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Home My WebLink AboutUntitled City of Arcadia, CA ,- Permit NOROOF-19-1644 f Development Services Department ' 1 �v/''��^r Permit Type:ROOF 240 West AH9106 -6 Drive,Post Office Box 60021C , `P It J'j ZWork Classification:Reroof-Residential Arcadia,CA 91066-6021 J11_(- - 4.i�j -� i : �i` '1 (626)574-5416 - - - - - Permit Status:Issued ARCADIA - • IssueCiate:08/21/2O19I Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 11rt 108 W Santa Anita TER Arcadia,CA 5782014048 i Contacts 1 SCOTT,WALTER AND ELIZABETH TRS Owner LANSFORD ROOFING' Contractor SCOTT FAMILY TRUST 3535 Landfair,Pasadena,CA 91107 108 W SANTA ANITA TER (626)390-3480 775436 Description:T.0 REROOF HOUSE/GARAGE WITH CERTAINTEED Valuation: $ 10,000.00 Tenant PRESIDENTIAL AUTUMN BLEND CLASS A 25 SQ(JC) Total Sq Feet: 0.00 Plan Check it Plan If t Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $290.51 Building Permit Fees 5237.25 Cash/Receipt JJ REC-02193-19 $290.51 Solid Waste Management Fee 56.25 Amount Due: $0.00 Total: $290.51 Cit 4•/2-/8 c --------- J �l, �ftrkijp CTIONS Request for ins®by 1 r rf,- - % . ,,- 1 PERMIT/PLAN REVIEW APPLICATION 0114 li — + lit*' Development Services Department,240 West Huntington Drive,Post Office Box 60021 "mm=ar„co" 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.li License Class C— 3 q License No0 I have and will maintain a certificate of consent to self-insure for workers' .�/J-11'74 Exp. Date Signature of Contractor + compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. OWNER-BUILDER DECLA 0 I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am ex t 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, I� Carrier y in .i."demolish,or repair any structure,prior to its issuance,also required the applicant 1111 y for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number Q�1J,f;(�' 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 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 corltpl with those provisions. or my employees with wages as their sole '(L 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 O 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),inaddition 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.ma� � Lt,ti'/n. Name Xiv ( Title( JtiAM PRINT NAME I certify that I have read this application and state that the above information is c rrect 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 thhuabove-mentioned pro erty for inspection purposes. ignature I Date Ci' /Sr�r.,w.v F 0�cn4sorNo AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: tOe I t/• ,4.J ��'lu r� Permit Number: 36 Brief Job Description: 160,01 Number of smoke alarms installed: C 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://osfm.fire.ca.govllicensinglistinqs/llcenselistinq 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. t declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) 3C 9I is/4 at Arcadia, California. Owner's Name (printed/typed): '1/4" W,4-4 TER SCOT(' Signature of Owner: 1( cle- 76— This affidavit must be returned to the City of Arcadia inspector prior to final inspection SMOKE AL,, ;, .1 ': l, .•_', jai,_• ' i ? . 11 Sina.1i _ ,------ Guest Roaiu aibroun' I _ llStorage Cr •: i ; Family Room firm 1 ' r a mis L______ mil Came �ry FIRST FLOOR PLAN Of, SMOKE ALARM L i = CARBON MONOXIDE ALARM Mair Bath AMaster Bedroom Dining Room Kitchen Bath — x Hall 01 CloSo-1- Closet= Closet Family Room __.:_� ` C'," 0 Bedroom Bedroom SECOND FLOOR PLAN 0 =SMOKE ALARM Ls n CARBON MONOXIDE ALARM