8101 E KAISER BLVD (13)SIGN PERMIT NO. SGN2018-00180 �'HerM e, BUILDING DIVISION
IGA
� t,+ 200 S. ANAHEIM BLVD.
0 (714) 765 - 5153
TYPE OF PERMIT
,Alter Attached to Structure Sign
DATE: 11/29/2018
JOB ADDRESS: 8101 E KAISER BLVD 110
LEGAL DESCRIPTION: P BK 240 PG 41 PAR 2
PERMIT APPLICANT: '
OWNER INFORMATION:
CONTRACTOR INFORMATION:
CREDIT UNION OF SOUTHER CALIFORNIA
SUNSET SIGNS AND PRINTING INC
%HEIDI ROTH
2981 E WHITE STAR AVE
LOS ANGELES, CA 90064-0733
ANAHEIM, 92806 CA
JOB DESCRIPTION: Installation of non
illuminated wall sign reads "BaronHR"
E I M INSP CTION65 -626EQUEST LINE:
QUARTER SECTION: 213
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 1,500.00 PROCESSED BY: CMN
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that 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 Professions
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 subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (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 does such work himself or herself or
through his or her own employees, 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 that he did not build or improve for the purpose of sale).
❑ I, as the owner of the property, am exclusively contracting with licensed contractors 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 Contractors
License Law).
❑ 1 am exempt under Sec. B & P.C. for this reason:
Date: Owner:
WORKER'S COMPENSATION DECLARATION LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: I hereby affirm under penalty of perjury that I am licensed
❑ I have and will maintain a certificate of consent to self -insure for workers compensation, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
� !-heave and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code,
or he performance of the work for which this permit is issued. My workers Compensation insurance carrier
and policy are:
Carrier: SECURITY NATIONAL INS. CO. Policy Number: SWC1185200
This section need not be completed if t he permit Is for one hundred dollars ($100) or less.
❑ 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 workers 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 forthwith
comply with those provisions.
Date 1/29/2018 Applicant: ,
WARNING: FAILURE TO SECURE WO ER'S COMPENSAT104 COVERAGE IS UNLA FUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HU DRED
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.
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec.3097.Civ.C):
Lenders 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 inspection purposes.
�\ Date: 11/29/2018
Signature of Applicant or Agent
e permit shall expire by limitation and become null and void if the building or work has
not passed final inspectoin 365 days from the date of permit issunace. A new permit is
required to commence or continue work.
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 11/29/2018
NUMBER:
BUS2014-01240
TYPE: C45
TYPE: BUS
Contractor:
EXPIRATION DATE:
5/31/2020
PERMIT EXPIRED
INSPECTION
NOT COMPLETED
DATE: Lt �-q t cr_
Fees paid for Permit:
Total:
414.50