HomeMy WebLinkAboutRALT-21-0276mmm
,.,., City of Arcadia, CA
Permit NO. RALT-21-0276
Development Services Department Permit Type:Residential Addition/Alteration
240 West Huntington Drive,Post Office Box 60021
rArcadia,CA 91066-6021 Work Classification:Res-Addition/Alteration
(626)574-5416 Permit Status:Issued
ARCAD lA Issue Date:04/28/2021 Expiration: 04/28/2022
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1232 SHORT ST Arcadia,CA 91006-4561 8509007002
-11
Contacts
BABAK NASSIRPOUR Owner
1232 SHORT ST
L (818)370-4841
Description:REMODEL KITCHEN AND BATHROOMS.ADD HALF Valuation: $ 58,492.07 Tenant
BATH. CREATE NEW PORCH AND 400 SQ DETACHED CARPORT.
REPLACE HVAC SYSTEM PER APPROVED PLANS.HERS Total Sq Feet: 0.00 Plan Check#21-276 Plan#445
REQUIRED FOR FINAL. REPLACE ALL WINDOWS.WITH -,
ELECTRICAL AND PLUMBING
i T.O,NEW SHEATHING,REROOF HOUSE/GARAGE AND 2ND •
UNIT WITH OWENS CORNING ARCHITECTURAL SAGE COOL
ROOF CLASS A 34 SQ.
TOTAL 3 BED 1.5 BATH
Fees Amount Payments Amount Paid
Bathtubs/or Combo $13.21 Total Fees $2,096.10
Building Issuing Fee $47.01 Cash/Receipt#REC-07456-21 $1,289.38
Building Permit Fees $881.65 Cash/Receipt#REC-06806-21 $806.72
Building Plan Review Fee $573.08
Amount Due: $0.00
Cal Green Plan Check $57.31
Compressor 3-5 Ton(3 to 15 hp) $36.35
Dishwasher $13.21
Electrical Permit Issuance Fee $47.01
Energy Plan Review Fee $176.33
Furnace or Burner<=100,000 BTU $19.86
Garbage Disposal Fee $13.21 CALLS FOR INSPECTIONS
Gas System(Outlets) $16.43 Request for inspection by telephone at 626-574-5450. Leave a message
Green Building Standard $3.00 requesting the address,timeframe and what inspection item is needed.
Install,Relocate Appliance Vent/Hood $9.94
Kitchen Sink $13.21
Lavatories $26.42 This permit/plan review expires by time limitation and becomes null and
Mechanical Permit Issuance Fee $47.01 void if the work authorized by the permit is not commenced within 180 days
Outlets-Receptacles&Switches $1.63 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
Plumbing Permit Issuance Fee $47.01
void if any work authorized by this permit is suspended or abandoned for 180
Solid Waste Management Fee $6.25 consecutive days or if no progressive work has been verified by a City of
Solid Waste Management Fee 2 51.00 Arcadia building inspector for a period of 180 consecutive days.
Total: $2,096.10
J1I COMPLETED
April 28, 2021
Issued By:Jeff Wang Date
April 28,2021 Page 1 of 1
SFA•
GIJ.IFOgy,,l ,
PERMIT/PLAN REVIEW APPLICATION
1t 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
0 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
Signature of Contractor performance of the work for which this permit is issued.
WNER-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
(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
exempt there from and the basis for the alleged exemption. Any violation of u '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
1:11, 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 l Z 1 l2 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
� attomey's fees.
U 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:
4/17/2-
L Lender's Name
) Date —1/17/L 1 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. ^^ '
ame .mac �1%- !V".SSI ( UY .PRINT NAME \Title t v 1,--a-v/
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
rcadia to enter upon h above-mentioned property for inspection purposes.
ignature / - ate 412-712
NOTES
Building Inspections Date Insp. Plumbing Inspections Date Insp. 23 2 S ti
100. Setbacks 210. Under flr.lbldg.drain FAG-r- 21-- o �(�
101. Rough grade 211. Copper underslab ,�,. (
102. Figs.&forms 212. Rough plumbing S13-
103. Pre-slab 213. Rough gas �[
104. Floor joists 214. Shower pan
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framing g43.2.1 fr 220. Fixtures
111. Occ./Area Sept.Wall 221. Final plumbing q."-I a h�
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid
114. Insulation Flr. 1i Pool Inspections Date Insp.
115. Insulation-Wall�ig,)f -21 �+ 240. Excavation/steel
116. Insulation-Ceil. 4/ 241. Rough plumbing
117. Drywall nailing 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade 245. Gas line&test
121. Final building 1,-8--21 fro 246. Fence,gates&signs
122. Final demoAot dear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final•lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Underground conduit
153. Underslab conduit Reroof Inspections I Date Insp.
154. UFER ground 270. Pre-reroof insp. _
155. Water ground 271. Roof framing
• 156. Rough electrical g-13-.24 iyki 272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E..t.bondin• Sign Inspections I Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric 9- _'2� iv.\ 281. Footing
282. Conduit/wirin.
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 284. Final sign
181. Furnace/A.C.
182. Rouch HVAC 2.1111=1 Miscellaneous Insp. I Date I Insp.
183. Fire dampers 290. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Hood dry chem.
188. Compressor setback 295. Final
189. Commerdal hood
190. Duct shaft Sewers&Offsite Insp. I Date I Insp.
191. Final mechanical - 114111 300. Lateral(main to PA.)
301. SaddleN
Block Wall Inspections Date Insp. 302. Ce •••lfilled
200. Footings 303. Sidewalk
201. Steel/rebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
,•,. City of Arcadia, CA
Permit NO. RALT-21-0278
a Development Services Department Permit Type:Residential Addition/Alteration
240 West Huntington Drive,Post Office Box 60021
0 Arcadia,CA 91066-6021 Work Classification:Res-Addition/Alteration
(626)574-5416 Permit Status:Issued
A.RCA D f A Issue Date:04/28/2021 Expiration: 04/28/2022
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1232 SHORT ST 1/2 Arcadia,CA 91006-4561 8509007002
dimmommommill
Contacts ,
BABAK NASSIRPOUR Owner
1232 SHORT ST
(818)370-4841
Description:REMODEL KITCHEN AND BATH WITH ELECTRICAL Valuation: $9,628.20 Tenant
AND PLUMBING
Total Sq Feet: 0.00 Plan Check#21-278 Plan#445
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $705.03
Building Permit Fees $237.25 Cash/Receipt#REC-07457-21 $487.93
Building Plan Review Fee $154.22 Cash/Receipt#REC-06807-21 $217.10
Cal Green Plan Check $15.43
Amount Due: $0.00
Dishwasher $13.21
Energy Plan Review Fee $47.45
Garbage Disposal Fee $13.21
Green Building Standard $1.00
Install,Relocate Appliance Vent/Hood 59.94
Kitchen Sink $13.21
Lavatories $13.21 CALLS FOR INSPECTIONS
Mechanical Permit Issuance Fee $47.01 Request for inspection by telephone at 626-574-5450. Leave a message
Plumbing Permit Issuance Fee $47.01 requesting the address,timeframe and what inspection item is needed.
Shower $13.21
Solid Waste Management Fee $6.25
Solid Waste Management Fee 2 $1.00 This permit/plan review expires by time limitation and becomes null and
Solid Waste Management Fee 2 $1.00 void if the work authorized by the permit is not commenced within 180 days
Strong Motion Inst.Program Res $1.26 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
Ventilation Fan(Single Duct) $9.94
void if any work authorized by this permit is suspended or abandoned for 180
Water Closet $13.21 consecutive days or if no progressive work has been verified by a City of
Total: $705.03 Arcadia building inspector for a period of 180 consecutive days.
b'?I COWIPIIETED
April 28, 2021
Issued By:Jeff Wang Date
April 28,2021 Page 1 of 1
I ,
F Ag
eIFOk
1 Pill 1 PERMIT/PLAN REVIEW APPLICATION
o►1 ® rim
a 441.,, 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.
S'._•: - of Contractor
OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section
al 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
is 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
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
zi
sale(Section 7044,Business and Professions Code:The Contractors License Date )2 7124 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 4121/ 2 1 Signature ../....._ _ Lender's Address
I 1PORTANT: APPLICATION IS H REBY 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 I�bIa.�f K.- Ni
#i t t v Q t Title 0 W`t--P.—y
PRINT N .
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
rcadia to enter upon the abo e-mentioned property for inspection purposes.
ignature /� T Date 1/2 1 / 2 I
,
NOTE/S"
Building Inspections Date Insp. Plumbing Inspections Date Insp. 1232 /Z 5 /v T
100. Setbacks 210. Under fir/bldg.drain T- 2-1 I O�7 O
101. Rough grade 211. Copper underslab
102. F's.&forms 212. Rou.h.lumbi • i-2-2, •a .
103. Pre slab 213. Rough gasueri- 6 K(T f
104. Floor joists 214. Shower pan (y t f--✓"`�'
105. Steel 215. Water heater
106. Grout lift 216. Roof drains
107. Shear nailing 217. Building sewer
108. Diaph nailing 218. Water service
109. Roof nailing 219. Final gas
110. Framingg�2 Zt ilf‘i 220. Fixtures pp
111. Occ./Area Sept.Wall 221. Final plumbing 4.p-2.
112. Sound walls 222. Sewer cap/demo.
113. T-bar grid
114. Insulation Flr. Pool Inspections I Date Insp.
115. Insulation-Wall 240. Excavation/steel
116. Insulation-Ceil. 241. Rough plumbing
117. Drywall nailing 242. Light shell/bonding
118. Interior lath 243. Underground conduit
119. Exterior lath 244. P-trap
120. Finish grade245. Gas line&test
L
121. Final building �� !v.1 246. Fence,gates&signs
122. Final demo/lot clear 247. Pool heater
248. Final electric
Electrical Inspections Date Insp. 249. Final.lumbin.
150. Power pole 250. Pool cover
151. Sales lot lighting 251. Pool final
152. Under.round conduit
153. Underslab conduitReroof Inspections I Date I Insp.
154. UFER ground 270. Pre-reroof insp. -
155. Water ground 271. Roof framing
• 156. Rough electrical 721 (11,1/41 272. Sheathing nailing
157. Fixtures 273. Final reroof
158. G.F.C.I.
159. E•,•t.bondi Sign Inspections I Date I Insp.
160. Service panel 280. Setback/overhang
161. Final electric i -� 3 281. Footing
282. Conduit/vin
Mechanical Inspections Date Insp. 283. Disconnect
180. Venting/flue 726 Z, , 284. Final sign
181. Furnace/A.C.
182. Routh HVAC Miscellaneous Insp. Date Insp.
183. Fire dampers 290. Fire alarm
184. Furnace compartment 291. Underground supply
185. Combustion air 292. Fire sprinklers
186. Smoke detectors 293. Monitor system
187. Metal F.P.rough 294. Flood dry them.
188. Compressor setback 295. Final
189. Commercial hood
190. Duct shaft Sewers&Offsite Insp. I Date I Insp.
191. Final mechanical {"Q - ' 300. Lateral(main to P/L)
301. SaddleN
Block Wall Inspections Date Insp. 302. Cess... filled
200. Footings 303. Sidewalk
201. Steellrebar 304. Driveway
202. Grout lift 305. Curb replacement
203. Final wall 306. Trash bin
City of Arcadia, CA Permit NO. ROOF-21-0645
Development Services Department Permit Type:Roof
240 West Huntington Drive,Post Office Box 60021Work Classification:ReroofResidential
I
Arcadia,CA 91066-6021
(626)574-5416 Permit Status:Issued
ARCADIA Issue Date:04/12/2021 1 Expiration: 04/12/2022
Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number
1232- 1232 SHORT ST Arcadia,CA 91006-4561 8509007002
1/2
Contacts
BABAK NASSIRPOUR Owner
1232 SHORT ST
(818)370-4841
Description:T/0 AND REROOF BOTH HOUSES 1232&1232 1/2 Valuation: $ 15,000.00 Tenant
WITH OWENS CORNING ARCHITECTURAL,CLASS A COMP,
COLOR:ONYX OVER NEW SHEATHING Total Sq Feet: 0.00 Plan Check# Plan#
Fees Amount Payments Amount Paid
Building Issuing Fee $47.01 Total Fees $374.01
Building Permit Fees $320.75 Cash/Receipt#REC-07283-21 $374.01
Solid Waste Management Fee $6.25 Amount Due: $0.00
Total: $374.01
4-1 q-2- r
FoOf atbe'rOilkielr 40g. 41\1
CALLS FOR INSPECTIONS
4`17- I Request for inspection by telephone at 626-574-5450. Leave a message
requesting the address,timeframe and what inspection item is needed.
1 coF f/A[AL ,
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
11 Arcadia building inspector for a period of 180 consecutive days.
151
COMDLE?ED
April 12, 2021
Issued By:Jeff Wang Date
Page 1 of 1
April 12,2021
%F A•
1 o
i! „Uvo,m..,g'g
: :* PERMIT/PLAN REVIEW APPLICATION
0
0.\,_ t.*, Development Services Department,240 West Huntington Drive,Post Office Box 60021
°,�Y�t N° 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
Sig tore of Contractor performance of the work for which this permit is issued.
WNER-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
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
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 ow
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
I, as owner of the property, am exclusively contracting with licensed
contractors to construct the project(Section 7044, Business and Professions attorney's fees.
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).
am exempt under Section 7044,Business and Professions Code,for this reason:
Lender's Name
sate•11/4 2124 Signature Lender's Address
ORTANT: APPLICATION IS HE EBY MADE TO THE BUILDING OFFICIAL FORA PERMIT SUBJECT TO THE CONDITIONS AND
TRICTIONS 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.
(
Na 3„,1,..1_ N(ASS't ✓ --- Title t,-)"4-9
PRINT NA
I ertify 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.
agree to comply with all City ordinances and State Laws relating to building construction. I hereby authorize representatives of the City of
rcadia to enter u n the above-mentioned property for inspection purposes.
S nature
l _ Date
,r
County of Los Angeles
l�il all DEPARTMENT OF PUBLIC WORKS BUILDING&SAFETY DIVISION
\` � Los Angeles Regional Uniform Code Program
- . .UC vi IrtL ^.L,ERVATION REPORT FORM
•
STRUCTURAL OBSEnv.TL, _ _ th, 1 ._...H._ ftti_ .r,✓..,..., far gc:-::-..r „L_.. _...
\rA I IVI.Illli.IIIJ IIIV V JJVuI V✓JVI.✓a/VI r V/ ✓Ja/uv.✓.u,
C:o_tion_.. ♦significant-..--1....-I•__ _t__.__ J_t_o___I_t'-..of
approved plans and specifications, at JIIJI I/IIt.O Ut t.V//JtI US.UVII stagos J Gi5U at l.VS,lf/IaitSV11 VI tilt.Ji,✓'..t Ul✓,3;:o:.;,;;. ✓.-.✓,✓I
nh'nnln+inn r/nno no+irlrlllrin or'..!"2!..-_,+ho rncnnnccihilih/forihe I.,'pe'±O,,S required by Section 108, 1705 or other sections
()fowl ns Angeles County Building Code.
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Y_ _ J {4day of 20 s./o Pa�: / of A.
This report _� .—,.
_
Project Add
..�ress:_.77.7 r z 3 2 s/i o rt St-
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ne.-noon C4rtura!Observer of Record(SOR): SOR Phone No.:
(t�6,s-�f-s(P-S#
LIR/-rcaal.i a, cA f/ooh Wc-n Y V" M v -. . ; . .o.
11L. '21-0Lr6 performed b /t L. I , _ C l6ra-r _ -- - J�6 ) Sst 3o�s-�
k� r I .... -,.
_ cI1-""GNTS/CONNECTION
r ..r.ATIn1� I •Ind I I __.. I n , .;rn'VATON LOCATION
I tato (, StOo' C.n l n(`nn.....'".'s
. . I O f G�1 i R a-t OC .
❑ Footing, Stem Walls ❑ Concrete._
r �.._, r, f r, I Corlhtctierf
_^r.._ ( n ,.l_-d r, C:77:4:".".oment 0 Wood
'
,....,,^ 'ms �, _ 1-..,me
❑ Retaining Fc,!^.._:.7.e ( - - I I
HillsidC^....;..�A. _„.1... 1
❑ Others: II
I�Others:Pore
— .—l ---
NOTE DEFICIEPtr''r.• '-- _+:-._n .._.:_.._^...:.t. ._ 777^7 :'_-.._ _` '_ ^_
777-
With the apprnved nIac• (A fin on
?l rnrf b,.+hr..'+r....+...nl ^1-................1-:-1.- .•+•.a•• +••• , L
ronlver.! . rer..Ilred before acceptance of thework by the buildingilftticla e A-03
_03 /7/i/ rc�a�Ce� �l c�s� w�rl�s
r'ord 7 i� �-"v1 [shhe c K o �t� vet
are tCceft� le cv;th•- s�c-lk.r4.J dTIC;(- MC%es. The clic o f Pereh Post b4.1e..
Conne-c.tc d to a .ist;ni eontc-rete sla b w;th M►►„ht,w or 4'-tnL tl�ietc Ver%fieI i
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tyA . Use 4;•.r•eh 1 f h Z in fra,r.t f e reh
;Gid , 71.0 tw-� cIt0+1,-n Cd�e f••ti"� r 0 �� � eeL1 e s t�s co/alca!itie+t.
V C f I
• CHARGE-FOR THE STRUGTUo"' T
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...^r v +" Tlr FaCicond.�Q._,„ UNC e2tG ::,;.� . _ 7.0 SITE•VIS TS AT
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v 70729 G
-- - - -” ^:i�niii.i11RE IS IN t('i rn1
3. ALL NOTE^ ^=.._._.._._� :....._.. ---•-�- •- - -....7777- ....._ _-_.: ..:_._.-- t\I'� r ��IL •��
ABOVE i
....-•m T..AT • ...is''se T..r .."""I^Tr.r,+I evcTeVs BY THE COUNTY OF `
__. ;:::::.�,;i.nc�.vRRECTED. ,',
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OBSERVER DAT t SIGNATURE OF OF ST UCTURAL OBSERVEK 7777__-- __ tY -
Vers ic-.^_.
/ 19'-3" /
/ 3'-6" f 15-9" /
3040SH
T LL t
MN
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1 A 1 C —7—I?:(' 1
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-
-N LIVING
EN i 3L6"T/ 3'-6" in
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x
i? 11'-11"
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ZO
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JI,, .K 2'-10"
M2 ii ,-' KITCHEN En DINING I R \
I iD �nTT` v
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/ 3'-6" / 6'-2" / 6'-7" 1 3' / •
/ 19'-3" / 1
TOTAL LIVING AREA 890 SQ.FT.
FIRST FLOOR
+/4'-,• NO STRUCTURAL GHANG
0 NO Y'IINDOIN REPLAGEME1
NO EXTERIOR CHANGES
I
Z 2- '/i 5A0r-f-
m I U u I 8 i 2'-11" cls
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P 6'-9" 13'-4112"
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/ 4' ,t' 8' ,I' 7'-11" 4'-2'
24'
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0
IFT-- 24' /
----
12' / 12' /
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3040s„
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H WE: / I I CPEN BELOW
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r / 6'-2" 5'-10" 5'-10" j/ 6'-2" /
Ui / 24' /
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r• Og D.'.l. °wnly44 CanhAwkw Ow Oro"w 4697901 G16114.
All WS OM3P0.ARRANGE/Ian AND PUNS INWARD R@R0D11®
119 M3 0RAWNG AC OWIRD IY AND MI PROPHIT OF P,l1.C.NC AHD 2V1 lab Aware_$.,6011
D WEIL alum main AND 0196 ®09POR INR OK AND 91 COMICIION Madw14 CA91001al i
.'ons WITH M=CAC PRO= W17916025 /N6d6VW
NOH609 ROI WA OCiOM AROAHIOOH6IIS ovum awl.sawD
41