HomeMy WebLinkAboutWALL-18-0121 ' a 7
City of Arcadia, CA C Perm tivq:_Wall 18-0121'
Development Services Department _ Permtt Type Wall .
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240 West Huntington Drive,Post Office Box 60021 -
Arcadia,CA91066-6021 i (2iJ1ijI'kg1 :
work ClassfficUnon•Garden.Wall .
( (626)574-5416 - " - - "
sr- -- - Permlt St6Yur.'ISSued
ARCADIA _ issuevDate 02113/20181 Expiration: 08/12/2018
Addr NO. Dir Prefix Street Name Street Suffix City,State,Zip Parcel Number
820 W Orange Grove AVE Arcadia,CA 5769015008
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Contacts - _ `_..... .�..-_:...�....
I KIM,EDWARD H AND MICHELLE CTRS Owner Garden View General Contractor(B)
EDWARD AND MICHEELE KIM TRUST 417 E Huntington DR 100,Monrovia,CA 91016
820 ORANGE GROVE AVE (626)303-4043
(626)394-6248
Description:5 PILASTERS,4'HIGH,GATE MOTOR Valuation: $337.32 Tenant
Total Sq Feet: 0.00 Plan Check N Plan it
Fees Amount payments Amount Paid
Building Issuing Fee $44.35 Total Fees $144.22
Building Permit Fees $40.65 Cash/Receipt If $144.22
Electrical Permit Issuance Fee $44.35
Motors,Generators<1 hp $7.62 Amount Due: $0.00
Splid Waste Management Fee $6.25
Solid Waste Management Fee 2 $1.00
Total: $144.22
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Insert a permit notice prefix in the report text bank,entry:
Permit Notice Prefix
' gr ZrVe j172/7,41,. /lev/ o/14/47,_c CC__
This permit/plan review expires by time limitation and becomes null and
in COMPLETED void if the work authorized by the permit is not commenced within 180 days
from the date of issuance or if the permit is not obtained within 180 days
from the date of plan submittal.This permit expires and becomes null and
void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
1.4
.1
't
\ - February 13,2018
Issued By: Date
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February 13,2018 Insert a permit page footer in the report text bank,entry:Permit_Page_Footer Page 1 of 2
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cPs"RyG.o
,r.• PERMIT/PLAN REVIEW APPLICATION
is „„ , i_
1: Development Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
JV:�I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
'h apter 9(commencing with Section 7000,of Division 3 of the Business and
Professions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License ClasACd7/CS3 License No.Lt(EsSiV Exp. Date Sia/I$ compensation, as provided for by Section 3700 of the Labor Code, for the
_Q_,_ _ performance of the work for which this permit is issued.
Signature of Contractor T i /�ccr��
OWNER-BUILDER DECLARATION! f: 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�y,,w��ojjrkers'�/compensation insursyue camd policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 42/-- / 1it't � /' �f
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number n(lp/lef J[/V(�/
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 co ed 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 roe )LeI'3Jie
hwith comply with those pr,isions.
❑ property,rty, or my employees with wages as their sole ,,
compensation,will do the work,and the structure is not intended or offered for gnature ( rte t-vsale(Section 7044,Business and Professions Code:The Contractors Licensev
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:Failureto 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
attomey.sfees.
❑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:
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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
—24further information.
e ® Title
PIiNT 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.
`x/ Q i
/Sig 'e �r�' 77r. Date o2-/
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