HomeMy WebLinkAboutRALT-18-2051 3
Permit No 'RACY 18 2051
op[ ., City of Arcadia,CA 14' t i t'= ,,
i 1 f. Development Services Department D r' Jf f'"ts 5'Thiv
Pierm rtType Residential Addition/Alteration
((
240 West Huntington Drive,Post Office Box 60021 al 't--1 t t r
99 , - s i WotkCtosstficatlon Res Remodel '
Arcadia,CA 91066-6021 ' - �i tm.i 1. '4 t.}`�J
I (626)574-5416 .Permit status:issued.
ARCADIA . issue Date:11/01/2018- Expiration: 04/30/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
320 San Luis Rey RD Arcadia,CA 5775018029 I
Contacts
,
WANG,XUEQIAO AND TIAN,JING Owner ENVIRONMENTAL 911* General Contractor(B)
320 SAN LUIS REY RD b
(626)319-7292 (818)720-7139 769610 't
Description:REPLACE BOTTOM 2 FEET OF Valuation: $500.00 Tenant '
DRYWALL/INSULATION IN KITCHEN DUE TO WATER DAMAGE .
AMENDED 12-10-18 ELECTRICAL AND PLUMBING Total Sq Feet: 0.00 Plan Check# Plan#
Fees • Amount Payments.. Amount Paid
Building Issuing Fee $44.35 Total Fees $264.34
Building Permit Fees $40.65 Cash/Receipt#REC-002778-2018 $119.18
Building Plan Review Fee $26.43 Cash/Receipt#REC-003092-2018 $145.16
Electrical Permit Issuance Fee $44.35
Amount Due: $0.00
Garbage Disposal Fee $24.92
Green Building Standard $1.00
Kitchen Sink $24.92 ter caw �gin
Outlets-Receptacles&Switches $4.62 l pPlumbing Permit Issuance Fee $44.359B
Solid Waste Management Fee $6.25
Solid Waste Management Fee 2 $1.00 CALLS FOR INSPECTIONS
Solid Waste Management Fee 2 $1.00 Request for inspection by telephone at 626-574-5450. Leave a message
Strong Motion Inst.Program Res $0.50 requesting the address,timeframe and what inspection item is needed.
•
Total: $264.34
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
(j'-� / ��, ( �-, 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 4'
/ November 01, 2018
Issued By: Date
December 10,2018 Page 1 of 1
< Gp.FoSC...t•
,:Pan I PERMIT/PLAN REVIEW APPLICATION
it milt j 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
0 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 ffoorcejand effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class Lic se No. b GI 0 Exp. Date f0/31 Ot 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 DE LARA ON ❑ 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../M�y workers'c1ompen anon insurance carrier and policy numbers am:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier.Ii-ii i Vei T mt.YUn C P Se/t/i CL'3
demolish,or repair any structure,prior to its issuance,also required the applicant r� linJ33 jar
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number !Q
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 ❑ 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 structureis not intended or offered for ((( tl�f� 1i
sale(Section 7044,Business and ProfessionsionsCode: ,
Date /
ode:The Contractors License Z lO` Signature
Law does not apply to an owner of property who builds or improves thereon, 1
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 pl,(A ✓ ?its CO JT grid him
PRINTATitle
B,4 .
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. �J
t\\Signature ; /�� Date /210-15
�/Of 5
City of Arcadia,CA7 CPI Permit No RALT 18-2051
Development Services Department $ iyr"- t Lf..` r -tPeerrmit Type Residential Addition/Alteration
240 West Huntington Drive,Post Office Box 60021 t-a' ` a1 €c .1� 1.1 l i c I E WorkClassigcatlon:Res-Remodel_,
I Arcadia,CA 91066-6021 t ��L.f i, ;„.!� t -
1 (626)574-5416 :.
Permit Status:I'n Review
ARCADIA /7__ •• .-/`g Issue-Date. I Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
320 San Luis Rey RD Arcadia,CA 5775018029
Contacts
WANG,XUEQIAO AND TIAN,JING Owner ENVIRONMENTAL 911* - General Contractor(B) E
320 SAN LUIS REY RD
(626)319-7292 (818)720-7139
Description:WL /IREPLACE
IOIN BOTTOM 2 FEET OF Valuation: S 500.00 Tenant
DRYWALL/INSULATION IN KITCHEN DUE TO WATER DAMAGE.
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $119.18
Building Permit Fees $40.65 Cash/Receipt#REC-002778-2018 $119.18
Building Plan Review Fee $26.43
Green Building Standard $1.00 Amount Due: $0.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Res $0.50
Total: $119.18 v t .$.( 3j CALLS FOR INSPECTIONCOAIPIETEn
Request for inspection by telephone at 626-574-5450. Leave a message
w '
_ I jg 'rl "1 11°t la
—I requesting the address,timeframe and what inspection item is needed.
YRYWC � This permit/plan review expires by time limitation and becomes null and
r 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
J�/�/� from the date of plan submittal.This permit expires and becomes null and
/ 4 �� 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 .
Issued By: Date -
November 01,2018 Page 1 of 1
•P •R
cyroxnr,:r .
PERMIT/PLAN REVIEW APPLICATION
4. _ „...ii
"EIDE' Development Services Department,240 West Huntington Drive, Post Office Box 60021
°%,„„„,er," 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 a _Lice se No. (]Exp. Date/0'3i'�y compensation, as provided for by Section 3700 of the Labor Code, for the
/�, r performance of the work for which this permit is issued.
Signature of Contractor Lice
OWNER-BUILDER DELLA' illi ❑ 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'com ensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 1:n, h4 riS(/ivn ce S C✓l//cr.S
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number U�d7 Jr O R3f 8
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 ❑ 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 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. 4
Name P C i[,3 co ✓ G PR12/ /flfle "up crap/ de - .
PRINT NAME
I certify that I have read this application and state that the above information is co ect 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
f enter upon
the above-mentioned property for inspection purposes.
Signature c �( X ----.. ate II —0 r — t8