HomeMy WebLinkAboutUntitled 4:444NCity of Arcadia, CA ;_, 2' ` 1 r
Permit NO TI-19-0222
Nit. { Development Services Department D�' - ,r Permit Type•Tenantlmproverflent-
240 West Huntington Drive,Post Office Box 60021 4. ¢ m
` Arcadia,CA 91066-6021 ti‘c WOrB Classrficanon Tenant Impr?yement
(626)574-5416 " : 2t s
� - -,--.0CIC-` ''` PermJtstatf!snlssued '
ARCADIA ='` Issue+oate 02/04/2o19° Expiration: 08/03/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
21 S FIRST AVE Arcadia, CA 5773013017
Contacts
QUYNH TRAN Agent for owner HUANG,JUN L CO TR JUN AND LING Owner
HUANG TRUST
(626)616-4925 9707 NAOMI AVE,ARCADIA CA,91007-7413
Description:REMOVE INTERIOR PARTITION WALL,ADD NEW Valuation: 800.00 Tenant
PARTITION WALL AND SPA CHAIRS Total Sq Feet: 0.00 Plan Check# Plan#IN FILE
Fees Amount payments Amount Paid
Accessibility Plan Check $5.20 Total Fees $372.08
Accessiblity Building Permit $5.33 Cash/Receipt#REC-00296-19 $372.08
Building Issuing Fee $47.01
Building Permit Fees $53.25 Amount Due: $0.00
Building Plan Review Fee $34.62
Cal Green Plan Check $3.47
Electrical Pl Permit IssuanceFee $47.01 1' COMPLETED
Energy Plan ReviewwFeea $10.65
Fixture with Trap/Misc. $87.22
Green Building Standard $1.00
Outlets-Receptacles&Switches $21.56 CALLS FOR INSPECTIONS
Plumbing Permit Issuance Fee $47.01 Request for inspection by telephone at 626-574-5450. Leave a message
Solid Waste Management Fee $6.25 requesting the address,timeframe and what inspection item is needed.
Solid Waste Management Fee 2 $1.00
Solid Waste Management Fee 2 $1.00 I
Strong Motion Inst.Program corn $0.50 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
Total: $372.08 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.
Dk>.."---.... February 04, 2019
Issued By: Date
February 04,2019 Page 1 of 1
AR
4 vu.ron,ti. f
4 ;s i PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
,:z.:.„.4.43:1,2,
m=a�.,orN 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 License No. Exp. Date 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 Contractor
OWNER-BUILDER DECLARATION ❑ 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 his permit
License Law for the following mason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.My 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
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
0 I certify that in the performance of the work for which this permit is issued,I shall
exempt there from and the basis for the alleged exemption. Any violation of
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($5(10)): compensation Laws of f alifomia,and agree that if I should become subject to the
workers'compensation provisions of Sec i r i 3700 of the a r Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered for , - ,`,
sale(Section 7044,Business and Professions Code:The Contractors License me` _. - - -^'+'$ignattire .
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 buiden 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's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions CONSTRUCTION LENDING AGENCY
Code:The Contractors License Law dews not apply to an owner of property
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
__.._-Sfgnatu)e® /' Lender's Address
IMPOR ANT: APPLICATION IS HE' mMADE 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. JlI
acme a/A y/�'( 7—gilt
/ Title
il
G PRINT NAME
' ertify 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
Acadia to enter i n tin,above-men 'i n:1 property for inspection purposes. Q
Signa .1111.- !L� t a ' Date •
t /
tl 111
NOTES
Building Inspections Date 'Insp. Plumbing Inspections Date Insp. 21 5_ PQS j
100. Setbacks 210. Under flr./btdg.drain /"� J G� ��Z ZZ
101. Rough grade 211. Copper underslab -re/
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. Roof nailing 219. Final gas
110. Framing 220. Fixtures L "�
111. Occ✓Area Sept.Wall 221. Final plumbing 3j�?�� yu
112. Sound walls 222. Sewer cap/demo. V
113. T-bar grid
114. Insulation-Fir. Pool Inspections Date . Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Cell. 241. Rough plumbing
117. Drywall nailing 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 245. Gas line&test
121. Anal building 246. Fence,gates&signs
122. Anal demo/lot clear 247. Pool heater
248. Final electric
ectrica Inspect', Dab - I 249. Final.lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting _ 51. Pool final
152. Under.round conduit -( ,,, -
153. Underslab conduit Reroof Inspections Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical 272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E..t.bondin. Sign Inspections Date Insp.
160. Service panel 280. Setback/overhang
161. Final electric 3.44°I 281. Footing
282. Conduithvirin.
Mechanical Inspections Date Insp." 283. Disconnect
180. Venting/flue 284. Anal sign
181. Furnace/A.C.
182. Rouch HVAC Miscellaneous Insp. Date Insp.
183. Fire 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. Flood dry diem.
188. Compressor setback 295. Final
189. Commercial hood
190. Duct shaft Sewers&Offsite Insp. Date Insp:
191. Anal mechanical 300. Lateral(main to PtL)
301. SaddleN
lock Wa Inspections Date Insp. 302. Cess...1 filled
200. Footings 303. Sidewalk
201. SteeVrebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Anal wall 306. Trash bin
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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: / � - Date=Q ?.-J/-X 1g- —
Property Address: a J. S. Rot Aia , A w piA 91006
Owner's Name: TU h(L.0 O 4N G
Owner's Address: 17-U i-' NAOt-ti /6015:
v
Phone # Cos) coo - 9gco
Agent's Name: ,• all YN 4-1 —reA---I
Agent's Address: 61/S1._/26i9 2g;ifOHRA00,-St , HCE-S�.�
Agent's Phone#: COC) 6L E —Isa-f^
Scope of Work: P/-11//t1b//l/4'
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.