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City of Arcadia, CA Permit NO ROOF-19-1340
Development Services Department •- IJ r ^err. � Permit Type:Roof
240 West Huntington Drive,Post Office Box 60021 I = ) ! n ( i { I 1
I Arcadia,CA 91066-6021 Li ,.ti i I I j i I `Work Classification_Reroof-Residential
(626)574-5416 . _ - .-- Permit Status:_issued
i AReaD IIAIssueDateP07/15/20191 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
2124 Highland Oaks DR Arcadia,CA 5765012018
Contacts
MITCHELL GEE Owner ALWAYS RELIABLE ROOFING* Contractor
2124 HIGHLAND OAKS DR 14410 Crystal Latern DR,Hacienda Heights,CA 91745
(626)723-9536 903930
Description:T.0 REROOF HOUSE/ATTACHED GARAGE WITH Valuation: $ 36,000.00 - Tenant
BORAL DURALITE SAXONY SHAKE CLASS A 55 SQ.HOA Gt
APPROVAL A-24-19 AgcoRE Total Sq Feet: 0.00 Plan Check tJ Plan N
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $681.26
Building Permit Fees $628.00 Cash/Receipt U REC-01815-19 $681.26
Solid Waste Management Fee $6.25 - - -
Amount Due: $0.00
Total: $681.26
0 COMPLETED
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15 6,„ \____-
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 fora period of 180 consecutive days.
•
•
July 15, 2019
Issued By: Date
July 15,2019 Page 1 of 1
o, rrokv.,
i PERMIT/PLAN REVIEW APPLICATION
il 'r4l*• Development Services Department,240 West Huntington Drive,Post Office Box 60021
71
,o Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
Iti 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
co
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 t39 License No.903730 Exp. Date 2-1 -20 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 Contract
WNER-BUILD DE L T 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.My workers'comp•e,^,nsationrr insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier S'I`ti1/4-c-_ 1-r_.vr�1
demolish,or repair any structure,prior to its issuance,also required the applicant 3 0o'3 9 1-0for 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 f rthwith 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 ate 7/S 19Signa
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.
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
contractors)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:
•
I. 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.
f f
ame J cfccti Vr v L nle Ow Art-4C
PRINT NAME
I ertify that I have read this application and state that the above information is cor ct and that I am the owner or duly authorized agent of the owner.
I gree to comply with all City ordinances and State Laws relating to building onstruction. I hereby authorize representatives of the City of
Acadia to enter upon the above-mentioned property for inspection purposes.
igna 4 i se7
ate -IX-11
rf • FILE NO. A - 2LI- Gb�7
DATE FILED UI i 13 za)9
t _�JJ ``
APPLICATION FOR HOMEOWNER ASSOCIATION
ARCHITECTURAL DESIGN REVIEW
(SHORT REVIEW PROCEDURE)
PROJECT ADDRESS: 1 I7'k \kcojktort€i � -..S 'Dr - A-T-cfAck1 C( 1C-4 q ID c).4,
PROPERTY OWNERS NAME: 1M i4c Aie-t I 6cc- vl-'I of WI I=1c9 n kvi
ADDRESS(IF DIFFERENT): _ I
TELEPHONE NO.:bib 32S-33 t, E-MAIL ADDRESS: f'Y1012e W et S+Wro LI ,'Pc(
APPLICANT NAMI1FD ERENT): 3 z t 3 J
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..vis_ible from)iron(and street side yards
O Hardscape, landscaping and structural elements in fiont 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
❑ Mechanical equipment
Roofing WOCaiI Cn,CCyiy Cl/14-e— eM C-kACAVCit
ACTION&FINDINGS: /
iApproved-The project Is consistent with all applicable guidelines
0 Conditionally Approved-With the following conditions,the project will be consistent with all
applicable guidelines
Li 1-nied=4/1/0 ploja : .n_ gi .g.0g 5 'n e L . he following guideline(s)
I
By! Mae= MOM OtP.Mila ,ARS Chairperson Date.
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Amilli ii ii -7u(_'1 I3 26
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AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON_ pMONOXIDE ALARMS
Property Address: Z12- l al.kJ f^f-1 PY. trr--4 i /C C( I DD�
Permit Number: l OO F - [o — 134 0
Brief Job Description: T-'OI?'
Number of smoke alarms installed: in
Number of carbon monoxide alarms installed: 2-
When
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://osfm.fire.ca.qov/licensinglistings/licenselistinq bml searchcotest.php
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 f9reg ing is true and correct, and that this
declaration was executed on (Date) I /0 ( i at Arcadia, California.
Owner's Name (printed/typed): WI I` I L6
Signature of Owner: /V Q)
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
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S' '0- C ' t :ON MO', •XI.E .; •,-'.'I'_ 0 0'
Guest Room ,45; �BatIi oo
Storage
0
Family Room
Garage
0
FIRST FLOOR PLAN
®= SMOKE ALARM I = CARBON MONOXIDE ALARM
I I ;; Mstr
L Bath
Master Bedroom
Dining Room Kitchen jo
— Bath
HallCloset
CD [21
• I Closet Closet
-
Family Room -—
Bedroom Bedroom
SECOND FLOOR PLAN
SMOKE ALARM I = CARBON MONOXIDE ALARM