416 E. Sycamore
TYPE OF PERMIT
Repair
DATE: 1/8/2004
'JOB ADDRESS: 416 E SYCAMORE ST 4
CITY
BUILDING DIVISION
200. S.ANAHEIM BLVD,.
(714) 765- 5153 .
INSPECTION REQUEST LINE:
(714)765-4626, '
CENSUS CODE: 434
QUARTER SECTION: 82
BUILOING PERMIT NO.
13LD?J04.0004~
i
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APPLICANT: JORGE NEGRETE , ' " I
OWNER INFORMATION: CONTRACTDRINFORMJ.\TION:
Thanh Nguyen COMMUNITY BUILDERflENTERPRISES
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1120 Maunakea SI#295 17686 CORINE WAY . '.
Honolulu, HI. 96817 RIVERSIDE CA 92504 coilo
, " '."
' , , BUSINESS PHONE: 9~976~-5937
JOS DESCRIPTION:Replac;e /repalr same for same. Flredal11age. INV2003.~)149 , '
VALuATION: .54,000.00". " . '.,:', ~ . 'PROCESSED BY: CAL .
'I hereby ~ffir~<Under penaKyof perjury that' amexemp~~~7h~.~~~~~;;;,~~;.~:t~9~ the following reason (Sec. 7031.5 Business and
Professi~nsCOde:'ahY city or county which requires d permit to construct,n!fsr, improve, demolish orrepa_ir.anystructure, pr:iorto its issua!,ce, als,o .
-requires the. appliCa~t for SUch permitto me a signed statementthat he is Ii.Cfnsed,pursuant to the provisions of the, Contractor's License Law (Chapter:..
9)(commencl'19: with'-Section-7000 of Division 3 of th~ Business and ,Profess': .hs CorJe)'or that he is exempt therefrom anp the hasis for the alleged
~;;(;9rion:~y Violatio~ of s.ectio~ ?~31.5 by a~y applicant for a, permit S~.: ,'eets the ap~licant to a dVil. penalty of n~t more ~an:fi.ve hUl.1d~ed dollars .
D 1,.;:3s,'owner oi property, or my employees with wages as the:ir sole c..orn~'~nsation, will do the worJ<, and the structure is not intended-or offered for,.
sale ($ec. 7044 '~usin~s and p'rofessions Code:' The Contractor's, LJcens~qfaw.does not apPlY,' to an ownerof property who builds or im'proves
thereon, andwh6 does such work himself or-herself or through his or her o~m employees, proVided that sUch iIJlProvements'an~ not intended or .
offered.'f'!r.sa....I~... If, hoW. ever,. the b~jjding. 9r improvement t3, sold with cn,',Y.:-i' r of OO,mpletion, the owner-bu i1~er will have the bUrdep Of, p~OVingtha,t he.
did no.tbuildorimprove for the purpose of sale). ',' '.'< ,~,' "" , , . , ' .
o I, as'the owner of the property,am exdusively contrE.c:.cting w:th l:cerise',~iX)nt.ractor$to:construct the project(sec., ',7q44 Business and Pro, fessions
. Coda: The-Contractor's License Law does, not apply to an.gwner of pr0pertYfNho buiids or- ill1proves ther~on, and who contracts for sudl prC?j~ts'with
FU(o!1tractor(s>'.-li~,~nsed pursuan~ to: the Contractor's Lirensp.~lD.w). . ,
U 1 am'exempt under See;, ",.8 & P.C. for this reasen:
Date: Owoer;"
I '. WORKER'S COMPENSATION DECLARATION '21,
. I,h~reby affirm under ~enaltyof perjury one,ofthe "follo.wing d~cla.rations: l' . ' ,
D .I have and wiII.ma. intairi a certificate'of consent to self-insure fo.r workt>l".'l.' compensation,
as provided tor by Section 3700 of the labor Code, for the performance.of t!1.3:'^,Orkforwhich
this mit.is issued. '. .;,
have and will mainta,in worker's compensation ins;urance, as _requir~d.o/ Section 3700 of
. ...abor Coda,_for the performance of the. work for wh_ich th~_ ~r~it IS i~;;frl. My wo~~r's
Compensation insura_nce carrier and policy are: ,,' }".
Carrier:- STATE FUND ' . .' Policy Nur.nber. 16Q1~~4:'v2 .
Thi~ sec~o~"raeed not b8 ,compieted ifthe pennit is ~ one huna~d~Il~S (~~ ~~ ~"ess.
, D ,:J certify that in theperfonnance of the~ work for whic~. t91Spe~~it is i~~.C~<I.'i'sha It OOt. ,
employ_any person inany mann~rso,as,to .~eeome subject.to',t,he:_worke-"'~~.t'~t,ensation laws
of California, and agree that i( I should become subjec:t. tothe~Q,"1(er's c6f..nf;~~'~s~lion' .', .
provisi~ns of $ection 3700 of the Labor Code, I shall forthwith co pIYWitht~.~'.:~r- provisi,ons.. Construcion Types:
VN, ,
LEGAL DESCRIPTION: OLIVE ST TR BLK1 LOT 6 AND BLK \
ARCHITECT/ENGINEER INFORMATION:
lICENSEO CONTRACTORS DECLARATION
I hereby affirm under penal~ of perjury that I_am
licensed under provisions of, chapter 9 (commencing
with Sectioi17000) of Divsion 3 ofthe Business and
ProfessionS Code. .. . r/J .. . /. .
1/8/2004eg/tIJ1'f. l'lfJ~".($t
Date: . ..... .. \j' . Cont~ctor :
NUMBEH ' " EXPI~TI~N DATE ' '.
471870 4/30/2005
TYPE B
TYPE HIC
Date: 1/812004 Applicant: -" .
WARNING: FAILURE TO SECURE TION COVi:NAGEiS::
UNLAWFUL, AND SHALL SUBJECT.AN 1M IN)\L PEN-'i_TIES AN\> CIVIL
FINES UP TO ONE HUNDRED THOUM 0 DOLLARS ($100,000), IN ;.nr:.! nONTOTHE
COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SF.CT'ct; 3706 OF THE '
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '"
I CONSTRUCTION LENDING AGENCY' ,,___i
h." th~r~,QY.-;;l_~!r~JtjJnd~x,.po.J)~_1tY: RtR~r1!!ry.JbatJb~r:~,,-~.p_con,$tr.uctior. ien:'::I~D..:31;."'IICY JqrtoE>
perforrT'.anceofthe work for which thi.s permitis issued'(Sec.3097 .Civ.C): .
Lender's Information:
..:
I certitY 'that I have read this application_ and state' that the' above information is c~rrect. I
~gree to oomply with all city ordinances and ~ate laws relating to building c01struction,_and
hereby authorize representives of this city taenter upon the above mentioned property for
jnspection.purposes.
Oat,,: 1/812004
Fees paid for Permit:
Total:
709,96
r ofAppli
. The permits ex by lim" ion and become null and void if thf, building,or
. wOrk has not passedfin,,1 inspection 365 days from the date of permit issuance. A
new p'ermit is required to commence or continue wOrk.
INSPECTION RECORD
_. . INSPECTION
-Temp<lrary Power .Pole .
Plumbing (DrainlWaste Pipe) .
EledriCaJ .Ground Electrode/lifer ... -
SetbacklFormsfTrenches (Footings) . .
Do not install subfloor or pour floor slab unti I the.
following applicable items have been signed: .
Plumbi ng (Water Pi pe;Sprinkler Valves) ..
. Mechanical (Groundwork)
Eledrical(Underground Conduit) . .
Pre-slab (l,;ompactionlMembrane.Reinf.
Underpinning (Roor Joist/Girders)
Do not cover or concea.1 the work below untIl the
following. applicable items have been signed:
1st Floor Shear. .. .
. Firesprinkler (Rough). .. .
2nd Floor Shear _ . . $ .
Roof (Sheathing/Diaphragm'Frane). r.,-j_"'-'l. Ii.JJ _~
Masonry (RelnfJBond BeanlPre-Grout) .
Rough Plumbing . (Top Out)
Rough MeChanical .
Rough BectrlCaI /DryWall)
Rough-Electrical ~
Framing - (Only after Plbg., Elec:, Mech., and-Fire) ;t~Zl;"-M- ' -
.. Insulation (SoundlEnergy) <d;
po not tape or pla~ter until the following applicable - _ .
Items have been Signed: "., - . .: ., ' ...... /1_
DryWall. .. rt/f,{)q "Ii iT f
Penetrations (Fire Rated) ElectriCal
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
. Interior Lath . .. .
Exterior Lath . PI' <
. . . GENERAL ITEMS
Exterior Plaster (Brown Coat) . .
T-Bar Eledrlcal
T'Bar Mechanical
T -Bar Structural
Sewer
Water Engineering- BaCkflow
Water Service
DATE
INSPECTOR
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FINAL INSPECTIONS
Electrical f'inal.
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire .Dept. Final 7654040
Water Engineering 765;5268
Sub ListiBusiness License 765'519
Date'
Zoning 765-5139
Building Final. (Last Inspection. Only '2'~, '
. After Above Complete)
PARTIALINSPJ:CTIONS
~~E:~~~+
/
Mechanical InsDections
Pluinbina InsDections
ElectricallnsDections