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HomeMy WebLinkAboutb00-058-666 " Development Services Department
:0 240 West Huntington Drive,Post Office Box 60021
Arcadia,CA 91066-6021 . .- PERMIT NO. B00-058-666
ArcCiadia of (626)574-5416,Fax(626)447-9173 "" Permit Type: Tenant Improve w/energ:
PROJECT TRACT NO. LOT NO. APPLICATION DATE ISSUED BY PRINT DATE PERMIT STATUS
0001 12/27/2017 CM 11:37 2/7/2018 Issued
ADDRESS NO. Dir.Prefix Street Name Street Suffix UNIT BLG ASSESSORS PARCEL NO. GEO CODE
411 E Huntington Dr 101 D 5778-015-024
OWNER MAILING ADDRESS
400 W Huntington Lie 6380 Wilshire Blvd Ste 800 PHONE NO. Plan Chk#: 17-482
Los Angeles, CA 90048 EMAIL ADDRESS: Plan#: 32441
APPLICANT MAILING ADDRESS
, PHONE NO.
Yongxiang Chen
EMAIL ADDRESS:
,
CONTRACTOR/PROFESSIONAL MAILING ADDRESS
Yongxiang Chen 3318 Linda Vista Ter PHONE NO. (626)456-0888 FAX NO.
Los Angeles,CA 90032 EMAIL ADDRESS:
License No. 742650 Type: B Expires: 11/30/2019 12:01
TENANT MAILING ADDRESS
Tawanese Eatery PHONE NO. FAX NO.
DESCRIPTION
INTERIOR TI FOR TAWANESE EATERY. REMOVE EXISTING KITCHEN EQUIPMENT,NEW PARTITIONS AND COUNTERS
Construction Type UOM #of Units Value Construction Type UOM 8 of Units Value
Value Value 15,000.00 $15,000.00
OCCUPANCY: Tenant Improve TOTAL VALUATION: $15,000.00
QTY UOM DESC AMT AMT PAID ACCT QTY UOM DESC AMT AMT PAID ACCT
each Plan review 208.49 208.49 01-3103 1.00 Flat SWMF 2 1.00 1.00 88-3027
each Energy p/c fee 64.15 64.15 01-3903
PC ADA 31.27 31.27 01-3103
PC Cal Green 20.85 20.85 01-3103
1.00 Flat Bldg Issue Auto 44.35 44.35 01-3104
each Bldg permit 320.75 320.75 01-3104 • -
Bldg Issue ADA 32.08 32.08 01-3104CaROB
0. .
1.00 flat Elec issue 44.35 44.35 01-3105
1.00 Flat Plmbg issuance 44.35 44.35 01-3105
ci_15_ 0 12.00 each Outlets 18.48 18.48 01-3105
1.00 each Grease trap 12.46 12.46 01-3105 '
10.00 each Ltg fixtures 15.40 15.40 01-3105
1.00 each T.I.Fire Pkc 280.00 280.00 01-3109
SMIP Corn 4.20 4.20 14-2207
gm bldg std 1.00 1.00 714-2203
1.00 Flat SWMF Auto 6.25 6.25 88-3027
1.00 Flat SWMF 2 1.00 1.00 88-3027
Total Fees: $1,150.43 Balance Due: $0.00 Paid Today: $545.67
This permit/plan review expires by time limitation and becomes null and void if the work authorized by the Receipt#: 119233
permit is not commenced within 180 days from the date of issuance or if the permit is not obtained within 180 days from
01-3104 397.18
the date of plan submittal.This permit expires and becomes null and void if any work authorized by this permit 01-3105 135.04
is suspended or abandoned for 180 consecutive days or if no progressive work has been verified by a City of 14-2207 4.20
Arcadia building inspector for a period of 180 consecutive days. 714-2203 1.00
88-3027 8.25
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)
•vARQ
4 .a]FOky'4
ti
G' 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.
License Class L5 License No. 7 0 I have and will maintain a certificate of consent to self-insure for workers'
� F c�p. Date(r V/ 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 came .nd policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier A r► I
demolish,or repair any structure,prior to its issuance,also required the applicant
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number ( G �
provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need no be completed if the permit is for.ne 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 forthwith comply with ose 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 Date 7i/7/( SignatureLaw 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 g
w
.
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. f�7,,�
)Name rip d /f�/'`���� C- !0 Title ilk er
/ / 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.
Signature 9 Date r e
NOTES fCii
Building Inspections Date Insp. Plumbing Inspections Date Insp.
100. Setbacks 210. Under ft./bldg.drain 7-I 2.4 iii.
101. Rough grade 211. Copper underslab 2�l Z l LI L GTi C /41 4c -
102. Figs.&forms 212. Rough plumbing
103. Pre-slab 213. Rough gas
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
109.10Roof nailing / , 22o19. Final gas
110. Framing 2, -I$ _�'r„/220. Fixtures
111. 0cc./Area Sept.Wall 221. Final plumbing 3-GS f
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid
114. Insulation-Flr. Pool Inspections Date . Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 2--13-L$ 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 246. Fence,gates&signs
122. Final demoAot clear 247. Pool heater
248. Final electric _
Electrical Inspections Date Insp. 249. Final dumbing
150. Power pole 250. Pool cover - -
151. Sales lot lighting 251. Pool final _
152. Underground conduit
153. Underslab conduit Reroof Inspections Date I Insp.
154. UFER ground 270. Pre-reroof insp.
155. Water ground 271. Roof framing
156._Rough electrical 272. Sheathing nailing
157. Fixtures _ 273. Final reroof
158. G.F.C.I.
159. Eqpt.bonding Sign Inspections Date I Insp.
160. _Service panel /i" / 280. Setback/overhang _
161. Final electric e/-5-/8 /4d 281. Footing _
282. Conduit/wiring
Mechanical Inspections Date Insp. ' 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC Miscellaneous Insp. I Date I Insp.
183. Fire dampers 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. Commercial hood
190. Duct shaft Sewers&Offsite Insp. I Date Insp.
191. Final mechanical 4 -3-tB row 300. Lateral(main to P/L)
301. Saddle/Y
Block Wall Inspections Date Insp. 302. Cess.00l filled
200. Footings _ 303. Sidewalk _
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
ti�o�F �dr
;;. :.
Anry[5,1901
C. .r#4e 00
�4a°ai`y°£�°� MEMORANDUM
Fire Department
DATE: November 27, 2018
TO: BUILDING DEPARTMENT
INSPECTOR
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 411 E. Huntington Drive #110
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 5-2-2018 Lill Huang
FIRE ALARMS
TANKS
HOOD & DUCT
KNOX BOX
OCCUPANCY
COMMENTS:
Emailed Bldg. Dept. 11-27-2018 Rita
"v 4 el
� �4k a �^a�,.xexi,� '4t ' ria} a�N � M s 3?aM r
City of Arcadia,CA t ;t ,- s, ?:Perm?tallo FIRE 18 1545
Development Services Department -,,,,---,;,'".4.,,,,,e,?' � ,p _ * * PermitType Fire
240 West Huntington Drive,Post Office Box 60021 4 f k { ~- ki ,. x
'1'0;0 i�„N WorkClass1ficat►on FIre,Suppression
1 Arcadia,CA 91066-6021 � k „7, ' gy i 7., s -
(626)574-5416 1 , u r '* 0 . � '.1.1'.-AW , Permit Status Issued 4
ARCADIA 6 'sa o9�/o5/z018isu � Expiration: 03/05/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 101 D Arcadia,CA 5773009069
4
a-
Contacts
HUNTINGTON LANMARK LLC Owner Zohar Avigad Applicant x
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 6154 Aura AVE,Tarzana,CA 91335
(877)256-0161 `s
r
Description:8 NOZZLES FOR HOOD SYSTEM FOR LU GAN BEI Valuation: $800.00 1 Tenant LU GAN BEI
Total Sq Feet: 0.00 Plan Check#18-1545 Plan#
Fees Amount Payments Amount Paid
Fire Extinguishing System Plan Check $280.00 Total Fees $378.60
Fire Issuance $44.35 Cash/Receipt#REC-002126-2018 $280.00
Fire Permit Fees $53.25 Cash/Receipt#REC-002223-2018 $98.60
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: $378.60 -,
} 1� CALLS FOR INSPECTIONS
�.i �r �'��s��.r �- ction by telephone at 626-574-5450. Leave a message
O�l lu k,i.:4,.*: 'dress,timeframe and what inspection item is needed.
L�
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
l 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 06, 2018
Issued By: Date
September 06,2018 Page 1 of 1
AR
ce
�`4 oFF kso,,
Ir
PERMIT/PLAN REVIEW APPLICATION
�o tat � 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
(0
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 ClassC_ I G License No.tr7(5QD2xp. Date I—3o— It 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
WNER-BUILDER DECLARATION ❑ 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 Professionsr
is issued.My,workers'compensation insurance carrier and policy numbers e:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier 5-Like,. �/M p n5et)Dn ;)/5' . tioc
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number g'02 V747 ©O
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
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 of
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 forthwith 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 9-6-1 F
sale(Section 7044,Business and Professions Code:The Contractors License Date Signa
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.
1:1 I,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] p /�f
Name -61 g A�I�AA
Title C O
PRINT NAME
certify that I have read this application and state that the above information is c rrect 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 buildinconstruction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentioned property for inspection purposes. 9
Signature ate / ' ) g
/4lF ARC
dr
mktamm
,Z ccs 5.903
o /�a
���4altyof op
MEMORANDUM
Fire Department
DATE: September 13, 2018
TO: BUILDING DEPARTMENT
INSPECTOR John Zurick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 411 E. Huntington Drive, 101D
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS 8-29-2018 Lill Huang
FIRE ALARMS
TANKS
HOOD & DUCT 9-12-2018 Lill Huang
KNOX BOX
OCCUPANCY
COMMENTS:
Emailed Bldg. Dept. 9-13-2018 Rita
1
A 3L 4j, :. V d .::,".% ,1::- -. T' s
City of Arcadia, CA ,� �� 1 . z:::.,..:;:,'.',.-
:Permit NO FIRE-18:41505
1.
ti D 4g.
�y rPermitT e Fire
Develoli/
pment Services Department y -i' Type.
240 West Huntington Drive,Post Office Box 60021 f :( n''''''' ,.i,
' 3"•f ; 'Work Clasfication:Fire prinkler
Arcadia,CA 91066-6021 l �, i �,
V�--li (626)574-5416
,,,$. `=.7=:,..;:•% t. ,; Permit'tatus Issued•.
ARCADIA 1 ' .,.Issue Date 08/27/2018 Expiration: 02/23/2019
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 101 D Arcadia,CA 5773009069
Contacts
HUNTINGTON LANMARK LLC Owner F&H Fire Protection* Fire Contractor(C-16)
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 1119 Westminster AVE,Alhambra,CA 91803
(626)262-3876 DANIEL@FHFIREPRO.COM
Description:SPRINKS FOR COMM.T.I SOUPER BOWL 10 HEADS Valuation: S 1,000.00 - Tenant
t.
Total Sq Feet: 0.00 Plan Check#18-1505 Plan#
,�v F.+ffi','< _ ....«-b h.:a3+*'L"'a" a. rT.a b'i.,^n-- �., .�:e'`"'.d '}'C as ..w.KS_+'1d5"A44'S s%^m .•4'd
Fees Amount Payments Amount Paid
Fire Issuance $44.35 Total Fees $387.00
Fire Permit Fees $61.65 Cash/Receipt#REC-002080-2018 $280.00
Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-002141-2018 $107.00
Sprinkler Heads $280.00
Amount Due: $0.00
Total: $387.00 -,
(j�Ufi�utl'LII
ii 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.
I
//
August 27, 2018
Issued By: Date
August 27,2018 Page 1 of 1
4�uF RR,v.�91,
v WINti
9 PERMIT/PLAN REVIEW APPLICATION
. 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
El 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 license is in full fo e and ect. ❑ I have and will maintain a certificate of consent to self-insure for workers'
License Class
Signature of Contractor 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.
OWNER-BUILDER DECLARATION © I have and will maintain workers'compensation insurance,as required by Section
Ell 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 worker 'compensation insurance cam and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier tue'YSCs re Toy,/rcr41 ce c y
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number 1 W G Ufa 0 J -1
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
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 of
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 forthwith 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 Date 7.� 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.at/�CS/ r A 7 1 /�
N me /� (
11— 5S (/ 1 (� /1/ Title l�
PRINT NAME
I ce ify that I have read this application and state that the above information is corre 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 co struction. I hereby authorize representatives of the City of
Arcadia to enter upon the above-mentioned property for inspection purposes.
Sign re Date 1�/�7 /1) l I
8/
Al Ail.
120
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OF 1OSay COUNTY OF LOS ANGELES o DEPARTMENT OF PUBLIC HEALTH
1, IIvA ENVIRONMENTAL HEALTH
SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
1 *. PLAN CHECK PROGRAM- BALDWIN PARK COUNTY OF LOS ANGELES
‘?":C•41164.1;'' 5050 COMMERCE DR, BALDWIN PARK, CA 91706 Public Health
PHONE: (626)430-5560
VVVVW.PUBLICHEALTH.LACOUNTY.GOV/EH
OFFICIAL PLAN REVIEW REPORT
DATE 02/05/2018 EHS VIVIAN TAN
PLAN CHECK NUMBER SRO129045
PROGRAM ELEMENT 1702 - RESTAURANT (501-1,999 SF)
OWNER/REQUESTER FRANK NGUYEN,ARCHITECT
DBA LUGAN BEI RESTAURANT
ADDRESS 411 E HUNTINGTON DR 101D, ARCADIA, CA 91066
REVISED PLAN REVIEW STATUS: APPROVED PF13
CORRECTIOI
•
CORRECTION CATEGORY DATE IDENTIFIED DATE CORRECTED .
WASTE WATER/PLUMBING 01/23/2018 01/25/2018
EQUIPMENT/STORAGE 01/23/2018 01/25/2018
FOOD PROTECTION/FOOD STORAGE •
01/23/2018 01/25/2018 •
VENTILATION 01/23/2018 01/25/2018•
VERMIN EXCLUSION/ENCLOSURE 01/23/2018 01/25/2018
PLAN SUBMITTAUREMODEL 01/23/2018 01/25/2018
PLAN SUBMITTAUREMODEL 01/25/2018 02/05/2018
•
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacounty.gov/eh. •
EHS Signature Page 1 of 3
OFFICIAL PLAN REVIEW REPORT
DATE 02/05/2018 EHS VIVIAN TAN
PLAN CHECK NUMBER SRO129045
PROGRAM ELEMENT 1702- RESTAURANT(501-1,999 SF)
OWNER/REQUESTER FRANK NGUYEN,ARCHITECT
DBA LUGAN BEI RESTAURANT
ADDRESS 411 E HUNTINGTON DR 101D, ARCADIA, CA 91066
DISCLOSURES
Prior to construction and approval from the Los Angeles County Department of Public Health Environmental Health Division
(DPH-EH) Plan Check Program,final inspections must be obtained from Building and Safety (mechanical, plumbing,electrical)
and all other enforcement agencies.
Failure to obtain a Public Health Permit/License prior to operation of the facility/establishment is a misdemeanor violation.
Construction ofthe food facility/establishment must be completed and approved within twelve (12) months from the date of
approval to avoid submitting new plans.
A copy of the approved plans must be available at the time of the field construction review.
All utilities must be on and operational at the time of the field construction review.
Please contact your plan check inspector at least 3 days prior to the field construction review.
Two field inspections will be covered under the Plan Check fees assessed upon plan submission.
A charge will be assessed for each subsequent field construction review.
Help us serve you better by completing a short survey.Visit our website at www.publichealth.lacounty.gov/eh.
EHS Sianature Page 3 of 3
. •
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COUNTY OF LOS ANGELES• DEPARTMENT OF PUBLIC HEALTH
ENVIRONMENTAL HEALTHcr(-
' :r } SPECIALIZED SURVEILLANCE AND ENFORCEMENT BRANCH
k� * PLAN CHECK PROGRAM- BALDWIN PARK
COUNTY oFLOS ANGELES
x 5050 COMMERCE DR, BALDWIN PARK, CA 91706 Public Health
PHONE: (626)430-5560
WWW.PUBLICHEALTH.LACOUNTY.GOV/EH '
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE 04/11/2018 EHS VIVIAN TAN
•
PLAN CHECK NUMBER SR0129045
PROGRAM ELEMENT 1702- RESTAURANT(501-1,999 SF)
OWNER/REQUESTER FRANK NGUYEN,ARCHITECT
DBA LUGAN BEI RESTAURANT
ADDRESS 411 E HUNTINGTON DR 101D,ARCADIA, CA 91066
FINAL REINSPECTION STATUS: NOT APPROVED
CORRECTIONS REQUIRET3€ v i CORRECTION CATEGORY: PLAN SUBMITTAL/REMODEL •IDENTIFIED: 04/11/2018
ta't?
CORRECTIVE ACTION: RE-INSPECTION CONDUCTED. THIS FACILITY IS HEALTH DEPARTMENT APPROVED; OK TO
STOCK AND TRAIN.
RECEIVED MEPF FINALS. APPROVAL TO OPERATE AND ISSUANCE OF PUBLIC HEALTH OPERATING PERMIT
ARE CONTINGENT UPON THE FOLLOWING: 0
•
-PROVIDE A COPY OF BLDG. FINAL APPROVAL.
-INSTALL THE AIR CURTAIN AT THE ENTIRE OPENING OF THE FRONT DOOR.
-SECURE LOCKERS TO THE WALL.
CALIFORNIA:RETAIL FOOD CODE:A person proposing to build or remodel a food facility shall submit complete,easily readable plans drawn to scale,and
specifications to:the enforcement agency for review,and shall receive plan approval before starting any new construction or remodeling of any facility for use
as a retail food facility. Section#:114380, 114381 .
COMMENTS '
NONE
Help us serve you better by completing a short survey.Visit our website at www.aublichealth.lacounty.aov/eh.
-1 EHS Signature Page 1 oft
PLAN CHECK OFFICIAL INSPECTION REPORT
DATE .04/11/2018' EHS VIVIAN TAN
PLAN CHECK NUMBER SR0129045
PROGRAM ELEMENT 1702 - RESTAURANT(501-1,999 SF)
OWNER 1 REQUESTER FRANK NGUYEN,ARCHITECT
DBA LUGAN BEI,RESTAURANT
ADDRESS 411 E HUNTINGTON DR 101D,ARCADIA, CA 91066.
DISCLOSURES
Itis a misdemeanor violation to begin operation without a valid Public Health Permit/License.The Public Health
Permit/License will be issued by the Los Angeles County Department of Public Health Environmental Health Division(DPH-EH)
Plan Check Program at the job site following final inspection and approval by all applicable agencies. Remodeled areas of an
existing food facility/establishment must obtain a final inspection and approval from all applicable enforcement agencies prior
to use.
Any future alteration,construction, building, renovation, repair, change of equipment,change of the operation of a food
facility/establishment or change of menu may require plans to be submitted to the DPH-EH Plan Check Program. Additional
approvals may be,required from other enforcement agencies.
•
It is improper and illegal for any County officer,employee or inspector to solicit bribes,gifts or gratuities ih connection with
performing their official duties. Improper solicitations include requests for anything of value such as cash, discounts,free
services, paid travel or entertainment,or tangible items such as food or beverages. Any attempf-by a County employee to
solicit bribes,gifts or gratuities for any reason should be reported immediately to either the County manager responsible for
supervising the employee or the Fraud Hotline at(800)544-6861 or www.lacountyfraud.org. YOU MAY REMAIN ANONYMOUS
Public Health Permit/License:
A separate fee is required for the Public Health Permit/License.A billing statement will be sent to the permit/license holder
annually by the DPH-EH. The fee is required to be paid to perform or carry on,conduct or engage in any mobile food facility
listed in.Los Angeles County Code,Title 8,Section 8.04.720.•
r
1a#;
State and Local Licenses and Permits: S
Contact the State of California and your local city hall regarding additional license and permit requirements.
Restrooms: S
Customer may use restroom facilities if they are located in a customer area. Customers may not enter,the food preparation
area,food storage area, or the utensils washing/storage areas in order to access the restrooms.All food, utensils and
equipment must be protected from contamination. .
Routine Inspection:The DPH-EH conducts routine inspections of all food facilities in Los Angeles County. Following the
issuance of your Public Health Permit by the Plan Check Program, an Environmental Health Specialist from your local district
will conduct an inspection of your facility. If your Business is located in a city that has adopted the grading ordinance,the
inspector will post a grade or score card at your facility. Grade/Score cards are not issued by the Plan Check Program.
•
tleip us serve you better by completing a
short survey.Visit our website at www.oublichealth.lacounty.gov/eh.
EHS Signature Page 2 of 2.
A
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A.ry.t 3,1903
ql
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°nity134� MEMORANDUM
Fire Department
DATE: March 29, 2018
TO: BUILDING DEPARTMENT
INSPECTOR John Zurick
FROM: FIRE DEPARTMENT
SUBJECT: FIELD INSPECTION
ADDRESS: 411 E. Huntington Drive, 101D
THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE
DEPARTMENT REQUIREMENTS:
TYPE OF INSPECTION DATE / INITIAL
FINAL INSPECTION
FIRE SPRINKLERS
FIRE ALARMS
TANKS
HOOD & DUCT 3-27-2018 Mark Krikorian
KNOX BOX
OCCUPANCY 3-28-2018 Mark Krikorian
COMMENTS:
Emailed Bldg. Dept. 3-28-2018 Rita
zSIGN "18 0944
City of Arcadia,CA
Development Services Department ; Permit Type $Ign
> ° 240 West Huntington Drive,Post Office Box 60021 t 4 " fig �'
Arcadia,CA 91066-6021 � 74r a :, 6 Wa'kClassification II ulthilated
. (626)574-5416 ; u I, *m F E Permit Status Issued
A RCAD LA ,Issue Date 06/06/2018' Expiration: 12/03/2018
INY
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
411 E Huntington DR 101 D Arcadia,CA 5773009069
_ � ;. ..• :,,. .. ., : . '. �. .,� ,. � . ,. ,....,,, woo_ �:. . -W�.6.�- �,,.,: : �a �,, � .r... a -xi •.,, w :�a
Contacts
HUNTINGTON LANMARK LLC Owner NEW SIGN SOLUTION INC* Electrical Contractor
411 E HUNTINGTON DR 309A,ARCADIA,CA 9106 (C-10)
9468 Garvey,South El Monte,CA 91733
(626)443-9288 KEN@NEWSIGNSPRINTING.COM
Description:LED ILLUMINATED SIGN FOR SOUPER BOWL Valuation: $ 1.800.00 Tenant
r Total Sq Feet: 0.00 Plan Check# Plan#
fi.
%{p:',9tdC.`s.. ...:.iAa..�&'.:.':".. ..,�>._::.w'.:...V&.,.i:.::- �.:in..:'d _,.,<•a.... '...:.Yh:..'9b"
Fees Amount Payments Amount Paid
Building Issuing Fee $44.35 Total Fees $316.50
Building Permit Fees $95.25 Cash/Receipt#REC-001363-2018 $316.50
Electrical Permit Issuance Fee $44.35
Amount Due: $0.00
Sign and Branch Circuit $62.13
Sign Connection $15.55
Sign Plan Review $47.62
Solid Waste Management Fee $6.25 n
Solid Waste Management Fee 2 $1.00 t//aA�
!/Na
i3 1ff e?
Total: $316.50
C 4FOR 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.
# 1
June 06,2018
Issued By: Date
June 06,2018 Page 1 of 1
V ARC
�~4O�F �'9di
Ir PERMIT/PLAN REVIEW APPLICATION
. _-'may,'.
\4% Development Services Department,240 West Huntington Drive,Post Office Box 60021
unity°fes° 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.\,
License Class e—y�r Lice e No.q%5101 Exp. Date a// ❑ I have and will maintain a certificate of consent to self insure for workers'
3f f(g 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.nM�w-orkers'compensation insurance carrier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, (Carrier I.
. --c,--—k l A S ,
demolish,or repair any structure,prior to its issuance,also required the applicant C 1 0�j 3 rill
for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number
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 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 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
sale(Section 7044,Business and Professions Code:The Contractors License Date 6 //? 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.
1�-R
Name " \--e- 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 to enter upon the above-mentioned property for inspection purposes. Q�
ignature Date 6 — "
109" ROUTING _� _ .__.�.,._.. __sACTION• %...-. -j
-..� Date and oAP- �`°�oAP� °�•o�� Notes
1 Initials of Pew C�° Pe4�,oQQ% on Sheet#
co i
x
4.51( =
Checker
t�� • Piannin• G Ps--- o�
_ I _
Building ---_1 -�i� � _l�C--,mac '.c.
Fre _..__I l_ ---- — –i
Proposing: Internally illuminated LED channel letter sign. PWS"Water + _t__--
WELD –
Face: 1/8"thk Red (#2793)Acrylic. Tres _I.__.i — —
Logo Face: 1/8"thk White acrylic with translucent vinyl overlay. -1 l ----
Trim
—Trim Cap: 3/4"wide bronze trim cap.
Letter Returns: 5"deep .040 aluminum bronze acrylic enamel finish.
Lighting: by LED, front lit.
13'
U.L LISTED
e
a
Trim Cap---1t PI
�ExlstIng J-Boxto Primary L - r_ r°
\..
�� ♦ Disconnect Swltih i1 DE� �`
LEDs Id..._Power'Supply - µ- �' f 4_
Aluminum c" - - .f(= 4.';i",—'-'.t Q SOUPER BOWLio ,'7A ;i
Backing �: —0.5 EMT Conducts P .-• - _
Acrylic Face—- ! I Mounting Serew ~ _ —�
�' (3-#10 x 2 12"Lag Screws +} 5a3+ ��`
Per Letter) 7 - .s `t i, —' ! i
t ��+{��flai;��� r �a_I ""rod' i, t
Weep Hole j°, „--}" , '. , --
DRYWALL!8ThD$ WOODSCRElV vo,u.TYPE TOX` YX m4•ER TYPE `w ,.''''pry , H;Y„'-( ,___1 I ' .. I -II
CONCRETE ANCHORAAO 88"TO14X1'TO4" 7 •t.•"
-. -. -.,.. -- �— t ' '•
STUCCOiet w.00K ANCHORAAG Air TOWXTTO4" '. - r- —
l! STEILBEMS YACMANCH. SKr TOWxVTo4" ,,,. - ' 1 ; `:rvtfr, 41' s+"This sign is Intended to be installed in accordance with the re uirements ofArticle 600 of the National "Electrical Code and+or other applicable local codes.This includes proper grounding of the sign. «#n . \ 7,1'1"-'4'.
=`N u -1----
©2018 NEW SIGN SOLUTION INC.ALL RIGHTS RESERVED.USE OF THE IMAGE WITHOUT CONSENT IS AN UNAUTHORIZED USE OF NEW SIGN SOLUTION INC.
NFkokiGu 9468 Garvey Ave.,
Date Created: Date Finaled: Prepared By: Approved By: (Print Name) So EI Monte, CA 91733
4/30/2018 Christina STel:626-443-9288
Job Location: Date Approved: Mon Inc. Fax:626-443-9218
411 E. Unit 101D, Huntington Dr., Arcadia, CA www.NewSignsPrinting.com info@NewSignsPrinting.com
a ,
Arcadia Fire Department
evEPARTM4,4
ER Permit Number 185913 Permit Date 12/28/2017 12:00:00 AM
Construction Effective Date
ARCADIA Permit Type Commercial Building 12/28/2017 8:24:14 AM
ARCADIA FIRE DEPARTMENT Tenant Improvement
FIRE PREVENTION BUREAU .
710'BOUTN SANTA'ANITA AVENUE Created By Chen, Rita Expiration Date:6/28/2018 8:24:14.AM
ARCADIA,CA 91006
iezei6;aa,04 (626)4as,e,eFAX
- , Authorized Date Authorized By :Site Information Billing Information
CONSTRUCTION: LU GAN BEI 411 E. Frank Nguyen &:Associates
.
HUNTINGTON DRIVE#1010 17-482 1711 Magellan ST
411 E Huntington DR#101 D . West Covina, CA 91792
Arcadia, CA 91006
Point of Contact
Frank Nguyen &Associates 626-915-6130
•Permit Notes::
t.
PC# 17-482.
Permit Formo" � °` 4 >u
'n& {�� yY't {N�k :l��� ��4eiA y '� '
Form: Commercial Building Occupancy Final
Description:Commercial Building Occupancy Final
Permit 17opics°
Plan Check Submittal
Application Date
Date :
Status:
Notes:- .
Plan Check.
PC#
Status:
Notes:
Contractor Information
Information
Status:
Job Description
Description
Status:'' : ..
Notes•
[Printed on 2(92%18_at 15 28,22 _Page_1_of 5
, . , „ _. . "-::.,•. .. • '. -..... . . . - ..• . - -, ,.,. . .
Job.Valuatio� . _
" Valuation .
7- ... '--••.-..•-,-.:-:-..-..--•.•.•.- •.-: ........, .• •status
Notes: . - S . Fres from"sprinkler pipe.
to ..
plan ReY1ew.gta Rent"RemONe
Piot APPS°Ved . e�luip
APPtoyed" - t'APPfOVe
d .. for- eW
Status:,Need hood system plans .
Notes. • :rr r i .
A.
mx »,�,
.,vi,"t -.4„,,,,,,;•. - .rw - ,
-.•,-/ A
r
EXit Signage
pass ._-
Pass
Status:
.
dotes: :.
Fail"
Fail
s .
Statu-
Notes` • •• '
NIA
:
I
J
I
\ \I
i
•
•
•
Exit Doors
Pass . . ,. . , . .
Pass
. Status:Approved
Notes: Need note above door"These doors to remain unlocked while space is occupied." Need lock Window•on'door
•
p• .
fix 1 0 ? ' .
t:;41,--;4;„;>,(,,,,yHb4t •l1 ,
,y ' l 'Y.4!!' -e .-' ';r11fj
_
/.
.• Fail.: : •. .'
Fail
Status:: '
•
Notes:.
Exit Locking Devices
Pass:: ..
Pass ..
'Status:Approved •
Fair
• Fail :.: •.
Status: .
Emergency Lighting
•
Pass•' .-
Status:
Notes: :. • . : . - -
Fail:. • .. .. . _ . .
Fail.
Status: .
Notes: •
:
-
NIA: . .
Status::Approved
-Notes:. • .
Fire Extinguishers
• Pass
Comments ' ; -
Status: •
• NoteS:
LPrinted on2112/18at 15:28:22
" • Page.3 of$1
Fail::.
Comments
Status: Not Approved
Notes:2A1OBC.and Class K needed
Address/Suite Number
Pass
Comments:
Status:Approved
Notes:
Fail ..
Comments
Status:
Notes:
Fire Resistive Assemblies
Pass
. .Pass
Status:Approved
Notes:
Fail.
Fail
Status:
Notes:-
N/A
Status:
Notes:
Fire.Lane
Pass
Pass
Status:
Notes:
Fail
Fail
Status:
Notes:
N/A . ,.
N/A.. .
'Status:Approved
Notes•
:Knox Box
Pass
Pass'
Status:
• -Notes:
Fail
Fail
Status:
Notes:
[Printed.766-27-1-211-87. 7 _. u�__� Page.4 of 51