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AMERICAN FIRST NATIONAL BANK
7•1144r,1 City of Arcadia, CA {} Permit NO.TI-19-0925 / Development Services Department d D Inc-inn-1r\!T -.Permit Type:Tenant Improvement .j 240 West Huntington Drive,Post Office Box 60021 r_ - i I r i• , I I I ; i ,,Work Class+i ic5tiod:Tenant Improvement Arcadia,CA 91066-6021 I . "„u L`-�+ ,-i�_v 1,- • (626)574-5416 Permit 5tottis:^Issued ARCADIA , - -;-Issue,Date:07/22/ZOi9' Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 815 W Naomi AVE 1 Arcadia,CA 91007 5383035034 Contacts • BALDWIN ARCADIA CENTER LP Owner DANIEL TAI Applicant 815 W NAOMI AVE A,Arcadia,CA 91007 322 E FOREST AVE,ARCADIA,CA 91006 (626)808-6560 USCA.COMPANY@YAHOO.COM ATECK CONSTRUCTION INC* Contractor P.O.Box 8249,Rowland Heights,CA 91748 (626)839-0079 845160 Description:T.I.AMERICAN FIRST NATIONAL BANK Valuation: $ 80,000.00 Tenant AMERICAN FIRST NATIONAL BAN Total Sq Feet: 0.00 Plan Check#19-925 Plan#89 Fees Amount Payments Amount Paid Accessibility Plan Check $103.06 Total Fees $2,792.58 Accessiblity Building Permit 5105.70 Cash/Receipt#REC-01870-19 $1,722.36 Building Issuing Fee $47.01 Cash/Receipt#REC-01237-19 $1,070.22 Building Permit Fees $1,057.00 Building Plan Review Fee $687.05 Amount Due: $0.00 Cal Green Plan Check $68.71 Commercial T.I.Fire Plan Chk. $280.00 Energy Plan Review Fee $211.40 Fire Final Occupancy Fee $200.00 Green Building Standard 54.00 Solid Waste Management Fee $6.25 CALLS FOR INSPECTIONS Strong Motion Inst.Program Com $22.40 Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. Total: $2,792.58 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 „Ifrom the date of issuance or if the permit is not obtained within 180 days I��j2 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 (N41- Arcadia building inspector for iof 180 consecutive days. 1 1 s- egiilist ift, July 22, 2019 \ Issued By: Date July 22,2019 Page 1 of 1 pP R ,aroAax, O g,-- ij1j PERMIT/PLAN REVIEW APPLICATION 141*' Development Services Department, 240 West Huntington Drive,Post Office Box 60021 oir 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 ful/orce and effect. IDI have and will maintain a certificate of consent to self-insure for workers' License Class Lice a No I r.1 c Y Exp. Date/ compensation, as provided for by Section 3700 of the Labor Code, for the P performance of the work for which this permit is issued. Signature of Contractor d11� . . :.� OWNER-BUILDER DECLARATION 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 mason(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 f br 7 pith demolish,or repair any structure,prior to its issuance,also required the applicant V r for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if t re 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 them 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.ecome subject to the workers'compensation provisions of Section 700 of Labor Code,I shall ❑I, as owner of the property, forthwith comply with those provisions. _ or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for ��!Q sale(Section 7044,Business and Professions Code:The Contractors License Date (� / -/ Signature /,,: ./ = r. et 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),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 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. ,�[T�,(' /J�'y� ��' Name Iwi��V/l 1 .� .4_- Title 'i vf�`-�l[`'—x "/ I r NA 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 ity ordin� and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the . ,ove-mentio property for inspection purposes. �/7// ten/ Signature 19 A 1 .-moms. _ Date f / y���/ r — ( L • ALA NOTEST Building Inspections Date Insp. Plumbing Inspections Date Insp. Si S /W A C5/N I 5 re. J 100. Setbacks 210. Under flribldg.drain 101. Rough grade 211, Copper underslab �^j r 102. Figs.8 forms 12. Rough plumbing ES-C.-14 'I�e uC.44- c e r? tc /N ree- 103. Pre-slab $-4-09 hk.71213. Rough gas WA-CC-S. 4j Lr - F,V&i re4C 104. Floor joists 214. Shower pan 666 105. Steel 215. Water heater 106. Grout lift 216. Roof drains g-Zf-{q 1JRYwM4 u.4414S erar 107. Shear nailing ___ __ __ _ __ 217. Building sewer `�' L 108. Diaph nailing 218. Water service 109. Roof nailing . Anal gas ge3-et 0'r1 76r -et- A T'Cc& 4. 110. Framing e -((-i9 � 22020. Fixtures /�(� 111. Occ./Area Sept.Wall 221. Anal plumbing 'WO4C.0-- ( 'o.itrK ,ACK 112. Sound walls 2 2. Sewer cap/demo. 113. T-bar.rid c'-LG-ela 114. Insulation-Flr. Pool Inspections I Date . Insp. sr/Z7/ O I,/ l /_ ni Si// 115. Insulation-Wall 240. Excavation/steel r '` TQ �(! //r',7` 116. Insulation-Coil. 241. Rough plumbing 117. Drywall nailing 242. Light shell/bonding 118. Interior lath 243. Underground conduit 119. Exterior lath E-J.R-11 \" \ 244. P-trap 120. Finish grade {��{"""J5. Gas line 8 test 121. Final building 1C3474L7`�j < 246. Fence,gates 8 signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final.lumbin. 150. Power pole 250. Pool cover 151. Sales lot lighting 251. Pool final 152. Under.round conduit 153. Underslab conduit $-4- - ti� Reroof Inspections I Date Insp. 154. UFER ground 270. Pre-reroof insp. 155. Water ground ,// 271. Roof framing 156. Rough electrical Q-(/-6�j' 6L'c/272. Sheathing nailing - 157. Fixtures 273. Final reroof _ 158. G.F.C.I. 159. E..1.bondin! Sign Inspections I Date I Insp. 160.1Servicepanel280. Footing overhang 161. Final electric (b-LK-L��281. Footing 282. Conduit/whin. Mechanical Inspections Date Insp. " 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/AC. 182. Routh HVAC Miscellaneous Insp. I Date I Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 292. Fire sprinklers 186. Smoke detectors 293. Monitor system 187. Metal F.P.rough 294. Hood dry them. 188. Compressor setback 295. Anal 189. Commercial hood 190. Duct shaft Sewers 8 Offsite Insp. I Date I Insp. 191. Final mechanical 300. Lateral(main to P/L) ■ 301. SaddlelY Block Wall Inspections Date lnsp. 302. Cess...1 filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement \203. Anal wall 306. Trash bin attae A � a. �°i- a��j+�n�a zf'°IP. ' ffPAW"% wv a it 4f to ,\1 � ,-�,e.soy e • tg- •'L'i^.Qftmps ^q.. ,d .. .xavr_ Harz. • .aw�3iac,x�.,�neme,..v- ,nt•,a,•cs+n.... . a.,- ..- .-. , , �1��^' ' I o ' �� w -. I tii Cn Cma rwa i ,.� ' it c • Certificate of Occupancy 1 4 f ..lCity of Arcadia it '11; Development Services Department—Building Division ti This certificate issued pursuant to the requirements of the b, f California Building Code cenifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use.(i .x Permit No. TI-19-0925 eft,rr Buildi,( ng address: 815 W. NAOMI AVE#J ARCADIA, CA 91006 • 1 E.y Permit Type: TENANT IMPROVEMENT EffectiveCBC: 2016 C.B.C. ty"c> n:3I'7j y Occupancy Code: B ] :K Zone Code: C-G )� �? Final Date. 10-17-19 Type of Construction: TYPE VB SPRINKLERED Owner: BALDWIN ARCADIA CENTER LP Tenant: NATIONAL BANK z c ` 6 x a_. Kenneth Fields, ding O ial ` r �, Post in Conspicuous Place t w' �'_ d P V IIIL''' ... rm .w. �. 4 N � �:to- «.� �, t1��' 1. " 4 /� i-- h r' 1 t r -' A.Asj 6 a r*^ Or .y¢ y ♦� ..aj �'.r 'M-. h �'t V.'ac 1 F. ., >,. �iv= k'� � t t� ,lt^v qtr ,� r �w�I_ �rK' �B L .M1 1 V „ ,r ltVArr - � il,\ p�a f \'•_ r T q---- ,, ,.--f -.. a v, dT'_l, '�. N C� \ � l;t*..., "^"' ✓a km 'r' y�,�. TI',, s` + w,,.F. f,�. ++;o-s.x ,.s 4c anf"�y' 7 t.,\ }. .t'...er `^�i.":9.+a:",.e�'. ,.-r.vrs.-- r ` --- -.v.7 „r,.-- ,0,.,,,L,,. v'(� # . _ ` .”" `.. ,,�„+� e, C" [4.4 \y11 ` City of Arcadia, CA Permit NO. MEP-19-2096 l Development Services Department /�'� "+�",r} —,,..iiS��rL�,, • Permit Type:MEP 1 240 West Huntington Drive,Post Office Box 60021 (� I ' 1 Arcadia,CA 91066-6021 J _ L �Work`ClassificationrMEP-Commercial --' (626)574-5416 - Permit Status:Issued ARCADIA Issue-Date:10/16/2019' Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 815 W Naomi AVE Suite.1 Arcadia,CA 5383035034 Contacts BALDWIN ARCADIA CENTER LP Owner ATECK CONSTRUCTION INC' Contractor 0 c/o CANDET Properties,Inc.PO Box 870,Alhambra,CA 91802 P.O.Box 8249,Rowland Heights,CA 91748 (626)281-9338 (626)839-0079 845160 Description:MEP FOR AMERICAN FIRST NATIONAL BANK T.I. Valuation: $ 0.00 Tenant AMERICAN FIRST NATIONAL BAN Total Sq Feet: 0.00 Plan Check ff Plan N Fees Amount payments Amount Paid Add/Alter Ducts $188.86 Total Fees $496.07 Electrical Permit Issuance Fee $47.01 Cash/Receipt tIREC-02809-19 $496.07 Kitchen Sink $13.21 Amount Due: $0.00 Lavatories $13.21 Light Fixtures $56.98 Mechanical Permit Issuance Fee $47.01 Outlets-Receptacles&Switches $47.44 Plumbing Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 51.00 CALLS FOR INSPECTIONS Ventilation Fan(Single Duct) $19.88 Request for inspection by telephone at 626-574-5450. Leave a message Water Closet $12.46 requesting the address,timeframe and what inspection item is needed. Total: $496.07 y-.�aL This permit/plan review expires by time limitation and becomes null and (0 void if the work ssuned by the permit is not commenced within 180a days /607�, 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. © 9, gg t 47 October 16,2019 Issued By: Date October 16,2019 Page 1 of 1 it NUvoRv4", ;,:.`+•� ' PERMIT/PLAN REVIEW APPLICATION 4to@3j 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 ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of I h reby 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 an effect. pp(%,�I • 0 I have and will maintain a certificate of consent to self-insure for workers' License Class A License Exp. Date I �/- co pensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor o 1 p ormance of the work for which this permit is issued. 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'corn ensation insurance carrier and policy numbers are: _Code.Any city or county which requires a permit to construct,alter,improve, Carrier 9-7A-res- demolish, lZ> or repair any structure,prior to its issuance,also required the applicant Number for such permit to file a signed statement that he or she is licensed pursuant to the Policyq/ provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed' the pe 't 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 sho.Id become ssu'ject to the orkers'compensation provisions of Section 3700 i.t the Labor ' i de,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comply w t//thh,,,]]]those provisions. / compensation,will do the work,and the structure is not intended or offered for Date r,e '�/t"/ Signature �,L AO sale(Section 7044,Business and Professions Code:The Contractors License 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 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),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. 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 further information. /� ,, m e —t�n a /a T . I Title �S[t( C7 V 1 PRINT . - / certify that I have read this application and stat that the above information is correct and that I am the owner or duly authorized agent of the owner. agree to comply with all ' ordinances i State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the a t mentioned p,+perry for inspection purposes. Signature ie14. A1/4.f. , —AA.A. Date l W` 17 iii City of Arcadia, CA O Permit-NO. FIRE-19-1569 N,,,,/, ,, ' Development Services Department f[P( LT '1 Box 60021 1{-,� i Work Classification:Fire Sprinkler (626)574-5416 - Permit Status:Issued ARCADIA - Issue Date:08/12/2019 I Expiration: 02/08/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number '815 NAOMI AVE 1 5383035034 Contacts BALDWIN ARCADIA CENTER LP Owner F&H Fire Protection' Contractor 0 c/o CANDET Properties,Inc.PO Box 870,Alhambra,CA 91802 1119 Westminster AVE,Alhambra,CA 91803 (626)281-9338 (626)262-3876 584319 Description:FIRE SPRINKS FOR AMERICAN FIRST NATIONAL Valuation: $ 2,000.00 Tenant BANK 19 HEADS Total Sq Feet: 0.00 Plan Check it Plan if Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $851.66 Fire Permit Fees $103.65 Cash/Receipt14 REC-02093-19 $851.66 Solid Waste Management Fee 2 $1.00 Sprinkler Heads $700.00 Amount Due: $0.00 Total: $851.66 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. . 4 PV ,te.",.c,h . s , op I I • August 12,2019 Issued By: Date August 12,2019 Page 1 of 1 . PERMIT/PLAN REVIEW APPLICATION tID*' 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 m license is in full fore an e ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C ( 0 License No.� xp. Date t Zr 7 f 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 t/ .P 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' pensation insurance carrier and poi y numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier JPl"c et e y1/49E,1 yv C-e. W demolish,or repair any structure,prior to its issuance,also required the applicant JC 7 �/S for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number ff provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is or one hand d 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. My 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 Labor Code,I shall ❑I, as owner of the property, or my employees with wages as their sole forthwith comp) w h th provisions. compensation,will do the work,and the structure is not intended or offered for 1 as C ------/------c77 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 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). 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 1 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). 0 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. N me .. al,/ i J . .. )Title Ci A i. ' PR NAME —' I rtify 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 ree to comply with a0 City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Ar adia to enter upon the above-mentioned property for inspection purposes. 1---d ny //,/' //// Si nature J Date U 1 l 2—