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1777 W. Westmont Dr.
TYPE OF PERMIT . Residentlal.Additlon . . DATE: 5/26f2004 JOB ADDRESS: .1777 W WESTMONT DR LEGAL DESCRIPTION: N TR1591 LOT 130 ElM BUILDING DiVISION 200 S. ANAHEIM BLVD,. . (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765' 4626 CENSUS CODE: 434 QUARTER SECTION: 46 . BUILDIN.G I"ERMIT NO..BLD2004-01997 CONTRACTOR INFORM/,TION: TOOL TIME 1731 E BORCHARD'ST SANTA ANA, CA 92707 OCJO BUSINESS PHONE: 714210-5014 JOB DESCRIPTIONRoom Addition.. New kitchen. (HIHt VALUATION: 21,000.00 I . OWNER-BUILDER DECLARATION I hereby affin;n under penalty of perJury that I am exempt from the ContractO::i.~:S_ Lic,ense Law for: the following reason (Sec. 70~1.5,Business'and . Professio':1s, Code: :any 9ty or county which requires a permit to construct, aJ~~r,lfnprove, demolish or repair any structure, priorto its issuance;" also requires"the- applicanlfo"r sl!ch PEtrmit to 'file a signed statement that he_ is llc~,nsed .pursuant to the provisions of the ~ontractor\s License law (Chapt~r ".9)(901T1mencjng with Section 7000 of Division 3 of. the Business and Profesg:~:ms C-ode) or that he is exempt t,herefrom and the basis for the alleged exempti,,?n. Any viola~ion of Section 1031.5 byany~pplicant for a permitsutj'tcts the ~ppli~antto a civil penalt.yof.not mora than fiv~hundred dollars. ($500).. .. '. ........ i ;', .. . .. . .. . . o . I, as, owner of property, army empJoYl3e~:p~,vlth wages,asthelr sorecom~.~nsatlon, Will do the work, .and the structure. IS not Intended or offered'for sale ($ec,_7044 ]~usiljess and Professions Code: 'The Contractor's License ~_dW does.not apply to an owner of property who buildsqr imprqves. thereon; and_ who does such worl< hiinself 'or he.rse1.f ortf:1rough his or her 0\r'''_;lf9mployees; provided that such improvements are,nat intended or offered for sa'le. If, however, the building or imProvement is sold with orie YE!.';' of_Completion, the o~ner-buirder will have the.burden'of provingttlat he . didriotbuild'orjmprave'fort~epu.rpose6fSale). ,': I." . " '," .' .', o 'I, 'as the owner of the property, am exdusively contracting with Ucensed:rontradors to construct the project(Sec. 7044 Business and Professions Code: ,Th~ Contr.actors License t.aw does not apply to an owner of properi~/who bUilds or improves th"ereon. and who contracts for suth projects with . ja..Q9.ntractor(s} licensed pursuant to the Contractor's Li~ns~ LClW), !._ ". . .... . _' . . : U'Ic;tmexer:nptul1derSec, .- - .,B&P.C.forthisreason: __i -, . .,.. '. . ". . '- .' Date:, . Owner:' _L I WORKER'S COMPENSATION DECLARATION , lli~reby affirm. under p'enalty 'of perjury one of the -followinQ. declarations: . o .1 ha~e and will maintain a certificate' of consent to self':'jr:lsure for worl(er~ com"ijensatio\l, as 'provided for by ~ction3700 of tt.le labOr Code, f9r the pe'riormance of U .~_ wo'rk for'-wtlidl this permit is issued, . "'. o Lhayeand willmaintainworker's compensation jnsu~ance, as required fl Sedian 37QO of, the LaborCoc.te, fb~ the performance of the 'Work for which this permit is issl.h:d.' Myworker's Comp'ensation insurance C<;3rrier and policy are: :' .-. . . Carrier:' ',.. " - Policy Number: EXEM~"!. APPLICANT: EFRAIN SANDOVAL OWNER INFORMATION: HUNG VAN NGUYEN 1777 W Westmon! Dr Anaheim, CA 92801 ARCHITECT/ENGINEER INFORMATION: PROCESSED' BY: ODC I B HIC EXPIRATION DATE 5/~1/2005 Date: 5/26/2004 Applicant: WARNING: 'FAILURETOSECUREWO 'S COMPE SATION COVERAGE IS . , UNLAWFUL, AND. SHALL SUBJECTEMPLOYE:R T CRIMINAL' PENA _TIES AND CIVIL . FINES !.II" TOONE HUNDRED TH SAND DOLLARS ($100,000), IN AD.t>lTlON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlm: 3706 OF THE LABOR CODE,INTEREST AND ATTORNt)'!SFE:ES, j CONSTRUCTION LENDING AGENCY _ I hereby affirm under penalty of perjury that there' _is a c;onstruction I~nding_,o?f_ency far the r.erforMl)!,~_{)ftF"""'\'0rk.f':'-r w~!r+. ~~iS P~:'r:"':~:e :=-::.:~J ~~:;::..3~~':C:;::;:::;;' ~.L--,-",_~':-". Lender"s Infonnation: . l Construcion Types: VN, . . Fire Sprinklered? Living Area: NO .271 Fees paid for Permit: Total: 2.10 Date: 5/2&2004 Signat f pplicant at Agent . permit shall expire by limitation and become null and void if the building or work has. not passed final inspection 365 dayS from the date of permit issuance. A new permit is required to. comnienceor corrtinue work. . INSPECTION RECORD .. '. . . '-' .. . .' . . . .' " .... . . INspeC110N . . '. "OII<TE . . INspeCTOR . Temporary Power Pole . . .. - PJumbing(Draini'Waste Pipe) . . . Electrical GrOund Electrodelurer .... . . I. ~baCl!IFcrmslTreriChe!l (Footings) '.:' , Do not install subfloor.or pour floor slab until the '.' 1 f9110wing applicable items have. been signed! '.- I" . Plumbing (Wate. Plpe.Sprinkler Valves) .' . .... Mechanical (GrOundWork) .... . '. . . . Elec;tric;al (Underground Condu it) . . .~ . Pre-slab (CompactIOnlMembrane.Rllinf. . . . . . . Underpinning(F!OClr .JoIst/.Glrders) . . .lJC) hot cover or.conCeal the workbelow untilthe . . following appliCable. items have bl'en signed: . . . '. 1 stFloor Shear , '. . Firespl"i n1der (Rou9 h) '. . . . . . . 2nd F.ioor Shear.- ROof.(SheathinglDiaphragnilFrame) , Ma$~nrY (Rilinf./Bond 8eamlPre.Grout) '., . R!>ugh Plumbing.(Top Outl .' Roug!l Mechanical, . . '. . Rilltlgh l:Iectrrcal aUI . Rough Electrical '. . .' . Framing '(Only a~er PJbg.; EleC:"J.'lech" and Fife) . In$Ulation (SolmdIEnergy) . '. . '. po not tape orpla~ter unlil tne fOllowing applicable .tems .have been sIgned: . '.. . Dniwall '" . . . .,' Penetrations (Fire Rated) Electrical :c. .' ". PenelraliOns.(Fire Rated) Mechanical . Penetrations (fire Rated) Plurilbing .' . .' Interior Lath . ." .' . Exterior lath ' '. . , . , .' GENERAL ITEMS '. Exterior Plasl!lr (Brown Coat) .' , ,. . . . T,Bar Electri<:al ., ... . ~ T-Bar Mechanical .... . .T-Bar Structural" . . - . Sewer . . . ' . . . '. Water ErigineeringBackflow . .'. '7 Water Service :" . FINAL INSPECT!ONS" Date" InsPl!!ctor .' Electrical Final , '. . . .... . . plumbing Final . ': ". '. . . . . Mechanical Final . .' , . Gas Test . . . .... .. . '. ..' ; Engi~ringlGr8ding Final 765,5126 . '. . Fire De;.>!. Final 7654040 . . ....... .... ". Water Engineering 765-5268 . . . . Sub 'list/Business .liCense76S_5~ II 1 '. Zoning 765,5139 . . '. .1 , . .. . Building Final last l~si>eCtiQn. d~ly .' . . . : . fter Abov,e Complete). . , . . . PARTIAL INSPECTIONS BuildinQ Inspections . '.., - . _ Mechanical Inspections " PJurnbin-Q Inspections Electrical Inspections . . . . PERMIT EXPIRED INSPECTION '. NOT COMPLETED\ DATE:flvv\D~' ....:..... ~C*OtflOI:lD i; f7?:,{ - it v ~- 11' ... ~ If ) I ) I ) j ----. l ~ 0'1 01 ~ '" ;; r -- ~- r 11 -1 - E :p f ~ ,t \k'4"-( If /, . -\-\.1,- / ,1- ~M!::>u.. PltA,>'\8'>- :$ ",..U.. p,LJI,~e~ .5 r:DE' lzJ"" ~f:.. . 'B "'~I<. \).) ~ Lt-. 0o\l CJ- _oj : S-Q GlS: ~~-- PLANNING DEPARTMENT APPFf.OVED DATE -?;lrd~;6N J BY ~A'11/AYu_ ( ~) u-""""~~~ (lnitia.l') FLOOD ZONE HISTORIC DiS.TR1Ci REVIEW: ~ ~r~t--~';~~~l~v:h\~n~a~e SEE BUILDING PERMIT FOR ANY CO~IDITION3 O\C.~ f1fLfV ~ cd- Co I ~~ em 'Sid&- ~ ~ -6 """::>' \u~ (y{\ -+t<eSl~ ~ +tto ~ a.fi'.<7-. 0-", ~, _ 0\(. ~ ~fD ~ ~ I We&- ~la-~S \'^ ~ a.<; ~, Fj2.0N\" _ .... _ \ _ .l-. Jj ~ ~ \JI t7 II'l O<J lj\ \J\ I!J\ o '<>,) o. .3 ~ ~ ~ ~ D rt- -- - C2 . ~ lC- !"#$%& ' ()*,),+,- )+ 8 9:$';$+"+,- . ! 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