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Home My WebLink AboutROOF-19-1600 ctCity of Arcadia, CA Permrt No. ROOF-19-1600 Development Services Department - j 6s - Permit Type:Raof it 240 West Huntington Drive,Post Office Box 60021 n � ° ' j33 LWork Glasst cation:Reroof Residential Vy Arcadia,CA 91066-6021 ,,,s �L..E -�L� i.,.J h i (626)574-5416 '_-, =:; ..- - Permit'Sta us:Issued ARCADIA Issue°Date:08/14/20191 Expiration: .T Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1113 E Camino Real Arcadia, CA 8510004016 Contacts JOHN LIEU Agent for owner KIM LAM Owner 1101 Camino Real AVE (626)698-8086 (626)698-8086 Description:T.O,NEW SHEATHING,REROOF HOUSE/GARAGE Valuation: $ 8,000.00 Tenant WITH GAF HD BIRCHWOOD CLASS A 15 SQ(VQ) Total Sq Feet: 0.00 Plan Check N Plan k Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $257.11 Building Permit Fees $203.85 Cash/Receipt k REC-02131-19 $257.11 Solid Waste Management Fee 56.25 Amount Due: $0.00 Total: $257.11 , row-- siim-vile &I _ (1"1I ! i �t- 8--2,7-1 7 CALLS FOR INSPECTIONS •_/�� ,�_I Request for inspection by telephone at 626-574-5450. Leave a message `ir V1'V 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. ilir August 14, 2019 Issued By: Date August 14,2019 Page 1 of 1 • 'R JAU PERMIT/PLAN REVIEW APPLICATION S7 Development Services Department,240 West Huntington Drive, Post Office Box 60021 m.a,,,< ^ 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 0 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 for such permit to file a signed statement that he or she is licensed pursuant to the olicy Number 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 I certify 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 'I 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 00 of the Labor Code,I shall ❑I, as owner of the property, forthwith co ply 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 (Date y lot Signature sale(Section 7044,Business and Professions Code:The Contractors License 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 coverageis unlawful, sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penaltiesandcivil 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 an Professions Code,for this reason: p� Lender's Name /Date O/�q 1 Signature • Lender's Address IMPORTANT: APPLICATION IS BY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND RESTRICTIONS SET FORTH ON 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 • . N ETitle l"JI e N T PRINT NAME 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 City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon t above-mentioned property for inspection purposes.• / p� ignature ate 1 Li / 1 of AR Mi 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 Owner-Builder Permit 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. • Property Owner's Signature: 7-2 Date: ,f/ Property Address: 1113 E• CAMINO ' hL AVE,. ARCALR CA-, ''/C°46 Owner's Name: KIM 4 LAN4 Owner's Address: 15 IF S• 3 (*IL At-CA D\t cA, q/ 006 Phone # (C.26) 25;-- 2Z Agent's Name: Ll fl t Agent's Address: 15113- 5. 3t° MVE. PrZCAhD Per Chi q/0 6-( Agent's Phone#: (41,6) (,qg �15-D$b Scope of Work: Rome SH-1N&,LESS gepLn(SM6-N T 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 I.D. with signature), when presented for issuance of a permit. • ®ta�� IFOq,p,1 \ ttIzqy% Dm , AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: I\\-3 (✓ CAS Idot41 1cV� Permit Number: iD* \0 - 1koQ Brief Job Description: RtX .51}I r (m1>(;, 1ZG?\ACE H A) T ae 2wf Number of smoke alarms installed: T 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/licensinolistingsllicenselistinq bml searchcotest.pho 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. I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) c5 )10\/ k at Arcadia, California. Owner's Name (printed/typed): M LAM Signature of Owner: • This affidavit must be returned to the City of Arcadia inspector prior to final inspection • B''•KE • Im' I2 .' :Ply CA- BO' 'l]iOXIDL .:»' •CATIO Guest Boom c �i;athroon U Storage • • Family Room • Garage FIRST FLOOR PLAN ®= SMOKE ALARM I = CARBON MONOXIDE ALARM • ` I Ito . Mstr Bat Bath Pi Master Bedroom Dining Room Kitchen — Bath Hall Closet Closet Closet Family Room Bedroom Bedroom • SECOND FLOOR PLAN II=SMOKE ALARM ® = CARBON MONOXIDE ALARM