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HomeMy WebLinkAboutUntitled on City of Arcadia, CA 7 PermtrNo P.Ium 18 1744'' I Development Services Department Drkr. Permit Type Plumbing d ` { 240 West Huntington Drive,Post Office Box 60021 i f -j i t i 11 i Arcadia,CA 91066-6021 � � i':Work cfassificonon Plumbing Resldenttal (626)574-5416 � *i' - Permit Status Issued ARCADIA issue Date 09/24/2018 Expiration: 03/23/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 47 Woodland LN Arcadia,CA 5770003009 Contacts DING,GANG Owner Tierra Engineering&Designs Inc.DBA General Contractor(B) 47 WOODLAND LN CATALINA BUILDERS 1739 Calatina DR,Pomona,CA 91766 (626)241-6121 Description:NEW MAIN WATER LINE AND GAS LINE Valuation: 5 0.00 Tenant Total Sq Feet: 0.00 Plan Check if Plan f! Fees Amount Payments Amount Paid Fixture with Trap/Misc. $12.46 Total Fees $73.36 Gas System(Outlets) $15.55 Cash/Receipt U REC-002380-2018 $73.36 Plumbing Permit Issuance Fee $44.35 Amount Due: $0.00 Solid Waste Management Fee 2 $1.00 Total: $73.36 /-7 4/ (77/ur l 0re5_514re 'Seib ok CALLS FOR INSPECTIONS CO?tfPLETEU Request for einspectiondesby telephonefmentd 626-what inspection Leaveema message ded. 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. • /4 September 24, 2018 Issued By: Date September 24,2018 Page 1 of 1 .F AR onUroRN'a<t 1 PERMIT/PLAN REVIEW APPLICATION 01 ,;,W h' Fila' 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 O I hereby affirm under penalty of perjurythat I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: I Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Cod nd my license is in full force and effect. /y,� ❑ I have and will maintain a certificate of consent to self-insure for workers' icense Class L' erase N...,:/ Exp. Dale©y/�6�'' 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 I have and will maintain workers'compensation insurance,as required by Section he ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for ns performance of the work for which this permit Law for the following reason(Section 7031.5,Business and Professions is issued.M orke 'coenation surance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier Q Cq / rit7 et demolish,or repair any structure,prior to its issuance,also required the applicant 9 L�� (/ for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number 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 d 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 A 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 II workers'compensation provisions of Section 3/%0 of the r Code,I shall ❑I, as owner of the property, or my employees with wages as their sole fo thw h comply w h those provisions. compensation,will do the work,and the structure is not intended or offered for aa�� / - sale(Section 7044,Business and Professions Code:The Contractors License ' Date 9/G /�d�/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 '1 hundred thousand dollars.($100,000);in addition to the cost of compensation, did not build or improve for the purpose of sale). r 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). 0 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. r Ii Q6C/A2?°l N e / •✓ L/' ;/,,,6 i ME Title PRINT NAME I II that I have read t j.pplication and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I dgree to comply 'th r, City ord'- . ' es and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter 4o/#a above-, �- 'ave/eeddproperty for inspection purposes. 2///57 / f/�/ r$� nature / ./// ` Date 9/2'V// 5 •