6507 E. Serrano Ave.
BUILDING PERMIT NO. BLD2005-01846
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TYPE OF PERMIT
Tenant Improvement (Limited) CITY
DATE: 7/18/2005
JOB ADDRESS: 6507 E SERRANO AVE C
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LEGAL DESCRIPTiON: SEC 7 T 4 R 8 POR SW1/4 AND POR
APPLICANT: VINCENT TRAN
OWNER INFORMATION:
CMC-NI NE
PO BOX 81290
CHICAGO,IL 606810000
CONTRACTOR INFORMATION:
CENTRAL PACIFIC DESIGN/BUILD
2412 W MILLS DR
ORANGE, CA 928680000
BUSINESS PHONE: 714719-1558
JOB DESCRIPTION,enant improvement, pedicure shop.
VALUATION: 12,000.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 286
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: DUC
OWNER.BUILDER DECLARATION
I hereby affirm un er penalty of perjury t at I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profession~ Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subje-:ts the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compersation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La'N does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own (Imployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year.of completion, the owner-builder will have the burden of proving thafhe
did not build or improve for the purpose of sale).
D I, as the owner of the property, am exclusively contracting with licensed cchtractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: ;
o I have and will maintain a certificate of consent to self-insure for worker's c~ompensation,
as provided for by Section 3700 of the Labor Code, for the pel'formance of the work for which
this perm it is issued.
1Yr-'l have and will maintain worker's compensation insurance, as required by ~?ection 3700 of
'fFi'e Labor Code, for the performance of the work for which this permit is issued Myworker's
Compensation insurance carrier and policy are:
Carrier: EXEMPT
Policy Number. EXEMPT
This section need not be completed if the pennit is for one hundred dollars ($100) cr less.
o I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compemation
provisiOns of Section 370001 the Labor Code, r~~ forthwith comply with those provisions.
Date: 7/18/2005 Applicant: ~ V
WARNING: FAILURE TO SECUREWORKE ' SATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR'CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
perf0l'mance of the work for which this permit. is issued (Sec. 3097 .Civ.C): ---'
Lender's Information:
I certify that I have read this application and state that the above information is correct. I
(agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
~ction purposer' ('~
.---- _ J _ Date: 7/18/2005
Sig~~h ,~~ . or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuMCe. A
new permit is required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that r am
licensed under provisions of chapter 9 (commencing
with Section 7000) Of(jiVSion 3 of the Business and
profesSio~. ( ~ .
711812005 ______
Date: Contractor
NUMBER
725395
TYPE
EXPIRATION DATE
4/3012007
B
Construcion Types:
VN, .
Occupancy Groups:
B, , , ,
Fire SDrinklered?
T.I.Area:
YES
1,000
Fees paid for Permit:
Total:
884.77
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole "
Plumbing (DrainlWaste Pipe) ~ Z/"-fJ( /.:iv,,,, 1M,
Electrical Ground Electrode/Ufer
SetbackIFormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below unlilthe
fOllowing applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (SheathinolDiaphragmlFrame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall) 11/#l/d{ 14ft-.'"
Rough Electrical /
Framing (Only after Plbg., Ele" Me<:. And Fire)
Insulation (SoundfEnergy)
Do not tape or plaster unlilthe following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -B:::;,:- E!ectr:cal
T-Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765.5139
Building Final (Laotlnopaction . Only
Aftar Above Complete)
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PARTIAL INSPECTIONS
Buildina InsDections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections