202 S. Western
BUILDING PERMIT NO. BLD2005-00418
TYPE OF PERMIT CITY
Patio Cover
DATE: 2/16/2005
JOB ADDRESS: 202 S WESTERN AVE
LEGAL DESCRIPTION: N TR 2611 LOT 87
APPLICANT: KRYSTLE TORRI;S
OWNER INFORMATION:
Steven Clark
202 S Western Ave
Anaheim. CA 92804
ElM
BUILDING DIVISION
200 S. ANAHI;IMBLVD.
(714) 765 - 5153
INSPECTioN REOUl;STLlNE:
(714) 765 - 4626
CENSUS <';ODE: 434
QUARTER SECTION: 9
ARCHITECT/ENGINEER INFORMATION:
CONTRACTOR INFORMATION:
ROOMS N COVERS ETC ,.
840 S ROCHESTER AVE #C'
ONTARIO. CA 917610000.
. BUSINI;SS PHONE: 9093"90-0555
JOB DESCRIPTION: Install 343 square loot solid palio cOver; ICBO# 2621P..
VALUATION: 4,700.00
I OWNER-BUILDER DECLARATION
I hereby affirm under pe':lalty of perjury that I am exemp~ from the Contractor''f ~jcense Law for the fol19wing reason (Sec. 7031.5~~~i~ess' and
Professions Code: any,.dty or county which requires a permit to construct, 'alt~i, improve, demolish or repair any structure, prior to itS 'issuance, also
requires the appfioan'tfor such permit to file a signed statement that he is !ice(1)~d pursuant to the plOvi~onsofthe Contractor'sUcense Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professi~~S Code) Of 1hat he is exer:npt Jherefrom and the basis for the 'alleged .
exemption. Any violation of Section 7031.5 by a~y applicant for a permit subJ~cts the applicant to a dvU penalty. of not more thanfiye hundred dollars
($500).. .' ... ...... . . .
o I, aspwner of property, or my employees with wages as their sole comp~nsation, will do the work, and the structure is \)Ot intem;:!ed'of offered for
sale (Sec. 7044 Business and Professions Gade: 'The Contractor's' License daw does not apply to an owner of property who builds.or improv~s
thereon, and who does such work himself or herself or through his or h~r cw~ ~mplo'yeesl provided that'such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one ye8r of ccmpletion, the owner-builder willl1ave the burden of proving that he
did not buUd or improve for theputpose of sale). ' _ ~ t. . _ . ' .
o I, as the owner of the property, amexdusively contractin9.\\Iith ncensed.ilontractqrs'tQ: construct th~ project (Sec.7044 Business andProfe'ssions'
Code: The Contractor's License Law does not apply to an ownelof propertiwho buUds"or.improves thereon, and who contracts for such,'projects with
, , ./ wM"" '.
PJrontractor(s) licensed pursuant to ~he Contractor's License Law). :t
U lamexemptunderSec.f" ' ,B&P.C.forthisreason: I
Date: . Owner: 1 i
I WORKER'S COMPENSATION DECLARATION ; L
I hereby affirm under penalty of perjury one of the following declarations: -~j'. '::
o I have. and will maintain ~ certificate of consent to 'self.,insure for worker~~ompensatlon,
a~ provid~ f~r by Section 3700 of the Labor Code, for the performanCe o~ th~ work for whid1
ifnh . perm~ IS ISSUed. . '\1'0 .
. . ' I have and will maintain worker's compensation insurance, as required 0..;.1 Section 3700 of
he Labor Code, for the performance of the work for which this permit isi~ue~. My worker's
omperisation insurance carrier and policy ate: ' ,:' i. '
Carrier: STATE FUND .' PoIi"" Number. 1606080-{OO3
This section need not be c:ompleted if the permit Is for OIl. hundred dollars ($100);or'I05s.
o ,I certify that in the performance ofthe work for which this permitis issued,:; 'sha'U n.ot
employ any person in any manner so as' to become subject to the worker's cp.;J,lpensation laws
of CalifomJa, and agree that if I should become subject to the worker's "2.om~h~.ati9:n. "
provisions of Section 3700 of the Labor Co ~,I shall forthwith comply with:thc.se provisions.
.'
PROCESSED BY: ENO
Date: 2/16/2005 Appiicant: .' .
. WARN ING: FAILUR~ TO S~CU ORKE COMP~NSATION COVER~GE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPlOYER TO CRIMINAl. PENALTIES AND CIVIL
FIN~S UPTO ONE HUNDRED THOUSAND DOLlARS ($100,000). iN ~DI1l0NTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, iNTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY.
I nerf-hy affirm under penalty of ~rjllry that there is Cl.c-,,"n$t(lict!Q!'~ 1~f'.-1~~ =c~n6yfcr ~iw
performance of the work for whim this permit is issued (Sec:3097.Civ.C): '
Lender's Information: .
I certify that. I have read thisapplicatio'n and state.that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction. and
hereby authorize representives of this city to enter upon the a bove mentioned property for
inspectio r:-poses
Date: 2/16/2005
Signa re of Applicant or Agent
T e permit shall expire by limitation alld become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permifls required to commence or continue work.
.,
LICENSED CONTRACTORS DECLARATION
J heret>y affirm under;penalty of perjury that lam
licensed under provisions of chapter'g (commencing
with Section 7000) of QiVsiOn 3 of the Business and
~7:;os~~ns )4,ft JdJtqtut ./
Date: /I - Contractor
NUMBER
517575
TYPE
TYPE'
TYPE.
~XPIRAtION DATE
913012005
C47'
C39
HIC
Construcion Types:
VN,' ,.
Fees: paid for Permit:
Total:
640.63
INSPECTION RECORD
INSPECTION. ,
DATE INSPECTOR
Temporary. Power Pole. .
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodelUfer .
setbacklFormsfTrenches (Footings) .
Do not install subfloar or. pour floor slab ulltil the
following applicable items have been signeq:
Plumbing (Water Plpe.SprinklerValves) ."
Mechanic.al (Groundwork) .
ElectriClll(Underground Conduit) .
Pre-slab (CompactionfMembrane.Reinr.;
Underpinning (Floor Joist/Girders) . .
Do not cover or.conceal the work below. until tile .
. following applicable items have been signeq:
1st Floor Shear . .
Firesprinkler. (Rough)
2ndFioo. S/lear .
Roof (Sheathing/QiaohraomlFrame)
Masonry (ReinfJBOnd Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical. .'
Rougn l:IectrlCaI(ury wall)
Rouoh Electrical .
. Framing. (Only an.rPII1!l., EI.c,: Mech. and Fire)
Insulation (SoundlEll!!tgy)
Do.not tape or plaster until lite following applicable I
items have been signed:. ' .
Drywall . . . '. '.
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical .' .'
Penetrations (Fire Rated) Plumbing
Interior Lath .
Exterior Latlt . . '.
GENERAL ITEMS
Exterior Plaster (Bl'O\Nn Coal)
T -Bar Electrical
T-Bar Mechanical "
T-Bar Structural'
Sewer ' , ,
Water Engineering Backflow
Water Setvice ,
FINAL INSPECTIONS Date. Inspector
Electrical Final , ,
Plumbing 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 ~astlnspection. Only ?Y/f -tP)" ,/)u;. . -&
fler Above Complete) ''TJ,,;'
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina InsJiections
Electrical Inspections