634 Wayside
,
BUILDING PERN'.FNO. BLD2005-00597
TYPE OFPERMIT
Residential Remodel
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765- 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 104
DATE: 3/8/2005
JOB ADDRESS: 634 S WAYSIDE ST
LEGAL DESCRIPTION: N TR 339'2 LOT 8
APPLICANT:
OWNER INFORMATION: . CONTRACTOR INFOR~,::\TION: ARCHITECT/ENGINEER INFORMATION:
BIARD & CROCKETT PLUMBING SERVICE
320 E KA TELLA AVE #P
ORANGE, CA 92867 000('
JOB DESCRIPTION:Minor bathroom remodel and lath around tub intelior.
VALUATION: 500.00
I OWNER-BUILDEr: DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractc:r's License Law for th~ following, reason (Sec. 7031.5 Business and
Professions Code: any city or county~hich requiresa permit to construct, a:ter, improve. del11<?lish or repair any structul e, priorto its issuance, also
requires the applicant for such permit to file a signed statement that he l~ ik;Jnsed pursuant to the provisions cfthe Contractor's License Law (Chapter
9)(commencing with Section 70aDof Division 3 of the Business and Pmies$.bils 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 eul~jecls the applicant to a civil penalty of net more than five hundred dollars
($500). . . t. '.
o I, as owner of property, or my E;!mployees with wages as their sole co:r;bensatior., wiJIdo the work, and the structure is' not li1tended or offered for
sale (Sec. 7044 Business arid professions Code: lhe Contractor's License~aw does not apply to ar. owner 6f propertywho builds or improves.
thereon, and who does sum workhimseff or herself or through his or ~er 0"':>';1 emploYE:les, provided that such improvements are not intended or
offered for sale. If, however, the building or improVement is sold with one yt!ar of completion, the owner-builder will have the burden of proving that he
did not bu ild or improve for the purpose of sGile),' 'j
. D' I, Bsthe owner of.the property, am exdusiveiy contracting with I icense6.; con tractors to construct tne project (See 7044 8usines;$ and ProfessioTls
Code: The Contractor's License: law does not apply to 'an owner of propertvwhO builds or improves' thereon, and who"c6ntracts for such projects w!th
a contractor(s) licensed pursuant to the Contractor's license law), .! .
D' , I am exempt under Sec. _ , ,B & P ,C. for this reason: ~
Date:" Owner: I
n'
I WORKER'S COMPENSATION DECLARATION
I hereby affirm unde-r penalty of perjury one of the following declarations:, 1
o ! have and will maintain a certificate of oonsent to self~insure for vvurkerk :::ompensdtion,
as provided for by Section 3700 of the Labor Code. for the performana). oft:-~c work ~or which
ifhi permit is issued: ~ - . ,
, I have and will maintain worker's compensation insurance, as required t~ SectkJh'3700 of
. Labor Code, for the. performance of the work for which this perf11it i::i issl.l"~. Myworkei's
Compensation insurance carrier and policy are: . . :. .
Carrier: ACCORD Policy Number. 1015H'j,arJ7
PROCESSED BY: MJF
---1
LICENSED CONTRACTORS DECLARATION .J
I hereby affirm under penalty of perjury tl1at I am
licensed under provistons of cha t!::!l 9 (commencing
with Section 7000) of n vsian 3 t Business and
Professio s ode. J
3/8/2005
Dat~.
This section need not be completed if thepennit is for. one hundred dollars ($~OfJ or less.
o I certifY that in the perfonnance ofthe work for which fhis permit is issue!d, I shan not .
employ any person in any manner so as to become subject to the workEJ;r's <::i~mpensation raws
of Califomia, and agree that if I should become subject to the worker's comj:"~nsation
provisions of Seotion 3700 ofthe labor Code,! hall fo i amply with trose provisions.
NUMBER
313514
.TYPE
EXPIRATION DATE
2/28/2006
C36
Date: 3/812005 Applicant:
WARNING: FAILURE TO SECUR WORKER'S OMPENSATION COVER"GiO IS
UNLAWFUL. AND SHALL SUBJE T AN EMPLOYER TO CRiMINAL PENAcTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADD!T,CN 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. .
I hereby affirm under penalty of perjury that there is a. construction lending Cl!":::.:.r1CYfor lhe'
. performance of the work'for which this permit is issued (Se0.3097 .Civ.C):
Lender's InforfTlation:
Construcion Types:
VN. .
Fire Sprinklered?
NO
I certify that I have read this application and state that the above information is correct. I
ag'ree to oomply,with arl city ordinances and state laws relating to building construction, and
he eby authorize represen 'ves of this dty to enter upon"the above mentioned property for
i pection poses:
Oat.. 3/812005
Fees paid for Permit:
Total:
107.24
Signature of Applicant or Agent
The permit hall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from tlK! date of ""rmit issuance. A
oow permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION DATE , INSPECTOR
Tempora!'Y Power Pole'
Plumbing (DrainlWaste Pipe) , ,
'Eledrical Ground Electrode/Uter,
SelbacklFormsfTrenches (Footings)
Do not install subflooror pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GroundWork)
Eledrical (Underground Conduit) ,
Pre'Slab (CompactionlMembrane,Rei nt.) -
Underpinning (Floor Joist/Girders) , "
Do not cover or conceal the work below until the
" following applicable items have been signed:' '
1 st Floor Shear ,
Firesprinkler, (Rough)
;lnd Floor Shear , ,
Roof (Shilathing/DiaphraamlFrame),
Mason!'Y(ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out) ~~.or I'//J.'u//~
'Rough Mlichanical ' , ,
Rougn t:IectrlCaI,(ury wall) , ,
RQugh Eledrical ~=,."1" /ttf . <diE..,-<=.
Framing (On~ afterPlbg:. Elec" Mech, and,Fire) ,
Insul,allon (SoundlEnergy),
po not tape or pla~ter' until the following applicable
Items have: been signed: .
Drywall ' ,
Penetrations (Fire Rated) Electrical
Penetratioils (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing ,., / /'
, Interior Lath ::t.,v.or ' ~ "'<.-,
Exterior Lath ,
GENERAL ITEMS
Exterior Plaster (Brown Coal) ,
T.Bar Electrical
T -Bar Mechanical , ,
T -Bar Structural ,
Sewer , ,
Water Engineering Backflow i'
Water Service ,
.
Oate" Inspector
FINAL INSPECTIONS
Electrical Final,
Pluinbing Final
Mechanical Final'
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-519
Zoning 765-5139
Building Final (Last Inspection. Only -7_<>r,
, After Above Complete)' 0-
PARTIAL INSPECTIONS
BOilding Inspections
,-
Mechanical Inspections
Plumbina Inspections
ElectricallnSDections