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✓s 18 ; a-. City of Arcadia, CA Permit No TI 1502 T ' i Development Services Department 7 \Jy �., q" "t PermitT a Tenant Improvement 240 West Huntington Drive,Post Office Box 60021 } ,,/Y br � J4 YP P . ; 1€ t�C --- orkCiassi canon tenantim rovement Arcadia,CA 910 6 6-6 0 21 �. _ (626)574-5416 'az, =,+i. ' --iPermit Status:Issued; s i' �ti :# ARCADI!?I , Issue Date 08/20/2018_ Expiration: 02/16/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip 1220 5 Golden West AVE D Arcadia,CA 91006 II Contacts Landtec Development Inc Contractor 9080 Telstar 307,El Monte,CA 91731 (626)280-8358 Description:T.I.V U A KHO BO INC Valuation: S 1,500.00 Tenant V U A KHO BO INC Total Sq Feet: 0.00 Plan Check#otc Plan# Fees Amount Payments Amount Paid Accessibility Plan Check $8.06 Total Fees $506.72 Accessiblity Building Permit $8.27 Cash/Receipt ft REC-002078-2018 $506.72 Building Issuing Fee $44.35 Amount Due: $0.00 Building Permit Fees $82.65 Building Plan Review Fee $53.73 Col Green Plan Check 80.00 Lam''/A C 9d64a G _,,,,r j� Commercial T.I.Fire Plan Chk. $280.00 !� �/`� 7 (J— Energy Plan Review Fee $16.53 Green Building Standard $1.00 Solid Waste Management Fee $6.25 Strong Motion Inst.Program Com $0.50 CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message Total: $506.72 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 nulland 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. 1 GOWILETED August 20, 2018 . Ise y: Date August 20,2018 Page 1 of 1 .F AR I. _ y. eUFnR e • - • '1 PERMIT/PLAN REVIEW APPLICATION 4 , � F 0.4 IsFElp .11 4flt Development Services Department,240 West Huntington Drive, Post Office Box 60021 -Jr Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia f) 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:1pChapter 9(commencing with Section 7000,of Division 3 of the sines Professions Codq,and my license is in full forc and effect. t p?/ ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class ' ense N . Exate Y compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Conn ctor 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 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 A 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 it 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 t �forthwi omply ith those provisi compensation,will do the work,and the structure is not intended or offered for Yb sale(Section 7044,Business and Professions Code:The Contractors License Date �Signam s- ` 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 Title PRINT NAME flcertify 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 rcadia to enter upoentioned property for inspection purposes. S.1 bature Date a— / t. NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 100. Setbacks 210. Under fir./bldg.drain 101. Rough grade 211. Copper underslab 102. Figs.&forms 212. Rough plumbing 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan 105. Steel 215. Water heater 106. Grout lift 216. Roof drains 107. Shear nailing 217. Building sewer 108. Diaph nailing 218. Water service 109. Roofnailing 4 19. Final gas 110. Framing g"' ming Z�"'�8 220. Fixtures 111. Dcc/Area Sept.Wall 221. Final plumbing 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. /�"�� 41. Rough plumbing 117. Drywall nailing `r-Y-ig 242. Light shelVbonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. P-trap 120. Finish grade45. Gas line&test 121. Anal building 1-10-18 h46. Fence,gates&signs 122. Anal demo/lot clear , 247. Pool heater 248. Anal electric Electrical Inspections Date lnsp. 249. Anal.lumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Undereround conduit 153. Underslab conduit Reroof Inspections Date Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground71. Roof framing 156. Rough electrical et-Y-48 / 72. Sheathing nailing -_ 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. Bit.bondin. Sign Inspections Date Insp. 160. Service panel //280. Setback/overhang 161. Anal electric °I`t6-i8 281. Footing 282. Conduitwirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Anal sign 181. Furnace/A.C. 182. Rouch HVAC Miscellaneous Insp. I Date Insp. 183. Are dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Are sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Anal -189. Commerdal hood 190. Duct shaft Sewers&Offsite Insp. I Date Insp. 191. Anal mechanical 300. Lateral(main to P/L) 301. Saddle/? 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 or:Os 44,0% COUNTY OF LOS ANGELES• DEPARTMENT OF PUBLIC HEALTH I ;p`} ENVIRONMENTAL HEALTH SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH }*.o, ... yF PLAN CHECK PROGRAM-BALDWIN PARK Cowry bLos:mums xGuwalloX 5050 COMMERCE DR,BALDWIN PARK,CA 91706 Public Health PHONE:(626)4305560 VJJJW.PUBLICHEALTH.LACOUNTV,GOV/EH PLAN CHECK OFFICIAL INSPECTION REPORT DATE 09/06/2018 EHS CHENG SHAO PLAN CHECK NUMBER SR0153629 PROGRAM ELEMENT 1701 -RESTAURANT(0-500 SF) OWNER/REQUESTER KEN FANG, DESIGNER,9095692069 - DBA VUA.KHO BO INC. ADDRESS 1220 GOLDEN WEST AVE D,ARCADIA,CA 91007 FINAL INSPECTION STATUS: APPROVED ADDITIONAL REQUIREMENTS APPROVED MARKET RETAIL, NO PI-IF COMMENTS. APPROVED OK TO OPEN - Help us serve you better by completing a short survey.Visit our website at waw.oublichealthlacounty.gov/eh. Operator Signature Page 1 or 2 PLAN CHECK OFFICIAL INSPECTION REPORT DATE 09/06/2018 EHS CHENG SHAO PLAN CHECK NUMBER SR0153629 PROGRAM ELEMENT 1701 -RESTAURANT(0-500 SF) OWNER/REQUESTER KEN FANG, DESIGNER,9095692069 DBA VUA KHO BO INC. ADDRESS 1220 GOLDEN WEST AVE D,ARCADIA,CA 91007 DISCLOSURES It is a misdemeanor violation to begin operation without a valid Public Health Permit/License.The Public Health Permit/License will be issuedby the Los Angeles County Department of Public Health Environmental Health Division(DPH-EH) Plan Check Program at the job site following final inspection and approval by all applicable agencies. Remodeled areas of an existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior to use. Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food facility/establishment or change of menu may require plans to be submitted to the DPH-EH Plan Check Program. Additional approvals maybe required from other enforcement agencies. It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or gratuities In connection with performing their official duties. Improper solicitations include requests for anything of value such as cash,discounts,free services,paid travel or entertainment,or tangible items such as food or beverages. Any attempt by a County employee to solicit bribes,gifts or gratuities for any reason should be reported immediately toeither the County manager responsible for supervising the employee or the Fraud Hotline at(800)544-6861 or www.lacountyfraud.org. YOU MAY REMAIN ANONYMOUS Public Health Permit/License: A separate fee is required for the Public Health Permit/License.A billing statement will be sent to the permit/license holder annually by the DPH-EH. The fee is required to be paid to perform or carry on,conduct or engage in any mobile food facility listed in Los Angeles County Code,Title 8,Section 8.04.720. State and Local Licenses and.Permits: Contact the State of California and your local city hall regarding additional license and permit requirements. Restrooms: Customer may use restroom facilities if they are located in a customer area.Customers may not enter the food preparation area,food storage area,or the utensils washing/storage areas in order to access the restrooms.All food,utensils and equipment must be protected from contamination. Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County. Following the issuance of your Public Health Permit by the Plan Check Program,an Environmental Health Specialist from your local district will conduct an inspection of your facility. If your Business is located In a city that has adopted the grading ordinance,the inspector will post a grade or score card at your facility. Grade/Score cards are not issued by the Plan Check Program. Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacountv.00vleh. Operator Signature Page 2 of 2