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HomeMy WebLinkAboutMECH-20-0772 City of Arcadia, CA it'" v d PermitNO Meech 20 0772 Development Services Department �� , ' �1 � < � � Permit Type Mechanical 240 West Huntington Drive,Post Office Box 60021 a ••. a �,; `- Arcadia,CA 91066-6021 <_ , .' Work Classification HVAC Repair/Replace, TW . , _ (626)574-5416 rs: z `^ Permit StatEis Issued_ A.RCA A y', < $issue fate 05/01/2020,1 Expiration: i,�, , a ., ,til.. Addr NO. . Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 630 W HUNTINGTON DR APT 0224 Arcadia,CA 91007-3428 5778001075 Contacts GRETEL HELLER Owner JORDANAIR INC* Contractor 630 HUNTINGTON DR 224 129 S HACIENDA AVE,GLENDORA,CA (626)963-3313 Description:REPLACE HVAC UNIT IN SAME LOCATION t Valuation: $ 0.00 Tenant (ROOFTOP). HERS REQUIRED FOR FINAL. 1. Total Sq Feet: 0.00 Plan Check# Plan# . .. ' Fees Amount Payments Amount Paid Compressor 3-5 Ton(3 to 15 hp) $36.35 Total Fees $104.22 Furnace or Burner<=100,000 BTU $19.86 Cash/Receipt#REC-04573-20 $104.22 Mechanical Permit Issuance Fee $47.01 Amount Due: $0.00 Solid Waste Management Fee 2 $1.00 Total: $104.22 C,,-66—Z-C, /47/144- j� ig c.EJyr° cobustAgr ©erreTaX LFi=s,XLrrci 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° ,,,, «r," ...„.4, June 01, 2020 Issued By: Date June 01,2020 Page 1 of 1 44 . FA0R F.16 _ 7 PERMIT/PLAN REVIEW APPLICATION Development Services Department,240 West Huntington Drive,Post Office Box 60021 m\Y% 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 ❑ 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 0 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). 0 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 niust 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 T PERMIT/PLANVIEW APPLICATI[4 N 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 A . • . 3S 'al IS: '�' b.IA .Job:Site.Address: /9 g/ 7. eIICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION hereby affirin•under penalty of perjury that'I aril licensed under provisions of I hereby affmrm'undei 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. tt��e/ El I have and will maintain a certificate of consent to self-insure for workers' License Class C- 4�. I:icense IVo. 5o€ .. exp. `^ 44ODate(J. compensation, as provided for by Section 3700 of.the Labor Code;for the pert Mice of the work.for Which this permit is issued: ,Signature of Condaci e %/i/- - ` _.-;- OWNER-BUILDER DECLARATIO 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 El License Law for the following reason(Section 7031.5;Business and Professions is issued.My ;orkers'corn ensation insurance c 'er and policy numbers are: • Code.Any city or county which requires a permit to constrict,alter,improve, Cartier L �` 7 ' - • demolish;or repair any structure,prior to its issuance,also required the applicant J for such permit to file a signed statement.that he or she is licensed pursuant to the Policy Number. (/(l/ 70 7. (This section need not be completed if the permit is for one hundred dollars or less) provisions of the Contractors License Law(Chapter 9(commencing with Section 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 0 - Section 70315 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 subjec the workers'compensation provisions of Section 3 00 of the-Labor C .I shall 0 I; as owner of the property, or my employees with wages as their sole forthwith comply with those pro ' ns, . • compensation,will do the work,and the structure is not intended or offered for % g /_ _ . sale(Section 7044,Business and Professions Code:The Contractors License Date [ CCV S'nature_ _ a ./_ ____ Law dries 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 seatre.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, as owner of theproperty, am exclusively contracting with licensed • contractors to construct the project(Section7044,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 contractors)licensed pursuant to the Contractors License Law). for the performance of the work for which this permit is issued (Section 3097, Civil Code). 0 I ant 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 TILE CONDITIONS ANI) RESTfIC"BIONS 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 strictures. 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)39672000 for further.information. //� / ��� Title (/ 1 . . Name� �� � _ 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 St.te Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the• e ove-menti ed pro,- or inspection purposes. L-- / , 0 Signature Date �� ! — 05/01/2020, 05:08PM 7148411551 ACUPUNCTURE 8, CHIRd PAGE 01/01 • • 4i..#,•-r• • • .t).1 • 4.tww. !•• AFFIDAVIT SELF.CgRTIFICATION FOR coilIPLIMOECT SZOKE ALArtritS Aiii?CARSON MO OXIDE.ALARMS Property Addreas: # 11/ 1,019 / _636 0 A.Ar '0,042.7‘ Permit Number__A/15 CIL:Z-6)72- Y. $rief Job Oascrptoi It1 oat: Number of arnoke alarms installed: ' Number of carbon monoxide alarms installed: 15'9 When alterations, repairs or additions requiring a permit occur,or sleeping Morris are created, Smoke alarms shall be installed in each sleeping roorn, and outside each separate • sleeping area in theirorylkjelei the be and on each adthtion story of tl'e &Licitly; inciuding basements and habitable attics es required by Sootier!R314 Of the 2016 California.Residentlai Code (CRC)and California•Health and Safety Code Section t3113i7. . For dwellings or sleeping units containing fuel burning appliances or having attached garages,carbon rnonmdde alarms- shall be installed outside each separate sleeping : area in the immediate viol* of the bedrooms, and on each additional story of the dwelling, including basements es required by Section R315 of the of the 2016 California Residential Code(CRC). muiti-purpose alarms(combination carbon monoxide and smoke alarms)may be.used All Warmth, snail comply with requirements for fisting and approval by the Office Of the State Fire MarShal, ntiD://cstm rag sa_Lia-Lacec) jagirsti searchootest.clui As owner of the above referenced property, I hereby certify that the smoke alarms and carbon monoxide alarms have been installed In accordance Will the manufacturer s Instructions and in compliance with the code sectiOns refereilcad above. Iitientare under penarcy of perjury that the•foregoin6m true and correct,and that this declaration was executed on (Date) • atArceielle, California. ‘r Ownes Maine (priniedi xed)i - .* " Np. err Signature of Owner' This affidavit rnusi be returned to the City of ArOadla inspector prior to final irlaPe tion • • • •