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HomeMy WebLinkAboutSNew-19-0758 City of Arcadia, CA Permit NO. SNew-19-0758 Development Services Department Permit Type:Single Family New 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:SFR-New Dwelling (626)574-5416 Permit Status:Approved ARCADIA Issue Date: Expiration: 10/22/2019 , Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 68 W Naomi AVE Arcadia,CA 5782011013 Contacts SOLEIL HOMES INC Owner SANYAO INTERNATIONAL INC. Applicant • 480 Las Tunas DR,Arcadia,CA 91007 255 E SANTA CLARA 200,ARCADIA,CA 91006 (626)319-1031 maggiegiumail@gmail.com (626)446-8048 RODEO CONSTRUCTION AND Contractor MANAGEMENT INC* • 11001 VALLEY MALL 301C,EL MONTE,CA 91731 (626)864-8648 1012238 Description:4 BED,4 BATH, 1 POWDER RM,LIVING,DINING, Valuation: $ 477,275.95 Tenant FAMILY,KITCHEN,WOK KITCHEN.2 CAR ATTACHED GARAGE. Total Sq Feet: 3.215.00 Plan Check#19-758 Plan#138 Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $19,227.25 Building Permit Fees $3,832.20 Cash/Receipt#REC-01066-19 $6,336.47 Building Plan Review Fee $2,490.93 Cash/Receipt#REC-02572-19 $12,890.78 Cal Green Plan Check $249.10 Amount Due: $0.00 Energy Plan Review Fee $766.44 Grading Issuance Fee $47.01 ' Grading Permit Fee(1-1000 CY) $450.00 Grading Plan Review Fee $850.00 "...CA Green Building Standard $20.00 .` C^l '' i'p. : nO_U `1L IiL� LID Plan Check Fee $100.00 Off Site Plan Check(Per Site) $240.00 CALLS FOR INSPECTIONS Parks&Recreation Fee(SFR) $5,429.25 Request for inspection by telephone at 626-574-5450. Leave a message Single Family Fire Plan Check $280.00 requesting the address,timeframe and what inspection item is needed. Single Family/Condo/Townhome Impact $1,983.00 Fee Solid Waste Management Fee $6.25 This permit/plan review expires by time limitation and becomes null and Strong Motion Inst.Program Res $62.05 void if the work authorized by the permit is not commenced within 180 days SWMF FEE 2 $1.00 from the date of issuance or if the permit is not obtained within 180 days SWMF FEE 2 $1.00 from the date of plan submittal.This permit expires and becomes null and WELO Permit Fee $625.00 void if any work authorized by this permit is suspended or abandoned for 180 WELO Permit Issuance $47.01 consecutive days or if no progressive work has been verified by a City of WELO Plan Check $1,700.00 Arcadia building inspector for a period of 180 consecutive days. Total: $19,227.25 Issued By: Date September 23,2019 Page 1 of 1 4 :00.FF. ` PERMIT/PLAN REVIEW APPLICATION IV-1"111 : Development Services Department, 240 West Huntington Drive, Post Office Box 60021 �0oel„of d Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 j City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 0 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, : d my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class License No. _ Exp. Date3131 compensation, as provided for by Section 3700 of the Labor Code, for the rperformance of the work for which this permit is issued. . Signature of Contractor 1 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 \41 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 P 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 CI/ v,/k(� 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 1 information.l ,� Name k\LV'\ Title VA1^ 1l PR ..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. t Signature w Date C f 2 /`C1 NOTES Building Inspections Date Insp. Plumbing Inspections Date Insp. / 4I. t w�„� A 1 100. Setbacks ,. 4, 210. Under flr.lbldg.drain ( I''.�' +'V (J ffN���111 /�J�'f,{" ` 101. Rough grade 211. Copper underslab ,'" /Q - (q- Q 7.rg 102. Figs.&forms 1Z-j�q.li 212. Rough plumbing ! Lp 103. Pre-slab /-2-240 r 213. Rough gas 3'tO'� 104. Floor joists 214. Shower pan y-/3-24s �!)"'7 Z-7-2.1- Na/c./A/G 61/adzT/GI4C.St/246.P5 105. Steel 215. Water heater ,Fig-A. 2,a FG‘,a/2- i%ie-Ase PAd 5 i3r_ 106. Grout lift 216. Roof drains 107. Shear nailing 7. Building sewer 12-I111 t "v r/fg t}<7 ..</b,0-.aAst_f/ 108. Diaph nailing ( --2v 218. Water service 3-S-24, E)CTE2ion, S, K ?n,,.aaz 109. Roof nailing 2-19-Z0 219. Final gas 1-,`3'-i( 110. Framing 31--24:. ' 220. Fixtures 1414./n4G 4 I.i 1's cr c..y 11 , .., ,,,7„, 111. Occ./Area Sept.Wall 221. Final plumbing frtt? 1-1-2-Csj r I/,QA/"/S 112. Sound walls 222. Sewer cap/demo. / 113. T-bar grid _.-._ 114. Insulation-Ar. Pool Inspections Date Insp. 115. Insulation-Wall '11_7.1) fiNi 240. Excavation/steel 116. Insulation-Ceil. J/ 41. Rough plumbing 117. Drywall nailing 3-2.3-2a 2. Light shell/bonding 118. Interior lath ‘i-13-2-6 ""' 3. Underground conduit 119. Exterior lath 7s5O-ZC► 44. P-trap 120. Finish grade 66GG 245. Gas line&test 121. Final building {._/9 _2/ - 246. Fence,gates&signs 122. Final demo/lot clear 247. Pool heater 248. Final electric Electrical Inspections Date Insp. 249. Final.lumbin. 150. Power pole /2-6-6 .In 250. Pool cover - 151. Sales lot lighting 251. Pool final 152. Under.round conduit 153. Underslab conduit Reroof Inspections Date Insp. 154. UFERround 9 (Z`lQ--►1 70. Pre-reroof insp. R4.•r• 7--k. C.S Y(, 155. Water ground , 271. Roof framing C.T r 'cabal- l 61 156. Rough electrical 272. Sheathing nailingF4,44.e.Te Slew 13b 157. Fixtures 273. Final reroof GRxD� �S ._ 158. G.F.C.I. 7i3` -Ze _ " 159. E.it.bondin. ',� Sign Inspections I Date I Insp. 160. Service panel vier V ♦ \ 280. Setback/overhang 161. Final electric I 1 \ 281. Footing 282. Conduit/wirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC _2.4f) i= Miscellaneous Insp. I Date I Insp. 183. Fire dampers 290. Fire alarm 184. Furnace compartment 291. Underground supply 185. Combustion air 3-026 �292. Fire sprinklers 186. Smoke detectors (-19 V .--/293. Monitor system 187. Metal F.P.rough (1 294. Hood dry chem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. I Date I Insp. 191. Final mechanical (.-M-2/ i300. Lateral(main to P/L) - 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess...l filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Anal wall 306. 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R 1 !ii b 1• FG1 1 ; A11 m lig "i Ip SE A e a I/[I1 I II. gl Q ai A£'S 9 i I c .i.� IQ 1. 1R g �1 p l ..• I >~s '• ÜH !1 _ 8kJiIjIJ Aa> 1 T I 3 �aBd 9 rd# • . 3a fiPi �p YI D 3 i�Jelt Y r 13O �l �� �iøffi � 1q�� R m 1< i zi � " � R; I � s � 1 � [ 4 t y�¢ �7F 6 �z tjJ i 11' 11 Qs 1.1 _ " g e tY, i ; y k i; y? �,- Gmi 11 4 lei$ tZ ° 1 e A 11 .1 r i $ ii i'I sno it 0 i$ II 0 ii .s CC• #' N T -1 - / i i ° SINGLE FAMILY HOUSE SANYAO INTERNATIONAL INC. o ' ! ^$ z 68 W.NAOMI AVENUE 1 F. u 2 •R.NIJ.nIINI VNnnMq ARCADIA,CA ]SSE San.cI,.s,1100,prc.w..c sIWI,U.SA. iO TN 16]61 MFS0.8•F".a 1,YF1 NSlA80 D Business Services 40,/ Certificate No. 20190226-019 150 South Third Avenue Arcadia,CA 10AvAHCAD A p 626 821 6631 Unified School District f 626 821 6632 Imagine • Inquire • Inspire www.ausd.net Certificate of Compliance for Payment of Developer Fees (Education Code §17620, et seq. & Government Code §65995, et seq.) Effective April 29, 2019 Current rate in effect applies at the time of imposition of fees/payment. Project Address/APN: 68 W. Naomi Ave., Arcadia, CA 91007 Number of Units: 1 Plan Check Number: 19-758 ❑ Exempt* ® Residential** ❑ Commercial/Industrial** El 500 sq.ft.or less(residential addition/expansion) $3.79/sq. ft. $0.61/sq. ft. El Other: Area in Sq. Ft.: 1,905 Receipt Number: 330498 Total Fee: $7,219.95 Check Number: 9562905438 Owner's Name: Soleil Homes INC Owner's Address: 480 Las Tunas Dr., Arcadia, CA 91007 Phone Number: (626) 319-1031 Email: maggiegiumail@gmail.com Representative's Name & Phone Number (if applicable): Maggie Qiu (626) 319-1031 *The above-described development has been determined to be exempt from the developer fees of Education Code §17620, et seq., and Government Code §65995, et seq., and a Building Permit may be issued therefore. **All fees due to the Arcadia Unified School District, under provision of Education Code §17620, et seq., and Government Code §65995, et seq., as a prerequisite to the issuance of a Building Permit by the Building Department of the City of Arcadia, City of Monrovia, City of Sierra Madre, City of Temple City, and County of Los Angeles, Department of Public Works have been received. Based on the information presented above, this Certificate of Compliance is hereby executed. Karine Hovsepian-Ruby LA A A. a-� IL.AIa >Accounting Supervisor 8/5/19 Signature of District Represe ,.tive Name/Title Date of Issuance The District charges a $100 fee to process reinstatement of the Developer Fee Certificate of Compliance resulting from an "insufficient funds" check in addition to a $35 fee for the returned check. Only cash or a Cashier's Check will be accepted as payment thereafter. The District charges a $100 fee for any amendments to or cancellation of a Developer Fee Certificate of Compliance formerly issued on any type of development. If 500 sq. ft. or less is the reason for exemption, any future additions, expansions, or remodels to the property that result in the past aggregate square footage to exceed the allotted 500 sq. ft. will be subject to fees at the current rate for the entire square footage of the development. Owner/developer may request a refund of fees paid to the District within 12 months of payment only in the event the Building Permit expires or the project is canceled without commencement of construction in accordance with Education Code section 17624 (all other requests for refunds must be made in accordance with the fee protest procedures set forth in Government Code §66020). All refunds will be reduced by a $100 administrative fee. The refund check will be issued in the name of the owner/developer and mailed to the address of payee. PURSUANT TO GOVERNMENT CODE§66020(d), OWNER/DEVELOPER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE OF COMPLIANCE TO PROTEST THE IMPOSITION OF FEES Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that the information he/she provided to the District true and accurate to t best of his/her knowledge. l�,Lj 1�t Ut,t 67,6-IE (� t� S� 15 Signature pf'Aplicant Name Date V ORIGINAL—City/County COPIES—Business Services,Fiscal Services&Applicant Certificate of Compliance(4-29-19) \,'v i,. A.� /41%,.. .-.- V. -/� Ai% 'J�;..\ i i \ ./ \1� i•„.. \ / �,v ./.',.., \ ,y i 1 ' �_s- .__ � __ ' i " 1 ! I' 3 m C C I 1 VI A ° �I a ' �, MI a v v i I 17. L. z . , v N CCC17 • / I rilVI N G \ O 'a. SII \ ---- \ (") 4 1,=.; ,,i 7. \ . \,....,, ,,,... fD lilt< .. t1 �.,GS (y r,' e S' tiT• , ,►p c 00 R A f'1 ►� A o �/ y �, s ; cA � \�i. Ir• 1y j • P.' i V 0 .0 ] "3 —Th-- Z fil 1.iii 10 ...< c Ir. 11: ' $, C11 c (0 d ffji l 1 N ? oo• .. � � S n 864q5 _7 n A A y tl < r`� nff y $ ,., •: 2,.t:•,,........ . ,op,. 1 , .,,,,„• _)tel • r m ^ 7,----(,-,--.:::"., S l l i a W r 4 cn p ro rii 1 ,'..,1 7 : ' / ) (� Y -- �"V �� V — V — —� V �_ -V ��---� V / ENVIRONMENTAL E -P5- ..... ....v:. GEOTECHNOLOGY %.........41t.-... ............ ::: LABORATORY INC. December 5, 2019 Ms. Maggie Qiu 480 Las Tunas Drive Arcadia. California 91007 Subject: Soils Compaction Report; Single-Family Residential Building, 68 West Naomi Avenue, Arcadia, California, EGL Project No.: 18-114-010C. References: 1. Report of Geotechnical Engineering Investigation for the Subject Site, by EGL, Inc., Project No.: 18-114-010GE, dated April 5, 2019. 2. 10-Scale Grading and Drainage Plan for the subject site by EGL Associates, Job No: 18-114-010, revised April 1, 2019. Ladies and Gentlemen: This report presents results of our field density tests performed on the building pad of the proposed residence at the subject site. Building pad was constructed for building foundations and associated structures. Site conditions, field and laboratory test results, and post-grading recommendations are presented as follows: SITE CONDITION Subject site is located on the south side of West Naomi Avenue and at a relatively short distance west of South Santa Anita Avenue in the City of Arcadia, California. Topographically, the subject site is relatively flat. Existing residence and associated structures were demolished prior to grading the building pad. Onsite loose and/or disturbed soils within the proposed building pad area were excavated to a maximum depth of three (3.0) feet below the existing ground surface and exposed competent natural soil. The existing pool shell was completely removed exposing competent natural soil at a maximum depth of 7 feet below the existing ground surface. Competent natural soils exposed within the excavated areas were inspected and are considered suitable for the proposed development. Prior to all backfill, EGL field personnel had checked excavated bottom receiving fills to ensure clearance of non-acceptable debris. Onsite and import soils were used as fill materials. Onsite soils consisted of olive brown silty sand (SM, Soil Type A). Import soil consisted of olive brown silty sand (SM, Soil Type B). 11819 Goldring Road, Suite A, Arcadia, California 91006 Phone: (626) 263-3588; Fax: (626)263-3599 Ms. Maggie Qiu Page 2 of 3 EGL Project Number: 18-114-010C December 5, 2019 LABORATORY TESTING Laboratory maximum dry density and optimum moisture content for the onsite soils was determined according to laboratory standard ASTM D-1557-12. Following table presents the test results of representative soil samples collected from the subject site: TABLE I LABORATORY TEST RESULTS Soil Type Maximum Dry Optimum Moisture Density (pcf) Content (%) A - Onsite olive brown silty sand (SM) 129.5 9.0 B - Import olive brown silty sand (SM) 133.0 8.0 FIELD DENSITY TEST 1. Field density tests were performed using the Nuclear Gauge Method (ASTM D-2922-01 and D-3017-01) and/or Sand Cone Method (ASTM D-1556-04). Field density test results are presented below in Table II. Approximate locations of the tests are shown on the enclosed Site Plan (Figure 1). TABLE II FIELD DENSITY TEST SUMMARY Depth Moisture Dry Relative Test Test Soil Test Date Below FG Content Density Compaction Type No. Location (ft) (%) (pcf) (%) Yp X-1 11/29/19 Pool 5.0 11.3 116.9 90.3 A X-2 11/29/19 Pool 3.0 7.2 117.0 90.4 A X-3 11/29/19 Pool 3.0 7.8 117.2 90.6 A X-4 11/29/19 Pool 3.0 7.0 116.8 90.2 A X-5 11/30/19 Building Pad 2.0 8.0 117.7 90.9 A X-6 11/30/19 Building Pad 2.0 7.4 118.8 91.7 A X-7 11/30/19 Building Pad 2.0 7.7 120.2 92.9 A _ X-8 11/30/19 Building Pad 2.0 9.6 120.0 92.7 A X-9 12/2/19 Building Pad FG 8.7 128.6 96.6 B X-10 12/2/19 Building Pad FG 9.1 130.3 97.9 B X-11 12/2/19 Building Pad FG 9.0 128.1 96.3 B X-12 12/3/19 Pool FG 10.2 121.5 91.3 B 1 X-13 12/3/19 Pool FG 10.7 120.9 90.9 B FG = Finish Grade 2. Field density tests were performed at random locations to check compaction effort provided by the contractor. Test results exceeded minimum required relative compaction 11819 Goldring Road, Suite A,Arcadia, California 91006 Phone: (626) 263-3588; Fax: (626) 263-3599 W LY..:. II II a, ° o .qW C1 � S � Z o tit II 03nOn3tl 3e 01 A I O 0., d d ce W Q>1 C z 1 33N33 N0a1.S X3' I I L .I•, O _. a (X Q i 0300 - ZO'09 ,•� 1S2,t0.68 .z) � �Y > 0 4 •-�o co-' a a, d "/ 60 60l . W U J O O so* .� i cg' "1:. eb1111 N Z U =12 ,e��^ k1,1....-4, •-• `.,.i °0yvl _ Itilt0} I,1254 (.I 3 d •I Ol�f" 1 !+ o. (1---‘,, S, S Iia RI RIS J co i .- t...../ Aorr, V' e.0 koblX L o I 0°1o6Q � l" 1 e:• I N U 1 W ` ° q i �p g , I = ,-/ -- I ue d 1 I !- '6�"s•° Il N .v ��X \pO�zhl" ��il \ J .N • 8 N1� c0 �.•oo l � � ,� h� ISI W( ' V eol j > r „Ler I IC �I _ r ' J 11 HI�ON N 3 w.0- __, w I i0 I w o w 1- R OS SO?nen 3 Una -1 U- Ny RX ZSO?m W r z LL d w J .: • W I g a n 1� UI I § CIJ I .., me °' I S S S L,i \i .. 1,11�� u u cif1 oai- L. l` s�' 0 D 11.1 lJ'—'L .''Lo.Si �'Lo. I a n, !fliCY L\ 11- 73 — ,e .0 Iprih0. n Il d $ I \\\ r'I ,S.r•�e! ,iko.� _ .x,00, 4- (4- O Ca , .1;19 M,S2..i.k6:' 51.`) l 11 > S 'O.yil \ high N g os, A ___,- - -... cx U ,.00 09. .... 04,..51 ,...0-s;,0% ir.. qiii. , L 0., fv0. �� w +J ti �/ 1 / D -X E � J � — +� ° gA6' IWOVN I-1-1 -___I- ¢a 0 l X y/� 4,.O,AI . I /\c J ' tc.. I X M M M M M Ms. Maggie Qiu Page 3 of 3 EGL Project Number: 18-114-010C December 5, 2019 of 90 percent. Test results herein are considered representative of the compacted area. 3. Onsite soils consisted of olive brown silty sand (SM, Soil Type A). Import soil consisted of olive brown silty sand (SM, Soil Type B). Soil samples were verified to match with the laboratory tested samples. 4. Compacted fill is considered adequate for its intended use. POST-GRADING RECOMMENDATIONS 1. All utility backfill should be brought to near optimum moisture content and then compacted to obtain a minimum relative compaction of 90 percent of the laboratory standard. 2. Soils generated from footing excavations should be compacted to 90 percent minimum relative compaction, whether it is to be placed in landscape areas or within areas to be improved. This material must not alter positive drainage patterns away from the structural areas. 3. All trench excavations should conform to CAL-OSHA and local safety codes. REGULATORY COMPLIANCE Cuts, fills or processing of original ground under the purview of this report have been completed under the observation of and with selective testing by EGL, and are found to be in compliance with the Grading Code of the City of Arcadia, California. EGL's findings were made and recommendations prepared in conformance with generally accepted professional engineering practices and no warranty is expressed or implied. This report is subject to review by the controlling authorities for this project. This opportunity to be of service is appreciated. If you should have any questions. please call the undersigned. Respectfully submitted. Environmental Geotechnology Laboratory Inc. L) oF��rFSS/(EGn\ c:6/\? c\-\ w No. 2852 m Exp... RyaP ari , GE 2852 �V Proje ngineer -� ACH\A )���/ Dist: (4) Addressee HJ/RJ/rj 11819 Goldring Road, Suite A,Arcadia, California 91006 Phone: (626)263-3588; Fax: (626) 263-3599 (eg w. Nowt! A vE. / eqe,4-p.14 ii lsli9 ^- Suer ldCQ6.. coQ,Vees -- G071F7 A4-1) 14A owtr AVE •• 03 0 ° � x _ • / 1 _ PL 6,o.oz A.- -r/c. //,754'.rs To r72aE a k'4# ' / F'.rrx?r r rr,Q. (,‘II;, 0 0 i., i/- - 0 — E i ` 0 :6:J6,C/it-leER.1/1/6.- \ 95' 787 0.177 FF `fo7.7b a 77fb 407. zo SAy . 0 0 ��' � H N N i 0 � �� �—.u��, f &C r4� I ,.....=-......... te` \ J -re'P �„ /&/ ALFIr D J. �,?\., Fxt0 E'L1 i TliELwLL�0/� 4y ' ( * EXP Go,3.c.-z..1 /,j / ti �� NO. 6999 / �pFESSID r� .,.!/, 11 ,„_,Ess, ,,,,,, ` Grazc3i 40...Po G.o � FOF ;,---1,. � .,- ����S\NG Llr �L ' -^1 �. �w = 45846 Poi I o� Exp. ._L._.— _\ — --o (P CIVIC. cd :� NO C1 . er (6 i SFT GO D'Ftitsi 0 far// //t.."‘-orrir i° PO ' C2' A3" Gr 5 #--..- INS!Dc 60 111 Pe.°P ,ezC. ,K1ES r/7 f ° 11 0 Pt... Go.oZ A‘(4111~44145" „;ef,, ' 11,4 11"� C%.0.00-'° CITY OF ARCADIA 240 West Huntington Drive Arcadia, CA 91007 FINAL GRADING VERIFICATION ATTENTION: Community Development Administrator SUBJECT: Grading Verification for Project No. 1 R--( tf —0(t Address: & ki . K1(Laryl, (6\--VQ Gentlemen: Finish grading operations have been completed for Project No. for Lots through (if applicable) and has been inspected by the undersigned Registered Civil Engineer or Licensed Architect. tothe Rough Gradinghas been Based upon the observations, the grading subsequent g completed in accordance with the approved plans and specifications and is in substantial conformance with the final grading plan approved by the City and no unauthorized deviations were made. All required surface drainage devices have been installed. Provisions have been made for drainage of surface waters around proposed buildings and their appurtenances. .0 ���pROFEss/o�G 4 �,c\S1NG,z/q 4 Engineer (Signature) c rQ� tiZ itect(Signature) zl R.C.E. No. * 48846 gi r . No. Date: 4 N9,. C �P Receiv-d and approved: OFCALIF�� / 141011. /� . f Lo +i' ��j%' Date: cc: C.D.D./Maint. Ser. C.D.D./Building DEPARTMENT OF BUILDING AND SAFETY STRUCTURAL OBSERVATION REPORT FORM REPORT NO. THIS REPORT INCLUDES ALL CONSTRUCTION WORK THROUGH I el DAY OF fb / ZD Zp PAGE NO. ( OF PROJECT ADDRESS Gc< AM M A-de- , STRUCTURAL OBSERVER S UC.OBS.PHONE NO. WOL �4- j1 ..�/ / (6 71.2 S W- 410190 OWNER UC.OR REGISTRATION NO. BUILDINPERMIT NO. bS-20 OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS LOCATION AND PORTION OF BLDG. DATE ❑- FOUNDATION WALL ❑- FRAMES El- FLOOR 0-FOOTINGS,SLAB&STEM VVALLS ❑-CONCRETE 0- STEEL MOMENT-SPECIAL ❑- CONCRETE ❑-PRESTRESSED CONCRETE SLABS ❑-MASONRY ❑- STEEL MOMENT-ORCINARY 0- STEEL DECK O-CAISSCNS,PILES,GRt,DE REAMS [WOOD ❑- STEEL BRACED Er WOOD ❑- HILLSIDE BLDGS-SPECIAL ❑- ❑- CONCRETE-DUCTILE ❑- FCUNE AT1ON ANCHORS 0- 0- 0- CONCRETE-NON-DUCTILE ❑- 1:9( :// fiz_414/ 7,1,71• ❑- OBSERVED DEFICIENCIES $i'fjf' iia- I T , d; ❑- DEFICIENCIES CONTINUED ON ATTACHED FORM(B&S 261 A) ( tJV CAl* Z ; •.C68205 SIGNED /et OF flogb„ ZO Zp AT e ,SCA xp.9/30% DAY MONTH AR CITY NtU/�`2 _ 'fig• . ' X WET SIGNA '4' REGISTERED CML OR STRUCTURAL ENGINEER OR LICENSED ARCHITECT STAMP OF ENGINEER OR ARCHITECT STRUCTURAL : ERVATION DOES NOT WAIVE ANY OF THE REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THIS DEPARTMENT DISTRIBUTION:STRUCTURAL OBSERVER TO SEND ORIGINAL TO THE BUILDING INSPECTOR'S OFFICE,ATTACH THE FIRST COPY TO THE APPROVED PLANS.AND KEEP SECOND COPY FOR STRUCTURAL OBSERVER'S RECORD AND OISTRIBUTIC'. DEPARTMENT OF BUILDING AND SAFETY STRUCTURAL OBSERVATION REPORT FORM EPORT NO. THIS REPORT INCLUDES ALL CONSTRUCTION WORK THROUGH ' 5 DAY OF 126t ;/ 2-'/i PAGE NO. / Cf- / PROJECT ADDRESS I[.,3 h/, /j,cO/4y Ac!c, STRUCTURALOBSERVER STRUC.OBS.PHONE NO. A - />-b d"I �,�, ��, ' ,S7/•-yO) OWNER LIC.OR REGISTRATION NO. ILDING PERMIT NO. L 6cz-o�' OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS LOCATION AND PORTION OF BLDG. DATE [- FOUNDATION ❑- WALL ❑- FRAMES ❑- FLOOR -FX;IWGS .LAB&STEM WI1S 0- CONCRETE ❑- STEEL MOMENT-SPECV1L ❑- CONCRETE ❑-FRESTRESSED D] RETE SLATS p- MASONRY ❑- STEEL MOMENT-ORDIN RY ❑- STEEL DECK ❑-CA6SONS,FILES,GRADE E3EA!AS ❑- WC' ) 0- STEEL BRACED ❑- mop ❑- HILLSIDE BLDGS-SPECVIL 0- ❑- CONCRETE-DUCTILE ❑- OUNDATION ANCHORS ❑- ❑- ❑- CCCRETE-NON-DUCTILE ❑- ❑- ❑" ❑" OBSERVED DEFICIENCIES: A L ( l - - f �,� . (I ' C h �� i/o( ❑- DEFICIENCIES CONTINUED ON ATTACHED FORM(B&S 261 A) tt �y,, �"l aY 11/ m � SIGNED �� OF �. iAT iR 1�CCA '`= •%. -' 4:S�u:, m DAY M NTH YEAR CITY ., xP• 9i30/ZI J ; X WET SIGNATURE OF REGISTERED CIVIL OR STRUCTURAL ENGINEER OR UCENSED ARCHITECT STAMP OF ENGINEER OR ARCHITECT STRUCTURAL OBSERVATION DOES NOT WAIVE ANY OF THE REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THIS DEPARTMENT DISTRIBUTION:STRUCTURAL OBSERVER TO SEND ORIGINAL TO THE BUILDING INSPECTOR'S OFFICE,ATTACH THE FIRST COPY TO THE APPROVED PLANS.AND KEEP SECOND COPY FOR STRUCTURAL OBSERVER'S RECORD AND DISTRIBUTION; • CITY OF ARCADIA 240 West Huntington Drive Arcadia, CA 91007 ROUGH GRADING VERIFICATION ATTENTION: Community Development Administrator SUBJECT: Grading Verification for Project No. l �_'I t ---0 f D Address: - JG� �iM� �� Gentlemen: Rough grading operations have been completed for Project No. for Lots through (if applicable) and has been inspected by the undersigned Registered Civil Engineer or Licensed Architect. Based upon the observations, the rough grading of the lot(s) listed above have been completed in conformance with plans marked "APPROVED" by the City. The work includes but is not limited to the following: grading to approximate final elevations; staking of property lines; location and gradient of cut and fill slopes; location, cross- sectional configuration and flow-line gradient of drainage swales and terraces; berms installed where indicated; and required drainage slopes provided on building pads. Enclosed herewith is a Soil and Compaction Report for the Building Division which is required on all new construction sit g inspection. Nr Engineer (Signatu Luiz ' 45846 Ar (Signature) R.C.E. No. 4579.1-1,Date: * R.P o. �� / OF CAU Received and approved: Date: C.D.D./Planning cc: C.D.D./Maint. Ser. C.D.D./Building City of Arcadia, CA Permit NO. Plum-19-2470 Development Services Department Permit Type:Plumbing 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Plumbing Residential (626)574-5416 Permit Status:Issued ARCADIA Issue Date: 12/11/2019 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 68 W NAOMI AVE Arcadia,CA 91007-4030 5782011013 —11 Contacts DIAN LIU Owner S&G PLUMBING INC Contractor 68 W NAOMI AVE 961 WASHINGTON ST,SAN CARLOS,CA 94070 (626)623-8222 (650)595-4050 841206 Description:PLUMBING FOR SF NEW Valuation: $ 0.00 Tenant Total Sq Feet: 0.00 Plan Check q Plan U Fees Amount Payments Amount Paid Clothes Washer $13.21 Total Fees $475.43 Dishwasher $13.21 Cash/Receipt tt REC-03305-19 $475.43 Garbage Disposal Fee $13.21 Amount Due: $0.00 Gas System(Outlets) $83.93 Kitchen Sink $26.42 Lavatories $105.68 Lawn Sprinkler System on One Meter $19.86 Plumbing Permit Issuance Fee $47.01 Sewer Connection on Property $33.01 Shower $52.84 Solid Waste Management Fee 2 $1.00 CALLS FOR INSPECTIONS Water Closet 566.05 Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. Total: $475.43 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. OPT) 11)1-0� �Lr December 11, 2019 Issued By: Date December 11,2019 Page 1 of 1 .� 4 ! ±w - PERMIT/PLAN REVIEW APPLICATION •4 r ' Development Services Department,240 West Huntington Drive, Post Office Box 60021 ce�¢I�se 0ee1ry of Ne Arcadia, CA 91066-6021,(626)574-5416, Fax (626) 447-9173 City of Arcadia ICENSED 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,andmy license is in full and ffect. 11 License Class C License No. r\43 Exp. D��/W3 or ❑ I have and will maintain a certificate of consent to self-insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor ��\ l performance of the work for which this permit is issued. WNER-BUILDER DECLARATION 0 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 Professionsis issued.My w rs'compe_nsation insurance carrier and policy numbers are: Code.Any city or county which requires a permit to construct,alter,improve, Carrier f!/�ti/(1Z/{`f/'TC demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number 0/`/� LIN�� for such permit to file a signed statement that he or she is licensed pursuant to the completed(This section need not be if the provisions of the Contractors License Law(Chapter 9(commencing with Sectionpermit 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 Date /h 1 I��� sale(Section 7044,Business and Professions Code:The Contractors License _ 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 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. Mame ��/1�� 1. Jfa fecu / vePRINT NAME (Title 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. , / ignature tate p11/20ti! I\ i'+ City of Arcadia, CA Permit NO. MEP-19-2352 Development Services Department Permit Type: MEP 240 West Huntington Drive,Post Office Box 60021 1 Arcadia,CA 91066-6021 Work Classification:MEP-Residential (626)574-5416 Permit Status:Issued ARCADIA Issue Date: 11/25/20191 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 68 W NAOMI AVE Arcadia,CA 91007-4030 5782011013 Contacts SOLEIL HOMES INC Owner RODEO CONSTRUCTION AND Contractor 480 Las Tunas DR,Arcadia,CA 91007 MANAGEMENT INC* (626)319-1031 maggieqiumail@gmail.com 11001 VALLEY MALL 301C,EL MONTE,CA 91731 (626)864-8648 1012238 Description:MECHANICAL AND ELECTRICAL FOR SF NEW.HVAC Valuation: $0.00 Tenant SYSTEM PER APPROVED PLANS.HERS REQUIRED FINAL.TPP Total Sq Feet: 0.00 Plan Check# Plan U Fees Amount Payments Amount Paid Compressor<3 Ton(up to 3 hp) $39.72 Total Fees $672.19 Distribution Panel $32.96 Cash/Receipt it REC-03173-19 $672.19 Electrical Permit Issuance Fee $47.01 Amount Due: $0.00 Furnace or Burner<=100,000 BTU $39.72 Hood Serviced by Mechanical Exhaust $29.92 Mechanical Permit Issuance Fee $47.01 Motors,Generators<1 hp $16.14 New Residential Accessory Bldg (sq ft $31.50 area) New Residential Elect.(sq ft area) $257.20 Residential Services up to 400 amps 516.48 CALLS FOR INSPECTIONS Solid waste Management Fee 2 $1.00 Request for inspection by telephone at 626-574-5450. Leave a message Solid Waste Management Fee 2 $1.00 requesting the address,timeframe and what inspection item is needed. Temporary Power Pole $33.01 Ventilation Fan(Single Duct) $79.52 Total: $672.19 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 c-.i Oi I TdP l�r g ni void if any work authorized by this permit is suspended or abandoned for 180 Jt v JIJL u L5consecutive days or if no progressive work has been verified by a City of Arcadia building inspector for a period of 180 consecutive days. 1— (jr...— / «`u it , November 25, 2019 Issued By: Date November 25,2019 Page 1 of 1 A of PERMIT/PLAN REVIEW APPLICATION 1.• 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 Codes 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 P. License No. ti ; 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 (Thi •coon need not be completed if the permit is for one hundred dollars or fess) 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 F4I 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 fI /1 sale(Section 7044,Business and Professions Code:The Contractors License Date {` �u( l� Signature aAA.,•----67)11-\ 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 IV/ employees,provided that such improvements are not intended or offered for WARNING: Failure to secure Workers'Compensation coverage is unlawful, sale.If,however, ti:a 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 W l\&\ ` " -- `h Title (MY-01V\ o " " NT 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 ��/`Ci • City of Arcadia, CA Permit NO. FIRE-20-0197 Development Services Department Permit Type:Fire 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Fire Sprinkler (626)574-5416 Permit Status:Issued ARCADIA Issue Date:03/03/20201 Expiration: 08/03/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 68 W NAOMI AVE Arcadia,CA 91007-4030 5782011013 Contacts DIAN LIU Owner SPECIALIZED FIRE PROTECTION, INC.* Contractor 68 W NAOMI AVE 18305 E Valley#H,La Puente,CA 91746 (626)623-8222 (626)416-9276 1005885 Description: FIRE SPRINKS FOR SF NEW 37 HEADS Valuation: $ 5,000.00 Tenant • Total Sq Feet: 0.00 Plan Check#20-197 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $901.76 Fire Permit Fees $153.75 Cash/Receipt#REC-04013-20 $201.76 Solid Waste Management Fee 2 51.00 Cash/Receipt#REC-03763-20 $700.00 Sprinkler Heads $700.00 Amount Due: $0.00 Total: $901.76 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. C;(.1 March 03, 2020 Issued By: Date March 03,2020 Page 1 of 1 ! • PERMIT/PLAN REVIEW APPLICATION # Development Services Department, 240 West Huntington Drive,Post Office Box 60021 Arcadia, CA 91066-6021, (626) 574-5416,Fax(626)447-9173 m�otr,of N City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 0 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 Cod d my lice rs n ll force d effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class_i Exp. Date 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 0 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 !i( if:://e, 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 ❑ 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 3 7;') 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 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. NameTitle P N E 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 ordinanc d State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentio -i •roperty for inspection purposes. Signature Date ?/ /2c Oy�FAR Rc9jr �, y -J Au 0,1901 (u• y°t� Q MEMORANDUM Fire Department DATE: January 20, 2021 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 68 W. Naomi Avenue THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC# 20-197) 9-16-2020 Jill Perumean FIRE ALARMS HOOD & DUCT KNOX BOX OCCUPANCY 9-16-2020 Jill Perumean COMMENTS: Emailed Bldg. Dept. 9-16-2020 Rita I 0 I I 1 Robert C. Ferrante LOS ANGELES COUNTY Chief Engineer and General Manager .11161111111110°eVSANITATION DISTRICTS 1955 Workman Mill Road,Whittier,CA 90601 1400 Converting Waste Into Resources Mailing Address: P.O. Box 4998,Whittier,CA 90607-4998 (562)699-7411 •www.lacsd.org Counter Hours: 7:00 a.m.-4:00 p.m.Mon.-Thurs. 7:00 a.m.-3:00 p m.Fri. Application No.: 5782011013-002 SEWERAGE SYSTEM CONNECTION FEE RECEIPT Date: January 19,2021 OPERTY&APPLICANT INFORMATIO APN:5782 011 013 District No.: 15 Owner/Situs Address Applicant Information DIAN WEN LIU Soleil Homes Inc Dian Wen Liu(Owner) 68 NAOMI AVE Mindy Huang ARCADIA,CA 91007 PO Box 504 Walnut,CA 91788 Phone: (626)378-6262 IICILITYIiVFORMATION& CONNECTION FEE CALCULATIONS 1 Facility Type Measure of Use Unit Rate Amount Single Family Home I) 1.00 DU Single Family Home \ 1.00 DU S1,551.00/DU $1,551.00 68 NAOMI AVE,ARCADIA Base Line Credit 1.00 CUs $1,551.00/CUs ($1,551.00) Connection Fee Due $0.00 Type Abbreviations N-New or Additional;C-Change of Existing;E-Existing to Remain;D-Demolition of Existing;T-Tenant Improvement of Existing;S-Septic to Sewer (E)SFR to be demolished;Construction of(N)3,215 sqft SFR;Demo credit given Includes demolition of 1.00 DU of existing Single Family Home Processor:Kimberly Gonzalez Approver:Nell Madigan • S/IIATATION O!R,CT$ D.C.: OF LOS ANGELES COUNTY %APPROVED Payment Received Check No. Amount MindyHuang $0.00 ROBERT C.FERRANTE CHIEF ENGINEER&GEN.MGR. Valid Only When Stamped THIS IS NOT A CONNECTION PERMIT. A CONNECTION PERMIT IS REQUIRED BEFORE CONNECTING TO ANY SEWER. DOC#6037262 a) # ,,,*,! k , +,,/ 4„ •=e 4WATER DIVISION ATTENTION: E-2<C DATE: a-17- - 2..v FROM: BUILDING DIVISION INSPECTOR: .4jeR j ,1 -7r it ADDRESS: G v fI4L o/4-1.I PERMIT NO.: Af(1i,,. l 1--015P> PLAN NO.: l 3 CONTRACTOR: ?6 UE .,4<5_7:k.4,c.;/o../ PHONE NO.: G2.6/34-y 8Lsib OWNER: c-e/c- e 5 PHONE NO.: PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT OF PUBLIC WORKS REQUIREMENTS. Type of Inspection Date& Initial Date&Initial Final Approval Meter Location rk/i(/ao Blackflow Devices - `eV 1\ft6/26 Irrigation System . 4Q I06/2o Fire Sprinkler System -366 "/a/20 Meter CIear A.P.P. 'fig \\(IG /ao Swimming Pool ` ' COMMENTS: �is.e_ 44le(5 I b L \fasTus _S_50 ( ma4 c1 b 3) weSA-bra.. r s3.9,�y _- _.__..7: r6.-,, CITY OF . : : WATER EFFICIENT LANDSCAPING DOCUMENTATION PACKAGE , CERTIFICATEOF GORAPLETlON Thiscertificate is.to Pe:filled out by the project applicant and the property owner upon completion of the Iandscepir project. • Project Information. Date of )-� an�pietto�t Penult Type and No. Project Ad ddrgssss 68 W Naonti o venaLi Rreadtia, CA 9/oo 7 ' Name of Pijec t: pplleant and Title Nan*Of Property Owner i' / ie Chat Mawa e4- Soi.ehI l-/ooze. inc- Company Name&Mailing Meiling Address P�0 i4ox ,sv�u teidnitt CA 9/7S8 cla/n czz , 6'99/]�8 :' • Telephone and Fax No(s). --T-eI iene-arid Fax No(s). 969 -2e3--.›63_3 6-)-6 -4*2- 8.3d'4 Email Address. Email Ades ,7n r3>-e,m = Chan @ 67mait.Coat Project Applicant -The signer of the landscape design plan, signer of the irrigalion plan, the licensed landscape contractor that installed the landscaping and irrigation, or a licensed i professional that performed periodic site observations to verify that the project is consistent with the Water Efficient Landscaping Documentation Package for the project and that theproject complies with Ordinance No. 2267. "I/we certify that based upon periodic site observations the work has been substantially completed in actiotdance. with Ordinance No. 2207 and that the landscape planting and irrigation installation conform with the criteria and specifications of the approved Landscape and Irrigation Plans and Landscape Documentation Package and acknowledge that the poi Oct may be subject to inspection and a Landscape Water. Audit to verify that the project is maintained in compliance wilt Ordinance No,2267.." • Signature 1 , i Date 1/2-1/ZI Name(prim Telephone-and Fax.No( ° i 3-i c 16i4q— 62-6 70.0 /6S Title Uce aseto..dr Oertilicatitin No. fi ate' 145Y13 'I- Company .1lo-�sam¢�"Jl� /-4 Jct F.i#iaii,4ddress ail cM Mailing Address /9a/ /d (p/Ga& ./ 4)$44 /i 3')) .� 6/:' 7/7o Property Owner c "l/we certify that Uwe havereceived copies of all the documents within the Water Efficient Landscaping Documentation Package for our project and that it is myfour responsibility to see that • the project is maintained in accordance with the Landscape and irrigation Maintenance Schedule for the project and In compliance with Ordinance No. 2267, and liwe acknowledge that the project may be subject to inspection and a Landscape Water Audit to verify that the project is being I maintained in compta •.= with Ordinance No. 2267. .r. _ .?i , Property Owner(s)10:1` ature(s) Date -1.1 - I