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Home My WebLink AboutDEMO-19-0330 CITY OF ARCADIA CHECK REQUEST Vendor No. Date AUGUST 27, 2019 (for Administrative Services Only) Pay to: ARMANDO CAMARENA 6656 YOUNGSTOWN ST CHINO CA 91710 Account No. Amount 714-2275 $ 1,628.00 $ $ TOTAL $ 1,628.00 Reason for payment. (PLEASE SUBMIT BACK-UP IN DUPLICATE) Please process a refund to the above recipient (Demolition Bond) 401 E LEMON AVE Permit: DEMO 19-0330 4 ❑ Check here if check is to be Approved by: /7/7returned to Department. BU. .Department: - City of Arcadia, CA Permit Na Demo19-0330 Development Services Department D .C Permit Type Dernolitit n $� zao west Huntington Drive,Post Office Box 60021 _ ��Work classification•Demo-Residential 1 e Arcadia,CA 91066-6021 }1 _ kk (626)574-5416 - �-- *„"3 Permit Scotus:Issued ARCADIAIssue;Date:.05/30/2019,1 Expiration: 11/26/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 401 E Lemon AVE Arcadia,CA 5790015026 Contacts E HIGHLAND US CORP Owner ARMANDO CAMARENA* Contractor 5003 Golden West Ave,Temple City,CA 91780 6656 YOUNGSTOWN ST,CHINO,CA 91710 (909)973-9144 1014168 Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. Valuation: $ 1,628.00 Tenant .f.� REFUND DEMO BOND TO ARMANDO CAMARENA 6656 YOUNGSTOWN ST CHINO CA 91710 CA 909-973-9144 Total sq Feet: 1.628.00 Plan Check tt Plan N Fees Amount payments Amount Paid Bond for Demolition $1,628.00 Total Fees $1,823.53 Demo-Sewer Cap and/or Cesspool Fill $16.48 Cash/Receipt it REC-01367-19 $1,823.53 Demolition Permit $77.78 Amount Due: $0.00 Demolition Permit Issuance Fee $47.01 Plumbing Permit Issuance Fee $47.01 ' Solid Waste Management Fee $6.25 Solid Waste Management Fee 2 $1.00 COFiPLTTotal: $1,823.53 Eii CALLS FOR INSPECTIONS 6 -43-1/ Request for inspection by telephone at 626-574-5450. Leave a message t requesting the address,timeframe and what inspection item is needed. OK "fb g iwo�D 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 idfrom the date of issuance or if the permit is not obtained within 180 days from uTpr me and 180 ,I void if the anydate workof authorizedplansbybmittal.thishis permiterist suspendedexpiresand orbabandonedcomesnull for ,[�lr}r consecutive days or if no progressive work has been verified by a City of . Arcadia building inspector for a period of 180 consecutive days. § I I 3912 Ln ” Z C LeMON qjc May 30, 2019 Issued By: Date May 3b,2019 Page 1 of 1 ,FAR 00.008v,,•i iiire •moi k PERMIT/PLAN REVIEW APPLICATION a 4'1r, Development Services Department,240 West Huntington Drive,Post Office Box 60021 4,40 it,GOV Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of Arcadia ZICENSED 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�t'\2 Code,and mylicense is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'' License ClassC• L}egns f(b' Exp. Dates 3 • compensation, as provided for by Section 3700 of the Labor Code, for the r (//'I�_ performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION 0 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 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 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 1'x�.y 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 'x`44 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 .,if I should.ecome subject to the workers'compensation provisions of Sec' i 3701 of I- Labor Code,I shall ❑I, as owner of the property, forthwith comply with those provisions. / or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for \DatA sale(Section 7044,Business and Professions Code:The Contractors License /rf�/7.0i f 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). ❑ 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. are i /I / i a d/ ✓7--6 h `Title kl"Q]^ PRINT NAME 1+ 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. Iagree to comply wit I City ordi ces and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upo a ab e- oned property for inspection purposes. \Date Siawm /fc/zI/9