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HomeMy WebLinkAboutB00-054-306 VE#
ig:76' <i \
Et (AP use only)
ACCOUNTS PAYABLE CHECK REQUEST
,4 /: !
09/18/2020 DSD - Building
r7\vil , Check Payable to
1131 DE ANZA PL, LLC
CITY OFA, 4470 W SUNSET BLVD STE 407
Address
R ADI 213-442-3245
City,State,Zip Code LOS ANGELS, CA 90027
INVOICE NUMBER(S)
(if applicable)
ACCOUNT NUMBER(S) AMOUNT
714-2275 $ 2,462.00
$
$
$
$
TOTAL CHECK AMOUNT $ 2,462.00
Reason for Payment:
REFUND DEMOLITION BOND TO ABOVE RECIPIENT
1131 DE ANZA PL
B00-054-306
APPROVED BY(MUST`,BE SIGNED BY AUTHORIZEDSIGNERSY �„ y,
Signature Date Approved
2ndSIGNATUREREQUIRED FOR ANY CHECK AMOUNTOVER'$2,500 ; , . . .. . L,':-;01,,:,, ,W . , -----., *. , , ,
Signature Date Approved
ACCOUNTS PATABLE USE ONLY ,
Check here if check is to be I I Reviewer's Initials
returned to Department
VR112019
t}r� Development Services Department
240 West Huntington Drive,Post Office Box 60021
• r' Arcadia,CA 91066-6021 •:P MIT NO ' ; BOO-054-306
City of (626)574-5416,Fax(626)447-9173
Arcadia PermitType - Demolition
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
15960 7/25/2016 CM 11:50 8/4/2016 Issued
ADDRESS NO. Dir:Prefix. -StreetName` - Street Suffix. UNIT BLG ASSESSORS PARCEL NO. GEO:CODE
1131 De Anza P1 5777-004-018
OWNER ,- - ,, MAILING ADDRESS ,. . ti.
1131 De Anza PI,LIc PHONE NO. Inspector#: JOHN
EMAIL ADDRESS: _
APPLICANT" - NAILING ADDRESS r,.,.:... - vs
Franklin Pineda Construction PHONE NO.
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS ° " `
Franklin Pineda Construction 1862 El Sereno Ave PHONE NO. (626)676-8867 FAX NO.
Pasadena, CA 91103 EMAIL ADDRESS:
License No. 874991 Type: B Expires: 3/31/2018 12:00:
TENANT .` -'MAILING.ADDRESS - - -
PHONE NO. FAX NO.
DESCRIPTION - -
DEMO HOUSE AND GARAGE IN PREP FOR NEW RESIDENCE-REFUND BOND TO: 1131 DE ANZA PL,LLC 4470 W SUNSET BLVD STE 407 LOS
ANGELES 90027 213-422-3245
Construction Type VOM #of Units Value Construction Type UOM 8 of Units Value
)24(66641C12 All'64.4144.12A 9—<7-2 02.47
OCCUPANCY: TOTAL VALUATION: $0.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
1.00 Flat Plmbg issuance 44.35 44.35 01-3105
1.00 each Sewer cap 15.55 15.55 01-3105
1.00 Flat Demo issue 44.35 44.35 01-3107
2,462.00 sq ft Demolition 77.78 77.78 01-3107
2,462.00 sq ft Bond-demo 2,462.00 2,462.00 2275 4 ,
,7
,,,
1.00 Flat SWMF 2 1.00 1.00 88-3027 �/dee(
/-2e—/t 9:&40V169e-
1
I2
1)4.' /
�i
1
`Q2.
Total Fees: $2,645.03 Balance Due: $0.00 Paid Today: $2,645.03
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 113845
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from
01-3105 59.90
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3107 122.13
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 2275 2,462.00
Arcadia building inspector for a period of 180 consecutive days. 88-3027 1.00
CALLS FOR INSPECTION INSPECTORS'OFFICE HOURS
Requests for inspection should be made at least Monday-Thursday Friday
one(1)business day in advance of the inspection 7:30 a.m.to 8:30 a.m. 7:30 a.m.to 8:30 a.m.
by telephone at(626)574-5416 for onsite work. 4:00 p.m.to 5:30 p.m. 4:00 p.m.to 4:30 p.m.
(Closed on alternate Fridays)
I PERMIT/PLAN REVIEW APPLICATION
OF ARe
opo
olj• Development Services Department,240 West Huntington Drive,Post Office Box 60021
'''°.ai.Yof1" Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
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 f rc�t. o3%3, ' C� I have and will maintain a certificate of consent to self insure for workers'
License Class Lic' se No. xp. Date compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
'gnature of Contra.or /
OWNER-B I 1 ER 1 CLARATION I i have and will maintain workers'compensation insurance,as required by Section
0 I hereby unde := alty 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 affirmr the following reason(Section 7031.5,Business and Professions is issued.My workers'c mpensation insurance carrier and policy numbersrare:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 1" a VJ�"� 1 o e(�, Cos u a (4-y Corr,
demolish,or repair any structure,prior to its issuance,also required the applicant �j3 3 I l
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number !!!""" l
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 i•
FP.,I certify that in the performance of the work for which this permit is issued,I shall
exempt there from and the basis for the alleged exemption. Any violation o
Section 7031.5 by any applicant for a permit subjects the applicant to a civ 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 Sectio 3700 of the Labor Code,I shall
❑I, as owner of the property, or my employees with wages as their sol; forthwith comply with those provisions.
compensation,will do the work,and the structure is not intended or offered fo Date O4"10 �Z©(C�!Signa iiir/-',1---"'-‘"-- G c
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 thropgfi•,this 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 burderi'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. \ r -nn
N. e f`ONAV� ( ,MAC".
,. Title V(/ .4—
PRINT NAME
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.
agree 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 fo 'nspection purposes.
Sig .ture '_L Date
9e oy 70/6