HomeMy WebLinkAboutPATIO-18-1817 City of Arcadia, CA -cPermit NO Patio-18-1817
Development Services Department Permit Type':Patio
240 West Huntington Drive,Post Office Box 60021 ..+
,,- Y r a Workclassification'Patio,
Arcadia,CA 91066-6021 1 , ✓ �, L �k = _ _ -,
(626)574-5416 - . ' r'++ t ,-Permit Status Estimate .
ARCADIA - Issue Date 10/03/2018 Expiration: 04/01/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
247 E Haven AVE Arcadia,CA 5772022003
Contacts
CHUNG,JACKIE C Owner TAI LY Agent for owner
247
(818)395-6440
Description:ATTACHED OPEN COVERED PATIO AT REAR OF Valuation: 5 4.51416 Tenant
HOUSE. 3 RETRO FIT WINDOWS PER APPROVED PLANS.
Total Sq Feet: 164.00 Plan Check#18-1817 Plan#OTC e
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $305.88
Building Permit Fees $153.75 Cash/Receipt#REC-002484-2018 $305.88
Building Plan Review Fee $99.94
Amount Due: $0.00
Green Building Standard $1.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Res $0.59
Total: $305.88
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CALLS FOR I ECTIONS
NiIriSftGT)o,a - Request for inspection by telephone at 626-574-5450. Leave a message
l requesting the address,timeframe and what inspection item is needed.
- L,4An INC- f �j k-L-- L • This permit/plan review expires by time limitation and becomes null and
void if the work authorized by the permit is not commenced within 180days
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.
i
`\ October 03, 2018
ss -d By: Date
October 03,2018 Page 1 of 1
1 man It PERMIT/PLAN REVIEW APPLICATION
em 411/ 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
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ILICENSED CONTRACTOR'S DECL'A'RATION WORKERS'COMPENSATION DECLARATION
❑i I here( a ,u rder penalty of peijpff h[I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
I. Chapter 9(commencingzwith:Sec`tion 7000,of Division 3 of the Business and
n:my icenseiis.In full force and effect.
❑ I have and will maintain a certificate of consent to self-insure for workers'
� ILicense/Professions Class=Code,deaLicense No"`� . Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
Si nnture o Contractor ��`�\ performance of the work for which this permit is issued.
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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
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 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 roe forthwith comply with those provisions.
property,rty, 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 Dates i�.S giratuies"3
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 am 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.
0 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
Dated /�3,'^ !'tSignatare`t 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
liefurther infoorrm—attiion.
//7t- / Title
YPRINT NAME
rtify 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-igree 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 th•• . ,. ••-mentioned property for inspection purposes. Z
Signature DaO /O /3//i
FORni't+
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AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: Zif�-f -A01V & 1 ./ , ywAa c% gL00
Permit Number:
Brief Job Description:
Number of smoke alarms installed: 3
Number of carbon monoxide alarms installed:
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created,
Smoke alarms shall be installed in each sleeping room, and outside each separate
sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the
dwelling, including basements and habitable attics as required by Section R314 of the 2016
California Residential Code (CRC) and California Health and Safety Code Section 13113.7.
For dwellings or sleeping units containing fuel burning appliances or having attached
garages, carbon monoxide alarms shall be installed outside each separate sleeping
area in the immediate vicinity of the bedrooms, and on each additional story of the
dwelling, including basements as required by Section R315 of the of the 2016 California
Residential Code (CRC).
Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used.
All alarms shall comply with requirements for listing and approval by the Office of the State Fire
Marshal. http://osfm.fire.ca.qov/licensinglistings/licenselistinq bml searchcotest.php
As owner of the above referenced property, I hereby certify that the smoke alarms and carbon
monoxide alarms have been installed in accordance with the manufacturer's instructions and in
compliance with the code sections referenced above.
I declare under penalty of perjury that the foregoii g is rue and correct, and that this
declaration was executed on (Date) // /ID / at Arcadia, California.
Owner's Blame (printed/typed): V,, OL�cA 2 LA
Signature of Owner:
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
SMOKE ALARM AND CARBON MONOXIDE ALARM LOCATIONS
Guest Room _ � 3athrau.
IStorage
0 gi
I I Family Room la
ima Garage
1.---------:-- 'Pill
FIRST FLOOR PLAN
11 = SMOKE ALARM ® = CARBON MONOXIDE ALARM
L Mstr
I_Int
aatlr
rQ, Master Bedroom
Dining Room Kitchen 30
Bath
A --
Closet
Hall 0 u
t 1 closet
----- - Closet
Family Room ® "'
CD CD
"' — Bedroom Bedroom
SECOND FLOOR PLAN •
ID=SMOKE ALARM ® = CARBON MONOXIDE ALARM
of AR
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City of Arcadia • Building Division
240 West Huntington Drive,Arcadia CA 91007
Office: (626) 574-5416 Fax: (626) 447-9173
When the permit application and the Owner-Builder Declaration have been executed by a person
other than the property owner, prior to issuing the permit, the following shall be completed by
the property owner and returned to the agency responsible for issuing the permit:
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal
responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign,
and file the documents necessary to obtain an Owner-Builder Permit for my project.
I declare under penalty of perjury that I am the property owner for the address listed above, and
I personally filled out the above information and certify its accuracy.
Property Owner's Signature: i Date: MI3/13
Property Address: Z±t E • /R1 fail vn
Owner's Name: (Ta c k
Owner's Address: Z I/q' ( /Ntn /Q
Phone # C ) ,32--1 Vol to I k
•
Agent's Name: 7f4-Z Ly
Agent's Address: pL6( /}0ic,ZA r--P pi
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Agent's Phone#: g(8) 3 9)/- c- C5
� Rrt(atnnte t 4 3 taesh:+3 w.ntl.ws
Scope of Work: 7-) parsed a now pni o OW.. sr ) .
NOTE: This authorization must be NOTARIZED or accompanied by a copy of the
homeowner's current photo I.D. (i.e., driver's license, passport or military I.D.
with signature), when presented for issuance of a permit.
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