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'C'',5,..,, (AP use only)
\� 1.> 1 ACCOUNTS.PAYABLE CHECK REQUEST
N%
Y.,y;.;r I Request Date Department rtment DSD - Development Services.
'-. .1----1 Check Payable to WHITE MECHANICAL INC
CITY°F. Address
27221 BURBANK
ARCADI1A-1
City,State,Zip Code FOOTHILL RANCH, CA 92610
INVOICE NUMBER(S)
(if applicable).
ACCOUNT NUMBER(S) AMOUNT ,
001-3105
$ 71.18
TOTAL CHECK AMOUNT $ 71 .18
Reason for Payment
, REFUND.TWO MECHANICAL PERMITS. BUSINESS CLOSED DOWN AND NO
LONGERNEEDS MECHANICAL.SYSTEM. PERMIT 20-1078 & 20-:1082
APPROVED BY(MUST BE SIGNED BY AUTHORIZED SIGNERS) :' • •• • • '
Signature Date.Approved ///4/20
7/
7
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 111
VR112019
•
fiLT. " r `+ MYyNar .,A
City of Arcadia, CA Permit ivo Mech 20 108.2'
Development Services Department , .. �y �t-..°s Permit Type Mechanical.
240 West Huntington Drive,Post Office Box 60021 'r
-- Work Classification =Mechanical,"'Commercial.
Arcadia,CA 91066-6021
r (626)574-5416 'Permit Status.Issued
k n
f2IIIssueDate 07/16/2020,1 Expiration: 07/16/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
•
1211 • E Foothill BLVD Arcadia,CA 91006-2509 5771028038
Contacts
RALPHS GROCERY CO C/0 PROPERTY TAX Owner WHITE MECHANICAL INC Contractor
211 E FOOTHILL BLVD 27221 BURBANK, FOOTHILL RANCH,CA 92610
1
(949)716-8379 822474
Description:REPLACE 2 TON SPLIT HEAT PUMP SYSTEM (LIKE Valuation: $ 0.00 Tenant
FOR LIKE)
Total Sq Feet: 0.00 4 Plan Check# Plan#
Fees Amount Payments Amount Paid
Air Handling Units<=10,000 cu ft per min. $14.96 Total Fees $82.83
Compressor<3 Ton(up to 3 hp) $19.86 Cash/Receipt#REC-04981-20 $82.83
Mechanical Permit Issuance Fee $47.01
Solid Waste Management Fee 2 $1.00 Amount Due: $0.00
Total: $82.83
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.
July 16, 2020
Issued By: Date
July 16,2020 Page 1 of 1
of
O~4 w 1416
_ a ire k PERMIT/PLAN REVIEW APPLICATION
0, insidi up
0o j` Development Services Department,240 West Huntington Drive,Post Office Box 60021
mbaa,,,of W Arcadia, CA 91066-6021, (626) 574-5416,Fax(626) 447-9173
City of
Arcadia
ICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION
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
LICENSED
Code,and my license is in full fore . ,ffect. ❑ I have and will maintain a certificate of consent to self insure for workers'
icense Class C70 compensation,or
se No. ,� Exp. Da.40i ��_ compensation, as provided for by Section 3700 of the Labor Code, for the
ir i' performance of the work for which this permit is issued.
Signature of Contractor - r
OWNER-BUILDER DECL TI ❑ 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 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 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 X71, Z'Z Signature
-
//7"
sale(Section 7044,Business and Professions Code:The Contractors License a ate
dfr
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 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.
Imi.„,e 6e6-0& �� e- /�Title /
PRINT NAME
II 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.
B gree 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.
f
Signature Date 007/b/Z62.0
{{ _ t}ui&Va r $� AAA m
tS
z City of Arcadia, CA 4< ',,,,,,,,,i'':.;•:6.,.k Pe mit No McCh 20 107$
, � Development Services Department :,S, i � , °4 a hp Permit Type M2chanical°_3
s 240' West Huntington Drive,Post Office Box 60021 ;:
Arcadia,CA 91066-6021 fp * Work Classification HVAC Repair/Replace
r. (626)574-5416 A`, Permit Status Issued
•
. ADI • _ ,;„ Issue Date 07/16/20201 Expiration: 07/16/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
298: E :-..' , •: LIVE OAK AVE Arcadia,CA 91006-5629 8572002010
°I,*,,K ,,,li\,,\is,,,,114,1, 1%, `.C..1/44,,,I, ,,,*
Contacts
I.
ABS CA 0 LLC C/O PROPERTY TAX Owner WHITE MECHANICAL INC Contractor
0 PO BOX 990,MINNEAPOLIS,MN 55440 27221 BURBANK, FOOTHILL RANCH,CA 92610
(949)716-8379 822474
aSAe J, ,,, 1@ \1A,. W ., K >s ", .Rli &L`�,1 ��:c .Sc? aFf,k,epi ftl.,-V0,4.tlatftuit
Description: REPLACE 4 TON HEAT PUMP (LIKE FOR LIKE) Valuation: $ 0.00 s Tenant
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 $84.36
Mechanical Permit Issuance Fee $47.01 Cash/Receipt#REC-04979-20 $84.36
Solid Waste Management Fee 2 $1.00
Amount Due: $0.00
Total: . $84.36 --
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
. ' ---V • 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.
July 16, 2020
Issued By: Date
July 16,2020 Page 1 of 1
j __
it wEREE .'
PERMIT/PLAN REVIEW APPLICATION
0.‹...1..- je Development
Arcadia,Services
CAp9 066-6021artment, 0 West(626) 574-5416 FaxDrive, Office Box 60021
, (626)
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 d ect. 11,, ❑ I have and will maintain a certificate of consent to self insure for workers'
License Class �7� License No. �Z�i � Exp. DateCJII 2021 compensation, as provided for by Section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
ignature of Contractor „
OWNER-BUILDER DELLA' TI40 have and will maintain workers'compensation insurance,as required by Section
IDI 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.M workers'compensation surtance bier and policy numbers are:
Code.Any city or county which requires a permit to construct,alter,improve, Carrier e �� r i L
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 Ice that 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 7031.5 by any applicant for a perp it 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
werkers'compensation provisions of Section 3700 of the Labor Code,I shall
fee with compl with those provisions.
❑I, as owner of the property, or my employees with wages as their MID,
/ /
compensation,will do the work,and the structure is not intended or offered for .) / d'OW'
sale(Section 7044,Business and Professions Code:The Contractors License
o' /o�f•L_ Signature -�
•Law does not apply to an owner of property who builds or improves thereon, • 07 I. ZGAl, 1,
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 'IRE 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.
Ir . ti
: e e ��I wr t7 Z Title /4/Cr .
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.
I agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
V,',rcadia to enter upon the above-mentioned property for inspection purposes.
IC, i / /
1 gnature ``, Date d 7/f��Zd Z d
I
•
Eric Pagliotti
From: John Lopez <jlopez@whitemechanical.com>
Sent: Tuesday, November 3, 2020 12:46 PM
To: Eric Pagliotti
Cc: Justin Stecker; Sandy Arlasky
Subject: Arcadia Wells Fargo HVAC Permitted Projects Canceled
CAUTION:This email originated from outside your organization. Exercise caution when opening attachments or clicking links,
especially from unknown senders.
Eric
As discussed we have 2 projects for Wells Fargo that recently closed these locations due to the COVID. Permits were to
replace HVAC mechanical equipment these projects have now been canceled. Below are the locations and permit
numbers.
PERMIT- MECH-20-1078
298 E Live Oak Ave,
Arcadia CA 91006-5629
PERMIT- MECH-20-1082
211 E Foothill Blvd, -
Arcadia CA 91006-2509
Please refund any associated costs to:
•
White Mechanical Inc.
Lic#822474
27221 Burbank
Foothill Ranch CA 92610
Thank you
John Lopez
Commercial Installation MGR, Sales
White Mechanical Inc.
27221 Burbank
Foothill Ranch,Ca. 92610
jlopez@whitemechanical.corn
949.716.8379 Office
949.521.6074 Direct Line
949.456.5328 Cell
949.716.8539 Fax
1
of ARc
P PERMIT/PLAN REVIEW APPLICATION
111M. -MO
E ' Development Services Department,240 West Huntington Drive,Post Office Box 60021
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
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 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 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
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).
❑ 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.
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