214 S. Walnut
BUILDING PERMh NO. BLD2004-03634
TYPE OF PERMIT
Residential Remodel
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CITY Q:F~~~ . t"":HEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 63
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DATE: 9/29/2004
JOB ADDRESS: 214 S WALNUT ST
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LEGAL DESCRIPTION: TR 131 LOT 11. BLK C NLY 50.44 FT
APPLICANT: JOSE MALDONADO
OWNER INFORMATION:
JOSE MALDONADO
214 S Walnut St
Anaheim, CA 92805
JOB DESCRIPTION: Investigation offramingforinstalJation of 4 new windo,^~. All windows are smaller than existing with no new windows in bedrooms.
VALUATION.. Inspector 10 veriiy 119hVVentJlation requirements. . .
2.000.00. . PROCESSED BY: MSM
I OWNER-BUILDER DECLARATION
I hereby:afflrm under penalty of perjury that I am exempt from the Contractcr~s UC'3nse Law for the following reason (Sec. 7031.5 Business and
Professions Code: any dty or county which requires a permit to construct, a~er, improv.e. demoli.S:h ~crepair any structure, prior to its,issuance, also
requires the applical)t fqr such permit to file a s!gned statement that he is licensed pursuant to the provisi,ons of the Contractor's License Law, (Chapt~r
9)(commencing with Section 7000 of Division 3 of the Business aoo_Profess:ons 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 subi~cts the'applicant to a civil penalty of not more than five hundred dollars
~s ,owner of property, or ~y employees with wages as their'SOI~'compkflsation. will ~o 'the ~ork, and 'the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The'Contractor's License l.aw 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 OWIl employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement'is,sold~with one ye;'!r of completion, the.owner-builderwill have the burden of proving that he
did not bu ild or improve for the pu rpose of sale),' , . '" ',..".
o , I, as the owner of the property, am exdusivElly contracfmg with licensed Contractors. to construct the project (Sec. 7044 Business and Professi~ns
'Gode: The Contractor's ~icense Law does not apply to a'n owner of profJerfyr.'ho builds orimproves)h,,~r,eon, a.~d -who contracts forsudl p~ojects with
t1ontradO~(S) licensed pur~uant to the Contractor's Uce~se La~), _ .
I a, xern t under Sec. ' P.C,>>?>>~C;;e}Sof).
;3te: ~. Owner: V ~
WORKER'S COMP SATION DECLARATION
t hereby affirm under penalty of pe~ury one of the foIICJwing'd.eclarations:
o I have and will maintain a certificate of con'sent to self-insure for worker'!; compensation,
as provided for. by Section 3700 of the Labor Code, for the performance.ofthqwQrk for which
this permit is issued. . .
o I have and will maintain worker's c:ompensation insurance, as required b::, Sec~lori'3700 of
the Labor Code, for the performance of the work for which this permit is issue\1. Myworker's
Compensation insurance canie'r and polioy,are:
Carrier: '
CONTRACTOR INFORMATiON:
. ARCHITECT/ENGINEER INFORMATION:
o
LICENSED CONTRACTORS DECLARATION.
i hereby affirm under penalty of.perjury that ,I am
licensed unde'r provlsions of cl'1apter 9 (commencing
with SectiOri 7000) of Di'vsion 3 of the Business and
Professions Code.
9/29/2004
Dale:
Contractor
Pol!oy. Number.
NUMBER
. EXPIRATION DATE
T~is s'ection need not be completed if the pennit is for one hundred dollars ($100;, or less.
o I ce-rtify that, in the performance of the work for-which this permit is issue'f'i. I shall not
employ any person in any manner so as to become subject to.the worker's c::::::npensaiiorlaws
of Califomia, and agree that if-I should become subject to the worker's comp~nsation _.-1
provisions of $~ction 3700 of the La,bar Cod ,I Sh~n ~~~With comply Withthi(Se provisions,
Date: 9/29/2004 Applicant: ~ . _
WARNING: FAILURE TOSECUREW KER'S COMPENSATION COVERAGE IS
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN!\YflES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN!\i;JDITIONTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SE<;1'j.QN 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 wor'k for whidl this'permit is issued (Sec,'3097 ,Civ,C).: ~ .
Lender's Information: . ,
. TYPE
Construcion Types:
VN. ,
Fire Sprinklered? NO
, I certify that I have read 'this applicatio'n and state that the above' information is correct. I
agree to oomplywith.all city ordinances and state laws relating to building cor:struction, and.
hereby authorize representives of this city to enter upon the above mention.ed property for
in ection rposes.
Date: 9/29/2004
Fees paid for Permit:
Total: 107.24
Sigflature of Applicant or Agent
The ermit shall expire by limitation and become null and void if the building.or
work has. not passed finafinspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
. INSPECTION . '. . DATE. .INSPECTOR
Temporary Power Pole . . .
Plumbing (DraintWaste Pipe) '.
Electril'al Ground Elel'trodelUfer . .
Setbal'k1Formsrrrenches (Footings). .
Do not install subflqoror pour floor slab until the
follpwing applicable items'have been signed:-
Plumbing (Water Plpe.Sprinkler Valves)
Meehanic:al (GroundwOrk)' . .
Electril'al (Underground Conduit) .
Pre-slab (Compal'tion/Membrane.Rei nt. .
Underpinning (Floor Joist/Girders)
Do notco.ver or conceal the work below until the
following app.licable rtems have been'signed:'
1st Floor Shear' . .
FireSprinkler (Rough) . '. . '.
2nd Fioor Shear . ,
Roof (Sheathing/DiaPhragm/Framel
Masonry (ReinfJBond BeamlPr&-G~t) .
Rough Plumbing (Top Out)
Rough Mel'hanical
'KPugh E1ectric:a1 II)
Rough Elecirical
Framing (Only after Plbg Elec.. Mech and Fire) . .
Insulation (SoundlEnergy)
po not tape or plaster until the following applicable.
Items have been Signed:' '. .'
Drywall . .
Pf!hetralions (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath .
Exterior Lath . . . .
. .' GENERAL ITEMS
Exterior Plaster (Brown Coat)
.1 -Bar Electrical . .' ...
T-Bar Mechanical "
T -Bar Structural
Sewer .
Water:Engineering Backflow , .
Water Service .
FINAL INSPECTIONS. . .' . Date Inspector
Electrical F.inal
Plumbing Final .
Mechanical Final .
'Gas Test
.Engineering/Grading Final 765-5126
Fire Dept. Final 7654040
Waler Enginee,ring 765-5268.
Sub List/Business License 1t;5-519
Zoning 765-5139 . :
Building Final ~astlnspection. Only .
fter Above Complete) ,
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
,Plumbina Inspections
. Electrical Inspections
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iL.Q\I'id r EXPI RED
INSPiECTfON.
NOT GOMPLETE'D
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