2059 S. Waverly Dr.
BUILDING PERMIT NO.
I
BLD2004-02786
TYPE OF PERMIT
Residenli~1 Aqdilion
DATE: 7/1412004
JOB ADDRESS: 2059 S WAVERLY DR
LEGAL DESCRIPTION: N TR 4731 LOT 5
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST liNE:
(714) 765.4626
CENSUS CODE: 434
'QUARTER SECTION: 58
APPLICANT: JAMES EROSE
OWNERINFORMA nON:
JAMES EROSE
2059 S Waverty Dr
Anaheim, CA 92802
JOB DESCRIPTION10sq. It e"tension o/existing bathroom.
CONTRACTOR INFORMHION:
ARCHITECT/ENGINEER INFORMATION:
MARGARITa CASTILLO,
4721 LOS COYOTES DIAGONAL
LONG BEACH, CA 90815
VALUATION: B73.0C
I . OWNER-BUILDE~QECLARATION
I hereby affirm under penatty of perjury that I am exempt from the Contracto;:"3 License Law for the following re~son (Sec. 7031.5 Business and"
Professions Code: any city or county which requires a permit to const~uct, Cjru~r, improve, demolish or repair any structure; prior to its issuance, also
requires the applicantfor such permit to file a signed statement that he is i!cf.:"sed pursuant tathe provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profesr,i":,ns 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 sut~ectsthe applicimt. to a civil penalty of 110t more than five hundred dollars
~$50). . . ". . .' .
.1, as owner of property, or my !'lmployees with wages as their sole corr:r:.'<msation, will do the work,. an.d t~e structure is not intended or offered for
ale {Sec~ 7.044 Business and Professions Code; The Contractor's License L8w,does not apply to an owner of property, who builds or improves
thereon, and who does such work himself or l)efSelf 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 y~.:;" of oompletion, the owner-builder will have the burden a(proving that he
did not build or improve for the purpose of sale). '. ,
. 0 I, as the owner of the property, am exdusively contradir1g with licensed:xmtmdors to construct the project (Sec. 7044 Business and Professions
Code: J'he Corltractor's License Law does not apply tc an owner of property:vho bUilds or improves thereon, and who oontracts for such projects with
ontractor(s) licensed pursuant to the COl}tr3ctor's License law).
exempt under Sec. , B & P.C.for this}96&9n: ~_:
Date: Owner: ~~ ~\..7<.ChA. .:::,.
WORKER'S CO ENSATION DECLARATION
. I hereby affirm uncier penalty of perjury one of the following declarations:
o I have a~d will mainta.in a certificate of consent to self":"i~sure fer wvrker". Gompensation~
as provided for by'S19ction 3700 of the labor Code, for the perlormance C'fih~ work for which
this permit is issued.
o I ':lave and wm maint8inworker's compensation insurance, as required h:~ Section 3700 of 7/14/2004
the labor Code, far the performance bj the work for which this permit :5 :SSli'i:~t Myworker's Date:
Compensation insurance canier arid pOlicy are:
Carrier:' Policy NU,mber.
!.
PROCESSED BY:MJF
=:J
LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 {cornmencing
with Section 7000) of DivsiOn 3 of the Business and
Professions Code. .
Contractor
NUMBER
EXPIRATION DATE
This section need not be completed If the pennit is for one hundred dollars ($10>j,'.,)( less.
. ~ 1 certify ~hat In ~he perfonnance of the work for Whj~h this permit is i!'>SL:~d: I ~haJI ~ot
~oy any person'ln any manner so as to become subject to .the workers ccrnpensatlon 'Iaws
of California, and agree that if I ,should become subject to the worker's compt~'nsatjon
provisions of Section 3700 of the la bor Code, I shall forthwith comply with.tb.:.se provisions.
Date: 7f14f2004 Applicant: ~~. ~ ~. . .
WARNING: FAILURE TO SECURE. RKER'S COMPENSATION COVER,\GE IS
UNLAWFUL, AND SHALL SUBJ!OCT AN EMPLOYER TO CRIMINAl PENA:.TiES AND GIVIL
FINES UPTO 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.
I CONSTRUCTION LENDING AGENCY .._
Ihereby affirm under penalty of perjury that the:re is a' conS~.\1ct!on le.rdil')g agf;ncy fc.r the
performa~'ce of the work fa:r which this permit is issued (Seq.3097.Civ.G): "_ _. .
-Lend.;;:(Siilfv~matro'I:, ,_., '
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
NO
,
I certify that t have ~ead this appliCation and state that the above information j;-, correct. I
agree to romply with all city ordinances and state laws relating to bu~ding construction, and
hereby authorize representives of this city to enter upon the a bove mentioned property for
i ion purposes.
Fees paid for Permit:
Total:
93.87
Dale: 7/14/2004
" Signature of Applicant or Agent .
permit shall expire by limitation and become null and void if the building or
work /las not passed final inspection 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 (DrainlWaste Pipe) . " .
. Electrical Ground Electrode/uter
SetbacklFormsrrrenches (Footings)
Do not install subfloor or pour floor slab until th~ .
following applical)le items have been signed:
Plumbing (WaterPlpe.Sprinkler Valve!;) . .
Mechanical (GroundWork)
Electrical (Underground Conduit)
P/ll-slab (Compactlon/Membrane.Rei nt. . .
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
. following applicableilems have been signed: . .
1 si Floor sliear . .
Flresprinkler (ROugh)
2nd Floor Shear
Roof (Sheathing/Diaphragm'Fr;me) .
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out) . .
Rough Mechanical .
Rough8ectrical (Dry Wall) . .
Rough Electrical . ~
Framing {Only aher Plbg.:Bec.. Mech.. .and Fire) r..tIiJ
Insulation (SoundlEnergy) . I .. .
Do not tape or plaster until the folloWing applicable
items have been signe:d: . :
Drywall . "'\4!~ 1-e1' ~..~
Penetrations (Fire Rated) Electrical.
Penetrations (Fire Rated) Mechanical ' .
Penetrations (Fire Rated) Plumbing ".
Interior Lath . . . .
Exterior Lath. .
.' . . GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bat Electrical .
T-Bar Mechanical.
T -Bar Structural .
Sewer .
Water Engineering Backflow .
Water Service . .
.
FINAL INSPECTIONS
Ele.ctrical Final .
Plumbing Final
Mechanical Final
Gas Test
Date
.
.
.
Engineering/Grading Final 765-5126
. . .
Fire Dept. Final 76~-4040
Water Engineering 765-5268
Sub List/Business License 765-51~ '.
Zoning 765-5139
BUilding. Final ILast Inspection. Only 12. {~/, " (" C () I r .
After Above Complete) 1'1" I ~,tGiV-Z
.
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbinq Inspections
Electricallnspectiol'is