HomeMy WebLinkAboutDEMO-19-0728 �.°14-:'.)*, CITY OF ARCADIA
11 CHECK REQUEST
•
Vendor No. Date August 23, 2019
(for Administrative Services Only)
•
Pay to: K Y INVESTOR, LLC
269 W LONGDEN AVE
ARCADIA, CA 91006
•
626-407-1510
Account No. Amount
714-2275 $ 3,874.00•
$ }
1
$
$
$ 1
TOTAL $ • 3,874.00
Reason for payment. (PLEASE SUBMIT BACKUP IN DUPLICATE)
Please process a refund to the above recipient, demo bond
DEMO-19-0728
A
215 W LONGDEN AVE
)
❑ Check here if check is to be Approved by: ;
returned to Department. BUIIdI partment
Department:
PermirNo.Demo=190728
116 City of Arcadia, CA Ci
t
Development Services Department � � a v--� Permit Type:Demolition
240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 Cr-,ripL. Work Classification:Demo-Residential
� . ���
(626)574-5416 Permit Status:issued
ARCADIA - , Issue',Date:os/o7/zo19 Expiration: 11/03/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
215 W Longden AVE Arcadia,CA 5785021003
Contacts
K V INVESTOR,LLC Owner BUILTEK CONSTRUCTION& Contractor
215 W LONGDEN AVE ENGINEERING'
13422 HOPE ST,GARDEN GROVE,CA 92843
(949)394-5468 1043265
Description:DEMO HOUSE/GARAGE IN PREP FOR SF Valuation: $ 0.00 Tenant
NEW/POOL HOUSE.REFUND DEMO BOND TO K V INVESTOR
LLC 269 W LONGDEN AVE ARCADIA CA 91006 6264071510 Total Sq Feet: 3.874.00 Plan Check N Plan U
Fees Amount payments Amount Paid
Bond for Demolition $3,874.00 Total Fees $4,100.68
Demo-Sewer Cap and/or Cesspool Fill $16.48 Cash/Receipt p REC-01151-19 $4,100.68
Demolition Permit $108.93
Amount Due: $0.00
Demolition Permit Issuance Fee $47.01
Plumbing Permit Issuance Fee $47.01
Solid Waste Management Fee $6.25 COMPLETED �p.�
Solid Waste Management Fee 2 $1.00
Total: $4,100.68 0 2-
CALLS FOR INSPECTIONS 0 L
G_347 Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
.5;w€e 61,
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
5-DEEP consecutive days or if no progressive work has been verified by a City of
8 . Arcadia building inspector for a period of 180 consecutive days.
'3-
—C-78-e7 , G�
Z a.a°EA'
May 07, 2019
Issued By: Date
May 07,2019 Page 1 of 1
i PERMIT/PLAN REVIEW APPLICATION '
E@l*' Development Services Department,240 West Huntington Drive,Post Office Box 60021
/.
„Fa Arcadia, CA 91066-6021, (626)574-5416,Fax(626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
❑ 1 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'effeect. ❑ I have and will maintain a certificate of consent toself-insurefor workers'
I License Class LiceNo.IOH32(Y p. Date fir-10compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor
performance of the work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER DECLARATION
Li 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
is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions s
Code.Any city or county which requires a permit to construct,alter,improve, Carrier Ca/ô'✓in44et S CvrF"P
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 Policy Number u K. i' •t t
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)
1
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 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 r'alifomia,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 forthwith comply with those provisions.
property, or my employees with wages as their sole O
compensation,will do the work,and the structure is not intended or offered for Date 6>y /y !G SignatureJ;?
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.aie notintended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
❑I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
13 I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
I. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further/information.
Mame a L1 (--s (20-.1-ILL— Ale p i sem'%d'7t J /�/G!�
111 TL AI
PROW NAME
I certify that I bave 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 enter6,./......-„7/7„---
upon the above-mentioned property for inspection purposes.
(Signature LLL I Date Q S - 6�- — �21:> (y
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