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Home My WebLink AboutUntitled rte• CITY OF ARCADIA :.\ CHECK REQUEST 3 7 ` 32 Vendor No. Date December 10, 2019 (for Administrative Services Only) • mc -r Pyr Pay to: WISTARIA OAK LLC, 1 14047 711 S FIRST AVE ARCADIA, CA 91006 626-802-7994 • Account No. Amount 714-2275 $ 1,855.00 $ 1 • } $ $ $ S. TOTAL $ 1,855.00 J Reason for payment. (PLEASE SUBMIT BACKUP IN DUPLICATE) Please process a refund to the above recipient, demo bond y tttt DEMO-19-0475 400 E WISTARIA AVE ❑ Check here if check is to be Approved by: �S returned to Department. / Department: BulIdI 1! De• - rt ent � y • -? f�c t. City of Arcadia, CA . permit NO Demo-19:0475 'r , Development Services Department CI tF r'• � Ti Permit Iype Demolition k111, s3 .1 7 9 240 West Huntington Drive,Post Office Box 60021 f , - c r R.-21),, I3f WofkClossrfic6tipn Demo Ijesidenttal Arcadia,CA 91066-6021 if t 1 r .-c "t r' (626)574-5416 ''- ` .l `'�' Nyr Permit stotus Issued, ARCADIAIssue`lDate 06/O6/20191 Expiration 12/03/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number . 400 E Wistaria AVE Arcadia,CA 5790018006 Contacts 11 TONG LING Owner G R MARTINEZ INC,DBA MARTINEZ Contractor 400 WISTARIA AVE,ARCADIA CA,91006 DEMOLITION CO' 14164 Joanbridge,Baldwin Park,CA 91706 (626)484-0033 863529 Description:DEMO HOUSE/GAR,REFUND BOND TO:WISTARIA Valuation: $ 0.00 Tenant . OAK LLC 711 S 15T AVE,ARCADIA,CA 91006 Total Sq Feet: 1,855.00 Plan Check ft Plan It Fees "E........----A-Mount payments Amount Paid Bond for Demolition $1,855.00 Total Fees $2,050.53 Demo-Sewer Cap and/or Cesspool Fill $16.48 Cash/Receipt ft REC-01457-19 $2,050.53 Demolition Permit $77.78 Amount Due: $0.00 Demolition Permit Issuance Fee $47.01 n Plumbing Permit issuance Fee $47.01 pa.,,,,_,L �s ",, �A` fSolid waste Management Fee $6.25 / 7p�t�tSolid Waste Management Fee 2 $1.00 &r/ ✓/ aCOMPLETED YyVVV771_7 Total: $2,050.53 f11' 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 6-41—Gtf Ey from the date of issuance or if the permit is not obtained within 180 days Sifrom the date of plan submittal.This permit expires and becomes null and fis 'cc Cour' } void if any work authorized by this permit is suspended or abandoned for 180 Qconsecutive days or If no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. 'I . "vim Z(" 19' VI/5testi!- June 06,2019 Issued By: Date June 06,2019 Page 1 of 1 0.1P1 ' PERMIT/PLAN REVIEW APPLICATION met Id111Development 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 O 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 eeffect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class CMZ License No. f ,L/�Exp. Date 20 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-BUII.DE TION ❑ 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 worker;'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier /h //•I'L' 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 them from and the basis for the alleged exemption. Any violation of 0 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 I 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 / sale(Section 7044,Business and Professions Code:The Contractors License Date 6/01 Signature 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 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). damagesas provided for in Section 3706 of the Labor Code, interest, and attomey'sfees. ❑I, as owner of the property, am exclusively contracting with licensed - - - contractors to construct the project(Section 7044,Business and Professions rode: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: 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 420.44!n7`44ta r G `! 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. / Signature �� Date 6/(9//