2465 W. La Palma Ave.
BUILDING PERMIT NO. BLD2003-04438
TYPE OF PERMIT
Seismic Upgrade .. CITY
DATE: 11/24/2003
. JOB APDRESS: 2465 W LA PALMA AVE
LEGAL DESCRIPTION: T 4 R 10 SEC 6 POR SW114
APPLICANT: DAVID FRIESEN
OWNER INFORMATION:
2000 T Salsbu ry
2465 W La Palma Av~
Anaheim. CA 92801
BUILDING DIVISION
200S.ANAHEIM BLVD.
(714)765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 24
CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
FRIESEN CONSTRUCTIC,N SERVICES
1919 ASPEN CIR
FULLERTON, CA 92835 oeoo
BUSINESS PHONE: 714990-1894
VALUATION: 14,000.00.
I .OWNER-BUILDER'DECLARATION
I hereby affirm under penalty of perjury that I am exempt from'the Con~ractofp: License Law for the follOWing reaSon (Sec. 7031.5 Business and
P.ro,fessions Code: any dty or county which requires a permit to construct, a itr. r. improve, demolish or repair any structure, prior to its issuance, also
. requires the applicant fo_r such permit to file a signed statement thathe is Iic~.lsed pursuant to the proVision,S of the Contractor's license Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and ProfesGi(ns Code) or that he'is exempt therefrom and the basis for the alleged.
. exemption._Any'violation of Section 7031.S.by any applicantfar a permits.ut~ects the applicant to a civil penalty of not more than five hundred dollars
($500). . . ..; .
o I, as' owner of property, or my employees :with wages as their. sole corTlp:msation, will do the work,' and .the stn.icture is not intended or offered for'.
sale (Sec. 7.044 Business and Professions Code: The Contractor's License W..... does not apply to an owner of property who builds or improves
thereon, and who dOes such work hims~Jf or helself or through.his orh\3r o'J':~i employees, provided that such improvements are not intended or .
offered for saie. If,however, the build.ing or tmprovement is sold with oneye~(' of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).. t! . . .
D I, as the owner ofthe property, am exdusive_1y cOl'Jfracti~g with licensed ~~.onti"~ctors to construct the project (Sec. 7044 Busine;ss and Professions
Code: The Contractor's License Law does not apply to-an owner of property jV;lO ;:'uilds or improves thereon, ar)d whorontractsfor sudl.projects with
fl..qontractor(s) licensed pursuant to the Contractor's License Law):
U I am exempt under Sec.' ~ B & P.C. for this reason:
Date: '. Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of oonsent to self-inSure for workel'~ cc:npensation,
as provided for by Section 3700 _of the.Labor Code, for the performance, ofthl\.work 'forwhich
this permit is issued.
o I have and will maintain worker's compensation insurance, as requiredty S~ctiOJi 3700 of .11/24/200
the Labor Code, for the performance of the work for which this permit is iss-ll:.d. Myworker's Date:
Compensation insurance c;arrier and policy are:' .
'Carrier: Policy Number...EXEMP1
T. is tion need not be'completed if the perinitis for 'one hundred dollars ($10Gi.'oi '~~~'__ ..
I certify that in the perfoffilance oft.he work for whiCh this permit is issu~d.l, sliaU-not
ploy any person in any manner so as to become subject to the Worker's cv41'pensaiion laws
alifomiaj and agree that if I should becom subject to the WOrk~'~;S 'COTPC:flsCltioh-~'-';
provisionsof'Section 3700 of the Labor Code, hall ~ rt ithcof!1plywith tl-'ose provisions.
. JOB DESCRIPTIONSeismic retrofit for walls.
PROCESSED BY: DUC
LICENSED CONTRACTORS DECLARATION
I hereby affirm un~erpenalty of perjury tt1at I am
lice.nsed under provisions of chapter 9 (commencing
with Section 7000) of Divskln 3 of the Business ahd
PTOf~ssjo s .ad
NU BER
463944
TYPE
TYPE
TYPE
-'--
EXPIRATION DATE
6/3012004
B
C10
'HIC
Construcion Types:
VN, , .
Fire Sprinklered?
YES
Date: 1112412003 Applicant:.
WARNING: FAILURE TO SE RE ORKE
UNLAWFUL, AND SHALL SUBJECT AN EM
FINES UP TO ONE HUNDRED THOUSAND OLLARS ($100,000), IN ADU'!lJO.~TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR II!,rS ECTI Qi:J :e7Q6 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .
I CONSTRUCTION LENDING AGENCY '.?:
I hereby affirm under penalty of parjury_ thatth~!e.!s CI ~ol1~~~n~:tI'~f:!.at?~v;fQ';'Jb&~......Y _
t::~-livrnlC:lnce ot !..,eworK Tor whici1. this permit is issued(~ec.309i' .Cr/.C}. ~--.o.
lender's Infonnation:
I.certify that I have read this application and state that the above information IS correct. I
agree to oomply with all city ordin-ances and state laws relating to bu ~djng cor:struction, and
hereby author representives of this city to enter upon the above memtioned property for
inspection pur s.
Date: 11/24/2003'
ure of pplicant or Agent. .
pire limitation and become nun and void if the building or
work has no as Iltal inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
464.21
INSPECTION RECORD
...,.. .
. INSPECTION DATE INSPECTOR
Temporary Power Pole .
Plumbing (DrainlWaste Pipe) .
.
'Electrical Ground Electrode/Uter .
SetblicklFormslTrenches (Footings)
Oo'not install su.bfloor or pour floor slab until the .
fOllowing applicable items have been signed: .
Plumbing (Water Plpe.Sprinkler Valves) . .
Mechanical (Groulldwork) . .'
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf. . .
, Underpinning (Floor Joist/Gin:Jers) '.
00 not cover or conceal the work below untIl the .
following applicable items have been signed:
. 1 st Floor Shear . . .
Nresprinlder. (Rough) .
. 2nd Floor.8hear .
RooflSheathing/DiaphragmlFrame) .
MasOnry (ReintJBond BeamlPre-Grout)
Rough Plumbing (Top. Out) -,-- . . .
Rough .MechanicaL.- .
RoUiill8ectrical1lJiYWiillT
. Rough Electrical .
Framing (Only a~er Plbg.. Etec.. Mecll:and Fire) .
Insulation (SoundlEnergy)
00 not tape or. plaster until the following applicable
items have been signed: . . . . I.
. Drywall . -,-- - . '.
Penetrations (Fire Rated) Electrical . . .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath- .
Exterior Lath . .' . '.
GENERAL ITEMS
Exterior Plaster (Brown Coal) . I
T -Bar Electrical .
T -Bar Mechanical
T -Bar Structural
Sewer . .
. Water Engineering Backflow
Water Se'rvice '. I.
FINALlNSPECTIONS Date Inspector
Etectrical Final . .' .
piumbing Final
Me-chanical 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 \kasllnspeclion- Only '.(z-z:-~ '-'.13~ &>ff-
fter Abbve Complete)
. .PARTIALIN$PECTIONS
Buildina Inspections
Mechanicallnsoections
. Plumbina Inspections
Electrical Inspections .