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HomeMy WebLinkAboutUntitled i City+of Arcadia, CA Permit,NO Plum 19 1057 Iv. : Development Services Department I D r�_ i , rl PermitType Plumbing 240 West Huntin on Drive,Post Office Box 60021 �Arcadia,CA 91066-6021 '�.\ '- iI~ . :Work Classification:Plumbing Commercial "- '---- (626)574-5416 — Permit Status:,Issued ARCADIA - Issue'Date:06/04/2019' Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1201 S Baldwin AVE Arcadia,CA 5383035029 Contacts YAN PING ZHOU Agent for owner BALDWIN ARCADIA CENTER LP Owner 815 W NAOMI AVE A,Arcadia,CA 91007 (626)423-9900 Description:ADD HAND SINK IN NAIL SALON Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check p Plan q Fees Amount payments Amount Paid Lavatories $13.21 Total Fees $61.22 Plumbing Permit Issuance Fee $47.01 Cash/Receipt it REC-01422-19 $61.22 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $61.22 1—V-4/ v t•PCA•Fc 004 e Pet/G/6 PcvwsBGnlG •7J3a-te1 vn wM-4- S-7 g--ltif Ft / V'v CALLS FOR INSPECTIONS L Request for inspection by telephone at 626-574-5450. Leave a message �}.� requesting the address,timeframe and what inspection item is needed. © � ...,./y.';' ' til This permit/plan review expires by time limitation and becomes null and +(f /y�' void if the work authorized by the permit is not commenced within 180 days r ;r' 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. gid} June 04, 2019 Issued By: Date June 04,2019 Page 1 of 1 ,FAR 17,., T PERMIT/PLAN REVIEW APPLICATION ti � Development Services Department, 240 West Huntington Drive,Post Office Box 60021 = co,, 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 License No. Exp. Date 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 ❑ 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 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 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 hose provisions. compensation,will do the work,and the structure is not intended or offered for `/ �l"f q Signature (1411----.1r— sale j sale(Section 7044,Business and Professions Code:The Contractors License Date 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(I)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). 0 I am exempt under Section 7044,Business and Professions Code,for this reason: II'' Lender's Name Tate V I tf I i/, Signature L Lender's Address IMPORTANT: APPLICATION IS HEREBY THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO 1'IIE 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 tor ��y�/// further information. )(lame fan inn 21,1D 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. , 614111 --24gnature 1 A 4 4�pbWogyi�N rrc...' Ft= %Nahy al" City of Arcadia • Building Division 240 West Huntington Drive,Arcadia CA 91007 Office: (626) 574-5416 Fax: (626) 447-9173 When the permit application and the Owner-Builder Declaration have been executed by a person other than the property owner,prior to issuing the permit, the following shall be completed by the property owner and returned to the agency responsible for issuing the permit: AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal - -- '- - responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an uildeirae`;rrnzt for my project. I declare under penalty of perjury that I am the property owner for the address listed above, and I personally filled out the above information and certify its accuracy. Propeity Own�ery Signaturer Date: r�� / 9 0 Abe Property Address: (2,0( S 6 a-/J u i )x Abe Aim et ae (4 7(057 Baldwin Arcadia Center LP Owner's Name: Owner's Address: 430 S Garfield Ave. , #338, Alhambra, CA 91801 • Phone# 626-281-9338 1 Agent's Name: /1 1 " Z)0 66 Agent's Address: b2-6- / Agent's Phone#: 4y3 - 97,8 • Scope of Work: NOTE: This authorization must be NOTARIZED or accompanied by a copy of the homeowner's current photo I.D. (i.e., driver's license, passport or military 1.D. with signature), when presented for issuance of a permit. Ga foto ejawI/ C 3ctCAit p- os(z312o17 California Jurat A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached,and not the truthfulness,accuracy,or validity of that document. State of California Subscribed and sworn to (or affirmed) before me County of Los Angeles on this day of 1 'k , 20 « , by _ QbN6- kJ DANIEL HAAG proved to me on the basis of satisfactory evidence .44,15$ Notary Public•California � Los Angeles County T to be the rson(s) who ap red b fore me. e+1 r Commission k 2245742 [ °' My Comm.Expires Jun 16,2022 p _ ll Signature U( Signature of Notary Public Place Notary Seal Above — --- OPTIONAL INFORMATION------------------ Although the information in this section is not required by law,it could prevent fraudulent removal and reattachment of this jurat to an unauthorized document and may prove useful to persons on the attached document. Description of Attached Document r r Title or Type of Document Mill40R—t 1 ttor PF !'�Geg Document Date of `u/ZOO .10 •PisierQ Number of Pages: ( ?Qatari QDt e- JFJe 9 4iaeOt Cc I ELb 5p`orp\1 Center ` /219/S /alGiti),V 4V K A i!a . oq 9�n7 . ; L I1 A p f}'On1 Jo�,Y Sink C7•,.. To i�ef— I a • V IP • . A Doe( 0 I a su�s\�o ',f. CIN NJ cE Cao xo• .•0- ' Oa �,,,a• gyp•', ; a \ON\\ ;'t V N •<- 1� miNO V I 21-0° O v N/ 4 7 A ' . _ >1 i3,- /a " Arcodia H(kb SbopP;^5 ( DR- MINAE • I Zo I S. 041,10404 AVC v 4rcao of CA 91 a? K > l< , IO -71-ont JooY ra Sink Toy let • n pesf)-com pool, v 0\ 1' Op U1 v IL / 3 /— /0" >I t " -City of Arcadia, CA Permit NOPIum-19-1057 { Development Services Department I D Iv r^'+`^"-�-' amt r Permit Type:Plumbing ' a 240 West Huntington Drive,Post Office Box 60021 I _r ' cr, ' ' Arcadia,CA 91066-6021 { i s ¢ P I F j I1 1 Work Classification:>Plumbing Commercial (626)574-5416 "- " " "` Permit Status:Issued ARCADIAIssuebater06/04/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1201 S Baldwin AVE . Arcadia,CA 5383035029 Contacts VAN PING ZHOU Agent for owner BALDWIN ARCADIA CENTER LP Owner 815 W NAOMI AVE A,Arcadia,CA 91007 (626)423-9900 Description:ADD HAND SINK IN NAIL SALON WITH WATER Valuation: $ 0.00 Tenant HEATER. Total Sq Feet: 0.00 Plan Check q Plan tJ ' Fees Amount Payments Amount Paid I Lavatories $13.21 Total Fees $76.77 Plumbing Permit Issuance Fee $47.01 Cash/Receipt k REC-01906-19 $15.55 Solid Waste Management Fee 2 $1.00 Cash/Receipt U REC-01422-19 $61.22 Water Heater and/or Vent $15.55 Amount Due: $0.00 Total: $76.77 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. -,.. r June 04, 2019 Issued By: Date July 25,2019 Page 1 of 1 Of •R cfrPFoRV,„:• • ' , _ ' PERMIT/PLAN REVIEW APPLICATION ora IFS i . 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'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 _ License No. Exp. Date 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 OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section 0 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 is 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 roe forthwith comply with those provision ❑ property,rty, or my employees with wages as their sole _ compensation,will do the work,and the structure is not intended or offered for of sale(Section 7044,Business and Professions Code:The Contractors License !Date 7�2 j 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: �J _ Lender's Name �//I Date7/ , Signature Yom'/ Lender's Address IMPORTANT: APPLICATION IS HEREBY TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON THIS APPLICA ION 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 UU/'1 1—",aJ C7L((/n (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. 77'‘F--- '7 Signature _ t SSS" I Date / 7'f