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Home My WebLink AboutDEMO-18-1086 VE# • ' ' (AP use only) ,•A.1 t ? 7, . ACCOUNTS PAYABLE CHECK REQUEST . 111 I A \ .1,1- r Request Date 09/18/2020 Department DSD - Building Check Payable to JENNY C CHANG CITYOF r Address 4046 TEMPLE CITY BLVD City,State,Zip Code ROSEMEAD, CA 91770 INVOICE NUMBER(S) (if applicable) ACCOUNT NUMBER(S) ( AMOUNT 714-2275 $ 2,351.00 $ $ $ . $ TOTAL CHECK AMOUNT $ 2,351.00 Reason for Payment: REFUND DEMOLITION BOND TO ABOVE RECIPIENT 135 W LEMON AVE DEMO-18-1086 9°•4 aaccs e t,?x,m i 4".;„ 4� Aft at ",. tt '�u 4,, WAPPROVED BY1 VIUST;BE SIGNED BY AUTHORIZED SIGNERS}s r,. ,:' e x °!,<.;a , „ t� ` N ;.; , Signature Date Approved • 2nd,°$1GNAT'URE REQU Std• C -, r 1RED,FOt�ANY CHEEK,AMOl�NT OUEft',�2,5tI0 a<. _.. � ��N,. � 4 Yes�° '4t��, � Signature Date Approved =ACC0U10S 4.00.1`USE.OhtLlf s ._.3 _ Check here if check is to be Reviewer's Initials returned to Department • VR112019 1 ''','".-4V ,' ; r g, , � a`'' ' Permit No De111018 1086 � City of Arcadia, CA ,�_� � �t Development Services Department s c r S47Perf�pit Type Demolition 240 West Huntington Drive,Post Office Box 60021 i' ` 4 f ` r t'l i o- u » x i ?Ar' , , WorkiClassification Demo Residential Arcadia,CA 91066 6021 q z x., ' k s - Li"; t1i i� 7 4 , ( (626)574-5416 . ars �' , 461- a" .'sr•`�r '� , Permit Status:Issued 2mk x 4',"; 5,- ,'; t d i .P s=,6, ... a .+ , ., ,w,.,..,.-,:-,;:;v'3a _, ARCA D EA -v `` Issue Date 08/01/2018d Expiration• 01/28/2019 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 135 W Lemon AVE Arcadia,CA 5782020006 Contacts CHANG,JENNY C Owner BUILTEK CONSTRUCTION&INVESTMENT Earthwork&Paving 135 W Lemon Ave,Arcadia,CA 91007 INC Contractor(C-12) 13422 HOPE ST,GARDEN GROVE,CA 92843 • (949)394-5468 Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. k Valuation: S 0.00 ': Tenant REFUND DEMO BOND TO JENNY C CHANG 4046 TEMPLE CITY . BLVD ROSEMEAD CA 91770 626-279-2848Total Sq Feet: 2.351 00 $ Plan Check# Plan# Fees- Amount Payments Amount Paid Bond for Demolition $2,351.00 Total Fees $2,540.28 Demo-Sewer Cap and/or Cesspool Fill $15.55 Cash/Receipt#REC-001899-2018 $2,540.28 Demolition Permit $77.78 Amount Due: $0.00 Demolition Permit Issuance Fee $44.35 Plumbing Permit Issuance Fee $44.35 Solid Waste Management Fee $6.25 CI ',, I I IL E I E ^I Solid Waste Management Fee 2 $1.00 v P Total: $2,540.28 fr'�E _- `�` 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. i�CR ^An 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 y vest from the date of issuance or if the permit is not obtained within 180 days 2 4r-ct 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 ,, 4 ,..`los Arcadia building inspector for a period of 180 consecutive days. 7 j VI August 01, 2018 • Issued By: Date August 01,2018 Page 1 of 1 of ARc Cil ...111 PERMIT/PLAN REVIEW APPLICATION -4 `I�+i' Development Services Department,240 West Huntington Drive,Post Office Box 60021 c,' y% 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 ;t.0 l 2. icense o. �}f J? Date compensation, as provided for by Section 3700 of the Labor Code, for the � � At performance of the work for which this permit is issued. Signature of Contractor L/d"��t / ` OWNER-BUILDER DECLARATION 0 I have 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 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 xiI 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 fate rthwith comply with those provisions. �� compensation,will do the work,and the structure is not intended or offered for p sale(Section 7044,Business and Professions Code:The Contractors License —0(` O Signature �� Law does not apply to an owner of.p.opeily-,w,ho bttelds ;"improves thereon, or who does such work himseltl or irers6 r. 't1roug'his or her own ,p l'„ •t a s,t ,<< ,i, employees,provided that such imNoxehieuts;are notiditended'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 attomey'sfees. ❑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. C)42-4-t1'1 ____ Name C, La 5 Title /1/1/(,'+‘. 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 entioned property for inspection purposes. Signature Date 0 L