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41-91.‘N 44City of Arcadia, CA —€��, � 2 Permit NO Plum 19 2343
Development Services Department u 'i ® f' 11 - :Permit TypePlumbing
a' 240 West Huntington Drive,Post Office Box 60021sit
1
Work Gossjicapon Wates Heater
Arcadia,CA 91066-fi021 .., ,I _ ._,{ : ' -
• (626)574-5416 _ Permit Stof) Issued..
ARCADIA IssuefDate;11/19/2019` Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
406 SAN LUIS REY RD Arcadia,CA 91007-3012 5775018033
Contacts
TONY SAWAYA Owner A.R.S./Rescue Rooter* Contractor
406 SAN LUIS REY RD 706 W Arrow Grand CIR,Covina,CA 91722
(909)553-3606 (626)858-9284 765155
Description:REPLACE WATER HEATER IN SAME LOCATION Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 Plan Check p Plan#
Fees Amount Payments Amount Paid
Plumbing Permit Issuance Fee $47.01 Total Fees $63.56
Solid Waste Management Fee 2 $1.00 Cash/Receipt p REC-03126-19 $63.56
Water Heater and/or Vent $15.55
Amount Due: $0.00
Total: $63.56
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lit GOPLET
A L�S 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.
November 19, 2019
Issued By: Date
November 19,2019 Page 1 of 1
,FAR
4 w I' PERMIT/PLAN REVIEW APPLICATION
1, .�z ` -,
o ff@)j, Development Services Department,240 West Huntington Drive,Post Office Box 60021
%aliyar Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S Lt ECL• ,' • ION WORKERS'COMPENSATION DECLARATION
❑ I hereby affirm under penalty of ped . that I .r nsed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7000,of I .ion 3 of the Business and
Professions Code,and my license is i.r full for.- .•d effect. 7 ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class Cite Liceos:/�,. �i��r�i Elle Date' 71'ZU compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
;if
Signature of Contractor �_-
-
OWNER-BUILDER DECLARATION I have and will maintain workers'compensation insurance,as required by Section
CII hereby affirm under penalty of perjury that I. axe : 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 70' . , :usiness and Professions is issued.My workers'rco pensation/insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier it tree V'-t.vIv a-
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number Vt'�7.to33 0 -So Sty 3/ • 6 r ce
for such permit to file a signed statement that he or she is licensed pursuant to the
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 ,,.�{{
Uexempt there from and the basis for the alleged exemption. Any violation of m
I certify that in the performance of the work for whit•this pe.. s 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 .•, e t to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that' sho, . .me subject to the
workers'compensation provisions of Section 00 i . e Labor Code,I shall
❑L as owner of the property, or my employees with wages as their sole f with comply with those provisions. �,
compensation,will do the work,and the structure is not intended or offered for i/ - 17- �CI Signature :V _ / /
sale(Section 7044,Business and Professions Code:The Contractors License D to
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 •iverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalti- a d 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 1•IiL 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.
tne r' it- — Ud✓ r
Title seir
P'4rN• 1•
rtify that I have read this a. . cation . .d state that the above information is co ct and that I am the owner or duly authorized agent of the owner.
gree to comply with all CP or.• .nces and State Law •lating to buildin construction. I hereby authorize representatives of the City of
adia to enter upon the e-men oned property for'.. pection purposes. / • /r/l - /C7Signature . Date /`