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SNew-18-0806
.. City of Arcadia, CA Permit NO.SNew-18-0806 Development Services Department Permit Type:Single Family New 240 West Huntington Drive,Post Office Box 60021 i Arcadia,CA 91066-6021 Work Classification:SFR-New Dwelling (626)574-5416 Permit Status:Issued ARCADIA Issue Date:11/19/2019 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 23 W Winnie WAY Arcadia,CA 5782017018 Contacts RICHARD TAO Owner PDS STUDIO* Applicant 23 W WINNIE WAY 711 S FIRST AVE,ARCADIA,91006 (626)294-9402 pchan@pds-studio.com T S H CONSTRUCTION &DEVELOPMENT Contractor INC 5605 TEMPLE CITY BLVD B,TEMPLE CITY,CA 91780 (626)688-6255 952913 Description:4 Bedrooms,5.5 Baths,Attached 2-Car Garage, Valuation: $ 569,447.40 Tenant Living Room, Dining Room,Family room,Kitchen,Wok RM, Library,Laundry,GYM/Exercise Room,Loft Total Sq Feet: 4.038.00 Plan Check#18-806 Plan#178 Fees Amount Payments Amount Paid Building Issuing Fee 547.01 Total Fees $21,512.37 Building Permit Fees $4,467.00 Cash/Receipt#REC-002278-2018 $6,917.31 Building Plan Review Fee $2,903.55 Cash/Receipt#REC-03132-19 $14,595.06 Cal Green Plan Check $290.36 Energy Plan Review Fee $893.40 Amount Due: $0.00 Grading Issuance Fee $47.01 Grading Permit Fee(1-1000 CY) 5450.00 Grading Plan Review Fee $850.00 Green Building Standard $23.00 LID Plan Check Fee $100.00 Off Site Plan Check(Per Site) $240.00 CALLS FOR INSPECTIONS Parks&Recreation Fee(SFR) $6,483.75 Request for inspection by telephone at 626-574-5450. Leave a message Single Family Fire Plan Check $280.00 requesting the address,timeframe and what inspection item is needed. Single Family/Condo/Townhome Impact $1,983.00 Fee Solid Waste Management Fee $6.25 This permit/plan review expires by time limitation and becomes null and Strong Motion Inst.Program Res $74.03 void if the work authorized by the permit is not commenced within 180 days SWMF FEE 2 51.00 from the date of issuance or if the permit is not obtained within 180 days SWMF FEE 2 $1.00 from the date of plan submittal.This permit expires and becomes null and WELO Permit Fee $625.00 void if any work authorized by this permit is suspended or abandoned for 180 WELO Permit Issuance $47.01 consecutive days or if no progressive work has been verified by a City of WELO Plan Check $1,700.00 Arcadia building inspector for a period of 180 consecutive days. Total: $21,512.37 ` compifiE $-2-L/ November 19, 2019 Issued By: Date November 19,2019 Page 1 of 1 sf A• 4�*LIFO!(,,,' .I �� PORT I. PERMIT/PLAN REVIEW APPLICATION g. ilLER ill t Development Services Department,240 West Huntington Drive,Post Office Box 60021 o` Arcadia, CA 91066-6021,(626) 574-5416,Fax (626)447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION A, 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: hapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code and my license is in full forc 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 Signature of Contractor performance of the work for which this permit is issued. 0 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 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 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 of321 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 1 --1-,c\ ,�~` , v sale(Section 7044,Business and Professions Code:The Contractors License Date 4 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). ) I am exempt under Section 7044,Business and Professions Code,for this reason: FF N{O . �ko`�e S Lender's Name.....1c. :44...,tc.,\) c. Date ` ` \ C 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 ow % \ •N Title A • 4. 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 Arcadia to enter upon the a 1 1 -mentioned property for inspection purposes. — \ — q \ Signature ����i Date .I • IIIIMIIIIIES Building Inspections Date Insp. Plumbing Inspections Date Insp. 2 ',\I` /A J`� I I I6 NAT , . 100. Setbacks ��10. Under W./bide.drain - I �`r-V rOV• `���) I 101. Rough grade toe/��'. E.W."F211. Copper underslab •V 102. Figs.&forms 7 �l ' „212. Rough plumbing a - 103. Pre-slab , 3- .:2•o. ---- 213. Rough gas 104. Floor joists 214. Shower pan q-120 3- 22. 4, r---0-r),-,4 * P•fys e !L-w2_�f24 ,•o 105. Steel 215. Water heater 5--(4---2-0 ` '��D r/r-s 106. Grout lift 216. Roof drains 107. Shear nailin. °-1-2-0 /l 17. Buildin.sewer _ ••tea&.ir to . /• ��D 108. Dia.h nailin. 23-2 ;�-2( --10--O Su •TiOt4 _I CIL 11 109. Roof nailin. - '-2O 4i‘ 19. Final.as 6-1°-2( ,ems ,,rr,,L� ,�,^' 110. Framing `-/Y-Z-> ,C.1.�220. Fixtures 14 V(- `�' v 111. 0cc./Area Sept.Wall 221. Final plumbing ;---5--21 41 " 112. Sound walls 222. Sewer capidemo. /-2.1-2 ie_...7,.. ,-" 113. T-bar grid 3-34,-7-I 4,�,A- r0�a j� 114. Insulation-Flr. . "i' Pool Inspections Date Insp. / -' 115. Insulation-Wall 01,,,.. .------- 240. Excavation steel �2ci 116. Insulation-Ceil. 241. Rough plumbing ���1J� �t``�O� `�/oF u 117. Drywall nailing �"v° 1242. Light shell/bonding �,lWL 0l,U t i i-' 1126eriple Cr-118. Interior lath � 243. Underground conduit r r,!V e- 119. Exterior lath 9-30-7-f-)� X244. P-trap { Qom/ 120. Finish grade /245. Gas line&test 121. Final building '3 Z-z-f -7 246. 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 conduit Reroof Inspections Date I Insp. 154. UFER ground > f 270. Pre-reroof insp. 155. Water ground Cri 271. Roof framing 156. Rough electrical 272. Sheathing nailing 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. E•.t.bondin. _-Zf ;- 4 Sign Inspections 1 Date Insp. 160. Service panel 280. Setback/overhang 161. Final electric 6,4 V-2 ,, 281. Footing 282. Conduit'wirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sun 181. Furnace/A.C. 182. Rouch HVAC `1-3-Z( 464 % li. ' •1'' I . 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. Hood dry chem. 188. Compressor setback 295. Final 189. Commercial hood 190. Duct shaft Sewers&Offsite Insp. Date 1 Insp. 191. Final mechanical ,--/V-2-( ' 300. Lateral(main to PI) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess.00l filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin .('-'--.--' n: ^� j , \ , J ,;',.1„.„------ ,•:,-...ii %fir� , ami;i ,,,n i „, ..... ....„, . r , , ..;.,LN, , _:_:., , ._:.: ''' c- `� I m O T O ro to /” - : ,n 7 = n T fD ° i E.. '':\ 1 Y -i go N 1 yN' n n '. a O A ---.) �`� 00 C/, it-4 r I c •,1 t \' t&) W i.r7 W , _ (,,,,, Zv n CT, ii: eD _ � rt / c a g-•-1 0 / H --,) ) !r ', a "mss °�° 8eke • /, ona o H \ y a ^* a n M d 2 a• f . 7. ? © a al 2. t, C \ 5 � '✓ 1, J1 .7C R c. s- m O et, aR 3 7 A ' , i ^O e 0- J a 1��, yr 00 f9 • �\ ( "0 \ c G A C a O n I 4 O F V c o c \\71...:, ,7", \//, b cn i ' Cil C . to F )y r ( g d = y,, (......„ \ ;,..„2.---...,---"11- . ,_.7.-,-,--0: --1 ., _, _ \:_, -- yi N._ ....-- \ - ,, ---.., __ _;" . ' •i. City of Arcadia, CA Permit NO. Elec-21-1032 Development Services Department Permit Type: Electrical 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Electrical Residential (626)574-5416 Permit Status:Issued ARCADIA Issue Date:06/09/2021 1 Expiration: 06/09/2022 , Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 1111 23 W WINNIE WAY Arcadia,CA 91007-8048 5782017018 Contacts RICHARD TAO Owner RUI LIANG* Contractor 711 S 1ST AVE,ARCADIA,CA 91006 421 W WINNIE WAY (626)524-2901 TUSHERIC@YAHOO.COM (626)236-6657 925139 Description:FOR SF NEW.400 AMP SERVICE,100AMP Valuation: $ 0.00 Tenant SUBPANEL Total Sq Feet: 0.00 Plan Check if Plan If Fees Amount L I Payments Amount Paid Distribution Panel $16.48 Total Fees $434.53 Electrical Permit Issuance Fee $47.01 Cash/Receipt q REC-07848-21 $434.53 New Residential Accessory Bldg (sq ft $30.52 area) Amount Due: $0.00 New Residential Elect.(sq ft area) $323.04 - Residential Services up to 400 amps $16.48 Solid Waste Management Fee 2 $1.00 Total: $434.53 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 144(i c r.." void if the work authorized by the permit is not commenced within 180 days OMP1 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. June 09, 2021 Issued By: Henry Kemick Date June 09,2021 Page 1 of 1 ti ! '± PERMIT/PLAN REVIEW APPLICATION vE.--a--- iDevelopment Services Department, 240 West Huntington Drive, Post Office Box 60021 000e.iq of•-• Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia 14 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 an effect. Na ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class % Cl2) 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 .�-y.,�—�— OWNER-BUILDER DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section 0 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 Policy Number for such permit to file a signed statement that he or she is licensed pursuant to the 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'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 Date� ' l ll 2/t 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 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. • e 1jt FAX I Title Ce.0 PRINT NAME certify that I have read this application and state that the above information is rrect 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 build' g construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-mentioned property for inspection purposes. n gnature Date 6 ic1, 1 y ( .,•.* City of Arcadia, CA Permit NO. Plum-21-1013 Development Services Department Permit Type:Plumbing 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Plumbing Residential (626)574-5416 Permit Status:Issued ARCADIA Issue Date:06/08/2021 Expiration: 06/08/2022 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 23 W WINNIE WAY Arcadia,CA 91007-8048 5782017018 Contacts RICHARD TAO Owner 1 V CONSTRUCTION INC* Contractor 711 S 1ST AVE,ARCADIA,CA 91006 2561 DENTON AVE,ROSEMEAD,CA 91770 (626)524-2901 TUSHERIC@YAHOO.COM (626)542-5965 961164 Description:PLUMBING FOR SF NEW Valuation: $0.00 Tenant Total Sq Feet: 0.00 Plan Check U Plan U Fees Amount Payments Amount Paid Bar Sink $13.21 Total Fees $455.52 Bathtubs/or Combo $13.21 Cash/Receipt#REC-07832-21 $455.52 Clothes Washer $13.21 Dishwasher $13.21 Amount Due: $0.00 Garbage Disposal Fee $13.21 , Gas System(Outlets) $19.71 Kitchen Sink $26.42 Laundry Trays $13.21 Lavatories $79.26 Lawn Sprinkler System on One Meter $19.86 Plumbing Permit Issuance Fee $47.01 CALLS FOR INSPECTIONS Sewer Connection on Property $33.01 Request for inspection by telephone at 626-574-5450. Leave a message Shower $52.84 requesting the address,timeframe and what inspection item is needed. Solid Waste Management Fee 2 $1.00 Water Closet $66.05 Water Heater and/or Vent $31.10 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 Total: $455.52 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. COMI'IIETEI June 08, 2021 Issued By: Henry Kemick Date June 08,2021 Page 1 of 1 c`I4 PERMIT/PLAN REVIEW APPLICATION IN+' + ' Development Services Department, 240 West Huntington Drive, Post Office Box 60021 i a 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,an my license is in full fo an effect.) I have and will maintain a certificate of consent to self-insure for workers' License Clas Contractor traonLicense No. -- Exp. Date / 2 compensation, as provided for by Section 3700 of the Labor Code, for the Signature of C ��o,re„ 'lrr n r ✓`S� performance of the work for which this permit is issued. OWNER-BUon ctor DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section 0 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 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 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 orthwithlccomply with those provisions. compensation,will do the work,and the structure is not intended or offered for 61"I /Zr'Z) Signature /-°�� r 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 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. 1I1 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. areI :f► �`� Title \ PRINT NAMEcertify that I have read this application and state that the above information is rrect 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. 1 Sign ture �; 1,/•--L'"• "-- Date (///7-� 7-- / City of Arcadia, CA Permit NO. Mech-21-1014 Development Services Department Permit Type:Mechanical 240 West Huntington Drive,Post Office Box 60021 ` Arcadia,CA 91066-6021 Work Classification:HVAC New System, Residential (626)574-5416 Permit Status:Issued ARCADIA Issue Date:06/08/2021 I Expiration: 06/08/2022 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 23 W WINNIE WAY Arcadia,CA 91007-8048 5782017018 Contacts RICHARD TAO Owner HY BUILDER INC* Contractor 711 S 1ST AVE,ARCADIA,CA 91006 88 LIVE OAK AVE B,ARCADIA,CA 91007 (626)524-2901 TUSHERIC@YAHOO.COM (626)384-8336 1033836 Description:INSTALL 2 HVAC SYSTEMS FOR SF NEW PER Valuation: $ 0.00 Tenant APPROVED PLANS.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) $72.70 Total Fees $277.77 Electrical Permit Issuance Fee $47.01 Cash/Receipt#REC-07834-21 $277.77 Furnace or Burner<=100,000 BTU $39.72 Gas System(Outlets) 516.43 Amount Due: $0.00 Light Fixtures $1.63 Mechanical Permit Issuance Fee $47.01 Outlets-Receptacles&Switches $3.26 Plumbing Permit Issuance Fee $47.01 Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 Solid Waste Management Fee 2 $1.00 CALLS FOR INSPECTIONS Request for inspection by telephone at 626-574-5450. Leave a message Total: $277.77 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. June 08, 2021 Issued By: Henry Kenrick Date June 08,2021 Page 1 of 1 f AR %�o 41111 . OOP 1 PERMIT/PLAN REVIEW APPLICATION o ,4„.. 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, my license is in full force and e'-et. / � 'rte ❑ I have and will maintain a certificate of consent to self-insure for workers' License Class License Ns f - p. Date( / I I 11 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 DE I TION IDI 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 Policy Number for such permit to file a signed statement that he or she is licensed pursuant to the 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 91I 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 La r Code,I sh• . 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 forsale(Section 7044,Business and Professions Code:The Contractors License \Date (; ( Signature -...--- Law 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 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. A 1, ame ( ��kA\ � /F/VC S k(?Ii/,I\�h �V� l.� Title G fj PRINT NAME J I certify that I have read this application and state that the above information is co ct and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances d State Laws re ling to buildin construction. I hereby authorize representatives of the City of Arcadia to enter upon the above-ment'r 1 property for ins• tion purposes.% çture _ =� `- Date (2 ( / / �( �i I � ' Op ,ARCA P. f�OR 4PoAeT89AT t9 CITY OF ARCADIA 240 West Huntington Drive Arcadia, CA 91007 FINAL GRADING VERIFICATION ATTENTION: Community Development Administrator SUBJECT: Grading Verification for Project No. I _ >t) Address: 2 vv. ov \ i Gentlemen: Finish grading operations have been completed for Project No. for Lots through (if applicable) and has been inspected by the undersigned Registered Civil Engineer or Licensed Architect. Based upon the observations, the grading subsequent to the Rough Grading has been completed in accordance with the approved plans and specifications and is in substantial conformance with the final grading plan approved by the City and no unauthorized deviations were made. All required surface drainage devices have been installed. Provisions have been made for drainage of surface waters around proposed buildings and their appurtenances. tk( t— �.QQROFESS/o�L �, ,�S4NG.�/.qy"9l Engineer (Signature) �Q � itect(Signature) !! Go 45846 R.C.E. No. 4 Jb * ;.. No. ri Date: (6, c 00. OF CALIF Received and approved: Date: 7r/' l2 f C. D./Pia g cc: C.D.D./Maint. Ser. C.D.D./Building A CITY OF ARCADIA 1 '= ._—a WATER EFFICIENT LANDSCAPING DOCUMENTATION PACKAGE CERTIFICATE OF COMPLETION i This certificate is to be filled out by the project applicant land the property owner upon completion of ; the landscaping project. . u Project Information Date of Project Completion Permit Type and No. —1--5 — ZoZ` NSW — la -OeoG Project Address z3 u) . c.J1�n\k, \k/o.•! . 1 Name of Project Applicant and Title I Name of Property Owner y Q..'t\o.' AQO , Company Name& Mailing Address Mailing Address • CSK Cons-k'ru :. 8, e.Q6Tme,- Iv.. Z.3 vki - w s0e X10.? . • cPS Tele 1k bl.i, . --temAQ c k-y Ncc a:(A, c N Telephone and Fax No(s). Telephone and Fax No(s). o-‘ 6b8 6255- 626 673 - x-113 Email Address Email Ad ress USh e.�i L ( y o�hoo - corn w-i c�a��\c-srao e a�o� , Gtn, f t Project Applicant — The signer of the landscape design plan, signer of the irrigation plan, the licensed landscape contractor that installed the landscaping and irrigation, or a licensed professional that performed periodic site observations to verify that the project is consistent with the Water Efficient Landscaping Documentation Package for the project and that the project complies with Ordinance No. 2267. "I/we certify that based upon periodic site observations, the work has been substantially completed in accordance with Ordinance No. 2267 and that the landscape planting and irrigation installation conform with the criteria and specifications of the approved Landscape and Irrigation Plans and Landscape Documentation Package and acknowledge that the project may be subject to . inspection and a Landscape Water Audit to verify that the project is maintained in • compliance wi • • •' ance No. 2267." 1 1 Signature Date i print) Telephone and Fax No(s). �� C cidAvA C-. �� ( G'1.c.) �c 4--__... Title License No. or Certification No. • (._G(,k‹)s k_c,c t t -- ,3c j Z c� Company Email Address ,s^i`k ir. �'0'1 Cc c Lw�-c) ,/s 1 A€ _ 144 . 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TYPE OF INSPECTION DATE& INITIAL DATE& INITIAL FINAL APPROVAL LANSCAPING/IRRIGATION '\jg Pi /2 I TRASH ENCLOSURES J PARKING/DRIVEWAYS STORAGE AREAS MECHANICAL EQUIPMENT WALL HEIGHT BACKFLOW SCREENING COMMENTS: C. LOS ANGELES COUNTY Robert ne Ferrante 011114410 Chief Engineer and General Manager 41011YSANITATION DISTRICTS 1955 Workman Mill Road,Whittier,CA 90601-1400 Converting Waste Into Resources Mailing Address:P.O. Box 4998,Whittier,CA 90607-4998 (562)699-7411 •www.lacsd.org CONNECTION FEE QUOTATION This quote is based on the category and square footage or number of units provided by the customer. Quotes are subject to change ifdifferent information is subsequently confirmed. Counter Hours: 7:00 a.m.-4:00 p.m.Mon.-Thurs. 7:00 a.m.-3.00 p.m.Fri. Application No.: 5782017018-002 Date: July 13,2021 SEWERAGE SYSTEM CONNECTION FEE PROPERTY&APPLICANT INFORMATION APN:5782 017 018 District No.: 15 Owner/Situs Address Applicant Information RICHARD L AND TAO Richard Tao 23 WINNIE WAY 23 West Winnie Way ARCADIA,CA 91007 Arcadia,CA 91007 Phone:(626)688-6255 FACILITY INFORMATION&CONNECTION FEE CALCULATIONS Facility Type Measure of Use Unit Rate Amount Single Family Home D 1.00 DU Single Family Home N 1.00 DU $1,551.00/DU $1,551.00 23 WINNIE WAY,ARCADIA Base Cine Credit 1.00 CUs $1,551.00/CUs ($1,551.00) TOTAL Connection Fee Due $0.00 Type Abbreviations N-New or Additional:C-Change of Existing;E-Existing to Remain;D-Demolition of Existing;T-Tenant Improvement of Existing:S-Septic to Sewer COMMENTS New 2-Story SFH(4038 sqft).Existing SFH Demolished-Demo permit provided.-No Fee Required. Includes demolition of 1.00 DU of existing Single Family Home Please make checks payable to:Sanitation Districts of Los Angeles County Online payments available at www.lacsd.org If you have questions regarding this fee quotation,please call Beth Anne Fuchs at(562)908-4288,ext.2727 Office hours:Mon-Thur 7:30 a.m.to 4:00 p.m.,Fri 7:30 a.m.to 3:00 p.m. THIS/S NOTA CONNECTION PERMIT. A CONNECTION PERMIT IS REQUIRED BEFORE CONNECTING TO ANY SEWER. . - w q-/kW CHEERS REGISTRYs;1 � II I� , :000 } ,,i: �: PROJECT STATUS REPORT 1 : � ,�,;;..� CHEERS ❑ �:r3o , ,o _ Scan to Validate PROJECT SUMMARY Project Name: A18-7432 HERS VERIFIABLECOMPLETE O Address: 23 W WINNIE WAY MEASURES City,State,Zip: ARCADIA,CA 91007 Building Department: Arcadia,City of ENERGY CODE COMPLETE O Permit Number: SNEW-18-0806 COMPLIANCE Building Energy Code: 2016 Standards CERTIFICATE OF COMPLIANCE (CF1R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 03/13/2018 CF1 R-PRF-01-E Performance Compliance 418-P010015339A-000-000-0000000-0000 05/18/2021 CF1R-SRA-01-E Solar New Construction 418-P010015339A-R01001A CERTIFICATE OF INSTALLATION (CF2R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 05/18/2021 CF2R-ENV-01-E Fenestration 418-P010015339A-000-001-E01002A-0000 O 05/18/2021 CF2R-ENV-03-E Insulation Installation 418-P010015339A-000-001-E03003A-0000 O 05/18/2021 CF2R-ENV-04-E Roofing Radiant Barrier 418-P010015339A-000-001-E04005A-0000 0 05/18/2021 CF2R-LTG-01-E Lighting 418-P010015339A-000-001-L01001A-0000 lO 05/18/2021 CF2R-MCH-01a-E HVAC, Ducts and Fans 418-P010015339A-000-001-M01006A-0000 0 05/18/2021 CF2R-MCH-27a-H Mechanical Ventilation 418-P010015339A-000-001-M27007A-0000 ee 05/18/2021 CF2R-PLB-02a-E Single Family Hot Water 418-P010015339A-000-001-B02004A-0000 1ST FLOOR AREA1 05/18/2021 CF2R-MCH-20a-H Duct Leakage 418-P010015339A-000-001-M20008A-0000 05/18/2021 CF2R-MCH-22a-H Fan Efficacy 418-P010015339A-000-001-M22010A-0000 05/18/2021 CF2R-MCH-23a-H Airflow Rate 418-P010015339A-000-001-M23009A-0000 -continued on next page- CHEERS NOTICE:This compliance summary report has been generated by a registration platform provided by CHEERS using information that has been uploaded to that registration platform by third parties that are not affiliated or related to CHEERS.Therefore,CHEERS is not responsible for,and cannot guarantee,the accuracy or completeness of the Page 1 of 3 information contained in this certificate. CHEERS REGISTRY ' � � Till I o� fo . ;i: /: PROJECT STATUS REPORT ,•.:42-.,:5. . .� r Scan to Validate CERTIFICATE OF INSTALLATION (CF2R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 05/18/2021 CF2R-MCH-25f-E Refrigerant Charge 418-P010015339A-000-001-M25011A-0000 05/18/2021 CF2R-MCH-29-H Duct Area Reduction 418-P010015339A-000-001-M29012A-0000 2ND FLOOR AREA2 05/18/2021 CF2R-MCH-20a-H Duct Leakage 418-P010015339A-000-001-M20013A-0000 05/18/2021 CF2R-MCH-22a-H Fan Efficacy 418-P010015339A-000-001-M22015A-0000 05/18/2021 CF2R-MCH-23a-H Airflow Rate 418-P010015339A-000-001-M23014A-0000 05/18/2021 CF2R-MCH-25f-E Refrigerant Charge 418-P010015339A-000-001-M25016A-0000 05/18/2021 CF2R-MCH-26-H High SEER&EER 418-P010015339A-000-001-M26017A-0000 05/18/2021 CF2R-MCH-29-H Duct Area Reduction 418-P010015339A-000-001-M29018A-0000 CERTIFICATE OF VERIFICATION (CF3R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 05/18/2021 CF3R-MCH-27a-H Mechanical Ventilation 418 P010015339A 000 001-M27007A- 0 M27A 1ST FLOOR AREA1 05/18/2021 CF3R-MCH-20a-H Duct Leakage 418 P010015339A 000 001 M20008A- 0 M20A 05/18/2021 CF3R-MCH-22a-H Fan Efficacy 418 P010015339A 000 001 M22010A O M22A 05/18/2021 CF3R-MCH-23a-H Airflow Rate 418 P010015339A-000 001 M23009A O M23A 05/18/2021 CF3R-MCH-29-H Duct Area Reduction 418 P010015339A 000 001 M29012A O M 29A 2ND FLOOR AREA2 05/18/2021 CF3R-MCH-20a-H Duct Leakage 418 P010015339A-000-001-M20013A 0 M20A 05/18/2021 CF3R-MCH-22a-H Fan Efficacy 418 P010015339A-000 001-M22015A- 0 M22A 05/18/2021 CF3R-MCH-23a-H Airflow Rate 418 P010015339A-000 001 M23014A M23A -continued on next page- CHEERS NOTICE:This compliance summary report has been generated by a registration platform provided by CHEERS using Oinformation that has been uploaded to that registration platform by third parties that are not affiliated or related to CHEERS.Therefore,CHEERS is not responsible for,and cannot guarantee,the accuracy or completeness of the Page 2 of 3 information contained in this certificate. I ❑ ,.{� 4 '' S*"1'Jr , c, :1 CHEERS REGISTRY ,.:1 . ` II II oJrlo o � :7 �: PROJECT STATUS REPORT . •� � .� CHEERS 030 ni 4r:°. Scan to Validate CERTIFICATE OF VERIFICATION (CF3R) DATE DOCUMENT TITLE REGISTRATION NUMBER STATUS 05/18/2021 CF3R-MCH-26-H High SEER&EER 418 P010015339A 000 001 M26017A M26A 05/18/2021 CF3R-MCH-29-H Duct Area Reduction 418 P010015339A 000 001 M29018A M29A • 1 NOTICE:This compliance summary report has been generated by a registration platform provided by CHEERS using CHEERSinformation that has been uploaded to that registration platform by third parties that are not affiliated or related to CHEERS.Therefore,CHEERS is not responsible for,and cannot guarantee,the accuracy or completeness of the Page 3 of 3 information contained in this certificate. 1071t- c�\''$s• City of Arcadia DEVELOPMENT SERVICES DEPARTMENT Inter-Departmental Inspection Request Date: 7- 7-- l Public Works (( To: From: 40.[Zi Address: W( ► WIAS Permit No.: 1,sj - t f"-08'0 Contractor: ` f C Tet cri ki Phone No.: 62-6-682'-6 t ((c) Owner: ri CA-Ain Titb Phone No.: Please inspect the following items to ensure that the Contractor/Developer is in compliance with all conditions of approval established for the project,and that the work performed meets the City's standard for Public Works construction: Type of Inspection Date& Initial Date&Initial I Final Approval Drainage Grading i'l6D 1 , l4-'Z, M 1 ��- Erosion Control in- Offsite tiOffsite Improvements Street Improvement(s) , 'A °l (conduit, curb/curb & 16() 1 ' (4 '1J\ \''0) - gutter, curb numbers, driveway approach, /1 W �I parkway planting, sidewalk, street light, traffic flow, etc.) Sewer(s) (lateral, grease/san /(4, interceptor, saddle,wye, etc.) COMMENTS: KA / r% 61W/tett (Z-pp 69(-' fvtoki\ pla C) Xjklakv, 66 k..uwn Lip WATER DIVISION ATTENTION: C DATE: FROM: BUILDING DIVISION INSPECTOR: /'f TJ 1 P---i ADDRESS: C2 3 vV , V V I /+3A PERMIT NO.: SNS-te-offt>6 PLAN NO.: / 7 g CONTRACTOICT5tA CDASIPACM(7(j PHONE NO.: bzD- 6 � t (gic) OWNER: l� --TAb PHONE NO.: PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT OF PUBLIC WORKS REQUIREMENTS. Type of Inspection Date& Initial Date& Initial Final Approval Meter Location -2/13/alBlackflow Devices Irrigation System 463 "lb t Fire Sprinkler System 7/i3/ . ( Meter Clear A.P.P. -657/r3/a t 493 7/I'S fa ( Swimming Pool COMMENTS: V e, `4 il ti �FF R1yc`9._ G 1111191A1 7 AvN9t S,•190) . 19 44vaityall MEMORANDUM Fire Department DATE: August 4, 2021 TO: BUILDING DEPARTMENT INSPECTOR Henry Kemick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 23 W. Winnie Way THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC# 20-638) 5-18-2021 Lili Huang FIRE ALARMS HOOD & DUCT IKNOX BOX OCCUPANCY 5-18-2021 Lili Huang COMMENTS: Emailed Bldg. Dept. 5-18-2021 Rita City of Arcadia, CA `'r Permit NO. FIRE-20-0638 Development Services Department Permit Type:Fire 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Fire Sprinkler (626)574-5416 Permit Status:Issued A.RCA DIA. Issue Date:05/18/2020 f Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 23 • W WINNIE WAY Arcadia, CA 91007-8048 5782017018 Contacts RICHARD TAO Owner UNITED FIRE&SAFETY CO.' Contractor 23 W WINNIE WAY 2318 CHICO AVE,SOUTH EL MONTE,CA (951)279-8208 621096 Description:FIRE SPRINKS FOR ADDITION 2 HEADS Valuation: $ 4,000.00 Tenant Total Sq Feet: 0.00 Plan Check#20-638 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $465.06 Fire Permit Fees $137.05 Cash/Receipt#REC-04380-20 5280.00 Solid Waste Management Fee 2 51.00 Cash/Receipt#REC-04492-20 5185.06 Sprinkler Heads $280.00 Amount Due: $0.00 Total: $465.06 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. May 18, 2020 Issued By: Date May 18,2020 Page 1 of 1 1091041.„ _ PERMIT/PLAN REVIEW APPLICATION • two,WEE. r 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 O 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 performance of the work for which this permit is issued. Signature of Contractor 0 I have and will maintain workers'compensation insurance,as required by Section OWNER-BUILDER DECLARATION ❑ 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 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 exempt there from and the basis for the alleged exemption. Any violation of 0 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. 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 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 PERMIT/PLAN REVIEW APPLICATION DIA �'t Job Site Address: 2� //i�/n�/e LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ElI 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,anylyiy license is in full force at d effect. /) ❑ I have and will maintain a certificate of consent to self-insure for workers,' License Class 6—'0 License No�j�/0I Exp. Date( /010 l 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 EII 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 ElI, as owner of the property, or my employees with wages as their sole forthwithcomply with those provisions compensation,will do the work,and the structure is not intended a offered for r ii?? sale(Section 7044, Business and Professions Code:The Contractors License DateJ >I[7I 0Signature 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(S100,000),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 I aw). 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 1MI'ORIANi': 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 NAMF - --- -- 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 p erty for inspection purposes. ,.•. , City of Arcadia, CA Permit NO.Wall-21-0949 Development Services Department Permit Type:Wall 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification:Wall Garden Wall (626)574-5416 Permit Status:Issued ARCADIA Issue Date:05/26/2021 Expiration: 05/26/2022 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 23 W WINNIE WAY Arcadia,CA 91007-8048 5782017018 Contacts L RICHARD TAO Owner R&W CONSTRUCTION GROUP INC* Contractor 711 5 1ST AVE,ARCADIA,CA 91006 E (626)524-2901 TUSHERIC@YAHOO.COM (626)856-5462 916370 Description:BLOCK WALL PER APPROVED PLANS,WITH SHARED Valuation: $ 1,239.84 Tenant WALL AGREEMENT 6'H X 21'LF ON WEST SIDE OF HOUSE Total Sq Feet: 0.00 Plan Check# Plan# • Fees Amount Payments Amount Paid Building Issuing Fee $47.01 Total Fees $127.51 Building Permit Fees $74.25 Cash/Receipt#REC-07739-21 $127.51 Solid Waste Management Fee $6.25 Amount Due: $0.00 Total: $127.51 IUMplET,. 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. . -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. May 26, 2021 Issued By: Henry Kenrick Date May 26,2021 Page 1 of 1 A• k .o±PERMIT/PLAN REVIEW APPLICATION it �. I • tot, Development Services Department, 240 West Huntington Drive, Post Office Box 60021 °m\,o......,;,-• 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 13) License No.9)I GJO Exp. Date/3//itL 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 ElI 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 Licenseis issued.My workers'compensation insurance carrier and policy numbers are: 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 6 wv F l CA--- demolish, A=demolish,or repair any structure,prior to its issuance,also requited 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 exempt there from and the basis for the alleged exemption. Any violation of ElI 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 FOLLOWINGi 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 iinformation. // • are /- I/ 6 Z— Title Pi"- --)S I de—v-1 7 - 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 S—A2 4/ O..Z / • A.f 00,3r R,41• # CITY OF ARCADIA ---7___ DEVELOPMENT SERVICES DEPARTMENT r:- 74. .. cFENCE. GARDEN WALL AND/OR RETAINING WALL ON ,e.4""'r/�' PROPERTY LINE RELEASE AND DECLARATION ADJACENT PROPERTY OWNER'S DECLARATION I, kA---- n\CN. \6k , as owner of the properly located at -7:1 „,) u ',,,r;:e W e y hereby grant permisyion to the adjacent property owner located at 23 ,v.; , W',,r`f-. Vic\ to construct Z lineal feet of 6 " high fence, garden wall, and/or retaining wall, so e of which will be located on my property. I acknowledge, understand and accept the scope and nature of the proposed work (i.e., color, size, S\, height, type and location of the fence, garden wall, and/or retaining wall and the removal � of landscaping). Name: \fine. Telephone Number: 6Z6 — 3(5— Z3-6c Address: 7 y Date: S-2-S-7--() 7-i Signature: -(----/. �'� (Lt ... ... ... ...... ...... ......... ............................................. ... ... ......... ... ... ... ... ... ... ... ... ... PERMIT APPLICANT'S DECLARATION I declare under the penalty of perjury that I have obtained the approval and release from the owner of the property located at to construct and locate part of a fence, garden wall, and/or retaining wall on their property. Name: Telephone Number: Address: Date: Signature: c: Applicant's file Neighbor's file Job site 1-15 `''��'•. CITY OF ARCADIA j,4047116.14/"'• DEVELOPMENT SERVICES DEPARTMENT 10-1 v_47.,?pm FENCE, GARDEN WALL AND/OR RETAINING WALL ON '`" PROPERTY LINE RELEASE AND DECLARATION 524ifr1 - G, ADJACENT PROPERTY OWNER'S DECLARATION I, I ° , as owner of the property located at -D-3 it .7 L� hereby grant perr•fission to the adjacent property owner located at to construct oZ 1 lineal feet of 6 ' high fence, garden wall, and/or retaining wall, some of which will be located on my property. I acknowledge, understand and accept the scope and nature of the proposed work (i.e., color, size, height, type and location of the fence, garden wall, and/or retaining wall and the removal of landscaping). Name: `� Zvi t e Telephone Number: G 7' 3 y a1 0GI, Date: 11:3<(7-)-t !� Address: GV. - Signature: ............... ...... ......... ............................................................ ... ... ... ... ............... PERMIT APPLICANT'S DECLARATION I declare under the penalty of perjury that I have obtained the approval and release from the owner of the property located at to construct and locate part of a fence, garden wall, and/or retaining wall on their property. Name: AlC/1A Is/_.(A.-l� -e- Telephone Number: g/37),, 3 1-A?27 Address: Date: Signature: c: Applicant's file Neighbors file Job site 1-15 M Department Of Building &Safety • Material Control Section 221 N. Figueroa , 7th Floor kr.] "^ ', Los Angeles, CA 90012 Tel. (213)482-0315 eMail:ladbs_materialscontrol@lacity.org www.LADBS.org FABRICATOR CERTIFICATE OF APPROVAL • Shop Location New Steel, Inc. Victor Hsieh Victor Hsieh (QC) • 2557 TROY AVE 2557 TROY AVE SOUTH EL MONTE, CA 91775 SOUTH EL MONTE, CA 91775 • • Approval No: FB03192 • Branch No: N/A Expiration Date: 1/1/2021 Approval Type: TYPW I STEEL LWS, HSS • You are herby notified that your certificate of approval is valid until the expiration date shown above under the provisions of the City Of Los Angeles Municipal Code, section 96.204(g) and information Bulletin P/BC 2014-042 (Part I) Renewal. . .. . 4 • tri Lisa Yancey , Principal Inspector Materials Control Section (213)482-7097 . . . . . . ii9e ."i t =. : '.', ! '! 1 •:•-•:::.1.::. I t. -c e..,n i 1 r.11$ t; .+ i g g 1 ... : ,_. i .• • •... I 1 ;.11,,,'4 , .1RinigiF- 1 I .; . Rigti ..;...:. -..:•.• 1 n in . i/ I:•.'1! i •• 1. . 1 i al , ....•• ,-:. 1 fa . ii iiVVii mai t i .:•.i 4 : 3 ! 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J "Ci ter UJ CO W i -c O CO I- N � Ir, N N 0 5 U N- CD e 03 ~- M C �y c� c �- c 0) Nc O }} .-- -- c O CD Z a) mU v- QO i. fn W O '� n Cflc.,.. O - +.+ aJ p O H is Q. c O c1 C1 •- i` a, w Z o in �,ro o � � o c; > 0 Z o c f- -e L o >, „„ o0 (n c Q a Z O ca co m p �- w c 0 ; m - a) } J > t ' > — c L.- c Tzi �N � O w o L o o CD Q •c� v 0 �aal = X = cCL z ca X 0.a ca a) c ._ RI c a, Cr) H o W .c cI 3 O Q CO LU < O c J Cl_ �2 N O U to O (� (� i Z > N W -I .z3 2 STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the ;proved plans and specifications, at significant construction stages and at completion of the structural system. S:ructural observation does not include or waive the responsibility for the inspections required by Section 108, 1704 or :::ner sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No. _ •..:'cr, ,nciudes all construction work through _8 _day of J 2O •v Page No _______of IPro.e:t Address: Structural Observer of Record (SOR): SOR Phone No.: i. .s..-j co r rJ nv I , 4 ,A 17',6,....)T.e,..p..1 Cc.re—r 6 L6 3-2-9' l L4) Permit No.: Structural Observation Observr Professional Lic.lReg. No.: Observer Phone No. I performed by: j:,&.4...\ ...7.4.. -`=c--.1 14 o cp.-6 '2-9 t" i- I i OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS I FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION =:;cting, Stem Walls 0 Concrete 0 Steel Moment Frame 0 Concrete I— r ; .1at Foundation 0 Masonry 0 Steel Braced Frame 0 Steel Deck Caisson. Piles, 0 Wood 0 Concrete Moment 0 Wood Grade Beams Frame = Reta:ning Foundation 0 Others: 0 Masonry Wall 0 Others: 1 ! :-..:s.c:e Special Anchors Frame L`"�0� prz'�l�� Ot^ers ❑ hers Oth : i NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that served deficiencies have been resolved is required before acceptance of the work by the building officials.? �✓1-1Via--12- 1.---3 4.-1„,t___ m.4.-, IA,.-r...7 es Lc SI-t v�-ri-t 7 i. Tc. --rbr eF �,cs,�i--L- . No 4.0r.o;..c:b l r..---ra- o F SG, Pk- DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE ' CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE I REQUIREMENTS OF THE COUNTY OF LOS ANGELES. : i. OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS Coal UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN .GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; i: Aa NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE: !I 4 I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE II CORRECTED. li -7 - 'a - ya :. --E7) (STAMP OF STRUCTURAL OBSERVER)'' :':A.T'JRE OF STRUCTURAL OBSERVER DATE :'s.cn '.0 ,2008 LACBC) Jar. 10 2008 7—c7-- (1 STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to the approved plans and specifications, at significant construction stages and at completion of the structural system. Structural observation does not include or waive the responsibility for the inspections required by Section 108, 1704 or other sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) -Itis report includes all construction work through i -' k r Report No. 9 day of�JIa_11 ,20--2—r) Page No. of Project Address: Structural Observer of Record (SOR): SOR Phone No.: i w.ecY(7, /Yn-r'7�.- ,1 /4-+.1'- ;,`i c'-e, -> 6,- .., . 1.-C-? / I !Building Permit No.: Structural Observation Observr Professional Lic./Reg. No.: Observer Phone No.: I performed by: OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS ELEMENTS/CONNECTION FOUNDATION WALL FRAMES FLOOR OBSERVATION LOCATION Footing. Stem Walls 0 Concrete ❑ Steel Moment Frame 0 Concrete i Mat Foundation ❑ Masonry 0 Steel Braced Frame 0 Steel Deck Caisson, Piles, 0 Wood ❑ Concrete Moment 0 Wood Grade Beams Frame i= Retaining Foundation ❑ Others: 0 MasonryWall 0 Others: Hillside Special Anchors Frame e-As!-foL Others. r�'�&�� ! 0 Others: pi-c30 1z Lti,a NOTED DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which states that all observed deficiencies have been resolved is required before acceptance of the work by the building officials.) a P S1--k —c,--t I,..I c, .r- L r.--` 1 DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: I AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS OF THE COUNTY OF LOS ANGELES. 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN ` , �,v GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; / 3 ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; _ CR\/\‘' ,-?. 4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. "1 CT 6 r 7" --).---e y" (STAMP OF STRUCTURAL OBSERVER) SIGNATURE OF STRUCTURAL OBSERVER DATE Version 1.0(2008 LACBC) Jan. 10 2008 3 43.605 35.942 4 52.352 31.093 5 94.034 44.695 6 98.882 53.441 7 99.951 55.370 8 102.168 59.210 Factor. of Safety *** 1.618 *** Failure Surface Specified By 6 Coordinate Points Point X-Surf Y-Surf No. (ft) (ft) 1 42.733 43.139 2 43.095 42.939 3 51.841 38.091 4 82.362 46.262 5 85.421 51.781 6 89.710 59.210 Factor of Safety *** 1.693 *** Failure Surface Specified By 8 Coordinate Points Point X-Surf Y-Surf No. (ft) (ft) 1 30.577 40.010 2 35.417 37.328 3 44.163 32.480 4 52.909 27.632 5 81.892 36.819 6 86.741 45.565 7 91.578 54.293 8 94.418 59.210 Factor of Safety *** 1.740 *** Failure Surface Specified By 6 Coordinate Points Point X-Surf Y-Surf No. (ft) (ft) 1 40.367 42.530 2 43.736 40.663 3 52.482 35.815 4 99.560 48.596 5 103.315 55.370 6 105.532 59.210 Factor of Safety *** 1.785 *** Failure Surface Specified By 6 Coordinate Points Point X-Surf Y-Surf No. (ft) (ft) 1 40.040 42.446 2 41.600 41.581 3 50.346 36.733 4 100.499 47.483 5 104.873 55.370 6 107.088 59.210 Factor of Safety *** 1.868 *** Failure Surface Specified By 7 Coordinate Points Point X-Surf Y-Surf No. (ft) (ft) 1 36.483 41.531 2 44.294 37.201 3 53.040 32.353 4 87.419 40.720 5 92.267 49.466 6 95.540 55.370 7 97.757 59.210 Factor of Safety *** 1.890 *** 1 County of Los Angeles W 1' DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION PUBLIC WORKS \•: Los Angeles Regional Uniform Code Program STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance : � 3F.:rye ed olar.s and specifications, at significant construction stages and at completion of the structural system 3(':ictural cbservation does not include or waive the responsibility for the inspections required by Section 108. ,;.0 4 ;r Dt:'e-sections of the Los Angeles County Building Code. (Sections 106.4.5, 1709) Report No `r s -eport includes all construction work through -27-N P.day of , ru L ,20 2t, Page No. ) ro;ect Aocress: ` bites Structural Observer of Record (SOR): SOR Phone No : w, W t•AN F_- w 3-2-f 14 )- 3uilcing Perm t No.: Structural Obbervation Observr Professional Lic./Reg. No.: Observer Pho-e k performed by: >4."*J-Ti J G-..1 (q-v 6 Z-6s tOBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNEC" DN OBSERVATION LOCAT ON Fcoting. Stem Walls 0 Concrete 0 Steel Moment Frame 0 Concrete LI3 ;1at Foundation 0 Masonry 0 Steel Braced Frame 0 Steel Deck J �aisson, Piies. 0 Wood 0 Concrete Moment 0 Wood ':rade Beams Frame I:3 Retaining Foundation 0 Others: 0 Masonry Wall 0 Others: Hi! s de Special Anchors Frame ' �1 a�� rP0.1 " hers: I 0 Others: �j,00rz. VJAL-` tNC'Ti_D DEFICIENCIES with the proposed corresponding corrective actions with respect to general conformance with the approved plans or in the load path: (A final report by the structural observer which state: ::'a pcservec deficiencies have been resolved is required before acceptance of the work by the building off cials. -— 2 N rr+ PL,D c, a[C_ -_- c.-t 5.-r> Y 1 N<tr -e. TO it G " i I DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: AM THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE RECUIREMENT$OF THE COUNTY OF LOS ANGELES. 2 , OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS JNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN <cO 3ENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; J 0 EXP.121311" �' 3 ALL NOTED DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED • tr ABOVE; '-s> elV1k- ti�� 4 RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY 9rF JF OAL���� DF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE OORRECTED. II (STAMP OF STRJCTU.RAL OBSE Vi:F S 3':A-URE OF STRUCTURAL OBSERVER DATE de-si,Dn 1 0(2008 LACK) an. 1 30 'c 'r E':ES-6, �-- t Q-3 'p�__ County of Los Angeles 4 •"P",w R'�7 •: DEPARTMENT OF Pt UBLIC WORKS BUILDING & SAFETY DIVISION �'��~�"'` ca��' o" / Field Office Address' I �LA R U C Pj STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to :ne aOo.c;ecr plans and specifications, at significant construction stages and at completion of the structural system. Strucrura1 cbse_.:=!,on does not include or waive the responsibility for the inspections required by Sections 108, 1701 or other sececr - :. e _c•s Angeles County Building Code.(Sections 106.4.5, 1702) �r work through 6 Report No. Th's report includes all constructionI ,.ay may o� fidfl c I zU ' Page No. of Project Aaaress: ��_ Structural Obsery r of Record(SOR): SOR Phone No.: .. 272,. IA-J. t.(-)t/..,/..,I a_ kii-L' i /4-12-c4-t-J,,/a 4)/4"CA ,, Go Pip C t6 3 1'i. 1 l tl- 3" ''n= Pvtcntt Nc - Structural Observationrformed b Pe Y• Observer Professional Lic.fReg No.s Observer Phone No. OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL " - - FRAMES -- FLOOR PORTION OB ERVED, IF NOT WHOLE I F o Un;.Stem Walls, ❑ Concrete 0 Stool Moment Frame —"- ❑ Concrete 72 Mat Foundation 0 Masonry 0 Steel Braced Frame --, ❑ Steel Deck .2 Caisson,Caisson, Piles,Grade Beams 0 Wood 0 Concrete Moment Frame 0 Wood I E Masonry Walt Fl sire C Others_ i Hiltsoe Spectai Anchors i + CR:`ers / CC"NG. ��.}3 Ijti—A 0 Others: • NOTES. co. - c - L,cl R12-.25-—1-3.�rz. a(< I — _. OBSERVED DEFICIENCIES: • DECLARE 7-+AT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: • 1 ATHE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE 4 M CHARGE RGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS 'I OF THE CITY/COUNTY OF g It ;.OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS UNDER ``; .i MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH S;GNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL w ,7�t�� CO^IFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; a '• # j' DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; " 1. - . RECOMMEND THAI ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE CITY/COUNTY t, DF BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ' ARE CORRECTED. i .____ ': ---2-72_,p,,,,,,-4 !c3 , 2'-'4"-'''' STAMP OF STRUCTURAL DATE OBSERVER OF RECORD -- _ARu1CP St.�,ctural Ooservation Report Form(V1.O.512000) --" ' ge ; ,�, . C.S. INSPECTIONS, Inc. acho932 N. Starcrest Drive Covina, CA 91722 :Inspections 951 .233.9464 csicsiatme Registered Inspector's Daily Report Date :3-5-20 Type of 0 Welding El Reinforced Concrete ❑ Quality Control Inspection ❑ High Strength Bolting ❑ Post Tensioned Concrete ❑ Epoxy Anchors Required ❑ Fire Proofing 0 Reinforced Masonry ❑ Other Job Address : 23 W. Winnie Way [City : Arcadia Job Name : Residential Permit : 19-2332 Issued By : Arcadia Type of Structure : Architect : Material Description : Engineer : Contractor : Armando Camare_n_a Inspector's Name : Jonathan Camacho Sub-Contractor : Inspection Summary : Provided continuous inspection during placement of 1-1/2" of Rapid Set High Strength Non- Shrink Grout at (11) HSS Column Baseplates. All locations were clean and clear of debris prior to placement of Rapid Set. No deficiencies were observed. See detail 4/SD-4. SAMPLES CONCRETE MORTAR GROUT BLOCK PRISMS DENSITY CERTIFICATION OF COMPLIANCE Page of I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE TIME IN TIME OUT REG.HRS O.T.HRS ALL OF THE REPORTED WORK UNLESS OTHERWISE NOTED,IS IN COMPLIANCE 4 WITH THE APPROVED PLANS,SPECIFICATIONS,AND THE APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS. ALL INSPECTIONS BASED ON A MINIMUM 4 HOURS&OVER Jonathan Camacho 5246612 4 HOURS=8 HOUR MINIMUM.ANY INSPECTION EXTENDING PAST NOON WILL BE CHARGED AS AN 8 HOUR MINIMUM SIGNATURE OF SPECIAL INSPECTOR CERTIFICATION NUMBER APPROVED BY 2- ( 3 t Es� Countyof Los `x Angeles ,�vDUBUC worm;•; •�:r-',7):a;y`,\ DEPARTMENT OF PUBLIC WORKS BUILDING & SAFETY DIVISION L_AR UCP 6-c`` � Field Office Address: ices-m° STRUCTURAL OBSERVATION REPORT FORM STRUCTURAL OBSERVATION means the visual observation of the structural system, for general conformance to :r;e sop:c iec plans and specifications, at significant construction stages and at completion of the structural system. St s2cturat os_r/Ei!ion does not include or waive the responsibility for the inspections required by Sections 108, 1701 or other sector. - :f.e Lcs Angeles County Building Code.(Sections 106.4.5, 1702) Report No. This report includes all construction work through Zara day of 1- 10.11—�44 , 20 Z Page No. of_ Protect Aooress: Structural Observilr of Record(SOR): SOR Phono No.: ?31"-)" I.J(NNS - , 1. Jr/0e- 0/4IU-Z..e.IJ C �( 61G 3 It di-I 3_, in Ftirrnn Nc Structural Observation performed by: , Observer Professional Lic./Reos Observer Phone No. --- D_ - ca t`.. �F-`�L 6, ►t 4-i OBSERVED STRUCTURAL ELEMENTS AND.THEIR CONNECTIONS FOUNDATION WALL. . - • FRAMES 7.t46:^;.?..."..'FLOOR PORTION OB ERVED,IF NOT WHOLE I Fo:itine,. Stem Walls, ❑ Concrete 0 Steel Moment Frame 0 Concrete • '' i Ma; Foundation 0 Masonry 0 Steel Braced Frame 0 Steel Deck 1 2 Caisson, Piles,Grade Beams 0 Wood 0 Concrete Moment Frame 0 Wood 2Ret=•ni-y Fccnoa:ion. ❑ Other: 0 Masonry Wall Frame 0 Others: — • Hills Ise Special Anchors C tr.ers (-- )219�IP/kr�— 0 Others: _._...._; 1.4 46‘..-F-- J N O T E S Fr J h3 t> u ry n-a - Vj4p0,2,.. QIC-- r.n-.c---F:0-. . Tel C (-r`r G as p is _- a—'S 41-6,) a p ___-.. ---- — OBSERVED DEFICIENCIES: DECLARE THAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: A1.1 THE ENGINEER OR ARCHITECT RETAINED BY THE OWNER TO BE IN RESPONSIBLE y CHARGE FOR THE STRUCTURAL OBSERVATION IN ACCORDANCE WITH THE REQUIREMENTS i OF THE CITY/COUNTY OF i+ it OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS UNDER / MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT EACH /,,,' 46` v 4/ S:GNIFICANT CONSTRUCTION STAGE TO VERIFY IF THE STRUCTURE IS IN GENERAL :, 471;U CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; �; Exp.144i1 2--/ ! ALL DEFICIENCIES WHICH REMAIN TO BE CORRECTED HAVE BEEN INDICATED ABOVE; 11:/,'•,,,. Cf_VI\-•% ' • 4 . RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE CITY/COUNTY F t1f • OF BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. 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' 1, I ..„..., ... i I ' 1 I . i •- . --÷—,..---,-- t----4---,- --i- 4:' j°b' CITY OF ARCADIA s: r. �° 240 West Huntington Drive �kpORA. Arcadia, CA 91007 ROUGH GRADING VERIFICATION ATTENTION: Community Development Administrator SUBJECT: Grading Verification for Project No. I L>o17-02/ Address: 11/ tik Ni, Vkiot Gentlemen: Rough grading operations have been completed for Project No. for Lots through (if applicable) and has been inspected by the undersigned Registered Civil Engineer or Licensed Architect. Based upon the observations, the rough grading of the lot(s) listed above have been completed in conformance with plans marked "APPROVED" by the City. The work includes but is not limited to the following: grading to approximate final elevations; staking of property lines; location and gradient of cut and fill slopes; location, cross- sectional configuration and flow-line gradient of drainage swales and terraces; berms installed where indicated; and required drainage slopes provided on building pads. Enclosed herewith is a Soil and Compaction Report for the Building Division which is required on all new construction site .- ��''� g inspection. PA �`<9,�,S�NG-LbtiA F2 Engineer(Signature) = 45846 Arc i i I (Signature) cc C. . 4±fir- R. E.E. N R.P . . io. 11' Date: (>0 FOF CAL\F� Received and approved: Date: C.D.D./Planning cc: C.D.D./Maint. Ser. C.D.D./Building ENVIRONMENTAL GEOTECHNOLOGY 441144,41a Oa/ LABORATORY, INC. '44 ttio.,4110411, February 3. 2020 Ms. Sammie Fong 20 West Camino Real Arcadia, California 91007 Subject: Soils Compaction Report; Single-Family Residential Building, 23 West Winnie Way, Arcadia, California, EGL Project No.: 16-203-029C. References: 1. Report of Geotechnical Engineering Investigation for the Subject Site, by EGL, Inc., Project No.: 16-203-029GE, dated March 23, 2018. 2. 10-Scale Grading and Drainage Plan for the subject site by EGL Associates, Job No: 16-203-029, revised June 18, 2019. Ladies and Gentlemen: This report presents results of our field density tests performed on the building pad of the proposed residence at the subject site. Building pad was constructed for building foundations and associated structures. Site conditions, field and laboratory test results. and post-grading recommendations are presented as follows: SITE CONDITION Subject site is located on the north side of West Winnie Way and at a relatively short distance west of South Santa Anita Avenue in the City of Arcadia. California. Topographically, the subject site is relatively flat. Existing residence and associated structures were demolished prior to grading the building pad. Onsite loose and/or disturbed soils within the proposed building pad area were excavated to a maximum depth of four (4.0) feet below the existing ground surface and exposed competent natural soil. Competent natural soils exposed within the excavated areas were inspected and are considered suitable for the proposed development. Prior to all backfill, EGL field personnel had checked excavated bottom receiving fills to ensure clearance of non-acceptable debris. Onsite and imported soils were used as fill materials. Onsite soils consisted of dark olive brown silty sand (SM: Soil Type A). Import soils consisted of dark olive brown silty sand (SM; Soil Type B). 11819 Goldring Road, Suite A,Arcadia, California 91006 Phone: (626) 263-3588; Fax: (626) 263-3599 Ms Sammie Fong Page 2 of 3 EGL Project Number: 16-203-029C February 3. 2020 LABORATORY TESTING Laboratory maximum dry density and optimum moisture content for the onsite and imported soils were determined according to laboratory standard ASTM D-1557-12. Following table presents the test results of representative soil samples collected from the subject site: TABLE I LABORATORY TEST RESULTS Soil Type Maximum Dry Optimum Moisture Density (pcf) Content (%) A - Onsite dark olive brown silty sand (SM) 131.0 9.0 B - Imported dark olive brown silty sand (SM) 137.0 7.0 FIELD DENSITY TEST 1. Field density tests were performed using the Nuclear Gauge Method (ASTM D-2922-01 and D-3017-01) and/or Sand Cone Method (ASTM D-1556-04). Field density test results are presented below in Table II. Approximate locations of the tests are shown on the enclosed Site Plan (Figure 1). TABLE II FIELD DENSITY TEST SUMMARY Depth Moisture Dry Relative Test Test Date Test Below FG Content Density Compaction Soil No. Location ft Type O (��) (pcf) (�o) X-1 1/22/20 Building Pad 1.5 9.6 118.0 90.1 A X-2 1/22/20 Building Pad 1.5 9.9 118.2 90.3 A X-3 1/22/20 Building Pad 1.5 9.7 117.9 90.0 A X-4 1/24/20 Building Pad 2.0 9.7 118.6 90.6 A X-5 1/24/20 Building Pad 2.0 10.6 119.0 90.9 A X-6 1/31/20 Building Pad FG 8.7 123.3 90.0 B X-7 1/31/20 Building Pad FG 7.6 126.2 92.1 B X-8 1/31/20 Building Pad FG 6.7 127.4 92.9 B X-9 1/31/20 Building Pad FG 8.1 124.0 90.5 B FG = Finish Grade 2. Field density tests were performed at random locations to check compaction effort provided by the contractor. Test results exceeded minimum required relative compaction of 90 percent. Test results herein are considered representative of the compacted area. 3. Onsite soils consisted of dark olive brown silty sand (SM; Soil Type A). Import soils consisted of dark olive brown silty sand (SM; Soil Type B). Soil samples were verified to 11819 Goldring Road, Suite A,Arcadia, California 91006 Phone: (626) 263-3588; Fax: (626) 263-3599 aoTi ce N +' O >, o 04 rnM N�Ol9 9 01 ^, POKER POLE N O w > Cl h 7 UNES W —00 SL �IS2,i0.668S W L UNES S _ u e- Z > 3 d -:cu 0 `yq^ O cu O d a ui C Zco ip 1' a5 4. .I.�q?•. > O 4 -, -la) 0 0'" I Cu dci_ ti ; Ir Wl7J ' 3� 10 cf 3 d r :•i'•�I•: : ::. • ••.m+•:•:i mr..:• • »:•: .•. I•:f _j M L F.. • .e'").L..:.tocat.Ails-a::.`� U cu<r F •r.'.•.•ras.. U J.•. s�1 . Io i L. y�� ^'� I'• ::::is?::: o t2 N 73 3 3� �'g` L t ,..:0311..y: �:. r 1P. N Q X 8 -2 yq^ x '1 s� � '•in � N N Lu!l M 1.. e < ew M ) • Al4 I L.,., gv R rn `." Mq^ ^' 8 `� ■I : • Iooz)M» `�q � � II r a�M > J I NORTH W L.L •3S R (2 11 �L ► ca I Z � > 23 L�q^ O is ll /. II <6j 13.1'41:.;41 MR 1:-..:1111r)lej .? d- 4,.,4ro I 'It 10 � 18C l"' JX�G1 mro n ^1 L X to R 'i I I O "C,, ,, II4. X •I . `' L_LK y l „ Jj in CU III � ..1". L40A Z I-- L 1.11 I `,q^ .1*:, ;e�5 ;i :tom 0 C 73 til q M.S2,i0.68S_-- •Lat0 - ,ELac 00'SLSoL6t I o �� 4- 4- ,Lq `.. ,...."'L_---_ (397) I I '° 0 O .i ^ I a A6 o. O II - - I - - - - d L -P 1 d ` 0 0a ti J u _ - _ CD +, AVM 3INNIAI 4'''� d i� �� S&W ON 0.1' n X E 0 <.',' j � a. -xx 0 J Q _M M M M M -,`�• ht- _I tr _j r — — — — — — I XC Ms Sammie Fong Page 3 of 3 EGL•Project Number: 16-203-029C February 3, 2020 match with the laboratory tested samples. 4. Compacted fill is considered adequate for its intended use. POST-GRADING RECOMMENDATIONS 1. All utility backfill should be brought to near optimum moisture content and then compacted to obtain a minimum relative compaction of 90 percent of the laboratory standard. 2. Soils generated from footing excavations should be compacted to 90 percent minimum relative compaction, whether it is to be placed in landscape areas or within areas to be improved. This material must not alter positive drainage patterns away from the structural areas. 3. All trench excavations should conform to CAL-OSHA and local safety codes. REGULATORY COMPLIANCE Cuts, fills or processing of original ground under the purview of this report have been completed under the observation of and with selective testing by EGL, and are found to be in compliance with the Grading Code of the City of Arcadia, California. EGL's findings were made and recommendations prepared in conformance with generally accepted professional engineering practices and no warranty is expressed or implied. This report is subject to review by the controlling authorities for this project. This opportunity to be of service is appreciated. If you should have any questions, please call the undersigned. Respectfully submitted, Environmental Geotechnology Laboratory Inc. (EGL) mo• i �`' -;41 a No. 2x352 �'� 1► 11.1 73 Exp. .� ., ,J Ry- •iJ• -s, GE 2852 ,* � � Proje• 'ngineer �cS'� `UT C�,�j; OF C Dist: (4) Addressee HJ/RJ/rj 11819 Goldring Road, Suite A,Arcadia, California 91006 Phone: (626) 263-3588; Fax: (626)263-3599 r kg_G4i-• k.per �� r 9 ,DBS REGISTERED DEPUTY INSPECTOR'S CERTIFICATE OF COMPLIANCE DEPARTMENT OF DINI E AND SAFETY Address 4(9 D 5. LD S t tJ _, Date of Certificate L4-R.y en,4. Zo — Fabricator c)\(t...k: <Sc�(•\, II u I tT -. Permit -T- --14-1P)Z- t— TO THE SUPERINTENDENT OF BUILDING: CITY INSPECTOR: I hereby certify that the following portion of the work at the above job address which required continuous and/or periodic inspection,and which I was employed to inspect,was inspected and approved by me and complies with provisions of the building Codes applicable thereto: Type of inspection: D Steel Construction in Sprayed Fire-Resistant Materials Distressed Concrete El Concrete Construction 0 Smoke Control D Drilled-in Anchor 5 [] Masonry Construction 0 Methane d Gunite/Shotcrete 0 Wood Construction p Exterior Insulation&Finish System 0 Seismic Resistance Ej Soils • 0 Wind Resistance [3 Other: Location and Description of work completed -1172.._-IA L ,L Ort n(2,14--,E _ t'T F 4- /OTA L �9.E, J -&C P 5. C H ._C R rte] (2-1\-u ���T°+ 1i - 1 - Cu r(z_aL� �l_l_A�)t t f)L.SI o (+0C-..E-5, 1 kpAc=r �RtR4.�J C ?- - Pic/Jur. '--- To £t..)S1c'� . /15p S ni\) N Size of Structure: TI.- I-7�t c.....- RI-bus- Time Arrived: (r,=ere,AIL-4 No.of Stories: -- Time Left Job: cee.. o. -1 Conc.Mix Design No.: P.S.I.: t c_� o S-t\V-7---4. t.•,. C0 v r--1 �G Registration Number: C -0 , L ..&• r crDb3-1 D Employed by: ) Lab: Independent: DI �j , ,.. Signature: AA Registered Deputy Building Inspec r: - Print Full Name:� . J 3 l M -1-7.6.< Cell Phone Number: (2t3 F 4- - Z( 7 3 E-Mail Address: ._C _t _ f A, - .0 e(o64-I. --- DO NOT AMEND,ALTER,CHANGE,DELETE OR APPEND ANY PRINTED PORTION OF THIS CERTIFICATE AS IT WILL RENDER IT NULL AND VOID. As a covered entity under Title II of the Americans with Disabilities Act,the City of Los Angeles does not discriminate on the basis of disability,and upon request,will provide reasonable accommodation to ensure equal access to its programs,services and activities. IN.Form 07(Rev.03-18-2016) www.ladbs.org Certificate No. 20190226-04C Business Services 150 SouthThird Avenue Arcadia,CA 91006 ARCADIA p 626821 6631 Unified School D+strict f 626 821 6632 Irnap!ne Incuire • I,s ire www.ausd.net - -— -- Certificate of Compliance for Payment of Developer Fees (Education Code§17620, et seq. &Government Code §65995, et seq.) Effective April 29, 2019 Current rate in effect applies at the time of imposition of fees/payment. Project Address/APN: 23 W.Winnie Way., Arcadia, CA 91007 Number of Units: 1 Plan Check Number: 18-0806 ❑ Exempt* ® Residential** ❑ Commercial/Industrial** ❑500 sq.ft.or less(residential addition/expansion) $3.79/sq.ft. $0.61/sq.ft. ❑Other: Area in Sq. Ft.: 2,275 Receipt Number: 330520 Total Fee: $8,622.25 Check Number: 110 0066380 Owner's Name: Sammie Fong Owner's Address: 20 W. Camino Real Ave., Arcadia, CA 91007 Phone Number: (626)272-2307 Email: sammiefong@sbcglobal.net Representative's Name & Phone Number(if applicable): ( ) * The above-described development has been determined to be exempt from the developer fees of Education Code §17620, el seq., and Government Code§65995, et seq., and a Building Permit may be issued therefore. **All fees due to the Arcadia Unified School District, under provision of Education Code§17620, et seq., and Government Code §65995, et seq., as a prerequisite to the issuance of a Building Permit by the Building Department of the City of Arcadia, City of Monrovia, City of Sierra Madre, City of Temple City, and County of Los Angeles, Department of Public Works have been received. Based on the information presented above, this Certificate of Compliance is hereby executed. / Connie Chu Senior Administrative Assistant 11/19/19 Signature of District Representative Name/Title Date of Issuance The District charges a $100 fee to process reinstatement of the Developer Fee Certificate of Compliance resulting from an "insufficient funds" check in addition to a $35 fee for the returned check. Only cash or a Cashier's Check will be accepted as payment thereafter. The District charges a $100 fee for any amendments to or cancellation of a Developer Fee Certificate of Compliance formerly issued on any type of development. If 500 sq.ft. or less is the reason for exemption, any future additions, expansions, or remodels to the property that result in the past aggregate square footage to exceed the allotted 500 sq. ft. will be subject to fees at the current rate for the entire square footage of the development. Owner/developer may request a refund of fees paid to the District within 12 months of payment only in the event the Building Permit expires or the project is canceled without commencement of construction in accordance with Education Code section 17624 (all other requests for refunds must be made in accordance with the fee protest procedures set forth in Government Code §66020). All refunds will be reduced by a $100 administrative fee. The refund check will be issued in the name of the owner/developer and mailed to the address of payee. PURSUANT TO GOVERNMENT CODE§66020(d), OWNER/DEVELOPER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE OF COMPLIANCE TO PROTEST THE IMPOSITION OF FEES Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that the information he/she provided to the District is true accurate to the est of his/her knowledge. it(10/ Ci S A141141 Sign ure of Applicant Name Date ORIGINAL-City/County COPIES-Business Services,Fiscal Services&Applicant Certificate of Compliance(4-29-19) Ta BupBisepauay 4mm1 '9oo16 VD'vlavDav �Td a jy '� OIGI11S Sad AVM 3INNIM M EZ :''Cm �_ - Q WOH ATIAI A TIDNIS -/41. as a asa a aa. iyy` aaa:. V,N 5 aloe ,q` `+8 '" 7i, 14A VI fl15.'' h3 ';�" g3i�E g 5--6i5g8 g l 6 i. 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Q � 11 c Q 1 CITY OF ARCADIA WATER EFFICIENT LANDSCAPING - ORDINANCE NO. 2330 LANDSCAPE DOCUMENTATION PACKAGE - SECTION A PROJECT INFORMATION Date: —�- Project Name: Project Applicant: t LEP C. ¢ 5 57-U0k 13 Project Address and Location: Street Address Assessor Parcel Number 57e2. — 017 —n lB Arcadia Tract/Parcel Map No.and Lot Number(s) C74-I( LOTS California 191007_ NgIs,N N Project Type (Please check all that apply): New ❑ Rehabilitation Single-Family Residential ❑ Private ❑ Public ❑ Multiple-Family Residential ❑ Commercial / Industrial ❑ Mixed-Use ❑ Institutional (i.e., hospital, school, etc.) ❑. Other Please fill in the information below to describe the landscape project: Total landscaped area 4 (sq. feet) Total turf area 9 e3 7 (sq. feet) Total non-turf area '- d.5 (sq.feet) Total active recreational areas1 I �� (sq. feet) Total area of Special Landscaped Areas (sq. feet) Total irrigated landscape area 11115 (sq. feet) Total non-irrigated landscape area ©` (sq. feet) Please check the Water Supplier for this project: City of Arcadia Water Services — 11800 Goldring Road, Arcadia, CA 91006 — (626)256-6650 ❑ East Pasadena Water Company — 3725 Mountain View Ave., Pasadena, CA 91107 — (626)793-6189 ❑ Sunny Slope Water Company — 1040 El Campo Dr., Pasadena, CA 91107 — (626)568-4266 LI California American Water — 2020 Huntington Dr' --, 3,�{:�,, 1108 — (831)646-3252 El Golden State Water Company — 110 E. Live r,/•'%. @SAW .`BA 006 — (626) 446-1372 Acknowledgment: / 7. ��; �\c\ I agree to comply with the requirements - rcadia at Efficient Landscaping 9 Ordinance and submit a complete Landsca • c ,•• - : - - e. 1 \ Sys Applicant's Signature r ..,,,,.\ A,e qa .1 5-1-2 - fa of cAU� 1 �„ r 2015