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RALT-19-0543
- - ;?ity2\ City of Arcadia, CA Permit No RALT-19-0543 t !!!f Development Services Department © Pe m f Type:Residential Addition/Alteration 3 240 West Huntington Drive,Post Office Box 60021 a 1 i r Arcadia,CA 91066-6021 Wyort assificanon:Res-Window Change-Out (626)57a-5416 Permit Status:Issued ARCAI)IA - Issue Date:03/19/20191 Expiration: 09/15/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 630 Beverly DR Arcadia,CA 5791022011 I • Contacts RAY&YUBING LIN Owner M G W CONSTRUCTION INC" Contractor 630 BEVERLY DR 526 HOFGAARDEN ST,LA PUENTE,CA 91744 (626)821-0800 (909)610-5392 Description:REPLACE ALL WINDOWS WITH RETRO FIT Valuation: $ 7,820.00 Tenant WINDOWS PER APPROVED PLANS.**HIP PROGRAM NO FEE" Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees Building Permit Fees $203.85 Building Plan Review Fee $132.51 Cal Green Plan Check $13.26 Amount Due: Energy Plan Review Fee $40.77 Green Building Standard $1.00 Solid Waste Management Fee $6.25 Tong Motion Inst.Program Res $1.02 COMP&ETED Total: $445.67 111 FOR INSPECTIONS 44--I t 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. March 19, 2019 Issued By: Date March 19,2019 Page 1 of 1 .F AR 0 ;• I' PERMIT/PLAN REVIEW APPLICATION • • , o@3j, 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,land my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class 13 License No.( f� I !Exp. Date I compensation, as provided for by Section 3700 of the Labor Code, for the _I performance of the work for which this permit is issued. Signature of Contractor . OWNER-BUILDER DECLARATI ❑ I have and will maintain workers'compensation insurance,as required by Section 0 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 mason(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 S"Pft'"e Z demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number a 1(y q 3 >— a.v 7 for such permit to file a signed statement that he or she is licensed pursuant to the (This section need n t be completed if the permit i 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 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 ❑L as owner of the property, forthwith comply with those provisions. p pent', or my employees with wages as their sole r1� compensation,will do the work,and the structure is not intended or offered for Date ��(� "/ sale(Section 7044,Business and Professions Code:The Contractors License I Signature Law does not apply to an owner of property who builds or improves thereon, or who does such work himself or herself or through his or her own 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). ❑ 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 o disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. ' 1 �,,rr /� CW Z Name CH-tA/C i CCI x-/V Title '`1Yac •�•�y7/�- '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. 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. Rgnature �• Date 3/ 1rt / 9City of Arcadia, CA LPermit NO Elec-19-0589 tM�f Development Services Department Permit Type:Electrical r 240 West Huntington Drive,Post Office Box 60021 ''' E ,tel Work Arcadia,CA 91066-6021 9assi Gabon:Elec-Servide Change (626)574-5416 ' - Permit Status:Issued ARCADIA - = Issuer/ate:03/25/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 630 Beverly DR Arcadia,CA 5791022011 Contacts RAY&YUBING LIN Owner MENDIETA ELECTRIC Contractor 630 BEVERLY DR 1708 5 Raymond,Alhambra,CA 91803 (626)821-0800 (626)688-9760 551372 Description:UPGRADE ELECTRICAL SERVICE,200 AMP Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount payments Amount Paid _ Electrical Permit Issuance Fee $47.01 Total Fees $64.49 Residential Services up to 400 amps $16.48 Cash/Receipt#REC-00755-19 $64.49 Solid waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $64.49 ¢-' ✓ COMPLETED tdA- fiboy0:1-1eN\ 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. March 25,2019 Issued By: Date March 25,2019 Page 1 of 1 .F AR • PERMIT/PLAN REVIEW APPLICATION ' t?3*' T Development Services Department,240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of radia 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 /'—/ D License No. • Exp. Date - •'- Y I compensation, as provided for by Section 3700 of the Labor Code, for the Signature of ContractoriiM, .erformance of the work for which this permit is issued. _ 4VI OWNER-BUILDER DELL,-'Z314 N aI have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit ❑ I hereby affirm under penalty of perjury,. I am exempt from the Contractors is issued.My workers'core ensatio insurance carrier and policy numbers are: License Law for the following reason(Sec ion 7031.5,Business and Professions / Code.Any city or county which requires a permit to construct,alter,improve, Carrier S t e(P r/H/' 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 exempt there from and the basis for the alleged exemption. Any violation of LII 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 .or Code,I shall ❑ as owner of the property, forthwith comply with those provisions. I, or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for kali— p 1// sale(Section 7044,Business and Professions Code:The Contractors License Date Lf•lC j l 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 Nit employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Co -n .ion 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 CONSTRUCTION LENDING AGENCY Code:The Contractors License Law does not apply to an owner of property 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: 1Lender's Name Date 1lnj7zk s 5- Signature �, �,/ I/ Lender's Address r,Ai IMPORTANT: APPLICATION IS HE' 1'At •DE 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. nn - Name \_ / r --Q UC_.` • ,L Title . - A JI _ _ 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 abov••i i enti ed property for inspection purposes. 1,�,�,,'`,� Signature yi)'Il�r Date 14 /Signature 5S' Pn 7 /Ojl' CITY OF ARCADIA HOME IMPROVEMENT PROGRAM Permit Fee Waiver Form The full name of the property owner(s) is/are of r U. 1,9 The full address of the subjecproperty is 1 A HIP grant was approved for the subject property on 37/ gJ The awarded contractor is ! (G,LU The approved improvements are �- � ��«� L�"t o (Ani.el uw 5 By signingbelow, the housing consultant confirms the information is true and correct: r' f 1:s. (e-/ 15 Bea 'Ce f'icon Date Housing Consultant • fy i i(1 h rt :T }5 •• i t 1 .,,} + t f '«-t 44W,: r �3 {r ' a ^ lint ,. ' r Y,-714 d%irt W- '� 4:71-',44 9 4 �! y t '\' Ye. t \ U .� �.. Tt+ R Y e` tAft t4 ,44:P k, rt . ' r @p rrs xv "¢- 1 t • � Y }' ..ti'" , iht;k o 0 ec, CO - - - cPo o, i , m 0 0 p \*6-6c5i_ 1 4_ 1 _4 --I �d yoa 06 . , Family Living .t "� aaOb Bedroom Bed U VII _ I 4' ctsin ,, ,--t- cu d� N o Kitchen &E°IT: 11 il Dianing Bth c Ka-1 • r Mir bedra z Laundry o .cc 5 . I ea em t11TLlan IIIIC.IC. nnia munneximirm ILIC!'iI`l_Igc3.C':iILORIMMZ .li— W asxs WA Era uu `rr--'!r"i CyMIMI a a►r7ia Garage l'!®:(pmwto/allc1 u*3►C 7Lttre-.Caa g l:mMOM arae lc1L•l1 .1:1 F471ILOria2t is Ilex iEr:Ira MOM si rarriitsii.raalla ars exam G!IcIL•usa Igc3►rrILNilMI►faMIIla aaUGC;I DM a/ :U>■■MI.CTiiWY. IMal 2f7laa Mal ItU: ctIIllISIM II*3.Ca?I NiIl.67MIa In a 1*1.Cr7LNia2faaal MS11leX >•PCSWAMI= I c3.r falialMNIZUMMIIM =frAiSOPYMMItitiWirt•IIIZc3.C51KOall al►[.7i— lKlMXIMI[Oa IVlsa 1*12t7,71itsis2 .lal! —r MN ax•ilc3'a&Mae 1c32M7i sall a2G7i— i6ai:( >■CI'AYLIEcLtI6lMI: IIIIN lCli.'l:iMNPSEGMI ha 11*3 2.7471 ii9Ls];Nu aa257aa Y Eli Vaal:MaClIK3Z31Plea liSI.[Ti121Cliii nallilMI L630 Beverly Dr. Arcadia Retrofit Windows and Door Replacement x Street ze- Oiyy�' / a�J • 4 � mi 5 a . AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS / Property Address: �30 vcRLY TR • f ck� , 9tco(p Permit Number: R/ALT-t9-oS437MecR— lA-os /Ekec--(`t 5t1 / Brief Job Description: 5 A' . • ! •Wit.. ` IL. t CA ��� -Ass' ' / Number of smoke alarms installed: a" UUEdv C0k pa�0 OS Number of carbon monoxide alarms installed: 1 When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. http://osfm.fire.ca.oov/licensinolistings/licenselistinq bml searchcotest.pho As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoirtg is true and correct, and that this declaration was executed on (Date) 31 `�a-- c 11 at Arcadia, California. O Owner's Name (printed/typed): 'iu ►►vaa r�9x' 1- vvt, Signature of Owner: (J This affidavit must be returned to the City of Arcadia inspector prior to final inspection SE OKRA14AR Nil AID.CA- !•,,v Ga RwaWt� L�,� P @ aCl-0n Guest ltuanti II lIatln•oun Storage > is :TIIbL tit oft : Carage FIRS FLOOR PLAN = SMOKE ALARM If LI CARBO O ONOXIDE ALARM - u t Mstr . —WitBatt Master Bedroom Dining Room Kitchen - - 30 -�13adh .m _____ _ Hap C ti Closet Closet Family Room 6 0 - Bedroom Bedroom SECOND -LOOR PLAN 0 =SMOKE ALARM El m CARBON MONOXIDE ALARM