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ROOF-20-0494
°� City of Arcadia, CA . ,v PermitNO ROOF 20 0494 �� r Development Services Department , �' � ti ,o Perms T, a ROOf� .`1- 240 West Huntington Drive,Post Office Box 60021 rs'' r '`` , YP Arcadia,CA 91066-6021 i t ',...'''''l i r' Work lass he ation RerOOf Residential `* (626)574 5416 ' ' x • 4i ' za, ti ` t 't 4Permit Status Vie' x ., yaw a +„:.F & .,, r...,..70-,7g,::'-'1, p%L .. h� Issue Date`I Expiration 1 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 425 SANTA CRUZ RD Arcadia, CA 91007-3035 5775013018 _ .• .r :: .. Contacts MO,JEROME F Owner SEDONA WEST ROOFING INC* Contractor 425 SANTA CRUZ RD 129E Colorado#443,Monrovia,CA 91016 (626)294-1909 891842 t. 4:, ,8 x..84, ,, Description:T/0 AND REROOF HOUSE AND GARAGE WITH Valuation: $ 10,500.00 Tenant CLASS A DIMENTIONAL COMP (OWENS CORNING,DURATION COOL 50 YR)OVER EXISTING SHEATHING.COLOR:FOREST Total Sq Feet: 0.00 Plan Check# Plan# BROWN REPLACE DAMAGED PLYWOOD WHERE REQUIRED �t S - �� Fees Amount Payments Amount Paid Building Issuing Fee 4.-- $47.01 Total Fees $307.21 Building Permit Fees $253.95 Cash/Receipt#REC-04180-20 $307.21 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total:.-- $307.21 - l'-/2(1.-ge) 3" e07gfr . e___ 9-/t 00 42m( 6L 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. '/')Oke de/leelri -(‘ --. (?g/7 %tC0(/711 4'! '‘ h•g'SL- 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. li*°''' e 84E1;.f-1, Issued By: Date April 01,2020 Page 1 of 1 ne vs. Of " r • PERMIT/PLAN REVIEW APPLICATION- `� .•,e7:7111\\mac �! Er Development Services Department,240 West Huntington Drive,Post Office Box 60021 ,ty% Arcadia, CA 91066-6021, (626) 574-5416,Fax (626) 447-9173 City of Arcadia ei il."-1-11 DP("li } LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 1 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 rofessions Code,and my license is in full force and effect. License Class IJ I have and will maintain a certificate of consent to self-insure for workers' �- License No. 1 �Z Exp. Date 071`2.7) 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 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 is issued.My worker 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 A-tA demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number (p t - ��l, for such permit to file a signed statement that he or she is licensed pursuant to the ed 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 Elcertify 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)): �ompensation Laws of California,and agree that if I should become subject to the 4orkers'compensation provisions of Section 3700 of the Labor Code,I shall ElI, as owner of the property, or my employees with wages as their sole forthwith comply ly with those provisions. compensation, dateation,will do the work,and the structure is not intended or offered forI ` l 12 � t �sale Section 7044,Business and Professions Code:The Contractors License u 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 I'HL 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. a lam _ I,uivU ) t V'\ \ Title ?�Prl�' PRINT NAME r `;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. 4,1Tiagree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter u nnJth�above-me coned property for inspection purposes. rgo L r:,,. ( I,L Oti I IA Ili° 1;:�gnature Date t . ., -. ? fr. AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS - AND CARBON MONOXIDE ALARMS Property Address. (4 VAT\ _,‘,1\1t4,. \Oca ( Piynx kin ' LaC) Permit Number: `) .0— 01--10tLA: Brief Job Description: c e.)-- cc© Number of smoke alarms installed: Number of carbon monoxide alarms installed: \ , When alterations, repairs or additions requiring a permit occur, or sleeping rooms are created, Smoke alarms shall be installed in each sleeping room, and outside each separate , sleeping area in the immediate vicinity of the bedrooms, and.on each additional story of the _ dwelling, including basements and habitable attics as required by Section R314 of the 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. • s. For dwellings or sleeping units containing fuel burning'appliances or having attached • garages, carbon monoxide alarms shall be installed outside each separate sleeping . area in the immediate vicinity of the bedrooms, and on each additional story of the dwelling, including basements as required by Section R315 of the of the 2016 California : :Residential Code (CRC). . . - Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used. . Fire ' - All alarms shall comply with requirements for listing and approval by the Office of the State F - - Marshal. http://osirn.fire.ca.govilicerisinglistinas/licenselistino bml searcist..pho As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed in accordance with the manufacturer's instructions arid in compliance with the code sections referenced above. I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on (Date) ) V V) _._ at Arcadia, California. . A, Owner's Name (printed/typed): I' iff Q •/1/ -____ ' Signature of Owner: This affidavit must be returned to the City of Arcadia inspector prior to final inspection • • '110 ,_ r A4,:dt:.1- { . 1 Guest JZ.tpOf1i u _w Dath oufl Ti 0 Storage i 1 _ . i+$titily 11000 aim GilIllgr II` ST FLOOR PLS C- iv SMOKE ALARM LI CArt ON MONOXIDE ALARM , �1! wr� sig { 0 ivinsier I3edronm Dining Room 10 } 11011 Closet Closet Chggt :t,, — -- - '.�w! Ilodroont i odrot n` SECOND FLOOR PLAN 1 SM'iNE At.ARRO ' CARBON MONOXIDE AL 2\7314. .