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Home My WebLink AboutUntitled (2) %'n c City of Arcadia, CA - - Permit NO. Meeh-19-1318 11/ DevelopmentSErv¢esDepartmentV' ,"v-� --'--it"� E. Permit Type:Mechanical 240 Wes[Huntington Drive,Post O(flce Box 60021 t'1 Arcadia,CA 91066-6021 r r� r; t I I Work Classification;HVAC Repair/Replace Ls L .� i. _.� • , (626)574-5416 - - Permit Status:`Issued ARCADIA Issue Date:07/10/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 408 S Santa Anita AVE 16 Arcadia,CA 5779001079 Contacts TERESA LIANG Owner JASON GOLDMAN Applicant 408 SANTA ANITA AVE 16 (818)437-0523 Description:REPLACE HVAC SYSTEM IN SAME LOCATION ON Valuation: $ 0.00 Tenant ROOF.HERS REQUIRED FOR FINAL. Total Sq Feet: 0.00 Plan Check# Plan# • Fees Amount Payments Amount Paid Compressor 3-5 Ton(3 to 15 hp) $36.35 Total Fees $104.22 Furnace or Burner<=100,000 BTU $19.86 Cash/Receipt#REC-01785-19 $104.22 Mechanical Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 Amount Due: _ $0.00 Total: $104.22 4-z.0- t 9 /� 144 COMPLETED (NAL_ OIZ �- I 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 for a period of 180 consecutive days. • July 10, 2019 Issued By: Date July 10,2019 Page 1 of 1 ,F AR c.p.0ro3/44:• PERMIT/PLAN REVIEW APPLICATION ljl 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. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date 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-BUILDER DECLARATION ❑ 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'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant for such permit to file a signed statement that he or she is licensed pursuant to the Policy N er provisions of the Contractors License Law(Chapter 9(commencing with Section (fhr, tion 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 certifythat 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 mom than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Se tion 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 sanctum is not intended or offered for ` sale(Section 7044,Business and Professions Code:The Contractors License 1 Date 7/10 __ Signature _ c''.......—N„, 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 Worke s'Compensation coverage is unlawful, sale.If,however,the building or improvement is sold within one(I)year of and shall subject an employer to criminal penalties and civil fines up to one ompletion,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 7/Il nJf,_��0 / 1 Signature ( / ��1 Lender's Address IMPORTANT: APPLICATION IS HIVEBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS J AND RESTRICTIONS SET FORTH ON T M IS 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 asbest containing materials requires an asbestos survey and removal prior to disturbing the asbestos. Please contact AQMD at(909) 396-2000 for further in rmation. 1 / p Name • ' I r .Vico'. lei . 600.-- ]Title L c J l ur d' PRI NAME • I certify that I h ve 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 corn ly with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia td enter upon the above-mentioned property for inspection purposes. t ni/1% 9 S gnatur 1 (Date 011,18:t Ttel lt�r 7} ;til< y. AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS I'raf erty Address: - 408 S.Santa Anita Me,Arcadia CA sino6 Pc-MitNumber. R —lq—l3fd' 5re. f -oh Description:_t a i'`LL•r ut s•:Ott u aiarms installed: 6 .::r irbcr of careen monoxide alarms Installed: 2 t^lhon alterations,repairs or additions requiring a permit occur,or sleeping rooms ate dsaiud ,, Smoke alarms shall be installed in each sleeping room, and outside each seperate sleeping area in.the Immediate vicinity of the bat toms. and on each additional logo tS dw'e:ting,including basements and habitable attics as required by Section R314 of itat20 tt. California Residential Code (CRC)and Calloraia Health and Safely Coda Sullen`131,18 , For dwellings or sleeping units containing fuel burning appliances a havifw4i' h.-• garages,carbon monoxide alarms shall be Installed outside oadisafrrruta ' 23 • area in the immediate vicinity of the bedrooms, and on each oddilforwltstoey.of'j dwell:ng. Including basements as required by Section R315 of the of the 201,6 o-r1S b Residential Cate(CRC). I.tuitl•purpose alarms(combination carbon manmade and smoke alarms)may bp, --J All alarms shall comply with requirements for Wing and approval by tha0411cc'eto± 'i•1,—., 1t rshal.)Sr Ip.Uastm,lire ca.govilicensinalislarto:'IiconSpNSlina bmf • -i•• f' As owner of the above referenced property.I hereby otxtify that the amolcs. ][%� monoxido alarms have been Installed in accordance wdh the mant:attun e; l enc;It compliance with the code sections referenced above. declareperjury under penalty of thatfore/going Ls true aritherret C; * 3 � r 1 declaration was executed on(Data) ._... ,- Owner's Name(prints d): Tige r 1 ( 4 �`^� .�+�- -- - SIgnatun of Owner. -_-$4 PAC.- kelt .-4551 -- -- - � ti This alffdavll must'belnikt to Ste • h „7'i r•.• ' i„ > f♦