HomeMy WebLinkAboutUntitled ti
iiiitiii ie.:� ' c k 4 := 'WittPermit NO TI 18 1757-
9- .1 City of Arcadia, CA r-. f - , a ,
':1 Development Services Department i t h,#^+%-it- -v:R r Permit�Type Tenant lmprovement4:
- .z # j 1 ,
{ fi 3 240 West Huntington Drive,Post Office Box 60021 Y Work Classrr canon Tenant Improvement
Arcadia,CA 91066-6021 3 '>a
er 3 n
(626)574-5416 t+ _, PermnStatus Issued
ARCADIA IssueDatet11/08/2018. Expiration: 05/07/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
615 E Live Oak AVE Arcadia,CA
5791024057
Contacts
6TH AVE INVESTORS LLC Owner RANUM MAGELLAN Agent for owner
1922 HUNTINGTON BLVD,SOUTH PASADENA,CA 417 SAN ANTONIO RD,ARCADIA,CA 91007
(323)580-3331 ARCADIAPLAYSCHOOL@GMAIL.COM '
Description:T.I.ARCADIA PLAY SCHOOL Valuation: S 60,000.00 ' Tenant ARCADIA PLAYSCHOOL,INC.
Total Sq Feet: 0.00 Plan Check#18-1757 Plan It 32631
Fees Amount Payments Amount Paid
Accessibility Plan Check $86.78 Total Fees $2,230.53
Accessiblity Building Permit $89.00 Cash/Receipt#REC-002399-2018 $1,181.13
Building Issuing Fee $44.35 Cash/Receipt#REC-002854-2018 $1,049.40
Building Permit Fees $890.00
Building Plan Review Fee $578.50
Amount Due: $0.00
Cal Green Plan Check $57.85 -
Commercial T.I.Fire Plan Chk. $280.00
Energy Plan Review Fee $178.00
Green Building Standard $3.00 0,i
Solid Waste Management Fee $6.25
lid j '1y„ �PECTI(NSStronMotion Inst.Proram Com 516.80Ell
Request for inspection by telephone at 626-574-5450. Leave a message
Total: $2,230.53 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.
November 08, 2018
Issued By: Date
November 08,2018 Page 1 of 1
Pan 1. PERMIT/PLAN REVIEW APPLICATION
z41r Development Services Department,240 West Huntington Drive,Post Office Box 60021
".f 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 0 I have and will maintain workers'compensation insurance,as required by Section
A3700I hereby affirm under penalty of perjury that I am exempt from the Contractors
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
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number
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 g. 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 Secti.n 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sole forthwith co ply ith those provisions.
compensation,will do the work,and the structure is not intended or offered for \J /��E^��� /A/✓`�
sale(Section 7044,Business and Professions Code:The Contractors License XDate � Signature f '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 shallsubject 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 thecost 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
�I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions attorney's fees.
-
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 exem ilu�Ier Sec `m 7 usiness ar o`fn scions;o.- for this reason:
A
7r Ori/]V:'/1FAl Lender's Name
/
/ 5 $ 1.
(Date 1 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
\/ furtherinformation.
,t� yy��y/�, ,, ,/e/�y ��
)Mame Pa num 1 t Ivt V1 cZ4I MYl Title
Aame
`pk/r/a't'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 en pon the ab ve-mentioned property for inspection purposes.
��`
)(Signature /ate 7(7$7( g
. .
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Ihsp. /(S Live OAK
100. Setbacks 210. Under fir/bldg.drain -10 1 , OT1 - 181-17.57
101. Rough grade 211. Copper underslab ,�.1
102. Figs.&forms 212. Rough plumbing 12-01 0 r v
103. Pre-slab 213. Rough gas !-e-(9 SLD 4 LthJ Wr a
104. Floor joists 214. Shower pan
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Anal gas
110. Framing 12-104" 64 220. Fixtures
111. Occ./Area Sept.Wall 221. Final plumbing 3-12-11
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid 2-5- jh,\
114. Insulation-Flr. Pool Inspections Date I Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing • _
117. Drywall nailing (-(O-rt 'V 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 245. Gas line&test
121. Final building 12-1111 '•v I 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date lust). 249. Final.lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Under.round conduit
153. Underslab conduit Beroof Inspections I Date Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156. Rough electrical 12-10-18 I1, 272. Sheathing nailing -
157. Fixtures 2s �-� 273. Final reroof
158. G.F.C.I.
159. E..t.bondin. Sign Inspections I Date I Insp.
160. Service panel 280. SetbacWoverhang ■
161. Final electric 3- (�(2-t 281. Footing
282. Canduit/wirin!
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVA D- • 1240 Miscellaneous Insp. Date I insp.
183. Fire dampers r' 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 chem.
188. Compressor setback 295. Final
189. Commerdal hood
190. Duct shaft Sewers 8 Off site Insp. I Date I Insp.
191. Final mechanical 3 Z-1 r ti 300. Lateral(main to Pt) ■
301. Saddle?!
Block Wall Inspections Date Insp- 302. Cess...I filled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Anal wall 306. Trash bin
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, ,,...\\„,,,,,, ,,. `,„ Ja� S ., 1/ \4.!/ £s� �i1�'i !\// '�"* 'f 7 \ ' .. . -\..ii tr," ( ."`\\ E/ :
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:41
•
Certificate of Occupancy
r City of Arcadia
Ita Development Services Department—Building Division �ti'
tot...V iiic* 'Ha _ I... This certificate issued pursuant to the requirements of the
California Building Code certifying that at the time of issuance this structure was in ,•�,� x
itg
T compliance with the various ordinances of the City regulating building construction or use. t• A
•
Permit No. TI-18-1757gr1
til:4.!
�� °�,
Building Address: 615 E LIVE OAK ARCADIA, CA 91006 t
1%!
Permit Type: TENANT IMPROVEMENT Effective CBC: 2016 C.B.C.
:
,� Occupancy Code: E Zone Code: CBI) f�'��i$f .`:.
s • ��
c(� Final Date: 12-19-19 Type of Construction: TYPE HI •�)
Yu ! Owner: 6TH AVE INVESTORS LLC e4.'`
f4(
m Kenneth Fields, ilding0 ial i,
U
Post in Conspicuous Place y
W— kr
..rov tµ N.�,
0 Ila 'Al
3
3/4--un„i7ttoaf
c0'\r%,
City of TEMPORARY CERTIFICATE OF OCCUPANCY
Arcadia MAXIMUM OF 90 DAYS
BUILDING ADRESS: 615 E. Live Oak Avenue
Development BUSINESS NAME: Arcadia Playschool Inc.
I' DURATION: 90 Days March 13, 2019 to June 11, 2019
Services
Department Owner agrees that the City of Arcadia is allowing the Temporary Certificate of
Occupancy to be issued for the commercial business entity located at 615 E. Live
Oak Avenue, Arcadia Playschool Inc. This building may open for business.
Jason Kruckeberg By opening prior to obtaining permanent "Certificate of Occupancy" all parties
Director of agree that during the next 90 days, the tenant/owner will resolve any outstanding
Development Services concerns/issues with any or all of the applicable Building Codes and
Requirements as set forth by any of the following Departments/Entities: Planning,
Public Works, Building and Fire. Furthermore, that any areas under construction
will have current permits and are not to be placed into service until "Final
Inspections"have been granted/approved by all concerned parties.
After"Final" clearances from each department listed above have been obtained, a
permanent"Certificate of Occupancy"may be issued.
I agree to the to listed above:
All 3 if i
'anum M;gellan, Arcadia Playschool Inc. Da e:
"7. t
WI 7
Kenneth F. ld uildi Official, City of Arcadia 2ete:
240 West Huntington Drive
Post Office Box 60021 .
Arcadia,CA 91066-6021
(626) 574-5415
(626)447-3309 Fax
wsvw.ci.arcadia.ca.us
PermitNO
TI-18;1760
Q City of Arcadia, CA
j Development services Department t" Flo r ^�' } "t Permit Type:Tenant Improvement
240 West Huntington Drive,Post Office Box 60021 „�¢ 1 r 'q IWofrk Cfassrfic6non 71-Intenor Demolition
Arcadia,CA 91066-6021 $ -1,` . 7 ) 11-1 :,
(626)574-5416 Permit Status'Estimate
ARCADiA Issue Date 09/26/2018 Expiration: 03/25/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
615 E Live Oak AVE Arcadia,CA 5791024057
Contacts
6TH AVE INVESTORS LLC Owner RANUM MAGELLAN Applicant
1922 HUNTINGTON BLVD,SOUTH PASADENA,CA 417 SAN ANTONIO RD,ARCADIA,CA 91007
(323)580-3331 ARCADIAPLAYSCHOOL@GMAIL.COM
Description:INTERIOR DEMOLITION FOR ARCADIA Valuation: $ 1.000.00 Tenant
PLAYSCHOOL
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Accessibility Plan Check $6.02 Total Fees $182.36
Accessiblity Building Permit $6.17 Cash/Receipt#REC-002406-2018 $182.36
Building Issuing Fee $44.35
Amount Due: $0.00
Building Permit Fees $61.65
Building Plan Review Fee $40.08
$4
Cal Green Plan Check 12.33 OP1T1
Energy Plan Review Fee $12.33
Green Building Standard $1.00
Solid Waste Management Fee $6.25
Strong Motion Inst.Program Com $0.50
CALLS FOR INSPECTIONS
Total: $182.36 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.
September 26, 2018
Issued By: Date
September 26,2018 Page 1 of 1
�� ,
PERMIT/PLAN REVIEW APPLICATION
e\��j.- 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
Policy Number
for such permit to file a signed statement that he or she is licensed pursuant to the
(This section need not be completed if the permit is for one hundred dollars or less)
provisions of the Contractors License Law(Chapter 9(commencing with Section
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 ❑II 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 rthwith c mply th hose provisions.
compensation,will do the work,and the structure is not intended or offered for q GO z/ /q
sale(Section 7044,Business and Professions Code:The Contractors License a O 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 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 contacts 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:
/j L // g Lender's Name
\
[Date %/24/ ( O 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.
Name Title
PRINT 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 gree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
cadia to enter
!upon the above-mentioned property for inspection purposes.
ignature (:+��ite Date
1 • -o,0 1 City of Arcadia, CA ThPermirNo FIRE 18 2073
Development Services Department D !a �'"'"` ---, i ) r Permit Type Fire
�/("/ •
240 West Huntington Drive,Post Office Box 60021 { "( E 9 Work Classification,FIre�Alarm
` % Arcadia,CA 910 6 6-60 21 .�, `.. 'l,..ft,1 � -+ -
i (626)574-5416 - 1, .+w - ;. _ .l Permit Status:-Issued'.
ARCADIA IssueDae 11/08/20181 Expiration: 05/07/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
615 E Live Oak AVE Arcadia,CA 5791024057
Contacts
6TH AVE INVESTORS LLC Owner USA ALARM SYSTEMS INC* Applicant
1922 HUNTINGTON BLVD,SOUTH PASADENA,CA 138 E CHESTNUT AVE,MONROVIA,CA 91016
(800)833-6068
Description:FIRE ALARMS 30 DEVICES , Valuation: $3.000.00 Tenant
t Total Sq Feet: 0.00 Plan Check#18-2073 Plan#
Fees Amount payments Amount Paid
Fire Alarm Plan Check $840.00 Total Fees $1,005.70
Fire Issuance $44.35 Cash/Receipt#REC-002819-2018 $840.00
Fire Permit Fees $120.35 Cash/Receipt#REC-002853-2018 $165.70
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $1,005.70
illCOWáPLflTfl
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.
Niir November 08,2018
ssued By: Date
November 08,2018 Page 1 of 1
,FAR
SS 1: PERMIT/PLAN REVIEW APPLICATION
*1 ' tSi
,rutor, 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. El have and will maintain a certificate of consent to self-insure for workers'
License Class �r No/I`a ' Exp. Date U compensation, as provided for by Section 3700 of the Labor Code, for the
Signature of Contractor Aiperformance of the work for which this permit is issued.
OWNER-BUILDER DECLARATION a 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 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 A
demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number r" LC
for such permit to file a signed statement that he or she is licensed pursuant to the
(This section need not be completed if the permit is for one hundred dollars or less)
provisions of the Contractors License Law(Chapter 9(commencing with Section
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 property, or my employees with wages as their sole forthwith comply with those provisi s.
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 l(���('� 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 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 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. •
i ame 's )�_ '' k-c. Title
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 he above-mentioned property for inspection purposes.
'gnature Date (( \ 8l 1 8
oc AR
Cji! "WM 7
am..�,,we
toe
c� tyot MEMORANDUM
Fire Department
DATE: February 19, 2019
TO: BUILDING DEPARTMENT
INSPECTOR Jeff Wang
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 615 E. Live Oak Avenue
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE/ INITIAL
FINAL INSPECTION
FIRE SPRINKLERS
FIRE ALARMS 2-8-2019 Jill Perumean
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY 2-19-2019 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 2-19-2019 Rita
of AR
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moms, cao
City of Arcadia • Building Division
240 West Huntington Drive,Arcadia CA 91007
Office: (626) 574-5416 Fax: (626) 447-9173
When the permit application and the Owner-Builder Declaration have been executed by a person
other than the property owner,prior to issuing the permit, the following shall be completed by
the property owner and returned to the agency responsible for issuing the permit:
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal
responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign,
and file the documents necessary to obtain an Owner-Builder Permit for my project.
I declare under penalty of perjury that I am the property owner for the address listed above, and
I personally filled out the above information and certify its accuracy.
Property Owner's Signature: / 717i ' C7`" ` Y1 Date: `A S�z b(cS)-
Property Address: ht S E . Live Oak Ave) /rt ad i K
Owner's Name: Mor3lah Ck iiii C14;in Liu funs G(1il, H.14 Lilt
Owner's Address: / fl. Oveviii44-1-nn Dr. Jo, pasade„ q, CA- 9/030
Phone # 6Z(7 -2k3- 4067
Agent's Name: RCA 14 UM lel ae dl z-
Agent's Address: 10 7 Sal 24n`/ lenity , a'ac9 %/OI7
Agent's Phone #: 3 -23 -5S0-3 .S3/
Scope of Work: 0( CO (A o l GM' a( L t-'e'/vw"V”
NOTE: This authorization must be NOTARIZED or accompanied by a copy of the
homeowner's current photo I.D. (i.e., driver's license, passport or military I.D.
with signature), when presented for issuance of a permit.