1240 S. State College Blvd.
BUILDIJII~ PEI\MIT NO. BLD2004-03354
TYPE OF PERMIT CITY
Tenant Improvement (Limited) .
OA iE: 111412004
JOB AODRESS: 1240 S STATE COLLEGE BLVO
LEGAL DESCRIPTION: P BK 117 PG 19 PAR 4
APPLICANT: BURT VEGA
OWNER INFORMATION:
PACIFIC COAST MANAGEMENT
1240S. STATE COLLEGE BLVD.
ANAHEIM. CA
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626 .
CENSUS CODE: 437
QUARTER SECTION: 116
ARCHITECT/ENGINEER INFORMATION:
SHIUH-GUAN LEE
CONTRACTOR INFORMATION:
VELOCITEL INC
18071 FITCH AVE #200
IRVINE. CA 926140000
BUSINESS PHONE: 949.809,4999
JOB DESCRIPTION:renant improvement, add new antennas and cabinets-on r~;Jf
VALUATION: 70.000.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that lam exempt from. the Contractor's. License LClW tor the following reason (Sec. 7031.5 Business and
. Professions Code: any city or county which requires a permit to construct, aft~'<;., improve, demolish or.repair any structure, prior to its: issuance, also
requires the applicant for such permit to fije a signed statement that he isllcerlsed pursuant to the provisions of the Contractor's License Law (Chapter
9)(comm~ncing with Section 7000 of Division 3 of the Business and Profess~c~ls Code) or. that he is exempt therefrom and the b~sis for the alleged
exemption. Any v~lation of Section 7031.5 by any 'applicant for a permitsiltijfts the _applicaot to advil penalty of not more than five hundred doJlar:s
~~~ . . . .. .. . .
o I,_as owner of property; or my employees with wages as their sole com!%hsation, wiff do the wo~k arid the structure is not intended or offered for
sale (Sec. 7044 Business anclProfessions Code: The Contractor's LicenseE;w does not apprytb an owne"r' of property who builds or improiJes
thereon, and who does such work, himself or herself or thro.llg hhis:or,tll~ro'W:h'empioy~es, provided .that such improvements a re not intended or
offered for sale'. If, however, the building or improvement is sold with on'eye"{r of completion, the owner-builder will h~ve the burden of proving that he'
did not"uild or improve for the purposeof sare). . f' . ."
o I, as the owner of the property; am exdusively contracting with licensed;',ionti~ctors to con!::itruct the project (Sec. 7044 Business and Professions
Code:,The Contractor's License:Law does_not apply to an owner of properfy"'vrho b'JildS or improves thereon, and Who contracts. for such projects with
~ontra~or(s) Ji~ensed pursuant tothe Contractor's license law).. .' '.}" . .
U I _am exef\lPt under Sec.. ' ,B & P.C. for this reason;:,,~, ,.
Date: . Owner:, ..
I WORKER'S COMPENSATION DECLARATION . :---..:::::J
I herebyaffirm-unde~r' penalty'of perjury one of the following declaration's: _ . _i
o I have and wi" maintain a certificate of oonsen~ to seff--insurefor worker'S:r.omper.sation,
as provided for by Section 3700 of the Labor Code, for the performance of the we rk fo!" which
~hiS rmitis issued. . , .' , '_",'
.I.t>ave anq will maintain worker.s compensation insurance. asrequired b/Section 3700 of
e bar Code, for the performance of the work for which this permit.is issued. My worker's
ompensation insurance earrier and poHcy are: , " . .
Carrier: ST. PAUL FIRE& MARINE I NSURAN Policy Number. WVA6101558.
This s~tion need'not be compl,eted if the permit is for one hundred dollars ($100) ~ I~s.
o I certify that in the perfonnance of the work for which this permjtiS:lssued~ , shall not
employ any person in any manner so as to become subject to the worke:ls"'coP-lpensation-laws
of California, and agree that if I should become subject to: the worker'~,-cqm~r:~atil?ri
provisions of Section 3700 of the Labor,Code I sh II forthwith complY With th(;.~,e provisions.
PROCESSED BY: ENO
I
LICENSED CONTRACTORS DECLARATION_J
I hereby affirm under penalty of perjury that lam
.' .licensed u,l1der provisions of chapter 9 (commencing
with Section 7000 'ion 3 of t e Busi.ness and
Professio C
11/4/2004
Oate:
NUMBER
817929
TYPE
Construcion Types:
VN, ,
Fire Sorinkle'red?
Date: 1114/2004 Applicant:
WARNING: FAILURE TO SECURE OR E COMPENSATION COVERAGE IS .
UNLAWFUL. AND SHALLSUBJE AN EMPLOYER TO CRIMINALPENAL-:-IES AND CIVIL
FINES UPTO ONE HUNDRED OUSAND DOLLARS ($100,000). IN ADDITION TO THE
COST OF COMPENSATION. AMAGES AS PROVIDED FOR IN SECTION. c706 OF THE
tABOR CODE, INTEREST AND ATTORNEY.S FEES.
I CONSTRUCTION LENDING AGENCY
I he~eb-f affi:"m ur1der per,3lty of_lJsrjury that there is a ccristructjoi1:leridirti:f3g~-yfot:Jhe-- .
performance of the work for wh,ich this permit is issued (Sec,3097.eiv.C}:
lender's Information:
I certify that I have read this application and state that theabov~ information is correct. I
agree to oomply wtth all city ordinanCes and state laws relating to building construction, and
~~s of this city to enter upon the above mentioned property for
.. ___ . Date: 11/4/2004
ignatu~e of Appl.icant 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 issuance, A
new permit is required to commence or continue work.
EXPIRATION DATE.
3/31/2005
B
5:
NO
. p,':
Fees paid for Permit:
Total:
1.524.75
INSPECTION RECORD
, DATI; ,
INSPECTION INSPECTO.R
Temporary Power Pole
, Plumbing (DlainNVaste Pipe)
Electrical Ground Electrode/Uter '
SetbacklFormsrrrenches (Footings)
Do not install sObfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pi~.Sprinkler Valves)
Mechanicai (GroundwOrk) "
Electrical (Underground Condu it) ,
Pre-slab (Compaction/Membrane.Rei nf. ,
Underpinning (Floor Joist/Girdl!l's) ,
Do,not cover or concealthe,work below until tne
following applicable items have been signed:
1 st Floor Shear , , ,
Firesprinkll!l' (Rough) , ,
, 2nd Floor Shear "
Roof (SheathinalDiaphlagm'Frame)
Masonry (ReinfJBond BeamlPr.Grout)
Rough Plumbing (Top Out) , ,
Rough Mechanical
Rougn l:IectrlCaI,(ury waU) ,
Rough Electrical ,
Framing' (Only after Plbg" EJec.. r...lech.. and Fire)
Insulation '(SoundlEl'Iergy)
Do not tape or plaster until the following applicable
items "haye been signed: - . -
DrYwall ' ' "
Penetrations (Fire Rated) EIl!(:trical ' ,
Penetrations (Fire Rated) Mechanical , ,
Penetrations (Fire Rated) Plumbing, ,
Interior Lath ,
Exterior Lath
, ' GENERAL ITEMS
Exterior Plaster (Brown Coal) .
T'Bar Electrical ' , ,
T -Bar Mechanical
T -Bar Structural '
Sewer:
Water Engineering Backflow
Water Service ,
FINAL INSPECTIONS 'Date ' .'nspe'etor
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 765-519
Zoning 765,5139 ,
Building Final last Inspection. Only ,
, ' fter Above Complete) ,
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections ,
Plumbhl(l Inspections,
Electricallnsoections
CONTRACTOR INFOI'UI.ATION: . ARCHITECT/ENGINEER INFORMATION:
PROCESS COMMUNICATION DEVELOPE.
3020 HARVARD STREE1
SANTA ANA, CA 92704
. BUSINESS PHONE: 714427-6370
JOB DESCRiPTtGNjenant improvement, "add new antennas and,cabinets or.; roof..{Transferpermit from Contractor ~Velocitel" to Contractor ,"Process
Corurn,UQi.ca.' tions". Ref: BLD2004-03354} i
VALUATION: fU.UUU.uu PROCESSED BY: MSM
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from U18 Contractcf's License Law for the following reason {Sec. 7031;5 Business and
Professions Code: any dty or county which requires a permit to construct, a'ter, jmpr~ve. 'demolish or repair any structure, prior-to its.issuance, also
requires.the applicant for such.permit to fife a signed statement that he is Iic.~nsed pursuant to the provisions of the Contractor's'License'law (Chapter
. 9}(cpmmencing with Section 7000 of Division 3 of the Business aild Pr{)fsS~:qQs Cod~) or that he is exempt there-from and the basis for the alleged
exem~tion. Any violation of Section 7931.5 by any applicant for apermit SlJ!'~,~.r-ts the applicant to a civil penalty of no.t more than five hundred doUars
~OO?l~s owner of prop~rty, or my emPloyees. with wages" as their sole c(":m~nsatio~, win do the work, arid the"structure ~not intended or o{f~red f~r
. sale (Sec. 7044 BusinessClnd Professions Code: The Contractor':, License H3W doesl'Jot apply to an owner of property who builds or improves .
thoreon, ~nd, who'does such work himself or herself o.r throughh!s or her o\"-n~emplQyees, provided ~hatsuch improvemer:ts are not intended-o~ , .
offered for Safe. If, however",the ,building or improvement is 301d with Oil"} Y?~rOf cornpl,etion. the'oW~r-buUder wiU have' the burd~n of proving th~the
did not build ar improve for the purpose of sale): .; "'", _C'__.' . , ~ '.
o , j! os the_owner of thcoroperty, am exclusively c~r.trscting with Ik:fO'mse<:h;pntract.orsto constructthe prbjecqSec.704.4 BusineSs and Professions
Code: .The Contractor'$ 'License L~w dqes not apply to an .owner of prop.~rt;twhn builds or improves thereon,-and.who-contracts'for such projects with
i;i..c~ntrach)r(s) !ic€:i"lSed pursual,t to the Contr~ctor'$ License Law). . 1 '
L.J. ! 31TI exempt under Sec. . .. ,8 & P.C. for thi~ reason:
Date: Owner:
BUILDING PERMIT NO. BLD200S-00028
TYPE OF PERMIT
. Tenant Improvement (Limited) CITY
DATE: 1/6/2005
. JOB ADDRESS: 1240 S STATE COLLEGE B!.VD
LEGAL DESCRIPTION: P BK 117 PG 19 PAR 4
APPLICANT: ERIC CHAVEZ
OWNER INFORMATION:
. PACIFIC COAST MANAGEMENT
1240 S. STATE COLLEGE BLVD.
ANAHEIM, CA
:'
.1 WORKER'S COMPENSATION DECLARATION j" 1
Il1ar€by affirm under penalty of perjury one of the fol,,?wing declarations~ \,
o I haYB and will maintain 3 certificate of oonsent to' self-insure fOf WCik~t$ compensation,
as 'provided far by Section 3700,of the labor Code, for the pe!formance cftl:;e \",,00<. forwhich
illl . permit is issued. '. '. -! .'
I, have and will maintain worker's compensation insurance, as required f'l Section 3700 of
Labor,-Code. for ~he performl;lnce of tlie work for which this permit is issu:3!d. .Mywcrker's
Compensation insurance carn'ef and policy are:
Carrier: STATECOMP FUND Policy Number: 1694765
This section ~ed nOt be- completed if the pennit is for one hundred dollars ($100) or iess.
o '1 certify that j:; the performance of the work for which this pe~mit Is Issu~~c1, I:shall net .
employ any person in.any manner so as to become slibject to. trleworke('s QmpenSation laws
af California, and agree that if J should becQme subject tothe,wcrker's cO"'ilI:~nsation
provisions of s.ection 3700 of the La~ COdra rthwith cOrTIplywith !;.;ose provisions.
nate;. 1/6/2005. . Applicant: .
WAHNING: FAILURE TO SECURE WORKER'S OMPENSA TiON.COVEF:AGS IS
UNLAWFUL, ANDS\:lALL SUBJECT AN E CRIM INAL PE"iAL TIES AND CIVIL
FINES UP TO ON:=' HUNDRED 1HOllSAND DOLLA8S ($100',000), iN ADDiTION TO THE
COST OF-COMPENSATiON,DAMAGES AS PROViDED FOR IN SECTION 3706 .OF THE
LABOR COilE, INTEREST AND ATTORNEY'S FEES.
'I CONSTRUCTION LENDING AGENCY
I hereby affir.m under.pena~1.y of perj_ury that there is a construction lending <:if:ency for the
V~-;'f0~v:&~~<)t:tt~'V""i;;,;:...fvl Wh\~l lill;JiJ'b:-ri,itbi:::;:;ueti (3t:c.S,J9T:Ci,/,Cl.---1-- . '.
Lender's Information:
r certify that I have read this-a pplication and state that the above information is correct. t
agre-e to oomply with all city ordinances and state laws relating to btJ ilding construction, and
'hereby authorize representjv- s of this city to enter upon the abave mentioned property for
ins ea:io~ pu~.
L Dale: 1/6/2005
Signat of plicaot or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work
BUILDING DIVISION . ._",-
2oo"S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 -4626
CENSUS CODE:' 437.
QUARTER SECTION: 116
I
LICENSED CONTRACTORS DECLARATION
tl).er~~y affirm und.er -penalty of perjury that ram
. licensed u nde:r provisions of chapter 9 (commencing
with Section.7000) of Oivsion 30fthe Busines_$;and
~/:~;;~O\. cr. L'q .
Date: .. y ~:"'qtcacto~
NUMBER EXPIRATION DATE
696069 9/30/2006
TYPE . B
TYPE. C10
TYPE . C20 HTAC
"Construcion Types: .
VN" .
Fire Sprinklered?
NO
".~ ,
Fees paid for Permit:
Total:
71.53
>
INSPECTION RECORD
... INSPECTION DATE. INSPECTOR
T!!mporary Pow!!r Pole .. .
Plumbing (DrainlWaste Pipe) .
Electrical Ground ElectrodelUfer .
SelbacklFormsrrrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed: .
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) . . .
Electrical (Underground Conduit) .
Pre-slab (Compaction/Membrane.Rei m. ..
Underpinning (Floor Joist/Girders) . ..
Do not cover or conceal the work below until the
following appiicable items have been signed: . .
1st Floor Sh!!ar . .
Flresprinkler (Rough) . . .
2nd Fh;lorSb!!ar : . . ..
Roof (SheathingfDlaphragrrv'Fnme) . .
Masonry (RelnfJBond BeamlPre-Grout)
. Rough Plumbing (Top Out) ..
Rough MI!chanical
Rough aectrlCaI II)
RoughEI!!clrical . . .
Framing (On~ after PIbg., Elee.. MectJ.. and Fire)
1l1sulation(Sou~nergy) . ..
. Do not tap!! or plaster until the following .applicable .
Items have been signed:
Drywall : .
Penetrations (Fire Rat!!d) EI!lClrical . . .
Penetrations (FIre Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Int!!rior Lath . .. .
Exterior Lath
. .. GENERAL ITEMS
Exterior Plaster (BlQWn Coat) ..
T .Bar E1!!ctrical
T~Bar M!lChanical . .
T.Bar Structural
S!!w!!r. . .
Wal!lr Engln!!!!ring Backflow .
Wat!!. Servic!!
FINAL INSPECTIONS . . Date Ins~tor
EI!!ctrical Final . JIIIVlf ./
Plumbing Final 0' :' . :
Mechanical Final . . . .
.. Gas Test
EngineeringfGradlng Final 765-5126 ,
Fire Dept. Final 765-4040 .
..
Water Engineering 765-5268 .
Sub List/Business License 765.519
Zoning 765-5139 . ..
Building Final *astlnSpeetiooCOnly . Id .",{ . ~,-1I1
fterAbove Complete). ur
PARTIAL INSPECTIONS
Building Inspections
Mechanicallnsoections
Plumbinalnsoections
ElectricallnsDectioris
,4 riff ~/rr rVlnr~t ,4'^'/I#'e>~
^ddr~s of / 2.. ~ t7 ~ .J,."., crc;tfe.w ~ IJ. CITY OF Le!! "I ULIllE3
aulldlng -.-.----...-----m--..--m-----------..-.-.....-....-------.[;l'f--cr-, DEPARTMENT OF
Off.Slte b~/4r /.. C;f), ~C. it:/~d$ BUILDING AND SAFETY
Fabrleator ____...____.__..._m._..___.....____.__.._._.___.__...__m__._._-...-....-..--. BUII.DING INSPECTION
~~":.:el!.?!!...~.~_~r.:._~!..l..._s:-!fyear __?::_~_o..z._..__ OAT / ft'- C;R~ '" Y
REGISTE ED DEPUTY BUILDING INSPECTOR'S CERTIF. An OF COMPLIANCE
TO THE SUPERINTENDENT OF BUilDING: CITY INSPECTOR:
I hereby certify that the following portions of the work at Ihe above address which
required continuous Inspection, and which I was employed to inspect, were Inspected by
me and comply with the provisions of the Building Code applicable thereto:
Type of inspection: ~ 2005
o Masonry 0 ReBar PfacemeJAN. 0 Concrete or Mb(er
%WeJding 0 Concrete Placement 0 Gunite
o Hi~Ten Bolts 0 Tendon Ple.<:cment tL 0 Other ....___~.~..h__.__...................
Description and location of work'completed: .--0..J--:r.!.t--Tm-----::--~f::'?..~--.--
...Y2trL.6..0_~___..'d.f~~Ii::.3!.c.____L9:x_..___.____~/...i':_X.__.?:~_._,___
...iJ_eY9_~--!I:.---e..~~U:e:-.--.f:.-~--.c.~(;.?C--~~~~~~-.-
.___z:.~,t?_.t!!.~_t?_____il'?_r._~_~.__.._.~_._e..:::!_.~_.L:E.L~%__-f:.____.__.____.__.__
__.~L_'!7r.___.J.fl.~.__/?-f::.:'!..f.P.;e.-----6..-~/.,e::r:::--.~-{:2~{."P.-.--__'lY!._____
___.~.~-.---~/.!:.......&.&.-(!.!.-----L:.-~-----.--.-.--6L~..-.~...~_f:t:.E!:':!C
...P..._,..~__~_.___.!!.f_.-----.:L~-q----.-~-------0f.-~--.-c.~.?7.___[.{~____..._...____
__..p.T:_~B_4.t_______':t_I(_C:r;--.:--.Lh~.-'l.:.--.~---2-~(~.-~.ciifl~{ft..:
...'If~BJ.~Q-~---.~----.<;;.:--/".;-~-!.(--..A~L=-?==.-.--~:-~-!.2-..__..______..._____
.--.1ft-~~-~i:~-2~fffj;~fA_~_t::~rcJl-_f:;!J:.-;-:~
.-------~--------~-.--...-.--.----.-7"-.--.-----.-....---.--..--.--.~-.-.--.-.-.----------..----------...--.---.----.---
.----f..J!J():::r-----~-ef..l:?!3'.--~-:---t.--?:::.-:::-!.-4...::...~-~r- ____~_~~!!.._.._!Z!:._t...___...__.
Size of Structure .. ___~_u~_...kjJ_u_..~m....m_...m.__w.m.._..._h Time A"i\led ____.___..__~"'_~_::!......._..____.___....__
No. of Stories --....-m-.-:-...---..-""i?--------.~---.----.----.--...m-..--. Time left Job ..__..L__k..._._~.~.;:'~_____.______._
COne. Mix Design No. __.________..____~..._.__... Psi _..____..____.._ SwimmIng Pool ____.______..d41:-._____...__..______..___
, had suffic:fent time to Inspect all """terials used and placed.
I was not employed by the contractor, subcontractor or material vendor.
~~~~PJ~:?;h<~
lab. _...__._.___._....__._.__.____..___.____.___..__.__..___.___._________ __._____.___________.._________________....:_____._.
~"::peB.~~tl!..) _.Lr~:~:1.?;r~.~;~_~e~~:r:____
,n Print Full N.....