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Home My WebLink AboutMECH-19-2190 • City. of Arcadia, CA Permit No Mech 19 2190.k i` ' l� ; Development Services Department w v Permit7ype Mechanlcdh • /'a" ` 240 West Huntington Drive,Post Office Box 60021 t Arcadia,CA 91066-6021 } �off(Classification:-HVAC Re air,' Re lace: (626)574-5416PermitStafus Issued ARCADIA .- - Issue Date 10/29/2019°I Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 827 CAMINO GROVE AVE Arcadia, CA 91006-4441 _ 5780023052 Contacts CHANG,GEORGE K TR GEORGE K CHANG Owner PLATINUM REPAIR INC Contractor FAMILY TRUST 11647 SWINTON AVE,GRANADA HILLS,CA 91344 827 CAMINO GROVE AVE (323)328-1125 991.373 Description:REPLACE EXISTING 3 TON CONDENSER,EVAP COIL, Valuation: $ 0.00 Tenant HERS TEST REQUIRED FOR FINAL Total Sq Feet: 0.00 Plan Check# , Plan# Fees Amount payments Amount Paid Compressor<3 Ton(up to 3 hp) $19.86 Total Fees $67.87 Mechanical Permit Issuance Fee $47.01 Cash/Receipt#REC-02928-19 $67.87 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $67.87 - -3-I i,NeArL OK .tv\I CALLS FOR INSPECTIONS. Request for inspection by telephone at\626-574-5450. Leave a message corequesting the address,timeframe and Y,hat inspection item is needed. PL F1'E D 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. 7r C44,6014 Mo&lbX(Oe smove ,4 f5 tAseeeV or•16) ) `1613. October 29, 2019 Issued By: Date October 29,2019 Page 1 of 1 • ,, PERMIT/PLAN REVIEW APPLICATION ` T Eoli`�' Development Services Department,240 West Huntington Drive,Post Office Box 60021 om\y o , Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia . iiii LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION a 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 . • Professions Code,land my license is in full force and effect. I have and will maintain a certificate of consent to self insure for workers' - License Class l..- ZO Lic- o. �9 - Thi xp. ate3 3 compensation, as provided for by Section 3700 of the Labor Code, for the P �_- performance of the work for which this permit is issued. Signature of Contractor /�� -�� r 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 Code.Any city or county which requires a permit to construct,alter,improve, Carrier e., NI �+ demolish,or repair any structure,prior to its issuance,also required the applicant IIS' L--,-..:—( /.._., '— for such permit to file a signed statement that he or she is licensed pursuant to the Polic Number provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need not be completed if the permit is for one hundred dollars or less) 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt there from and the basis for the alleged exemption. Any violation of 0 I certify that in the performance of the work for which this permit is issued,I shall Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should-become sem: - o the workers'compensat' n provisions of Section 3700 •f •e L. 9.0•;000,r.1 ❑I, as owner of the roe forthwith co ply w' those provisions. ��i� property,Pty, or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for `6 2 f / Signature /�/ �� . sale(Section 7044,Business and Professions Code:The Contractors License Date / _ J • r. 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. • e if-6(<- / c Ai G r"S Title PRINT N I certify that I have read this application and state that the above info • . T• is correct and that I am the owner or duly authorized agent of the owner. I agree to comply with all Cit s dinanc•: .nd State r• . • , o building construction. I hereby authorize representatives of the City of Arcadia to enter upon the . •ove-••e •ne• •roper :'i•.t' 0 - tl i i ses Si:nature _41111(41---- • - ji Date r