HomeMy WebLinkAboutMISC-20-1815•
City of Arcadia, CA Permit NO. Misc-20-1815
Development Services Department Permit Type:MisC
240 West Huntington Drive,Post Office Box 60021 Work Classification:Misc-Renewal
Arcadia,CA 91066-6021
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:11/05/2020 I Expiration: 11/05/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1006 FALLEN LEAF RD Arcadia,CA 91006-1903 5769006001
1111111111111111111111111111111111•11111•1110. qffitttleuggiNaAltsts
Contacts
HAN,JERRY CO TR JERRY HAN AND LYNN Owner
11 LAM TRUST
1006 W FALLEN LEAF RD
(626)375-5349
Description:RENEW EXPIRED PERMITS A8901720,A8902578, Valuation: $0.00 Tenant
B00-027-127 FOR DETACHED GARAGE 1989
Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $84.28
Renewal Fee 531.02 Cash/Receipt#REC-05978-20 $84.28
Solid Waste Management Fee $6.25
Amount Due: $0.00
Total: $84.28 -
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.
or COMDLETED
November 05, 2020
Issued By: Date
November 05,2020 Page 1 of 1
i
%1 A'
oxIFOR.,'
•4 I PERMIT/PLAN REVIEW APPLICATION
.4, a 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
1:1I 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 ❑ 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 stricture 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.
ame T '‘-( Title OI�iJ'&79---•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 compl with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
Arcadia to er pon thea ve-mentioned perty for inspection purposes.
Signature Date t i
1 �/l7
City of Arcadia, CA Permit NO. ROOF-20-1816
Development Services Department Permit Type:Roof
240 West Huntington Drive,Post Office Box 60021 Work Classification:Reroof-Residential
Arcadia,CA 91066-6021
(626)574-5416 Permit Status:Estimate
ARCADIA Issue Date: Expiration: 11/03/2021
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1006 FALLEN LEAF RD Arcadia,CA 91006-1903 5769006001
Contacts
HAN,JERRY CO TR JERRY HAN AND LYNN Owner
LAM TRUST
1006 W FALLEN LEAF RD
(626)375-5349
Description:REROOF EXISTING DETACHED GARAGE WITH Valuation: $ 1,000.00 Tenant
BUILT UP ROOFING SYSTEM OVER NEW SHEATHING,COLOR
TO MATCH HOUSE Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees
Building Permit Fees $61.65
Solid Waste Management Fee $6.25
Amount Due:
Total: $114.91 -
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.
COMPLETED
Issued By: Date
November 16,2020 Page 1 of 1
`crroRivai
OOP 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
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 ❑ 1 have and will maintain workers'compensation insurance,as required by Section
1:1I 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 ❑ 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.
❑1, 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
1 jo)).-- 6fr
; :: :: : � BUILDING & SAFETY DIVISION
240 West Huntington Drive •
•
41110 Arcadia,California 91006-3104
��`O\Art0- ( 818) 574-5418 e7Cea
Page 1 of 1
1006 W FALLEN LEAF RD 04/13/89 14:30
Permit No : A8901720 Autoproj No : AU002480
Status : APPROVED Validated by : LB
Inspector area: 206
This type : Single Family Project Applied : 04/13/89
Issued : 04/13/89
Parcel number : 5769-006-001 Finaled
Group-occup/use: To Expire •
Owner • : BARRENECHEA, LUIS
Applicant : V.P. CONSTRUCTION CO.
_ ..Applicant Addr : 9832 READING AVE GARDEN GROVE, CA 92644
Job Address : 1006 W FALLEN LEAF RD
Phone number : 714-539-9363
Class code •
Valuation • 6,664
Construction : ADD
Permit to do : GARAGE ONLY
CONTRACTOR : V.P. CONSTRUCTION Lic. C 242860 714-539-9363
• Plan No. > 23371
School Certification No> 627
Fee description Units Fee/Unit Ext fee Data
Garage (Enter Square Footage) 3104> 392.00 .00
Building Permit Fee 3104> 127.55
S.M.I.P. Fee 714-2207> .50
*** Fees Required *** *** Fees Collected & Credits ***
Receipt No. Date Payment
04/13/89 128.05
Fees: 128.05
Adjustments: .00 Total Cradits: .00
Total Fees: 128.05 Total Payments: 128. 05
Balance Due: .00
CALL FOR INSPECTION DECLARATIONS
Requests for inspections should be made at least In accordance with Health & Safety Code, Section
Requstshours n advance by madetelepat e at 19825,all required declarations on the reverse side of
twenty-fourt4ho:00 A.M.-adv:00 P.M. this form have been properly signed and dated by
the permittee.
Inspectors office hours are: Verified by:
8:00-9:00 A.M.; 1:00-1:30&4:30-5:00 P.M. Signature
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I. " . ''1 BUILDING & SAFETY DIVISION
rr 240 West Huntington Drive
241,i• Arcadia,California 91006-3104 /�
•�• ( 81 8) 574-5418 CiJCI�oP
Page 1 of 1
1006 W FALLEN LEAF RD 06/01/89 09:11
Permit No : A8902578 Autoproj No : AU002480
Status : APPROVED Validated by : LB
Inspector area: 206
This type : Electrical Project Applied : 06/01/89
Issued : 06/01/89
Parcel number : 5769-006-001 Finaled
Group-occup/use: To Expire •
Owner : BARRENECHEA, LUIS
Applicant : BARRENECHEA, LUIS
Applicant Addr : 1006 FALLEN LEAF ARCADIA, CA 91006
Job Address : 1006 W FALLEN LEAF RD
Phone number : 818-355-4125
Class code
Valuation • 0
Construction : OTH
Permit to do ELEC FOR GARAGE ADDN
Fee description Units Fee/Unit Ext fee Data
Original Permit Issue Fee (YES/NO) 27 .55 Y
Outlets 3105> 7 .00 6.65
*** Fees Required *** *** Fees Collected & Credits ***
Receipt No. Date Payment
06/01/89 34.20
Fees: 34.20
Adjustments: . 00 Total Credits: .00
Total Fees: 34.20 Total Payments: 34.20
Balance Due: .00
CALL FOR INSPECTION DECLARATIONS
in accordance with Health & Safety Code, Section
Requests for Inspections should be made at least 19825,all required declarations on the reverse side of
twenty-four hours In advance by telephone at this form have been property signed and dated by
574-5416,8:00 A.M.-5:00 P.M. the permittee.
Inspectors office hours are:• Verified by:
8:00-9:00 A.M.; 1:00-1:30&4:30-5:00 P.M. re
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•". MARY B. YOUNG
�� �; . 4 da MAYOR PRO TEMPORE
,f - . /1►‘\, 240 West Huntington Drive CHARLES E. GILB
A . Arcadia, California 91007 ROBERT C. HARBICHT
r� 440 # o� (818)574-5400 DENNIS A. LOJESKI
c �o COUNCILMEMBERS
4POR k1
GEORGE J. WATTS ROGER CHANDLER JUNE D. ALFORD
CITY MANAGER MAYOR CITY CLERK
•
• 7 Pie04112147 efl
414 i• 44/te/fe !e%telt .. (date)
Re: /0,04. .5z/tits 4 ( .
Permit No. APAP172r01251T, issued on 0/14 49///
Type of permit: ld[ - 1,
-1 (104446)
The Arcadia Municipal Code states that all permits shall
become null and void, 180 days after the last inspection
or if no work has begun.
0 Your permit is about to expire. If a time extension
is required, a request must be filed prior to the
expiration of the permit. If the work has been com-
pleted, please contact the Building Division.
Your permit has expired. A new permit will be re-
)Wf
quired before work can be commenced.
If you have any questions please contact 4n/40 4As''t
at (818) 574-5416.
Yo rs tr ,
liti ,''', ''
Illf
RHF/cep
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