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Home My WebLink AboutUntitled o 4i 41:4'44: City of Arcadia, CA " Permr'GNO ROOF 19-0996.' Development Services Department !^-7 `( x� Permit Type:Roof 240 West Huntington Drive,Post Office Box 60021 7 *'�+ j f� - F Arcadia,CA 91066-6021 '��I tl 141 t 1-t work t/assnc�at on. Reroof 3Resldential' t . (626)574-5416 ' - ,.- - - permit Status:Issued ARCADIA _ Iss eoate:OS/28/2019=' Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1231 S SIXTH AVE Arcadia,CA 5780008013 Contacts SEC)NI KONG Owner 1 H ROOFING INC DBA:Pro Roofing Co. Contractor 12315 SIXTH AVE 10405 CLANCEY AVE,DOWNEY,CA 90241 1050512 Description:T/0 AND REROOF HOUSE AND ATT.GARAGE WITH Valuation: $ 14,000.00 , Tenant OWENS CORNING, DIMENTIONAL COMP,CLASS A OVER EXISTING SHEATHING Total Sq Feet 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $357.31 Building Permit Fees $304.05 Cash/Receipt#REC-01333-19 $357.31 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $357.31 S-3 0—1 eto COMPLETED — U * MI q, CALLS FOR INSPECTIONS FNA t._ (o.12 .i q l7`—` 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. May 28,2019 Iss ed By: Date May 28,2019 Page 1 of 1 PERMIT/PLAN REVIEW APPLICATION IP, _ cis% Development Services Department,240 West Huntington Drive,Post Office Box 60021 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 ti 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' ,+Y License Class C3 License No 0 f 647.7-- ¢-1)ate —��' r compensation, as provided for by Section 3700 of the Labor Code, for the p � —//-2/ performance of the work for which this permit is issued. 1 ;Signature of Contras _ ____ A OWNER-BUILDER DECLARATION Save and will maintain workers'compensation insurance,as required by Section + ;'' 3700 of the Labor Code,for the performance of the work for which this permit ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.s y workers'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions 1::-.'i Code.Any city or county which requires a permit to construct,alter,improve, 1;t=,.Carrier t pc v Fu- ,Ori demolish,or repair any structure,prior to its issuance,also required the applican`,3r 1 9' 1� p �///�/� for such permit to file a signed statement that he or she is licensed pursuant to the (_, (Policy Number / 0 provisions of the Contractors License Law(Chapter 9(commencing with Section t?.,;(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 'it^'Q I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of , Section 7031.5 by any applicant for a permit subjects the applicant to a civil ,.,v;,t'not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): :'. t compensation Laws of California,and agree that if I should become subject to the 4.. workers'compensation provisions of Section 3700 of the Labor Code,I shall ❑ as owner of the property, t f rthwith comply with those provisions. I, or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for ate / sale(Section 7044,Business and Professions Code:The Contractors License — — Signature C�� 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}s 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). damagesas 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 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 Al further information. i (7 Name �'� Title • {{1�0 2 emuNTm ]it / i; J,0 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. J i+ISagree 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. .41 '/,-1- j1 Signature Date ^a ^/? °A r d6 R A�o6 AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: ,433/ 9 c,;A 4/Ii✓ Permit Number: Roc-- /9- D 19( Brief Job Description: R ni; +- Number of smoke alarms installed/:: tt - Number of carbon monoxide alarms installed: S _ 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/licensinglistinasllicenselistinq 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 foregoing is true and correct, and that this declaration was executed on (Date) I—,-2— /1 at Arcadia, California. Owner's Name (printed/typed) Jao- i em, Signature of Owne --- This affidavit must be returned to the City of Ar dia inspector prior to final inspection Sli •K- -••L 3'.' N' C,' =O', Me' OJIA i A ii L•C : s I ._ . _ . Guest Room � nk7N : 1/4%'4 , . • _0 Battreoo - . iJ Storage t; . d Q . Family Room • IGarage G FIRST FLOOR PLAN ®= SMOKE ALARM......- $ = CARBON MONOXIDE ALARM .,174._ n Msir • . Bath . - • Master Bedroom Dining Room Kitchen -13nde Urt4:0, '' Wall hE;sCL —JCioset ClOset Family Room — a m at Bedroom Bedroom ' SECOND FLOOR PLO , 0=SMOKE ALARM ® = CARBON MONOXIDE ALARM .