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HomeMy WebLinkAboutMECH-21-1416 Permit NO. Mech-21-1416 , ;. City of Arcadia, CA Development Services Department Permit Type:Mechanical 240 West Huntington Drive,Post Office Box 6002 Work Classification:HVAC Repair/Replace T Arcadia,CA 91066-6021 (626)574-5416 Permit Status:Issued ARCADIA Issue Date:08/02/2021 1 Expiration: 08/02/2022 , Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number L42 W LE ROY AVE Arcadia,CA 91007-4023 5782010009 - - Contacts SPENCE SU Owner BRYANT HEATING&AIR Contractor 42 W LE ROY AVE CONDITIONING* (626)353-7989 1350 Las Tunas DR,San Gabriel,CA 917761706 (626)286-1141 948151 Description:REPLACE EXISTING COOLING COIL IN ATTIC AND 3 Valuation: $0.00 Tenant TON A/C UNIT ON GROUND,SAME LOCATION,HERS TEST REQUIRED FOR FINAL Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Compressor 3-5 Ton(3 to 15 hp) $40.00 Total Fees $101.22 Mechanical Permit Issuance Fee $55.00 Cash/Receipt q REC-08370-21 $101.22 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Technology Fee(Permit) 55.22 Total: $101.22 , CALLS FOR INSPECTIONS 1,., -;___, compiETED Request for inspection by telephone at 626-574-5450. Leave a message requesting the address,timeframe and what inspection item is needed. 9--I-2( / ^. 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. August 02, 2021 Issued By: Henry Kemick Date August 02,2021 Page 1 of 1 A' __ 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. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class C2 LtC t7lo._ Exp. Date6-3a- compensation, as provided for by Section 3700 of the Labor Code, for the Signature of Contractor ��[[[//�Y! l/ll(��/%%iiovr t� 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.A workers'compensation insurance carrier and policynumbers are: License Law for the following reason(Section 7031.5,Business and Professions C � Code.Any city or county which requires a permit to construct,alter,improve, Carrier l/Ttg- 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 CST.ccpleted US 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 I certify that in the Performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of 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 COmP1Ywi th 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 )ate 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. 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). 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. 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 buildin construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. Signature Date 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 ONLINE PERMIT/PLAN REVIEW APPLICATION t, CITY or T� w1 A-RCADIA Job Site Address: Cw� LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 0 I hereby affirm under penalty of perjury that 1 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.) --6=.1.3) ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class C b nse N 9'n1-5/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 t911 � OWNER-BUILDER DECLARATION a I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit ❑I hereby affirm under penalty of perjury that I am exempt from the Contractors is issued.My workers'com�nsation 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[-0''-* - demolish,or repair any structure,prior to its issuance.also required the applicant Ydpir for such permit to file a signed statement that he or she is licensed pursuant to the Policy NumbeR__. (This section need not he completed if the permit is for one hundred dollars or less) 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 LiI certify that in the performance of the work for which this permit is issued.I shall exempt there from and the basis for the alleged exemption. Any violation of 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(5500)): ' compensation Laws of California,and agree that if 1 should become subject to the workers'compensation provisions of Section 3700 of t bor 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 forj t.743f sale(Section 7044, Business and Professions Code:The Contractors License Date .Z�Signals �� _ 1 -.A4��--- 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. ❑I, as owner of the property, am exclusively contracting with licensed ----- -- -- contractors to construct the project (Section 7044, Business and Professions CONSTRUCTION LENDING AGENCY Code:The Contractors License Law does not apply to an owner of property 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 TIM.%PPL!CATION 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. -7/c%.25/1 / Nannie- i ?O-55 p)-.5C-~b — Titict KI -- --- PRINAs 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 ordinances and State Laws relating to building construction. 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