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DEMO-18-0410
VE# (AP use only) Weal ACCOUNTS PAYABLE CHECK REQUEST \\If it 09/18/2020 DSD - Building Check Payable to JOHNNY CHUNG LAM cur Y AiAddress 1026 EDNUEL ST ARCADIA 626-318-9999 City,State,zip Code ARCADIA, CA 91006 INVOICE NUMBER(S) (if applicable) ACCOUNT NUMBER(S) AMOUNT 714-2275 $ 1,730.00 $ $ $ $ TOTAL CHECK AMOUNT $ 1 ,730.00 Reason for Payment: REFUND DEMOLITION BOND TO ABOVE RECIPIENT 1826 WATSON DR DEMO-18-0410 A1PPROUED BY;(M1IST BE SIGNED BV AUTaHdRIZESIGNERS}: fr Signature Date Approved • 2�r(tisStGNATUI3 itEQLllftEb.FOR ANY.CNECK/1IVIOUN7 OVER2�,�SQO s a � e� Signature Date Approved ACCOUNTS PAXABLE;lt5ESN Check here if check is to be I I Reviewer's Initials returned to Department VR112019 r1 itµ r kip i City of Arcadia, CA u� ,, . A m 6 ` Perp? NO 1@1110 1$ U41U: ' a s ro '"� w / Development Services Department - •-f,---;,:-,---;,-.;: Perr»FtT a Demolition a 240 West Huntington Drive,Post Office Box 60021 u i4:011:citi:0' YA , _9�° _ � ; 11Work lan,Demo Residential a Arcadia,CA 91066-6021 € t (626)574-5416 a ,"�� 6.,,,,411,,,,,,,,s.,‘.,..„,..,.,.,.,„ 1 z 0 »fifes£ „-y ''� P„ermit Stains Estimate:'.; y�, q � ,,ave ti 1 * , '54-6444"*''''' .,^_''1 A RCA J I 40 ,'P ” Issue1�bate 11 �i ��... ..,.1,.. d . .z.,_-_,.r, ., �. Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1826 Watson DR Arcadia,CA 5789010016 e mazisommumnalmsrter. Contacts JOHNNY LAM Owner ORTIZ DEMOLITION INCORPORATED* Earthwork&Paving 1826 WATSON DR Contractor(C-12) (626)379-8131 3045 S ARCHIBALD AVE H310,ONTARIO,CA 91761 (213)216-4405 902123 Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. I Valuation: $ 492,708.44 Tenant REFUND DEMO BOND TO JOHNNY CHUNG LAM 1026 EDNUEL ST,ARCADIA,CA 91006 626-318-9999 Total Sq Feet: 1,730.00 Plan Check# Plan# •., . Fees Amount Payments Amount Paid Bond for Demolition $1,730.00 Total Fees $1,924.60 Demo-Sewer Cap and/or Cesspool Fill $15.55 Cash/Receipt#REC-00279-19 $1,924.60 Demolition Permit $77.78 Demolition Permit Issuance Fee $47.01 Amount Due: $0.00 Plumbing Permit Issuance Fee $47.01 Solid Waste Management Fee $6.25 911e -Ge.. Solid Waste Management Fee 2 $1.00 Total: $1,924.60 rr �� SPL T CALL ;+ PECTIONS J Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. lelc 4 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 I ( void if any work authorized by this permit is suspended or abandoned for 180 L21consecutive days or if no progressive work.has been verified by a City of 4Q0 Arcadia building inspector for a period of 180 consecutive days. z66 se 13� C� a Issued By: Date January 31,2019 Page 1 of 1 or AiRe '� 0 PERMIT/PLAN REVIEW APPLICATION Ok 112 OP • . Development Services Department,240 West Huntington Drive,Post Office Box 60021 \Y% Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia . 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: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code an y license is in full force and effect. g, ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C— License No. 902-/2 Exp. Date' )`I / compensation, as provided for by Section 3700 of the Labor Code, for the AV. = performance of the work for which this permit is issued. Signature of Contractor \h... ❑ I have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DECLARATION ❑ 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 S1P1t--c--1)a—)0 demolish,or repair any structure,prior to its issuance,also required the applicant policy Number 11 O 4 0s ) 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 70315 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 for23 '- sale(Section 7044,Business and Professions Code:The Contractors License Date Signatures' 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 at 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). ;t 1` .; ')�-` damages as provided for hi Section 3706 of the Labor Code,,;interest, and ..,...:1 u 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 /— 31- 1', Signature e27 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 ©S G/9 .— ®‘YZ-`, /_ Title �0✓"2,,=-ALE .4— PRINT PRINT NAME I certify that I have read this application and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. 2 / 7Signature � — -.-41 Date `� /