HomeMy WebLinkAboutUntitled (2) ' Permit.NO. Plum-20-1070/
'` City of Arcadia, CA
„. Development Services ''', ,+2;Of ; M - Permit Type=`Plumbing,
F ArO diasCA 91066t-60211Wet Huntingon Dive,Post Ofice Box 600z1 a ; Work ClaSsificaboM Water Heater
47+.$ ;te•;f (626)574-5416
Permit Status:Issued
'ARCADIA 4 Issue°Date:07/15/20201 Expiration: 07/15/2021
Addr NO. Dir Prefix Street Name - Street Suffix Unit City,State,Zip Parcel Number
•
802 . • W • • NAOMI AVE UNIT B Arcadia, CA 91007-7550 5383031045
Contacts
KAREN&EARLE LEVINE Owner A.R.S./Rescue Rooter* Contractor
802 W NAOMI AVE B,ARCADIA,CA 706 W Arrow Grand CIR,Covina,CA 91722 It
(626)627-8284 (6.26)858-9284765155
Description:REPLACE WATER HEATER IN SAME LOCATION Valuation: $ 0.00 Tenant
Total Sq Feet: 0.00 i Plan Check# Plan#
Fees Amount Payments Amount Paid
Plumbing Permit Issuance Fee $47.01 Total Fees - $63.56
Solid waste Management Fee 2 $1.00 Cash/Receipt#REC-04971-20 $63.56
Water Heater and/or Vent $15.55
Amount Due: $0.00.
Total: •$63.56 -
7-z4,, j74,4( a._ ?;1 COMPLETED
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.
•
1)(
July 15, 2020
Issued By: Date '
July 15,2020 Page 1 of 1..
•_ PERMIT/PLAN REVIEW APPLICATION
it . �
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• .'� Development Services Department,240 West Huntington Drive,Post Office Box 60021
°°,.Y°tN°�`° Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173
City of
Arcadia
LICENSED CONTRACTOR'S i 'CL, ' ,TION WORKERS'COMPENSATION DECLARATION
I hereby affirm under penalty of perjury ,'at I am licensed under provisions of I hereby affirm under penalty of perjury one of the following:
Chapter 9(commencing with Section 7 t 00,of Di ' ion 3 of the Business and
Professions Code,and my license is• llfor - •t d effect. 0 I have and will maintain a certificate of consent to self-insure for workers'
License Class C3 4 Licen: , . � �_ Exp. .to 7'3I • " 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
0 I hereby affirm under penalty of perjury that I am exempt from t e 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 . d Professions is issued.My or�cers' mpen�satioon in urance arrier and policy numbers are:
Code.Any city or county which requires a permit i. construct, .'er,improve, Carrier L-6 l.3LV
r "id L/01
demolish,or repair anystructure,prior to its issuance, . s. t ed the applicant A r� i
p nt Policy Number v/3 • lD 3 - cjO ' I U/�
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 o ndr 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 pe r'.'t 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 becoPr
a sugject to the workers'
penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I•tould;eco 'e subject to ..•
workers'compensation provisions of Section 37''0 .f the L L..or Code, all
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 for1
, (S'Zo
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'Compensatto t covera 1- is unlawful,
sale.If,however,the building or improvement is sold within one(1)year of and shall subject an employer to criminal penalties an. civil i u es 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 c. t of compensation,
did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Co'e, 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 wo• authorized b 's 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 ri ual' Mana ment District(AQMD)regulations,renovation and remodeling work that results in the removal,stripping,or altering
of asbestos conta'.'.s g terials equine an asbestos survey and removal prior to disturbing the asbestos.Please contact AQMD at(909)396-2000 for
further informatio.
Name I...., 0 Air Title licap-e"•••Sf-
PRINT NAME
I certify that I have rea•'this . . . cation and state that the ave information is correct and that I am the owner or duly authorized agent of the owner.
I agree to comply wi i all ki ty +rdinances d State L•a"
relating to building construction. I hereby authorize representatives of the City of
Arcadia to enter upo 1 the . 'o e-m• 1 tioned ' II,erty for' ection purposes.
1. /5...
Signature Date