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HomeMy WebLinkAboutUntitled / City of Arcadia, CA Permit NO. RALT-19-0643 Development Services Department Permit Type:Residential Addition/Alteration 240 West Huntington Drive,Post Office Box 60021 t Arcadia,CA 91066-6021 Work Classification:Res-Addition/Alteration (626)574-5416 Permit Status:In Review ARCADIA Issue Date: Expiration: 09/28/2019 , Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 868 San Simeon RD Arcadia,CA 5776028004 Contacts CHHAN,JASON AND CHAN,JANET Owner 868 SAN SIMEON RD (951)906-5564 Description:ADDITION TO ENLARGE WOK RM Valuation: $ 0.00 Tenant LTotal Sq Feet: 112.00 Plan Check#19-643 Plan#29 Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $843.84 Electrical Permit Issuance Fee $47.01 Cash/Receipt#REC-01067-19 $843.84 Gas System(Outlets) $15.55 Install,Relocate Appliance Vent/Hood $9.94 Amount Due: $0.00 Kitchen Sink $13.21 Light Fixtures $3.26 Mechanical Permit Issuance Fee $47.01 Outlets-Receptacles&Switches $4.89 Parks&Recreation Fee(SFR) $319.20 Plumbing Permit Issuance Fee $47.01 compaTED Single Family Fire Plan Check $280.00 CALLS FOR INSPECTIONS Solid Waste Management Fee $6.25 Request for inspection by telephone at 626-574-5450. Leave a message Solid waste Management Fee 2 $1.00 requesting the address,timeframe and what inspection item is needed. Solid waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 Strong Motion Inst.Program Res 50.50 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 Total: $843.84 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. Issued By: Date April 25,2019 Page 1 of 1 C,..„..,..s, 4 ! i PERMIT/PLAN REVIEW APPLICATION *4 IFEE.0:::,....... ,• Development Services Department,240 West Huntington Drive,Post Office Box 60021 .gyp 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 la 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 Policy 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 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 wi those provisions. compensation,will do the work,and the structure is not intended or offered J i. c 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 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 4 Date 25 A ` Signature Lender's Address (PORTANT: 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. I'_,- are Oat` Cka Title P TTT NAME 1 certify that I have read.Ihis 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 • NOTES � - - 6 v Building Inspections Date Insp. Plumbing Inspections Date Insp. //`d 7 .1 //r {7 OF 100. Setbacks 210. Under fir/bldg.drain 5-7 ,- ' _ " // 101. Rough grade 211. Copper underslab 102. Figs.&forms C/7c/git_ 212. Rough plumbing ,/q/t dt 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan 105. Steel 215. Water heater 106. Grout lift 216. Roof drains 107. Shear nailing 6-kit _i-,---z 217. BuMdmg sewer 108. Diaph nailing 218. Water service 109. Roof nailing r17 219. Anal gas 110. Framing p 4 220. Fixtures 111. OcciArea Sept.Wall 221. Anal plumbing /o f-fig 7 112. Sound walls 222. Sewer cap/demo. 113. T-bar grid 114. Insulation-Flr. Pool Inspections Date "Insp. 115. Insulation-Wall : '712/f1. 240. Excavation/steel 116. Insulation-Cell. J' 0L 241. Rough plumbing 117. Drywall nailing 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath 244. Pimp 120. Finish grade 245. Gas line&test 121. Final building /o9// ' 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Anal electric Electrical Inspections Date Insp. 249. Final 'lumbin' 150. Power pole 250. Pool cover - 151. Sales lot lighting 251. Pool final 152. Unde!round conduit 153. Underslab conduit Reroof Inspections Date Insp. - 154. UFER ground 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical 677/, /l C 272. Sheathing nailing - 157. Fixtures 273. Anal reroof 158. G.F.C.I. 159. Es it.bondin, Sign Inspections I Date . Insp. 160. Service panel 280. SetbacWoverhang 161. Final electric 70feJai l 281. Footing ////// 282. Conduit/wiring Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Anal sign 181. Fumace/A.C. 182. Rauch HVAC iCNna Miscellaneous Insp. Date Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Are sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Anal 189. Commerdal hood 190. Duct shafta Sewers&Offsite Insp. I Date Insp. 191. Final mechanical Dr ' / 300. Lateral(main to P/L) r/ 301. Saddler( Block Wall Inspections Date Insp. 302. Cess.00l filled 200. Footings 303. Sidewalk - 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin ---- DATE FILED APPLICATION FOR HOMEOWNER ASSOCIATION ARCHITECTURAL DESIGN REVIEW (SHORT REVIEW PROCEDURE) PROJECT ADDRESS: %, l PROPERTY OWNER'S NAME: J1t/t(k Cttc )�zcy1 (/162c.1/1 ADDRESS (IF DIFFERENT): 1 TELEPHONE NO.: (6-21Q,—SLS-24t5L E-MAIL ADDRESS: c Ck1 t a CJ mo.` Cep\ APPLICANT NAME (IF DIFFERENT): ADDRESS: TELEPHONE NO.: E-MAIL ADDRESS: DESCRIPTION OF PROJECT(Check applicable): ❑ Single-story remodel (includes window replacement)and/or addition(s) ❑ Detached accessory structure(s) and/or Accessory Dwelling Units—new, additions to, and/or remodels ❑ Fences and/or walls in and/or facing (i.e., visible from)front and street side yards ❑ Hardscape, landscaping and structural elements in front and street side yards, including without limitation, swimming pools, spas,fountains and other water features ❑ Fences, lights, and other features related to tennis courts, sports courts or other significant paved features El/Mechanical equipment 2/1 Aoki-ACkkgA se 't 1“tckefrt CiRgN ACTION & FINDINGS: Approved—The project is consistent with all applicable guidelines U Conditionally Approved—With the following conditions, the project will be consistent with all applicable guidelines U Denied—Tke project is not consistent with the following guideline(s) By �. , ARB Chairperson Date: 3fI4(tj 4 L \ 10/18 STHTE OF CALIFORNIA ,. -1 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification War I CEC-CFIR-ADD-02-E(Revised MMIYY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 1 of 9) Project Name: 86 43. Slmec4 Rd Adothon Date Prepared: 4/((/(i This compliance document is only applicable to additions 300 ft`or less,or additions that do not require HERS field verification for compliance.-When HERS verification is required,a CF1R-ADD-01 shall first be registered with a HERS Provider Data Registry. Alterations to Space Conditioning Systems that are exempt from HERS verification requirements may use the CF1R-ADD-02 and CF2R-ADD-02 Compliance Documents. Possible exemptions from duct leakage testing include:less than 40 ft of ducts were added or replaced;or the existing duct system was insulated with asbestos;or the existing duct system was previously tested and passed by a HERS Rater. If space conditioning systems are altered and are not exempt from HERS verification,then a CF1R-ADD-01 must be completed and registered with a HERS Provider Data Registry. Additions or alterations that utilize close Cell Spray Polyurethane Foam(ccSPF)with a density of 1.5 to less than 2.5 pounds per cubic foot having an R-value other than 5.8 per inch,or Open Cell Spray Polyurethane Foam(ocSPF)with a density of 0.4 to less than 1.5 pounds per cubic foot having an R-value of 3.6 per inch,shall complete and register a CF1R ADD-01 with a HERS Provider Data Registry. If more than one person has responsibility for installation of the items on this certificate,each person shall prepare and sign a certificate applicable to the portion of construction for which they are responsible.Alternatively,the person with chief responsibility for construction shall prepare and sign this certificate for the entire construction.All applicable Mandatory Measures shall be met. Temporary labels shall not be removed before verification by the building inspector. A.General Information 01 Project Name: O60 San Strneo 1€prq addition 02 Date Prepared: 4/ (j /ici 03 Project Location: $6nt S' San Siecn r•-c) 04 Building Front Orientation(deg): &5 de (Na)G `J • 05 CA City: A rectd 1 4 06 Number of Dwelling Units with Additions: 07 Zip Code: 9 ( O0 6 08 Fuel Type: Nxtsnctl &L5 09 Climate Zone: CA LL I tmccre Zone 09 10 Total Conditioned Floor Area(ft2)(Addition): 4 12 11 Building Type: S a 9 t . f undly 12 Slab Area(ft2): 4000 (attade) 13 Project Scope: 3t0 ( reused) (12 (addr`Cec.% CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STP,TE OF CALIFORNIA r' 1 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification (0l I CEC-CF1 R-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 2 of 9) ProjectName: pate Prepared: B.Opaque Surface Details—Framed(Section 150.2(a)) 01 02 03 04 05 06 07 I 08 I 09 10 11 Proposed Required Frame Frame Continuous Appendix1A4 Reference Depth Spacing Cavity Insulation Tag/ID Assembly Type Frame Type (inches) (inches) R-value R-value U-Factor Table Cell U-Factor Comments 1 Vi OM Wand 2Y6 l6tl R—tet o.O 4. 43.1 As V .0114 2 goof Woo@ rt z+ q R-30 O. 031 4.2. 1 A'20 O . o 3 1 Note: • Where insulation is installed above the roofing membrane or above the layer used to seal the roof from water penetration the insulation shall have a maximum water absorption of 0.3 percent by volume when tested according to ASTM Standard C272. CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STATE OF CALIFORNIA f.-� Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification tri( 1 I CEC-CFIR-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 3 of 9) Project Name: Date Prepared: C.Opaque Surface Details—Non-framed(Section 150.1(c)1) 01 02 03 04 _ 05 06 I 07 08 09 10 11 Proposed Required Appendix JA4 Core Continuous Reference Thickness Insulation Insulation U-Factor from Tag/ID Assembly Type Assembly Materials (inches) R-value R-value U-Factor Table Cell Package A Comments Note: • Where insulation is installed above the roofing membrane or above the layer used to seal the roof from water penetration the insulation shall have a maximum water absorption of 0.3 percent by volume when tested according to ASTM Standard C272. D.Opaque Surface Details—Mass Walls(Section 150.1(c)1) 01 02 03 04 05 06 07 08 I 09 10 I 11 Proposed Required Interior Insulation Exterior Insulation Appendix JA4 Interior Insulation Exterior Insulation Walls Mass Furring Strip Reference Above Thickness Thickness Tag/ID Grade Mass Type (inches) (Inches) R-value U-factor R-value U-factor Table Cell R-value U-factor R-value U-factor CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STATE OF CALIFORNIA �. Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification tM1 CEC-CFIR-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 4 of 9) Project Name: Date Prepared: E.Slab Insulation(Table 150.1-A) 01 02 03 04 05 06 Proposed Required Insulation Insulation Insulation Insulation Floor Type R-value U-factor R-value U-factor Comments Slab e a 0 ."13 R-V o :73 Note: • Heated slab floors require mandatory slab insulation(see Table 110.8-A). F.Radiant Barrier(Section 150.1(c)2) 01 02 Radiant Barrier installed below the roof deck and on all gable end walls Comments gad,en/ Burlier Provided o" POOP, A radiant barrier is required(for Climate Zones 2-15) • Radiant barriers shall meet specific eligibility and Installation criteria to receive energy credit for compliance with the Building Energy Efficiency Standards for low-rise residential buildings. Refer to RA4.2.1 • • The emittance of the radiant barrier shall be less than or equal to 0.05 as tested in accordance with ASTM C1371 or ASTM E408. • For Prescriptive Compliance the attic shall be ventilated to provide a minimum free ventilation area of not less than one square foot of vent area for each 300 ft2 of attic floor area with no less than 30 percent upper vents.Ridge vents or gable end vents are recommended to achieve the best performance.The material should be cut to allow for full airflow to the venting. I CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STATE OF CALIFORNIA 1 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification dal I CEC-CFIR-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 5 of 9) ProjectName: Date Prepared: G.Roofing Products(Cool Roof)(Section 150.1(c)11) 01 02 03 04 05 06 07 08 09 10 11 12 Mass Roof Proposed Required 251b/ft2or Method of Product CRRC Product ID Initial Solar Aged Solar Thermal SRI Aged Solar Thermal SRI Greater Roof Pitch Compliance Type Number Reflectance Reflectance Emittance (Optional) Reflectance Emittance (Optional) No . g : 12 A9 el Itylttvalq o060 0. 12 o . 12 0.qI 4 ©. I - NOTESNotes; • Any roof area covered by building integrated photovoltaic panels and solar thermal panels are exempt from the above Cool Roof requirements. • Liquid field applied coatings must comply with installation criteria from section 110.8(i)4. H.Fenestration/Glazing Allowed Areas and Efficiencies(Section 150.2(a)1) 01 02 03 04 05 06 07 08 Maximum Allowed Maximum Allowed Fenestration Area For All Orientations ft2 West-Facing Fenestration Area Only ft2 The Greater The Greater Maximum Maximum Addition Type ft2 Maximum Maximum Allowed Allowed Comments Calculated Maximum Calculated Maximum U-factor SHGC based on Calculated based on Calculated Allowed% Allowed ft2 Allowed% Allowed ftI 2 .4400 Si— SO tit 120 30 `A I20 0 .32 0.25 CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> • STATE OF CALIFORNIA :-1 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification 1�1 I CEC-CFIR-ADD-02-E(Revised MMIYY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 6 of 9) Project Name: Date Prepared: I I.Fenestration/Glazing Proposed Areas and Efficiencies 01 02 03 04 05 06 07 08 09 10 11 12 13 Proposed Combined Orientation Proposed Exterior Dynamic Number of West Facing Proposed Proposed SHGC from Tag/ID Fenestration Type Frame Type N,5,W,E Fenestration Source Shading Glazing Panesz Fenestration U-factor SHGC CF1R-ENV- or Roof Area ft Area ft z Device 03 t Orcnhle Wmdora .Mo-ttd. SW doiMe 3 0 3,0 0.3 0 0.22, ) I Vi 6A a OPeuRble WIHdocQ Mere( jt1 W doable. 3a 30 0 .30 0 .2.2. 1I'Q int 14 Total Proposed Fenestration Area �J 0 15 Maximum Allowed Fenestration Area Ia 16 Compliance Statement Total Proposed Fenestration Area 5 Maximum Allowed Fenestration Area Res 0 No 17 Total Proposed West-Facing Fenestration Area by 18 Maximum Allowed West-Facing Fenestration Area 1 ?POI 19 Compliance Statement Total Proposed West-Facing Fenestration Area 5 Maximum Allowed West-Facing Fenestration AreaI "Yes ❑No 20 Proposed Fenestration U-factor 0 SD - 21 Required Fenestration U-factor 0.32 22 Compliance Statement Proposed Fenestration U-factor 5 Required Fenestration U-factor 011es 0 No 23 Proposed Fenestration SHGC 0.'2,2 24 Required Fenestration SHGC aIS 25 Compliance Statement Proposed Fenestration SHGC 5 Required Fenestration SHGC I34es 0 No I CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STkTE OF CALIFORNIA <•1 Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification liar I CEC-CF1R-ADD-02-E(Revised MMIYY) CALIFORNIA ENERGY COMMISSION -- CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 7 of 9) Protect Name: Date Prepared: J.Space Conditioning(SC)Systems—Heating/Cooling(Section 150.2(b)) Alterations to Space Conditioning Systems shall be exempt from HERS verification requirements as prerequisite for use of the CF1R-ADD-02 and CF2R-ADD-02 Compliance Documents. If new space conditioning systems are installed or existing systems are altered and are not exempt from HERS verification,then a CF1R-ADD-01 shall be completed and registered with a HERS Provider Data Reiistry. In each row below for each dwelling unit in the building,check the box that indicates the exemption from HERS verification compliance: a: space conditioning system was not altered; b: less than 40 ft of ducts were added or replaced; ❑ c: (exempt from duct leakage testing)if: the existing duct system was insulated with asbestos; O d: (exempt from duct leakage testing)if: the existing duct system was previously tested and passed by a HERS Rater. 01 02 03 04 Dwelling Unit Name SC System Identification or Name SC System Location or Area Served Exemption from HERS Verification 0a 0b 0c 0d 0a 0b 13 13 0a 0b 0c 0d 0a 0b 0c 0d 0a 13 13 0c 0d 0a 0b ID 0d 0a 0b ❑c 0d 0a 0b 0c ID 0a 0b 0c 0d 0a 0b 0c 0d 0a 13 0c 13 0a 0b 13 0d 0a 0b 13 0d 0a 13 13 13 0d CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STATE OF CALIFORNIA Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification if r�f I CEC-CFIR-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 8 of 9) Project Name: Date Prepared: K.Water Heating Systems(Section 150.1(c)8) List water heaters and boilers for both domestic hot water(DHW) heaters and hydronic space heating. 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 Water Water Heater Back-Up Water Heating Water Heating Heating Water qof Rated Rated Heating Heating Exterior Solar System Water Storage Dwelling Unit Identification or System Location System Heater Heaters Volume Input Input Efficiency Efficiency Standby Insulation Savings Name Name or Area Served Type Type In System (gal) Fuel Type Type Value Type Value Loss(%) R-Value Fraction CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> STATE OF CALIFORNIA ...,\ Prescriptive Residential Additions 300 Ft2 or Less, or Additions That Do Not Require HERS Field Verification HU? CEC-CF1R-ADD-02-E(Revised MM/YY) CALIFORNIA ENERGY COMMISSION CERTIFICATE OF COMPLIANCE CF1R-ADD-02-E Prescriptive Residential Additions 300 Ft2 or Less,or Additions That Do Not Require HERS Field Verification (Page 9 of 9) Project Name: Date Prepared: DOCUMENTATION AUTHOR'S DECLARATION STATEMENT 1. I certify that this Certificate of Compliance documentation Is accurate and complete. Documentation Author Name: Documentation Author ture: bert ' Company: Signature Dpte: ?DS 3-[bio Inc. 4 / 19/11 Address: CEA/HERS Certification Identification(if applicable): 1 " S.. Rat Me City/State/Zip: Phone: ArCat)tu cA grpot, Gab 294 `+0` . RESPONSIBLE PERSON'S DECLARATION STATEMENT I certify the following under penalty of perjury,under the laws of the State of California: 1. The information provided on this Certificate of Compliance is true and correct. 2. I am eligible under Division 3 of the Business and Professions Code to accept responsibility for the building design or system design identified on this Certificate of Compliance(responsible designer). 3. That the energy features and performance specifications,materials,components,and manufactured devices for the building design or system design identified on this Certificate of Compliance conform to the requirements of Title 24,Part 1 and Part 6 of the California Code of Regulations. 4. The building design features or system design features identified on this Certificate of Compliance are consistent with the Information provided on other applicable compliance documents, worksheets,calculations,plans and specifications submitted to the enforcement agency for approval with this building permit application. 5. I will ensure that a registered copy of this Certificate of Compliance shall be made available with the building permit(s)issued for the building,and made available to the enforcement agency for all applicable inspections.I understand that a registered copy of this Certificate of Compliance is required to be included with the documentation the builder provides to the building owner at occupancy. Responsible Designer Name: Responsible Designer Signature: Aibert- la company: Date signed: PDS Stu01.0 ins 4/ rq /14 Address: License: 'Jt t S. First Ade City/State/Zip: Phone: Arcndh,t cA 11006 C26 1% 5402 For assistance or questions regarding the Energy Standards, contact the Energy Hotline at: 1-800-772-3300 CA Building Energy Efficiency Standards-20136 Residential Compliance <Date> '.+ ` City of Arcadia, CA Permit NO. FIRE-19-1105 Development Services Department Permit Type:Fire 240 West Huntington Drive,Post Office Box 60021 Work Classification:Fire Sprinkler Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued ARCADIA Issue Date:06/12/2019 Expiration: 12/09/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 868 San Simeon RD Arcadia, CA 5776028004 Contacts CHHAN,JASON AND CHAN,JANET Owner Superior Fire Protection* Contractor 868 SAN SIMEON RD 18120 ROWLAND ST,CITY OF INDUSTRY,CA 91748 (951)906-5564 (626)965-6900 664427 Description:ADD ONE HEAD FOR SFR/ADDITION Valuation: $ 1,000.00 Tenant I Total Sq Feet: 0.00 Plan Check# Plan# I Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $389.66 Fire Permit Fees $61.65 Cash/Receipt#REC-01511-19 $389.66 Solid Waste Management Fee 2 $1.00 Sprinkler Heads $280.00 Amount Due: $0.00 Total: $389.66 1--,-(1 COMPLETED 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. June 12, 2019 Issued By: Date June 12,2019 Page 1 of 1 A; .GrLIFOgN�'i, t PERMIT/PLAN REVIEW APPLICATION �• tilt*' Development Services Department,240 West Huntington Drive,Post Office Box 60021 .f 140Arcadia, 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. 0 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 ❑ 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 Policy 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 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 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 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: 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 A/10 Title t-12'1 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 tha : •• e-mentioned property for inspection purposes. �•. Signature AO- Date � � /� 9 44 r w ncas_ j- 0- A.(v.�lrlNl C�\0 % Y o MEMORANDUM Fire Department DATE: September 12, 2019 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 868 San Simeon Road THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS 9-12-2019 Jill Perumean FIRE ALARMS HOOD & DUCT KNOX BOX OCCUPANCY 9-12-2019 Jill Perumean COMMENTS: Emailed Bldg. Dept. 9-12-2019 Rita