HomeMy WebLinkAboutUntitled City of Arcadia, CA - y ry: ,. Permit NO.'ROOF-20-1140'
` Development Services Department Permrt Type Roof
i y1 • 240 West Huntington Drive,Post Office Box 60021 �,
* a,, Arcadia,CA 91066-6021
Work'Classification Reroof Residential
.*.{)'"I'll.• ' (626)574-5416 Permit Status:Issued
A RCA D I Issue Date:07/24/2020
Expiration: 07/26/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
700 W WISTARIA AVE Arcadia,CA 91007-7969 5383024043
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Contacts
LIM,THOMAS AND CAROLYNE T TRS LIM Owner
FAMILY TRUST
700 W WISTARIA AVE
(626)802-7318
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Description:T/0 AND REROOF HOUSE AND GARAGE WITH Valuation: $ 15,000.00 i Tenant
CERTAINTEED LANDMARK,CLASS A DIMENTIONAL COMP OVER
NEW SHEATHING.COLOR: BURNT SIENNA Total Sq Feet: 0.00 Plan Check# Plan#
SArt -.. .g}: b YfA*S'.SY s"A.&IM��R.2M^.Vh-M'�s`aYSt'Od:`.nta'+33 4; 4 .t4' ."1vv. 4433.443 V.44 .VI aaaq�'.VAt`.34..... t.t&'%. '�.T....V.PI,t3.,.5 �w `vas.-. ,
Fees Amount Payments Amount Paid i.,
Building Issuing Fee $47.01 Total Fees $374.01
Building Permit Fees $320.75 Cash/Receipt#REC-05053-20 $374.01 _,
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $374.01 - .
• ili COMPLETED
8_26_Zo c,,;,,,4‘. eZEd("FP r5/110Perste. CALLS FOR INSPECTIONS
/�FF��aV 4T for by telephone
f� reqRequestuesting the addressinspection,timeframe e andat w626-574-5450.hat inspection Litem ave isa neededmessage
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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.
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July 24, 2020
Issued By: Date
July 24,2020 Page 1 of 1
of ARe
4 0,13
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PERMIT/PLAN REVIEW APPLICATION
Development Services Department,240 West Huntington Drive,Post Office Box 60021
o{N°e� 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 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
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.
0 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
AFFIDAVIT SELF ER i A QN.
FOR COMPLIANCE-9FsiMMOKO,ALARI .
MO CAREICN i6IIiV'lA*16E+r.:At..'„ I
Pr pArtJ. :ddr; ss '" t >: - e AVe: Ae+ dal-0;
_ 'ersit. Num �'_-.:Rct► ''.'..' e›.,:114` ;
BriefJob Description:-•" `'` -
Number of mot e-.alard s installed
'flAin r•.of" rbon.mono ide Alarms-Installed; ,
When alter tion repairs or additions eq shin pairrsst rr, r`sle o ing ros areci t :
Smoke alarmsshall e°installed in each`'sleeping room .arid outside each separate..
sleeping area in the immecilate vicinity of t e bedrooms ,;and on eats dditionai.;storyf tie:;
. dwelling,r tuding.''basernent and habitable attics .b s.required Section; 3'14-ot tt e 201 .
California"Residential Code (CRC)and California Health And,Safety .Section 1. ` 7:,
- For dwellings:or sleeping'units Oontainingluel burning appliances or having attached -
garages s rbon,monoxide alarms shall''bp' installed outside,;€each"'separate sleeping
area in the immediate r iciniity-of the bedroor , and.en, ch additional'story f the
• dwailing, including basements A }r quired, bySection 8315.of""the`.-of the"2010 !California
Residential.Code;(CRC):;
' ulti-purpose alarms:(combination,carbon monoxide.and smoke-alarms) ay e used.
Alf alarms shall comply*itis requirements far listing,and approval.by the ffice'of.the Mato Fire,
Marshall; tt'd Ii sf ":fire,ce.tos,WIli nsi ' titin s/.lice aselsstin II. b" i 'sears col g 4..
As owner of the above ref rence f p p r +`,:.I ereby° ►tify'that the smoke atai is and:carbon .
;mons:xide alarmshave ben installed:in pecOrdarice with tbo'manufacturers instr�uctionis' nd'r
compliance, ith,the code e ions r "er�n d.abp a .
l declare un erpenalty of perjury that the foregoing is true anti correct,and thatthis
eci ration was;executedon'(Dat , , 1c) .at Argadia;-Calif rnia
ner's Ramo(printe"dlty'pe )>' i s prr s .'L i r ' ;
Signature of Owner - .
.
This affidavit must° returned:to:the City of Arcadia inspector prior to final inspection,
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PER. MiriiPLAN:REVIEW
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AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: moo W. W;s-tctria Ave. Arcadio, CA Conon
Permit Number: tzooF-ao- ;ty.o
Brief Job Description: Reroo-
Number of smoke alarms installed: s
Number of carbon monoxide alarms installed: 3
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 2013
California Residential Code (CRC) and California Health and Safety Code Section 131'13.7.
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 2010 California
Residential Code (CRC).
Multi-purpose alarms (combination carbon monoxide and smoke alarms) may be used.
All alarms shall comply with requirements for listing and approval by the Office of the State Fire
Marshall, http://osfm.fire.ca.govllicensinglistinc sllicenselistinq bml searchcotest:php
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 and 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)- 0 9-5 12°2° at Arcadia, California.
Owner's Name (printed/typed): i h omas L;m
Signature of Owner: e7/6/1,/
This
This affidavit must be returned to the City of Arcadia inspector prior to final inspection