HomeMy WebLinkAboutPLUM-19-0817 City of Arcadia, CA
Permit NO:Plum 59=0817
" ' Development Services Department 11D�,? ?rri"`" R'iic s a = . Permit: Type-`Plumbing,
240 West Huntington Drive,Post Office Box 60021 _ 't t- u
' I—'� ° 1 °f •v l I ff Work Classification:'Plumbing Residential..
Arcadia,CA 91066-6021 _ ,- -I R- Ire i— i _ ..
(626)574-5416 ' -•PermitStatus,4ssued"
ARCADIA Issue Date:05%01/2019 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
424 E Pamela RD Arcadia,CA 5780001021
Contacts
Tone Billie 1 Tr Billie J Tone Trust Owner A.R.S./Rescue Rooter* Contractor
424 E Pamela RD,Arcadia,CA 706 W Arrow Grand CIR,Covina,CA 91722
(626)858-9284 765155
Description:REPLACE WATER HEATER IN SAME LOCATION . Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Plumbing Permit Issuance Fee $47.01 Total Fees $63.56
Solid waste Management Fee 2 $1.00 Cash/Receipt#REC-01098-19 $63.56
Water Heater and/or Vent $15.55
Amount Due: $0.00
Total: $63.56
5-17-!1 ,t' COMPLETE
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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.
/ May 01, 2019
Issued By: Date
May 01,2019 Page 1 of 1
.FAR .
,0n uucy<1'ei
I� wen, b PERMIT/PLAN REVIEW APPLICATION
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@T'1' 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'.. t- CLARATION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of p- at I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Secy• '00,of Division 3 of the Business and
Professions Code,andmylicens '. i• full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C�fa Li 1J.,4 o. G I SCJ. Bap. Date7'30.2o compensation, as provided for by Section 3700 of the Labor Code, for the
40I' 1// performance of the work for which this permit is issued.
Signature of Contractor
NI
OWNER-BUILDER DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury th. . 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 c er and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier Li ( y Mud-kiwi
demolish,or repair any structure,prior to its issuance,also required the applicant_ �%�6- 5o [7[O� ��Q•
for such permit to file a signed statement that he or she is licensed pursuant to the Policy NumberD
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundreddollars 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 0 I certify that in the performance of the work for whi this •1 •'t 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 b; •• : s eject to thy orkers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that i I sh,ul5 becomes Jgect to the
workers'compensation provisions of Section 6 00 •f t•a Labor r ode,I shall
❑ as owner of the property, forthwith comply with those provisions.
I, e work,and employees with t nges as thew sole
compensation,will do the the structure is not intended or offered forI �y
sale(Section 7044,Business and Professions Code:The Contractors License Date I v, Signa[me or i
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 are2not intended or offered for WARNING: Failure to secure Workers''Compensation cove i 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($100,000),in addition to the cost of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Code, interest, and
attorney's fees.
0 I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon,and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
Date Signature Lender's Address •
IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
RESTRICTIONS SET FORTH ON THIS APPLICATION AND THE FOLLOWING:
1. The City's approved plans and permit inspection card must remain on the job site for use by City inspection personnel.
2. Final inspection of the work authorized by this permit is required.A Certificate of Occupancy must be obtained prior to use and occupancy of new buildings
and structures.
3. Per South Coast Air Quality Management District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos containing materials requires an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909) 396-2000 for
further information. y/n /�
(4ame ` •tCU�.IWI d Jr, 'r Title P mI�f f /$.cr
PRINT AME
I certify that I have rea/' a,plication and state that the above information is c rect and that I am the owner or duly authorized agent of the owner.
I agree to comply wi all ty ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upo/the ab' .-mentioneyproperty for inspection purposes. 1
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Signature \DateC ; - `