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HomeMy WebLinkAboutTI-18-1933 ` , City of Arcadia, CA permitNO.T1-1.871 933 5111/ Development Services Department -,k % ' '.: �t- .., --; Permit Type Tenant Improvement 7. f240 West Huntington Drive,Post Office Box 60021 C t:1‘ r , .) r i Work Classification:;Tenant Improvement,. Arcadia,CA 91066-6021 .� ., �,,�. �_. (626)574-5416 ` w Permit Status Issued ARCADIA issue bate 07/08/2019-: 1 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip• Parcel Number 133 E Foothill BLVD Arcadia,CA 5771021029 Contacts HIGHLANDER CENTER LLC C/O GLOBE Owner ' KC DESIGN ARCHITECTS,INC* Applicant PROPERTIES 121 Foothill BLVD (310)446-1888 C D G BUILDERS INC Contractor 24 EXECUTIVE PARK 150,IRVINE,CA 92614 (949)892-3510 921615 • Description:T.I TO CREATE A DIALYSIS CLINIC.MINOR SHELL Valuation: $ 600,000.00 Tenant MODIFICATION FOR NEW DOORS AND ROOFTOP AC UNITS. NEW TRASH AND INFECTIOUS WASTE ENCLOSURE,MEP's Total Sq Feet: 0.00 Plan Check#18-1933 Plan#77 INCLUDED. Fees Amount Payments Amount Paid Accessibility Plan Check $455.72 Total Fees $12,720.34 Accessiblity Building Permit $467.40 Cash/Receipt#REC-02158-19 $95.00 Air Handling Units<=10,000 cu ft per min. $98.77 Cash/Receipt#REC-002642-2018 $5,012.43 Backflow Protective Device 2"&smaller $31.10 Cash/Receipt#REC-01755-19 $7,612.91 Building Issuing Fee $47.01 Building Permit Fees $4,674.00 Amount Due: $0.00 Building Plan Review Fee $3,038.10 Cal Green Plan Check $303.81 s l I . �-- %Nk� Commercial T.I.Fire Plan Chk. $280.00 Compressor<3 Ton(up to 3 hp) $18.74 Distribution Panel $62.20 CALLS FOR INSPECTIONS Electrical Permit Issuance Fee $47.01 Request for inspection by telephone at 626-574-5450. Leave a message Energy Plan Review Fee $934.80 requesting the address,timeframe and what inspection item is needed. Fixture with Trap/Misc. $87.22 Floor Drain Fee $124.60 Floor Sink $249.20 This permit/plan review expires by time limitation and becomes null and Furnace or Burner<=100,000 BTU $149.92 void if the work authorized by the permit is not commenced within 180 days Green Building Standard $24.00 from the date of issuance or if the permit is not obtained within 180 days Kitchen Sink $386.26 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 Lavatories $62.30 consecutive days or if no progressive work has been verified by a City of Light Fixtures $223.80 Arcadia building inspector for a period of 180 consecutive days. Tota l: $12,720.34 I4- COMPLUEO _ ... July 08, 2019 Issued By: Date August 19,2019 Page 1 of 1 C7.,, 4�ytyo R�9d i O -.1, PERMIT/PLAN REVIEW APPLICATION o� ,• Development Services Department,240 West Huntington Drive,Post Office Box 60021 4ltnity oie° 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 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. Signature of Contractor OWNER-BUILDER DECLARATION ❑ I 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 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 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 Li 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 1:1I, 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 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 LG>L}) G// (Title SGC i 1/ P NAME 1 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 t t : .bov entioned property for inspection purposes. q _ ( et gnature / 1 Date ` /l /13 E Fo o7)f/_�L-- ► • NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. I$ - 1133 100. Setbacks 210. Under ft/bldg.drain 101. Rough grade 211. Copper underslab g••-•/9' F✓c3� S//E,/) 4 o.tal/ C.i Alt. 102. Figs.&forms 212. Rough plumbing I I I.(en•I9 ^,,,,11 , 5z-- 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan 5"-7./9 1%/cc/'.3Finars/,vr /NSc1u-1)0-' • 9' 105. Steel 215. Water heater 106. Grout lift 216. Roof drains g F3 /9 NM/f7N� 7.4 J) /y Ex 27�wA- 107. Shear nailing 217. Building sewer � /Jr �'7 - '''- 108. Diaph nailing 218. Water service I.23.0 2'" F„k/avCFJL/,vc,1 f-&VA. • 109. Roof nailing 219. Final gas I�X e T' 110. Framing 220. FixtureT-2_ 0ccutasL,.•C7 „jj0i!_c,e'D 111. Occ./Area Sept.Wall 221. Final plumbing $.1.s Z.o 7.74/./9 Uh ,i„/457E-1 41/r71-71-- /1/1i,/Io,/� 112. Sound walls Q 222. Sewer cap/demo. f 113. T-bar rid IZ•13'(! �- )Q S'3./9 -L ( ott_ (% fO' ecno-� ,- 0. . - 114. Insulation-Flr. Pool Inspections I Date I Insp. /3S Q.nPg.ovet 4: -.‘-- 115. Insulation-Wall 240. Excavation/steel S«`% X0.7•/9 /33 SEbta& C' tiJ�Vo4 116. Insulation-Ceil. 241. Rough plumbing r 117. Drywall nailing if.I R•19 T--- 242. Light shell/bonding LJ/s ,,o cs, P,z' -SL& , .419/go vei -: - 118. Interior lath 243. Underground conduit /0•`)•/9 ' '/�0 5c2-t466 119. Exterior lath 244. P-trap 4 ,Aa-r1 Aka.. - gL 120. Finish grade 245. Gas line&test lo•I o•(`l T/ul•Mr,-1i, /- /47 oz- e A.L L.-te 7)2 - 121. Final building 246. Fence,gates&signs i 122. Final demo/lot clear 247. Pool heater ��L r NU � � �� t5-- -. 248. Final electric 1 D.lr{•l/ 2na)/....4-10,- L 6oL.Lgrt Aa,iz_ Electrical Inspections Date Insp. 249. Final.lumbin• 150. Power pole 250. Pool cover A-JD (Z) 0.01,, S r� `,c, a Z ��� 151. Sales lot lighting 251. Pool final )0./6--// PAA774-+ 3 . 17t_' um/11-n_ Sr'n"1c( 152. Underground conduit it'l t bt 71(12.b of r",-,Sra-s- . 153. Underslab conduit Reroof Inspections I Date Insp. ���� 154. UFER ground 270. Pre-reroof insp. /0.)`)-i/ /4 0 S1 ✓/ bizn.,r. -31-, v- 155. Water ground 271. Roof framing J d•2 /9 /-5r/4-7 ix- )47 c„ a JLL 156. Rough electrical 17.13.Iq f--- 272. Sheathing nailing 157. Fixtures 1 Z•11.(1 C'+- 273. Final reroof q-4 51 .'^LSI.G. <1 ----- 158. ---'158. G.F.C.I. 4=A2-1- t 159. E..t.bonding Sign Inspections I Date Insp. 1°./9./9 Pw2r 2N1j e 160. Service panel 280. Setback/overhang ))i--AA i Si^'S . 'r�4'^'_ 6 1�A- I*(L I EAl-r SI ds� 161. Final electric g,11,10 f`- 281. Footing QE r:rr) 1-1 ,. I›r ' �-�_ g, O Gc . L-7E1282. Conduit/wirin• Mechanical Inspections . Date Insp. 283. Disconnect to.31-I9' P,t,_n,t.,_ lir Cyt_, e i2-76-- 180. 80. Venting/flue 284. Final sign ))00,4-.k I$t G Q.4C,.c. $i bE . ^'b Kvt1% 181. Furnace/A.C. 182. Rauch HVAC Miscellaneous Insp. I Date Insp. @ 1 £ W c c: .130t,,_.40., T VL 183. Fire dampers 290. Fire alarm 6 1....4.0.^-0A/2 7 4..,1A1.- Tyl-444 r n..,a Pe#4 1030)' 184. Furnace compartment 291. Underground supply nn 185. Combustion air 292. Fire sprinklers r(.6.(9 4 d 41�wdJ/.J4, /L' C • 186. Smoke detectors 293. Monitor system 'N (1/Fr 14,S r (N'-^n r o( _ W 5 l (-S/)E 187. Metal F.P.rough 294. Hood dry chem. 188. Compressor setback 295. Final h0,4 `"'/r1L' ArntOJ )• 4ILfrt -Po, f .'SILk1r 189. Commercial hood R Soc v it + (moo✓EY1. . .7c -- 190. Duct shaft Sewers&Offsite Insp. Date I Insp. J- 191. Final mechanical .3'//• Zo 300. Lateral(main to P/L) /��//l!q o,` ���� U (4z. 191. 301. Saddle/Y • I'(•i 7'// 7/'4Nt G.Jo L Lw(Z 7'iZ ec- i ,/- Block Wall Inspections Date• Insp. 302. Cess.00l filled 5E7°14.411 as r 200. Footings l 2.I I.19 51-- 303. Sidewalk 201. Steel/rebar 1 Z.Z3 -s-----.0 -s----- 304. Driveway fl•,S./q (3r/4-ice 2 )01.4„44- A cctirt5 ) 202. Grout lift 305. Curb replacement 2 203. Final wall 306. Trash bin Z///L � nooPI (1�1� 'b frr );iotn.NJL 1\11 Co GMS r-1 6A...-iS• ---75t-- 5f.3o•20 p, e i13r s a F-- • a .�..; '';;*:E=",;',.:,4 ,. ▪ 44',„ 'Permit NO TI 18 1933.' a City of Arcadia, CA 'i • �, ,„ ,. a a > , Development Services Department f � ,'.�-4,..,-,;„,.;,..•,,,,,,,„,40;p4-: ,•.,---,t 2° '"""' ," Pe trit�Type Tenant Improvement`, 240 West Huntington Drive,Post Office Box 60021 ( f 1 k 1 . P i l r, ' .1:g t work Classification Tenant Improvement'' `�) Arcadia,CA 91066-6021 k a f 1, ` YA 1`a ;, (626)574-5416 Permit Status Expired , ARCADIA h ' ; �� ��" Ni � s'sueoate � Expiration: 10/21/2019 ave Akre. ' 1:: e , a.,'x'°, 4. P ,-r a "146; • Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number q 133 E Foothill BLVD Arcadia,CA 5771021029 i ,,,,,,,‘MAV.. ,,'',,w Contacts HIGHLANDER CENTER LLC C/O GLOBE Owner KC DESIGN ARCHITECTS,INC* Applicant 1 PROPERTIES 121 Foothill BLVD (310)446-1888 C D G BUILDERS INC Contractor 24'EXECUTIVE PARK 150,IRVINE,CA 92614 (949)892-3510 921615 Description:T.I TO CREATE A DIALYSIS CLINIC. MINOR SHELL Valuation: $ 600,000.00 i Tenant MODIFICATION FOR NEW DOORS AND ROOFTOP AC UNITS. NEW TRASH AND INFECTIOUS WASTE ENCLOSURE,MEP'sTotal Sq Feet: 0.00 f Plan Check#18-1933 Plan#77 INCLUDED. oz� � 1 Fees Amount Payments Amount Paid Accessibility Plan Check $455.72 Total Fees $12,625.34 Accessiblity Building Permit $467.40 Cash/Receipt#REC-002642-2018 $5,012.43 Air Handling Units<=10,000 cu ft per min. $98.77 Cash/Receipt#REC-01755-19 $7,612.91 Backflow Protective Device 2"&smaller $31.10 Amount Due: $0.00 Building Issuing Fee $47.01 Building Permit Fees $4,674.00 Building Plan Review Fee $3,038.10 Cal Green Plan Check $303.81 Commercial T.I.Fire Plan Chk. $280.00 Compressor<3 Ton(up to 3 hp) $18.74 Distribution Panel $62.20 CALLS FOR INSPECTIONS Electrical Permit Issuance Fee $47.01 Request for inspection by telephone at 626-574-5450. Leave a message Energy Plan Review Fee $934.80 requesting the address,timeframe and what inspection item is needed. Fixture with Trap/Misc. $87.22 Floor Drain Fee $124.60 Floor Sink $249.20 This permit/plan review expires by time limitation and becomes null and Furnace or Burner<=100,000 BTU $149.92 void if the work authorized by the permit is not commenced within 180 days Green Building Standard $24.00 from the date of issuance or if the permit is not obtained within 180 days • Kitchen Sink $386.26 from the date of plan submittal.This permit expires and becomes null and Lavatories $62.30 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 Light Fixtures $223.80 Arcadia building inspector for a period of 180 consecutive days. Total: $12,625.34 zitcomp ED Issued By: Date July 08,2019 Page 1 of 1 OF AR 4`0,tvoRryti9d a PERMIT/PLAN REVIEW APPLICATION E 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 y . LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION Ifo 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: `iiT Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and mylicense is in full force and effect. ❑ I have and will maintain a certificate of consent to self-insure for workers' if i License Class Agii . 92.161 G Exp. Dater/30 J20 compensation, as provided for by Section 3700 of the Labor Code, for the y performance of the work for which this permit is issued. �`ISignature of Contractor .1 OWNER-BUILDER DE LA' TION ii'VI have and will maintain workers'compensation insurance,as required by Section LII hereby affirm under penalty of perjury that I am exempt from the Contractors ,''I 3.700 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.1My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, ;'; Carrier 1.1 6C -T\{ MATI/1VIA._ demolish,or repair any structure,prior to its issuance,also required the applicant nl�' 2?�Q I[� O'f� G' for such permit to file a signed statement that he or she is licensed pursuant to the PolicyNumber 1/v !1 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 1 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)): I 'compensation Laws of California,and agree that if I should become subject to the 1 ';i workers'compensation provisions of Section 3 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 I g I 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: p� Lender's Name Date 11 p(�J 2) 1 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. 1.1 1,1Vame J OM NA C HAN Title P TE CT EN O IN eE- IPRINT NAME r,.Ni 'A`certify 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 ove-mentioned property for inspection purposes. g'°11 201 , nature Date rl- • NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. 100. Setbacks 210. Under flr./bldg.drain 101. Rough grade 211. Copper underslab - 102. Figs.&forms _212. Rough plumbing t?•2/•& tit-"M IS/4 i vihL (e) PkrGftp4;j 103. Pre-slab 213. Rough gas 104. Floor joists 214. Shower pan Ib'd f.Mr 0*Alva-- I^LS ML L A-no•) • 105. Steel 215. Water heater 7-Zek„`.` 0 12.,y1.1rM.c a,,,/ 1nE/Ki2- LG • 106. Grout lift 216. Roof drains 107. Shear nailing 217. Building sewer idere...G' + , 108. Diaph nailing 218. Water service -t-3v--g C OpOsi f _ reqz, 7 Rcso-P 109. Roof nailing 219. Final gas ite110. Framing 220. Fixtures � � .�'�'�' V��Tc 111. Occ./Area Sept.Wall 221. Final plumbing yS•/9 bail Cc(NC w4-L'- X24-A.64 e tvar 112. Sound walls 222. Sewer cap/demo. 113. T-bar grid sr ' 114. Insulation-Flr. Pool Inspections Date 'Insp. Q 77i9 t. 3r ti,f't-_ (.JSvL./tno.) - 81 115. Insulation-Wall 240. Excavation/steel o q 116. Insulation-Ceil. 241. Rough plumbing 0 r-j /p ��I �S I�/�j STEyL 117. Drywall nailing 242. Light shell/bonding til t,./A-t, t - jeVi•� Lit' •-t /ST 1.47a. 3 118. Interior lath 243. Underground conduit $13./, tvar z,.ti) /�,7 Q.c/avi_ S,�,..,a,� >sr 119. Exterior lath 244. P-trap `'" / 120. Finish grade 245. Gas line&test b'J�'� b/21 1--00-i- AQ,pR.di'-z, ." ...:7 121. Final building 246. Fence,gates&signs 8.'q 1% 2ND � t Q�x /Ung 122. Final demo/lot clear 247. Pool heater / J_ )041(s(n4) e-f 248. Final electric fs r / `j 1W L`d e Electrical Inspections Date Insp. 249. Final plumbing f/t'Tr 0e- "44/0). 150. Power pole 250. Pool cover ,,, 151. Sales lot lighting 251. Pool final 8'21.11 /-/.7`(?L U AtglA, L,0 O'er 152. Underground conduit �t O'` • 153. Underslab conduit Reroof Inspections I Date I Insp. 154. UFER ground 270. Pre-reroof insp. $.2341 PI, f e CEr1.I.45 Ash d•r 155. Water ground 271. Roof framing of It OccutAA3 e7 &ni Lex- 521----- 156. Rough electrical 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. Eqpt.bonding Sign Inspections I Date Insp. . 160. Service panel 280. Setback/overhang 161. Final electric 281. Footing • 282. Conduit/wirin' Mechanical Inspections . Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC Miscellaneous Insp. 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 I Insp. 191. Final mechanical 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cesspool filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin ; t : City of Arcadia, CAfr `. PermrtNO FIRE-19-2063. ` Development Services Department "� t ^„fw p $� m PermrtType Fire' i:4.4.\\I 4,4 I I/ 240 West Huntington Drive,Post Office Box 60021 r ),[,i r-,-,,,,..- ` Work Crassr cation Fire Alarm Arcadia,CA 91066-6021 � r Th i (626)574-5416f.......i x ', % A ` =.PetmrtStatus issued ARCADIA Issue�Date•1.0/21/2019 . Expiration: 04/11/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 133 E Foothill BLVD Arcadia,CA 91006-2506 5771021029 Contacts HIGHLANDER CENTER LLC C/O GLOBE Owner REGENCY FIRE PROTECTION INC* Contractor PROPERTIES 121 Foothill BLVD (818)765-1822 Description:FIRE ALARM FOR MEDICAL OFFICE 70 DEVICES Valuation: $ 50,000.00 Tenant Total Sq Feet: 0.00 Plan Check#19-2063 Plan# Fees Amount payments Amount Paid Fire Alarm Plan Check $980.00 Total Fees $1,834.51 Fire Issuance $47.01 Cash/Receipt#REC-02833-19 $854.51 Fire Permit Fees $806.50 Cash/Receipt#REC-02755-19 $980.00 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $1,834.51 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. 4Pt . . D iiii, October 21, 2019 y i Issued By: Date October 21,2019 Page 1 of 1 ARC A `4 F ON'. X19 d, ,,., PERMIT/PLAN REVIEW APPLICATION 0.„›,, j., Development Services Department,240 West Huntington Drive,Post Office Box 60021 4hinItY.0 1" 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,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 2.31/6- License Da--/ G 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. Signature of Contractor WNER-BUILDER DECLARATION 0 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'compe sation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier Ori r demolish,or repair any structure,prior to its issuance,also required the applicant li 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 ❑ 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 a - / / Signature Law does not apply to an owner of property who builds or improves thereon, -e 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 /9 ✓/ e,,/1-S.7- 2�/At /-c [Title •/ rt PRINT NAME I certify that I have read this application and state that the above information is corr 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 Arcadia to enter upon the above-mentioned property for inspection purposes. ignature r � /�� Date / 2-../ '- / j State of California—Health and Human Services Agency California Department of Public Health CERTIFICATION FORM FOR CLINICS AND FREESTANDING OUTPATIENT CLINIC SERVICES OF A HOSPITAL I certify that the following facility conforms to current applicable edition of the California Building Standards Code*and as such meets the applicable clinic standards (OSHPD 3) propounded by the Office of Statewide Health Planning and Development. Facility Quality Dialysis Center Foothill Street Address 133 E. Foothill Blvd" City Arcadia, CA 91006 Type of Facility • Chronic Dialysis Clinic(see note 1) ❑ Surgical Clinic(see note 1) o Rehabilitation Clinic ❑ Primary Care Clinic o Birthing Clinic o Psychology Clinic ❑ Out Patient Clinic Service of a Hospital Service(s): Name Steve Roberts Title Building Inspector Street Address 240 W. Huntington Dr City Arcadia Signature Date 5• I • Z o *2015 IBC and 2016 California Amendments(2016 California Building Code—Part 2,Title 24, CCR) 2014 NEC and 2016 California Amendments(2016 California Electrical Code—Part 3,_Title 24, CCR) 2015 UMC and 2016 California Amendments(2016 California Mechanical Code—Part 4, Title 24, CCR) 2015 UPC and 2016 California Amendments(2016 California Plumbing Code—Part 5,Title 24, CCR) 2015 IFC and 2016 California Amendments(2016 California Fire Code—Part 9,Title 24, CCR) Also see attached amended CAN 1. • Note 1: Per Health and Safety Code§ 129885 certification of chronic dialysis and surgical services'are required to be provided by city or county building department with jurisdiction over the project. If the building jurisdiction will not be providing this certification, plans shall be submitted to OSHPD for certification review. CDPH 270(6/17) State of California—Health and Human Services Agency California Department of Public Health Enforceable Codes' The following are the enforceable codes for facilities under the authority of the Alfred E.Alquist Hospital Facilities Seismic Safety Act of 1983: Application means the submission of a Preliminary or Final Application for Plan Review. Code means the official compilation and publication of the adoptions,amendments and repeal of administrative regulations to California Code of Regulations,Title 24, also referred to as the California Building Standards Code. APPLICATION CODE All applications submitted on or after 2016 California Administrative Code(CAC) January 1,2017 Part 1,Title 24, California Code of Regulations(CCR) 2016 California Building Code(CBC) Part 2,Title 24, CCR Based on the 2015 International Building Code (IBC) 2016 California Electrical Code(CEC) Part 3, Title 24, CCR Based on the 2014 National Electrical Code (NEC) 2016 California Mechanical Code(CMC) Part 4,Title 24, CCR Based on the 2015 Uniform Mechanical Code (UMC) 2016 California Plumbing Code(CPC) .Part 5,Title 24, CCR Based on the 2015 Uniform Plumbing Code(UPC) 2016 California Fire Code(CFC) Part 9,Title 24, CCR Based on the 2015 International Fire Code(IFC) All applications submitted between 2013 California Administrative Code(CAC) January 1, 2014 and December 31, Part 1,Title 24, California Code of Regulations(CCR) 2016. 2013 California Building Code(CBC) Part 2,Title 24, CCR Based on the 2012 International Building Code (IBC) 2013 California Electrical Code(CEC) • Part 3,Title 24, CCR Based on the 2011 National Electrical Code (NEC) 2013 California Mechanical Code(CMC) Part 4,Title 24, CCR Based on the 2012 Uniform Mechanical Code (UMC) 2013 California Plumbing Code(CPC) Part 5, Title 24, CCR Based on the 2012 Uniform Plumbing Code (UPC) 2013 California Fire Code(CFC) Part 9,Title 24, CCR Based on the 2012 International Fire Code (IFC) CDPH 270(6/17) k(--4 , ,.. „-)0 (). p' , _. (7r - '*.-t.--) 6 Ameni , , The. Water. Purification Specialists Amen Wa ter Medical .Revers. .. . Osmosis Systems :, : ; , , This document certifiesthat thiswater treatment system has passed Amen Water . Inc, 's stringent quality control specifications:. ' AmeriWater Inc: : is registered with the Food and Drug Administration as a medical device manufacturer, .refurbishes and.:accessory supplierfor watertreatment systems. . FDA. Regulation 876.5665;- .-Class II: This water treatment system is builtin compliance with .the specifications in FDA 510K File #K924695, 'K991519, K111740, K131622, K131904, and/or K133783. Serial # furl.' [/ IModel # }'' ,/ /1/6121/ 4/ Date !� Ja? 0 •g& ,. toriLf) , ,FRM.80Certificate510K, MRO. Rev.C' Ilt . 0:354114., . -440- WATER DIVISION ATTENTION DATE: . 3 • 1 FROM; BUILDING DIVISION INSPECTOR: S ADDRESS: 1 33 z. •R-io•erl-k PERMIT NO.: I 11 3 3. PLAN No.:: t? i . CONTRACTOR: C.:6G (1_,t)I !L.-es PHONE NO.: '7 -re)C.-- Gp 01 2 OWNER: 1414 PHONE NO:: PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT • OF PUBLIC WORKS REQUIREMENTS. Type of Inspection Date&Initial Date&jnitial Filial Approval Meter Location • " C2D 3/16/ 0 1$1ackflow Devices Irrigation System Fire Sprinkler System 3/14/ao Meter Clear • Ciao Swimming Pool COMmENTS: a,< 42 \A;L\ 3As (.4 ao 6 t-4 1)) NJ 5ict e -va 7 115y \A (44‘) bMT TrNS:Ae -FL'A Ale% ttak4,1? A-to Likr‘k,ki A . - . 4gortzz x u %4.7 °' °{4 City of Arcadia. DEVELOPMENT SERVICES DEPARTMENT Inter-Departmental Inspection Request Date: 3 • I • 20 Public Works Inspector ' n To: From: Address: /33 E. :. {-b oT(I i Lt. Permit No.: I � - 19.33. , Contractor: C b —3-0 NI Phone No.: 7(' S-23(o Co 012 Owner: '1414-to-Li>,�iJ : iT Phone No.: Please inspect the following items to ensure that the Contractor/Developer is in compliance with all conditions of approval established for the project,and that the work performed meets the City's standard for Public Works construction;. Type of Inspection Date &Initial : Date& Initial Final Approval - Drainage / Grading . . ► tl✓� Erosion Control . Offsite Imrnprovements.. Street Improvemennt(s) (conduit, curb(curb gutter, curb numbers, driveway approach, parkway.planting, sidewalk, street light, traffic flow, etc:) Sewers) (lateral,grease/san intercepter, saddle,wye, .1 etc.) COMMENTS: & 1: ..7 c)6'1711'.-t6 l-1 1,t 147- li-t STd�L�t�l� b t-, c�csGtr-�17 jl Fs t--� i Rev.V12/11 - . . 1 =l mat✓ . min 12 ;. ICDA.Inas 'bots,*-Int.-ion -?' ( E)DEMISING WALL e(N)2-HR FIRE WALL > (E)PLYWOOD SHEATHING (E)CONTINUOUS BLOCKI .I.F). ' (E)6X16 PURLIN 07 (E)SLIP TRACK(V.I.F). • M a� 4/ 1 CI(E)2X4 ROOF RAFTER (E)TOP PLATE(V.I.F). Ex. . (N)600S162-43(33)C.J.@ 24"O.0 I (E)2x4 ROOF RAFTER @ 24"O.C. • t= •• , '•I~ . -._ .�.___... ... . ..... ._ r., ` Cir�1}'uat i.e.r.r..sstu..zo ii...,__. � � . stag to crest.Iran yon... ��-.. �t w.+-ed..ce9ooss—"" he II III ca ko J 1 iiii ' A /ANFIk I " .00s1� J.@' o:c �F` '-0o� a`3rt,�Git7a\i°diiZ' 1 ilk Illi acmigIWA. if o s. , . . ® ie a Ou O wavy, v '�; -� tan0��P ^tii� . ,e ��Jn;ie baSv eri / r . � �� ,�es`^P•�ip dio i�b1er,;�� �. �eCmilnstcU. �r to �iG 11� a , �a ){ ? - beth vF ,� a a � \i� ,..� (: o• to `- I .,%�i (N)LAYER OF 5/8"TYPE ",9�P ep tSEE A-i;3�D OCe pian, J;o at,'.!_ es• inn-5-0" O� 5' 0" ,r I V W/SLIPTR�AC ,{ tes4e ai��yo le !+t\ 'Co`�i (N)LAYER OF 5/8"TYPE"X"GYP.BD.SEE A-2.3D / (N)600T125-43(33)TRACK ,U o1 at i O i I (N)LAYERS OF 5/8"TYPE"x' GYP'tsp.O/( appnan Geo; Ca`�,•e� .•if (N)HAT CHANNEL �:ei l`t'* oI t., �r�O `� t (N)600T125-43(33)TRACK sY'iu' 1i b -I m r _ (N)6005162-43 MTErS TUD;@16'°O.C. F' �, E (E)DOLLAR TREE (N)BLOCKING AS REQ'D. ° (N)METAL STUDS TO,BE SECURELY PI �.d I .•'' ATTACHED TO(N)HAT CHANNEL. ® 0 c a M-OCCUPANCY(N.I.C.) / j i , a'c (E)%e'TYPE"X"GYP.BD.V.I.F. _..I�' ® cai G FUTURE DIALYSIS CLINIC -n c I-2.1 OCCUPANCY (N)%4'HAT CHANNEL W/#8 r TEK SCREWS X 2"LONG. (N) j := (N)%e'TYPE"X"GYP.BD. Z FIAT CHANNELS TO BE I 0 . ` (N)362S162-33 METAL STUD @ 24" SECURELY ATTACHED TO(E) Ank I �. O.C. EXCEPT AS REQUIRED TO F2T 0 cil 44 5 S'.Q A�C, 0 METAL STUDS. _ _ -i__ r - - M/P/E PIPES. o (N)2 LAYERS OF 5/8"TYPE"X"GYP.BD. 5 ILI gpi '.J '?. A -i ...� (N)MINERAL WOOL INSULATION ig �� (E)%8'METAL STUDS @ 24"O.C. j c�` (N)33 MIL.BOTTOM TRACK �� (N)HILTI X-U POWER DRIVEN FASTENER t ` - ye ESR#2269 0.157"0 X 1 1/8"@ 32"0.C. Z. 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STUD.HAT CHANNEL-Tar -et',02 ic 2 1 BE SECURELY ATTACHED - �..-Op'...co-kW' �Shth0i'��ak'O(j :f 2 \ (E)%'GYP;BD ~Jyy�ra 4 eCIZ +Otl�tn.ICG'• ��uPY'nit Pf'r = x (E)DOLLAR TREE �'�. a. iSk lg, 9 l (� e M-OCCUPANCY(N.I.C.) E METAL ST�JDS -3,af' y'�4 .`{r�'1}S,Se a c)tjenoe • �£P J� g �c��D ARCy @)24"O.Cy- `�Ga�Z,C C��On ,.) �1G�tty C 1 "D�a.` T air ce\-31 rr,-�1i a;��,tca of a 10 p be con��� ,6-.4c.1.- 9 1�e y G il c���'�, is m...fa.1 h':� Yantir+g not ems, 6 ,33E all th ,� • 9.° ` aP is�;t�a+Ic „.°qe 'Pians „iatj0n o .so. c� such �e ! "ane `a1 0� eo�e atlyNo fern`+� ro.iis+a , « p inn • •, T' ,eiro + ovula to oT ca+Ice -CONST --g -. ' IFO�� 00 �t(3+•„; k0 ai+�• d.. o7izarzo+s CAI 1/3 k)• rkl a1 '"'"'2078-037 r}:- M o N (E) MODIFIED DEMISING WALL/2HR FIRE WALL SK-1 b' A-6. 1 1"=1-0" PAGE 2 OF 2 z IACD Inc LEGEND: .rrr.Aj.. .=.(E)anwoR WAIL 4 NEW WALL-ML STUDS m 3P 0.G W]Efr OVT.B04R 'T.•-�i 3 iaoM19euis "g TYPExuSTUB(IX®FO RIRR04 WAUSA5CE 0ET4LS y7 F'.`� �• 373, 'Y��YFY�•YLr3i'F Ira ln ., �.,1., a •P�• AA ' S iil 4 4 f 4 14 f 1 I^ ,' • ••°m. 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TION I 1 'I -III e PARTIAL FLOOR PLAN �!� T A•2.2B ur.1Nr N 1 11 66 r I 1 City of Arcadia, CA Permit No. FIRE 19 1484 \IA-, Development Services Department ); ;' - ,Permit Type:,Fire Alit] 240 West Huntington Drive,Post Office Box 60021 . j r r 1 a � s , Work Classification Fire Sprinkler i Arcadia,CA 91066-6021 �,._ a i y t t k d (626)574-5416 ' �� ��Permit Status Issued ARCADIA issuecDate 08/12/201:9-1 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 133 E Foothill BLVD Arcadia,CA 5771021029 Contacts HIGHLANDER CENTER LLC C/O GLOBE Owner SINGLETON FIRE PROTECTION INC* Contractor PROPERTIES 12990 BRANDFORD ST G,ARLETA,CA 91331 121 Foothill BLVD (818)252-5744 667001 Description:FIRE SPRINKS FOR TI WORK.232 HEADS Valuation: $ 17,400.00 Tenant Total Sq Feet: 0.00 Plan Check#19-1484 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $1,258.86 Fire Permit Fees $370.85 Cash/Receipt#REC-02104-19 $418.86 Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-01993-19 $840.00 Sprinkler Heads $840.00 Amount Due: $0.00 Total: $1,258.86 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. �P August 12, 2019 Issued By: Date August 12,2019 Page 1 of 1 OF&Re a, �; 'NI PERMIT/PLAN REVIEW APPLICATION .Et w' Development Services Department,240 West Huntington Drive,Post Office Box 60021 °% ,,°sK°e° Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia .- ( ICENSED CONTRACTOR'S DECLARATION W RKERS'COMPENSATION DECLARATION hereby affirm under penalty of perjury that I am licensed under provisions of I ereby 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 m/y license is in fullforce and effect. 2 I have and will maintain a certificate of consent to self-insure for workers' License Class C —I(i0Signature of Contractor 6- 4 License1- /-No. 7"0/ Exp. Date 1.'Jd�y 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.M workers'corn ation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier L. � demolish,or repair any structure,prior to its issuance,also required the applicant S 3Dd oo 4-��e r q, for such pennit 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 _I-1I 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 0 I, as owner of the roe forthwith omply with those provisions. r property,rty, or my employees with wages as their sole /, / ����y���/ compensation,will do the work,and the structure is not intended or offered for1 2-714 1��,�ee.' sale(Section 7044,Business and Professions Code:The Contractors License Dates 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 1HE 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. N e r . ; i . 4 Title MIL_�,�� d j�': 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. agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. I S ature — Date '1 ( Z{11 ov Alto v IO d44/1 Aor !.1903 -m4aity°tom MEMORANDUM • Fire Department DATE: April 29, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 133 E. Foothill Blvd. THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC# 19-1484) 4-27-2020 Jill Perumean FIRE ALARMS (PC# 19-2063) 3-16-2020 Jill Perumean FIRE ALARMS (PC# 20-09) HOOD & DUCT KNOX BOX OCCUPANCY (PC# 18-1933) 4-29-2020 Jill Perumean COMMENTS: Emailed Bldg. Dept. 4-29-2020 Rita