HomeMy WebLinkAboutDEMO-20-0269 , ay, nye,4 b r .. t
`- Perm�tNo Demo 20 0269,
R ;, Citq-of Arcadia, CA ;
,,;� i .t , Development Services Department kf ,n,-,-,\ ) aPerrriitType De"m011�tiOn`
240 West Huntington Drive,Post Office Box 60021 >= 3 F ( A �.
g� I -J I i-- i Work Classification:Demo".Residential
.",-.:-°:1. ;�� Arcadia,CA 91066-6021 ems} �,�,_,r �1 r.� �
"_lt (626)574-5416
Ma Permit Status:Issued '
3a
ARCADIA Issue Date 02/13/2020-1 Expiration:
"
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
78 W SANDRA AVE Arcadia,CA 91007-8522 5788020051
Contacts
LEE,PATRICK H AND HELEN S TRS LEE Owner
FAMILY TRUST
78 W SANDRA AVE,ARCADIA,CA 91007-8522
Description:DEMOLISH ILLEGAL STRUCTURE ATTACHED TO Valuation: $ 0.00 4 Tenant
GARAGE(SEE SITE PLAN)
ft Total Sq Feet: 0.00 i Plan Check# Plan#
-W. "...�maa"
Fees Amount Payments Amount Paid
Building Plan Check Fee Residential $50.00 Total Fees $103.26
Demolition Permit Issuance Fee $47.01 Cash/Receipt#REC-03868-20 $103.26
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $103.26 -
3- (s-- COMPLETED
t.,4 i o
- i-14
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.
February 13, 2020
Issued By: Date
February 13,2020 Page 1 of 1
�4 1ARC'qd ,
.;• 0_ PERMIT/PLAN REVIEW APPLICATION
/111\\..c
'E a• Development Services Department,240 West Huntington Drive,Post Office Box 60021
o %
yArcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173
City of
Arcadia
LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
0 Ihereby 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
❑ 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 ay--that if I should become subject to the
workers'compensation provisions of S c .6 37)0 of the Laboi+yade,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 X713.Zo?-0 --`` .' 1 ,► ,�
sale(Section 7044,Business and Professions Code:The Contractors License -TDateSignature _n v.-
Law
Law does not apply to an owner of property who builds or improves thereon, -
or who does such work himself or herself or through his or her own .
employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer-to criminal penalties and civil fines up to one
completion,the owner-builder will have the burden of proving that he or she hundred thousand dollars($100,000),in addition to the cost of compensation,.
did not build or improve for the purpose of sale). damages as provided for-in Section 3706 of the Labor Code, interest, and
attorney's fees.1:1 I,I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractors License Law does not apply to an owner of property CONSTRUCTION LENDING AGENCY
who builds or improves thereon, and who contracts for such projects with a I hereby affirm under penalty of perjury that there is a construction lending agency
contractor(s)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Busines d Professions Code,for this reason:
AP Lender's Name
Dae,..29a- t. Y S tune — e �� Lender's Address
APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS AND
S�TRICTIONS 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. / /
iftamreORTANT:
iA ! Title £W A
NAMEtertify that I ha 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 't a City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter up h:>T- i ve 1'entio I ed • ,•rty for inspection purposes.
I/ I , A 1 - , V -1c-J-Qac;J
gnature Date
I
orr�' d 'r�RC NM A '
Development .,
rrvices D
e
;arteent
il) , ' - ROVED
c4 i.'
i_ This set of plans an ..Ee(iti( lt) Ilti must be
kept
on the 6)E)atl . ltno changes or alterations
shall he made<\ , t hy the EilCi:g Division.
The StaanE)ial':ad►f thEilsl andandspecification shall not
t
xrrlit or�,,he and al)Pror aE of the violation
heh!�icitoE '
of an provisions,a ;lli'city ordinance or stateEilv`
a
s�6"� a — - s '7 s`-6171
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I . 3w r permrtNO DernO 20 0292
City of Arcadia, CA pd ,
Development Department r ° ^ `` �
P p it , �Perm�tType Demol�tion �
".t 240 West Huntington Drive,Post Office Box 60021 *' ' r M,
Arcadia,CA 91066-6021 10 "� ,3 u� i , Work Classrf7cabora Demo/Pool.
i (626)574-5416
= M� t Permit Status Issued
A CAD IA �Iss4e1Date 02%19/2020 Expiration:
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
78 W SANDRA AVE Arcadia, CA 91007-8522 5788020051
. .
Contacts
LEE,PATRICK H AND HELEN STRS LEE Owner
FAMILY TRUST
78 W SANDRA AVE,ARCADIA,CA 91007-8522
Description:DEMO INGROUND POOL AT REAR OF HOUSE 97 PF Valuation: $ 0.00 s Tenant
Total Sq Feet: 0.00 s Plan Check if Plan#
Fees Amount Payments Amount Paid
Demolition Permit(Pool/Spa Backfill) $53.00 Total Fees $106.26
Demolition Permit Issuance Fee $47.01 Cash/Receipt#REC-03898-20 $106.26
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $106.26 -
331 -7,
gcr!'ToM l'tbI ti,l, E10
PlE[[
,-- 6.--2 () CALLS FOR INSPECTIONS
\ Request for inspection by telephone at 626-574-5450. Leave a message
P�x>L a�� �Vf1_w"1 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.
•
February 19, 2020
Issued By: Date
February 19,2020 Page 1 of 1
of ARc
ti4_,400 ''946
cl -111 PERMIT/PLAN ItVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
0mtiai.Y o(N 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
Signature of Contractor performance of the work for which this permit is issued.
OWNER-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'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 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 agr;e : if .hould become subject to the
workers'compens• ion provisions of Se 'on 711 of L• ejli".ode,I shall
❑I, as owner of the roe forthwith co 'ply ith those rovisions.
property,rty, or my employees with wages as their sole
compensation,will do the work,and the structure is not intended or offered for W�, I ��
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.
0 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 Co :ctors License Law). for the performance of the work for which this permit is issued (Section 3097,
Civil Code).
❑ I am exempt under Section 7044,Busines- . . ' of-lions C'.de,for this reason:
Lender's Name
t
CC
firer
V Ade
Date Signature Lender's Address
ORTANT: 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 P_P' l Title _0_0_,_____Q __
�
PRINT NAME
I certify that I hay:read his a;, ication and state tha • above information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply . th 11. , or:i jj-ances and,:s#Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter us i n t e ab v,- i enioned pr1-�,J.1 r inspection purposes.
Signature Date C:97( 13 (-70c-2-2
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