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Home My WebLink AboutRoof . ;, City of Arcadia, CA Permit NO ROOF-194%19. Development Services Department e ;- r-r"y"'.^"Y rf a Permrt,Type ROOF' 1114 240 West Huntington Drive,Post Office Box 60021 < 33 f.- `1 ``tt)) Arcadia,CA 91066-6021 , ,Li, 3 1 Wocasslhcaeon ReroOf;Resldential' j (626)574-541fi `• - Permit Status:Issued ARCADIA Issue ate os/01/2019 I a Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit • City,State,Zip Parcel Number 178 W Palm DR Arcadia,CA 5788015002 n Contacts _ LEUNG,NANCY F ET AL LEE,KARMAN Owner A&J ROOFING SERVICE CORP Contractor 301 Foxdale Ave,West Covina,CA 91790 957 5 LORENA ST,LOS ANGELES,CA 90023 (323)266-3156 877485 Description:T/0 AND REROOF HOUSE AND ATTACHED GARAGE Valuation: $ 15,000.00 Tenant WITH OWENS CORNING,CLASS A,DIMENTIONAL COMP OVER NEW SHEATHING,COLOR:MOJAVE Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount payments Amount Paid Building Issuing Fee $47.01 Total Fees $374.01 Building Permit Fees $320.75 Cash/Receipt#REC-01100-19 $374.01 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $374.01 S--3 19 gpor siirafiti dN\ ✓ COMPLETEt CALLS FOR INSPECTIONS 51-9 -15 / , �L Request for inspection by telephone at 626-574-5450. Leave a message /lav 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. May 01, 2019 Issued By: Date May 01,2019 Page 1 of 1 • 'r- . _ •el .;:;„per r4, PERMIT/PLAN REVIEW APPLICATION E@i� Development Services Department, 240 West Huntington Drive,Post Office Box 60021 '• 4,,,,,,,,-`" 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: i 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 L 311 License Na (n-7'4 Cs Exp. Date 5"3j-20 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. .i,• ave and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER D ION IT - 3700 of the Labor Code,for the performance of the work for which this permit ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions 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 applicantolic " I LF for such permit to file a signed statement that he or she is licensed pursuant to the his s Number efY provisions of the Contractors License Law(Chapter 9(commencing with Section 's section need not be completed i the rmit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is ❑t 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 of employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): mpensation Laws of California,and agree that if I should become subject to the orkers'compensation provisions of Section 37�^00`fof the Labor Code,I shall I, as nsa owner , the property, forthwith comply with those provisions / ❑ or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for LI sale(Section 7044,Business and Professions Code:The Contractors License I 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 111 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: I. 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. rs'l aneO Cinit <y Title _ r PRINT NAME P 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 u on the above-mentioned property for inspection purposes. _Signature Date CC( / /1--I • �'VFa�,p� :p u3ii . lei AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS ' Property Address: f 7 g WO_ PPae/f1Dr, . AYeaJJi . CA 9/007 Permit Number: WOOF -`°I - O`?I Brief Job Description: _t c 90e Number of,smoke alarms'installed: W Number of carbon monoxide alarms installed: C2— When When alterations, repairs or additions requiring a permit occur,.or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outsideeach 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 containingfuel burning appliancesor having attached r. 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 pf 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/Iicensinolistinilsilicenselistinq brill searchcotest.php As owner,of the above referenced property,I hereby certify thatthe•smoke alarms and carbon monoxide alarms have been installed in accordance with themanufacturer's instructions andin compliance with the code sections referenced above. • declare under penalty of perjury that the f re oin is true and correct, and Manilla declaration was executed on(Date) 671 I f 9 at Arcadia, California. Owner's Name(printed/typed): Lt6 KAR 1-0 ('ftP CL ' :...„,..._1_______,---' Signature of Owner- This affidavit must be returned to the City.of Arcadia inspector prior to final inspection • 1