No preview available
HomeMy WebLinkAboutTI-19-1799 / viji„No €�i , -5 , � Permit N0 J 19'1799 City of Arcadia, CA „ d • !# , Development Services Department ,. HPermttkT'ype ,Tenant Imp ovement 240 West Huntin to,n Drive,Post Office Box 60021i,i id`s. ( esA i0-; 00! ,; `� "�m Arcadia,CA 91066-6021 x ( ( ;"--74,'+'7:4" Work Classfi,.-6,..---„at�onTenant Improvement L" (626)574-5416 r; "" 00e ;Perm4-4,It tusYGomplete ARCADIA g,� Issue /27/ 19j Expiration: . Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 125 W Huntington DR BUILDING Arcadia,CA 5775015029 ti A1ST FLOOR . Contacts VG PROPERTY INVESTMENTS LLC C/O Owner GONZALO DE VERA Applicant MIKE SOO 903 CAZLE AMANECER 210,SAN CLEMENTE,CA 92673 125 W HUNTINGTON DR (714)600-2234 CON-AM INC* Contractor 903 Calle Amanecer 210,San Clemente,CA 92673 (949)498-1003 698311 Description:INTERIOR TI FOR BUILDING A FIRST FLOOR FOR 1 Valuation: $ 300,000.00 Tenant MOB.OUT PATIENT CLINIC FOR USC a Total Sq Feet: 0.00 4 Plan Check#19-1799 Plan#183 0-00000m000 Fees Amount Payments Amount Paid Accessibility Plan Check $253.89 Total Fees $6,130.21 Accessiblity Building Permit $260.40 Cash/Receipt#REC-03217-19 $3,213.66 Building Issuing Fee $47.01 Cash/Receipt#REC-02405-19 $2,916.55 Building Permit Fees $2,604.00 Building Plan Review Fee $1,692.60 Amount Due: $0.00 Cal Green Plan Check $169.26 /- Commercial T.I.Fire Plan Chk. $280.00 55'-Z4-00 /, C .T Energy Plan Review Fee $520.80 C� Fire Final Occupancy Fee $200.00 Green Building Standard $12.00 Solid Waste Management Fee $6.25 CALLS FOR INSPECTIONS Strong Motion Inst.Program Corn $84.00 Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. Total: $6,130.21 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. November 27, 2019 Issued By: Date November 27,2019 Page 1 of 1 ARe U~4 oFF y1dr ggi —II a PERMIT/PLAN REVIEW APPLICATION coig „is... .. Development Services Department,240 West Huntington Drive,Post Office Box 60021 4,aai,r°IN Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173 City of Arcadia 0LI SED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ereby 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. ��•.yy�� ❑ I have and will maintain a certificate of consent to self-insure for workers' J AriL License Class � •o.9442// Exp. Date l`ZP/R compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor ir p rformance of the work for which this permit is issued. \.,, JWNER-BUILDER �CLARATION (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 carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier 7' �V wf� � �11J � /G� demolish,or repair any structure,prior to its issuance,also required the applicant -7 LU o47.� � for such permit to file a signed statement that he or she is licensed pursuant to the Policy Number ll 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 D 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 37jjji - 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 l7 • 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, `____.....---7 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 I6' dp-L J/ VL'��, 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 . ; ; ,. •- - • tioned property for inspection purposes. Signature � �^ Date (//Z717/ q . • .... µr w» .. . , _ . . .. 2lt .„,,, ,, . •' ��. 2�° *' .\.`:, r.. ,;� ��� '-97�,-, :. ::�-31- � s Pr � �,�,r% .r:. ..._ ,. >,�`A�� •`�� ,e4,..„,„.„, ^,�/'.,c+'�A�°^7�t z������ f I .. N,Y- : .Si • i`: n,. ..e '" -7=— \ -714- � '�"Y` r �14 "'.;,t�rt�'�' �. 1 _ ,,,-.4^'' _ .#fin._ .,, was•-..�� ., ... �. �-.-..,._;?...a..,... � 5� -l��j��,, lY,'" "°!,tg� 'f�ffTG3',' ^r,' ': • e. tf, P • ttc too Ic. 1rncy . . t4fi� a rtoie City of Arcadia i _ Development Services Department Build• ing Division j: . . . . . . . ,..,..,..... �r .. . ,. , .. 1, .. . ... ., r This certificate issued pursuant to therequirements of the, A!%i* California Building Code certifying that at the time of issuance this structure was.in .. k � compliance with the various ordinances of the.City'regulating building construction or use. 2` c s • • ,-wig,. ` Permit No. ' :. TI=19=1799 . .,,,,, ..\.4.,,• , ,/,'„,,i Building,Address: .125 W.HUNTINGTON DR AVE ARCADIA,-CA.9.1007. - • • `�+ Permit Type: . . TENANT IMPROVEMENT Effective CBC: 20'16 C.B.C. . Occupancy Code: B . A1lp,,,‘ deZone Code: CG Final Date: 5-2'6-2020 Type oi'Construction: TYPE I].SPRINKLERED. R i.,.. • ' --)ir, �s' t • Owner: YG'PROPERTY INVESTMENTS LLC . tenant:USC BUILDING TA .1S1 FLOOR 1 Y A Kenneth Field';Building ficial.. • , . . . . . . . ' , . r , - Post in Conspicuous Placam. bi _ . . 'f , Ys ~ l�,( }� •RFYF5 c:',, + Tfwo,rtN. .^ ..,, F iuS �w P..�'. 2'i+s', .r/� S`i M ::letab.1 ,,,, SS,ru., *it,,,, Vl °°T.,�t , ,L � h - \ p � tt+rn iz F, ` - . . , _ • .,a - ',�u�'4t!: r�=-,. -�-`�`��a€s�u:.,, si� 0 �a f �f�� , .dY ,,��/ A4-.7,:o ..j .�l ,�r �-: \.... :'t,'' 4U S c :.' . 'V'' i- - w' 1. ,.. . ,Rig`-r's"??''1 2,7t „�iC. 1— �.,V:. -iit1hp II - '°a 1 t: ' � �". ;� ...�,; � a a �:.,�_-- '^u�W:��A� 4 'F� - '.'A, . � x - .,u�'.'k _ - .r �II�{�Y. -0.,V:.4 � $�. ,y a . ._ ., fist. '`wl' City of Arcadia, CA " � r b i� PerfflJtNo McCh 20 0623 �� Development Services Department " �M a` b _ r Penn t Type 2ChaniCaI 240 West Huntington Drive,Post Office Box 60021 I " walk Classi canon nMechanical Commercial Arcadia,CA 91066-6021 h (626)574-5416 ARCADIA Issue bate.o4/29/2020,1 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 125 W HUNTINGTON DR Arcadia, CA 91007 3050 5775015027 Contacts _ 6 VG PROPERTY INVESTMENTS LLC C/O Owner C E MECHANICAL INC Contractor MIKE Y S00 13327 Elliot AVE,Chino,CA 91710 125 W HUNTINGTON DR (909)548-0925 765670 O_ � � . . Description:MECHANICAL FOR BLDG A LEVEL 1 Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount payments Amount Paid Add/Alter Ducts $9.94 Total Fees $336.53 Air Handling Units<=10,000 cu ft per min. $119.68 Cash/Receipt#REC-04362-20 $336.53 Furnace or Burner<=100,000 BTU $139.02 Amount Due: $0.00 Mechanical Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 Ventilation Fan(Single Duct) $19.88 Total: $336.53 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. 427* GIGI April 29, 2020 Issued By: Date Page 1 of 1 April 29,2020 o1 &RQ44. GP%IFOiu.1q slampil ' PERMIT/PLAN REVIEW APPLICATION , `►� -44,0, • 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 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. ❑ 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 Signature of Contractor performance of the work for which this permit is issued. OWNER-BUILDER DECLARATION ElI 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 carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of ❑ 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 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 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. Signature Date PERMIT/PLAN REVIEW APPLICATION Development Services Department, 240 West Huntington Drive, Post Office Box 60021 ' ` Arcadia,CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 ONLINE PERMIT/PLAN REVIEW APPLICATION - CAMMCAMA Job Site Address: 125 W. Huntington Drive, Arcadia, CA 91007 • LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ElI 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. - E I have and will maintain a certificate of consent to self-insure for workers' License Class c2e License No. 765°10 Exp. Date 07/31/2121 compensation, as provided for by Section 3700 of the Labor Code, for theti� t ti _ performance of the work for which this permit is issued. Signature of Contractor '' OWNER-BUILDER DECLARATION 111i have and will maintain workers'compensation insurance,as required by Section the ❑I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for ens 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 Everest Premier Insurance,co demolish,or repair any structure,prior to its issuance,also required the applicant 7600020640191 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 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 0 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 04/29/2020 •-----Joel A.Hill sale(Section 7044, Business and Professions Code:The Contractors License Date Sigtiature ^^ 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. Ell, 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). tElI am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name 04/29/2020 ,_--Joel A.HillW7--3.1 -2 Date 5lgnature' / _ . ' 7: 7 \ 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 Joel HillProject Manager 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. 3gnature a„ loela HIt.m w ._._ __,.. ..•.ate Date 04/29/2020 .. '6' , r r J ` <City of Arcadia, CA ` Permit NO d:°;,". 0 Plum 0654- Development Services Department Permit Type Plumbing xa 240 West Huntington Drive,Post Office Box 60021 t Work Classification Plumbing Commercial. Arcadia,CA 91066-6021 I ; i (626)574-5416 ��• �� ��„� � ,ec� � � ;� Permit Status Issued ARCADIA Issue Date 05/05/20201 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 125 W HUNTINGTON DR A 1ST Arcadia, CA 91007-3050 5775015027 AAAA FLOOR Contacts _.� L VG PROPERTY INVESTMENTS LLC C/0 Owner PIPELINE PLUMBING INC* Contractor MIKE Y SOO 15510 ILLINOIS AVE,PARAMOUNT,CA 90723 .125 W HUNTINGTON DR (562)408-6483 669158 sea N. 4t AI*A AAAAN MMOMESEZIMMEMEMSF Description:PLUMBING FOR TI BUILDING A 1ST FLOOR Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Garbage Disposal Fee $13.21 Total Fees $380.60 Kitchen Sink $250.99 Cash/Receipt#REC-04405-20 $380.60 Lavatories $26.42 Amount Due: $0.00 Plumbing Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 ' Water Closet $26.42 5!/fj C.0 A4CO—Z___ Water Heater and/or Vent $15.55 ((– Total: $380.60 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. a .U. May 05, 2020 Issued By: Date May 11,2020 Page 1 of 1 s c) 1•1 , .,,,,,.. 1! �' PERMIT/PLAN REVIEW APPLICATION - �, ,, Development Services Department,240 West Huntington Drive,Post Office Box 60021 0mo4,,Y al 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 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 0 I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit License Law for the following reason(Section 7031.5,Business and Professions is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant 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 (Ts 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 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 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. Signature Date ' City of Arcadia, CA Permit No.EIec-20-0622 IA Development Services Department 'Permit Type:Electrical ' `a 240 West Huntington Drive,Post Office Box 60021 e Arcadia,CA 91066-6021 , ( ( r Work Classification Electrical Commercial - 1, : ' (626)574-5416 Permit Status:Issued A RCA D I A Issue{Date:04/28/2020'I Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1. 125 W HUNTINGTON DR Arcadia, CA 91007-3050 5775015027 Contacts VG PROPERTY INVESTMENTS LLC C/O Owner AMP'T ELECTRIC INC* Contractor MIKE Y S00 3121 E LA PALMA,ANAHEIM,CA 92806 125 W HUNTINGTON DR (714)204-0728 911942 It Description:ELECTRICAL FOR T.I.BLDG A Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 , Plan Check# Plan# , Fees Amount Payments Amount Paid Distribution Panel $49.44 Total Fees $334.37 Electrical Permit Issuance Fee $47.01 Cash/Receipt#REC-04347-20 $334.37 Light Fixtures $77.12 Outlets-Receptacles&Switches $159.80 Amount Due: $0.00 Solid Waste Management Fee 2 $1.00 • /J �/1 �j Total: $334.37 5/-&"—(. /;G4 ( C L__. 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. . ,a, :44.1}:e '740 April 28, 2020 Issued By: Date April 28,2020 Page 1 of 1 4ORc• p,,1 Rk,9 1 100104 7 PERMIT/PLAN REVIEW APPLICATION • Development Services Department,240 West Huntington Drive,Post Office Box 60021 m°anty of 0° 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 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 1:1I 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 ❑ 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 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 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. Signature Date • • ' c . PERMIT/PLAN REVIEW APPLICATION Development Serviees Department, 2 . '' ' ' ' 40 West Huntington Drive,Post Office.BOX 60021 5 \ i i . i 1.44 i, Arcadia,CA 91066-6021, (626),574-5416, Fax(626Y 447-9173 i • '04. I . ONLINE PERMIT/PLAN REVIEW APPLICATION cirvor 1:7,A01 A. . ..e.:-.- --..-.., .--7,_:- ,. Jab Site AildeesHttill.; ifitta-VD1c—teatilia—r,1G . ' ,,,, .., . LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 1:3 I hereby affirm under penalty of perjury that1 am licensed under provisions of fhereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section,7Q00,of Division 3 of the Business and Professions code,and my-lIcense is in full force and effect. ' E] 1 have arid will maintain a certificate of consent to self-insure for'Workers' cm , 'compensation, as provided for by Section 3700 of the Labor Code, for' the LicenseClassLicense No. 9.114.4 Exp. Date 202? ... ... performance of the,work for which this permit is issued Signature Of Contractor ,' .,..46,..,., - - '-' ' ,--- El I have and will maintain Workers'eompensation insurance,as required by Section OW.NER-BOIL,DIZ DECLARATION ' , 3700 of thel.abor CodeJor the.performance-of the work for which this,permit E 1.heretiyaffirm under penalty of perjury that 1 am exempt from the Contractors -is issued.My workers'compensation insurance carrier and policy numbers are: License Law for the,folloWing reason(Sectitin 2031.5,Business,and Professions Cade.Any city or county which requires a permit to'construets alter,improver Carrier Mid-CenhaV ,- demolish,or repairany structure,prior to its issuance,also,required the applicant Policy Number B0948-5131 - - for such permit to file a-signedstatement that he or she is licensed pursuant to the (This se etion need not be completed ifthe,permit•is.for one hundred dollars or less) provisions of the Contractbrs Licens,e Law(Chapter 9,(commencingwith Section. 7000)of Division 3 of the Business and Professions Cede).or that,he or she is El icertify that in the performance of the work forwhich-this pent-Mit issued:I shall exempt there-from and the:basis for the"alfegad exernPlitm•Any vialatibn bf - ,not employ any person in any manner so as'to become subject to the workers' Section 7031.5-by any applicant for a pennit subjects the,applicant to'a civil , , penalty,of not more than jive hundred dollam($500)): compensation Laws of California„and agree that if!should become subject to the ., workers'compensation provisions of Seeded),3700 of the Labor Code,"shall forthwith comply with those provisions. 'Fi I, as.owner of the property. or my-emPloyees'with wages as their,sole - , compensation,will do theyork;and the structure is not intended or offered,for Date 4. Signatur 2820, - . -.- — - ... :p , , ,, • .-, ,-, • , -- -;, sale(Section 7044,Business and Professions Coda:The Contractors License —.„ : ,, .„ Law'does not'apply to,antwiner Of prOperty'Who builds or iniproves thereon, or lid 'does such work, himself 'or herself or through his or her own employees.,prOVided that such improVements are riot intended or offered for WARNING:,Failure to secure Workers'CiimpenSation coverage is unlawful; safe.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 thathe or she, hundred thousand dollars.($100,000),in"addition to the cost of compensation, ... did not build or improve for the pittpbse orsale). 'damages as provided for in-Section 3706 of the Lab ' Code,:interest;and . attorney's feesi E]L. as owner of the property, an excItisively 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 LENDINp.AGENCY who builds or Improves thereon.'and who contracts for such projeetk with a I hereby affirrn.under•penalty Of perjury that there is a constrUCtion lending agency contractor(s)licensed pursuant to the Contractors License Law), for the performance of the work.for which this'permit is issued.(Section 3097, Civil Code). 0 J am exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name._ ... . . • . . Date Signature: - , ' '''''''• ''`.' .''''-,=-',_: ' '. Lender's Address . . .. . IMPORTANT:,APPLICATION IS-Ill MADE TO l'IJE 8C11:1)INCI ()MIMI, .14.)11 A PERMIT SUBJECT TO THE CONDITIONS AND RESTI1 ICIIONS Sifir cOterti ON MILS APPLICATION:AND VIE F-01.:Lf)')AtINC: I. The City's apprOved plant and permit inSpection card.must,remain on the job site.fdr 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 CbastAir.",,Quality-Managenient District(AQMD)regulations;renovation and remodeling work that results in the removal,stripping,or altering of asbestos.contairring materials:requires an asbestos survey and removal prior to disturbing the asbestos. Please contatt'AQMD at(909)396-2000 for. furtherinformation. , , Name 1\flik CastleThie President , , _ ......... -pgiNT NAME .. I certify,that I have read this application and state that the above information is correctand that I am the owner or duly'authorized agent of the.ownen I agree to'comply with all City.Ordinances and State Laws relating to building"construetiou. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned'property'for inspection purposes. Signatures ,-.:- - . -'- ' ''-' ',''; ': - ',. ,— .- Date 4.28. o _ . . _.. . ... . . . . .. . _ . ,..,., ,......... ....„,.. , ., . , , ...._ ____......„. "''''"-,--",-,-:-:;:7'5'W,,--,-:,"--' , !k SR ,:i,;;7-7',"'"''''',:':',..`,4".1'-',",,k,,,,' "w, S � City of Arcadia, CA -6,;;;,,,,,,~e„...:,ti.,,,',:,- k,a ,, , ,, Permit No FIRE 19 2518': me rez4 ^ ` r -,. Development Services Department ") v t*' r" i$taii `$Per(7jt Type Fire At-....- 240 West Huntington Drive,Post Office Box 60021 ; 1 r a • a: '• Arcadia,CA 91066-6021 2t° a 1 ,.. r'worrk ciassitiOnon Fire-,AlrYi' (626)574 5416 $ $ ott $ R ; F S a u „ Permit S,atus Issu d '„,,i"..'44s - - t, °aA "`rtea .` .:. .. ... P AC '. Asa / I ,1 Expiration: 06/14/2020 Issu6'Date 12 , =209 9. Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 125 W HUNTINGTON DR Arcadia,CA 91007-3050 5775015027 ,Contacts•= - -•"• .. VG PROPERTY INVESTMENTS LLC C/O Owner WEST COAST FIRE&INTEGRATION INC Contractor MIKE Y SOO 3199-D AIRPORT LOOP DR,COSTA MESA,CA 92626 125 W HUNTINGTON DR (714)878-4673 989173 Description:FIRE ALARM SYSTEM Valuation: $ 18,000.00 Tenant Total Sq Feet: 0.00 Plan Check#19-2518 Plan# Fees Amount Payments Amount Paid Fire Alarm Plan Check $840.00 Total Fees $1,258.86 Fire Issuance $47.01 Cash/Receipt#REC-03375-19 $840.00 Fire Permit Fees $370.85 Cash/Receipt#REC-03430-19 $418.86 Solid Waste Management Fee 2 $1.00 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. . . tv‘ip , _ . . 4i)ft. : ,,.... i 02 December 23, 2019 Issued By: Date December 23,2019 Page 1 of 1 of vs4 00 l' . a 17 PERMIT/PLAN REVIEW APPLICATION - 4,1 0j� Development Services Department,240 West Huntington Drive,Post Office Box 60021 m.oi•y a-* 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. 0 I have and will maintain a certificate of consent to self insure for workers' License Class G 10 Licen No. 1 . Date 12/3%119 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. ❑ I have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DECLARATION 3700 of the Labor Code,for the performance of the work for which this permit ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions Q ; I Code.Any city or county which requires a permit to construct,alter,improve, Carrier demolish,or repair any structure,prior to its issuance,also required the applicant policy Number 0 v. F.;1 e- for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt there from and the basis for the alleged exemption. Any violation of 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 j sale(Section 7044,Business and Professions Code:The Contractors License Date 2/Z 3( 1 cl Signature /�. z 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 l- VA res �'_a r b a�c t l Title PRINT NAME I I certify that I have read this application and state that the above information is cor4ect 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. \i_Signature e�G. Czt,C E ate 1 2—/ 2-5/1 9 1 City of Arcadia, CA �, .� a Perrz�rtNo FIE-2O—0129, Development Services Department (�� y � (� Permit Type Fi• re 240 West Huntington Drive,Post Office Box 60021 l E I xFs Arcadia,CA 91066 6021 ) ( pia f �} Work classification Fire,Sprinkler 1;Y-49-4'1 (626)574-5416 �ltt; �a ,' �� A tS Fnw,p;:4 Permit$CafUs Issued,) A 2CADIA � Issue Date 02%18/2029f Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 125 W HUNTINGTON DR A 1ST Arcadia,CA 91007-3050 5775015027 FLOOR Contacts VG PROPERTY INVESTMENTS LLC C/O Owner PENDENT CORPORATION dba AVALON Contractor MIKE Y 500 FIRE PROTECTION* 125 W HUNTINGTON DR 1261 N LAKE VIEW AVE J515,ANAHEIM,CA 92807 (714)616-0295 787301 Description:FIRE SPRINKLERS FOR TI BUILDING A 1ST FLOOR Valuation: $ 6,500.00 Tenant 62 HEADS Total Sq Feet: 0.00 1 Plan Check#20-0129 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $935.16 Fire Permit Fees $187.15 Cash/Receipt#REC-03664-20 $700.00 Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-03882-20 $235.16 Sprinkler Heads $700.00 Amount Due: $0.00 Total: $935.16 - 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. 4 e 40/0, February 18, 2020 Issued By: Date February 18,2020 Page 1 of 1 OF AIC 1~ �N�' PERMIT/PLAN REVIEW APPLICATION Development Services Department,240 West Huntington Drive,Post Office Box 60021 \y% Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 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' • -I License o. II wLrcense Class � Exp. Date q r3i 21 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 /[pit _� OWNER-BUILDER DECLARATIONillhave 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 f 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 f is issued.My workers'compensation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, ;u lj Carrier Z H5,ra,4CC (,,,r,,,1 0 p 4tie Vie5Y- demolish,or repair any structure,prior to its issuance,also required the applicant j Policy Number I/ FL-S Q 5r-1 17 5-..1G D 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 Ili 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 co ly 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 ate C Z Signature i �!� 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. � qq t j� / R 2^ Name (it(', �J ©e �/ 1 9 Title rid'L'G� Aia,,,g6, gr.. PRINT N U [f ;itj;; :7I 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. `? 1 agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of t1 Arcadia to enter upon the above-mentioned property for inspection purposes. OPP / _ ) } Signature a//i� _�._� Date Z i rg l/ZO ZU OV Ake loom Auryet S,19D3 4441 Unity Of MEMORANDUM Fire Department DATE: March 26, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 125 W. Huntington Drive, Building A, Levels 2 & 3 THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC#'18-679) 8-16-2018 Jill Perumean FIRE ALARMS (PC# 18-1008) 9-5-2018 Jill Perumean TANKS HOOD & DUCT KNOX BOX OCCUPANCY COMMENTS: Emailed Bldg. Dept. 3-26-2020 Rita 4 or Ake 4.1,241-14 ". 1 , Ir Mat:`. r* 4! oi --Ineorpon 90 aeu.t 3,1903 0,, ,,,..7 /`� ,„..ity air MEMORANDUM Fire Department DATE: April 23, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 125 W. Huntington Drive, Building A, Level 1 THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS FIRE ALARMS HOOD & DUCT KNOX BOX OCCUPANCY (PC# 19-1799) 4-23-2020 Jill Perumean COMMENTS: Emailed Bldg. Dept. 4-23-2020 Rita of Mk. 40 01,1,1F ORAr9 4 46 1013 Aaeurt 7.1903 L °a``y°i'6$ MEMORANDUM Fire Department DATE: March 26, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 125 W. Huntington Drive THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC# 18-1251) 8-16-2018 Jill Perumean FIRE SPRINKLERS (PC# 20-129) 3-20-2020 Jill Perumean FIRE ALARMS HOOD & DUCT KNOX BOX OCCUPANCY COMMENTS: Emailed Bldg. Dept. 3-26-2020 Rita 4 OFForyo Re I% -749;, 4:014 4aityot111.$ MEMORANDUM Fire Department DATE: May 20, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 125 W. Huntington Drive, Building A, Level 1 THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS FIRE ALARMS HOOD & DUCT KNOX BOX OCCUPANCY (PC# 19-1799)- 4-23-2020 Jill Perumean COMMENTS: Emailed Bldg. Dept. 4-23-2020 Rita