HomeMy WebLinkAboutMech-21-0496 .•'`^,. City of Arcadia, CA Permit NO. McCh-21-0496
Development Services Department Permit Type: Mechanical
240 West Huntington Drive,Post Office Box 60021 Work Classification:HVAC Repair/Replace
Arcadia,CA 91066-6021
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:03/23/2021 Expiration: 03/23/2022
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Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
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912 ARCADIA AVE 9 Arcadia,CA 91007-1229 5783002077
Contacts
EVANS,HUGH E TR HUGH E EVANS Owner SOUTHLAND HEATING&AIR Contractor
TRUST CONDITIONING
912 ARCADIA AVE 9 3529 OLD CONEJO RD 107,NEWBURRY PARK,CA 91320
(626)241-4456 (805)498-6700 797064
Description:REPLACE EXISTING 4 TON PACKAGE UNIT LOCATED Valuation: $ 0.00 Tenant
ON ROOF,SAME SIZE AND LOCATION,HERS REQUIRED FOR
FINAL Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Compressor 3-5 Ton(3 to 15 hp) $36.35 Total Fees $104.22
Furnace or Burner<=100,000 BTU $19.86 Cash/Receipt#REC-07117-21 $104.22
Mechanical Permit Issuance Fee $47.01
Amount Due: $0.00
Solid Waste Management Fee 2 $1.00
Total: $104.22
CALLS FOR INSPECTIONS
ti • j / Request for inspection by telephone at 626-574-5450. Leave a message
Crequesting the address,timeframe and what inspection item is needed.
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4' ""--1/ 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
Rbc. /✓EO .Mom DerE4-1D•1-- 1`F'e`2A✓' 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.
•
March 23, 2021
• Issued By: Henry Kemick Date
March 23,2021 Page 1 of 1
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PERMIT/PLAN REVIEW APPLICATION
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Development Services Department, 240 West Huntington Drive,Post Office Box 60021
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/�• 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'
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License Class .ce se No. 41 p 9 Exp. Date1«30/a. 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 a I have and will maintain workers'compensation insurance,as required by Section
❑ I herebyaffirm under 3700 of the Labor Code,for the performance of the work for which this permit
penalty of perjury that I am exempt from the Contractors is issued.My workers'compensation insurance carrier and policy numbers are:
License Law for the following reason(Section 7031.5,Business and Professions
Code.Any city or county which requires a permit to construct,alter,improve, Carrier e ch 14 furanee COMpetil../
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 CaS q
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 3r2 202.( 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:
I. 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 l✓ ()4'l 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 . • •-mentioned� 2 property for inspection purposes. /
Signature /f / �i3(20 Z/
Date
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AFFIDAVIT SELF-CERTIFICATION
FOR COMPLIANCE OF SMOKE ALARMS
AND CARBON MONOXIDE ALARMS
Property Address: OA \ccc x a \\C- 1
Permit Number: lAPCv\- .\^o\Aq `
Brief Job Description: C"�C_�� u'f11 �
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Number of smoke alarms installed: (2)
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.ca.qov/licensinglistings/licenselisting 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 f kebOig is true and correct, and that this
declaration was executed on (Date) 6 \ D\ ® at Arcadia, California.
Owner's Name (printed/typed): Y A J
Signature of Owner: L ‘ ? -
This affidavit must be returned to the City of Arcadia inspector prior to final inspection
SMOKE ALARM AND CARBON MONOXIDE ALARM LOCATIONS
Guest Room Si
Bathroom
Storage
Family Room ---
Garage
•
FIRST FLOOR PLAN
Eb= SMOKE ALARM I = CARBON MONOXIDE ALARM
il Mstr 1 Bath
Master Bedroom
Dining Room Kitchen
-- Bath
op Tor.
Hall 0 El Closet
Closet Closet
Family Room
Bedroom I3edroom
SECOND FLOOR PLAN
=SMOKE ALARM I = CARBON MONOXIDE ALARM
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PROJECT SUMMARY
Project Name: HUGH EVANS HERS VERIFIABLE
COMPLETE
MEASURES
Address: 912 Arcadia Ave-9
City, State,Zip: Arcadia,CA 91007
Building Department: Arcadia,City of ENERGY CODE COMPLETE
Permit Number: MECH-21-0496 COMPLIANCE
Building Energy Code: 2019 Standards
CERTIFICATE OF COMPLIANCE (CF1R)
DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS
03/23/2021 CF1R-ALT-02-E Residential HVAC Alterations 421-A020040539A-000-000-0000000-0000
D06 changed from".80"to"0.8"
CERTIFICATE OF INSTALLATION (CF2R)
DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS
04/19/2021 CF2R-MCH-01b-E HVAC, Ducts and Fans 421-A020040539A-000-001-M01001A-0000
Location 1
04/19/2021 CF2R-MCH-20d-H Duct Leakage 421-A020040539A-000-001-M20002A-0000
04/19/2021 CF2R-MCH-23a-H Airflow Rate 421-A020040539A-000-001-M23003A-0000
System 1
04/19/2021 CF2R-MCH-25f-E Refrigerant Charge 421-A020040539A-000-001-M25004A-0000
CERTIFICATE OF VERIFICATION (CF3R)
DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS
Location 1
04/19/2021 CF3R-MCH-20d-H Duct Leakage 421-A020040539A 000 001-M20002A O
M20A
04/19/2021 CF3R-MCH-23a-H Airflow Rate 421-A020040539A 000 001 M23003A O
M23A
INOTICE:% CHEERS
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information contained in this certificate.