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Home My WebLink AboutROOF-20-1018 1 / •. City of Arcadia, CA Permit NO. ROOF-20-1018 • Development Services Department 240 West Huntington Drive,Post Office Box 60021 Permit Type:Roof Arcadia,CA 91066-6021 Work Classification:Reroof-Residential (626)574-5416 Permit Status:Issued �� '4 r�,� Issue Date:07/06/2020 I Expiration: 07/06/2021 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number l 521 VAQUERO RD Arcadia, CA 91007-6045 5776024016 Txew.xsa ix,vinrear Contacts RICHARD LIE Owner IRINCO JAIMES Agent for owner Lammu' 521 VAQUERO RD simmont, (626)898-3641 (626)837-1673 Description:REMOVE EXISTING TILE,REPLACE Valuation: $ 15,000.00 Tenant J UNDERLAYMENT, REINSTALL ORIGINAL TILE I Total Sq Feet: 0.00 Plan Check 11 Plan tt Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $374.01 Building Permit Fees $320.75 Cash/Receipt$$REC-04898.20 $374.01 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $374.01 ./-14—* 21)ji,f/C. 0—"Z______ CCALLS 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. July 06, 2020 Issued By: Date July 06,2020 Page 1 of 1 r %f A' . 4 PERMIT/PLAN REVIEW APPLICATIOAT •+' �. to*, Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °0.4tl,,,,of„°m• 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 ❑ I have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DECLARATION 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'compensation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions Carrier Code.Any city or county which requires a permit to construct,alter,improve, 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 (This section need not be 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 ❑ 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 not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil compensation Laws of California,and agree that if I should become subject to the penalty of not more than five hundred dollars($500)): workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. ❑I, as owner of the property, or my employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for ate C Z 6 Z-"-Signature sale(Section 7044,Business and Professions Code:The Contractors License 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 attomey's fees. yas owner of the property, am exclusively contracting with licensed ntractors 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). lam exempt under Section 7044,Business and Professions Code,for this reason: Lender's Name Date 7 C 2G�ignature 62...4-2.-----/ Lender's Address IM ORTANT: 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 flew 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 U--c- \.‘I.,_ o -7-0,-<<kkes' Title PRINT NAME 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 .4L«v`Z. Date 7 2 0 2_0 -# %VA . 7 4 riimik Ih\v r City of Arcadia • Building Division 240 West Huntington Drive,Arcadia CA 91007 Office: (626) 574-5416 Fax: (626) 447-9173 When the permit application and the Owner-Builder Declaration have been executed by a person other than the property owner, prior to issuing the permit, the following shall be completed by the property owner and returned to the agency responsible for issuing the permit: AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. I declare under penalty of perjury that I am the property owner for the address listed above, and I personally filled out the above information and certify its accuracy. Property Owner's Signature: Date: 7A'( --°Z(-2 Property Address: 5,Z \ V4 O-4-&E RO R0 . Owner's Name: R ,dGHf 9 � s /Dz Li 6A) Di/ Owner's Address: 5 4-61.ye,1(o 1. p. Phone # (P 2-(0 - - 3 6 ) Agent's Name: \\i\e o C,U„`p S-. Agent's Address: 2.5W w C t e V e o Ns--d. St; Agent's Phone #: COC Scope of Work: R6) (5g. c i NOTE: This authorization must be NOTARIZED or accompanied by a copy of the homeowner's current photo I.D. (i.e., driver's license, passport or military I.D. with signature), when presented for issuance of a permit.