128 E. Water St.
.,..tAA...~
DATE: 11/16/2004
JOB ADDRESS: 128 E WATER ST
LEGAL DESCRIPTION: N TR 373' BLK B Lor 1
I
BUILDING DIV;SION
200 S. ANAHEIM BLVD.
(714} 765.5153.
INSPECTION REOUESTLINE:
(714)765 - 4626
CENSIJS CODE: 434
QUARTER SECTION: 84
(}B-
BUILDING PERMIT NO.' BLD2004-03467
.' .
TYPE OF PERMIT
Residential Addition
""""\.
:(i$~~;::~~~\;1
CITY 0,1';c~NIHEIM
\/~~~~1~~f~/ .
APPLICANT: OSCAR MR. ..,
OWNER INFORMATION: CONTRACTOR INF0Rw:nON:
. Danny J Porter RUSSEU. MILLER
1;;:8 F. WaterS! 2480 IRViNE BLVD #303
Anaheim, CA 92805 TUSTIN, CA 92782 e035
. . . . ' BUSINESS PHONE: 714 2:J;<:-7272
JOB DESCRIPTION Bedroom and detaclled garage addition - ,:,
VALUATION: . .. 45,000:00 . if: .. . PROCESSED BY: JNJ . . .
r . . OWNER-BUlLDEi-'{Slf'cCARATION .. . _~~-~----==::J
I hereby affirm,Under pf:n~!ty oi perjury that I am exempt fromth~ Con~ract(o:ls-Ucensp. l.~\V fortt)efollowing reason {Sec,,7Q31.5 Busi.n~ss and
?1t~fessjonsCode: a.ny.city cr.countywhich reau;re& a pennit to con5tru::t,a~~.r, :~pro'fe, demolisn or repair a,l)' stn.:cturz., pr!i)r to its !xu<ll1ce, also
requires the app.liC?~t for such penninQ file as!gned statement thafh-; is !iC'J'~~:~'sed QUr~uant to !h~ orovfslansof the Contractor's, Licen~,e Law.(Chapter
9)(cnmmencing With Section 7000 of Divislon3 of'th.::: Business and P,of.)..<;~~'1S COde) crthat hsds exempt therefrom andth~ o~si$ for the alleged _
exemption. . Any viol<:1tion of Section 7031.5.by any 'llp~ic9nt k.r a permit Sl,~jt-cts til.so:ppHcan~. to a civillX~nalty of nut mor~ thc::n five hundred dolf-ars
($50(;). ... . . . . . .. v.,'. . .. ..
C. \, asowner of property, or my employe~with wages ~s the-Ii Si;~€ COr.l.~;:\s~t!on, wlHrlo thewcrk, andthe,structure is not inte.nded or offered for
s;1le ,(s..~c. 7044 Bll$iness and Profe~,sions-Code: The Gont,.acfo:-'s Ucent,sJaw does lio't.aoplyto an ownt::f'uiproperty \vho builds.or impro~~,s
thl';:reon, a.nd who does :":.>uch work himself or herSelf or throtigh hi~ or het Q\i'.'h;empiov~es, prqvided tl~atsuch jmprOv~m~...,t$ 8m not lntend~.6r
offa(ed for sab. 'If, however, the buiiding or lmprov09!1leht is said ;;'/i~h QnE-.y~ikr ~toor{ldetjon. the owner-builder ....~il! hfilve too burden '':)f pmv);,b that h*
dicil'otbu~dorif"'!provefort,he;p~lpo3eofsale).. , ' ".~~.. '. .,... .' ';'.',
U kas the owner of'the property, enl eXCh.l$lv~!y cont:c;cting WIth ncer.$.edl,Car,tri3ctors~l::c::)n5trlJct ti:1e rimject (Sl:3(.l 7044 8u3lnes;' C)i1d Profe$3ionz
, 9~de:The Colitr?ctQr's License law do~s r::ot ep:.:>iy to an owrl~: (;}T :)rop:;r::~"j'.\~'~~ b"uuos.'c:r,'im;xc,:es t~el'eo!1, and who CO!ltr3u~ for's\:;c;h projects ...~ith
~ontr~'idor~Sj iice,n~ed pcrsuant to the COf"ltrcid~ir's U~!1se L3'h}.t1 .... ..
L.j"farnexemptunderSec:. .3&P.C.~orth!~r(!2>s'}n:' 11...... . .
Date;" . Ow~.~ . ... '-~.;:~r.--:-"- -'.-"7:--'~--.~~-:--~--' ----".--:--~-
. [ .. ---~.WORKE~.S COMPENSAT:ON~DECLARATlot.L~"l}=:~-=~~ LICEN$E~ CQf.'!TR}.C;'ORS OECLABATION J.
inereby affirm.'_'n<i~r penalty of perjury one of the foilowing O'3C!i3!<:!tion!5: ~,. ,ih~re:Jy.~ffitrr: U;-rdN ren~lt'/ . ~, y that j am
[J .' h~~e a~..d will m8i,!"ltali1 a certif:c:Elte of o:m~nt to G.elf.ins~te for w!}ri.:~~'~:i;(i!11nenSa~i~n, I~ensed t!!"Vier !)r"o:1~io?:". __" ~!~:: 9 (~;o~,Jmen~~~.tJ
, .a~ pro. v!a.oed for.by Sed:er.' 3700 of the L.a-bor Code. for t!1e pti::l1wrinZ'nC'9 d H.\.B.. '-"'D.rk. for ylllll::h I WIth Sect!On 700U} m I~. n ,) 0, \"e BUSiness .1"iJ.,_
jlJI! per,nii. is issued. . '. .' . . ','e, , . '.., Pl'Of'tsslo!1S Code.
. . .J)ll.~VG :::Jrto V-Im.mair:tai.~ worker's COITlP6.rrsotion lnsuranc~. a;' ((';ql.::!"~d ':.';;<> -e(:iibn,3700.Ot..... ,I 11/15J2004-__ __~_
or e. Labor.Cade. fcfthe pe.rformance of the work for Wh.iOh th;s.perrr:lt j~ :i:>S:lj~d. Uyworker's _ Date: C . .
. onm::Jc.0(
COtnflensat1on insurance carrier and po.ficy are:. .
Carrier: NO f:MPLOYEES . Poi.lcy Nl:m~e!: E.~E~F'f-.. NUMBER EXPlRATiQN DATE
. . "..'.. . 716745 <"31"005
This section ne$d not be completed if the permit isfcrone hundred doil!trs {$l-G'-'.;iu !~s. TYPE B '" ,~ ,
[J. lr:erllfy, thatir. t~e perf9~ance oftne work forwh~ch is r;nit ~i~iyi~.4:! ~halt n0~ TYPE Hie
. employ any.person i~ any,manner soas to become sothO' WC(;~eots~~:c~n9~{1Sat(on laws
of Califomia, and agree, .th.at if I should become'" ct to the wo~er's cO"i)i:;,.~nsath:m .
provisions of Section 3700.ofthe Lab.or Code, aU for::hwl,th f.;omply wiH-) r".:;5e pr6vi::.ions.
ARCHITECT/ENGINEER INFORMATION:
Construcionivpes:
VN, , ..
Occupancy Groups:
R3, U1, " -
FIre Sprinkiered?
DwellinQ Units;
I Living Area:
. Gara!::w Area
I
,
NO
1
494
441
Oat", 11/16/2004 Applicant: _. _.___.
WARNING: FAILURE TO SECURE WORKER'S COMPENSAT!ON\COVi;f.4G~ !S
UNLAWFUL; AND ,sHALL SLi8JECT A"J EMPLOYER TO CRiMINf\L\P~-N':~i..:'r:ES AND CiVIL
FINES-UPTO ONE HLlNDRED THOLlSAND DOLLAHS ($"100,000). IN ;..o,';lTlON TO THE
COST.OF COMPENS.ATION, DAMAGES AS PROVIDED FOR IN SEC-Ci(}, .3706 OF THE.
lABOR CODE. INTEREST AND ATTORNEY'S FEES.
.1.:.. <\ .. . CONSTRUCTlON lENDING AGENCY ":._~_
! herf;b~{affirni:under p~r;alty ()f perjury that th.-j'e. is a r.:O!1s:nlc!ion !~r.(ij,:g ~~~~~rley for tb.~,
-.<rt.';;~;:10;;':';~31M'~l"?ils-wtitii.c'ibf--Wtft(jI-';hl~'peini7{'r-"i3Sli€l~,j(>S'eC:Y..T31;C1'lJ.:'!.'.--''"- '- . .-
Lender's Information: .
i
I certify that I have read this'appllcati state that th'e above informatior! is correct: i
agree to oomply'.with all city 0 es and State laws relating to buiiding construction, 'anej
hereby authorize representi of this city to enter u'pon the above men~ioned 'property for
iiispection'purposes. '
Fee's paid for Permit:
Total:
2,935.72
Oak 11/16/2004
Signature of Applicant or Agent
The permitshall expire by limitation and become null and void if thll 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.
~.
-
. INSPECTION RECORD . . FINALlNSPECTIONS Dale. . .lnsjlE!f:lor
, . c.' , DATE INSPECTOR, Electricall'inal ., , . 1'1!//..o,,"" A/L ~'
o . INSPECTION
T !lmporary Power Pole . . . Plumbing Final , .4' ~#;K' ~) .
, p,lumbing(OrainlWaste Pipe) . . ~ Mechanical Final 'it ,-'fLu<"" ,.. kJ. ,..".
Electrical GrOund Electlt!de/Ufer' . 1'1, /JIll J Gas Test 1-0'(' /.X
. SetbacklFormsITreriches (Footings) .. ~ ,.'1--, /1" '
I ' -
00 not install subfloor or poudloorslab unlillhe r Engineering/Grading Final 765<;126 ' . .. ,.
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) Fire Oept. Final 765-4040 ' .
Mechanical (GroundwQrk) Water Engineering 765.5268 .
Electrical (Underground Conduit) / Sub UstlBusiness License 765-:5111 ..
Pre-slab (Compaction/Membrane.Relnf. .AA~ .
,Underpinning (Floor JoistlGirders) ,. r--Z/~ r~ / Zoning 765-5139 , ' ,/)
00 IlQI co)ler or conceal the work,below unlillhe .p Building Final \t-asllnspection-Only ~~< ., /2,;. /1.,
'following appiicable items have been signed: ' fter Above Complete)
1st Floor Shear , PARtiAL INSPECTIONS .
Firesprinkler (Rough)
2nd Floor Shear . Buildinq Inspections
Roof (Shealhing/OiBDhra!lmfFrame) -7 -at;; y '*-~m -rj~ ("~J"
Masonry (ReinfJBond BeamlPre-Grout) .. .
Rough Plumbing (Top Out) . '
, Rough Mechanical . .
ROugh l:Iectrical (ury wall) . .
Rouah Electrical' . . ,.
Framing IOn~ after Plbg.. Elec. Mech" and F;re) -,/:-0(5 71#;,. , . '
Insolallon (SOIlndlEnergy) . -/6-46 .
00 not tape or plaster until the following applicable (7 Mechanical Inspections
items have been signed: , ,. '. , . .
Drywall ., ~ .
Pe!tetrations (Fire Rated) Electrical . .'
. ' .,
Penetrallons (Fire Rated) Mechanical ..
Penetrations (Fire Rated) Plumbing
Interior Lath / . .
. . I . /~~
Exterior Lath ' ...., ~l"f-l?" Mh ." ./ Pfumbina InsDeCtions; ., , .J;.A~
j. . GENERAL ITEMS. . 2 -/ $"" cd:" (J,.,J...--rW.....,,;- ~lJ' " ,
Exterior Plaster (Brown Coat) ../' .+ (J"" ~+- )(,(JI/' :.t"'.lf ' ~.1 '0) .....,."f 7..c-~"',
T -Bar Electrical ,
T~r Mechanical , V/ I
T -Bar Structural . . ,. . .
Sewer. . . .... ,
,.
Water Engineering Backflow . '. Electrical Inspections
Water Servicl> '
~'