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HomeMy WebLinkAboutUntitled '', Permit NO RALT 18-1291 :11,,,,,,R,.. City of Arcadia, CA w Development Services Department1 t,?-4-i-Ac:;---"e-..Pee�iPTyke Residential:Addition/Alteration 240 West Huntington Drive,Post Office Box 60021 '{ I I t� �;� °' 1 I Work Classiffcation::'Res-Addition/Alteration Arcadia,CA 91066-6021 � �,( ��-,- (626)574-5416 - " - °- . ' Permit Status:issued" ARCADIA Issue-Date:03/27/2019,1 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 16 W Birchcroft ST Arcadia,CA 5788010054 Contacts ,, .._ _ -.. _.. JIANA WU Owner MING HUO Contractor 16 W BIRCHCROFT ST,ARCADIA,CA 91006 1700 CAMERO AVE 212,WEST COVINA,CA (626)203-5673 JINAW61@YAHOO.COM (626)500-5977 1010604 Description:ADDING 3 BED,2 BATH,NEW 1 CAR ATTACHED Valuation: $ 155,303.25 Tenant GARAGE. CONVERT EXISTING ENCLOSED PATIO TO COVERED PATIO. Total Sq Feet: 942.00 Plan Check#18-1291 Plan H 4 TOTAL 6 BED 4.5 BATH. -"— - ` Fees Amount Payments Amount Paid Bathtubs/or Combo $24.92 Total Fees $6,559.72 Building Issuing Fee $47.01 Cash/Receipt U REC-00809-19 $4,806.20 Building Permit Fees $1,610.40 Cash/Receipt#REC-001797-2018 $1,753.52 Building Plan Review Fee $1,046.76 Cal Green Plan Check $104.68 Amount Due: $0.00 Compressor<3 Ton(up to 3 hp) $18.74 /' ff Distribution Panel $15.55 Electrical Permit Issuance Fee $47.01 600144. ii— —/? moi/{ Energy Plan Review Fee $322.08 Furnace or Burner Cr 100,000 BTU $18.74 Green Building Standard $7.00 CALLS FOR INSPECTIONS Lavatories $49.84 Request for inspection by telephone at 626-574-5450. Leave a message Light Fixtures $41.80 requesting the address,timeframe and what inspection item is needed. Mechanical Permit Issuance Fee $47.01 -- Outlets-Receptacles&Switches $57.80 Parks&Recreation Fee(SFR) $2,684.70 This permit/plan review expires by time limitation and becomes null and Plumbing Permit Issuance Fee $47.01 void if the work authorized by the permit is not commenced within 180 days Single Family Fire Plan Check $280.00 from the date of issuance or if the permit is not obtained within 180 days Solid Waste Management Fee $6.25 from the date of plan submittal.This permit expires and becomes null and Solid Waste Management Fee 2 $1.00 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 Solid Waste Management Fee 2 $1.00 Arcadia building inspector for a period of 180 consecutive days. Total: $6,559.72 fit CU!WPLETED)\\%) ..°. March 27, 2019 Issued By: Date • March 27,2019 Page 1 of 1 •!� 1; PERMIT/PLAN REVIEW APPLICATION -.: r='* o�I3j. Development Services Department,240 West Huntington Drive, Post Office Box 60021 m<=,,,=,N Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION J. 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: S 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' x License Class D" Signature of Contractor License No. I° °66 Exp. Date° 3( compensation, as provided for by Section 3700 of the Labor Code, for the L performance of the work for which this permit is issued. � OWNER-BUILDER DECLARATION nave and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3 00 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 70313,Business and Professions is sued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, er Clier ke-AA L!^m2.v lc /h pa ram u Cu demolish,or repair any structure,prior to its issuance,also required the applicantGST MI?for such permit to file a signed statement that he or she is licensed pursuant to the o'cy Number provisions of the Contractors License Law(Chapter 9(commencing with Sections section need not be completed f 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 ,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 o�employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): r mpensation Laws of California,and agree that if I should become subject to the orkers'compensation provisions of Section 3700 of the Labor Code,I shall ❑I, as owner of the property, or1hwith 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 ';1 y� /-w(5j Signature sale(Section 7044,Business and Professions Code:The Contractors License a 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 am 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.I '. j _Name itt Title f tc SI d-R.t..k P2PIt'NAME n certify that I have read this application and state that the above information is correct and that I am the owner or;duly authorized ed agent of the owner. agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of d cadia to enter upon the above-mentioned property for inspection purposes. / Signature ? Date 3(.0 / 17 1l LLL RALT1s ./291 NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. '(p ki 17O f 0_,N Ciao pT 100. Setbacks 210. Under firJbldg.drain xf./(o•/'f 101. Rough grade (.{/�/^ry�',211. Copper underslab o z 102. Figs.&forms cl/g-/9`' " l 212. Rough plumbing S�1-/1 d�("' t$/7-/) ECECTi te- Sex VICa SPfQfr r 103. Pre-slabloo213. Roughgas ,518'(O� f _-_•� 104. Floor joists 214. Shower pan 105. Steel 215. Water heater 106. Grout lift ,.�.✓J,�� .*4? ()NI16. Roof drains 107. Shear nailing 1r/(/9//i�- 17. Building sewer S" N+l 108. Diaph nailing / � 18. Water service ‘1," 109. Roof nailing r-13-•/9 219. Final gas 110. Framing (,-/7-f9 220. Fixtures 111. Occ/Area Sept.Wall 221. Final plumbing //-2/-19 112. Sound walls 222. Sewer cap/demo. 113. Tbar!dd - - - - 114. Insulation-Fir. Pool Inspections Date Insp. 115. Insulation-Wall „6271' I'1'� 240. Excavation/steel 116. Insulation-Cell. -a/ y 241. Rough plumbing 117. Drywall nailing iii ��-��1 242. Light shelVbonding 118. Interior lath 7'�Y 243. Underground conduit 119. Exterior lath 6471 244.4P-trap -- 120. Finish grade 5. Gas line&test 121. Final building 11L2/-/9 , G 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final•lumbin• 150. Power pole 250. Pool cever 151. Sales lot lighting 251. Pool final 152. Under•roundconduit 153. Underslab conduit • Reroof Inspections Date Insp. - - 154. UFER ground 1a% r/" 270. Pre-reroof insp. 155. Water ground • .17 / 271. Roof framing 156. Rough electrical . 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. E.•t.bondin• Sign Inspections I Date Insp. 160. Service panel %��/-•'•y�p80. Setback/overhang 161. Final electric //-2/-i A / 81. Footing - - - 282. Conduit/wirin• Mechanical Inspections Date Insp. 283. Disconnect 180. Ventingdlue 284. Final sign 181. Fumace/A.C. 182. Rauch HVAC Miscellaneous Insp. Date I Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Fire sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry diem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. Date Insp. 191. Final mechanical 300. Lateral(main to P/L) 301. SaddieN Block Wall Inspections ' Date Insp. 302. Gess.••I filled 200. Footings 303. Sidewalk 201. SteeVrebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin Certificate No.20121023-925 ARCADIA UNIFIED SCHOOL DISTRICT 150 South Third Avenue, Arcadia, CA 91006 • (626) 821-8300 Ext. 6732 Certificate of Compliance for Payment of Developer Fees (Education Code§17620, et seq. &Government Code§65995, et seq.) Effective July 24,2017 Current rate in effect applies at the time of imposition of fees/payment. Project Address/APN: 16 W. Birchcroft St . , Arcadia, CA 91007 Number of Units in Project: One Plan Check Number: 18-1291 [ j* [X]** [ Exempt: [ i 500 sq.ft or less(residential addition/expansion/remodel) Residential Commercial/Industrial [ I Other: $3.20/sq. ft. $0.51/sq.ft. Area in Sq.Ft.: 942 Receipt Number: 330446 Total Fee: $3 , 014 . 40 Check Number: 1157424138 Owner's Name: Jiana Wu Owner's Address: 16 W. Birchcroft St . , Arcadia . CA 91007 Phone Number: Email: 626-203-5673 jinaw6l@yahnn r-om Representative's Name& Contact Info (if appl.): *The above-described development has been determined to be exempt from the developer fees of Education Code§17620,et seq., and Government Code§65995,et seq.,and a Building Permit may be issued therefore. ** All fees due to the Arcadia Unified School District, under provision of Education Code §17620, et seq., and Government Code §65995, et seq., as a prerequisite to the issuance of a Building Permit by the Building Department of the City of Arcadia, City of Monrovia,City of Sierra Madre,City of Temple City,and County of Los Angeles,Department of Public Works have been received. Based on the information pre ted above,this Certificate of Compliance is hereby executed. Connie Chu Senior Administrative Aggt 12/21/18 Signature of District Representative Name/Title Date of Issuance > The District charges a $100 fee to process reinstatement of the Developer Fee Certificate of Compliance resulting from an "insufficient funds"check in addition to a$35 fee for the returned check. Only cash or a Cashier's Check will be accepted as payment thereafter. > The District charges a$100 fee for any amendments to or cancellation of a Developer Fee Certificate of Compliance formerly issued on any type of development. > If 500 sq. ft.or less is the reason for exemption,any future additions,expansions,or remodels to the property that result in the past aggregate square footage to exceed the allotted 500 sq. ft. will be subject to fees at the current rate for the entire square footage of the development. ➢ Owner/developer may request a refund of fees paid to the District within 12 months of payment only in the event the Building Permit expires or the project is canceled without commencement of construction in accordance with Education Code section 17624(all other requests for refunds must be made in accordance with the fee protest procedures set forth in Government Code §66020). All refunds will be reduced by a $100 administrative fee. The refund check will be issued in the name of the owner/developer and mailed to the address of payee. PURSUANT TO GOVERNMENT CODE§66020(d), OWNER/DEVELOPER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE OF COMPLIANCE TO PROTEST THE IMPOSITION OF FEES Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that the information he/she provided to the District is true and accurate to the bes f his/her knowledge. Signature of Applicant: Name: ' 7L4kJ V l 14 WHITE—City/County YELLOW—Fiscal Services PINK—Business Services GOLD—Applicant Certificate of Compliance(7-24-17) tag COUNTY OF LOS ANGELES I DEPARTMENT OF PUBLIC WORKS �i PUBLIC WORKS BUILDING AND SAFETY DIVISION SPECIAL INSPECTOR REPORT Each inspector must complete this report and mail it to the District Office where the permit was issued. ` ❑ DAILY ❑ WEEKLY [ -FINAL Report Date 1 fl C (1 cl Building Permit# tom. L _. ( .-t2 cC I DistrictOffice# Job Address 'Cr. (4 . 512_'f CP Cry sr {kfLC.ttyp General Contractor Engineer of Record Inspection Frequency: LY-Continuous 0 Periodic Type of Inspection: 0 Reinforced Concrete 0 Gunite/Shotcrete 0 Prestressed Concrete ❑ Masonry For any of above types of inspections provide Design Mix PSI 0 Welding ❑ High-Strength Bolts ktipoxy 0 Other Location on Site 2 +zF4EZ. Ps'p'P1rt 4=44t .Ei4kc44- S1P.i✓ 0 P�Ta 3S- s. p� vZ.„ �nlM-Ls . l Describtion of Work I flspEerE.fl 4 v ,t2i21(,.Lj7 o Q.v L OW a t_ yet: o Srt t7, G. .NEC V1/1317--V SiA- 1 co(,K? - ssarr,a.-{,g. Usi s�c� 3i- - tove3,2pc'TtaA pt-A`tt (t_ 3r SP,, 2.#*)C..0 kN C: --P. r A-a . 1 ocrnrlel S7t lj€L$ $P.. s\Lra 4-7s t CD"MttS .@ 18eo.c..E i.1 . €Lt e, obt AP-4,' '7oL.tt=t,s, Acs- clAtc. 0--)41.-STUAct L- s_ 2.c, . 2 © c Ptaii4 var. s( JQ�-- . t/ 1r6.)C4tcMMtt1 .T 1 Maa. raoLT.Sl `v S7CtN(L&Bots2`{ aAR wf�tri. .j) ( i.rAUtmot.i , PG-11 4:>/s 2•zl Vat' ce c 4e M41trt . & 24"o..4. sIuP cs uL ,ss. A - Lock-itoN t� ,, f5 & ,�PPs&v8 91-4N; was • Discrepancies N t7 'PtSCe WkJC4 S All work on this job to date HAS /HAS NOT been satisfactorily completed in conformance with the approved plans and requirements of the Los Angeles County Building Code. Signature LA Co ID# Ot et 18 Date >-$ P ' (I3 o'Zo ,,` L n OLS562. eX?. sof ol (z Print Full Name PWN14N-r kk 4P -' ¶tlZZO\*% Daytime Phone# -3 le x-22 SI-REPORT Revised 04-29-14 County of Los Angeles P• UBLIC WuKs N DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION Los Angeles Regional Uniform Code Program STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observationdoes not include or waive the responsibility for theinspections required by Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. ?j Thisreport includes all construction work through ¶0 tit day of 5On - ,20 19 Page No. I of Project Address: Structural Observer of Record(SOR): SOR Phone No.: 16 WgcHcRon St. APcphlA-CA a- 1-4140/4.1. Sotsdl C567.)863-4°I91g Building.Permit No.: Structural Observation Observr ProfessionalLic./Reg. No.: Observer Phone No.: pAet -Is -{291 performed by:&,MtortAa screw, S -5266 (562)863-9999 OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS • FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION ❑Footing; Stern Walls 0 Concrete 0 Steel Moment Frame ❑Concrete Ter T❑ r tAtf.. ,USN /141- 0 Mat Foundation 0 Masonry 0 Steel Braced Frame 0 Steel Deck KoTtkft, "TL O Caisson, Piles, t 'Wood 0 Concrete Moment 0 Wood Grade Beams 'Car pt, 6c14l. Frame ' rA710 Gov Eft (2.12.. ❑Retaining Foundation I¢Others: 0 Masonry Wall ❑Others: to 14476. to %JP,C Hillside Special Anchors t,EM[[gtc. • Frame Gestalt • 0 Others: 0 Others: WHA' HAVE;' EEta tt4.5TAL(.E1p fl.t S[1zUctoVtAtt-Au.EliCbbLE. t o C FIc,tc`p Orlaiiitat NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) 1 . Pltoutv-F 5T6 z.2.4. PC -5 Mt soli- MI; rut" 'MTS'S wHE-Iet. 'Mg. Tor p.2Arc5 13641 ,Cddt Feilt tit tKKAt : tk& oY V11fC 2 . vc s 4114 atilitimArr _ACFJc tAltt . To U . Z-`$ 1.Cr6GgQ . IF/Sig/sea of-? `)eR" V.A7tca As t141vt&M64.0 art 9/voz. I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE.BEST OF MY KNOWLEDGE: 1. I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE 'FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. „/4OrLaSI , 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE.AND IS /.,0 We(14���='� UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT ./,;(,- ` i� l ‘ EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN / o t.,-)mk GENERAL,CONFORMANCEWITH APPROVED PLANS.AND SPECIFICATIONS; 16 "1 .- 55266 " t-131-1 n: 1 3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED EJ! tuj Jl�l :.: ABOVE; \ s�s� „1*/ e IIrTU�i;;;�t ti, . 4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THECOUNTY - .n •, OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. ( Jct./1k- I Di 20(9 6/6/ (STAMP OF STRUCTURAL OBSERVER) SIGNATURE OF STRUCTURAL OBSERVER DATE I�' Version 1.0(2008 LACBC). Jan.10 2008 �� � � County of Los Angeles , DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION PUBLIC WORKS . Los Angeles Regional Uniform Code Program STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. Z This report includes all construction work through 21 day of Mat ,20 Lef Page No. l of Project Address: Structural Observer of Record (SOR): SOR Phone No.: 16 w - Oiechr,reti est Nectseth . Cagloo ZZ- rite riot. �ll (562)863 111Building Permit No.: Structural Observation � Obse(vr Professional Lic./Reg. No.: Observer Phone No.: E2.AL.T—1 g—( Z9 j performed by: E.l'4(c , 501.14 5-5266 C562-)663�ggq OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS • FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION ❑Footing, Stem Walls 0 Concrete ❑ Steel Moment Frame 0 Concrete tom*, tic ..I,IJ. of El Mat Foundation 0 Masonry 0 Steel Braced Frame ❑ Steel Deckp1 �1��� 0 Caisson, Piles, (@'Wood 0 Concrete Moment 0 Wood Grade Beams 4.0.5 Frame ❑Retaining Foundation 0 Others: ❑ Masonry Wall 0 Others: Hillside Special Anchors Frame ❑Others: 0 Others: NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approvedplans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) Ho 2 lGltt�(AV, ots5ERVE10 YM1S T{ftsVLSI-, I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: 1. I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. �cj?ESSION 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS S\CHAE'Q�F. S UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT _ EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN — P•41 S 5 . . C m GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; y (q/}�' 3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED d D�T' ctrABOVE; *02. tRUCNCtcr 4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY qit OF CO OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE s^ o CORRECTED. /fr / s 5/2-04-0 17 (STAMP OF STRUCTURAL OBSERVER) SIGNATURE OF STRUCTURAL OBSERVER DATE J Version 1.0(2008 LACBC) Jan.10 2008 County of Los Angeles -74, - DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION PUBLIC WORKS Los Angeles Regional Uniform Code Program STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. I This report includes all construction work through 19 1 day of .11pYIL€.. ,20 '41 Page No._i_of I Project Address: Structural Observer of Record (SOR): SOR Phone No.: I(7 ?1(iv C.41GYoft -St. MCact4t. CA Z- vile-HAW Son461 (562)863-961,9 Building Permit No.: Structural Observation Observr Professional Lic./Reg. No.: Observer Phone No.: HLT-Ig-129 j performed by: Z. ( taiAE1.,$ofd(,1 S- 5266 C562)863-8999 OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION )11. / OBSERVATION LOCATION NJ Footing, Stem Walls ❑ Concrete ❑ Steel Moment Frame ❑ Concrete /NDy -toN tsf cAi fotifq46 ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame 0 Steel Deck ❑ Caisson, Piles, ❑ Wood ❑ Concrete Moment ❑ Wood t � IZ(�lhLI Nt7 Grade Beams Frame AWS. 5-0t, 61 TZPARE ❑Retaining Foundation ❑ Others: ❑ Masonry Wall 0 Others: Hillside Special Anchors Frame 63/Others: ?I 0'5 . A*'5 ❑ Others: NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) A1x V -Vic16N Cia O '59AM.49 have 136.44 categgagia - I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: 1. I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. QkOFESS/0� rc- 1,11Cyq, 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS �� UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT ti� 4,� - °rp FC EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN S t, S 5 6 c$> z GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; w m 3. ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED --�,�L�, *// ABOVE; `�gRUC7UKT'�Q'/ 4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF CAL� OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE A �I p/Zpl9 CORRECTED. / Y Arra(.. 19, �I (STAMP OF STRUCTURAL OBSERVER) SIGNATURE OF STRUCTURAL OBSERVER DATE 7 Version 1.0(2008 LACBC) Jan.10 2008 t R1.- rt. .'DA !TNInn)snfi( L rins'rm I' 4 �J I rS:chitzr..1Mrft-ate.,Arrc ii3,C'-. 4ffex . its: } 21-SAO:Eos 67,3,2 cerinicup for Prrivutent if!ku iapr Felm era t:a tom y 1701 rr seyi. 4:Goy an d CiNair 69993_et seq.) - - - } f._ffcllxcJLil; 14. 37 C ur ent sal a in effect applies:21 1[he lime of impaae.ilv,rn ol`f eXaaleta. 1'fii AdtlresiarArNt 16 V. sirchcriti4' St.. . Arcad i0, CA 919° a v tipmSer a trinst,m?nuke*: one9 Y"J3n �,7ttih;ti rnt,er-_ -I,�`)' I ii r : I!Ce iarH 4ii1Ferr :tl tt') G R L ,_:.-43, ,_ , -.}iI: Sfe? ifFi_�ft. 11i yjSi t ft.� A InReceiptReceiptNumber:Number: g J iSq }-t_ '94.7 1 330486 ' Taal t: S3:014 „La' 1 (Lima N ember. 3 35742e.1138 t i. - - -- • Jiann La t3;antr :t8dre, --- 16 V_ Birchcr_p $Y . Arcadia, rot '31 t57 +1 Mow 'gmt�tr — - Frew& i b 626-203-5673 _rt '�ft. iarnhan_enw, RntirboaLitir s r \sme&ContactI.(otta(rpLFt 'The te.xtci,..a-Ossi Vis:kS--..._3 E'st,rya 4.-t-olj-cd b tie Tan LTC cIkt CIO* Etc cE EJmziaa.Co-it}1ta83D,or iiv. ni' fi_..a.. e-1 CC- 1:at.1.51 if crc'-. 4 att,T.it=cal'to i&-iaE Icetatc, ••4-59 L-t- .§c r.,Cr A� .1-a t E11—yd�St•_9 ER-�s n ai&t ctiritt n ci Manus Cale;176_11 e.5e0,g9-Ga�s�a�>(res Cc* '� Y •,:r7c T`- r'i c. imarSe it it LT'._ A'1 FM l= fsr Bill* Eirrar't*-4,ci �49 Arafat,C'e5 00 1�.ix:this YS Y L .-� kcs*:aa. -ci&Tan e. '-€,Coy c$Tc t Cr,;.mad Ciet ,of te, ,tg+_tiegntra wt Pay`&Wats line btn Ct ivcd_ Fiarc4 a'p 61 *'trt etT'4t+4.fh'CznS: :cititcarx.tt.hrthyeideoro'4- Connie ch czu — Senior Av`a9tAlJtrwR txrltssr T l2/'23f1 ffidl!_: rtirkikepastui[ite tiaeltptit Use a1 gnawir - - i a- ne tk..tin c-s..rrlo; 4 5K')Ur m Fiat)rcinKaa's'4 ftt Irk-r& •e Irr Coda t1 Omar resain Ws a Srtc-41 c-gg t c23.11,to a icte t,a S33 fee(cc ete ecru.'ctacci Ot cnk cs.a 00.0: 'a Owl.tail 6e sycittrij r , L4fitWE4 f ral t - The i).,g-g,-L tc+rr.s SU-91W int LRS43 a c-r irec.L.,cc a--cis s ti a Daelepca Pot Ca-filmic,c#C*asir i.+a»ty ifRoos 3 cr Lit r t:recta ter rtitaries. .'fafter acMia t+L'.aa iism.(artaxia3.IV OK$1tr al,tax @MS i or j 51a rte c(calf•a,s y^cta the ATI a-4 50)sq.IL lull tic.taken 40 Ice,sa ilit alter ers tee tic er ter ` O` .1 i'et i-r'm enii,o4 a rctaai of ices Nei to et-F}eva-s nua 13 month d 6g)rem c5 i lat hist Sc Bairn %mea rt-6' cr FM p-ssa re f:a''ri$mom.`*i CiTeilr:,-t-cwcai ci ..t44a tt r KiaNslar silo Sat Cain 9t t Li 7&,,y4'{,crh_r.rc a fry srtizcie Kra.;t'a OPaxrcrctsrax.,pty or 6Y min r++ Axle u d,r dam. ta -]L .V11Lor ,. .a F �t # 1 S aifilicfS TES mcrl ;beet silI br kisne.i IT.Sc *f Art,,°me , a a rad u et tires, dTi;re. '4 VT n Qfl Lt IIF%tCOP,E daomAl ,ernaEv 3"a HAS A'PERIOD OFnnjpFktWI" K , Dire Oiffcsgt, `F,of 7111.5 CEinIFICI it OF CO ktPLIM.VCETtiPRO izirM£ftr p.%!r)FFFCFJS kprizaas eireza Ike" -.te a;a sv;d cw ysa tall t-dubie t gsr i,.sedc'!'srkq,ar a..1 erre iskreuticerktra. Sled atr iMc :i ( +7rM rt.Lets aea9 l-rat a•4c h,i'S his:UT ast..>ti . ��e (f{�j� p �a :_ dta `�y *Mt -Ce.;�,t lit ter"-1snt3!MN:-. nits\- - - w.Lv x ate-„:�m c... Gala-.yah.-a�, a'n rrsC�� `'t : _ . City of Arcadia, CA )(7-\,/-3-1-7?—,-----,, Permit No Elet 19=1127 v E Development Services Department 1 D n L1 Permit Type Electrical 91 240 West Huntington Drive,Post Office Box 60021 r f� l} "� t, rVt_ 1 ( 1 4 NorkC/assri cation:Elec Service Change_ Arcadia,CA 91066-6021 { z _� _r (626)574-5416 - - _- -- Permit Status:Issued ARCADIA Issue Date:06/14/2,019I Expiration:, Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 16 W Birchcroft ST Arcadia, CA 5788010054 I Contacts . 1 11ANA WU Owner Line Electric Inc Contractor 16 W BIRCHCROFT 5T,ARCADIA,CA 91006 4055 Wilshire BLVD#524,Los Angeles,CA 90010 (626)203-5673 JINAW61@YAH00.COM (213)272-3364 910172 T 1 Description:SERVICE PANEL UPGRADE TO 200 AMP 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 $64.49 Residential Services up to 400 amps $16.48 Cash/Receipt#REC-01548-19 $64.49 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $64.49 - bible- sl-21—‘p 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. 4 CompiErit June 14, 2019 Issued By: Date June 14,2019 Page 1 of 1 �ylFOry,� , 1 PERMIT/PLAN REVIEW APPLICATION -1t4 1,, . Services Department,240 West Huntington Drive,Post Office Box 60021 �0m•a,,,.i°'. 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: 71, Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. /gyp/ 0 1 have and will maintain a certificate of consent to self-insure for workers' License ClassB C(� Lic nse Noq 1 �� 7 Z Exp. Date'/"//t compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor C performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section 0 I hereby affirm under penalty of perjury that I amexempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit is issued. y workers'compensation in urance c er avd policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions P. 1. Sh Code.Any city or county which requires a permit to construct,alter,improve, Carrier P1{t Dlld% I.fAU8 t l 1A AM FIrC Insad taco demolish,or repair any structure,prior to its issuance,also required the applicant f A 91.1 G �u " for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number -v provisions of the Contractors License Law(Chapter 9(commencing with Section (This section ne d 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 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 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 6 / 4 n I - - . ,J sale(Section 7044,Business and Professions Code:The Contractors License Date / 1�f- /19 Signature 1`'''M_Y/tMU(�"UF"� 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 attomey'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 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 1 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. r_ /� SI Name IA;&IAA ej( `�. ` � tp_.0 \Titie PRINT N ME 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. !L \Signat . \Dateo 6 1 �r 1 2,0 t City of Arcadia, CA _, Permit No FIRE-19-0957 Development Services Department i 0 }`u�C�.'a-)Tv"r-"F1 _ - •. Permit Type.Fire �' 240 West Huntington Drive,Post Office Box 60021 3 <� c---_,(( S f i (I 4 ' �t. Arcadia,CA 91066-6021 'ir� e ( i'I i -Work Classificahon FireSprinkler -L.-'tail L.-' (526)574-5416 -,:. .Permit Statusr Issued ARCADIA Issue Date 06/24/20191 Expiration: 11/18/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 16 W Birchcroft ST Arcadia, CA 5788010054 Contacts JIANA WU Owner F&H Fire Protection' Contractor 16 W BIRCHCROFT ST,ARCADIA,CA 91006 1119 Westminster AVE,Alhambra,CA 91803 (626)203-5673 JINAW61@YAHOO.COM (626)262-3876 584319 Description:FIRE SPRINKS FOR SF ADD 40 HEADS Valuation: $ 4,000.00 Tenant Total Sq Feet: 0.00 l Plan Check#19-957 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $885.06 Fire Permit Fees $137.05 Cash/Receipt#REC-01616-19 $185.06 Solid Waste Management Fee 2 $1.00 Cash/Receipt Al REC-01288-19 $700.00 Sprinkler Heads $700.00 Amount Due: $0.00 Total: $885.06 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. eekit et filed oi.,....r"...,____...- ,...,_______ June 24, 2019 Issued By: Date lune 24,2019 Page 1 of 1 of AR . .444 PERMIT/PLAN REVIEW APPLICATION ig 1411° Development Services Department,240 West Huntington Drive, Post Office Box 60021 %,.„„,„cot Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia tiliICENSED 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 license is in full orce and -�ect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Classes License No. Exp. Date li 4 ( 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 4 0 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.�ty workers'cnpens n insurance carrier and p icy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Comer ey of e i-1 f e Cy demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number El-INA/ LT, ill 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 oneeund 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 ❑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, gom, wi , ose provisions. or my employees with wages as their sole forthwith 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 i a 7 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 theproperty, 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. X S' Name ,A LM M P `8/PRINT NAME " 1,/ Title C t 'Vv 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 presentatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes.__,../.---1.----7( �/7` (� Signature Date `� Z / I