HomeMy WebLinkAboutTI-18-2263 tal:141Thr+ a' ' %ity of Arcadia, CA Permit NO TI-18-2263,
X - Development Services Department ID ,-t, Permit Type:Tenant Improvement
\ ttt 240 West Huntington Drive,Post Office Box 60021
ei Arcadia,CA 91066-6021 kir II f -� .- I k C1ossificabon:'Tenant Improvement
. j (626)574-sa16 "n`-- - ' - PermitstatUi Issued'
ARCADIA Issue Date'01/29/2019 1 Expiration: 07/28/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 102 Arcadia,CA 5773009069
Contacts
HUNTINGTON LANMARK LLC Owner PATCH CONSULTANTING CORP Applicant
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 1701 W CEDAR ST 9,ALHAMBRA,CA 91801
(626)203-7921
SPIRIT GENERAL CONSTRUCTION" General Contractor(B)
(626)922-1698 578216
Description:INTERIOR TI FOR LAN NOODLE HOUSE. WITH EMP Valuation: $ 35,000.00 Tenant LAN NOODLE HOUSE
Total Sq Feet: 0.00 Plan Check#18-2263 Plan#32671
Fees Amount Payments Amount Paid
Accessibility Plan Check $59.99 Total Fees $2,241.72
Accessiblity Building Permit $61.53 Cash/Receipt#REC-00241-19 $1,338.76
Building Issuing Fee $47.01 Cash/Receipt it REC-003073-2018 $902.96
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 CU!VIPL
Fee $123.05Fixture with Trap/Misc. $12.46
Floor Drain Fee $49.84 CALLS FOR INS ECTIONS
Floor Sink $24.92 Request for inspection by telephone at 626-574-5450. Leave a message
Gas System(Outlets) $90.11 requesting the address,timeframe and what inspection item is needed.
Green Building Standard $2.00
Hood Serviced by Mechanical Exhaust $28.22
Install,Relocate Appliance Vent/Hood $37.52 This permit/plan review expires by time limitation and becomes null and
Kitchen Sink $87.22 void if the work authorized by the permit is not commenced within 180 days
Lavatories $12.46 from the date of issuance or if the permit is not obtained within 180 days
Light Fixtures $4.62 from the date of plan submittal.This permit expires and becomes null and
Mechanical Permit Issuance Fee $47.01 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
Outlets-Receptacles&Switches $30.80 Arcadia building inspector for a period of 180 consecutive days.
Total: $2,241.72
RAJA-t_ (, .3 . 'C3
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January 29, 2019
v
Issued By: Date
January 29,2019 Page 1 of 1
.FAR
,..0.0ro'H'4`
meow PERMIT/PLAN REVIEW APPLICATION
:
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Et i*' Development Services Department,240 West Huntington Drive,Post Office Box 60021
\ /e 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 eff t. ((]] ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class License No.s, xp. Date-1rll q compensation, as provided for by Section 3700 of the Labor Code, for the
13
Signature of Contractor performance of the work for which this permit is issued.
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 this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, er
demolish,or repair any structure,prior to its issuance,also required the applicant
for such permit to file a signed statement that he or she is licensed pursuant to the olis s Number
provisions of the Contractors License Law(Chapter 9(commencing with Section olds ection 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. A
or my employees with wages as their sole p //
compensation,will do the work,and the structure is not intended or offered for Date ��2g l� •` J`
sale(Section 7044,Business and Professions Code:The Contractors License 1lSignature
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./r`4
ame VAl C t c s /, Fe
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-mentioned property for inspection purposes. //� /
\Signature _ _ — \Date C L 29' (� f 7
`f(( E- Mi nnrci7ea (ol
NOTES _•
Building Inspections Date Insp. Plumbing Inspections Date Insp. --1 - /9- - Z z&3
100. Setbacks 210. Under fir/bldg.drain
101. Rough grade 211. Copper underslab e
102. Figs.&forms 212. Rough plumbing 7.Z7-(9 - 3-ZG•19 hit-7(44-w_ Nan/04_ ras
103. Pre-slab 213. Rough gas y.S•/9 t���
104. Roar joists 214. Shower pan (X ,S1A4 L,A42Lf /16-,.4) 1,,,c). ?I--
105. Steel - 215. Water heater tC.3. t9 a Aver
106. Grout lift 216. Roof drains ����//,,,,���� Si,� �1,,
107. Shear nailing 217. Building sewer ,1111- rte. S'-i 7�3r 4p z.-
108. Diaph nailing 218. Water service 9.5.J,l {/c& v vcr (,Sr l-try(-2 dz-
109. Roof nailing 219. Anal.astie)
110. Framing 2•ZZ•19 C..-- 220. Fixtures t/--9'/R 2 - 4,4-$E /7 &s rex_
., ..
111. Occ/Area Sept.Wall 221. Anal plumbing 5-30.11 ' - ¢csK treat,:real,
112. Sound walls 222. Sewer cap/demo.
113. T-bar.rid
114. Insulation-Flr. Pool Inspections Date Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 242. Light shelVbonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 245. Gas line&test
121. Final building (9•3.19 '^--� 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Anal.lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. 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 1.•;2--1/ `P-- 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 281. Footing
282. Canduit/wirin. •
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. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fre sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Final
189. Commerdal hood
190. Duct shaft Sewers&Offsite Insp. Date Insp.
191. Final mechanical 5.30- 300. Lateral(main to P/L)
301. Saddle/1'
Block Wall Inspections ' Date Insp. 302. Cess.00l filled
200. Footings 303. Sidewalk
201. SteeVrebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
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Certificate of Occupancy l
'' tr City of Arcadia
? Development Services Department—Building Division i;9
@ i :a�\/
405. �+.„�_3 This certificate issued pursuant to the requirements of the
ii ' California Building Code certifying that at the time of issuance this structure was in
.. 1 c} compliance with the various ordinances of the City regulating building construction or use. <
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Permit No. TI-18-2263s` '`
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Building Address: 411 E. HUNTINGTON DR#102 ARCADIA, CA 91006 ea
Permit Type: TENANT IMPROVEMENT Effective CBC: 2016 C.B.C.
A,45
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Occupancy Code: B Zone Code: C
v Final Date: 6-3-19 Type otConstruction: TYPE V SPRINKLERED 1/
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1 Owner. HUNTINGTON LANMARK LLC Tenant: LAN NOODLE HOUSE 1r---1-,
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?�or wS4 COUNTY OF LOS ANGELES • DEPARTMENT OF PUBLIC HEALTH 4,,,--.
�' r. �`�, ENVIRONMENTAL HEALTH
f I { SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
k .�„ # PLAN CHECK PROGRAM-BALDWIN PARK COUNTY OF LOS ANGELES
x°luiocN«X 5050 COMMERCE DR,BALDWIN PARK,CA 91706 Public Health
PHONE:(626)430-5560
WNW.PUBLICHEALTH.LA000NTY.GOV/EI j
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 06/04/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0167847
PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF)
OWNER/REQUESTER PATRICE,ASSISSTANT
DBA LONZHOU BEEF NOODLE
ADDRESS 411 E HUNTINGTON DR 102,ARCADIA, CA 91006
FINAL CHARGEABLE REINSPECTION STATUS: APPROVED
CORRECTIONS COMPLETED
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED
PLAN SUBMITTAL/REMODEL 06/03/2019 06/04/2019
PLAN SUBMITTAL/REMODEL 05/22/2019 06/04/2019
PLAN SUBMITTAL/REMODEL 04/23/2019 05/22/2019
SCOPE OF OPERATION
APPROVED TO STOCK PREPACKAGED/NON-POTENTIALLY HAZARDOUS FOODS
APPROVED TO STOCK PERISHABLE/POTENTIALLY HAZARDOUS FOODS
APPROVED FOR FOOD PREPARATION
ADDITIONAL REQUIREMENTS
ALL VIOLATIONS CORRECTED. RECEIVED BLDG. FINAL.
THIS FACILITY IS HEALTH DEPARTMENT APPROVED; OK TO OPERATE.
THE DISTRICT INSPECTOR WILL CONDUCT AN INSPECTION AND ISSUE A LETTER GRADE.
COMMENTS •
NONE
Help us serve you better by completinga short
tssurvey.Visit our website at www.publichealth.lacountv.nov/eh.
t-/—C...-
Operator Signature Page 1 of 2
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 06/04/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0167847
PROGRAM ELEMENT 1702-RESTAURANT(501-1,999 SF)
OWNER/REQUESTER PATRICE,ASSISSTANT
DBA LONZHOU BEEF NOODLE
ADDRESS 411 E HUNTINGTON DR 102,ARCADIA, CA 91006
DISCLOSURES
It is a misdemeanor violation to begin operation without a valid Public Health Permit/License.The Public Health
Permit/License will be issued by the Los Angeles County Department of Public Health Environmental Health Division(DPH-EH)
Plan Check Program at the job site following final inspection and approval by all applicable agencies. Remodeled areas of an
existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior
to use.
Any future alteration,construction,building,renovation,repair,change of equipment,change of the operation of a food
facility/establishment or change of menu may require plans to be submitted to the DPH-EH Plan Check Program. Additional
approvals may be required from other enforcement agencies.
It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or gratuities in connection with
performing their official duties. Improper solicitations include requests for anything of value such as cash,discounts,free
services,paid travel or entertainment,or tangible items such as food or beverages. Any attempt by a County employee to
solicit bribes,gifts or gratuities for any reason should be reported immediately to either the County manager responsible for
supervising the employee or the Fraud Hotline at(800)544-6861 or www.lacountyfraud.org. YOU MAY REMAIN ANONYMOUS
Public Health Permit/Ucense:
A separate fee is required for the Public Health Permit/License.A billing statement will be sent to the permit/license holder
annually by the DPH-EH. The fee is required to be paid to perform or carry on,conduct or engage in any mobile food facility
listed in Los Angeles County Code,Title 8,Section 8.04.720.
State and Local Licenses and Permits:
Contact the State of California and your local city hall regarding additional license and permit requirements.
Restrooms:
Customer may use restroom facilities if they are located in a customer area.Customers may not enter the food preparation
area,food storage area,or the utensils washing/storage areas in order to access the restrooms.All food,utensils and
equipment must be protected from contamination.
Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County. Following the
issuance of your Public Health Permit by the Plan Check Program,an Environmental Health Specialist from your local district
will conduct an inspection of your facility. If your Business is located in a city that has adopted the grading ordinance,the •
inspector will post a grade or score card at your facility. Grade/Score cards are not issued by the Plan Check Program.
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacounty.aov/eh.
—
Operator Signature Page 2 oft
COUNTY OF LOS ANGELES • DEPARTMENT OF PUBLIC HEALTH
( ENVIRONMENTAL HEALTH
criC
{4. SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
PLAN CHECK PROGRAM -BALDWIN PARK
COUNTY o,.ros ANGELES
5050 COMMERCE DR, BALDWIN PARK, CA91706 Public Health
PHONE: (626)430-5560
VVWVV.PUBLICHEALTH.LACOUNTY.GOWEH
OFFICIAL PLAN REVIEW REPORT
c 01/17/2019 EHS VIVIAN TAN
AN CHECK NUMBER SR0167847
AOGRAM ELEMENT 1702- RESTAURANT(501-1,999 SF)
OWNER/REQUESTER PATRICE,ASSISSTANT
/DBA LONZHOU BEEF NOODLE
ADDRESS 411 E HUNTINGTON DR 102,ARCADIA, CA 91006
/ REVISED PLAN REVIEW STATUS: APPROVED
CORRECTIONS COMPLETED
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED
FLOOR DRAINS/FLOOR SINKS 12/26/2018 01/17/2019
WATER SUPPLY 12/26/2018 01/17/2019
WASTE WATER/PLUMBING 12/26/2018 01/17/2019
EQUIPMENT/STORAGE 12/26/2018 01/17/2019
FOOD PROTECTION/FOOD STORAGE 12/26/2018 01/17/2019
VENTILATION 12/26/2018 01/17/2019
PLAN SUBMITTAUREMODEL 12/26/2018 01/17/2019
•
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacounty.gov/eh.
EHS Signature Page 1 of 3
OFFICIAL PLAN REVIEW REPORT
DATE 01/17/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0167847
PROGRAM ELEMENT 1702 - RESTAURANT(501-1,999 SF)
OWNER/REQUESTER PATRICE,ASSISSTANT
DBA LONZHOU BEEF NOODLE •
ADDRESS . 411 E HUNTINGTON DR 102,ARCADIA, CA 91006
ADDITIONAL REQUIREMENTS
THE REVISED PLANS ARE APPROVED, SUBJECT TO ON-SITE INSPECTION PRIOR TO OPERATION OR STOCKING
FOOD ON THE PREMISES. APPROVAL IS CONTINGENT UPON THE FOLLOWING:
1) OBTAIN LOCAL BUILDING DEPARTMENT PERMITS AND APPROVALS.
2) SUBJECT TO ON-SITE INSPECTION AND APPROVAL. ALL EQUIPMENTS MUST BE CERTIFIED OR CLASSIFIED
FOR SANITATION BY AN AMERICAN NATIONAL STANDARDS INSTITUTE(ANSI)ACCREDITED CERTIFICATION
PROGRAM OR AN ACCREDITED TESTING AGENCY.
3)ALL USED AND/OR EXISTING EQUIPMENT AND FINISHES SHALL BE IN GOOD REPAIR AND ARE SUBJECT TO
ON-SITE INSPECTION AND APPROVAL.
4) ENSURE THAT THE COMMERCIAL HOOD AND MECHANICAL EXHAUST AND MAKE UP AIR SYSTEMS MEET THE
UNIFORM MECHANICAL CODE.
5) READ AND COMPLY WITH THE FOLLOWING ATTACHMENTS REGARDING:
A) FINAL INSPECTION NOTICE
B) PLAN APPROVAL CHECK LIST
C) CERTIFIED FOOD HANDLERS CERTIFICATE
6) HEALTH DEPT. APPROVED SET OF PLANS SHALL BE MADE AVAILABLE-SITE AT THE TIME OF FINAL
INSPECTION.
CONTACT VIVIAN TAN AT 626 430-5546NTAN@PH.LACOUNTY.GOV TO SCHEDULE A FINAL INSPECTION.
PROVIDE AT LEAST 3 WORKING DAYS PRIOR NOTICE FOR A FINAL INSPECTION.
A FINAL INSPECTION SHALL BE CONDUCTED AND A PUBLIC HEALTH PERMIT SHALL BE OBTAINED PRIOR TO
OPENING AND OPERATING THIS FOOD ESTABLISHMENT.
COMMENTS
NONE
•
Help us serve you better by completing a short survey.Visit our website.at www.oublichealth.lacountv.gov/eh.
—✓
EHS Signature Page 2 of 3
OFFICIAL PLAN REVIEW REPORT .
DATE 01/17/2019 EHS VIVIAN TAN
PLAN CHECK NUMBER SR0167847
PROGRAM ELEMENT 1702- RESTAURANT(501-1;999 SF)
OWNER/REQUESTER PATRICE,ASSISSTANT - _
DBA LONZHOU BEEF NOODLE
ADDRESS 411. E HUNTINGTON DR 1.02,ARCADIA, CA 91006
DISCLOSURES
Prior to construction and approval from.the Los Angeles County Department of Public Health Environmental Health Division
(DPH-EH) Plan Check Program, final inspections must be obtained from Building and Safety (mechanical, plumbing, electrical)
• and all other enforcement agencies.
Failure to obtain a-Public Health Permit/License prior to operation of the facility/establishment is a misdemeanor violation.
Construction of the food facility/establishment must be completed and approved within twelve (12).months from the date of
approval to avoid submitting new plans.
A copy of the,approved plans must be available at the time of the field construction review.
All utilities must be on and operational at the time of the field construction review.
Please contact your plan check inspector at least 3 days prior to the field construction review.
Two field inspections will be covered under the Plan Check fees assessed upon plan submission.
A charge will be assessed for each subsequent field construction review.
•
•
•
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacounty.gov/eh.
EHS Signature Page 3 of 3
h tl
#tl City of Arcadia, CA Permit NO SIGN-190344.'
[\ 141/17.
14(/17, Development Services Department 1 '-
n�- b w--.�-; 4 �-'• Pefmft Type Sigr1
5 f 240 West Huntington Drive,Post Office Box 60621 ' 4 r"' J I �I t} r
Arcadia,CA 91066-6021 br U i work C/assiJicauon•Sign-,Illuminated
"'I (626)574-5416 -PermitStatusilssued
ARCADIA Issue Date 02120/2019 Expiration. 08/19/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR Arcadia,CA 5773009069
Contacts
HUNTINGTON LANMARK LLC Owner ALEXIS ESTRADA Contractor
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 1928 TYLER AVE F,SOUTH EL MONTE,CA 91733
(562)441-3172 432339
Description: 1 LED SIGN FOR LANZHOU BEEF NOODLE Valuation: $ 2,200.00 Tenant c '�
Total Sq Feet: 0.00 Plan Check ft Plan N
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $364.14
Building Permit Fees 5120.35 Cash/Receipt tJ REC-00448-19 $364.14
Electrical Permit Issuance Fee 547.01
Amount Due: $0.00
Sign and Branch Circuit $65.86
Sign Connection $16.48
Sign Plan Review $60.18
Solid Waste Management Fee 56.25
Solid Waste Management Fee 2 $1.00
Total: $364.14
CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
9
fvA-L xrequesting the address,timeframe and what inspection item is needed.
•3.1 —
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.
ellifiperip
February 20, 2019
Issued By: Date
February 20,2019 Page 1 of 1
•FAIR
d,"°'
il 1;;,-• 1 PERMIT/PLAN REVIEW APPLICATION
oki\0. 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 Co.e . dm license is in II .rce apo 'ect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
If License Class i i. �w:_/7_1/( `_I Exp. Date, compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor \\ V performance of the work for which this permit is issued.
OWNER-BUILDER DELL- ' TION ❑ 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'compensation insurance tamer and policy numbers are:
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 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
exempt there from and the basis for the alleged exemption. Any violation of Oi I certi 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 of e 'toy any person in any manner so as to beco u..ect t• a workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and- -- that if sh. . o I 'ect to the
workers'compensation provisions o - 1\.!700 0�, �i . ,I shall
❑I, as owner of the property, forthwith comply wi those provision• \ ,+
or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for I Q"�1
Silink
sale(Section 7044,Business and Professions Code:The Contractors License ate V�/ \ 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($100,000),in addition to thecost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for
further information.fo � `V1 LYE
yA�—//{N$me VN": V.W-rk Title 41 / \v1 '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 comp '.1 all C, or C. .. and S . aws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter pon + • .bo•I enti+ t , k•rty ' pection purposes.
Signature 1 ` .Date 2--- 1 0 if
•
c240a Permit No FIRE-19,0715
C City of Arcadia, CA
Development Services Department D / 4 6 +fl �`1=� Permit Type:Fire
t
West Huntington Drive,Post Office Box 60021 � ! I ` i .wank Classi cation Fire Sti cession
! Arcadia,CA 91066-6021 , ,. )4 I ti _PP
(626)574-5416 PermitStatus:Issued,
ARCADIAissue gate:04/24/2019 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 102 Arcadia,CA 5773009069
Contacts
HUNTINGTON LANMARK LLC Owner Zohar Avigad Contractor
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 6154 Aura AVE,Tarzana,CA 91335
(877)256-0161 976500
/!I
Description:HOOD SYSTEM BEEF NOODLE 11NOZZLES Valuation: $ 3,000.00 Tenant
Total Sq Feet: 0.00 Plan Check#19-715 Plan tt
Fees Amount Payments Amount Paid
Fire Extinguishing System Plan Check $560.00 Total Fees $728.36
Fire Issuance $47.01 Cash/Receipt f!REC-00943-19 $560.00
Fire Permit Fees $120.35 Cash/Receipt N REC-01047-19 $168.36
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $728.36
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.
* e
arrimitsii,
April 24, 2019
Issued By: Date
April 24,2019 Page 1 of 1
,FAR
4, 0r.UFOgm.N•I
P 1 PERMIT/PLAN REVIEW APPLICATION
lit :., /44 i4:.
Ea 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,and mfy license is in full force and effect. p 9 I have and will maintain a certificate of consent to self-insure for workers'
License Class C- I to License No. q GGGSeax . Date I J p- '9 compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor ., :tr-O
performance of the work for which this permit is issued.
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 this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve,
/is
Do -F7
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 (Tlds 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 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 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
Evorkers'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 orthwith 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 / 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 criminalpenalties 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
,,y, further information.
Ndme 2011 A R AV TGIID Title C jva
PRINT NAME
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.
1 agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upon the above-mentioned property for inspection purposes. 9-21,-1,9-51 Signature 7 Date -2 J 9
,
'o City of Arcadia, CA Permit Na FIRE-194)959_
IIciI
- - ,-,
/7
Development Services Department D - l-y_ `.TBox 60021 {{ s.1i -WorkCldssficotion Fire626)574-5416 t 'f�-.� - a
( ,::.; my ,-. _ ' `r- - PermitStatUS:,Issued
ARCADIA lssueabatefos/28/20191 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 102 Arcadia, CA 5773009069
Contacts
HUNTINGTON LANMARK LLC Owner SPECIALIZED FIRE PROTECTION,INC.* Contractor
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 18305 E Valley#H,La Puente,CA 91746
(626)416-9276 1005885
Description:SPRINKS FOR TI 7 HEADS LAN ZHOU BEEF Valuation: $ 2,000.00 Tenant
NOODLE
Total Sq Feet: 0.00 Plan Check#19-959 Plan#
Fees Amount payments Amount Paid
Fire Issuance $47.01 Total Fees $431.66
Fire Permit Fees $103.65 Cash/Receipt#REC-01290-19 $280.00
Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-01329-19 $151.66
Sprinkler Heads $280.00 -
Amount Due: $0.00
Total: $431.66
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.
44% .
May 28, 2019
Issued By: Date
May 28,2019 Page 1 of 1
0UF-1/4
wan t PERMIT/PLAN REVIEW APPLICATION
el f„..fY/.s..rlt S,,,
Development Services Department,240 West Huntington Drive, Post Office Box 60021
, �je Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
O 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 y 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. filkg- Exp. Date 7.311 compensation, as provided for by Section 3700 of the Labor Code, for the
performanceof the work for which this permit is issued.
Signature of Contractor
OWNER-BUILDER DECLARATION 1,<♦.t 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
License
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'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier (114fC.-
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number �vrx»>— SS37 %(
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($500)): compensation Laws of California,and agree that if I should become subject to the
workers'compensation provisions of Section 3700 of 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
Date 5-it 11 Signature
sale(Section 7044,Business and Professions Code:The Contractors License
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. t /� )
NameAMEGvv v Title
in'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 ordinanceisState Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentionedityfor inspection purposes.
Signature Date </78/I I
1 of Alio0�4,0AF0m.�9j
int rrasz.; r-
s t'
0m�nity ot8 MEMORANDUM
Fire Department
DATE: May 30, 2019
TO: BUILDING DEPARTMENT
INSPECTOR Steven Roberts
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 411 E. Huntington Drive #102
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 5-29-2019 Mark Krikorian ) _
FIRE ALARMS
TANKS
HOOD & DUCT 5-15-2019 Lili Huang
KNOX BOX
OCCUPANCY 5-30-2019 Lili Huang
COMMENTS:
Emailed Bldg. Dept. 5-30-2019 Rita