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HomeMy WebLinkAboutUntitled 454, City of Arcadia, CA \ HuntingtonDevelopment pmtrviDepartment Dv lD e Ofce Box 60021 Permit Na M p o j ''^'' - r�- Si(( � � - I ( Permit Type:MEP i - - -. ; I `, Work Classifcation:.MEP-ResidentialArcadia,CA 91066-6021 _ I -., _ I (626)574-5416 - _ - -Permit Status:Issued ARCADIA - Issue Datefo5/06/2D19'I Expiration: ' Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1321 Holly AVE Arcadia,CA 5784009010 Contacts LOPEZ,REINALDO A AND IRMA L TRS Owner HA MY DESIGN INC Contractor LOPEZ FAMILY TRUST 22222 SHERMAN WAY 210,CANOGA PARK,91303 1321 HOLLY AVE (800)285-3002 999603 Description:REMODEL BATH RM,DRYWALL REPAIR,NEW TILE Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# . — -- - Fees Amount Payments Amount Paid Electrical Permit Issuance Fee $47.01 Total Fees $215.09 Lavatories $26.42 Cash/Receipt#REC-01131-19 $215.09 Light Fixtures $6.52 Amount Due: $0.00 Mechanical Permit Issuance Fee $47.01 Outlets-Receptacles&Switches $3.26 Plumbing Permit Issuance Fee $47.01 I '' CO � pIETED Shower $12.46U Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 Ventilation Fan(Single Duct) $9.94 CALLS FOR INSPECTIONS Water Closet $12.46 Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. Total: $215.09 ,{q r p ?py&Jl ECSC. MECO-- 1 /LtiGe 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 Cru—17 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 � 7.�—r , ,,1` void if any work authorized by this permit is suspended or abandoned for 180 SY' consecutive days or if no progressive work has been verified by a City of / Arcadia building inspector for a period of 180 consecutive days. 47-44r�/C bNawER "--2-7/1 2,442- 6-2L)-i? /eG a= May 06, 2019 Issued By: Date May 06,2019 Page 1 of 1 •F A• 0y,Fogytia' 4n ,-, c I'F PERMIT/PLAN REVIEW APPLICATION %1 .m-- � 'Edir Development Services Department,240 West Huntington Drive,Post Office Box 60021 °°r,, r Arcadia, CA 91066-6021, (626)574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION o I hereby affirm under penalty of perjury that I'am licensed undo .visions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of a .usiness and Professions Code,and my license is in full forcecand effect. / Li I have and will maintain a certificate of consent to self-insure for workers' License Class 3 License No. I fifo60 Er.�a to �2.3� P 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 191 have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DECLARATION ❑ I hereby affirm under penalty of perjury that I am exe './om the Contracto . 3700 of the Labor Code,for the performance of,the work for which this permit License Law for the following mason(Section 7031.5,B mess and Professi.ns G is issued.My workers'compensationf - insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier 5 CR t .0/a" demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number /0 1 '307/ for such permit to file a signed statement that helot 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 them from and the basis for the alleged exemption. Any violation of LiI 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 sub'ect to the workers' penalty of not mom than five hundred dollars($500)): compensation Laws of California,and agree that if I sho •��•.- .me subject to the workers'compensation provisions of Section rmo Labor Code,I shall I, as owner of the property, forthwith comply 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 �; —I Signature sale(Section 7044,Business and Professions Code:The Contractors License Date i / Law does not apply to an owner of property builds 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 isunlawful, 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 contractors)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 materia s requires,an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for further information. ft_ s�' - 11 Mile • e o' I PRINT NAME I certify that I have read this application and'sta • ' the above information is correct and that I am the owner or duly authorized agent of the owger. I agree to comply with all City ordinances,and e Laws relating to building construction. I hereby authorize representatives of the Cit<vlof Arcadia to enter upon the above-mentioned prop. .r inspection purposes. � Signature DateD (9 �I J