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94 S ANAHEIM BLVDCERTIFICATE OF OCCUPANCY This structure has been inspected and is in compliance with the applicable provisions and ordinances of The City of Anaheim. Any change of occupancy group requires renewal of this Certificate. Classification Group Typey --� p (�laoY SISFies Use Zone Permit No. 627isO Building Owner: Woodbridge Pillage Ltd, Building Address' + S. Anaheim Blvd. By S. Ic rai.h in Date: N OUAN ITEM AMT. OUAN ITEM. AMT. / WATER CLOSET 3 00 3 l/ll GAS SYSTEM GAS SYSTEM BATH TUB - 6 OR MORE OUTLETS-PER SHOWER WATER HEATER OR VENT WATER DOFTSYR 2 KITCHEN SINKS KITCHEN WATER B L t ONLY EXISTING BLDG. ONLY de GARBAGE DISPOSAL WATER MAIN 1st 100 CLOTHESWASHER WASTE gpPL. 100 SLOP SINK LAWN SPRINKLER VALVES FLOOR SINK ADDITIONAL VALVES EA FLOOR DRAIN SEPTIC TANK AND SEEP PIT DISHWASHER SEWER CLOSED LAUNDRY TRAY SEWER 151 100 DRINK FOUNTAIN ADD'L 100 URINAL BACKFLOW PREVENTER GR GREASE INTERCEPTOR RAINWATER DRAINS SAND N S INTERCEPTOR SOLAR PANELS BAR SINK SOLAR TANK I have carefully read and examined the above a r ll a know same rue and c bred All of m ll orovleion5 of Laws and Or Or uance r pled ring this type Of construction will be with fl s whether spea herein not. No �/ b boon shall be employed ye In violation io n of me Labor Code of the Slate lale of f California ornla AMOR By G �j TOTAL ABOVE /� - 0C �"' ISSUING FEE /0 TOTAL FEE l * 94 South Anaheim Blvd. CITY LIC. NE. PLUMBING PERMIT ! 0- 042099 A (714j 999 5161 TELEPHONE BUILDING DIVISION ANAHEIM, CALI 39 -7727 CONTRACTOR STATE LIC. NO. Spar Plumbing and Heating 342576 MAILING ADDRESS 15641 Spar Street CITY Garden Grove, Ca. 92643 OWNER - TEL N0 'bodbndge Village (Suivillian ing Center) MAILING ADDRESS 50 S. Anaheim Blvd. PROPOSED n NEW ❑ REMODELED CI RELOCATED USE: IX,I BLDG. BLDG. BLDG. DESCRIPTION OF WORK Tenant improvement When properly validated in this space and paid for this form constitute a _permit to - do the work described hereon. The issuance of this permit does not authorize the violation of any state or local law. AI id -1' 1 AB L6S. IF • - Nz- b.= : DU='erit,R ROR'lHORIZEDAGENT 10 -10 -85 PERMANENT BLDG 12 JOB ADDRESS APPLICATION FOR A 160CT85 TOTAL $22.000 PERMIT TRANSACT€ 3215.' GROJN� J ORK (WASTE) GRGUN6 WORK TWA ER-GAS) RCUGh GA SEEPAGE DRR tiE( E FINAI GAS _ j _ PARTIAL OR MISC. INSPECTIONS t$ISPECTION RECORD BASIC INSPECTION y CLCL. I MIL. YCRIYII 1 BUILDING DIV ISION - ANAHEIM, CALIF. C ITY NC. NO 0 .. h r l' CON fy. TO� /SiT TEL ✓ .A' CG Co( `, • • 1 a R3RJ LT 3 I t7tJ LING ADDRESS MAILING If.On AL &20i cj"-y 40 STATE LIC. NO 6 3632SS CITY Aleal4 w r �p G W ocd .neA6 I TE 5 2o 9730 I 44,--a. JOB ADDRESS APP ICATION FOR AN �j NO. EACH - — `9 OUTLETS:AND a SWITCHES AT LIGHTING FIXTURES BLDG 10 (714) 999 -5161 MAILING A_ 4-setM *Lop i+ /•r NO ICJ SLOG. ❑ BLDG. ❑ CHAR SERV. E ❑ OR ESEAL NOTE! TOTALS SHOWN BELOW MUST BE SUBMITTED IN DIAGRAM ON SEPARATE WORK SHEET. ' TEMPORARY POWER POLES - ® (GENERATORS, MOTORS, TRANSFORMERS OTHER) 8_ 6. So When properly validated in this space and d for this arm constitutes a permit to do the work described hereon. The issuance of th' permit does not authorize the violation of any state or local law. SIG . ATURE OF OWNER OR AUTHORIZED AGENT PERMANENT EA SUBTOTAL NO. ITEM .. EACH - SELF-CONTAINED FACTORY - WIREDAPPROVEDUNIT - ( SERVICE 2 .00 y 6 NO. TRANSFORMERS If SIGNS NO. LAMPS 9 - RESIDENTIAL Square Feet - - GARAGE Square Feet - MISC. I have arefully read and examined the above applica ion and know the same to be true and correct All provisions of Laws and Ordin- ances covering this type 01 constructon will be compli d with whether specified herein or not. No person shall be employed in violation o the Labor Code of the State of California APP - TOTAL ABOVE q, • r0 L D ISSUING FEE `® I TOTAL FEE ?jl 60 JOB ADDRESS APP ICATION FOR AN �j NO. EACH - — `9 OUTLETS:AND a SWITCHES AT LIGHTING FIXTURES BLDG 10 (714) 999 -5161 MAILING A_ 4-setM *Lop i+ /•r NO ICJ SLOG. ❑ BLDG. ❑ CHAR SERV. E ❑ OR ESEAL NOTE! TOTALS SHOWN BELOW MUST BE SUBMITTED IN DIAGRAM ON SEPARATE WORK SHEET. ' TEMPORARY POWER POLES - ® (GENERATORS, MOTORS, TRANSFORMERS OTHER) 8_ 6. So When properly validated in this space and d for this arm constitutes a permit to do the work described hereon. The issuance of th' permit does not authorize the violation of any state or local law. SIG . ATURE OF OWNER OR AUTHORIZED AGENT PERMANENT DATE 4 I _ INSPECTOR t c 7 ¢,,( mss Q ; 1UN ©ER GROUND CONDUIT tFLE j = i ROUGH ELECTRICAL f' vlq P sci t ELECTRICAL SERVICE EtcCT R I T ELECTRIC, ,0'; t' a CE Li NG NEAT I - $F t, ?/.73 RATE F t - tTER9 INSPECTOR DATE 1 TEM!CRARV ?CLE ; 1UN ©ER GROUND CONDUIT tFLE j = i ROUGH ELECTRICAL f' vlq P sci t ELECTRICAL SERVICE EtcCT R I T ELECTRIC, ,0'; t' a CE Li NG NEAT I - AFTIAI. INSPECTIONS ?J -/ Of A'4'A174i - ` /i G Q 3 C/ CENSUS CODE 937 ZS z 1 SSS{'063E.4 'DY LC No O - (03/ - L / ��jj ��(// �nn FIRE ZONE P S - CONST p/�AMee ENGINEERING 1 OFF SITE IMPROVEMENTS. DEDICATION STREET IMPROVEMENT PLAN BOND: REVIEWED' SEWER ASSESSMENT: B Menci .te6.EVIw,&e LTD. k7o -97 PUB. SERVICE PLAN CHECK FEE ,r /1 So FIRE PERMIT FEE \ HEALTH STATE TAX / 61 SANITATION MICROFILM FEE 3 C"/7 `j WITH PERM. PLAN WITH PLAN wlouT PLAN A BY TOTAL FEE // Q l` � 6/ APPLICATION FOR A PERMIT PLANNING DEPT BUILDING ANAHEIM, CALIF. cUI BUI C LDING V • 1. 4s. JS1 &DGTI c1■ SSS{'063E.4 'DY LC No O - (03/ - L / MAILING ADDRESS !/�1Y) A1.Q2,OAri4L/W O/ F . 4 . ❑ ggCH. 0 ENGR. TEL NO MAILING ADDRESS STATE LIC NO. Menci .te6.EVIw,&e LTD. k7o -97 N b .qB ADDRESS 9 �. 1aa%r1 ILL_ • MAILING ADDRESS - 5n S 14n 4M£.l %VI #� NtPccA&IT - - PRESENT BUILDING USE PROPOSED ILDISG • . BUILDING L;/�a L ♦r1` DESCRIPTION OF WORK NEW pq ADON ❑ ALTER. ❑ REPAIR ❑ DEMOLISH 0 GARAGE NO. OF NO. OF DWELLING AREA SO FT STORIES I UNITS FLOOR ❑ INCREASE AREA O DECREASE DESCRIBE WORK TO BE DONE VALUATION I have carefully read Laws and Oran son shell be BLDG9 X07 ;C I P-.NJEA7- 4a'ovrt&4r NOTE Include Labor, May Wlrmp, Numb., Heat, Etc. When properly validated in IM space a for Iris 1 rat constitutes a permit tom the work described hereon. The issuance of this permit l aulh Olize th violation of any state or local law. 040CT8S TOTAL $163.61M TRANSACTION 62780s IMame to be rue and correct NI provisions M MM whet specified herein or nth. No per- Ca PERMANENT S10 ATURE OF • ER OR AUTHORIZED AGENT Z3, Ooo SO FT FOUNDATION -: FRAMING - _ MISC. INSPECTION i7. /J �? s n- /< }Ai/-/y'- if h - , /I 7 -t ?' PEktTH DEPT. PEEOUHEM NTS ENAL ZONING REOJI MENTS ESTEGEGEPENG, REGLEPPMENTS FIRE I:E REGLJ Pi MENTS L. SIDE SET BACKS SIGN PERMIT NO. SGN2003 -00041 TYPE OF PERMIT New Attached to Structure Sign DATE: 3/21/2003 JOB ADDRESS: 94 S ANAHEIM BLVD LEGAL DESCRIPTION: P BK 178 PG 22 PAR 1 APPLICANT SUE MODEREGER OWNER INFORMATION: Holualoa Anaheim 100 S Anaheim Blvd Anaheim, CA 92805 JOB DESCRIPTION: VALUATION: 950.00 C IT Y la _ .7 0 y.," AH El M • .� CONTRACTOR INFORMATION: ICON IDENTITY SOLUTIONS INC 9645 ARROW ROUTE RANCHO CUCAMONGA, 91730 0000 CA Install (1) wall sign "Wells Fargo Home Mortgage" 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) U 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 contractor(s) licensed pursuant to the Contractor's License Law) I am exempt under Sec. B & P C for this reason: Date: Owner WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following de darations ❑ I have a d will maintain a certificate of consent to self- insure for worker's compensation, as provi d or by Section 3700 of the Labor Code, for the performance of the work for which this mit is issued. I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's Compensation insurance carrier and policy are: Carrier NORTHERN INSURANCE CO OF NY Policy Number WC3672915 This section need not be completed if t he permit is for one hundred dollars ($100) or Tess. El 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 California, and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code, shall forthwith pomply with those provisions Date: 3/21/2003 Applicant: WARNING FAILURE TO SECURE WORKER'S COMPENSATION 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 performance 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. 1 agree to comply with all city ordinances and state laws relating to building construction, and hereby .` • e represent' es of this city to enter upon the above mentioned property for inspect'• . 41.t, poses. ���-- Date: 3/21/2003 ature of Applicant r,Agent The 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. BUILDING DIVISION 200 S. ANAHEIM BLVD (714) 765 - 5153 INSPECTION REQUEST LINE. (714) 765 - 4626 QUARTER SECTION: 83 ARCHITECT /ENGINEER INFORMATION: PROCESSED BY: ODC LICENSED CONTRACTORS DECLARATION I I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Prof ode Date: 3/71/2003 NUMBER: BUS2001 -03257 3/21/2004 TYPE. C45 TYPE. BUS TYPE. HIC Contractor EXPIRATION DATE: Quanity . 1 Electric Sign (Y /N): N Fees paid for Permit: Total: 78.04