4950 E. La Palma Av.
TYPE OF PERMIT
Tenant Improvement (Limited)
DATE: 3/1/2005
JOB ADDRESS: 4950 E LA PALMA AVE
LEGAL DESCRIPTjON: P BK 19 PG 26 PAR 4
CITY
'i<-~;:;i5~~-\~f~>:
i;-"I4f~~-~' -' ,': ",,~;.\'~.
F,"<!tffA,",:~) -}_ :'\'9*';\;: . - .
~m:~ll~-'lfK'H ElM
~~i2~~t;l<,~~
\~~~~~:1~/
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESnlNE:
(714) 765 -4626
<:ENSUS CODE: 437
QUARTER SECTION: 172
~(
BUILDING PERMIT NO. BLD200S-00531
CONTRACTOR INFORWlION:
"!HORPE CONSTRUCT!C", INC
4563 E EISENHOWER CIR
ANAHEIM, CA 92807 Gono'
BUSINESS PHONE: 714 77': 3811
JOB DESCRIP110N,enanllmprovement, convert 200081 01 office-space into '.,;arehouse
VALUATION: . 150,000.00
.C= OWNER'BUILDERDE_CLARATION
! ,her~by affin:n under penalty of perjury thet ! am exempt from th!3 Contractt)r'~Ucense Law for the following reason (Sec. 70315 Business and
Professions Code: any city orcountywhich requires a permit to com;truct, at:~r. improve, demolish or repair any structure. prior to its-issuance, also
requires the applicant for sU,ch permit to mea signed, statement that he is lic't:~n~d pursuant to the provisions-of the Contracto(s License law (Chapter
S)(commencing with Section 7000 of DiviSion 3 of the Business and'ProfessjiJils Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 703'1.5 by any applicant for a permit SU.b~~ct~ tt){: appllcant to a dvil penalty of not more than five hundred dollars,
($500). ',. . ,..
o I, as owner of property, or my employees witn '.Nage~ as their .<;ole com;':'-fnsation, will do the: work, and the struct~re is not intendedor offered for
sale (Sec. 7044 Business and Prof~;sions Code: The Contractor's Licen.<:;:e If.lW does not apply to an owner cf property who builds or i~prove5
thereon, and whodoes suCh work himself or herself or through his or her ol.f!\~ employees, provided that sur.;h lmplOVI3ments are ~ot if')tel'}!1edor
offered for sale: If, however, the building or improvement is sold with one,yei;r af completion, the owner-builder will hal/e the burden of proving that he
didnotouildorimproveforthepurpuseof-::.ale1, i' " '-" _
, ." . ". I. ..'.... '" '-.
o I, as the owner of the property, am exdusively contracting "","'lith licens~ c"OntractoTs to construct the project {See: 704.~ Busi'less _and Pmfessions
Cone: The ContractQr's licenSe Law does not apply to an owner.of prope;ty,'.:ho buMs or improves thereon, and who oor..tracts fer SlIth, Projeds with
fU;ontrador(sl ticen?ed purs.uarit to the Contractor's License Law). '
,U ,\ am exempt under Sec,. ,3 & P.C, for this reuscm: _ ',..'
Date: Owner.
I
APPLlCANr: SCHLUELER
OWNER INFORMATION:
Peter W Biche
'3220 The Strand
Hermosa Beach, CA 9L">254 .
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MJL
~
_ WORKER'S COMPENSATION DECLARAT!QrI
I hereby affirm under" pemilty of ~..erjury on~ of the following declaraiions: '. ,
.0 I have and _will'ma intain a certificate of.oonSent to :;elf-insure for v~crker'; compensation,
as pro'/ided for. by Section 3700 of the Laber Code, for the perrormaJ1:.;e of i/'i.~ v.fofk for which
~'s permit is issued,' :'
_ . '1 have and will'maintain worker's compensation inSurance, as ~quired t<; See.tion 3700 of
the 8bor Code. for the performance of the.work for which this permit .is lSS'Jt-.'f. My worker's
Cumpensation .insurance carlier and policy are: '
Carrier: STATE COMPENSATION PoliGY Number. 1589565')?'
This section need not be completed if ~e pemlit is for one hundred dollars {$1 oq~ odess. .
~. J certify that In the perforrnanceofthe work for whleh thi's permit is IsstJe~j. I 'shail not .
~lqy Cl:t"!Y ~rson i'n any manner 50 as to become subject to the worker's cirr:pensation laws-
of CaHfomia, and agree that if I should beeo sub' to the work's omptt.s"?tion
provisions of Section 3700 of the or Co 'El, I it pi it. -, ~~ proviSl ns.
3J.1J2005'
Date:
NUMBER
568357
TYPE
TYPE
EXPIRATION DATE
5/31/2005
Il
HIC
Dale: 3/.1/2005 Applicant:
WARNING: FAILURE TO SECUREW
UNLAWFUL, AND SHALL SUBJECT EMP eyER TO CRIMINAL PENAl TIES AND CIVIL
FINES UP TO ONE HUNDRED THO SAND DOLLARS ($100,00G),"IN AGD'TION TO THE
COST OF COMPENSATION,DAM GES AS PROVIDED FOR IN SECTiON 3;05 OF THE
LABOR CODE, INTEREST AND ORNEY'S FEES.
CON;! RUCTION LENDING AGENCY
I h_.et'''lbV;::lffirm undp.[ penalty Qtoeriury that there ~'3a cnnsf..ruction lending :~(,"..;.":ncy fo:" the
performance of the: work for which this permit is issued .(Sec.3097'.Civ ,C):
Lender's Information:
Construcicn Tvpes:
VN, ,
Fire Sprinkiered?
NO
Date: 11/2005
Fees paid for, Permit:
-rotal:
1.224,55
S gnature of _ pplican or ent
The p 't shall expire by limitation and become null ~nd void ifthebuilding or
work as. not passed fi nal inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work. .
, , iNSPECTOR
INSPECTION , , DATE
Temporary PowerPoie " , ,
Plumb! ng (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer , ,
SelbacklFC)rmslTrenches (Footings)
DO not install subfloor or pour floor slab until the ,
following appliCable items have been signed: ' ,
Plumbing (Water Plpe.Sprinkler Valves) I
Mechanical (GrOundwork)
Electrical (Ul1<ierground Conduit) , "
" Pre-slab (CompactlonlMemorane.KllInf.
Underpinning (Floor JOist/Girders) , ,
'DO not cover or concealthe woll< below until the ' , ' ,
foll0",ln9 applicable items h,ave been signed: ' "
1 st Floor Shear , ,
Flresprinkler (Rough)
2nd Floor Shear " , ,
Roof (SheathiIl!llDiaphragmlFrame) " ,
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out)
Rough Milchanical
~ugn t:Iectrlcal all)
Rough Electrical
Framing (Only alter Plbg" Elec.. MeCh.. and Fire)
inSUlation (SOllndlEnergy)
Do not tape or plaster until the following applicable ,
items have been signed:. . ,
DryWall , ' '
Penetrations (Fire Rated) Electrical' ,
Penetrations (File Rated) Mec:hllriical ' '
Penetrations (Fire Rated) Plumbing
,Interior Lath ,
Exterior Lath ,
GENERAL ITEMS ' '
Exterior Plaster (BlOWn COal) " , I
T -Bar Electrical
T -Bar Mechanical ,
T-Bar Structural
Sewer ,
Water Engineering Backflow
Water Service , , ,
INSPECTION RECORD
FINAL INSPECTIONS , Date !nspector
Electrical Final ,,'
Plumbing Final
Mechanical Final , ' ,
Gas Test , , ,
,Engineering/Grading Final 765-5126 '
Fire Depl. Final 765-4040" , ' ' '
Water Engine~ring 765-5268 ' ,,' ' ,
" ,
Sub List/Business Licerise 765-519<
Zoning 765-5139 ,
Building Final ~ast inspection- Only \ ' 1~1t~ ~J,d'
fter Above Complete) ,'~'
PARTiAl INSPECTIONS
'"
BLiildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections