HomeMy WebLinkAboutplum-19-2567 I _ Permitwo.Plum-19-2567
City of Arcadia, CA ti "
r Development Department 'I r r-_'- 1-7-11-1
"-✓'� IIrl 1.. PermitT a:
P P I , I t-" H I Type:Plumbing
240 West Huntington Drive,Post Office Box 60021 r1{ °` r i t rl
Arcadia,CA 91066-6021 �r �.• - �J,L, il_� Work Classification:Water Heater
(626)574-5416 - Permit status .Issued
ARCADIA Issue Date:12/24/20191 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number {.r
37 W ARTHUR AVE Arcadia,CA 91007-8202 5788003040 f
Contacts
CHERYL LEHMANN Owner A.R.S./Rescue Rooter` Contractor
37 W ARTHUR 706 W Arrow Grand CIR,Covina,CA 91722
(626)445-4228 (626)858-9284 765155
Description:REPLACE WATER HEATER IN SAME LOCATION . Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 : Plan Check N Plan N
Fees Amount Payments Amount Paid
Plumbing Permit Issuance Fee $47.01 Total Fees $63.56
Solid waste Management Fee 2 $1.00 Cash/Receipt ff REC-03444-19 $63.56
Water Heater and/or Vent 515.55
Amount Due: $0.00
Total: $63.56
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12 A LCOMPNIETEL\i s
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.
December 24, 2019
Issued By: Date
December 24,2019 Page 1 of 1
NU°ogyy
01m i PERMIT/PLAN REVIEW APPLICATION
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co Development Services Department,240 West Huntington Drive,Post Office Box 60021
,tr Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia !DECLICENSED CONTRACTOR' ARATION WORKERS!COMPENSATION DECLARATION
❑ I hereby affirm under penalty of perj no that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Seed.(h 7000„'f Division 3 of the Business and
Professions Code,and my license' full'f.rce and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class 03(0 Lice e �
✓ tap. Date '317 compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor /� performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION pPa ..ve and will maintain workers'compensation insurance,as required by Section
❑ I hereby affirm under penalty of perjury that I I. exem rt 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 70 . , :usiness and Professions is issued.M) wort ers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier L. al WlcY4'V a1
demolish,or repair any structure,prior to its issuance,also required the applicant W . 103 Q• 50 75(4;3 1 • Q
1 Cl
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 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 them from and the basis for the alleged exemption. Any violation of ❑ I certify that in the performance of the work for w ch this pe..'t 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 me su+ject to the workers'
penalty of not mom than five hundred dollars($500)): compensation Laws of California,and agree[ha if should .- .me subject to the
workers'compensation provisions of Sectio 37 G o'f o 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 Date 12 -2-H * I G SignatureSi
sale(Section 7044,Business and Professions Code:The Contractors License �'
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 i unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall.subject an employer to criminal penalties and civ' fin 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 ompensation,
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. '',, // } �,/
Mame .4)1(4/70144{ion P22'r (Tide 0�,
1 /
I certify that I have read applica on a
• nd 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 i City 'r''names and Stat'Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upon t :bo••-m ntioned property lir inspection purposes. L��T
gnature (Date /2 •21
./y
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