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HomeMy WebLinkAboutRALT-18-2398 ,.�., City of Arcadia, CA Permit NO. RALT-18-2398 Development Services Department Permit Type:Residential Addition/Alteration 240 West Huntington Drive,Post Office Box 60021 Arcadia,CA 91066-6021 Work Classification: Res-Addition/Alteration (626)574-5416 Permit Status:Issued ARCADIA Issue Date:04/24/2019 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 519 Campesina RD Arcadia,CA 5776017008 Contacts PDS STUDIO* Agent for owner JIMMY VO Owner 711 S FIRST AVE,ARCADIA,91006 519 CAMPESINA (626)294-9402 pchan@pds-studio.com (626)399-4152 PCB DEVELOPER INC* Contractor 9573 E GARVEY AVE 13,SOUTH EL MONTE,CA 91733 (626)589-2027 1014361 Description:ADDITION OF MASTER BATH, EXTEND FRONT Valuation: $ 218,284.31 Tenant PORCH AND REMODEL ENTIRE HOUSE. FAMILY,BREAKFAST RM,KITCHEN,DINING,LIVING,LAUNDRY. Total Sq Feet: 531.00 Plan Check#18-2398 Plan#28 4 BED,3.75 BATH .WITH EMP,HVAC SYSTEM PER APPROVE • D PLANS.HERS REQUIRED FOR FINAL.REWIRE ENTIRE HOUSE. • Fees Amount Payments Amount Paid Bathtubs/or Combo $37.38 Total Fees $6,620.30 Building Issuing Fee $47.01 Cash/Receipt#REC-01048-19 $4,469.02 Building Permit Fees $2,045.10 Cash/Receipt#REC-003247-2018 $2,151.28 Building Plan Review Fee $1,329.32 Cal Green Plan Check $132.94 Amount Due: $0.00 Clothes Washer $12.46 ~ Compressor<3 Ton(up to 3 hp) $37.48 Dishwasher $12.46 Electrical Permit Issuance Fee $47.01 Energy Plan Review Fee $409.02 Furnace or Burner<=100,000 BTU $37.48 CALLS FOR INSPECTIONS Garbage Disposal Fee $12.46 Request for inspection by telephone at 626-574-5450. Leave a message Gas System(Outlets) $77.75 requesting the address,timeframe and what inspection item is needed. Green Building Standard $9.00 Install,Relocate Appliance Vent/Hood $9.38 Kitchen Sink $12.46 This permit/plan review expires by time limitation and becomes null and Laundry Trays $12.46 void if the work authorized by the permit is not commenced within 180 days Lavatories $49.84 from the date of issuance or if the permit is not obtained within 180 days Mechanical Permit Issuance Fee $47.01 from the date of plan submittal.This permit expires and becomes null and New Residential Elect.(sq ft area) $224.00 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 Parks&Recreation Fee(SFR) $1,513.35 Arcadia building inspector for a period of 180 consecutive days. Total: $6,620.30 Lg COMPLETED /r April 24, 2019 Issued By: Date April 24,2019 Page 1 of 1 A:. cfrlFoRNi, r41 1 PERMIT/PLAN .,REVIEW APPLICATION ' ' ,_4I j� Development Services Department,240 West Huntington Drive,Post Office Box 60021 0..,,,,ort" Arcadia,CA 91066-6021,(626)574-5416,Fax(626)447-9173 .1 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 Li No.I 61113401 Exp. Date�-t^rk 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 is issued.M workers'corn tion insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions A M€ft Ce ' permit Code.Any city or county which requires a to construct,alter,improve, Carrier ;/410 a ,V1 demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number W L a ? `/ 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 forthwith comply with those provisions. compensation,will do the work,and the structure is not intended or offered for tttity 1 tsale(Section 7044,Business and Professions Code:The Contractors License Date Signat 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: 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. I Name Id L A atvfl - Title P NI,NAhEE ,I certify that I have read this application and state that the above information is co rect and that I am the owner or duly authorized agent of the owner. I agree to comply with all City ordinances and State Laws relating to buildin l construction. I hereby authorize representatives of the City of Arcadia to enter u th ve-mentioned ro for inspection purposes. ignature Date / l1 7 NOTES . � Building Inspections Date Insp. Plumbing Inspections Date Insp. c-7 - ,,e , 100. Setbacks 210. Under flribldg.drain Ole/ e...5// A? 101. Rough grade 211. Copper underslab 102. Figs.&forms 61,97A? 49-1_ 212. Rough plumbing r /�J�/ (/ ��J' 103. Pre-slab 213. Rough gas �`"" ��� `C� �'G�/��� 104. Floor joists 97� / �1 214. Shower pan ••2t� C� a r -,� frit 105. Steel f `1' 215. Water heater 106. Grout lift _ 216. Roof drains �� S � 107. Shear nailin. , . 217. Buildin.sewer0 108. Diaph naili rMilall 218. Water servic: AriimI � _.i // r� 109. Roof nailin. `1 /0� IC l L vL .� 219. Final ss /441115M24111 110. Framing j It 220. Fixtures ' .�, . rill. M, /�+i../ /fr' A 111. Occ./Area Sept.Wall 221. Final.lumbin. �r d 112. Sound walls 222. Sewer cap/demo. `�� / // p S 113. T-bar grid e n . n 44( -, .. "5 114. Insulation-Flr. �^ Pool Inspections Date Insp. �" 115. Insulation-Wall 240. Excavation/steel ,,/ 116. Insulation-Ceil. -�.p / 241. Rough plumbing ,�� 9�/. v// V 6 `/ 117. D all nailin. • - //_ 242. Li.ht shelt/bondin. ��' A' ` 118. Interior lath -7,0243. Underground conduit r 119. Exterior lathT'� A, J t! 244. P-trap 120. Finish grade, 245. Gas line&test .e'14 eC fr '121. Final building jo-/G� 1 246. Fence ates&sins / ,l (/, ' 122. Final demo/lot clear 247. Pool heater �j 248. Final electric Cr- T `y�f"-i Cie -blew-'4v7 Electrical Inspections Date Insp. 249. Final.lumbi . (; 150. Power pole 250. Pool cover f 151. Sales lot lighting 251. Pool finall / /,...'. /4/ � /i , r 152. Under.round conduit 153. Underslab conduit Reroof Inspections I Date Insp. 154. UFER ground i'' 270. Pre-reroof insp. 155. Water ground 271. Roof framing 156. Rough electrical ^?(j G 1 272. Sheathing nailing - 157. Fixtures 273. Final reroof 158. G.F.C.I. 159. E..t.bondin. Sign Inspections I Date Insp. - 160. Service panel 280. Setback/overhang 161. Final electric /67 -4,› 6-4._ 281. Footing 282. Conduit/wirin. Mechanical Inspections Date Insp. 283. Disconnect 180. Venting/flue 284. Final sign 181. Furnace/A.C. 182. Rouch HVAC - ,4 A* Miscellaneous Insp. 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 I Insp. 191. Final mechanical 0 it. 300. Lateral(main to P/L) 301. Saddle/Y Block Wall Inspections Date Insp. 302. Cess•..l filled 200. Footings 303. Sidewalk 201. Steel/rebar 304. Driveway 202. Grout lift 305. Curb replacement 203. Final wall 306. Trash bin Certificate No.20121023-955 ARCADIA UNIFIED SCHOOL DISTRICT 150 South Third Avenue,Arcadia,CA 91006 • (626) 821-8300 Ext. 6732 Certificate of Compliance for Payment of Developer Fees (Education Code §17620,et seg. &Government Code §65995,et seq.) Effective July 24,2017 Current rate in effect applies at the time of imposition of fees/payment. Project Address/APN: 519 Campesina Rd. , Arcadia, CA 91007 Number of Units in Project: One Plan Check Number: 18-2398 [ ['i' [x]** [ ]** Exem pt: I ]500 sq.ft.or less(residential addition/expansion/remodel) Residential Commercial/Industrial I ]Other: $3.20/sq. ft. $0.51/sq.ft. Area in Sq. Ft.: 531 Receipt Number: 330476 Total Fee: $1 , 699. 20 Check Number: 1 1 1 Owner's Name: Huy Jimmy Vo Owner's Address: 519 Campesina Rd. , Arcadia, CA 91 007 Phone Number: 626-399-4152 Email: jvo532@gmail.com Representative's Name&Contact Info (if appl.): *The above-described development has been determined to be exempt from the developer fees of Education Code§17620,et 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 pr nted above,this Certificate of Compliance is hereby executed. Connie Chu Senior Administrative Asst. 4/23/19 ignature 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 $100 administrative fee. The refund check will be issued in the name of the owner/developer and mailed to the address of payee. PURSUANT TO GOVERNMENT CODE§66020(d),OWNER/DEVELOPER HAS A PERIOD OF 90 DAYS FROM THE DATE OF ISSUANCE OF THIS CERTIFICATE OF COMPLIANCE TO PROTEST THE IMPOSITION OF FEES Applicant confirms that he/she is authorized to sign on behalf of the owner/developer and that the information he/she provided to the District is true and accurate to the best of owledge. Signature of Applicant: Name: Ht. CA M, i WHITE—City/County YELLOW—Fiscal Services PINK—Business Services GOLD—Applicant Certificate of Compliance(7-24-17) r EE.CVM;BiOC4WALl T0RENF 90.00 + 1T —� z 14 i m m m 73 I I a 3r• X . i a r ' I • x z y' I I O o • Oi Z r .D I1 , _;s if P , }— 7-----y--''--1`' P _ I (rs, ISI$ 1 s.t I ; ;Z '..,.." q I4. I:i ''.----- E, ,,:it,, I I t,--F I I j inX .... 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HOMEOWNER UNDERSTANDS AND AGREES THAT ANY DEVIATION FROM THESE APPROVED PLANS,ABSEI\f PRIOR WRITTEN AU T FHORiZATION FROM THE ARB,CONSTITUTE • REASONABLE GROUNDS FOR THE REMOVAL OF NON COMPLIANT IMPROVEMENTS AT THE OWNERS EXPENSE. • DATE BY OATS 23ZU24J BY HO -OWNS . f s . : ., r.t,0 fi Si xX 'S•!4a+ t '-,•Px>. -siti1f., , i 2 ,C r v rd Ge { r '4 ,f:n , /�Ift,. .. to fr ( f lf , -,...';4t.,,:..1,,,,.r...,-,..;:::..,.,, tJ5rr txhtS `VA4 ?r� ar "Y;t , › f r rtx , 1 it ; {" �. 3 rJai. 01 • .j .............•••r r ` i 999 TTT TM. i , t. k r u.c v � J � , f14 9,�s+J DC a -C=} ,, h ,�3.�. 1 ��.�ce �-'t w.it he3',zl�lle �.� �� 01 Pc,Siln•l WAt\ �,��e S o.� Erol C( Wc, II u.. 1 i� �►Y,I� core 1J a S'�� � �,asks Slee\iz �' -7 r 1 - 1 I 11 .7:41-"':':'7'1::.: r X11 i IIki12ff LOOi6 VJ 'VIOtlJbtl sad- � -13aoW321 AlIWd3 3-ION'S O N V?N Ss'i/V:1 ' fes;^ tY_ ��rY g 8 r;: '1--II I Q i }ter. 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C ' v/ .� I,',' 3WOH AIIWVd 319NIS :• I ° 1 t _... H 3 AilOIS-t'X3 I I x1 '1 4 S I I ' 1 li I . r• � � -�-� ^tom':, 4 I II I i • I Ij t< JI ,, �M. 'Y” U {I' 7 I t I '•.:'“t.\‘' \\ I ii. I 1 IR..,.I 5 I \.• ` 17 T L I 1 1 :� '.J7 1 ;' .,! ..� g • I • 1 SII I k O r n �t I --5. I .g„ I I1 g •I 1'-' y'Js,. .I ti -h }C r , I P i,,1 l�, M;; 1 .11 oti.•: tL_ 1 .' d 1• ( • I I t 1' u w is i : L :. 14 ./ ':.;.1 .\•i �' 1 1 W W W . i 1 CI � 1 '.---J____—____... . .''...._._• —J -LI- - wnnvm77rmon w' AJ 00'06 ... i DEPARTMENT OF BUILDING AND SAFETY STRUCTURAL OBSERVATION REPORT FORM REP RT NO. THIS REPORT INCLUDES ALL CONSTRUCTION WORK THROUGH 2 0 DAY OF16-g, / 202:0 / PAGE NO. / OF PROJECT ADDRESS Si Cj CA.pi 7-:e,S .4 ,p STRUCTURAL OBSERVER STRUC.OBS.PHONE NO. -C / C 4- /r'7 /x / ' OWNER LIC.OR REGISTRATION NO. BUCDING PERMIT NO. OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS LOCATION AND PORTION OF BLDG. DATE ❑- FOUNDATION ❑- WALL ❑- FRAMES ❑- FLOOR 0-FOOTINGS,SLAB&STEM WA_:S ❑-CONCRETE ❑- STEEL MOMENT-SPECIAL 0- CONCRETE ❑-PFESTRESSED CONCFETE SLABS ❑- MASONRY ❑- STEEL MOMENT-ORDINARY ❑- STEEL DECK ❑-CAISSONS,FEES,GRADE BEAMS 0- WCOD ❑- STEEL BRACED ❑- WOOD ❑- HILLSIDE E',LDGS-SPECIAL 0- ❑- CONCRETE-DUCTILE ❑- FL,UND.ATION ANCHORS LI- ❑- 0- CONCRETE-NON-DUCTILE ❑- E1- (rirul 4,--e--_-; ❑- ❑- OBSERVED DEFICIENCIES: e .,✓ ie- --4-f >r'i . S/- Vii-,‹ l tiT ( 5 r ' Thi-- — f-? 6'5)," ________ ❑- DEFICIENCIES CONTINUED ON ATTACHED FORM(B&S 261 A) �OESS1c, (----- , .,0.C6820t, \,y\ m . SIGNED 2-ec OF fe16, �� I� `� , ua AT CA � Exp.913004' DAY MONTH YEAR CITY •.c ' CNi`.�._Q X WET S'GNATURE A.F REG ERI:;CML OR SIHUCTURAL ENGINEER CR LICENSED ARCHITECT STAMP OF ENGINEER OR ARCHITECT STRUCTURAL OBSERVATION DOES NOT WAIVE ANY OF THE REQUIREMENTS FOR BUILDING INSPECTION BY AUTHORIZED EMPLOYEES OF THIS DEPARTMENT DISTRIBUTION:STRUCTURAL OBSERVER TO SEND ORIGINAL TO THE BUILDING INSPECTOR'S OFFICE.ATTACH THE FIRST COPY TO THE APPROVED PLANS.AND KEEP SECOND COPY FOR STRUCTURAL OBSERVER'S RECORD AND DISTRIBUTE:'. City ofc"- t Los Angeles Uniform Code Program Uniform Procedure I-7: Special Inspections Special Inspection Report • DISCREPANCY °I—CONFORMANCE All discrepancies shall be brought to the immediate attention of If work conforms to approved design and code requirements,submit — the Contractor for correction. If corrections are not made in a this report to Building Department and copies to Contractor,Engineer/ Itimely manner,this report shall be used as a discrepancy notice. Architect of record and Owner no later than the business day following - Submit the original to Building Department and copies to the conclusion of the special Inspection, For inspections greater than 5 Contractor,Engineer/Architect of record and Owner. , days duration,submit a conformance report at least once every week. This Is a: Progress Report • Final Report Report No. _1 Page No. _1_of_1_ Project Address: Description of Project: s--viC i S P- I rx--e7-7 Permit Number: Owner: Architect/Engineer of Record: Contractor: i —2315 3-1 A4 kJ's(' Vc Le-wvi/7-Aeu P.i5 Full Name or Special Inspection: City Registration Number: Company: Phone Number: Huan Van Bui P013049 'r--1"--r- L4 VanBui Inspection 714-345-8266 Type of Inspection: -- o Reinforced Concrete o Structural Masonry o Piling, Piers &Caissons 0 Smoke Control o Prestressed/Post-tensioned o Bolts in Concrete/Masonry a Excavation and Fills 3 Energy Compliance a Shotcrete/Gunite a Structural Welding a Spray p Fire Proofing a Testing Reports o Insulating Cancrete/Gyperete a High Strength Bolting -Other 9 ry1 ar-- , , Time Time Date Arrived Departed Description and Location of Work Inspected C--ti- te't 5 : itidt t ,moi tr.4- •Ebex.)- ---(3 -A ,;.'( Lesx. , i A,&-r-Aititrejo tov 3/it 7 A'( r &r 4, .term` ,tiit citi 2-4i 4t 73. 6 /0 9 au /c=1,, (01..) --cezns, 0 Zf7/I-tam-- M' !��-yr a.p, L G`f eve_ ,Nt� • Remarks: / 04-1/C3-0710-elArm ?z=, .eve_ 2--s 8, '''Ic/eP, r,i/.3E.V(7.,--- a-e.z.), 2-'g=7—•tc--r// I HEREBY DECLARE THAT THE FOLLOWING IS TRUE TO THE BEST OF MY KNOWLEDGE: `.. :AM,OR MY COMPANY IS,RETAINED By THE OWNER OR THE ARCHITECT/ENGINEER OF RECORD TO PROVIDE SPECIAL INSPECTION FOR THE WORK COVERED IN THIS REPORT. 2. i HAVE PERFORMEDTHE REQUIRED INSPECTION DURING THE TIME PERIOD AS STATED ABOVE. 3. THE WORK COVERED IN THIS REPORT IS IN CONFORMANCE TO THE APPROVED PLANS,SPECIFICATIONS AND APPLICATICN WORKMANSHIP PROVISIONS OF THE CODE,EXCEPT AS INDICATED OTHERWISE. Signature: �'� - ta-' Date o' ire?l (T Huan Van But, Deputy Inspector City of -- EDI , Los Angeles Uniform Code Program Uniform Procedure I-7: Special Inspections Special Inspection Report • DISCREPANCY /CONFORMANCE i Al discrepancies shall be brought to the immediate attention of If work confomms to approved design and code requirements,submit � t e Contractor for correction. If come-dons are not made in a this report to Building timely manner,this report shall be used as a discrepancy De P�>ent and copies to Contractor, Engineer; - • screp ncy notice. Architect. of record and Owner no later than the business day following - Submit the original to Budding Deponent and copies to the conclusion of the special Inspection, For inspecdors greater than 5 Contractor,Ens'neer/Archi t of record and Owner. da dwat+on, subrrft a conformance resort 24 least once eve, week. This is a: 24-Progress Re..rt • Final Re..rt Re..rt No. 1 ' Prue t tidd,az: Descripd� P� _ Pa•e No. 1 of 1 S`(c7 C' 1 �t s cam ' - - — Permit Number: H vntr: V 1(fC7 J/-LT 1k—Z g .( VIj�:�Engineer C, Record: Cocraciar:t �'v PGS ?/. �ti� Full Name Special rr,spection: City R 7e)Ion Number: Huan Van Bui pp13�g �- Company' Phcne Number: Type of Inspection: f�?7ar �. VanBui Inspection 1714345-8266 a Reinforced Concrete I c Structural Masonry o Piling, Piers & CaissonsControl o Prestressed/Post-tens.oned o Bolts in Concrete/Masonry a Excavation and Fills o mp c Shotcrete/Gunite a Structural Welding a _ a Energy Compliance a Insulating Concrete/Gyperete a High Strength Bolting 0 Other ��� Proofing Testing Reports Time Time ---- �l°''��" 57Date Arrived Departed Description and Location of Work Inspected 0.2/9 //.',� -Z.'0,7° 6 (2) s,� r/s (. > p 5,4 4 a,f � �� ; ,'.r iii-/,7' 9t AP, , /- e" S/3//ic l / / ' -e- T..i2/� i-- ilf , 'Cj / sevt- (>4') / /2 —f//c 7l .fe Remarks; ' (/qo),f�Dl �� 475 . j -ter lam'' C tae � _ I—% — ! HEREBY DECLARE THAT THE FOLLOWING IS TRUE TO THE BEST OF MY KNOWLEDGE: . :AM, OR MY COMPANY IS, RETAINED BY THE OWNER OR THE ARCHITECT/ENGINEER OF RECORD TO PROVIDE SPECIAL INSPECTION FOR THE WORK COVERED IN THIS REPORT, 2. I HAVE PERFORMED THE REQUIRED INSPECTION DURING THE TIME PERIOD AS STATED ABOVE. 3. THE WORK COVERED IN THJS REPORT IS IN CONFORMANCE TO THE APPROVED PLANS, SPECIFICATIONS AND APPLICArICN' WORKMANSHIP PROVISIONS OF THE CODE, EXCEPT AS INDICATED OTHERWISE. � Signature: ( --- Date ,E517e,e-17' Huan Van Bui, Deputy Inspector ",..r, County of Los Angeles fei; RKS BUILDING & SAFETY DIVISION PUBLIC WORKS DEPARTMENT OF PUBLIC WO \11.11401V- Los Angeles Regional Uniform Code Program 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) Report No. This report includes all construction work through /� day of �/p/-) ,20/7 Page No. of Project Address: Structural Observer of Record (SOR): SOR Phone No.: 5:/g 6?iry2-e5i//A / / Aread�� 5/1/9-e? _Ali" /-/1otin7 zb-z�-/_ �G ``� Building Permit No.: Structural Observation Observr Professional Lic./Reg. No.: Observer Phone No.: Add/ -,/y 7 3 <f performed by: see d6Dve C 3Z1�O 4 26 ` - /-9-G f ll- OBSERVED STRUCTURAL ELEMENTS AND THEIR CONNECTIONS FOUNDATION WALL FRAMES FLOOR ELEMENTS/CONNECTION OBSERVATION LOCATION ?Q Footing, Stem Walls El Concrete 0 Steel Moment Frame 0 Concrete ❑ Mat Foundation ❑ Masonry ❑ Steel Braced Frame ❑ Steel Deck ❑ Caisson, Piles, ❑ Wood 0 Concrete Moment 0 Wood Grade Beams Frame E)Retaining Foundation ❑ Others: 0 Masonry Wall ❑ Others: Hillside Special Anchors Frame ❑Others: ❑ Others: 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,/,4S 's y+ed de 71/1i Ph Ci c_S `a oe 6-ee1i cr'sx ✓P.1 - ,t as--C/'r.4-4`DSI /i,/, 7/ .�y err /K�P �.P� - -r/ r. a/474 Q-2 f Gi"f Q� (/a ree",,c - leo riO r ) - /a/ c-P 4 g4 Gi/-1z1.0►L, , i Q et-/i/ /- d7--7Ui as7 .61_ver/ -4/-3e,,7 l7 ;e/ r,P Cr/e i'd �'4 P I DECLARE TAT THE FOLLOWING STATEMENTS ARE TRUE TO THE BEST OF MY KNOWLEDGE: 1. 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. �OQi\OFESS/CNyI 2. I, OR ANOTHER ENGINEER OR ARCHITECT WHO I HAVE DESIGNATED ABOVE AND IS 4P ,0,H,1NG UNDER MY RESPONSIBLE CHARGE, HAS PERFORMED THE REQUIRED SITE VISITS AT , g ;�'j6 EACH SIGNIFICANT CONSTRUCTION STAGE TO VERITY IF THE STRUCTURE IS IN w w/ n", GENERAL CONFORMANCE WITH APPROVED PLANS AND SPECIFICATIONS; ¢ No.C 36602 r 3. ALL NOTED DEFICIENCIES WHICH REMAIN O BE CORRECTED HAVE BEEN INDICATED Q 'r Exp.6-::: j ABOVE; \4:5> C I V IL Q' ,. 4. I RECOMMEND THAT ACCEPTANCE OF THE STRUCTURAL SYSTEMS BY THE COUNTY T\CAI.*(Ps OF LOS ANGELES BE WITHHELD UNTIL ALL OBSERVED DEFICIENCIES ARE CORRECTED. /�� 6 --/g -/1-/1 (STAMP OF STRUCTURAL OBSERVER) SIGNATURE OF STRUCT RAL OBSERVER DATE Version 1.0(2008 LACBC) Jan. 10 2008 �.• City of Arcadia, CA Permit NO. Mech-20-0061 Development Services Department Permit Type:Mechanical • 240 West Huntington Drive,Post Office Box 60021 Arcadia CA 91066-6021 Work Classification:Mechanical, Residential (626)574-5416 Permit Status:Issued A RCA D I A Issue Date:01/13/2020 Expiration: Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 519 CAMPESINA RD Arcadia,CA 91007-6014 5776017008 Contacts JIMMY VO Owner 519 CAMPESINA (626)399-4152 Description:2 FIRE PLACES FOR SF ADD Valuation: $0.00 Tenant Total Sq Feet: 0.00 Plan Check# Plan# Fees Amount Payments Amount Paid Fireplace Pre-Fab $29.92 Total Fees $77.93 Mechanical Permit Issuance Fee $47.01 Cash/Receipt#REC-03555-20 $77.93 Solid Waste Management Fee 2 $1.00 Amount Due: $0.00 Total: $77.93 � r /a ./?4 �Si% ( 6 - R.:1 COMPLETED 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. dr/ January 13, 2020 Issued By: Date January 13,2020 Page 1 of 1 ar; PERMIT/PLAN REVIEW APPLICATION id' • s : e{;4' Development Services Department,240 West Huntington Drive, Post Office Box 60021 '� �` Arcadia,CA 91066-6021,(626)574-5416,Fax (626) 447-9173 '°ontrr of H City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION ❑ I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and my license is in full force and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class License No. Exp. Date compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Signature of Contractor OWNER-BUILDER DECLARATION ❑ I have and will maintain workers'compensation insurance,as required by Section 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 I 7000)of Division 3 of the Business and Professions Code)or that he or she is,►4.1 . 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 o' hi not employ any person in any manner so as to become subject to the workers' Section 7031.5 by any applicant for a permit subjects the applicant to a civil 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 ii_5)i7o 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 W Date l 13171' Signature ..."---------.7---- Lender's Address IMPORTA T: 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 w \Title PRINT NAME I certify that I hav • . ' . - . .plication and state that the above information is correct and that I am the owner or duly authorized agent of the owner. I agree to . ply with all C • .rdinances and State Laws relating to building construction. I hereby authorize representatives of the City of Arcadia to . r upon the above-m• •tioned property for inspection purposes. // /2„., kz.........--....- )signature • Date / • City of Arcadia, CA Permit NO. FIRE-20-0246 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 ARCADIA Issue Date:03/06/2020 f Expiration: 08/09/2020 Addr NO. Dir Prefix Street Name Street Suffix Unit City,State,Zip Parcel Number 519 CAMPESINA RD Arcadia,CA 91007-6014 5776017008 Contacts VO,HUY J AND MARIKO S Owner F&H Fire Protection* Contractor 519 CAMPESINA RD 1119 Westminster AVE,Alhambra,CA 91803 (626)262-3876 584319 • Description:FIRE SPRINKS FOR SFR/NEW Valuation: $ 7,500.00 Tenant Total Sq Feet: 0.00 Plan Check#20-246 Plan# Fees Amount Payments Amount Paid Fire Issuance $47.01 Total Fees $951.86 Fire Permit Fees $203.85 Cash/Receipt#REC-03836-20 $700.00 Solid Waste Management Fee 2 $1.00 Cash/Receipt#REC-04063-20 $251.86 Sprinkler Heads $700.00 Amount Due: $0.00 Total: $951.86 - tOMPETE 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. March 06, 2020 Issued By: Date March 06,2020 Page 1 of 1 00.IFO1044., iI PERMIT/PLAN REVIEW APPLICATION R= Ns : rob, Development Services Department, 240 West Huntington Drive, Post Office Box 60021 ' ,/r Arcadia, CA 91066-6021, (626) 574-5416, Fax (626) 447-9173 City of Arcadia LICENSED CONTRACTOR'S DECLARATION WORKERS'COMPENSATION DECLARATION 0 I hereby affirm under penalty of perjury that I am licensed under provisions of I hereby affirm under penalty of perjury one of the following: Chapter 9(commencing with Section 7000,of Division 3 of the Business and Professions Code,and/�y license is in fuforce and effect. 0 I have and will maintain a certificate of consent to self-insure for workers' License Class L /v License No.,Q�?/7 Exp. Date a3o. 2/ 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 �,.tP) Lkt- OWNER-BUILDER DECLARATION 0 I have and will maintain workers'compensation insurance,as required by Section ❑ I hereby affirm under penalty of perjury that I am exempt from the Contractors 3700 of the Labor Code,for the performance of the work for which this permit is issued.My workers'cora nation insurance carrier and policy numbers are: License Law for the following reason(Section 7031.5,Business and Professions Qr�� Code.Any city or county which requires a permit to construct,alter,improve, Carrier " rSs/? rjaU..-e� J" ` ,r. demolish,or repair any structure,prior to its issuance,also required the applicant Policy Number F LA el 31. sl ->'q 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 0 I certify that in the performance of the work for which this permit is issued,I shall exempt there from and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil not employ any person in any manner so as to become subject to the workers' penalty of not more than five hundred dollars($500)): compensation Laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall 0 I, as owner of the property, or my employees with wages as their sole forthwith comply with those provisions. / compensation,will do the work,and the structure is not intended or offered for Date • G / Signature S L 1 c 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 contactor(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. IN arae TAU Mei S LI C.) ry .. . Title '1 (f` 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. / ignature /K�'"4S Date U 2 of ARC 44111;44tit6r Por".....r � 117 0:1 - rib C‘ i°1;_/* �4n►`y°`� MEMORANDUM Fire Department DATE: July 30, 2020 TO: BUILDING DEPARTMENT INSPECTOR John Zurick FROM: FIRE DEPARTMENT SUBJECT: FIELD INSPECTION ADDRESS: 519 Campesina Road THE FOLLOWING ITEMS WERE CHECKED FOR CONFORMANCE WITH APPLICABLE FIRE DEPARTMENT REQUIREMENTS: TYPE OF INSPECTION DATE / INITIAL FINAL INSPECTION FIRE SPRINKLERS (PC# 20-246) 7-30-2020 Jill Perumean FIRE ALARMS KNOX BOX OCCUPANCY (PC# 18-2398) 7-30-2020 Jill Perumean COMMENTS: Emailed Bldg. Dept. 7-30-2020 Rita 00.410AZZIk f) 460611,011‘.# City of Arcadia DEVELOPMENT SERVICES DEPARTMENT Inter-Departmental Inspection Request Date: Public Works Inspector / To: From: d.4 n 1 Address: C/6., C 'ec11 Permit No.: Contractor: Phone No.: Owner: Phone No.: 31, /z/.5.17 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 Final Approval Drainage k69 9 Grading hY4- Erosion Control Offsite Improvements Street Improvement(s) � _ (conduit,curb/curb & 0'112)11'-' 171‘, 1--) 9- I J gutter, curb numbers, driveway approach, parkway planting, sidewalk, street light, traffic flow, etc.) Sewer(s) (lateral,grease/san interceptor, saddle,wye, etc.) COMMEN UJ '.A.l r"A# t-N l t` ' � 01—t ret12W i-v1k ✓ )4 102-15 • Re..1/12111 — — ---- WATER DIVISION ATTENTION: _ DATE: P71; - FROM: BUILDING DIVISION INSPECTOR: CR4/7 � '1 ADDRESS: 57 ��1,�;y�e�/21. • PERMIT NO.: PLAN NO.: CONTRACTOR: PHONE NO.: OWNER: //�j%?( PHONE NO.: 3/2- WIZ PLEASE INSPECT T E FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT OF PUBLIC WORKS REQUIREMENTS. Type of Inspection Date& Initial Date& Initial Final Approval Meter Location 'eiS (14/1%/10 Blackflow Devices / Irrigation System �l%`a -eB "6/1 Fire Sprinkler System Meter Clear A.P.P. , 'w i,/a a Swimming Pool +16 Ails/20 ` , 2000? COMMENTS: T%cG �jnn�t��• 1��t DL A/0'63 ( 27 )(47,?.:7_54 A r