221 E. Water St.
TYPE OF PERMIT
Blockwalll Columns
CITY
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BUILDING DIVISION
200 .S, ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765' 4626
CENSUS CODE: 434
QUARTER SECTION: 84
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BUILDING PERMIT NO:. BLD2005-01242
...
DA TE: 5(2/2005
JOB ADDRESS: 221 E WATER ST
LEGAL DESCRIPTION: N TR 497 LOT 15
APPLICANT: ENRIQUE CHAVEZ
OWNER INFORMATION: CONTRACTOR INFORMAlIOf'!:
Enrique M Chavez
221 E Water 5t
Anaheim, CA 92805 .
JOB DESCRIPTION:Buitd 6 fl. high block wall at 42 linear fl. per cityspecifications.
VALUATION: 1,000.00
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exemRt from the Cbntractor's.ucens~ Law for the following reason (Sec. 7031.5 usiness and
Professions Code: anydty or county which requires-a permit to construct; altet. if!lprove, demolish or repair any structure, prior to its issua'nce, also.
requires the applicant for such permit to fite a.signed statement that he is licenSed pursuant to the provisions of the Contractor's License Law(Chapter.
9)(commencing with Section 7000 of [)ivision 3 of the Businessand Professions Code) brthat he is- exempt thelBfrom and the basis for the~lIeged
exemption. Any violation of Section 7031.5 by any applicant for a permit-subjects the applicant -to a civil p€malty of .not more than five hundred dollars
f1JO~!~s owner of property,.or ~y employees with. wag~s ~ their ~le'compe~$ation, will do ~he work, and the structure is not intended or offered for..
sale (Sec. 7044 _Business and Professions Code: The Contractor's Ucense 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 in:tprovementis sold with one year'of completion, the owner-builder will have the burden of proving that De
did not build or improve for the purpose of sale). . ,- _ '_ ,-
.0 I, as \he owner of the property, am exclusively contracting with licensed cc'ntractors 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 projeCt~With
ontractor(s) licensed pursuant to e Contractor's License Law). .
I a. ex pt under Sec. P.C. for this reason: .-;.......
ate: )..' Owner. _____.. ,--~
PENSATlON DECLARATION
I hereby affirm under penalty of rjury one'of the following declarations:
o ,.1 have' and. will maintain a certificate of consent to setHnsure for worker's compensation,
as, provided for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issueq. .... . :
o I have and will maintain worker's compensation insurance, as required by Sec~ion 3700 of
'the Labor Code, for the performance of the work for whicl} this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: .' Policy Number.
Thj.s s_ection need not b:e' completed if the pennit is for one hundred dollars ($1 00) or less.
[]\]' _I certify that in the perto.rmance, of the work for which this permit is issued, .1 shall not
employ any person in any. manner so as to become subject to the worker's compensation
of Califomia,' and agree that if' shou1d become subject to the worker's com .
provisions of Section 3700 of the abQr.Code; I shall forthwith comply wi those pr lsions.
LICENSED CONTRACTORS DECLARATION'
I hereby a irm un er penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professio~ Code.
5/212005 .
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Date: 5/2/2005 Applicant:
WARNING: FAILURE TO SECUREW KER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED TH SAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAM GES AS PROVIDEO FOR IN SECTION 3706 OF THE
LABOR COOE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penaltybf.perjury that there is a construction lending agemyfor the
performance of the work for which this permit is issued (Sec.3097.Civ.C): _ .
Lender's Information:
Construcion Tvpes:
VN, ,
Fire Sprinklered? NO
I certify that I have read this application and state thiit the above information is correct. I
agree to comply with all city ordinances and stat relating c:rnorng-construction, and
hereb authorize reAresentives of this city to ter upon the ove mentioned property for
!OnJ2IIC/Y'~
Dale: 5/2/2005
Fees paid for Permit;
Total: 125.79
Signature 'of Applicant or A eRt--'---
ermi' hall expire by Iimita'ion and become null and void if the building or
wor has not passed final i n$llecti<il1 365 days from the date of permit issumce. A
new permit is required to commence or continue work. '
INSPECTION RECORD
. INSPECTOR
INSPECTION . DATE
Temporary Power Pole
Plumbing (Draln/Waste Pipe) .. .
Eledrical Ground Electrode/uter.. , ...... , Ii! / .
SelbacklFormsrrrench~~ ::. '-'oJ L.
Do.not install subfloor or pODnloor slab until the .
following. applicable items have been signed: .
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) .
Eledrical (Underground Conduit) .
Pre-slab (\;ompactionlMembrane.Reinf., .
Underpinning (Floor Joist/Girders) .
Do not cover or. conceal the work bel.ow.untllthe
following applicable.items have been signed:
1 st Floor Shear
Flresprinkler (Rough) .
2n.dFloor Shear
. Roof (Sheathing/Diaphragm' Frane) . . -.
Masonry (RslnfJBond BeamlPre-Grout) r;/~,{,r 171
Rougn Plumbing (Top Out) , ./
Rough Mecnanical ./
I Rough BectrlCaI(Dry Wall) .
Rough Electrical "
Framing. (Only after Plbg.. Elec:. Mech.. and Fire)
Insulation (SoundlEnergy)
po not tape or pla~ter . until the foltowing applicable
Items have been Signed:
Drywalt . . . . .
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical . .
Penetr.allons (Fire Rated) Plumbing
interior Lath . .
Exterior Lath
;. . GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Eiectrlcal .
T -Bar Mechanical . . '.
T -Bar Structural .'
Sewer' .
Water. Engineering Backflow
Water Service .
-'
FINAL INSPECTIONS Oate Inspector
Electrical Fin!>1 . . -
Plumbing Final
Mechanical Final"
Gas Test .
Engineering/Grading FInal 765-5126 .
.
Fire Depl. Final 765-4040
Water Engineering 765-5268 .
Sub ListlBusiness License" 765-519 ..
Zoning 765-5139 .
-i~
Building Final . ~ast Inspection- Only --JI-<t)
fter Above Complete) ,
-
PARTIAL INSPECTIONS
. Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections
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THE ISS A OE OF' THIS PERMI11! OOES
NOT AP " VE VIOLATION OF NY OF'
THe: au LING OODe:S OF TH CITY.
THe: H L E:.R OF THIS P RMI,.
PROCe: S AT HIS OWN RISK.
fM\Y 0 2 2005
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BUILDI
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G DIVISION OF ANAHEIM
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