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HomeMy WebLinkAboutELEC-19-0788 t __ ciae1 City of Arcadia, CA _ Permit Na Elec-19-0788 • Ci t i f 1/., Development Services Department rV , �r-'l —. of ) - Permit Type:Electrical r 240 West Huntington Drive,Post Office Box 60021 )(7,-Trp �tC/ 1 - t ( 1 11 I 1 1I ,1 Work Classl cation.Elec-VCU-Residential Arcadia,CA 910 6 6-60 21 " —��I _st ,, �)�, t h - i (626)574-5416 `_ - - Permit Status-Issued ARCADIA Issue,Date:04/24/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 29 W Palm DR Arcadia,CA 5788011043 I Contacts CHENG,MU TAN TR MU TAN CHENG Owner Trout Electric Contractor TRUST 17843 Glen Hollow WAY,Riverside,CA 92504 29 W PALM DR (951)743-0702 933396 Description:INSTALL(2)240 V 50 A NEMA 14-50 OUTLETS FOR Valuation: $ 0.00 Tenant ELECTRIC VEHICLES Total Sq Feet: 0.00 Plan Check tt Plan q Fees Amount payments Amount Paid Electrical Permit Issuance Fee $47.01 Total Fees $61.21 Electrical Vehicle Unit(240 Outlet) $13.20 Cash/Receipt U REC-01057-19 $61.21 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $61.21 17,414 e- 5--ti- tet it/ /2 tripittirn 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. • (----, • f\ % April 24, 2019 Issued By: Date April 24,2019 Page 1 of 1 ,FAR . 000014,4-•i PERMIT/PLAN REVIEW APPLICATION • •. ,. -.qv,. - Development Services Department,240 West Huntington Drive,Post Office Box 60021 'mm,,,,o0y, Arcadia, CA 91066-6021, (626) 574-5416,Fax (626)447-9173 City of Arcadia ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: hapter 9(commencing with Section 7000,of Division 3 of the Business and fessions Code,and my license is in full force and effect. /� (SD( ■ I have and will maintain a certificate of consent to self-insure for workers' License Class CUD License No. 9 S7(Exp. Date lv compensation, as provided for by Section 3700 of the Labor Code, for the qa performance of the work for which this permit is issued. Signature of Contractor G i OWNER-BUILDER DECLARATION ti ::1 ave 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 .( C,04' I demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number r ` r4-� © ,p- d 1 /q C d T� o 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 11 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 as owner of the property, forthwith early with those provisions. C ❑I, or my employees with wages as their sole LlI/ compensation,will do the work,and the structure is not intended or offered for (q 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). ❑ I am exempt under Section 7044,Business and Professions Code,for this mason: 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. /�, V� came ✓ '�(i�(t«r �K/ `LCA Tale �� PRINT NAME / ertify 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 aB City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of cadia to enter upon the abov entioned property for inspection purposes. // j� �tgnamre Date If'" "I/, /