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HomeMy WebLinkAboutTI-18-2070 •
I'� `,I City of Arcadia,CA { } , . Permit Na T1-18;2070
I Development Services Departmentfs) ' H Permit Type•Tenant Improvement
240 West Huntington Drive,Post Office Box 60021 f-
Arcadia,CA 91066-6021 V . 17M1 l�k Classification:Tenant Improvement
Li
(626)574-5416 - t - Permit St• atus:Issued :
Al2CADIAIssue 12/17/2018 Expiration: 06/15/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1
558 Las Tunas DR Arcadia,CA 8586001010
Contacts _ }�
SIEN,RICHARD AND GRACE TRS ET AL R Owner JASON WANG Applicant
AND G SIEN TRUST AND HSIEH,DAVID 1081 OVERLOOK RIDGE RD,DIAMOND BAR,CA 91765
556 W LAS TUNAS DR (626)720-7999
LY ENGINEERING INC* General Contractor(B)
2972 JUNE ST,SAN BERNARDINO,CA 92407
(626)905-7718 1019146
Description:NEW KITCHEN EQUIPMENT IN BAR AREA FOR Valuation: $35,000.00 Tenant HOKEE CAFE
HOKEE.NEW ADA RESTROOM.WITH EMP
Total Sq Feet: 0.00 Plan Check#18-2070 Plan 0 32649
Fees _ Amount Payments Amount Paid
Accessibility Plan Check $59.99 Total Fees $2,016.48
Accessiblity Building Permit $61.53 Cash/Receipt it REC-003168-2018 $1,393.52
Building Issuing Fee $44.35 Cash/Receipt ft REC-002815-2018 $622.96
Building Permit Fees $615.25
Building Plan Review Fee $399.92 Amount Due: $0.00
Cal Green Plan Check $40.00
Commercial T.I.Fire Plan Chk. $280.00
Electrical Permit Issuance Fee $44.35
Energy Plan Review Fee $123.05 ,yri4C 3—/2547
Floor Sink $62.30
Gas System(Outlets) $62.20 CALLS FOR INSPECTIONS
Green Building Standard $2.00 Request for inspection by telephone at 626-574-5450. Leave a message
Hood Serviced by Mechanical Exhaust $14.11 requesting the address,timeframe and what inspection item is needed.
Kitchen Sink $49.84
Lavatories $12.46
Mechanical Permit Issuance Fee $44.35 This permit/plan review expires by time limitation and becomes null and
Outlets-Receptacles&Switches $6.16 void if the work authorized by the permit is not commenced within 180 days
Plumbing Permit Issuance Fee $44.35 from the date of issuance or if the permit is not obtained within 180 days
Solid Waste Management Fee $6.25 from the date of plan submittal.This permit expires and becomes null and
•
Solid Waste Management Fee 2 $1.00 void if any work authorized by thisc�Mpermitpl is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Solid Waste Management Fee 2 $1.00 Arcadia building inspector for a period of 180 consecutive days.
Total: $2,016.48
�fD nd
. -4/2
December 17, 2018
Issued By: Date
December 17,2018 Page 1 of 1
. of AR
0,0ruc3/4„.d _
. PERMIT/PLAN REVIEW APPLrCATION
• ethk. .,
:ij 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
❑ 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,andmylicense is in full force and effect ) ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class .0 License a 0 (9' Exp. Dad hII' ° 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 DECLARA ION ❑ I have and will maintain workers'compensation insurance,as required by Section
o 1 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 rs issued.My wort rs'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 7 L Fa IA%
demolish,or repair any structure,prior to its issuance,also required the applicant Q�/
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number / IS( �7'710 1
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need no be comp et d if the pe t�s 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 0 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 th(�ose provisions.
compensation,will do the work,and the structure is not intended or offered for Date (D---C 1 —1 6 Signature '-r
sale(Section 7044,Business and Professions Code:The Contractors License
1111.
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 am 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(I)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
contractors)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.
,. `
arae I, r� Al♦l ► 1 Title o1/1 n_vt
PRINT AME'
IJ
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
ISto enter upon the above-mentioned property for inspection purposes. 2
ignamre IcS?/ }ate te(Z-i 1-1 tL
SSB i-a . Tt&' S DR-
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. ' l_ .Q _ Zoty�v
100. Setbacks 210. Under fir/bldg.drain 12,Qۥ15 /
101. Rough grade 211. Copper underslab
102. Figs.&forms 212. Rough plumbing INS(6 17_!`7 gaud.* EZe vtc I.4 WA-a-5
103. Pre-slab 213. Rough gas
104. Floor joists 214. Shower pan OF Ktizasa 4seance. Pig* a7.zy$
105. Steel 215. Water heater
106. Grout lift 216. Roof drains _ y.,l,�.,�,
107. Shear nailing 217. Building sewer (_� ' / r/a-l 1'`a ' /
108. Diaph nailing 218. Water service ?a-.SAA/(- Triroa C Rapt J
109. Roof nailing 2_19. Final gas G
110. Framing I -(� �i'7 220. Fixtures
111. Occ/Area Sept.Wall // 221. Final plumbing 5-Y-(9 14:7/1-2.5:11 Pi°-ka4..04c- ems- 2 atoll/
112. Sound walls 222. Sewer cap/demo.
113. T-bar.rid KCsar Pu.G .{Kllx"-vf Acke-
114. Insulation-Flr. Pool Inspections Date Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Cell. 241. Rough plumbing Z?-Ict f 4( t't 8 ti-t . -1146/ BEY
117. Drywall nailing 242. Light shell/bonding
118. Interior lath 243. Underground conduit /Sj`¢Yac F20-+ iLG'�
119. Exterior lath 244. P-trap
120. Finish grade E�"46. Gasline&test
121. Final building 34 84.1246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Anal electric
Electrical Inspections Date Insp. 249. Anal•lumbins
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Unde lround conduit -
153. Underslab conduit Retool Inspections Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical f- 4, ificre 272. Sheathing nailing
157. Fixtures 273. Anal reroof
158. G.F.C.I.
159. Ett.bondins Sign Inspections Date Insp.
160. Service panel0. Setback/overhang .
161. Final electric 2-2.141A717/22881. Fooling
282. Conduitkvirin,
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC Miscellaneous Insp. Date Insp.
183. Fire dampers 290. Are alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Anal
189. Commercial hood
190. Duct shaft Sewers&Of!site Insp. Date Insp.
191. Anal mechanical 3-'f4t *:/ 300. Lateral(main to PIL)
301. Saddle/Y
Block Wall Inspections ' Date Insp. 302. Cess•••I filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
.l,N 41 �u �1N fi p px
F Gam'' ��grom.''Hy '64:4-------#0x aamr wFgrt 1 �`�_Y * jar ;aawsatr :I�` 5': -, ar Cr''' Ms. -aI
SS 71e. , 9 r,4,„/Vo t$aa. Mi R �� ,r u, .a�
.DMaF'"�.w.,' � C"�•� y / - '1'E"E1 ,fir 4 ''� �A♦Vt 4,74-44 a 5";� `^ ‘.
X99
I ,•'.[..
14
I, '
tie: i
twi
'%.. (4,s Certificate of Occupancy a
d / City of Arcadia
" Q Development Services Department—Building Division 1:.. ;it.;
iii
This certificate issued pursuant to the requiissuancerementsThis of thestructure was in n�,.
1, ``' ilding Code certifying that at the time of
California Bu
^PI teat ; compliance with the various ordinances of the City regulating building construction or use.
0d' e
est tt
44
�`' Permit No. TI-18-2070
t(
Building Address: 558 LAS TUNAS DR ARCADIA, CA 91006 t�
�t` -
Permit Type: TENANT IMPROVEMENT
Effective CBC: 2016 C.B.C. (d d.
Occupancy Code: A-2C-G
Zone Code:
•
Final Date: 3-18-19 TypeTYPE VB SPRINKLERED ��°�
`�G ,� of Construction:
F
Owner: SIEN TRUST Tenant: HOKEE y
•
/ nw
, ,,(1...../
�'
Kenneth Fields,Build' Official s "
" r
wit kg\
p 1
i Post in Conspicuous Place
a a*� gk '� W:: .Nea., n. 3."kb.:. . '6..vrvhl w ,n .W 3
n
�^ ''tea / 4444:0- ,��yryc,� fT \ rII ! tV ��p` �
44,4
,ate
•
I L WAS if TO I- —� �-- 17: = ; 41 I w l�f.+•a:".. '7� 1.-.'
I • •• •• �.� • ,rte ----:w �.,
Illnnnnnmmilumumllllllllll������lllllpoinii ililllllll��ll I'l nummol Or o®` . , I (N)SER1/ICE AREA; 1 •
�tIIII
1' "a._ Y
0 (E)WALK—IN 0 . flEicikif , )
D4 COOLER a.� ;: ,r�
is lfl_ i, - � ;�•ti
)PANEL°A'eE PANEL"3" IIII IIIIII I III IIIIIII IIII III IIIII:II IIII I III IIIIIIIIIUIIx `i+ 0 I,
' { -t...,:„.:4- -•
-4" 8-3" 8'-3" f it?r• _ • .9'- 5 � . •
EINALJN_SPECTION AND APP9QVAL ?- v ,•• _ l_—"-l vim•YUL15ait;"-el32-:
. aro required prior to beginninn OPefatirtg., „� .. ..t.„,,./.., ' s,vi aE"::,...::!k_..t.17 i-t;�k;LitlC
The Deportment requires©T LGAS T jR e j cy{r4 r
t
WQRLCIMG DAYS PRIOR notice to arrange 7 �5,,: a 1 ` r ,_ .- n
for final Inspection.
CE31 P PGPCD� t F`S '-� ,1 fr H L" Ef9.@ IS
p ,. , ' A"P'.."6/,'•:1-, CILVE Iyiy*j�'S1�'fI12.. 1de E•OP:
•
�t - _ ... . •
BEGIN . - ' ,O9v-.:-v 'V
SECTION ` •
�` adOFl a(3Ui'oT:S;L`SfL`�IS?TlT
HEALTH ;LOS ANGELES COUNTY . ' .'~�.F3Eit YiiS/Y'r',3.+,£tC91;.?fVOTAU7'FO ETHE VIOLATION OFIIINY
A.COUNTY - B€FARTMENT OF PUBLIC HEALTH i a r W,OR13YtiAINL'E[�?;lt£GyJLMION.
FLAN CHECK PROGRAM I , { - '
-"^O 5PSA COMMERCE DRIVE•
•
_ r/
. ,:.-rECTION BALDWIN PARK, CA 91706 r k� ;:5 TA:.
Jl Q��Y:
` Ba6.430-5560 ' '�/ 3„1.COUNTY Ii&U,Tk3 OFFICER
•
`.4 ;. . ftAiltf3121 iIt9A1SMFT(Ag!ACS)
ANY CMNnr:•-;Try n 0nOVEO PLAN (wan
' • 'MC T r E NI:OLUC H 1' ...YOUR FLAN
. CHECKERS ATTEr',TION
g ,
=frrs
a:.. . -'t,y.-"`.R.i' �' �:a :Lti'Cf7i:'c.".,s7. a,+Lz �:.o`."•tX�ieirT•; i.
16 17
a 9
r — -
•
COUNTY OF LOS ANGELES• DEPARTMENT OF PUBLIC HEALTH
tI#.pw ENVIRONMENTAL HEALTH
t !Air
pp.,
tA ' + SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
tk..� p yf PLAN CHECK PROGRAM-BALDWIN PARK
COMM'OF LOS ANGELES
•
x°4w0-00 X 5050 COMMERCE DR,BALDWIN PARK,CA 91706 Public Health
PHONE: (626)430-5560
WWW PUBLICHEALTH LACOUNTY GOV/EH
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 03/18/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0164433
PROGRAM ELEMENT 1704-RESTAURANT(4,000-9,999 SF)
OWNER/REQUESTER JASON HONNG,DESIGNER
DBA HO KEE CAFE
ADDRESS 558 LAS TUNAS DR,ARCADIA,CA 91007
FINAL REINSPECTION STATUS: APPROVED
GORRECTIONSCOMPLETED
:•.a' re,.b i,wx w -�. n .1.,r�.,.�>. �.e.� s,., °,.. «._� »£�o� v ". w. .�a .. x. �,r6.. ,�`} �s�,. �-x}__.., _.
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED
PLAN SUBMITTAL/REMODEL 03/13/2019 03/18/2019
PLAN SUBMITTAL/REMODEL 03/05/2019 03/13/2019
ADDITIONAL REQUIREMENTS
RECEIVED A COPY OF THE BLDG.FINAL.
THIS FACILITY IS APPROVED AND ARE OK TO OPERATE CONTINGENT UPON
THE INSTALLATION OF THE SELF-CLOSING DEVICE AT THE DELIVERY DOOR AND
SEALING THE GAP AT THE BOTTOM OF THE DELIVERY DOOR.
THE DISTRICT INSPECTOR WILL CONDUCT A ROUTINE INSPECTION AND ISSUE A LETTER GRADE.
r
COMMENTS
NONE
Help us serve you better by completing Ia short survey.Visit our website at www.oublichealth.lacountv.gov/eh
EHS Signature Page 1 of 2
City of 21,-0/0/4
Los Angeles Uniform Code Program
Uniform Procedure I-7: Special Inspections
Special Inspection Report
• DISCREPANCY • CONFORMANCE _
All discrepancies shall be.brought to the Immediate atenfion of If work conforms to approved design and code requirements,submit
the Contractor for correction. if corrections are not made in a this reportto Building Deparbnent and copies to Contractor,Engineer!
timely manner,this report shall be used as a discrepancy notice. Architect of record and Owner no later than the business day fallowing
Submit the original to BiNding Departrnentand copies to the conclusion of the special Inspection, For inspections greater than.5
. Contractor,Engineer/Architect of record and Owner. days duration,submit a conformance report at least once every week.
This Is a: oe Progress Report • Final Report Report No. 3 Page No. _1_of_1_
' r
// or_pdon Protect
s -g ,/ /eafri 74#1°.• cii.gr 'ec Seder/i6 _z •'
Permit Number: Ar nnpineer of Record: Contractor:
.Z /f-2o 70 ,CczE e' �/6itJ Of E11G�irE,�1u�° �
Full Name of Special Inspection: City Registration Number: Company: Phone Number:
Huan Van Bui P013049 e'er 4" VanBui Inspection 714-345-8266
Gv2�oi 3
Type of Inspection:
❑ Reinforced Concrete a Structural Masonry o Piling,Piers &Caissons a Smoke Control
o Prestressed/Post-tensioned o Botts In Concrete/Masonry o Excavation and Fills a Energy Compliance
Shotcrete/Gunite o Structural Welding o Spray-Applied Fire Proofing a Testing Reports
o Insulating Concrete/Gyperete a High Strength Bolting e-Other
Time Time
Date Arrived/�� Departed Description and Location of Work Inspected
/72,/67 %'/I' / / /o/6G$a,r,e..) CZ) ke/77- c7S /2 4/7
a4-. 4-47%
g fria5 or (z) ctg
h/CT, /o'hnce, , Qfyl7i/--e.dii�S
') .//CT l/srir-T ,e92-/e ,K4-'a'
Remarks: z ele-c7�a cc &'o// r -i''27, e-g3
I HEREBY DECLARE THAT THE FOLLOWING IS TRUE TO THE BEST OF MY KNOWLEDGE
. :AM,OR MY COMPANY IS,RETAINED BY THE OWNER OR THE ARCHITECTIENGINEER OF RECORD TO PROVIDE SPECIAL
INSPECTION FOR THE WORK COVERED IN THIS REPORT.
2. I HAVE PERFORMED THE REQUIRED INSPECTION DURING THE TIME PERIOD AS STATED ABOVE.
3. THE WORK COVERED IN THIS REPORT IS IN CONFORMANCE TO THE APPROVED PLANS,SPECIFICATIONS AND APPLICATION
WORKMANSHIP PROVISIONS OF THE CODE,EXCEPT AS INDICATED OTHERWISE.
Signature: l/ e _ Date /72-S-47
Huan Van Bui, Deputy Inspector
i4, Perml NO.
A'� m� amity of Arcadia,CA � +� _ . SIGN 19-0060
I - lip Development Services Department rit• 4'"", •,!;,,,III Permit Type Sign'
s
h VII 240 West Huntington Drive,Post Office Box 60021 ` T
' I ', ik , Work�ClassWcatroR Slgnt Iilurtiutated!.
I �. Arcadia,CA 91066-6021 s it h
I (626)574-5416 ';'� a . 3,,PI41 ' Permit Status:Issued
ARCADIA Issue Date 01/10/2019 Expiration: 07/09/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number {r
[558 Las Tunas DR Arcadia,CA 8586001010 1
LL Contacts 1
SIEN,RICHARD AND GRACE TRS ET AL R Owner Signs Express Mfg Co.• Electrical Contractor
AND G SIEN TRUST AND HSIEH,DAVID (C-10)
556 W LAS TUNAS DR 1438 Santa Anita,S El Monte,CA 91733
(626)443-3333 552097
Description:ONE CHANNEL LETTER ILLUMINATED SIGN FOR HO Valuation: $2,480.00 ' Tenant
KEE CAFE Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount payments Amount Paid
Building Issuing fee $47.01 Total Fees $297.35
Building Permit Fees $120.35 Cash/Receipt#REC-00069-19 $297.35
Electrical Permit Issuance Fee $47.01
Amount Due: $0.00
Sign Connection $15.55
Sign Plan Review $60.18
Solid Waste Management Fee $6.25 0 '`_—
Solid Waste Management Fee 2 $1.00 EL/J�,L 3-485-6 `
Total: $297.35
wisiiiil CALLS FOR INSPECTIONS
Request for Inspection by telephone at 626-574-5450. Leave a message
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.
January 10,2019
ssued By: Date
January 10,2019Page 1 of 1
afrpo
Obi r PERMIT/PLAN REVIEW APPLICATION
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
U 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. '.�611 Exp. Date 1110 19• compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor �,/
it
performance of the work for which this permit is issued.
OWNER-BUILDER DEC 4ARATI 4P '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 he work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My wgrkeaconsation insurance Cartier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier �1�`"`'' t1,,''/,,``TC(°°AA�II;
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number (0'Kr)f7--
•
for such permit to file a signed statement that he or she is licensed pursuant to the (this section need not be completed if the permit is for one hundred dollars or less)
provisions of the Contractors License Law(Chapter 9(commencing with Section
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 ❑II 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 ( � ' Iq
1 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(I)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.j
Name WVeV�0..f,1r Tut Title C.Qi✓'
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 th
above-mentioned property for inspection purposes.
Signature t , 10
Date I 1 10 ( ��
City of Arcadia, CA 'Permit NO FIRE-18=2289 '
M j t ' \9( i PermftType:F?
re
Development Services Department iJ
240 West A 9106 -6 Drive,Post Office Box 60021 J
Arcadia,CA 91066-6021 � ���)� �.? iti t, � Work Classification Fre Sprinkler
(626)574-5416 •
Permit States:2Issued
i
ARCADIA issue Date'01/02/2019 l Expiration: 06/10/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
558 Las Tunas DR Arcadia,CA 8586001010
Contacts . _._.
SIEN,RICHARD AND GRACE TRS ET AL R Owner F&H Fire Protection' Applicant
AND G SIEN TRUST AND HSIEH,DAVID 1119 Westminster AVE,Alhambra,CA 91803
556 W LAS TUNAS DR (626)262-3876 DANIEL@FHFIREPRO,COM
Description:FIRE SPRI NKS(8 HEADS)AND FIRE NOZZLES(10) Valuation: $ 2,000.00 Tenant !
FOR TI. Total Sq Feet: 0.00 Plan Check#18-2289 Plan#
L
Fees Amount payments Amount Paid
Fire Extinguishing System Plan Check $280.00 Total Fees $709.00
Fire Issuance $44.35 Cash/Receipt If REC-000003-2019 $149.00
Fire Permit Fees $103.65 Cash/Receipt#REC-003088-2018 $560.00
Solid Waste Management Fee 2 $1.00
Sprinkler Heads $280.00 Amount Due: $0.00
Total: $709.00
D tOgin
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
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-
•p
January 02, 2019
I -ued By: Date
January 02,2019 Page 1 of 1
OF A'
opmFORV,„<
Pal PERMIT/PLAN REVIEW APPLICATION
ji -..moi -+
z�D*' Development Services Department,240 West Huntington Drive,Post Office Box 60021
°m° 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 Busines an.
Professions Co e,,d• license is in ful forV,ffect. Q I have and will maintain a certificate of consent to self-insure for workers'
License Class i License No. r Exp. Date J 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
Q I hereby affirm under penalty of perjury that I am exempt m 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. y workerslt'compensation insurance carrier an policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier rrPLl,—le3S ir'vi YG1�f2 (j.Pvt C�/
demolish,or repair any structure,prior to its issuance,also required the applicant of
.�j (�
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number W G / b 6r U V.>—
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 ❑II 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'compensationvvvprovisions of Section 3700 of the Labor Code,I shall
I, as owner of the property, or my employees with wages as their sole for hwitl}t y ith those provisions.
compensation,will do the work,and the structure is not intended or offered for I // •
sale(Section 7044,Business and Professions Code:The Contractors License Date Z 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
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverageis 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).
Q 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 CL14f SL.f/17 /i/// w Title ( . ✓
PRINT 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--mmentioned property for inspection purposes.
Signature C Date i /1 7