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HomeMy WebLinkAboutUntitled CS' Permit NO ROOF-19 2144 :'gland City of Arcadia, CA '�`�'I, (+ Development Services Department [�' Permit type:Roof r, it`i 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 e _Mil -l�Work.Clossificatlon:Reroof-Residential l' I (626)574-5416 _ - - Permit Status:Issued ARCADIA _ Issue.Date:.10/23/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1218 S FIFTH AVE Arcadia,CA 91006-4334 5780008004 Contacts STAN WOOTON Owner .1N DAVIS ROOFING COMPANY* Contractor 1218 S 5th AVE,Arcadia,CA 91107 (626)815-1279 572125 Description:T.O,NEW SHEATHING.REROOF GARAGE ONLY Valuation: $ 2,500.00 Tenant WITH CERTAINTEED PRESIDENTIAL AUTUMN BLEND CLASS A 5 SQ(CS) Total Sq Feet: 0.00 Plan Check q Plan if Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $173.61 Building Permit Fees $120.35 Cash/Receipt N REC-02866-19 $173.61 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $173.61 /2-3°_I T pop-- 504914inst ii< ohni Ei tchlie //7r/7 Rau (" d 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. Smoke ck- se( c'f 7'� 701-7 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. 7- / October 23, 2019 Issued By: Date October 23,2019 Page 1 of 1 U,UFOyyN !Pi"! 1' PERMIT/PLAN REVIEW APPLICATION alga. tile oC it j, Development Services Department,240 West Huntington Drive, Post Office Box 60021 eatairtn-f"° 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 c ]Professions Code,anpd,my license is in full force and effect ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C S I Licens No.Sn�-I Z5— Exp. Date I II co 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 ❑ 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 5T 2 1n '+'O demolish,or repair any structure,prior to its issuance,also required the applicant l 163pri© 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, forthwith c mply 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 Daze a Z ( 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. ' ,�,, ,, o- �y,.,� Z Name � Title "^"�"6\ 111 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. ignature C:52------------ Date LP/z;/15 T +: it d � t I tle f 9.5. rs •om � , AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON -MONOXIDE ALARMS Property Address: /2/(ft S. I gm' itluc Permit Number: /9-^�t'7 Brief Job Description: a- OF 644-6€ Number of smoke alarms installed: I Number of carbon monoxide alarms installed: When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. • For dwellings or sleeping units containing fuel burning appliances or having attached garages, carbon monoxide alarms shall be installed outside each separate sleeping area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California Residential Code (CRC). Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. All alarms shall comply with requirements for listing and approval by the Office of the State Fire Marshal. http:l/osfm.fire.ca.qov/licensinglistingsllicenselistinq bml searchcotest.ohp As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions and in compliance with the code sections referenced above. I declare under penalty of perjury that the fore oing is true and correct, and that this declaration was executed on (Date)� _/(7. ���� Je/1 at Arcadia,Ar' California. Owner's Name (printed/typed): C fffiQ� S.Ic hD jOAJ . (alk) Signature of Owner: , This affidavit must be returned to the City of Arcadia inspector prior to final inspection SMOKE ALARM AND CARSON MONOXIDE ALARM LOCA:BONS Guest Roam _ ,Bathroun Storage 13 II Family Room Illt. ' Ls__ .-,Garngc M FIRST FLOOR PLAN tit= SMOKE ALARM = CARBON MONOXIDE ALARM r L 4 btmit Bath - AMaster Bedroom Dining Room Kitchen -- -Bath BailJ Closet ®� Closet 1 Closet Family Room _ -• --6 — - G>', a 3' N L., .:;\ ' 1.• . 'BedrOOlii-1�: 13cdroorn SECOND FLOOR PLAN =SMOKE ALARM K o CARBON MONOXIDE ALARM