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HomeMy WebLinkAboutUntitled (2) '� PermltNO.'Demo-19-2189
gg City of Arcadia, dA - 1�.
),,i al Development Services Department 1 D x ^r"+— -s- -i-?c�.j I-7 Reimrt Type Demblitidi
240 West Huntington Drive,Post Office Box 60021 1 r-of ' , t ; i :i f i
`v Arcadia,CA 91066-6021 -u "? r I Li i i -� Work Classrrcohon:De"mo/Pool
(626)574-5416 '" _ 7'..:17-2x:4rt,..--- .Permit Status:Issued.
f ARCADIA 'Issue Date10/29/20191 Expiration: 04/26/2020
,
a Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
724 E WINNIE WAY Arcadia,CA 91006-4813 5791001038
Contacts ... _ .... .... .a. .�..�.. .,. ,�.,,,.,,,
STANLEY LEVY Owner ACE DEMOLITION CORPORATION* Contractor
724 WINNIE WAY 6924 CANBY AVE 120,RESEDA,CA 91335
(626)840-7139 (818)223-3366 833408 R•
-
Description:DEMO INGROUND POOL 30'X14' Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 Plan Check# Plan#
,
Fees Amount Payments Amount Paid
Demolition Permit(Pool/Spa Backfill) $53.00 Total Fees $106.26
Demolition Permit Issuance Fee $47.01 Cash/Receipt It REC-02929-19 $106.26
Solid Waste Management Fee $6.25 - - -
Amount Due: $0.00
Total: $106.26 m/
/ /'t —,t l 1COMPLETED
not BO TOM dot&) bk. 4,4
11-'5-11 APKtr)C f2� 6 F 1' 9 ass - CALLS FOR INSPECTIONS
Request for inspection by telephone at 626-574-5450. Leave a message
?6146v612 requesting the address,timeframe and what inspection item is needed.
•
I /-2447
may. This permit/plan review expires by time limitation and becomes null and
Pj�L void if the work authorized by the permit is not commenced within 180 days
7 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 orabandoned 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.
•
VI
October 29, 2019
Issued By: I Date
October 29,2019 Page 1 of 1
C
,FAR
,UF ,,\
i� 119112.pylitii 1 PERMIT/PLAN REVIEW APPLICATION
e 13 i Development Services Department,240 West Huntington Drive,Post Office Box 60021
=msµ° Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of 4
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 L 7-, nse g3 7 ye S Exp. Date 2.0 compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor 4-( performance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION C 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 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 TTAT C to rt PG—ti sit.—r-f ®d7
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 Number 7 c 9
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 0 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 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 71 / 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(1)year of and shall subject an employer to criminal penalties and civil finesup 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
Daze 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.
file I Name P u( An drew S PRINT NAME Orr C
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
Arcadia to enter u the above-mentioned property for inspection purposes.
Signature `�--� /Date (D/?-19 7 1
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AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: 7914 E 1JJ1 wlrJlg
Permit Number: /halo — ir- Wel
Brief Job Description: i,,1 Si' L _ .. i� 0. ecxi a r LMO dkriOjk
Number of smoke alarms installed: 4-1
Number of carbon monoxide alarms installed: `!''
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. htto://osfm.fire.ca.oovllicensinglistines/licenselistinq 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) *le) .1q at Arcadia, California.
Owner's Name (printed/typed): *\ L.
Signature of Owner:
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
Si4 oA A _k 4 '-,tt e,t.-! '* lak• • j1._-+ ' Ill • ...0 •i 14_,
Guest Room 1 l'n;ttliroo
1. Storage
Family Room ,' ' ism
stagy
Garage
L_____________ poili
FIRST FLOOR PLAN
SMOKE ALARM II m CARBON MONOXIDE ALARM
Mstr
L Bath —
PMaster Bedroom
Dining Room Kitchen - -
Bath 0
i,
Hall o
Closet
Closet Closet
Family Room _ - •
Bedroom Bedroom
SECOND FLOOR PLAN
0=SMOKE ALARM 1 I o CARBON MONOXIDE ALARM
a laid
City of Arcadia, CA }: t_ Permit NO Wall'''1.9 2303
Development Services Department © lr"".,,.y�-+'"+ ^^t-"t-F5 r,�"p Permit Lype:Wall
240 West Huntington Drive,Post Offite Box 60021 /J 13 t'1 L7 €� `
`t i $q 1 3 ,I t-,WorkclassiJrcation Wall Garden-Wall
• � Arcadia,CA 91066-fi021 �� t�_1.�-, .�...
l� `i (626)574-5416 - , `-,r , , - - - permit stoius:Issued
ARCA I)IA _Issue'Date"11113/2019 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
724 E WINNIE WAY Arcadia,CA 91006-4813 5791001038
Contacts
STANLEY LEVY Owner ERIC PETERSON CONSTRUCTION Contractor
724 WINNIE WAY 200 N ENCINITAS AVE,MONROVIA,CA 91016
(626)840-7139 (626)357-6999 775425 .
Description:1 'LBLOCKED PL BETWEEN GARAGE AND HOUSE 6'H Valuation: $ 944.64 Tenant R
X16'LF PER APPROVED PLANS
Total Sq Feet: 0.00 Plan Check q Plan N
Fees Amount Payments Amount Paid
Building Issuing Fee 547.01 Total Fees $114.91
Building Permit Fees 561.65 Cash/Receipt P REC-03074-19 $114.91
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $114.91
II T-11 �// �I CALLS FOR INSPECTIONS
. 6f/(T Request for inspection by telephone at 626-574-5450. Leave a message
I r'✓ requesting the address,timeframe and what inspection item is needed.
/ 1'2'6'4 i
mA-L O� A 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
November 13, 2019
Issued By: Date
November 13,2019 Page 1 of 1
,FAR
I ,:1. PERMIT/PLAN REVIEW APPLICATION
. .�..,w
3
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,an my licensfull force and effect. pp�� 2 ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class Li o. 77���a Exp. DateD' 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 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 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 Labor Code,I shall
❑I, as owner of the roe 'forthwith comply with those provisions.
property,rty, or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for Date It/3.ter Signature
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 tosecure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer tocriminal 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).
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 MRIs 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.m1G �
\Tiue
Name T � dW t`K-'-
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.
I agree 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.
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