HomeMy WebLinkAboutROOF-19-2174 �. Permit NO: ROOF-19-2174
' � Cit{.r�f Arcadia, CA - _
'l ( Development Services Department v^ n �y -1 Permk7ype 'ROOf,
1 f 240 West Huntington Drive,Post Office Box 60021 '' ! - -'
Work C/osslificotion•Reroof Residential
t a Arcadia,CA 91066-fi021 L'- . ,
I-7—V. ' 1 (626)574-5416 y-1.- 14141:., , _ - ^ - "Permit Stows issued
ARCADIA Issueoate 10/28/20191 Expiration.
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
740 SOUTHVIEW RD UNIT D Arcadia,CA 91007-6719 5783013092
Contacts
EDUARDO TSAI Owner ATO JACK ROOFING I , Contractor
12387 CLINTON ST,EL MONTE,CA 91732
(626)272-6378 (626)922-2234 816608
Description:LOATH REROOF HG 120 WITHASS A S SQ(LT)G, Valuation: $ 10,500.00 Tenant
COLOR TO MATCH EXISTING 120 LBS CLASS A 35 SQ(LT)
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $307.21
Building Permit Fees $253.95 Cash/Receipt#REC-02903-19 $307.21
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $307.21 0 GOiIiE'LErui
pt-Rc- 1N3fC661%1
cos taxsige. o- vr_,141
(j CALLS FOR INSPECTIONS
Q��,,c r T(�'� Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
11-4(—i9 .�ia-c-
-CCE/VEV COWWKB Per K Arre cavi Tis permit/plan review expires by time limitation and becomes null and
dresr void if the work authorized by the permit is not commenced within 180 days
from the date of issuance or if the permit is not obtained within 180 days
from the date of plan submittal.This permit expires and becomes null and
void if any work authorized by this permit is suspended or abandoned for 180
consecutive days or if no progressive work has been verified by a City of
Arcadia building inspector for a period of 180 consecutive days.
October 28, 2019
Issued By: Date
October 28,2019 Page 1 of 1
,FAR .
C..]FO$VGu,
A u fl i. I'' PERMIT/PLAN REVIEW APPLICATION
S'.....1
J>, Development Services Department,240 West Huntington Drive,Post Office Box 60021
memo-•-.) Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of
Arcadia
LICENSED 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 full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class _- �a License No.• --. Data�t-'Nk-) I compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Connac• fperformance of the work for which this permit is issued.
1111
ave and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER D ,
ir_' ••T 1 N 3700 of the Labor Code, ormance of the work for which this permit
0 I hereby affirm under penal . perj th. I am exempt Item the Contractors is issu y ork rs'compe ation msutance carrier and policy numbers are:
License Law for the folio ' _ -. on .`- tio' 7031.5,Business and Professions
Code.Any city or county w h requires a pe .'t to construct,alter,improve, Carrier _ b v..._.
demolish,or repair any stmc t. prior to its issuance,also required the applicant Policy Number �R,y
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 comp eted if 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 permi ' rssu- 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 sub' t to the w•rkers'
. penalty of not more than five hundred dollars($500)): compensation Laws of California, •.: :•. that if I should .- .me sub', t to the
workers'compensation provisions . tion 3700 of .e Labo •.de,I shall
❑I, as owner of the property, forthwith compl with those provision
or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for PP Date10'1 t I Signature
sale(Section 7044,Business and Professions Code:The Contractors LicenseLaw does not apply to an owner of property who builds or mproves 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 WorkeIlk
mpensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to ' .-.1 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 additionto 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
er informatio . -
\ �._
-• 11L�1./._te cit _ Title 411,111
PRINT
I ce Ty •t I have read this application and state : . ii a above'' 1 • ' .tion is correct and that I am the owner or duly authorized agent of the owner.
I ag •• to .mply with all City ordinances ...d State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia •, a I. •r upo , .. •• . . •erty for inspection p •oses.
C! Date'Q°�- Z l�
Signature
- , I City of Arcadia, CA - PermitNO. ROOF'19274
Dev - ,Box 60021 Work Classlflcation:Reroof Residential
fjijjEffjjp
�, (626)574-5416 - "
A .' - pr, x-, � { .--**: - .PermitStgfus. Issued
ARCADIA Issue'Date:1028/2019.1 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
740 SOUTHVIEW RD Arcadia, CA 91007-6719 5783013092
Contacts _ m ffi-
EDUARDO TSAI Owner ATOJACK ROOFING Contractor
12387 CLINTON ST,EL MONTE,CA 91732
(626)272-6378 (626)922-2234 816608
Description:" ENDED 10(29"*REQ• APARTMENTk Valuation: $ 10,500.00 Tenant
BUILDING OVE- ONE °XI S NG LAYER OF COMP WITH CLASS
A,LIFETIME,DIMENTIONAL COMP,COLOR:4-lefilIBR BLEND, Total Sq Feet: 0.00 Plan Check q Plan N
38 SQ JEFF 4114
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $307.21
Building Permit Fees $253.95 Cash/Receipt p REC-02903-19 $307.21
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $307.21
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.
October 28, 2019
Issued By: Date
October 29,2019 Page 1 of 1
A ; PERMIT/PLAN REVIEW APPLICATION `
• i -+
p '4 1" Development Services Department,240 West Huntington Drive, Post Office Box 60021
*Natty en" Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
VIA 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:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
rofessions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class C- 3 1 License No. 4r/ _1 pg- Exp. Date/E//2-°lo compensation, as provided for by Section 3700 of the Labor Code, for the
K performance of the work for which this permit is issued.
Signature of Contractor ,
OWNER-BUILDER DECLAIRATION IrCi 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 Policy Number
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 there from and the basis for the alleged exemption. Any violation of D, 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 Date �a/24// Signature
sale(Section 7044,Business and Professions Code:The Contractors License //
Law does not apply to an owner of property who builds or improves thereo
or who does such work himself or herself or through his or her o n
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 thecost 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.
Name 9e IG C-va.n. Title -0117 c -
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 Date /c/217/ 5
7
n
.n
L4\
fI , y '.
4bwilt,0.11°
AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: WO S s-unwteU
Permit Number: RcSsF tq -21n y
Brief Job Description: /.talar Camp. Rcrsem avec 'I EK-M-416 Z
�� 4-y
a
Number of smoke alarms installed: "i`//-
Number of carbon monoxide alarms installed:
When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created,
Smoke alarms shall be installed in each sleeping 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 dwellings or sleeping units containing fuel burning appliances or having attached
garages, carbon monoxide alarms shall be installed outside each separate sleeping
area in 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.
All alarms shall comply with requirements for listing and approval by the Office of the State Fire
Marshal. http://osfm.fire.ca.qov/licensinglistings/licenselistinq bml searchcotest.php
, As owner of the above referenced property, I hereby certify that the smoke alarms and carbon
monoxide alarms have been installed in accordance with the manufacturer's instructions and in
compliance with the code sections referenced above.
1 declare under penalty of perjury that the foregoing 's true and correct, and that this
declaration was executed on (Date) "/70q// at Arcadia, California.
Owner's Name (printed/typed): K V O C t cA I
Signature of Owner: V.w-0 C- ^�o�.
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
Si.'Q AL, 1 CI c i, sih MI. i ItiE 1:1 ',; II *CI, MI
Guest Roomi fest
SatinI
Storage
Family Room
Garage
1.-------------.- Pill
FIRST FLOOR PLAN
*1= SMOKE ALARM N = CARBON MONOXIDE ALARM
Mstr
ClL [hath.
AMaster Bedroom
Dining Room Kitchen 30
-
Bath
Hall Closet
- r_ Closet Closet
Family Room — C. -
Bedroom Bedroom
SECOND FLOOR PLAN
SMOKE ALARM M ® CARBON MONOXIDE ALARM