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Home My WebLink AboutROOF-20-1232 City of Arcadia, C, _ e Permit NO. ROOF-20-1232 Development Services Department Permit Type:Roof 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Reroof-Residential (626)574-5416 Permit Status:Issued A RCAI)IA Issue Date:08/20/2020 I Expiration: 08/20/2021 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 860 • PALO ALTO DR Arcadia,CA 91007-6418 5777020018 Contacts —__ ---__—_-- GEORGE VILLALOBOS Owner SIERRA PACIFIC ROOFING Contractor 860 PALO ALTO DR 1042 N Mountain,Upland,CA 91786 (626)445-7423 (909)949-7663 627233 Description:T/0 AND REROOF HOUSE AND GARAGE WITH Valuation: $ 20,000.00 Tenant BORAL PINECREST STEEL SHAKE,CLASS,COLOR:TIMBERWOOD OVER EXISTING SHEATHING Total Sq Feet: 0.00 Plan Check it Plan# Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $457.51 Building Permit Fees $404.25 Cash/Receipt#REC-05274-20 $457.51 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $457.51 - "fh_ 9.1(4, .;•0 jCOMPLEIE '; 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. August 20, 2020 Issued By: Date • August 20,2020 Page 1 of 1 A• • • 4 pis• 1 PERMIT/PLAN REVIEW APPLICATION • o� ltje 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 ❑ 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 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. ❑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 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 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 PERNII.'I'JPI..AN REV'J E APPL 'A • ON (Itst=m �. ARCADIA Job Site Address: clLICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury that 1 am licensed under provisions of 1 hereby affirm under penalty of perjury one of the following 111"""""""`LICENSED 9(commencing with Section 7000,of Division 3 of the Business and Professions Co��d++e,and my license is m full force and effect. Ej I have and will maintain a certificate of consent to seif-insure for workers' License Class L.,..•"5e1 tcensetrVo. , , j at,. Date 214/ compensation,as provided for by Section 3700 of the Labor, Coit. fa the performance of the work for which this permit is issued Signature of Contractor i _. F104410 tr OWNER-BUILDE' A c TION vo!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 1 hereby affirm under penalty of perjury that 1 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 S Code.Any city or county which requires a permit to construct,alter.improve. Career demolish,or repair any structure,poor to its issuance.also required the applicant A J�( , for such permit to file a signed statement that he or the is licensed pursuant to the Policy Number__ „S t.sv.� provisions of the Contractors License Law(Chapter 9(commencing with Section (This section need nut be completed if the permit is lex one hundred dollars a tease 7000)of Division 3 of the Business and Professions Code)or that he or she is 1 certify that in the performance of the wreck for which permit is issued l shalleaters n these from and the basis for the alleged exemption. Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil not employ any person in any manna so as to become subject to the workers' penalty of not more than five hundred dollars(S500)). compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 700 of the Code.1 shall ❑1. as owner of the property, or my employees with wages as their sole forthwith comply 'th those provision. compensation will do the work,and the structure is not intended or offered for Darr .� 2.4/2.(, Signature sale(Section 7044,Business and Professions Code:The Contractors License i 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 employers,provided that such improvements are not intended or offered for WARNING: Failure to serum Workers'Compensation coverage is unlawful, suit.If,however,the building or impruwe_rn lent is sold within one(I)year of and shall subject an employer to criminal penalties and civil fines ftp to one completion,the owner-build r will have the burden of proving that be or she hundred thousand dollars($100,000),in addition to the cost of axmpenation, did not build or improve for the purpose of sale). damages as provided for in Section 3706 of the Labor Cade, interest mei aticxney's fees. 01,as owner of the property, am exclusively contracting with licensed contractors to construct the project(Section 7044,Business and Professions CONSTRUCTION LENDING AGENCY Corer: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 1 hereby affirm under penalty of perjury that there is a construction lending agency cornactor(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 1 am exempt under Section 7044,Business and Professions Code.for this reason: Lender's Name Date�/ L Signature i r Lender's Address IAtPONT.a f1 tP1'LIC'Alto's f, IiIRIJi'i %IA1t) 'Ito 7.11£ BL'II.Z)INC I)f'fit11,1, lOR A PERMIT SUBJECT TO THE c'l')',''1)1TlONS ANT) RESTRICTIONS SET FORTE(ON THIS.t.1'P1-)£A79i>ti y'l)rut.ft>I LOWING; Ii 1. The City's approved plans and permit inspection card most remain on the job site for use by City inspection personnel 2 Final mspection of the work authorized by this permit u 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 fere ec ( . , t l�t Tule __ at-_ '�4210 MIA'(NAM*. I certth that I have read this application and state that the above irdorsnation is correct and that I am the owner or duly authorized agent of the I agree to comply with all City ordinances and state Laws relating to building crmatntc2ieta. 1 .. reifies sed the Arcadia to miter u m the:horn -mentioned property for inspection purposes, Signature,__ ..f. Date „ G- 1� • 1 • , CITY OF ARCADIA ►wr r� v MOA ARCHITECTURAL REVIEW ROAM SHORT R!V!IW AJPLICATIOH ",i i's10 •t AM COMItEW tN ►au tauitt01. #444013 A00%SS b 'I IT � Q ' 4, Ar 7, ._ ._-- • or LI p latut still . 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