HomeMy WebLinkAboutUntitled ',(444:11 City of Arcadia, CA ' Permit NO: Comm 19 1170
'r Development Services Department P1 ).r--- '"x" r- —y Permit Type Commercial
1 1 240 West Huntington Drive,Post Office Box 60021 i '�'f {"'1L '1E""
4 �1 dl JJ€€ Work Cfas`sf cation:Commercial=Add Alt
Arcadia,CA 91066-6021 � - � - /
(626)574-5416 =. - _.- - ` , Permit status:;Issued
ARCADIA --,1 ''- Issue=Date o7/ia/2019."I Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
670 ORANGE GROVE ARCADIA,CA 91007 5769017900
. _. . . - . .. , , _. - _
Contacts .... .
ARCADIA CITY Owner Crown Castle International Applicant
240 W HUNTINGTON DR Corporation
200 Spectrum Center DR,Irvine,CA
(949)930-7464
MASTEC NETWORK SOLUTIONS INC' Contractor
1825 PONCE DE LEON BLVD 543,CORAL GABLES,FL 33134
(818)821-9086 • 984138
Description:REMOVE/REPLACE 3 ANTENNAS,REMOVE/REPLACE • Valuation: $ 15,000.00 . Tenant
3 RRUS AND MISC EQUIPMENT
CHANGE OF CONTRACTOR TO MASTEC 11-1-19 t Total Sq Feet: 0.00 : Plan Check#19-1170 Plan#88
Fees Amount Payments Amount Paid
Accessibility Plan Check $31.28 Total Fees $1,089.99
Accessiblity Building Permit $32.08 Cash/Receipt#REC-02972-19 $73.93
Building Issuing Fee $47.01 Cash/Receipt#REC-01856-19 $411.29
Building Permit Fees $320.75 Cash/Receipt#REC-01592-19 $604.77
Building Plan Review Fee $208.49
Cal Green Plan Check $20.85 Amount Due: $0.00
Change of Contractor $57.50
Commercial T.I.Fire Plan Chk. $280.00E
Green Planng w Fee $64.15 COMPLEMa
Green Building Standard $1.00
Solid Waste Management Fee $6.25 OR INSPECTIONS
Strong Motion Inst.Program Corn $4.20 Request for inspection by telephone at 626-574-5450. Leave a message
Supplemental Building Issuance $16.43 requesting the address,timeframe and what inspection item is needed.
Total: $1,089.99 1
•
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
nRJAf_ //•/.-•/? 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.
July 18, 2019
Issued By: Date
November 01,2019 Page 1 of 1
.1-:non--,�,;,, 1 PERMIT/PLAN REVIEW APPLICATION
. _
�i3* 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
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 A/O/C/9 CI Liters o.Q /1 Exp. Date 6�7tn01r 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 Contractor
OWNER-BUILDE DECLARATION 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 he Labor Code,for he performance of the work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.Myf workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, I Carrier 4 C, ail em.'caa-- 1/4,5 .
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number M/L C `Q 4 OG z for 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
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 abor Code,I shall
❑I, as owner of the property, forthwith comply with those provisions.
or my employees with wages as their sole .+r �/
compensation,will do the work,and the structure is not intended or offered for Date ill //i J
sale(Section 7044,Business and Professions Code:The Contractors License Signature i
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 coverageis!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 ofcompensation,
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 /r/N-
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.
\N
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.
ame
lAdonA /t'I DI'ece.h aim Title ti
til
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.
agree to co ply with all C' or ' nces and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to e r upon th e- tinned property for inspection purposes.
Signature 'Date 1////, g
City of Arcadia, CA ;� Permit NO. Comm 19-1170
Development Services Department nJ�'t �s.^'' - -%'•��=strlr Permit Type:Commercial
240 West Huntington Drive,Post Office Box 60021 A ( S r =
ty. «J Arcadia,CA 91066-6021 k t u Work Oass/ficahon:Commercial.-Add/Alt
is t � `5i! •
{ (626)574-5416
- .— = PermitStatus: ssued
ARCADIA 4-*uegate 07/18/20191 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
670 ORANGE GROVE ARCADIA,CA 91007 5769017900
Contacts
ARCADIA CITY Owner NUWAVE INTERNATIONAL INDUSTRIES Applicant
240 W HUNTINGTON DR INC*
1875 CORONADO AVE CORONADO AVE,SIGNAL HILL,CA 90755
(562)498-0800
Crown Castle International Applicant
Corporation
200 Spectrum Center DR,Irvine,CA
(949)930-7464
Description:REMOVE/REPLACE 3 ANTENNAS,REMOVE/REPLACE EM Valuation: $ 15,000.00 Tenant
3 RRUS AND MISC EQUIPMENT Total Sq Feet: 0.00 Plan Check#19-1170 Plan k 88
6
Fees Amount Payments Amount Paid
Accessibility Plan Check $31.28 Total Fees $1,016.06
Accessiblity Building Permit $32.08 Cash/Receipt U REC-01856-19 $411.29
Building Issuing Fee $47.01 Cash/Receipt N REC-01592-19 $604.77
Building Permit Fees $320.75
Building Plan Review Fee $208.49 Amount Due: $0.00
Cal Green Plan Check $20.85
Commercial T.I.Fire Plan Chk. $280.00 COMPLETEDGreen PlanngStanFar $$1.00Ei
Green Building Standard $1.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Com $4.20 CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
Total: $1,016.06 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.
July 18, 2019
Issued By: Date
July 18,2019 Page 1 of 1
al man li
PERMIT/PLAN REVIEW APPLICATION
,N.....4 -2.:.%., Development Services Department, 240 West Huntington Drive,Post Office Box%Qom, Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION •
WORKERS'COMPENSATION DECLARATION
ri( 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,�dand my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class 06100 License No.1060 /32 Exp. Date Gl/71/j' compensation, as provided for by Section 3700 of the Labor Code, for the
}� ��J, p-rformance of the work for which this permit is issued.
Signature of Contractor _i r✓�)p9—C — 4
OWNER-BUILDER DECLARATION l� 1., I have and will maintain workers'compensation insurance,as required by Section
0 I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of he work for which this permit
License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insur2ece carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Caries, (0 - p / t b cl
demolish,or repair any structure,prior to its issuance,also required the applicantS t5
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number- t g
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 civi 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 forthwith 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 Date 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(I)year of andshallsubject 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.
o 1, 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.
i
l to {/l p I
are NT Title
PRINTN E -
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
(re
to enter upon the above-mentioned property for inspection purposes. ( (� I S
Signature_L//C� Date 7 l 7S /