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Home My WebLink AboutPLUM-19-1915 City of Arcadia, CA Permit NO Plum-19-1915 Development Services Department r— { -- - s} Permit Type:P.lumbing 240 West Huntington Drive,Post Office Box 60021 1•a t €. Arcadia,CA 91066-6021 ` t�:i , - r _ _ Work ClassifiCohon Water Heater - 4 1a (626)574-5416 .,. . ,..... . s` "" .- - Permit Status:Issued ARCADI.Aissueoate>09/19/2019,I jmExpiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 39 Fano ST B Arcadia, CA 5779011100 Contacts W ^ SHAKIB,JAVAD S AND Owner WATER HEATERS ONLY INC Contractor SALMANPOUR,SAKINEH 970 E Main#200,Grass Valley,CA 95945 39 FANO ST (530)274-3001 374573 Description:REPLACE EXISTING WATER HEATER,SAME Valuation: $ 0.00 Tenant LOCATION ` Total Sq Feet: 0.00 Plan Check# Plan it Fees Amount Payments Amount Paid Plumbing Permit Issuance Fee $47.01 Total Fees $63.56 Solid Waste Management Fee 2 $1.00 Cash/Receipt It REC-02556-19 $63.56 Water Heater and/or Vent $15.55 Amount Due: $0.00 Total: $63.56 TED 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. September 19, 2019 Issued By: Date September 19,2019 Page 1 of 1 .F 0.10°1^.,4` Nom PERMIT/PLAN REVIEW APPLICATION- `1,. .:7-4.-.4sDevelopment Services Department, 240 West Huntington Drive,Post Office Box 60021 %au.,Goy° Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia til CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Z'Pereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business andprofessions Code,and my license is in full force and ffect. [� I have and will maintain a certificate of consent to self-insure for workers' License Class C3 kP Lice a No.S 5 i'� Exp. Date '5 131 121 compensation, as provided for by Section 3700 of the Labor Code, for the J .i %I� performance of the work for which this permit is issued. -.Signature of Contractor 1�-..., 7i7. OWNER-BUILDER DI. TION ), ave and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty, that I am exempt from the Contractors • 13700 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 Siotk CD t"in"t e demolish,or repair any structure,prior to its issuance,also required the applicant 112y le IP S(4-2-0l cl for such permit to file a signed statement that he or she is licensed pursuant to the , Policy Number 1 provisions of the Contractors License Law(Chapter 9(commencing with Section (�f�'s 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 ',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 t 1 of employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): i�',compensation Laws of California,and agree that if I should become subject to the lii' workers'compensation provisions of Section 3700 of the Lab.- .ode,I shall ❑I, as owner of the roe forthwith comply with those provisions. property,try, or my employees with wages as their sole J f compensation,will do the work,and the structure is not intended or offered for Date `I I (ct l« Signature Min 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' nation 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 finesup 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 ��+y9y further -i innffo�rmat�ion. } /± fi\ came tin k 19 �%1 Ivt P Title 0\Oe tet{' PRINT NAME u cc certify that I have read this application and s • that the above information is correct and that I am the owner or duly authorized agent of the owner. c 'Arcadia .604 ijY. agree to comply with all City ordinances , 1 State Laws relating to building construction. I hereby authorize representatives of the City of to enter upon th bove-men Coned r •rty for inspection purposes. ii ignature .b 4 �� Date `l ( i 9 I N 1'u AFFIDAVIT SELFCERTIF!CATION FOR COMPLIANCE OF SMOKE ALARMS O� f�AND CARBON MONOXIDE ALARMS• Property Address: 3 + h'n C f- o f 5 Permit Number:. I ULr 1 9 - Brief Job Description: MQt at Number of smoke alarms installed:- 1-1 Number of carbon monoxide alarms installed Z When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall:beinstalled in each steeping 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 dweliings'orsteeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installedoutside each separate sleeping areain 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. AH.alarms shall comply with requirements for listing and approval by the:,Office of the State Fire Marshal. Nip ttosfrn fire:ca,q_avilicensiriglistings/iicenseiistinq,bml searchcolest:ohi As owner of the abovereferenced property, I hereby certifythatsmoke alarmsand 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 foregoing istrue;and corrEct, and that this declaration*as executed:on (Date) . saina't.Z.o .9 . -: . _ - ,..at Arcadia,:California. "0+ur1eY's fan?@t Firr€ei gisa. '._ c r&dSkoc1 - 0 r Sif{rrature of OWner°''ro_ _. a''ad S.a�. This affidavit must be returned to the City of Arcadia inspector prior to finalinspection