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Home My WebLink AboutUntitled Apit CITY OF ARCADIA k •Pam CHECK REQUEST Vendor No. 3 7 1 3 Date December 10, 2019 (for Administrative Services nly) 6(c * Oroctpt Pay to: AMY J HWANG 11740 1490 RUBIO DR SAN MARINO, CA 91108 626-321-7688 Account No. Amount 714-2275 $ 1,782.00 $ TOTAL $ 1,782.00 ii Reason for payment. (PLEASE SUBMIT BACK-UP IN DUPLICATE) 4 Please process a refund to the above recipient, demo bond 467, DEMO-18-0780 414 E LEMON AVE a ❑ Check here if check is to be Approved by: returned to Department. •S Department: Build) g partment is Ems" - — m3 y .y' a c z r t"5 b <' t P .r1 � c t._ ; City of Arcadia,CA „ �` ` % Permrt'NO iyemO'18`'0780 \\11/ I Development Services Department r iiI:'� i„ ,, i " Ex; a PermIt-Type Demolition / 240 West Huntington Drive,Post Office Box 60021 r+'? f) s . . -' n t > ;;V.1„-° + 1 l r 4 i t. 4 b r4 ' , , WorkCki#/fiicanon Demo Residential'; Arcadia,CA 91066-6021 : - '" �- S Si'l s'.ki �ZY yt fiJ T n 3 k i't i (626)574-5416 ..1i-if "',,:r-"° ,R 4:yias' . r "F` Permitc—rf., aiSSued, ARCADIA IssueaD to 05/1o/2o's Expiration: 11/06/2018 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 414 E Lemon AVE Arcadia,CA 5790016003 Contacts HWANG,YEN MING AND MIAO JEN TRS Y Owner Mc Wong Holding Co General Contractor(B) M AND M 1 HWANG TRUST 809 S Atlantic 201,Monterey Park,CA 91754 414 E LEMON (626)570-9969 Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. Valuation: 5 0.00 Tenant REFUND DEMO BOND TO AMYJ HWANG 1490 RUBIO DR SAN MARINO 91108 CA 6263217688 Total Sq Feet: 1.782.00 Plan Check# Plan# N Fees oun PaymentsAmount Paid Bond for Demolition $1,782.00 Total Fees $1,971.28 Demo-Sewer Cap and/or Cesspool Fill $15.55 Cash/Receipt#REC-001136-2018 $1,971.28 Demolition Permit $77.78 Amount Due: $0.00 Demolition Permit Issuance Fee $44.35 Plumbing Permit Issuance Fee $44.35 Solid Waste Management Fee $6.25 Solid Waste Management Fee 2 $1.00 a. COMPLETED R. / 'J f ;° r�0---•—` Total: $1,971.28 6-1' 1 g CALLS FOR INSPECTIONS Qtv,sp• kJ Request for inspection by telephone at 626-574-5450. Leave a message OC lb �J requesting the address,timeframe and what inspection item is needed. This permit/plan review expires by time limitation and becomes null and 26 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 b consecutive days or if no progressive work has been verified by atity of %9— {b Arcadia building inspector for a period of 180 consecutive days. 1 O i 1 IT. 11}..1 4 May 10, 2018 Issued By: Date May 10,2018 Page 1 of 1 !�'+ . PERMIT/PLAN REVIEW APPLICATION ist :4a 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 Co and my license is in fullforce and effect. , ❑ I have and will maintain a certificate of consent to self-insure for workers' teense Class rcense No. g ?/Lp/LU Exp Date. Date. l311 compensation, as provided for by Section 3700 of the Labor Code, for the gnature of ConuaD IO - performance of the work for which this permit is issued. WNER-BUILDER DECLARATION UA ❑ I have and will maintain workers'compensation insurance,as required by Section El hereby affirm under penalty of perjury that I am exempt from the Contractors is of the Labor Code,for the performance of the work for which this permit is issued.My workers'compensatio insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions M O N --p.:( �, 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 ElI certify that in the performance of the work for which this permit is issued,I chap 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, 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 sale(Section 7044,Business and Professions Code:The Contractors License Ir Date l Sigrtature � S '� 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 forwAgNl1•jG: Failure to secant 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 penaltiesand civil fines MP to;one completion,the owner-builder will have the burden of proving that he or she hundrechliousandAollars($100,000);in-addition to the cost elconipensafion,. 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 CONSTRUCTION LENDING AGENCY Code:The Contractors License Law does not apply to an owner of property 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'sapproved 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 K \. ...-\ , Title _G C.-- PRINT 'PRINT NAME? certify that I have read ibis 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 j 4.- . Date CIi b / '1 Il