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HomeMy WebLinkAboutRALT-18-0714 C City of Arcadia,CA Permit Na RALT-18-0714 1 • Cl-f� 4171 Development Services Department %-"`z `'�"'�� " �"` `Permi[Type Residential Addition/Alteration 240 West Huntington Drive,Post Office Box 60021 r- -I Za i ,L f) }i 47 rArcadia,CA 91066-6021 I j }.fWork Classiricat{oa Res-Addition/Alteration (626)574-5416 7 Permit Status:Approved` ARCADIA 1� �----pie date:. Expiration:11/02/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1162 La Rosa RD Arcadia,CA 5776004004 Contacts YUUKI AMARIS STICH Owner William Carrasco General Contractor(B) 2058 N Mills AVE#633,Claremont,CA 91711 (909)630-6649 (909)244-8384 wcprecisionr@gmaill.com Description:ADDITION TO ENLARGE MASTER BED,BATH#3, Valuation: S 98.578.92 Tenant -� NEW FAMILY RM Total Sq Feet: 748.00 Plan Check#18-714 Plan#32567 Fees Amount payments Amount Paid Building Issuing Fee $44.35 Total Fees $4,527.20 Building Permit Fees $1,215.65 Cash/Receipt#REC-001060-2018 $1,112.33 Building Plan Review Fee $790.18 Cash/Receipt#REC-001964-2018 $3,141.87 Cal Green Plan Check $79.02 Energy Plan Review Fee $243.13 Amount Due: $273.00 Green Building Standard $4.00 Parks&Recreation Fee(SFR) $2,131.80 Solid Waste Management Fee $6.25 Strong Motion Inst.Program Res $12.82 Total: $4,527.20 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. COMPLETE 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. 15/ Issued By: Date August 07,2018 Page 1 of 1 PERMIT/PLAN REVIEW APPLICATION \jam 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 my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class A, C —I U License No. 83.1(p() Exp. Date S/71/2 u 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 DECLARATION ave and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 00 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 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 I certify that in the performance of the work for which this permirisissued,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 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 f' sale(Section 7044,Business and Professions Code:The Contractors License Date t7 O 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 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 them 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). 0 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. • e' w I I l s ann C Geer/q,S c- Title ©t^'/kL✓ PRINT NAME I 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 gree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of cadia to enter upon the above-mentioned property for inspection purposes. ignature ^ /� Date d[1 — 7-if NOTES Building Inspections Date Insp. Plumbing Inspections Date ns 100. Setbacks 210. Under rrhldg.drain - % 1Insp. / a16-68" 1 _ Q , 101. Rough grade 211. Copper underslab UAW Afacrts 102. Figs.&forms 212. Rough plumbing /0'?/5-/,7 103. Pre-slabzs-7/56-i-L___ 213. Rough gas Asa. ,/ 104. Floor joists 214. Shower pan (J /0(4/b 2t n/ / l'�//J�,',/ 106. Steel 215. Watfr heater v/e ��r /� �f��l„111[[[/J2�^��'\� 106. Grout lift y��/ 216. Roof drains /I /(p 107. Shear nailing ed, /"6(9/O L 217. Building sewer X I`' 0-, , ((/5 47/ 108. Diaph nailing 218. Water service /J6 1' 109. Roof nailing ^�� CR__219. Final gas / �/ 110. Framing . �V _220. Fixtures 111. Occ./Area Sept.Wall . 221. Final plumbing 671/r/ , 112. Sound walls 222. Sewer cap/demo. 113. T-bar!rid 114. Insulation-Flr. Pool Inspections Date Insp. 115. Insulation-Wall er-y i 0 240. Excavation/steel 116. Insulation-Ceil. /t 1-/ 0 241. Rough plumbing 117. Drywall nailing /6-f''' _ 242. Light shell/bonding 118. Interior lath / t 243. Underground conduit 119. Exterior lath /7 ,'"/: 244. P-trap 120. Finish grade ,,/ 245. Gas line&test 121. Anal building 67/�, J 246. Fence,gates&signs 122. Anal demo/lot dear 247. Pool heater 248. Anal electric _ Electrical Inspections Date Insp. 249. Anal .lumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Underground conduit 153. Underslab conduit Bernd Inspections Date Insp. 154. UFER ground a sr JO , - 270. Pre-rercof insp. 155. Water groundqq 271. Roof framing 156. Rough electrical ,07.76 �7 272. Sheathing nailing _ 157. Fixtures 273. Anal reroof 158. G.F.C.I. 159. E.it.bondin! Sign Inspections Date Insp. 160. Service panel280. Setback/overhang 161. A /nal electric u. 7/tg JX1 281. Footing l 282. Conduit/wirim Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Anal sign 181. Furnace/A.C. . 182. Rouch I-WAG AO Miscellaneous Insp. Date Insp. 183. Fire dampers 290. Fire 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. Final 189. Commercial hood 190. Duct shaft _ Sewers&Offsite Insp. Date Insp. 191. Final mechanical r ?/ / 300. Lateral(main to Pt) rr 301. SaddleN Block Wall Inspections Date Insp. 302. Cess...l filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Anal wall 306. Trash bin Certificate No.20121023-891 ARCADIA UNIFIED SCHOOL DISTRICT 150 South Third Avenue,Arcadia, CA 91006 • (626) 821-8300 Ext. 6732 Certificate of Compliance for Payment of Developer Fees (Education Code §17620, et seq. & Government Code §65995, et seq.) Effective July 24,2017 Current rate in effect applies at the time of imposition of fees/payment. Project Address/APN: 1162 La Rosa Rd . , Arcadia, CA 91007 Number of Units in Project: One Plan Check Number: 18-714 [ ]** [X]** [ ]** Exempt: [ ]500 sq.ft.or less(residential addition/expansion/remodel) Residential Commercial/Industrial [ ]Other. $3.20/sq.ft. $0.51/sq. ft. Area in Sq.Ft.: 748 Receipt Number: 330412 Total Fee: $2 , 393 . 60 Check Number: 1492 Owner's Name: Yuuki & Amaris Stich Owner's Address: 1162 La Rosa Rd. , Arcadia , CA 91007 Phone Number: 909-630-6649 Email: amarismao@gmail .com Representative's Name&Contact Info(if appl.): William Carrasco 909-667-6077 *The above-described development has been determined to be exempt from the developer fees of Education Code §17620, et seq., and Government Code§65995,et seq.,and a Building Permit may be issued therefore. ** All fees due to the Arcadia Unified School District, under provision of Education Code §17620, et seq., and Government Code §65995, et seq., as a prerequisite to the issuance of a Building Permit by the Building Department of the City of Arcadia, City of Monrovia,City of Sierra Madre,City of Temple City,and County of Los Angeles,Department of Public Works have been received. Based on t ; ' formation prese ted above,this Certificate of Compliance is hereby executed. Connie Chu / Senior Administrative Asst . 8/6/18 ignature of District Representative Name/Title Date of Issuance ➢ The District charges a $100 fee to process reinstatement of the Developer Fee Certificate of Compliance resulting from an "insufficient funds"check in addition to a$35 fee for the returned check. Only cash or a Cashier's Check will be accepted as payment thereafter. > The District charges a$100 fee for any amendments to or cancellation of a Developer Fee Certificate of Compliance formerly issued on any type of development. • If 500 sq.ft.or less is the reason for exemption,any future additions, expansions,or remodels to the property that result in the past aggregate square footage to exceed the allotted 500 sq. ft. will be subject to fees at the current rate for the entire square footage of the development. ➢ Owner/developer may request a refund of fees paid to the District within 12 months of payment only in the event the Building Permit expires or the project is canceled without commencement of construction in accordance with Education Code section 17624(all other requests for refunds must be made in accordance with the fee protest procedures set forth in Government Code §66020). All refunds will be reduced by a $100 administrative fee. The refund check will be issued in the name of the owner/developer and mailed to the address of payee. PURSUANT TO GOVERNMENT CODE§66020(d), OWNER/DEVELOPER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE OF COMPLIANCE TO PROTEST THE IMPOSITION OF FEES Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that the information he/she provided to the District is true and accurate to the best of his/her knowledge. Signature of Applicant: Name: k/, ] I t Urn (qw-&s GO WHITE—City/County YELLOW—Fiscal Services PINK—Business Services GOLD—Applicant Certificate of Compliance(7-24-17) rXct19f41 L( ARUCP Y•aGPX SPECIAL INSPECTION REPORT ❑ DISCREPANCY A CONFORMANCE All discrepancies shall be brought to the immediate attention of the All work conforms to approved design and code requirements, submit Contractor for correction. If corrections are not made in a timely this report to the Building Department and copies to Contractor,Engineer manner,this report shall be used as a discrepancy notice.Submit the or Architect of record and Owner no later than the business day following original to the Building Department and copies to the Contractor, the conclusion of the special inspection. For inspections greater than 5 Engineer/Architect of record and Owner. days duration,submit a status or progress report at least once a week. This is a(check one) Progress Report Final Report Report No.: Project Address: Description of Project: /i6a Ladeoy& sof. a nad,,rr, 7/007 F&ovse .4ctc',-6, „ Permit Number: 'Owner rchitect/Engineer of Record: Contractor. /84— p174 cnin Miro irr ��ib ,P#-os4 gra-W/0ro �h1 oc9P/,h„ Full Name of Special Inspector. Registration Number&Expiration D to Company: Phone Number. Aarrw tree- to,fl5 Ctt7 t ) C n9 Aa TPr 2/3 r34r 7760 Type of Inspection: ❑Reinforced Concrete ❑Structural Masonry ❑Piling, Piers and Caissons ❑Smoke Control ❑Prestressed/Post-tensioned ❑Bolts in Concrete/Masonry ❑Excavation and Fills ❑Energy Compliance ❑Shotcrete/Gunite ❑Structural Welding ❑Spray-Applied Fire Proofing ❑High Load Diaphragms ❑Insulating Concrete/Gyperete 0 High Strength Bolting , Other C72"xy, Time Time Date Arrived Departed Description and Location of Work Inspected A9-3+ }-P# l4S eot rps Ply r /3a r t/ r6`' firefe,e, 'f/rS -erket Ark,— 1/2!3 " /1dfres Gu/ . cF! ' F 6" Gn4, tt /WV C > 1SPd fiJ1,5_ 74 Observations/Remarks: •r - / i r .1 I• A .r r / / i ri( .,...i ' 4v_ tG . 6 I HEREBY DECLARE THAT THE FOLLOWING IS TRUE TO THE BEST OF MY KNOWLEDGE: 1. I HAVE ALREADY BEEN PRE REGISISTERED AND APPROVED BY THE LOCAL JURISDICTION. I HAVE FIRST CHECKED IN WITH THE LOCAL BUILDING 8 SAFETY OFFICE BEFORE REPORTING TO WORK AND PRIOR TO CONDUCTING INSPECTIONS AT THIS PROJECT. 2. I AM OR MY COMPANY IS, RETAINED BY THE OWNER OR THE ARCHITECT/ENGINEER OF RECORD TO PROVIDE SPECIAL INSPECTION FOR THE WORK COVERED IN THIS REPORT. 3. I HAVE PERFORMED THE REQUIRED INSPECTION DURING THE TIME PERIOD AS STATED ABOVE. 4. THE WORK COVERED IN THIS REPORT IS IN CONFORMANCE TO THE APPROVED PLANS, SPECIFICATIONS AND APPLICABLE WORKMA IP PROVISIONS OF THE CODE.EXCEPTyAS INDICATED OTHERWISE. /• / _ no,..2-/-/F Print Name /14e,-170) Lee _ Lic#l/—Wor Signature V Date (Revised 10/2011) Page 1 of 1 1 • FILE NO. a DATE FILED APPLICATION FOR HOMEOWNER ASSOCIATION ARCHITECTURAL DESIGN REVIEW (SHORT REVIEW PROCEDURE) • PROJECT ADDRESS: I 1 Ca a L o\ Rose. A v^cc,A., o. PROPERTY OWNER'S NAME: "I L&k I Acv n GY,i S f 5 t' Cin ADDRESS(IF DIFFERENT): • TELEPHONE NO.: 010°‘ - (a'30- (.v t,L1 el E-MAIL ADDRESS: CLW Gt V` 1 5 n c o to 50,c,; (.. APPLICANT NAME(IF DIFFERENT): W Vv i I 1 t & C Caw- c.,o C-4,510"C-4,510"cis ADDRESS: a(DAyr._ tt- (o 33 GI e.,re.vy,o,4- C. PV TELEPHONE NO.:ct oq - t. t:-7_ (y o '7'1 E-MAIL ADDRESS: w Cy)cp e' S t 0>n Y^ e q vticx;� rlovvt DESCRIPTION OF PROJECT(Check applicable): pi. Single-story remodel(includes window replacement)and/or addition(s) ❑ Detached accessory structure(s)and/or Accessory Dwelling Units-new,additions to, and/dr remodels ❑ Fences and/or walls in and/or facing (i.e., visible from)front and street side yards ❑ Hardscape,landscaping and structural elements in front and street side yards, including without limitation, swimming pools, spas, fountains and other water features ❑ Fences, lights, and other features related to tennis courts, sports courts or other significant paved features ❑ Mechanical equipment ❑ Roofing • AC N&FINDINGS: Approved-The project Is consistent with ail applicable guidelines U Conditionally Approved-With the following conditions,the project will be consistent with all applicable guidelines • o Denied-T -pr\oje project Is not consistent with the follwinwgaripeflneSel..ltw�ppoo,,�to?'(THL. PLl,rva v;AVL: JAG..i,. l._�. i._h • ..L. • e , e m • - - ¢r 'CHO SANTA ANITA By 'e� C MEOOWNERS ASSOCj I ���e �EOOVtr R Ui;.1ER &Nrro.AND 'S AGREES THAT ANY DEVIATION FROI' l hIES T�� .''. te. - = EN1 PRIOR WRITTEN AUTHORIZATION FROM THE ARC, ONSTITUTE REASONABLE GROUNDS FOR THE REMOVAL OF NON COMPLIANT IMPROVEMENTS AT THE OWNERS EXPENSE. DATE 4 BY e..•11 e• ER 6/ to 17 DATE 4 z' BY I' ARS G I t The attached plats were made acailoble to the following neighhors for review: Impacted Neighbor Impacted Neighbor I15S rktoMq ex_ • It43 )� Wm)* tizA Adder i\�kt s. --_... .....__._.---- • -1,30r_ _CttURfu7l Amor, yy SF/(fir t1_.C1. LGRWA Pnnt s 4J Nan Name Stgnaturc ta • Date Signature , - )alc Adjacent Neighbor p} jAdjacent Neighbor // w tial .t1411:10: ° r 1 t Adz/lc , /t fAu 1Qa .• Ad ss v."-; S t CI C",1/41'ti�, amr °-_.-• Print Name �r : !11 r IeLr Ai Name Si •If An' /a i;�Q Address I 1 G.J.. Signature Date d I• Facing Neighbor Facing Neighbor Facing Neighbor 1155 LA RASA,- ' tkou,5e, for 5 c e_ i >n Addres Address Add El42143E-1-1 &16(..AR o Lc_.)ap Ar-i.5 ei c—� u " P 'L1Print Name Print Name Signat a R Signature Date Signature Date The neighbors have seen the plans 7 am submitting for Architectural Committee Approval(see above verification). I understand neighbor objections do not to themselves cause denial. However the Architectural Committee will review the neighbors to determine their objections and their appropriateness. SUBMITTED BY: t Name: Pc ten,�v j 4 SA-Ce -N. t Date: y a l� 1 A I W PLANS HAibc i ':;E1"JED ANO APPROVED BY THb Address: w _ . _ _ . _r_ _ ., 7 _ : _ _ , . SANTA ANITA • HOMEOWNERS ASSOCIATION. HOMEOWNER UNDERSTANDS AND AGREES THAT ANY DEVIATION FROM THESE APPROVED PLANS,ABSENT PRIOR WRITTEN AUTHORIZATION FROM THE ARB,CONSTITUTE REASONABLE GROUNDS FOR THE REMOVAL OF NON COMPLIANT IMPROVEMENTS AT THE OWNERS EXPENSE. DATE BY • •)1/43s. e ER DATE 4I3ult8 BY c� RB City of Arcadia, CA PermitNo. EIeC 18 0459' .f i Development Services Department - �1-'\f-7"'` }1 permitType Eiictrical I A, 240 West Huntington Drive,Post Office Box 60021 3 ., k i" 1 p. f Arcadia,CA 91066-6021 LV f5� .., fa Iy. 'lyork Class ficaoon:Electrical Residential ( (626)574-5416 ? - Permit Statas"=Issued, ARCADIA - Issue Date 04/02/2018.1 Expiration: 09/29/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1162 La Rosa RD Arcadia,CA 5776004004 • Contacts COLOMBO,SAMUEL AND GRACE A Owner I William Carrasco Electrical Contractor 1162 LA ROSA RD (C-10) 2058 N Mills AVE#633,Claremont,CA 91711 (909)244-8384 Description:REWIRE 3 BEDROOMS 1 BATHROOM AND DINING Valuation: 5 0.00 Tenant ROOM.RELOCATE SUBPANEL. Total Sq Feet: 0.00 Plan Check it Plan It Fees Amount Payments Amount Paid Distribution Panel $15.55 Total Fees $130.90 Electrical Permit Issuance Fee $44.35 Cash/Receipt#REC-000720-2018 $130.90 New Residential Elect.(sq ft area) $70.00 Amount Due: $0.00 Solid Waste Management Fee 2 $1.00 Total: $130.90 211 CALL cQ*LFED SN 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. / April 02,2018 Issued By: Date April 02,2018 Page 1 of 1 of AR ; 1.tht.zii I. PERMIT/PLAN REVIEW APPLICATION "Edra, Development Services Department,240 West Huntington Drive,Post Office Box 60021 'mmoa„oc Arcadia, CA 91066-6021, (626) 574-5416,Fax (626)447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 1I 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 g c-i L) License No.8 39(o!f Exp. Date S23I// 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 he Labor Code,for the performance of the work for which his 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 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 (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 ,} 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 1`''t 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 w[i�th those provisions. compensation,will do the work,and the structure is not intended or offered for I Date gi'a -i/ Signature .....L.-4—,t-----.„— sale(Section 7044,Business and Professions Code:The Contractors License 11 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 andshall 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. 0 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 came further information. 4..) t b 1 t%Cont Cc,P-e-A f IE Title 0 U LI e_......- PRINT NAME I 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. 1( Signature ./L�`------% Date ��.7•' I \k 2 City of Arcadia, CA �'1:' -- 1:-....1.,_1 ::::'ZPermrtNo:MEP 18 1846;; Development Services Department 3 \"'+'�f' ""�r^'t } a permit Type.MEP' 240 West Huntington Drive,Post Office Box 60021 i r ti S y - I Arcadia,CA 91066-6021 { li�j V✓ork C/Gssrficanon MEP Residential` (626)574-5416 = _ Permit Status"Issued ARCADIAIssueDafe 10/08/2018, Expiration: 04/06/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1162 La Rosa RD Arcadia,CA 5776004004 Contacts YUUKI&AMARIS STITCH Owner William Carrasco General Contractor(B) 1162 LA ROSA RD 2058 N Mills AVE#633,Claremont,CA 91711 , (909)630-6649 (909)244-8384 wcprecisionr@gmaill.com Description:PLUMBING/MECHANICAL FOR ADDITION. NEW Valuation: $0.00 Tenant HVAC PER APPROVED PLANS.HERS REQUIRED FOR FINAL. Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Bathtubs/or Combo $12.46 Total Fees $277.72 Clothes Washer $12.46 Cash/Receipt#REC-002518-2018 $277.72 Compressor 3-5 Ton(3 to 15 hp) $34.29 Amount Due: $0.00 Furnace or Burner<=100,000 BTU $18.74 Lavatories $37.38 MechanicalmbiPeritIs Issuanceance Fee $44.35 Plumbing Permit Issuance Fee $44.35 Showerld $24.92 4 e Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 /412;9 Ventilation Fan(Single Duct) $18.76 CALLS FOR INSPECTIONS Water Closet $12.46 Request for inspection by telephone at 626-574-5450. Leave a message Water Heater and/or Vent $15.55 requesting the address,timeframe and what inspection item is needed. Total: $277.72 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. ar/7 a/ �&./r at #6%1(7'— October 08,2018 Issued By: Date October 08,2018 Page 1 of 1 of AR Nprokv, PERMIT/PLAN REVIEW APPLICATION ii !U =_"► zli:'' 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 Ctoode,and my license is i s full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License ClassRj Cot I O Lice (59t,/5 Exp. Date 37'h5 compensation, as provided for by Section 3700 of the Labor Code, for the i j performance of the work for which this permit is issued. Signature of Contractor j/VTION OWR-BUILDER ; 0 I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under pen. • 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, 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 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' s r uld become subject to the workers'compensation provisions of Secti r• `tt/of the Labor Code,I shall 0 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 in_423. f s /// sale(Section 7044,Business and Professions Code:The Contractors License Signature i/ 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 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. 0 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. ( ,/� came (o(r,Q1()IPS ., (r;1ihi,1A. PRINT NAME I certify that I have re: : .appli : ion 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 • . Ci • ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to ante:,: aoe1entionedp erty for inspection purposes. Signature • Date 1 0 J 3 J(ei