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HomeMy WebLinkAboutELEC-21-1576 i, Permit NO. EIec-21-1576 ...IP.. City of Arcadia, CA Development Services Department Permit Type:Electrical 240 West Huntington Drive,Post Office Box 60021 ° Arcadia,CA 91066-6021 Work Classification:Elec-Service Change (626)574-5416 Permit Status:Issued ARCADIA. Issue Date:08/20/2021 Expiration: 08/22/2022 -, Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number [454 W DUARTE RD A Arcadia,CA 91007-9166 5784007070 Contacts CHEN LIU Owner XIAOFENG XU Agent for owner 454 W DUARTE RD A (626)673-7487 ,R" Description:RESTORE POWER AFTER EDISON SHUTDOWN, Valuation: $ 0.00 Tenant ELECTRICAL SERVICE RELEASE AFTER REQUIRED INSPECTION Total Sq Feet: 0.00 Plan Check# Plan# -, Fees Amount Payments Amount Paid Electrical Permit Issuance Fee $55.00 Total Fees $82.24 Residential Services up to 400 amps $22.00 Cash/Receipt#REC-08590-21 $82.24 Solid Waste Management Fee 2 $1.00 Technology Fee(Permit) Total: $4.24 Amount Due: $0.00 $82.24 8�—z3 —z� 36piii c. d-vJ CALLS FOR INSPECTIONS 11 8_?6-2'1 Request for inspection by telephone at 626-574-5450. Leave a message i7 I requesting the address,timeframe and what inspection item is needed. FiKIAL b14 (1114 This permit/plan review expires by time limitation and becomes null and C void if the work authorized by the permit is not commenced within 180 days W-1 OMPLETED 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. August 20, 2021 Issued By: Henry Kemick Date August 20,2021 Page 1 of 1 `,0FORN,, A if:0,1 1 PERMIT/PLAN REVIEW APPLICATION tlt Development Services Department,240 West Huntington Drive, Post Office Box 60021 E ti+ o Y ov. 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. 0 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 Coptractor 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 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 Et 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 $ ILf Signature ;/ O� sale(Section 7044,Business and Professions Code:The Contractors License Date \ 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(I)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 Sir( ZO /It Signature C>C & Lender's Address IMPORTANT: APPLICATION IS HEREBY MADE TO THE BUILDING OFFICIAL FOR A PERMIT SUBJECT TO THE CONDITIONS ANI) 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 )( 1ASO V C rV 6 X (A Title Pr0?evi / M-41hAff'v PRINT NAME ?evil J 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. iagree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of rcadia to enter upon the above-mentioned property for inspection purposes. Signature X_ Date e 1 _0 /2,( DocuSign Envelope ID:48E6F511-0AE0-4889-A7F6-5F7EF31 F5D4C AGENT AUTHORIZATION FORM Property AIN: 5784-007-070 Street Address: 454 W Duarte Rd Unit A, Arcadia, CA 91007-9166 Property Owner: Chen Liu The undersigned, registered property owners of the above noted property, do hereby authorize Xiaofeng Xu of Uniroom, Inc to act on my behalf and take all actions necessary including of the tenant screening, leasing agreement management, collecting rent, paying the bill, and arranging for all necessary repairs. I 4 We hereby certify the above information submitted in this document is true and accurate to the best of our knowledge. DocuSigned by: (-DocuSigned by: Cae„,j.,µ xia0 f-t 4 XU C6A77A13DE890409. C508237813504CE. Property Owner Property Manager I I 0 I II' Ir � aity of N� AFFIDAVIT SELF-CERTIFICATION FOR COMPLIANCE OF SMOKE ALARMS AND CARBON MONOXIDE ALARMS Property Address: 4=544 A A ; , " ic{ c,117/607 Permit Number: / 2 - ,2j /,37/ Brief Job Description: ly/Ger2- Number of smoke alarms installed: Number of carbon monoxide alarms installed: .. 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 2016 California Residential Code (CRC) and California Health and Safety Code Section 13113.7. 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 2016 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 Marshal. http://osfm.fire.caqov/licensinglistings/licenselistinq 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 t,� foregoing is true and correct, and that this declaration was executed on (Date) „p /.-!=a_.___ _T T_._ at Arcadia, California. Owner's Name (printed/typed): Signature of Owner: , 12,< This affidavit must be returned to the City of Arcadia inspector prior to final inspection la • x IN %. : • i. IIi , • . . A. 1 .• • • . ;:;iicst Room c )0bathroo U Storage 0. (.''' 1g. ...1 IL "°V\7 -_-...-. ....... fFaill ily Room FIRST FLOOR PLAN SMOKE ALARM = CARBON MONOXIDE ALARM -=-- 0: 1I ' ath Master Bedroo, i I)illistg Room Kitchen L.._ j--�Bath ( III 0 -- -Y-, Closet Hall ( i 'Cl Closet �s{yt ^p.� °set ` Fancily Room — .."'''e'`` �1 -- . l cdrocom 13edtooii Wiz; ® -- =G =. .........••••••=••••• -:'::"2"-f---' ••••• -: ,.---' SECOND FLOOR PLAN ' = SMOKE ALARM t r- CARBON MONOXIDE ALARM