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HomeMy WebLinkAboutB00-050-016 • ' Development Services Department
tirlr? . y
240 West Huntington Drive,Post Office Box 60021
X21 Arcadia, CA 91066-6021 PERMIT NO. BOO-050-016
City of (626)574-5416,Fax(626)447-9173
Arcadia Permit Type: SF Add/Alt
' PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
14036 4/272015 CM 7:57 9/22015 Issued
ADDRESS NO. Dir.Profit Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
36 E Las Flores Ave 5789-015-005
OWNER MAILING ADDRESS
Steve Chou&Lingshien Chou P 0 Box 2298 PHONE NO. (626)675-2849 Plan Chk#: 15-270
Arcadia,CA 91077 EMAIL ADDRESS:
Plan#: 31712
APPLICANT MAILING ADDRESS
Steve Chou PHONE NO.
EMAIL ADDRESS:
'
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Steve Chon 2298 Po Box PHONE NO. (626)675-1695 FAX NO.
Arcadia,CA 91077 EMAIL ADDRESS:
License No. 703622 Type: B Expires: 4/20/2016 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
ADDITION TO CREATE 2ND STORY CONSISTING OF MASTER SUITE. FIRST FLOOR, ADD BED 62, FULL BATH AND LAUNDRY ROOM.
CONSTRUCT NEW 3-CAR ATTACHED GARAGE
Construction Type UOM N of Units Value Construction Type UOM N of Units Value
Type V Wood Frame Good sq ft 1,428.00 $181,841.52
Air Conditioning Res sq fl 1,428.00 $6,354.60
Sprinkler System sq ft 1,428.00 $4,726.68
Wood frame garage sq ft 725.00 8 ,671.75 CO PLET
Sprinkler System sq fl $2
725.00 $2,399.75 ,eit
OCCUPANCY: Dwellings TOTAL VALUATION: $219,995.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 1,333.80 1,333.80 01-3103
each Energy p/c fee 451.44 451.44 01-3103
PC Cal Green 133.38 133.38 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 2,052.00 2,052.00 01-3104
1.00 each SF/MF Fire Pkc 245.00 245.00 01-3109
SMTP Res 28.60 28.60 14-2207
gni bldg std 9.00 9.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
N.
Total Fees: $4,303.82 Balance Due: $0.00 Paid Today: $2,140.20
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Rt t.dpt N. 1102 r2
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3104 2,096.35
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 14-2207 28.60
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 8873 6.25
Arcadia building inspector for a period of 180 consecutive days. 88-302702 6.25
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m. to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
4 � 1. PERMIT/PLAN REVIEW APPLICATION
to z e4
4ileDevelopment Services Department,240 West Huntington Drive,Post Office Box 60021
Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
CENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
Iembyaffirm under penaltyof perjury that I am licensed under provisions of I hereby affirm under penaltyof perjuryone of the following:
apter 9(commencing with Section 7000,of Division 3 of the Business and
ofessions Codde,amend my�nse is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
ense Class 90' 3 License No. �7621' Exp. Date D f/ 70 + 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 rte —
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, Carrier
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
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 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
sale(Section 7044,Business and Professions Code:The Contractors License Date _ 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 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).
aI am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name _
Date 0//v /)Q/
ignature Lender's Address
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AM)
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
fir
further information.V-6-
J `' V I�t
Name C W°L Title bt�-�)�I /`
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 itgree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Acadia to enter upon the above-mentioned property for inspection purposes.
� � � 0)75).--/D-0 ��
Signature Date
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. 2/ E / A S e -S
100. Setbacks 210. Under flr.ibldg.drain JCJ L7-Sn /l',.V.�
101. Rough grade q Ir 211. Copper underslab �j(�}ri .-dim v� of&
102. Figs.&forms �11't-� �(1� 212. Rough plumbing 2 2,
103. Pre-slab 3,2.1-I4, .V7.','.� 213. Rough gas '(6-4
104. Floor joists 214. Shower pan
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 2•6� 217. Building sewer
108. Diaph nailing 2-l' 17 218. Water service
109. Roof nailing S-23-1 219. Final gas
110. Framing S-�B-i 220. Fixtures `
111. OcclArea Sept.Wall 221. Final plumbing g s-f q d'YV
112. Sound walls 222. Sewer cap/demo.
113. T-bar.rid
114. Insulation-Hr. Pool Inspections Date Insp.
115. Insulation-Wall 4^ 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing J,�'� 242. Light shell/bonding118. Interior lath -j 243. Underground conduit
119. Exterior lath 7-4 1 244. P-trap
120. Finish grade II 245. Gas line&test
121. Final building �'r�•l� ihAl 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final.lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Undereround conduit
153. Underslab conduit Reroof Inspections Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical ¶444 7 272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
ri
159. Eqpt bonding l Sign Inspections Date Insp.
160. Service panel Q'(41 280. Setback/overhang
161. Final electric 3 I.$-(( VA) 281. Footing
282. ConduiNvirin.
Mechanical Inspections Date Insp. 283. Disconnect
180. Ventinghlue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC 1/2: _a' Miscellaneous Insp. I 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. I Date I Insp.
•
191. Final mechanical tel, ' r 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess...I filled
200. Footings 303. Sidewalk
201. Steel/mbar304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
Certificate No. 20121023 - 476
ARCADIA UNIFIED SCHOOL DISTRICT
150 South Third Avenue,Arcadia, CA 91006 • (626) 821-8300 Ext. 6732 •
(Certificate of Compliance with Fee Provisions of Government Code Section 65995)
This new Fee Schedule is effective December 26,2012.
Any Developer Fee Worksheet brought in on or after this date will be charged at the new rate.
Address of Development: 36 E. Las Flores Ave, Arcadia, CA 91006
Number of Buildings in Project: one Plan Check Number: L5-270
[ 1 1 )1 [ 1 11
Exempt' (500 sq. ft. or less. Residential2 Commercial/Industrial Commercial/Industrial
Future additions chargeable $3.20/sq. ft. $0.51/sq.ft. Parking Structure
at regular rate) $0.26/sq.ft.
Area in Sq. Ft.: A developer may request refund of fees to the
1428 District within twelve months of payment of fees,
' in the event the Building Permit expires or the
Developer Fee: $ project is canceled. The refund will be reduced by
4 , 569.60 a $100 administrative fee. The refund check will
Receipt No. [ ] N/A be issued in the name of the original payee and
P I XI 318025 mailed to the address of payee.
Owner: Steve Chou Developer:
Address: Address:
36 E. Las Flores Ave
Arcadia, CA 91006
Home Phone: 626-675-1695 Business Phone:
Pager/Cell Phone: 626-675-2949 Pager/Cell Phone:
'This is to certify that the above-described development has been determined to be exempt from the developer fees
of Government Code Section 65995 and a Building Permit may be issued therefore.
2This is to certify that all fees due to the Arcadia Unified School District, under provision of Government Code
Section 65995, as a prerequisite to the issuance of a Building Permit by the Building Department of the
Development Services Department,have been received. Based on the information presented above,this Certificate
of Compliance is hereby executed.
➢ 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 bounced check. Only cash or a
Cashier's Check will be accepted as payment thereafter.
➢ The District charges a $100 fee for any amendments to or cancellation of a Developer Fee Certificate of
Compliance issued on any type of development. Said request for refund of fees paid to the District must be
made within twelve months of payment of fees.
Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that
the information he/she provided herein is true and accurate to the best of his/her knowledge.
—� „ow.
Signature of Applicant:
•
District Approval: / Date: /31/15
WHITE—Applicant YELLOW—Accounting Dept. PINK—Business Services Certificate of Compliance(10-23-12)
/'svrccnc)\ c\
LA�
, 3*11 � DBS REGISTERED DEPUTY INSPECTOR'S
�,
CERTIFICATE OF COMPLIANCE
DEPARTMENT OF BUILDING AND SAFETY
Address 1-0k5 F\o Yes Av e Date of Certificate t4/16 /l 5
Fabricator
Permit
TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR:
I hereby certify that the following portion of the work at the above job address which required continuous
and/or periodic inspection,and which I was employed to inspect,was inspected and approved by me and complies
with provisions of the building Codes applicable thereto:
Type of inspection:
[ ] Steel Construction [ I Sprayed Fire-Resistant Materials [ ] Prestressed Concrete
[ ] Concrete Construction [ ] Smoke Control [y(] Drilled-in Anchor
[ ] Masonry Construction [ ] Methane [ ] Gunite/Shotcrete
[ I Wood Construction [ I Exterior Insulation&Finish System [ ] Seismic Resistance
[ ] Soils [ ] Wind Resistance [ ] Other:
Location and Description of work completed
SY iOQCtec\ 41v�, i . 5�a\\ 0.-k or o-4 ckwe\s W..-Ft, C'k:Yk'v cotncvzfe
vii �r.11 p�o�l ,vn QSbv 5c,-1/4XQ,I
�5� 2— 1#4 7oG co � �ottD W1Fm7C�Kne h ` u
G h2W .fort‘‘.)
COKV\2 C.-tiuV1 S .
RoV s;ze , L.c\e ale c--64 o44 ckeAln\t—ess %5 C.cce -cable
Size of Structure Time Arrived
No.of Stories - Time Left Job
Conc.Mix Design No. P.S.I.
Registration Number LA Coktitr otC LLQ /i cccl2l5 b$�1
Employed by:
Lab:
Independent [ ]
Signature:
Registered Deputy uilding Inspector:
Print Full Name: CICOJ e �� N9
Cell phone number: Z4;" f<2 Z _2-0
E-Mail Address:
DO NOT AMEND,ALTER,CHANGE,DELETE OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL
RENDER IT NULL AND VOID.
IN FORM 07(Rev. 01/04/12) www.ladbs.org
- INSPECTOR'S DAILY REPORT OF COMPACTED FILL
Job Name Job Location Job No. - Page of
corrlie) . i n3De[4i 36 L•Lq) Wore S avc. , >` -c�'S 15-•,-t 1 _. oo I 1 /�
General Contractor i - Grading Contractor _ - Date f Day'of Week
11—)4- 1 ,rt0Q ,
Grading Shift Hrs.. . . Contractor's Supt of Fore a &Signature Field Tech. 'Hrs..on Site
.40
V - J t...,..----.----.., EA_ From$-.o& To
Source and Description of Fill Materials / - Approximate Fill Yardage
Total Req'd Placed this shift Total to Date
Weather Report Sequence No.
Test Test Elevation Soil Fill Test.Dry %of Max Remark
No. Location or Type Moisture Density Dry
Depth, % lbs/cu.ft. .Density
nh r, of c Ii vri7 rc.r7} to clad- (tot -is: 4 At svSrct`( Sir , -tok 1 cle.,i' of- (54c A 9A 1ciJf
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d Md . i> const clt't A Sul--)a.k Car
_1"h (.4 J&t.. Vu lo0ms}( Wt qr.-)vii
Remarks (Describe equipment used hauling, spreading, watering, condition and compacting; also report
thickness if lifts, removal of poor soil insufficiently compacted,and comment in unusual events.)
Ni" l Act }- Qf„ vest
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56" 1 t '
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11819'Goldring Road,Suite A I
Arcadia,CA 91006
Tel:(626)263-3588•Fax:(626)'.263-3599
INSPECTOR'S DAILY REPORT OF COMPACTED FILL
-
JobJoName JobLocation
L
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Job No., Page.of
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ce*:"Le(�a( lqlrAW ?es-I x _ _ t1-0S- IS r tkursdc„
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Source and Desoription of Fill Materials '- .Approximate Fill Yardage
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Weather Report Sequence No.
Test Test Elevation Soil Fill Test Dry %of Max Remark
No. Location or Type Moisture Density Dry
Depth L % lbs/cult. Density
x i I - 1.5 I\ _ 6.R qa. a
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11819 Goldring Road,.Suite A - .
- - Arcadia,CA 91006 -
Tel:.(626)263-3588•Fax:(626)263-3599
INSPECTOR'S DAILY REPORT OF COMPACTED FILL --
-Job Name Job Location Job No. Page of
_ h6j v"- I^1Det.�-j.Y/� S6 E- L51 f?anySue t. 4n'& JS—z3ti — 0,0I 1 J t
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Ii-1-'r we -
Grading Shift Hrs. -1. Contractor's Supt;of Foremaan&Signature Field Tech: . Hrs..on.Site
r/i From?;00 To
Source and.Description of Fill Materials - -� . Approximate.Fill Yardage
Total Req'd Placed thisshift Total to Date
Weather Report Sequence No.
Test Test Elevation Soil Fill Test Dry %of Max Remark
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Depth % lbs/cu.ft. Density
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11819 Goldring Road,Suite A
Arcadia,CA.91006
Tel:(626)263-3588•Fax:(626)263-3599.
-
- - INSPECTOR'S DAILY REPORT OF COMPACTED FILL
Job Name Job Location Job No. Page Of
Compo/-.Lr 7 Yt? 3b E. LaS �(a^es ave, 11 -27' —Doi !7 '
General-Contractor Grading Contractor -d-.-5 - - - Date D y of Week
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Source and Description of Fill Materials 'C.. Approximate Fill Yardage
6) ��5; , Total,Req'd Placed this shift Total to Date
Weather Report Sequence No,
Test Test Elevation Soil Fill Test Dry %of Max Remark -
No. Location' Or Type Moisture Density Dry
Depth lbs/cu.ft. Density (1.'
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11819 Goldring Road,Suite A , C
Arcadia,CA91006.
Tel:(626)263-3588•Fax::(626)263-3599
e, Development Services Department
240 West Huntington Drive,Post Office Box 60021 PERMIT NO.
' \.,--es Arcadia, CA 91066-6021 BOO-057-805
City of (626) 574-5416,Fax(626)447-9173 Permit Type: Fire
Arcadia
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
14036 9/11/2017 CM 14:51 9/21/2017 Final
ADDRESS NO. Dlr.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
36 E Las Flores Ave 5789-015-005
OWNER MAILING ADDRESS
Chou,Chenju L P O Box 2298 PHONE NO. Plan Chk#: 17-309
Arcadia, CA 91077 EMAIL ADDRESS:
APPLICANT MAILING ADDRESS
PHONE NO.
EMAIL ADDRESS:
CONTRACTORIPROFESSIONAL MAILING ADDRESS
626 NO. 255-2312 FAX NO.
F&H Fire Protection 1119 Westminster Ave PHONE (
Alhambra,CA 91803 EMAIL ADDRESS:
License No. 584319 Type: C16 A B Expires: 4/30/2019 12:00:
TENANT MAILING ADDRESS
PHONE NO. FAX NO.
DESCRIPTION
FIRE SPRINKS FOR SFR
Construction Type UOM H of Units Value Construction Type UOM H of Units Value
Value Value 2,500.00 $2,500.00
OCCUPANCY: Fire Sprink/Alm TOTAL VALUATION: $2,500.00
QTY UOM DESC AMT AMT PAID ACCT QTY NOM DESC AMT AMT PAID ACCT
25.00 each sprinkler pek 700.00 700.00 01-3109
1.00 Flat Fire Issue Auto 44.35 44.35 01-3112la
each Fire Permit 121.00 120.35 01-3112
��
1.00 each SWMF 2 Auto 1.00 1.00 88-3027 ���
Total Fees: $865.70 Balance Due: $0.00 Paid Today: $165.70
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt if: 117976
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from 01-3112 164.70
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 88-3027 1.00
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.
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
9)
(Closed on alternate Fridays)
w,'°°ava
k .; PERMIT/PLAN REVIEW APPLICATION
1-,
i • Development Services Department,240 West Huntington Drive,Post Office Box 60021
%%h,at'''. Arcadia, CA 91066-6021, (626) 574-5416, Fax(626) 447-9173
City of
Arcadia
i3 ICENSED 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 fullforceand effect. 13 I have and will maintain a certificate of consent to self-insure for workers'
License Class C- 1'6 License No. C0'f5l 9 Exp. Date 09/3o//Q 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 have and will maintain workers'compensation insurance,as required by Section
CII 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 WO R4uA-R p 1445. co-
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number r, W L 8 7 87 87
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 them 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, 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
sale(Section 7044,Business and Professions Code:The Contractors License Date 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 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
further' information.l
Name (641 ili ru V4 Title
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 7i�l2nr./"' Date 0 4/Z t% 7
f ARc
ORN
% OAF " �.
i
eo0fik
j `'.
MEMORANDUM_
Fire Department
DATE: September 25, 2019
TO: BUILDING DEPARTMENT
INSPECTOR Jeff Wang
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 36 E. LAS FLORES
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 8-9-2019 Jill Perumean
FIRE ALARMS
TANKS
HOOD B. DUCT
KNOX BOX
OCCUPANCY 8-9-2019 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 9-25-2019 Jill
,
WATER DIVISION
ATTENTION: mARK DATE: CS �
FROM: BUILDING DIVISION INSPECTOR: -Jeff-
ADDRESS: 36 'Er Lkf ttR S
( 7/vCPERMIT NO.: FJOC - asD—0 d2 PLAN NO.: 3 ( 7/2--
CONTRACTOR:
ONTRACTOR: OMI b 00 I t PHONE NO.: 6 Z 6-6-71---16"717
OWNER: STEUe 0146“ PHONE NO.:
PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT
OF PUBLIC WORKS REQUIREMENTS.
Type of Inspection Date& Initial Date& Initial Final Approval
Meter Location
C��S1NeC�
Blackflow Devices
Irrigation System
CkiC 14M-4
Fire Sprinkler System
Ofk411 65)
Meter Clear A.P.P.
Swimming Pool
COMMENTS: 566- I-4° \ "--1 \7/LID NU/ t9 . V k9 MOS