611 S. Warbler Cir.
-
B:.J:LD;NG PERMiT NO. GLD2004-02J81
TYPE OF PERMIT
Residential Addition
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CITY ~~~~:'?,~iHEIM
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BUILDING DIVISION
200 S, ANAHEIM B,LVD,
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765,' 4626
, CENSUS CODE: 434
QUARTER SECTION: 210
DATE: 7/6/2004
JOB ADDRESS: 611 S WARBLER CIR
LEGAL DESCRIPTION: N TR 8463 LOT 7
y,I'ICl',
APPLICANT: DEAN KOUKLADAS
OWNER INFORMATION:
K KOUKLADAS
611 's Warbler Cir i
Anaheim, CA 92807, "
JOB.DESCRIPTIONRoom Addition~ 2nd"f1ooraddjtion over existing 3-ca~ gar~!ge..
, , " ' II, ,
VALUATION:,. 46,000,00" ,,', ' ' , PROCESSED BY: FAN, '
'I ' ',' 'OWNER~BUILDEi~,DECLARATION'" "
I hereby affirm under penalty of perjury that I am exempt from the Ccntr8ctd;'$-License Law for the. following reason (Sec. 7031.5 Business and
Profess~ons Code: any dty or county which requires a permit to construct, a~er, improve, demolish, or repair any structure>:priorto its issuance, also
requires the. applicant for suCh permit to file a signed statement that he is lic\hsed pursuant to the provisions of the Contractor's License Law (Ch;apter
9)(commericin'g with Section 7000 of Division :3 of the Busil"!ess and profesdpns Code) or tt">at he is ex'empt therefrom and the basis for the alleg,ed
[iixe ption. Any violation .of Section 7031.5 by any ap"pli(;an, tfor a permit s L'~,j,$cts tha Ctpplic:ant to 8; dV,~ penalty of n,ot morethan, five hundred d,?lIars
~ ~, ' , ~ ' , ."
. I, as owner'Jf property, or my employees with'wages as their COld comi!:QnsBtioi1, y,:P! do the work, .and the structure is not intended or offered for
.sale' (Sec. 7044 Business and Professions Code: The Contractor's Licen~eF:aw doe's not apply to an owner of property who,bujlds or improves.
thereon, and who does sud'rwork himself or herself.or through Dis or hl3r Ov-f0 employees, provided that such improvements ar~ not if'ltendec! or '
o,ffered for sale. If" hpwever, the bUl,'lding or improvement is, solcfwith one y~r~r of co, m,' pletion, the owner-builder willha ve, the ,burd, en ofpfov:ing that he
did not build or improve for the pU'rposeof sale). . i., " "
o I, as the owner of the property, am exdusively contracting with iiCense,y0r~r<Jctol's to construct the project (See. 7044 Busin~ss andprofessiolls
Code: The Contractor's License Law does not apply to,an.owner.cf pr(;~,r.:rtlfwtlo bwtds or improves therooi1, and wbooontracts for such projects with
~ontractor(s) lic.ensed pursuant to the Contractor's License Law). '_ _ ~t'-" " '__ ."
U I am exempt under Sec. ,B p, for this rea.son: __.J' - -
Date: ') -:"4. Owner: (' :..--::f
1 WORKER'S COM PEN ION DECLARAT!ON t
I hereby affirm under penalty of perjury one of the following declarati'Jns:, .
o .' have a~d will maintain a certificate of consent to self-insure for worl;,,::.!s cv,npelisation,
8_S pro~ided'for by Section 3700 of the Labor Code, for the performance of~ew<.:rk for which
this permit is issued. . _s'
D. I have and wHI maintain worker's compensation insurance, as :-equ:red ~h, Seci.!cr: 3700 of
the Labor Code, for the'performance of the work for which this permit Lc; iSSLjxt. M'Iworker's'
Compensation insurance carrier'and policy are; . -~ .
~h~'~:~on need notbe completed if the pennit is fo;::~::~~~e:~!!ars 1$1'1~; or l~.
l\Zf ' I certify thalln the perfo.nnance of the work for which this permit is iSSU-\d, I shall not
employ any person in any manner so as to become subject to thE! workers c')rnpensation laws
of Califomia, and agree -that if I should become subject to the WCi"rker's com~nsatio.; .
.provisions of Section 3700 of the Labor C e, I s all forthwith comply with t.~o5e provisions.
I;'
CONTRAC10R INFORWATION:
ARCHITECT/ENGINEER INFORMATION:
MOHEB D FARAH
1411 S RIMPAU
CORONA, CA 91719
I
L1CENSfUCONTRACTORS DECLARAtiON ,I,
; I hereby affirm under penalty of perjury that. ; ,am
licensed under provisions o'r chapter 9 (commencing
with Section 7000) of Divsion 3 of the Busineis~ and
Professions Code.
7/6/2004
Date:
Contractor
NUMBER
EXPIRATION DATE
TYP~
Date: 7/6/2004 Applicant: . I
WARNING: FAiLURE TO SECURE RKER'S COMPENSATION COV['~AGI;' IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER-TO CRIMINAL PEN.'.;_TI~S AND CIVIL
. FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADknCN TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN S ECTI 0:, 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 constructionlellding r:~j~ncy f~)r thf:l
perform.'3;nce ofthe work for whidl this permitis issued (Sec.3097 ~CiV._~):) r~ ":
,~.....":..:;~':.~.:-;vr;---..:'~-~:' -~.'_.-~-- .~._,,--_. -,' - ,~ ---.., . ,'-.
Construcion T'Ipes:
V,N, ,
Fire Sprinklered?
LivinQ Area:
NO
682
. I certify that I have read this application and state that the above informatior. is correct. I
agree to oompty with all city ordinances and state'laws'relating to bu~ding cC'l1struction, and
hereby authorize representives of this city to enter upon the above mentionej property for
i,n~pecti ses.
Fees paid for Permit:
Total:
1,739.50
Oat,,, 7/6/2004
Signature of Applicant or Agent
The pe mit shall expire by limitation and become null and void if tho building or
work has I10t passed final inspection 365 days from the date of permit, issuance. A
,new permit is required to commence or continue work.
.~-/-..-.
",~
FINAL INSPECTIONS
Date
In pector
I INSPECTION, DATE INSPECTOR I, Ell!.:trica]Yinal -z.--?-(.J\ //1. ,-....-
Temporary Power Pole PiUinbing Final ' , V --t>C ,./1.. A "
/
'Plumbing (DrainIWaste Pipe) . ' Mechanical Final .,-~,!!, .., .,..77-0\ " I .
Electrical Ground Ele'ctrode/Ufer .
SetbacklForrnSlTrenches (Footings) Gas Test ,
Do hot install subfloor or pour floor slab until the, Engineering/Grading Final 765-5126
following applicable items have been signed: .. ' ,
Plumbing (Water Plpe.Sprinkler Valves) Fire Depl.Final 7654040
Mechanical (Grouhdwork) Water Engineering 765-5268 ' " .
Electrical (Underground Conduit) Sub List/Business License 765-519 - ,
Pre-slab (Compaction/Membrane.Rei nt.
Underpinning (Floor Joist/Girders) Zoning 765-5139 ' , "
Donot cover or <;anceal the work below until tne Building Final . ~ast Inspection. Only ,
following applicable items have been signed: . , Ite, Above Complete)
1 st Floor Shear e, ~b -'" c,t /I ///. .L-
e PARTIAL INSPECTIONS
Firesprinkler (ROugh) , , '/
2nd Fioor Shear /tI-: ~ 7 :.pt,. kf. A v Buildina Inspections
ROof (SheathinglDiaphragm'Frame) M 17,7~ oM -, ..---.... , . ,
MasonrY (ReinfJBond BeamlPre-Grout) , , "
Rough Plumbing (Top Out) ",,.tv,,.. ~ "
Rough Mechanical - "PtJ ~-/'i>..t
Rough BectricaJ (Dry wall, ' f . ,
Rough Electrical
Framing (Only ,after Plbg,. Elec.. Mech', and Fire) IU I ~ " , ,
..
Insulatiori (SoundlEnergy) 11Jt,l.17'f J Mechanical Inspections
Do not tape or plaster until the following applicabl '
items have been signed: " . , ,
Drywall '7.7lf~ II' .L / " ,
, Penetrations (Fire Rated) Electrical ,
,
Penetrations (Fire Rated) Mechanical
Penetratiol)S(Fire Rated) Plumbing . , , ,
"
.Interior, Lath , ' .# "
Exterior Lath ' L:. ~..6. -'Plumbina Inspections
, GENERAL ITEMS (
Exterior Plaster (Brown Coal) /IU/OS , "
r .Bar Electrlcal . f
r.Sar Mechanical . , ' , .
T .Bar Structural ,
Sewer , "
Water Engineering Backflow " Electrical Inspections
Water Service . -- ,
,
INSPECTION RECORD
~~~
~1~imI~
1('-) 4 D.EPUiY
Special Inspector's Report
_Daily _Weekly --.Final
TOTAL DAYS ON JOB _ BUILD PERMIT: b 2. ~131 CITY: tel; 'r:fPl
JOB ADDRESS: NERAL CONTRACI'OR: (}.L'VA~U-
4)"",b1u e..W
TYPE OF WORK:
_ REINFORCED CONCRETE
_ PRESTRESSED CONCRETE
_MASONRY
_WELDING
_ HI-TINSILE BOLTING
+-EPOXY
DESClUPllON andl.OCADON ofWORKINSPECIED:
OAT"':; ~ ~ ~ ~ L
. " . ~IJ::;j~~~~ ~ r: ) -f a'lo
9B~'
i-J~1d;5;. . ~r!;;~:i~ ~ pad ~//i
ltJer-1: -nil" 'i>t~....r JUD. Droc~.i.l. '.'r" S
I / 't!P1
Above mention
d approved by
No. oB5qS20-~fJ
This report has been file and states that the work inspected has been satisfactorily
completed. and complies with the a proved plans. and requirements of The Uniform Buildinl1: Code.
m-d.t._J~ 'a1.. a~---!$,.,u,
1WlC1f~~iI fj#l ~IB
~'~imllltmmd~
1(8fl0) 4 DEPUlV
~~1
Dail
- y
Special Inspector's Report
_Weekly
F' al
_ill
TOTAL DAYS ON JOB .L BUILDING PERMIT:' 2004-02381 CITY: Anaheim
JOB ADDRESS: 611 Warbler Cr GENERAL CONTRACTOR: Owner Builder
TYPE OF WORK:
_ REINFORCED CONCRETE
_ PRESTRESSED CONCRETE
MASONRY
_WELDING
Hl-T1NSILE BOLTING
...2L EPOXY
DESCRIPTION and LOCATION ofWORKINSPF.CI'ED:
DATE: 7/20/04
Observed installation of #4 dowels. Into pre-drilled, brushed,
and blown clean holes. Simpson ET-22 epoxy used.
Locations:
1.) 2- 2' 6"sq pads along south garage foundation
* per details on sheet 14, and pad schedule p-2
. 2- L bars each side into existing foundation.
* slab dowels aisomstalled (6" embedment)
2.) 1- 2' 6" sq pad, and 1- 3'sq pad along grid line B
* per details on sheet 14, and pad schedule p-Z & p-3
* 2- L bars each side into existing foundation.
* slab dowels also installed (6" embedment)
3.) 1- 2' sq pad along north garagefoundation.
* per details on sheet 14, and pad schedule p-l
* 2- L bars each side into existing foundation.
.. slab dowels also installed (6" embedment)
4.) 1- 3' fl' sq isolated pad.
* per details on sheet 14, and pad schedule p-4
* 2- L bars each side into existing foundation.
* slab dowels 6" embedment
Remarks:
At areas were footing. was only 6" wide and detail called for 12"
embedment. Holes were drilled in an angle to achieve at least 8" embedment.
Otherwise work was done. per approved plans, and mfg procedures.
Above menti ned w rk has ee in e d, and approved by
Deputylnspe No.!) 95152.0-88
This report has been filed and states that the work inspected has been satisfactorily
completed, and complies with the ap oved plans, and requirements of The Uniform Building Code.
TYPE OF PERMIT.
Reroof
CITY
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 210
BUILDING PERMIT NO.
BLD2005-00695
.
DATE: 3/14/2005
. JOB ADDRESS: 611 S WARBLER CIR
LEGAL DESCRIPTION: N TR 8463 LOT 7
CONTRACTOR INFORMATION:
SHARP ROOFING
10782 S MEADS AVE ,
. ORANGE, CA 928690000
BUSINESS PHONE: 714771'0118
JOB DESCRIPTION:Tear off existing roof, "'-sheet with 1/2" CDX, install 24 ",Gares of Eagielite tile .7.1 IbslCBO #4660 over 30lbs fell.
VALUATION: '12,000.00 PROCESSED BY: ENO
I. OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the-Contract.or' License Law for the following reason (Sec. 7031.5 Business ~nd
Professions' Code: .a."y city or countywhich-requir'e"s a perm~ to construct, altw. improve, demolish or repair anY-structure, prior to its issuance, also
requires the applica nt for such permit to file a signed statement that he is l:ce~)sed pursuant to the provisions of the Contractor's License Law (Chapter
9)(coJnrnencing with Se9tion 7000 of Division 3.of the Business a nd Profes.sien5 COlle) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a dvU penalty of not more than five hundred dollars
~~ . . .! ..
01, as owner of property, or my employees with wages as their-sote conip~-nsation, will do the work, and the structure isnot intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's Li~ense lilW 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 owr:.employees, provided that such improvements are not intended or
offered for Sate. 'If, however, the building or improvement is sold with one ye=.',: of compietion, the owner-budder will have the burden of proving th,at he
'. did not build or improve for the purpose of sale)"., . . :1" . ~
D I, as the owner of the property, amexdusively contracti~g with licensed ;~i1tractors to construcfthe project (See, 7044 Bu'siness and Profe~ions
Code: The Contractor's License :law does not apply to an owner. of property'.rho builds or improves thereon, and who contracts for such projects Witfl
~ontractor(s) licensed pursuant to the Contractor's UcenseLaw). '~\ - ,
l-.J I am exempt under Sec. " B & P.C. for this reason: .
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I'hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate 'of consent to setf~inSure for worker'~ .::;ompe~sation,
as provided for by Section 3700 of the labor-Code; for the'performance or thc......ork forwhich
~thiS rmit is issued. . . -,
. . _ I.have and wiU rnainiai~ worker's compensation insuran~e, ,as required b~: ~ection 3700 of
- e"labor Cqde, for the performance, of the work for which this permit is issup.-:t Myworker's
ompensation insurance carrier and policy are: '. j -,'
Carrier: STATE,FUND Policy Number. 285-0002320
APPLICANT: JOHN SKIRZYNSKI
OWNER INFORMATION:
Clayton A1biston
611 S Warbler Cir
Anaheim, CA 92807
ARCHITECT/ENGINEER INFORMATION:
. - . - I .
.~h. see,lion need n'at. be cOmpleted if the pennit isfor one hundred doll~ ($10C;'fJi~~s" .
I'certify that in the perfonnance of the work for wt:lich this per I is issuc(),Jshal' not
m . y any person in any manner so as to beco e subjec to the ,orker's cc'npensation laws
of California, and' agree that if I should become bject to e ompe:l$ation
provisions of Section 3700 ofth Labor C e. all ~ I w th tt";:':::e provisions.
Date: 3/14/2005 Applicant:
WARNING: FAILURE TO SECURE ER'S COMPENSATION COVERAGE is
UNLAWFUL. AND SHALL SUBJECT/AN EMPLOYER TO CRIMINAL PENAl_TIES AND CiVIL
FINES UP TO ONE HUNDRED TH U'SAND DOLLARS ($100,000), IN ADCI'i10NTO THE
COST OF COMPENSATION, DAM GES AS PROVIDED FOR IN SECTION .3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES... .
I CONSTRUCTION LENDING AGENCY ,
! hf>r~by C'ffirm IIrv:fer !)em~~1 of pt"ril.!ry th:=lt th~rp. is::::. t:orist!"l..!ctj')r) :eI:1in~::>':';:~:1cyfo!'" thF...
performance of the work for whid1 this permit is issued (Se0.3097 .Civ.C): ~.
Lender's Information:
NUMBE
571575
TYPE
TYPE
C39
HIC
EXPIRATION DATE
~/30/2005
Construcion Types:
VN,. .
Fire Sprinklered?
NO
te that the above information is correct. I
ate ws relating to building construction, and
ter n the above mentioned property for
Date: 3/14/2005
Fees paid for Permit:
Total:
482.64
Si nature of Applicant or Agent
he permit shall expire by limitation and become null and void if the building or
(k has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to com~ence or continue work.
INSPECTION RECORD , FINAL INSPECTIONS I Dale' ;. L~specoOr
"INSPECTION , ' , ' DATE, INSPECTOR' Electrical Final , ' ..
Temporary Power Pole Plumbing Final' .'.
Plumbing (DrainlWaste Pipe) Mechanical Fil1al ,
Electrical Ground ElecirodelUfer
"
SelbacklFormslTrenches.(Footings} , Gas Test ' ,
Do not install sUbfl()or or pour floor slab unlillhe Engineering/Grading Final 765-5126
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) Fire Dept. Final 765-4040
Mechanical (Groundwork) , .' Water E,ngineering 765-5268 .. ,
, '
Electrical (Underground Conduit) Sub i.,ist/Business License,7ii5-519 ,
Pre-slab (CompactionlMembrane..Rei nt. "
Underpinning (FI.oor Joist/Girders) , Zoning 765-5139 , b /',' i "
"
Do not cover or conceallhe work below until the , Building Final ~ast Inspection. Only; .~S't<" ~
following appl!,catl1e items have been signed:.. , 1-- ~ fter Above Complele) -
1 st Floor Shear ' , PARTIAL INSPECTIO
FireSprinkler, (Rough) , ,.
2nd Floor Shear ' , , , 1 Buildina Inspections!
RQof (Sheathing/Diaphragrn'FrlW11e) ~'" ./ ~_uf::" ' f-J. ~ ~. , .
Masonry (ReinfJBond BeamlPre-GlO\It} , , "
Rough Plumbing (Top Out}
Rough Mechanical, ,
Rough Electrical (Dry wall) , , " ,
Rough Elecirical , .'
Framing '(Only after Plbg.. Elec.. Mech and Fire) , , ,
Insulation (SoundlEnergy) , Mechanical Inspections
po not tape or pla~ter until the following applicable' -
It~ms have been signed: " '_ - " . ,
DryWall ' " . , ' , . ,',
Penetrations (Fire Rated) Electrical ..
Penetrations (Fire Rated) Mechanical , ,
Penetrations (Fire Ratel;l) PlUmbing .. ,
Interior Lath , , ' ,', ,
ExteriOr Lath Plumbina Inspections
GENERAL ITEMS . . ",
ExteriOr Plaster (Brown Coat) " ,
T .Bar Elel:tril:al " ,
T -Bar Mechanical, , ' , ,
, ,
T -Bar Structural ' -
Sewer ' , " , ,
Water Engineering Backflow , Electrical Inspections
, "
Water Service
, , "