final.lumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Under.round conduit 153. Underslab conduit Reroof Inspections Date I 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. bondin! Sign Inspections Date I Insp. 160. Service panel 280. Setback/overhang 161. Final electric 281. Footing 282. Conduithvirin. Mechanical Inspections Date Insp.' 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC Miscellaneous Insp. 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. Flood dry chem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. Date I Insp. 191. Final mechanical _ 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess.00l filled 200. Footings 303. Sidewalk 201. SteeVrebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Anal wall 306. Trash bin i -t;-- -,-,$) City of Arcadia,CA iS AC r,,- :Permittalk-184555, l ( - ''' �V77—'`m 5 Permit Type Tenant Improvement � 1{1�(/ Development Services Department �'� Fi �� 11- � F 1W 240 West Huntington Drive,Post Office Box 60021 Er • f Arcadia,CA 91066-6021 'LC"--.),t 4Ay d I; kClassification Tenant Improvement -• (626)574-5416 =� � P.ermrt5tafuslssuedY . xr . ti . :.. ARCADIA IssueDmp 10/11/2018.1 Expiration: 04/09/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 5649 Peck RD Arcadia,CA 8538017019 Contacts 5649 PECK ROAD LLC Owner JTC ARCHITECTS,INC. Applicant 5649 PECK RD 65 N 1st AVE 201,Arcadia,CA (626)254-8884 H C OLSEN CONSTRUCTION COMPANY General Contractor(B) INC 710ELOS ANGELES AVE,MONROVIA,CA 91016 (626)340-7247 Description:T.I.AT&T-CREATE MEN'S AND WOMEN'S ¶ Valuation: S 80.000.00 Tenant AT&T RESTROOMS ON FIRST FLOOR,REMODEL SECOND FLOOR BATH ROOM WITH EMP Total Sq Feet: 0.00 Plan Check 418-1555 Plan 4 32607 Fees Amount Payments Amount Paid Accessibility Plan Check $103.06 Total Fees $3,049.93 Accessiblity Building Permit $105.70 Cash/Receipt 4 REC-002559-2018 $1,699.71 Building Issuing Fee $44.35 Cash/Receipt 4 REC-002137-2018 $1,350.22 Building Permit Fees $1,057.00 Building Plan Review Fee $687.05 Amount Due: $0.00 Cal Green Plan Check $68.71 Commercial T.I.Fire Plan Chk. $280.00 Electrical Permit Issuance Fee $44.35 Energy Plan Review Fee $211.40 Fixture with Trap/Misc. $12.46 Floor Drain Fee $37.38 CALLS FOR INSPECTIONS Green Building Standard $4.00 Request for inspection by telephone at 626-574-5450. Leave a message Lavatories $99.68 requesting the address,timeframe and what inspection item is needed. Mechanical Permit Issuance Fee $44.35 Outlets-Receptacles&Switches $9.24 Plumbing Permit Issuance Fee $44.35 This permit/plan review expires by time limitation and becomes null and Solid Waste Management Fee $6.25 void if the work authorized by the permit is not commenced within 180 days Solid Waste Management Fee 2 $1.00 from the date of issuance or if the permit is not obtained within 180 days Solid Waste Management Fee z $1.00 from the date of plan submittal.This permit expires and becomes null and Solid Waste Management Fee 2 $1.00 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 Strong Motion Inst.Program Com $22.40 Arcadia building inspector for a period of 180 consecutive days. Total: $3,049.93 ,F, October 11, 2018 Issued By: Date October 11,2018 Page 1 of 1 •F A• ,_ ir 1 PERMIT/PLAN REVIEW APPLICATION 0 4 * id 10' Development Services Department,240 West Huntington Drive,Post Office Box 60021 0unly or 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 Co e,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 i• e No. I .LI Exp. Date Atcompensation, 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 w rkers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires'a,permit to construct,alter,improve, Carrier �t��ti�DK. demolish,or repair any structure,prior to its issuance,also required the applicant < '7 r for such permit to file a signed statement that he.or she is licensed pursuant to the Policy Number t u r T provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the per tis for one hu dred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt them 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 w h those provisions. compensation,will do the work,and the structure is not intended or offered foro ...I /s sale(Section 7044,Business and Professions Code:The Contractors License Date 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 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 doll={$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 Ai VI (/ 1-1 PR1N AME 'Pule H-!' r)i SeI 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 .onstruction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. (Date (0 /— (r nature - / -1SSS- Building Inspections Date Insp. Plumbing Inspections Date Insp. S"-041 Pe-c-44- (2b 100. Setbacks 210. Under ft/bldg.drain '/S'i. ,94 1�- 101. Rough grade 211. Copper underslab ,f 7,. //.7./t5 102. Figs.&forms 212. Rough plumbing /,��4y; pry PAic kL Fre-7s c.a.. ICE Hh(t-YL, geLcrhRA$ 103. Pre-slab J1�201t' 410‘) 213. Rough gas //1� 104. Floor joists 214. Shower pan ;Oi�1'rr - JIG @Lc U.giutr -M CATE. (3/4 105. Steel 215. Water heater 106. Grout lift 216. Roof drains LWit Fitv"r Agip 5�'ar�z7b erWASTE 107. Shear nailing 217. Building sewer 419/9/1-0 IQ g-Z-- 108. Diaph nailing 218. Water service 109. Roof nailing 219. Final gas 110. Framing �2-4-�s Vl� 220. Fixtures 111. CccfArea Sept.Wall 221. Final plumbing 2-)1-1- (R 112. Sound walls 222. Sewer cap/demo. 113. T-bar.rid 2-1 - - -- 114. Insulation-Flr. Pool Inspections I Date I Insp. 115. Insulation-Wall 240. Excavation/steel 116. Insulation-Ceil. 241. Rough plumbing 117. Drywall nailing .11-`3ifr 11'4 242. 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 2-))-It en.) 246. Fence,gates&signs 122. Anal demofot clear1 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. Unde 'round conduit 153. Underslab conduit Hereof Inspections I Date I Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical /24-it 272. Sheathing nailing - 157. Fixtures /247-/g. N.% 273. Anal reroof 158. G.F.C.I. 159. E..t.bondin. Sign Inspections I Date I Insp. -- 161. Final Service pct c %" , 280.1Footing overhang ■ 161. Final electric �-22-ft ` 1/4 281. Footing 282. Conduittwirin. Mechanical Inspections Date Insp. 283. Disconnect _ 180. VentingRlue 284. Final sign 181. Fumace/A.C. 182. Rouch HVAC Miscellaneous Insp. Date Insp. 183. Fre 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 Sewers&Offsite Insp. I Date I Insp. 191. Final mechanical r "1 300. Lateral(main to PI) 301. Saddle/Y Block Wall Inspections - Date Insp. 302. Cess..d filled 200. Footings 303. Sidewalk 201. SteeVrebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin 5. yt City of Arcadia,CA ryy PermrtNO Elec 18 1729 Development Services Department D �''"- +-' v } F'k.. ,� Permit Type Electrical { 240 West Huntington Drive,Post Office Box 60021 l � 1 tt C� -;N" + .,--,v,fir' ' Li ‘ 4`[Zk Clossi cC -, Ele . ,„ Commercial Arcadia,CA 91066-fi021 . (626) I (626)574-5416 • ' Permit Status Issued ' ARCADIA . Issue nate:o9/2o/2o1a Expiration: 03/19/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 15649 Peck RD Arcadia,CA 8538017019 Contacts 5649 PECK ROAD LLC Owner Dba: Anthony Electric Dba: Anthony Electrical Contractor 5649 PECK RD Electric (C-10) 10207 Freeman AVE,Santa Fe Springs,CA 90670 (323)268-9311 Description:ELECTRICAL FOR AT&T T.I - Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check N Plan Ft Fees Amount payments Amount Paid Distribution Panel $15.55 Total Fees $102.63 Electrical Permit Issuance Fee $44.35 Cash/Receipt U REC-002353-2018 $102.63 Motors,Generators 1-10 hp $15.55 Amount Due: $0.00 Outlets-Receptacles&Switches $26.18 Solid Waste Management Fee 2 $1.00 Total: $102.63 ,2":12---1 1 5 COMPIEE f_i_ u n f52f J} I CALLS FOR INSPECTIONS �V/'S l/ (/6�- V ' `t 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. September 20,2018 Issued By: Date September 20,2018 Page 1 of 1 to- h PERMIT/PLAN REVIEW APPLICATION a '" E4i�' Development Services Department, 240 West Huntington Drive,Post Office Box 60021 ,Iv 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 yeffect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class e- /t Li nse No. t'5 f#b p Exp. Date //�.0D�/r compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor •U. � y y 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 's issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Camey VENRJIQOL)(L /4041QilNe_EIJC,et/f E es demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number O '5r/LI 901-S 9 9 —I 7 —af,—1... 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 0 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 g/�I�� O ureV�rG/ <0i/ sale(Section 7044,Business and Professions Code:The Contractors License Date u Signat d.[.Lt,//� , V 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 L _ 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(I).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 contractors)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 4NTo/NEr,E ,C. sJi rrm e.- (Title AAmuJ. A-55r ' 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. /� y�, (� çSinature £,L,,. ( OI'rU4l/uQ `Date 7 —� C/ i 6 S ; _ + 1. r+ _- Permit Na FIRE 19 0253 :QS9P City of Arcadia, CA 's; r. Development Services Department p p D PermitType Fire`• 240 West Huntington Drive,Post Office Box 60021 \til e � T WorkCtassificaoon Fire sprinkler: Arcadia,CA 910fi6-6021 - - .. " ""--{ (626)574-5416 • Permit Issued ARCADIA Issue,Date 02/1.2/2019. Expiration. 08/11/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 5649 Peck RD Arcadia,CA 8538017019 Contacts 5649 PECK ROAD LLC Owner WEST COAST FIRE PROTECTION INC* Contractor 5649 PECK RD 13933 Ramona AVE Unit I,Chino,CA 91710 (909)548-4200 899577 Description:RELOCATE 1 HEAD AND ADD 2 Valuation: $700.00 Tenant Total Sq Feet: 0.00 Plan Check#19-253 Plan# Fees Amount payments Amount Paid Fire Issuance $47.01 Total Fees $377.06 Fire Permit Fees $49.05 Cash/Receipt#REC-00336-19 $280.00 Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-00377-19 $97.06 Sprinkler Heads $280.00 Amount Due: $0.00 Total: $377.06 COMP[ETS 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. • February 12,2019 Issued By: Date February 12,2019 Page 1 of 1 40,,,,rcogR,,..4:t 4 ;., I PERMIT/PLAN REVIEW APPLICATION IIII IS -II E n Development Services Department, 240 West Huntington Drive, Post Office Box 60021 '0m°°r,,°r"°" Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION o 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' 1 License Class C I (a License .,,.S 97 57 p. Date r2 VD/el compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor t! performance of the work for which this permit is issued. / OWNER-BUILDER DECLARATION 0 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 _ ©,i /_t-Ct.- 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 them from and the basis for the alleged exemption. Any violation of 0 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, forthwith comply with those provisions. or my employees with wages as their sole 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 a'/1 Z/1e)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'op she hundred thousand dollars($100,000),in addition to the cost ofcompensation, 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.id- 4.- ^^ -- JJJ "Tame /d-� 4A-/ ' (Title 4/2(LScd 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 II / / \Date ?/j 24�g CPC ARO �cfrtroRiNeg011 4:444 °°'`YDir MEMORANDUM Fire Department DATE: March 5, 2019 TO: BUILDING DEPARTMENT INSPECTOR Jeff Wang FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 5649 Peck Road THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 2-20-2019 Jill Perumean FIRE ALARMS TANKS HOOD 8, DUCT KNOX BOX OCCUPANCY 2-20-2019 Jill Perumean COMMENTS: Emailed Bldg. Dept. 5-5-2019 Jill