HomeMy WebLinkAboutTI-19-0606 /
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City of Arcadia, CA
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Ferm,t No TI X19 0606,
Development Services Department �� 0� °rte s�
P P Perini Type Tenant Improvement ,
N:\,
240 West Huntington Drive,Post Office Box 60021 1 1 a'ti ' ; , ; ,,,, T ,:
i Arcadia,CA 91066-6021 0,,,, ,,,A'..\•::::-.0-.$`� j,���,Wo[kCIassifica on!TenantImprovement
(626)574-5416 • ' *, a,r v� sig
'kPerm,tStatus ssued"
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ARCADL. , x rb + ` � 1� IssueDate 06/04/2019Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR BUILDING Arcadia,CA 5775015029
B 1ST
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner ' GONZALO DE VERA Applicant
MIKE 500 903 CAZLE AMANECER 210,SAN CLEMENTE,CA 92673
125 W HUNTINGTON DR (714)600-2234
Con-Am Inc* Contractor
903 Calle Amanecer 210,San Clemente,CA 92673
(949)498-1003 698311
Description:USC MEDICAL OFFICE TI FOR BUILDING B 1ST i Valuation: $400,000.00 Tenant
FLOOR.MEP WORK,CT EQUIPMENT OSHPD 3.
Total Sq Feet: 0.00 Plan Check#19-606 Plan#50
-T,
-
Fees Amount payments Amount Paid
Accessibility Plan Check $321.17 Total Fees $7,620.14
Accessiblity Building Permit $329.40 Cash/Receipt#REC-00779-19 $3,615.18
Building Issuing Fee $47.01 Cash/Receipt#REC-01405-19 $4,004.96
Building Permit Fees $3,294.00
Building Plan Review Fee $2,141.10 Amount Due: $0.00
Cal Green Plan Check $214.11
Commercial T.I.Fire Plan Chk. $280.00 5<-f6...
� �44 C ��_
Double Fee(Building) $0.30 V
Energy Plan Review Fee $658.80
Fire Final Occupancy Fee $200.00 .
Green Building Standard $16.00 CALLS FOR INSPECTIONS
Solid Waste Management Fee $6.25 Request for inspection by telephone at 626-574-5450. Leave a message
Strong Motion Inst.Program Corn $112.00 requesting the address,timeframe and what inspection item is needed.
Total: $7,620.14
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.
/iff . C
alliPlifie
gi' June 04, 2019
• Issued By: Date
June 04,2019 Page 1 of 1
U�4 ouF 'a9.. r
maw 7 PERMIT/PLAN REVIEW APPLICATION
Y/ll\\\`.c yy
o4/je Development Services Department,240 West Huntington Drive,Post Office Box 60021
m.,..hy of 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:
hapter 9(commencing with Section 7000,of Division 3 of the Business d
ofessions Code,and my license is in full force and effect. ❑ I have and will maintain a certificate of consent to self insure for workers'
iceature ofss Lice . �. ��Idl elp,„,„1___1 ...- _ Exp. Date 1 N /�• compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
II.
ature Contractor
IDI have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDE!DECLARATION
❑ I hereby affirm under •-nalty 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 itativ24:2 um I U)e4W /1 W g'• CQ plel p.
demolish,or repair any structure,prior to its issuance,also required the applicant policy Number I G w 4B46-36 , 1
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 co pl 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 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 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 pri r to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further information.
.c. •
Name I''0-, • Y� % • ` Tide r ! . `
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 atitho ized agent of the owner.
I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives the City of
rcadia to enter upon the above-mentioned property for inspection purposes. ] J�/�j
S gnatur ate "" �(/� /
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Certificate: ®f Occupancy � @ I:r
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� ` City of Arcadia ,�
"' Development Services Department—Building Division �s
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i'',,,.i,1::,..*
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q f7 This certificate issued pursuant to the requirements of the
e, California Building Code certifying that at the time of issuance this structure was in vtr .,
r 41F compliance with the various ordinances of the City regulating building construction or use. '�"
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Permit No. TI-0606
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Sry" �4: Building Address: 125 W. HUNTINGTON DR BLD B 1ST FLOOR ARCADIA, CA 91006 "/" g`
t Permit Type: TENANT IMPROVEMENT Effective CBC: 2016 C.B.C.
.ti Rt AQ F�
aag
w a Occupancy Code: B •t. '- f
� Zone Cody. CG �t
Final Date: 5-26-2020 Type of Construction: TYPE I-I SPRINKLERED ..1),g, -,,,:,'
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Owner: VG PROPERTY INVESTMENTS LLC Tenant:USC MEDICAL
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,/
� � �_ .PermitNO Plum 19 1361
City of Arcadia, CA -,':-',,,v
Development Services Department ",-i +'° -`- , a�„s - ° tA,Vt Permit Type lPlumbing
'" 'i 240 West Huntington Drive,Post Office Box 60021 ; 1" , e m ' ';''
Arcadia,CA 91066-6021 F�� ' s Work Classification Plumbing Commercial
a
t
P tt$t' �» all : Ai a 4 ja s- f(626)574-5416
- .., Status,tI,-
A RCADIA Issue plate 07 16"2019 _
Permit ed.
:. I l I Expiration: � �
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR BUILDING Arcadia,CA 5775015029
B 1ST
FLOOR
.
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner MUIR-CHASE PLUMBING CO INC* Contractor i.
MIKE S00 4530 BRAZIL ST, LOS ANGELES,CA 90039
125 W HUNTINGTON DR (818)500-1940 539835
Description:PLUMBING FOR USC TI BUILDING B 1ST FLOOR Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 Plan Check# Plan# It
...r.,.'A
Fees Amount Payments Amount Paid
Backflow Protective Device 2"&smaller $16.48 Total Fees $383.21
Fixture with Trap/Misc. $92.47 Cash/Receipt#REC-01827-19 $383.21
Floor Sink $13.21
Garbage Disposal Fee $26.42 Amount Due: $0.00
Kitchen Sink $52.84
Lavatories $52.84 S'�2(� ��ti co----e_
Plumbing Permit Issuance Fee $47.01
Solid Waste Management Fee 2 $1.00
Water Closet $49.84
Water Heater and/or Vent $31.10
CALLS FOR INSPECTIONS
Total: $383.21 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.
o C
egiell'in
fie1
July 16, 2019
Issued By: Date
July 16,2019 Page 1 of 1
Of ARC
�s GP�.LFORA'I99.Oj ,.
1! •
V . PERMIT/PLAN REVIEW APPLICATION
.gr, IFE443,1f EA`,_ 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
Signature of Contractor
performance 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'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, 1 Carrier Ill},1GJj fis1Ac-1.%C.Lt._ (K .53.5
demolish,or repair any structure,prior to its issuance,also required the applicant I Policy Number e/( 8 7 O Y
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 nee 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 orthwith 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
sale(Section 7044,Business and Professions Code:The Contractors License ate 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 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.
ame igo go ci c3?11 <>414 rxrrrT y I- /iyt- Title
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.
II 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.
Signature v // I/ Date 0 7 46 ~I'
fi F 4
City of Arcadia, CA �,Pe mit NO<EleC 19 1556`
Development Services Department TrFkPermitTypE Electrical
fAAdiff240 West Huntington Drive,Post Office Box 60021 f ' +
Arcadia,CA 91066-6021 r r. WorkClbssrficatron Electrical Commercial'
( (626)574-5416 + Permit s Issued.
A CAD I Aphi Issue,Date /08'0 /8 20°i'9ti
Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR Arcadia,CA 5775015029
1ptt r� a
Contacts
VG PROPERTY INVESTMENTS LLC C/0 Owner AMP'T ELECTRIC INC* Contractor
MIKE S00 3121 E LA PALMA,ANAHEIM,CA 92806
125 W HUNTINGTON DR (714)204-0728
Description:ELECTRICAL FOR TI,BUILDING B 1ST FLOOR. 0 Valuation: $ 0.00 t Tenant
Total Sq Feet: 0.00 t Plan Check# Plan#
Fees Amount Payments Amount Paid
Distribution Panel $82.40 Total Fees $353.81
Electrical Permit Issuance Fee $47.01 Cash/Receipt#REC-02068-19 $353.81
Outlets-Receptacles&Switches $223.40
Solid Waste Management Fee 2 $1.00 Amount Due: $0.00
Total: $353.81
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.
74,
August 08, 2019
Issued By: Date
August 08,2019 Page 1 of 1
OF ARC, • '
` G
, Pl.1FOlu.,9', -
Cl. I1' PERMIT/PLAN REVIEW APPLICATION
o y. • Development Services Department,240 West Huntington Drive,Post Office Box 60021
@'4..,,ly-tom° 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class tl-r a License No.Gil I°N1--1"1-- Exp. Date I itO
Signature of Contractor compensation, as provided for by Section 3700 of the Labor Code, for the
performance 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'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 01'-.! FI l....(:!'
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 ❑ 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 abor 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 / /i�1 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 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.
Name 1- )111"--(' G/4>.fr` Title /t Dt—►---3 t
PRINT NAME
I certify that I have read this application and state that the above information is cor ct 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
Arcdia to enter upon the above-mentioned property for inspection purposes.
Sig ature ---. Date / /
1
City of Arcadia, CA Permit NO. Mech-19-1730
:NE 342'4
Development Services Department t� r - ! Permit Type Mechanical
240 West Huntington Drive,Post Office Box 60021 ' ) c �' r s t
',\'\V
r f r i g;Worrk Gossification :0V9anical,Corninercial
471 Arcadia,CA 91066-6021 1 �s, 1 ' t_„( %._) i ,a „
(626)574-5416n. _, *.� , o Permit Status:Issued
s
ARCADIA Issue"Date:08/29/20'19"I Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR Arcadia,CA 5775015029
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner VECTOR AIR SYSTEMS* Contractor
MIKE SOO 25250 VISTA MURRIETA, MURRIETA,CA 92562
125 W HUNTINGTON DR (951)894-2413 723012
Description:MECHANICAL FOR BLDG B 1ST FLOOR TI Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount payments Amount Paid
Air Handling Units<=10,000 cu ft per min. $119.68 Total Fees $326.57
Compressor<3 Ton(up to 3 hp) $158.88 Cash/Receipt#REC-02305-19 $326.57
Mechanical Permit Issuance Fee $47.01
Solid Waste Management Fee 2 $1.00 Amount Due: $0.00
i
Total: $326.57
c-a- /' 72.4( ?---
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.
40
iffitik
_.,
August 29, 2019
Issued By: Date
August 29,2019 Page 1 of 1
G, or.' 1b
t;= �' PERMIT/PLAN REVIEW APPLICATION -
7 '11
,413%4 Development Services Department,240 West Huntington Drive,Post Office Box 60021
04111tY.111.° 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
Pro essions Code,and my license is in full force and effect. El I have and will maintain a certificate of consent to self-insure for workers'
Lice Ise Class ' 0 icen No. 72 251/2— Exp. Dates 2. 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 � have and will maintain workers'compensation insurance,as required by Section
El 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
is issued.My workers'compensation ins anc�ai policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions ✓
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 9 N
!"demolish,or repair any structure,prior to its issuance,also required the applicantpolicy 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 ❑ 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 ip 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
ElI, 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 ate Z9'i (
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 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 I
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
r�information.
Name /ONy le/!✓O/y Title 6W/Vel
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 on tthh bove-mentioned property for inspection purposes.
\ ____
��" " d� -
Signature Date O a�
44.4 IF,Fe City of Arcadia, CA rr ° , ; �Q 4 3ry ria M Pe nhNO FI -R—E-43-94P37M
4 � � ?
Development Services Department j s '4 444-444,444 s Permit�Type Fite'
t;'', 240 West Huntington Drive,Post Office Box 60021 , t4 F ) = _ 4
4-4 4 , ��n ; 1 a 4 k e Work Glassficat�on Fire Sprinkler''..
Arcadia,CA 91066-6021 =' h, r� ) w. I Aj , ' cia 0 li
(626)574-5416 L '/„..-0,„4„,;,:, , �6 permit Status.,Issued
A CAD! e Expiration: 03/22/2020
`= Issue Date 3.0/09/201 .1'9.
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR BUILDING Arcadia,CA 5775015029
B 1ST
FLOOR
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner A&D FIRE SPRINKLERS INC* Contractor
MIKE S00 1601 W ORANGE WOOD AVE,ORANGE,CA 92868
125 W HUNTINGTON DR (562)405-5136 902053
Description:FIRE ALARMS FOR TI BUILDING B 1ST FLOOR 5 Valuation: $ 12,000.00 Tenant
i.
DEVICES
Total Sq Feet: 0.00 Plan Check#19-1937 Plan#
Fees Amount payments Amount Paid
Fire Alarm Plan Check $280.00 Total Fees $598.66
Fire Issuance $47.01 Cash/Receipt#REC-02736-19 $318.66
Fire Permit Fees $270.65 Cash/Receipt#REC-02583-19 $280.00
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $598.66
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 4 701/1",e;,
41/
October 09, 2019
Issued By: Date
October 09,2019 Page 1 of 1
o
`'�4,,Fe C9�9
PERMIT/PLAN REVIEW APPLICATION
W-4 11ME111 '11
004�j� Development Services Department,240 West Huntington Drive,Post Office Box 60021
%unit),ail" 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 licen - is'' full force and effect. / ❑ I have and will maintain a certificate of consent to self insure for workers'
License Class t ,'l I,. du/� Exp. Date�131'�ir 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.
���
0 I have and will maintain workers'compensation insurance,as required by Section
OWNER-BUILDER EC j' ' •TION 3700 of the Labor Code,for the performance of the work for which this permit
0 I hereby affirm under penalty of,erjury that I am exempt from the Contractors is issued.My workers'compensation ins anctern and policy numbers are:Law for the following reason(Section 7031.5,Business and Professions - „ ,LCj�Ll�6L6S
Code.Any city or county which requires a permit to construct,alter,improve, Carrier ' -sg)1
demolish,or repair any structure,prior to its issuance,also required the applicant ') 3
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number �"� �tJh
provisions of the Contractors License Law(Chapter 9(commencing with Section (T s section need not be completed' e ern it 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 Se si.13700 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 p q
sale(Section 7044,Business and Professions Code:The Contractors License Date / - ( Signature A ,
Law does not apply to an owner of property who builds or improves thereon, r
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).
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.
Name
al*/
Name f`L-lf Title
I certify that I have read t ' ap i•'cation 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 if 111 City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upo 1 e above 1• •ntioned property for inspection purposes.
Signature 46 / � Date /
,' City of Arcadia, CA r Permit NO FIRE-19-1524
z
;:\:\ ili
i. Development Services Department �' r' ^�y" � Permit Type Fire
e . 240 West Huntington Drive,Post Office Box 60021 3 �� '
f° Arcadia,CA 91066-6021 \ 't , , , r , , Wor'o CIassificpttci Fire Alarm;
r-4.„.„----1 (626)574-5416 ,Permit Status:Issued
ARCAI)}fA >Issue Date:08/14/2019`1 Expiration: 02/01/2020
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR 1ST Arcadia,CA 5775015029
• FLOOR
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner A&D FIRE SPRINKLERS INC* Contractor
MIKE 500 1601 W ORANGE WOOD AVE,ORANGE,CA 92868
125 W HUNTINGTON DR (562)405-5136
Description:NEW FIRE ALARMS FOR 1ST FLOOR TI 30 DEVICES Valuation: $ 3,000.00 Tenant
Total Sq Feet: 0.00 Plan Check#19-1524 Plan#
Fees Amount Payments Amount Paid
Fire Alarm Plan Check $840.00 Total Fees $1,008.36
Fire Issuance $47.01 Cash/Receipt#REC-02126-19 $168.36
Fire Permit Fees $120.35 Cash/Receipt#REC-02028-19 $840.00
Solid Waste Management Fee 2 $1.00 —
— Amount Due: $0.00
Total: $1,008.36 -
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.
•
oph
,,r4z0
q:2
August 14, 2019
Issued By: Date
August 14,2019 Page 1 of 1
pF ARC
4 coyFc �r q'
a,
0' PERMIT/PLAN REVIEW APPLICATION
o 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. ❑ I have and will maintain a certificate of consent to self-insure for workers'
icense Classy License No.—�xp. Date&S\ 72 compensation, as provided for by Section 3700 of the Labor Code, for the
ignature of Contractor C c �J W�.b performance of the work for which this permit is issued.
WNER-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\ �S\n,\Je.\\Or ,,,.),,,_..k. \vl c C.,, .
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number "�Q�e)Pa\.Lt� �
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 D. 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 �'�r 1 I `�
sale(Section 7044,Business and Professions Code:The Contractors License Date "ll Signature
an.11.) `j4,.,==.-
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. 11
�
Name � , A r 1 (Tide _ ^�Vv 1 - _—
P'I NAME
I certify that I have read this application and state that the above information is cor ect 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 a ove-mentioned property for inspection purposes.
ignature Date lj 4(ICI
City of Arcadia, CA • • Permit NO. FIRE-19-1700
Development Services Department j i zS 1 r :Permit-Type:Fire
I 240 West Huntington Drive,Post Office Box 60021 ) �) 4.) + ��� ��
Ai( J • Arcadia,CA 91066-6021 's �Wor,Cfass f cation Fire-`Sprinkler
°1-
(626)574-5416
� �PermitStatus Issued
ARCADIA ;"Q IssueDate 09/10/2919° Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR B Arcadia,CA 5775015029
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner A&D FIRE SPRINKLERS INC* Contractor
MIKE S00 1601 W ORANGE WOOD AVE,ORANGE,CA 92868
125 W HUNTINGTON DR (562)405-5136 902053
Description:FIRE SPRINKS FOR BLDG B Valuation: $ 18,000.00 Tenant
Total Sq Feet: 0.00 Plan Check#19-1700 Plan#
ti
Fees Amount
Payments Amount Paid
Fire Issuance $47.01' Total Fees $1,118.86
Fire Permit Fees $370.85 Cash/Receipt#REC-02445-19 $418.86
Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-02263-19 $700.00
Sprinkler Heads $700.00
Amount Due: $0.00
Total: $1,118.86 •
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.
4j0:0
•
•
September 10, 2019
Issued By: Date
September 10,2019 Page 1 of 1
v`4 oFF wv�4,
1�. PERMIT/PLAN REVIEW APPLICATION
:Ei ar, A Development Services Department,240 West Huntington Drive,Post Office Box 60021
0.
°4fty°tom Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of
Arcadia
,;' , ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
- CI I hereby affirm under penaltyof perjury that I am licensed under provisions of I hereby affirm under penaltyof perjury Yone of the following:
Chapter 9(commencing with Section 7000,of Division 3 of the Business and
+, "j Professions.Code,and my license is in full force and effect. IDI have and will maintain a certificate of consent to self-insure for workers'
License Class C`1(p ens= �. ' 2D2 ) Exp. Datet�'��L( compensation, as provided for by Section 3700 of the Labor Code, for the
Lperformance of the work for which this permit is issued.
Signature of Contractor
, / 02,41
OWNER-BUILDER DE&i ARATION X'y'0 I ave and will maintain workers'compensation insurance,as required by Section
❑ I herebyaffirm under penaltyof perjury that I am exempt the Contractors'1 ;,''3100 of the Labor Code,for the performance of the work for which this permit
P rJ rY P !•is issued.Myworkers'compensation insurance carrier and policynumbers are:
License Law for the following reason(Section 7031.5,Business and Professions' f;. P
Code.Any city or county which requires a permit to construct,alter,improve, 7 1'1' arrier 0 A.) t'
demolish,or repair any structure,prior to its issuance,also required the applicant i +°olic Number
for such permit to file a signed statement that he or she is licensed pursuant to the" f , y
provisions of the Contractors License Law(Chapter 9(commencing with Section Al
1,a (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 iso •14
exempt there from and the basis for the alleged exemption. Any violation of 4 1 certify that in the performance of the work for which this permit is issued,I shall
Section 7031.5 byanyapplicant for a permit subjects thea applicant to a civil '•f,i not employ any person in any manner so as to become subject to the workers'
penalty of not more than five hundred dollars($500)): PP # i,$.tcompensation Laws of California,and agree that if I should become subject to the
A ; .4',workers'compensation provisions of Secti0700 of 'or Code,I shall
,� 'forthwith comply with those provisions. `
❑I, as owner of the property, or my employees with wages as their sole
;j c
compensation,will do the work,and the structure is not intended or offered for'.I.
." f .� Signature ' i-<41sale(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 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
571 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 Kix
LPRINTM Title
N
/ ertify that I have read t•' ap! I,.tion and state that the above information is correct and that I am the owner or duly authorized agent of the owner.
7I`agree to comply wil . C'i, •rdinances and State Laws relating to building construction. I hereby authorize representatives of the City of
`'yi'A� rcadia to enter upo 'e ab i • entioned property for inspection purposes.
.cicA�.'2
e�, 9�/J
• ! O
Signature 1,„,„,A . Date
1
(44t ,' City of Arcadia, CA Permit NO.-FIRE-19 0624=
\�� i'j�t Development Services Department . EftJJ
240 West Huntinon Drive,Post Office Box 60021 !1f 114,E�l.v,r Work Clgss�flcation:Fire Sprinkler`,
I (626)574-5416 3• -, PermitSta'tus:Issued
ARCADIA ;. Issue Date 04/05/20191 Expiration: 09/24/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
125 W Huntington DR B Arcadia,CA 5775015029
Contacts
VG PROPERTY INVESTMENTS LLC C/O Owner PENDENT CORPORATION dba AVALON Contractor
MIKE SOO FIRE PROTECTION*
125 W HUNTINGTON DR 1261 N LAKE VIEW AVE 1515,ANAHEIM,CA 92807
746160295
Description:FIRE SRINKS FOR T.I FOR BUILDING B 59 HEADS Valuation: "$ 9,000.00 Tenant
Total Sq Feet: 0.00 Plan Check#19-624 Plan#
Fees Amount payments ' Amount Paid
Fire Issuance $47.01 Total Fees $968.56
Fire Permit Fees $220.55 Cash/Receipt#REC-00879-19 $268.56
Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-00812-19 $700.00
Sprinkler Heads $700.00
Amount Due: $0.00
Total: $968.56 -
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.
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April 05, 2019
Issued By: Date
April 05,2019 Page 1 of 1
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a C. PERMIT/PLAN REVIEW APPLICATION
iiil. ifr j`, Development Services Department,240 West Huntington Drive,Post Office Box 60021
4/0AitY.i Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of
Arcadia
ti, LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
0 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:
'ii 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 C—►b m�L;icense No.7�S ' t Exp. Date 9�30I1G compensation, as provided for by Section 3700 of the Labor Code, for the
' Signature of Contractor
Wt.. performance 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 herebyaffirm under penaltyof perjury that I am exempt from the Contractors a 3700 of the Labor Code,for the performance of the work for which this permit
❑ P rj rY P �.
License Law for the following reason(Section 7031.5,Business and Professions s issued.My workers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve„'`1 Carrier Nati t✓Yn r1C Ma,:Nri E- co.dt 6 er,.croI I Tr,i(..a ii r e
demolish,or repair any structure,prior to its issuance,also required the applicant r,l.i tS 00 g 2Z� 3 U
R
for such permit to file a signed statement that he or she is licensed pursuant to the ii.
olicy Number W
provisions of the Contractors License Law(Chapter 9(commencing with Section :1,)(:�T 1s section need not be completed if the permit is for one hundred dollars or less)
4 1
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 03Iycertify 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 Mot 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
forthwith comply with those provisions.
❑I, as owner of the property, or my employees with wages as their sole ,I•U
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 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 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 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
furtherthinformation.
Name C .-L('I' 9 Lc' �t,4 Title P(D jeL'i Airs ha6 er
i PRINT NAME U
Iertif that I have read this application and state that the above information is correct and that I am the owneror duly pp authorrzed 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.
11i
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OL C(4 ._________
Date qicbq
ti4 F 06
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Au�rt S,907
411inity Of MEMORANDUM
Fire Department
DATE: April 23, 2020
TO: BUILDING DEPARTMENT
INSPECTOR John Zurick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 125 W. Huntington Drive, Building B, Levels 1 & 2
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS (PC# 19-624) 5-23-2019 Jill Perumean
FIRE SPRINKLERS (PC# 19-1700) 3-26-2020 Jill Perumean
FIRE ALARMS (PC# 19-701) 7-2-2019 Jill Perumean
FIRE ALARMS (PC# 19-1524) 4-23-2020 Jill Perumean
FIRE ALARMS (PC# 19-1937) 4-23-2020 Jill Perumean
HOOD & DUCT
KNOX BOX
OCCUPANCY (PC# 19-0606) 4-23-2020 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 4-23-2020 Rita
44'0C1:1FORIpiN
111,61011
Au(uee 33,1903
N"aity°c� MEMORANDUM
Fire Department
DATE: April 23, 2020
TO: BUILDING DEPARTMENT
INSPECTOR John Zurick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION -
ADDRESS: 125 W. Huntington Drive, Building B
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS
FIRE ALARMS
HOOD & DUCT
KNOX BOX
OCCUPANCY (PC# 19-1203) 4-23-2020 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 4-23-2020 Rita
of ARc
~�
GfriFORM?may
Avsu.t- 449-a-;91
tounity al"
� MEMORANDUM
Fire Department
DATE: May 20, 2020
TO: BUILDING DEPARTMENT
INSPECTOR John Zurick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 125 W. Huntington Drive, Building B, Levels 1 & 2
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS (PC# 19-624) 5-23-2019 Jill Perumean
FIRE SPRINKLERS (PC# 19-1700) 3-26-2020 Jill Perumean
FIRE ALARMS (PC# 19-701) 7-2-2019 Jill Perumean
FIRE ALARMS (PC# 19-1524) 4-23-2020 Jill Perumean
FIRE ALARMS (PC# 19-1937) 4-23-2020 Jill Perumean
HOOD & DUCT
KNOX BOX
OCCUPANCY (PC# 19-0606) 4-23-2020 Jill Perumean
COMMENTS:
Emailed Bldg. Dept. 4-23-2020 Rita