2190 E. Winston Rd.
TYPE OF PERMIT
New Commercial Construction
CITY
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BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765" 5153 '
INSPECTION REQUEST LINE:
(714) 76'5 - 4626
CENS0sCODE:. 320'
QUARTER SECTION: 116
BUILDING PERMIT NO. BLD2003-03404
DATE: 312612004
JOB ADDRESS: 2190 E WINSTON RO BLDGA
LEGAL DESCRIPTION: SEC 24 T 4 R 10 18,55 AC SW1/4
APPLICANT: DERRICK EVANS
OWNER INFORMATION:
STADIUM WEST
1391 ALLEC
ANAHEIM, CA' 92805
JOB DESCRIPTIONNew 5461 sq,ft. concrete tilt-up building.
, VALUATI,ON: 218,440,00 '\
I 'OWNER.BUILDER\OECLARATION
I hereby affirm under penalty of, perjury that! am exempt from the Contractort.~~L,igen~e Law for the foHqwlng' reason (S~c, 7031~5 Business and
Professions Code: any dty or coli,ntywhich requires a" permit 10 construct, a"Jt.tr.._:!rf1pro"e; demolish or repair any structure, prior to its Issuance, also
r~quir~ the ~ppli~ntfor ~uch Permit t~ ~l~ a sign,ed state.ment that he ISI~s~;~e~'J}Llrs.uant iothe.pTOvtsfons of the Contractor's LV~ense Law'(Chapter '
9)(comm,enclng WIth SectIon ('DOOof DIVISIon 3 of the BusmessandProfcsskinsH.ode),_or that h{7IS exempt therefrom and the baSIS for the alleged,
exemption.:' Any'violation of Section 7031.5 by'?'!ny applicant, for a permit su~~ds'the:~pp\icant-to a dvil'penaltyof hot morethan'five ~u~dred dollars
($500), ' ,,' " 'J, ".- ' . ,"_
o I, as own(~r-ot p,opir.ty, or m~t emPioyeeu with wages as their s9le r;orn~?,i)S~tiorr Will do thework, ~nq,the structure isnotihtende? or offen:~q' for.
sale (Sec. 7044 Business and Professions Coqe:, The.Contractor's lice~se,tJiVl_'does notapp!yto,an oWr1~r of..property who,buildspril11pro.,es " '
t~e(ecn, and who does s~l;lth W?"k himseM or helSelfor thrgugh his or"J:er- o\vu:en1ploY~~i:proviqe,~,thatsuchirl'PlUvements are:not intende~ or-' .
?ffere sale. . If, how}'wer, the building or improvement Is sold with onf? ye'r,:of .coFl1pleti'or., 'the ovmer~builder will have the burdi?n of provl'1g, that he
did t build or improve for the purposeof sale). . . . ,'!h',;' _" ," ". ,-- '. _\. "
'1, as-the owner of-the 'p~9perty, am eXd,usively contracting w~l:1license~h~~)~tract0rs ip G.o_c;struct th,e pr~)ject ~Sec. 704-+BUSl:1es~ and Pro~essions
o e: The yontractor's Li~nse, Law does not apply to an owner of property,i?;ho buiios qf fMpioxc5:her~o", an(i who rontract'S for'such,prcjects with,
ontractor(s~ Ilcen'sedpursuanfto the Contractor's Li~nse L~W)... ,f,j' '
,I am exemPt, under Sec, ','~' B .& "lC, forr~is Jl'\ison: >_-'--', ','
Dale: . Owner: .~iZ: ~, ' " _
,I ,WORKER'S COMPENSATION DECLARATION ,\ rucENSEDCONTRACTOR$ DECLARATION I',
I hereby affi.rrrr~nderpenalty of perjuryone'of the following declarations:' . t ~ he~eby affir,m under penalty of p~rjury' th~t '_'am .
O. I have and, will maintain _a certifiyate of consent to self-insure forworl;er':{'compensation, "~~',li~ens6d und:.r PloVjSiO'~S ~f chapter ~ (co~mencing
as provided for by Section. 3700. of the Labor Code, for the performdncecfthf work forwhich~W!thSechon 1000) of ()l\'$lor,~ 3 ofthe, BUSiness and
this permit is issued. " . , .t'. " Professions Code, . . .
o J have and wW'maiotain worker's compensation lnsurance,as required bl~ectiori-370o of 3/26/2004 " . '
tf:le Labor Code, fo,r the performance of the- work for which this permit is iSSU'r~ My worker's Date:' Contractor
Compensation insurance carrier and policy are: ' - '.
Carrier' ," Policy Number. NUMBER EXPIRATION DATE
, . . -,
ecti6n need not be completed if the pelTnit is for one hundred dollar!i ($~ oo~ CirJEiss. .
" , ,', . ':, ",';. ,-;:'~ # ;.'~' " ~:, ,C,
I certify that-in the perfonnance of-the. work for which this permit,iS' isS~~;:;:,t~~all n9t
e ploy any person in any manner ,s'o as to become sUbJecqo, the worker's~Cf'[ :,~~si:l.tionraws
California; and agree that if I should b,ecome subject to the-wo~er's comP;e!,ii~tion _ '
provisions of Section 3700 of the Labor Code, I shan forthwith comply wml:"tf..~s~'provisions.
., Date: 3126/2004 , Ap~IiCanef)~, >;'" ~_;.:.., '
WARNING: FAILURE ,0 SECURE WORKER'S COMPENSATION COVgR GE;.IS'
UNLAWFUl,AND SHALL SUI;lJEC, AN EMPlOYER TO CRIMINAl PENAl,f1ESAND CIVIL
FINES.UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDnlON :Td THE
COST OF COMPENSATION, DAMAGES AS PFlOVIDED FOR IN SECnQN 3706 ()FTHE
LABOR CODE, INTEREST AND ATTOFlNEY'S FEES.' ,.
I CONSTRUCTION LENDING AGENCY :,
'1 hereby affirm under penalty.of perjury that there is a construction lending aJ . ncyfOf,the
gelformance of the work for which this,permit is issued {Sec.3097.Civ.Q}: ~,____
Lenaefs InTvrmStlOn: -- -'- -- ---- ---. -- -
.1
CONTRACTOR INFORM(,TlON:'
ARCHITECT/ENGINEER INFORMATION:
MICHAEL SCHAFER
18002 COWAN
IRVINE, CA 92614 0000
'PFlOCESSED BY: DUC
TYPE
Gonstrudon Tvpes:
V,N, "
Occupancy Grouos:
B, S1, , ,
Fire Sprinklered?
Number of. Stories
New I Additiona', Area:
YES
1
5,461
.;'
I ,certify that I have I:"ead this application and.state that the above information b corre.ct. I
agre~ to oomply with ,all city ,-ordinances and state laws relating'tei building construction, a-nd
hereby authorizerepresentives of this citytaenter'upon the'abov.e mentioned property for
Jn~p~ ~ ~ Oat~:3f2612004
Signature of Applicant or Agent ,
The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance, A
new permit is required to commence or continue work.
Fees paid fqr Permit;
Total:
5,310,84
INSPECTION RECORD . FINAL INSPECTIONS . Date . Inspector
.. .INSPECTION . DATE' . . INSPECTOR Electrieal l7inal . ....'" .'.
.
Temporary POwer Pole . . . Plumbing Final '$-/<1. ",1 :..\.7';""1(.,
Plumbi~ (DrainlWaste Pipe) . . Mechanical Final' . .'
Electrical Ground Electrode/Ufer . . j , .
.
SetbacklFOI'mslTrenches (Footings) /; ZZ~6 I G;.s Test . . .
Do not install. subfloor or pour floor slab untilthe : I:ngineerin~GradingFinaI76S..s126 . .
following. applicable items have been signed: .- . ,
Plumbing (Water Pipe.Sprinkler Valv.es) . ..' Fire Dept. Final 7654040 . . .
Mechanical (GroundwOrk) . . '. .' Water Engineering 765-5268 . .... .
Electrical (Underground Conduit) ..' .I ".
I Pre-slab(CompactionlMembrane.Reinf. ''tN,. _Sub List/Business License 765-519 Izh~q. gd~ .
Underpinning (F1OO1'Joist/Girders) . . ' . '. I., Zoning 765.5139 , ' .
00 n'lt cover or conceal the W'lrk below until the Building Final ~astln.pection' Only '. l,r ", ~.n '.
following applicable items have been signed: '. '. C' . fter Above Completel J-/4.ps-
1st Floor Shear , PARTIAL INSPECTIONS ,"
, Firesprillkler . (Rough) '.' , . I
2nd Floor Shear . . . ~li~if~:~:~
Roof (Sheathing/Diaphragm/Frame) 'i'~/~ ---
Masonry (ReinfJBond BeamlPre.Grout) /' . .'
R'lugh Plumbina (Top Out) ,
Rough Mechanical '. ,
I Rough Electrical (ury waU) .
Rough Electrical . , .
Framing (Only after Plbg., Elec.. J,,1echu and Fire) - ~ . . .
Insulation (Sou!IdIEnergy) . , . , . .'
00 not tape or plaster until the following applicable . MechanicallnSDections
items have been "igned:' ,.., ' ,.
Drywall' . . . .' .' . J~/;/0' /J".z/ r/ l ,,'
Penetrations (Fire Rated) Electrical '. . .' . '. ..
Penetrations (Fire Rated) Mechanical . ,i .
Penetrations (Fire Rated) Plumbing . .
Interior Lath , , '. ' ,
. Exterior Lath' . ,Phimbinalilspections . .
. . GENERAL ITEMS .,'
Exterior Plaster (Bl'O'Nn Coat) . . .
T .Bar Electrical '. . . . .
T.Bar Mechanical .
, . . .
. T-Bar Structural . , .' , .
Sewer , , . . . .' . .' ' ,
Water Engineering Backflow . . . l Electricallnspections
Water SArvice . "
'.'
, .
'CErtnFICA Te..()J= :Og~(JF),AI\ACY
...CitYiipfAnafteirn.'>....
This 'Structure h<ls beenjn~pe~tedpl!rsu~nt to the .' ......... ....~~~. l;h~~2-~OOJ~ditiOriaS~QoPtedand amended by '.
The C.ity;ofAryahffini> '. .. ..... . '. ...... .
.... '-'-':'" .,-,,', ':-. '.... ," "'.- .. ....
. Any ch<1ngein the. character of ~ccupanCie
ot' occupa~GieSrequires a nrm Certificate
.'
-,',' "
ttJebuilOingin a different divisjonorgroop..'
OCCUPf\r.JfYCLASSIf=ICATION: B....... ....
NO. OF STORIES:. . f .~.,
._,-~..;~._--.".:".....,., -,_.---,..... .,,-_...-~,_.._.-.-.,~.. ",-_.' ,-,-'.~~._.>._...-"" ~;_.,:. .)",~",_.
. CONSTRUCTION tyPE: .' VN"H.RESpi~1
...... ....... .......~
...l?iJJLDING OWNER: .' STAOfUr.1WE$<
. BUILplNG ADDRE~~: .2190 E WINSTON
. . DA~E OF ISS\.lANCE: . 1118/2005.. .
PROCESSED BY:.MflrYMo~tg()me;; .
....,
JULIE A. SEAY,C
"BOILOINGOFFtCII>:
-:\..
;>';";;;~fl;:;Ity. ot AnaheIm .' .
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L'~':?i{:'~ik1JlJ1LDING DIVISION' FINAL INSPEC'nONS '. [1A,TE I 'IN,sPECJO!- .
~i~*:t~%':~:~r~;;:l~t-,',.:,. , .' ',', ' .... -., '_:..-'
.," !~rINS.eECTION,RECORD. E.lectrlcaIFinal.'. .'. .' ..111'(J..,u ....<+1IA '. ~...,.
- ;/".<:',-,,,:.i-," .'. -, .." . ',-.,' ' -'.c- ,--,.'.','.- Cross C,onnec1lon Conttol.' ~
.....;:iLp~st.inll Conspicuous Place OnJhe'Jo~.. (714)765-42$0.. /1,. .if,w qJJ . ". .......
.Do noiotcupythi;'building uhtii the final insp~cti~nsh~veb~en made.' Plumbing Final." .' z--It/-df 0 ~. /I . ()
AD.DRES.S:. ......2190. '. N'RDBLDG4 c. ." . . '.' .... Mechanical Final h ". ..... ~~.1..'/,"
'PERMIT#:" DATE ISSUED:' .n 4A
OWNER:, ....... . VILLE .' .... . GasTest. '.' ". ' .' JI~,J1n/ I-rA:
DESCRIPTIClN:.Ne~5'I€>1 sq.f1. concrete tilt,upbuildin9.' .. Engineering/Grading Final . /l.-I",{iLl . ~... . .....
. . (714) 765-5126 .... '. N w,..;
..BUILDING PERMIT DOES NOT AUTHORIZE ELECTRICAL. PLUMBING OR . ..
MECHANICALlNSTALLATIONS. SEPARATE PERMITS ARE REQUIRED. . '. Fire Dept. Final (714) 765-4040. VI I ~16r-
. . . INSPECTION RECORD ..' Water En~eering :.' .
. . "INSPECTION ....'.1 DATE INSPECTOR (714)765 91, '. IJ.;6.11
Do not pour coricrete until the followjngAPPLICABLE items. . ".!!.u~.List/Business License '. /';'2? .;..
heve been signed: . . . . . .714,765-5194 . . . C/ ;:7''''(
Temporary Power Pole ". ..' .. /'. Zonillg(714)765-5139 I;!:/\;.,!df c-~ '.
Plumbing (Drain/Waste Pipe) <T '^ BUildln9Flnal(L.astlnspeciion.onIY, ,,/ ._ II -/,,;!J;O .
Electrical Ground ElectrodelUfdr,I""-:f {b,.!JiH ~ v . ..After Above Complete) -/'T-~"/ ~. ..
SetbackiForrnslTrenches (Footings) 'FINAL INSPECTION must p,e approved by the Sd' 6ingDivision..
Do n~tinstal! subfl~or or pour floor ~Iab untll.lhe"
folloWIAO aooltcable Items have been signed;
Plumbing (Water PipelSprlnkler Valves
Meehanical'(Groundwork) .'
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane/Rein
Underpinning (Floor Joist/Girders), I I'
Do Iiot cover or conceal the work below until the
following applicable items have been signed:
1 sf Floor. Shear . '.
Firesprinlder (Rough) . . .' .
2nd Floor Shear '. . .. .'
Roof (Sheathing/Diaphragm' Frame) ?--/-D4'
Masonry (Reinf./Bond Beam/Pre-Grout) I. . r . .. . /'
Rough Plumbing (Top Out). J ~ ' "-
Rouoh Mechanical' {/)(/-d'Y J .w- -o41'lli1.~
Rough Seetrical (Dry Wall)""' l/ ' ~ P""'
Rough Electrical .. \ .. .' .
FramJng'Only'afterPlm: Elec, Mech, an J.
Insulation (Sound/Energy) '. :./.
po not tape or pla~ter until the following 'l!ppllcable
Items have been signed:
DryWail '. teRM ?xLZl./l .
Pen.etratlons (Fire Rated) Electrical
Penetrations' (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath ,.. /l ~ "" /
Exterior Lath. . . Ii . 1~.
GENERAL ITEMS _
Exterior Plaster (Brown Coat)' /'....t,;.~ -r~ . .
T-Bar Electrical' -12." ~II. , .'
T-Bar Mechanical .
T-Bar Structural 1- 'U1. ~,
Sewer ~ .
Water Engineering Backflow . IL- ~ '
Water Service '. 'f- 'f_e~ III
Call. (714) 76S-4626 for Inspectionl :
'Requests made before 5:00 P:M. will be mad'e on the following
, work day, in m9st cases. .
.
I, ,I .
. .
'. ,AII.applicable items below must be signed before utilities .will be rele.sed.
, .'
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'BuS .....
PARTIAL INSPECTIONS
. .
Buildina Insoectioni; . /J' /. /J ~ . ~. .
. t,,,-//J 1Jc.f__rtlM/~ ~y /J".. I~".
'" ~ ,fA-4-'&' A ,.,- A'l/L /J fiJ
7.:.J<::kJi./ttJIA 41.' -tJ.../f/....') ,:I-. ..........
.tfJrJJ'J;''-;-'/.... A/fkA;d%' J.' .'
~--z,~.;.~..:u. oJ<L.s.mI~'7"Ta If'LU...:B.
\ .~.'~M-~ ~ v\-c;J\...-.. '.
. Mecha"nlcal. Insoec. .tions '" L . I ,
", q,....'Z-9.;aq.. d_r~L n' vo/('
I ......-10 J'tASdd-~ t,' OJ//, . ~['-dd~"
.-"hi./- '. . ......
~ -oY"FI2A"J IJ-oi..C .e>~41'"t;d..t>~ /-II>(
lo.'13'~ 1N5c.cL IS> 4..#C".L~_ 7~ .'Y .~
'. /> /
Plumbloa Insoections j,./
;Uf...oqj~O/ p.-:r,"b?$ .~~,
~~ 9...ZJ2.o<7 ~~C.UL.
~ ~;;i! 2;;;Zd~1v
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