HomeMy WebLinkAboutDEMO-21-1215 ',� A1a gf,xi 0���' 0R
01144 City of Arcadia, CA Per`m�tNO Demo 20 1215'
Development Services Department s ; , �'' , PerrnrtType aD2m011tioh
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240 West Huntington Drive,Post Office Box 60021 � ,» �d � �� � �
.t. Arcadia,CA 91066-6021' �� i r f WorkClassification Demo-'Residential,.°
f t (626)574-5416 -x-t a-z� + PfmitSltLS'
ISSUedQ
ARCADIA ,, '' Issue;pate 08/19%2020 I Expiration: 08/19/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit •City,State,Zip Parcel Number
309 E FLORAL AVE Arcadia, CA 91006-2504 5772019013
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Contacts
MENG NIAN NIU Owner ORTIZ DEMOLITION INCORPORATED* Contractor
309 E FLORALL'AVE,,"ARCADIA,CA 91006 3045 S ARCHIBALD AVE H310,ONTARIO,CA 91761
(626)340-9458 mniu2008@gmail.com (213)216-4405 902123
Description:DEMO HOUSE/GARAGE IN PREP FOR SF NEW. Valuation: $ 0.00 Tenant
REFUND DEMO BOND TO 532 W LEMON AVE ARCADIA CA
91007 JINGYANG HE 6263409458 Total Sq Feet: 1.793.00 Plan Check# Plan#
Fees Amount payments Amount Paid.
Bond for Demolition $1,793.00 Total Fees $1,988.53
Demo-Sewer Cap and/or Cesspool Fill $16.48 Cash/Receipt#REC-05253-20 $1,988.53
Demolition Permit $77.78
Amount Due: $0.00
Demolition Permit Issuance Fee $47.01
Plumbing Permit Issuance Fee $47.01 '
Solid Waste Management Fee $6.25
Solid Waste.Management Fee 2 $1.00 compiErED
Total: $1,988.53
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.
•
sP
August 19, 2020
Issued By: Date
August 19,2020 Page 1 of 1
7 PERMIT/PLAN REVIEW APPLICATION
N 01
. ..j. Development Services Department,240 West Huntington Drive,Post Office Box 60021
mmtia«yo'Ste 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 t1'24 License No. /OM 13 Exp. Date 2-31-2''( 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
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
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 51--12V—rf --VU%Jn
demolish,or repair any structure,prior to its issuance,also required the applicant
Policy Number V-1 0 kt�s I
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
❑ I cethat 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 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 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
ate S''' 19,LW-0 Signature
sale(Section 7044,Business and Professions Code:The Contractors License
Law does not apply to an owner of propertj%ivja;bililds'or improves thereon,
or who does such work himself or herself or ;tliroiigh''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 penaltiesandcivil 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 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. ^
�
ame Oserf - 0/2-77Z V)Title 1,0 /0-1(
PRINT NAME
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.
agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter upon the above-mentioned property for inspection purposes.
Ignature Dite
(Zt • 11. boto
VE#
' : (AP use only)
ACCOUNTS PAYABLE CHECK REQUEST
VILI/i/f
,'! Request Date 11/09/2020 . Department Building
} ' \ JINGYANG HE
Check Payable to
CITI'OF
AIcADIA Address 532 W LEMON AVE
' City,State,Zip Code ARCADIA CA 91007
INVOICE NUMBER(S)
(if applicable)
ACCOUNT NUMBER(S) AMOUNT
714-2275 $ 1,793.00.
$ .
$ .
TOTAL CHECK AMOUNT $ 1,793.00
Reason for Payment
Please process a demolition bond refund,to the above recipient.
Job-Address. 309-E FLORAL AVE_
Permit# 20-1215
•
APPROVED BY"(MUST BE SIGNED BY AUTHORIZED S NERS)
Signature Date Approved ///1/2.e,
2nd SIGNATURE REQUIRED FOR ANY CHECK AMOUNT OVER$2,500
Signature Date Approved
ACCOUNTS PAYABLE USE ONLY
Check here if check is to be ❑ Reviewer's Initials
returned to Department
VR112019