303 N. La Reina St.
BUILDING PERMIT NO. BLD2004-01857
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8UILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
.. INSPECTION REQUEST LINE:
(714) 765.- 4626
CENSUS CODE: 434'
QUARTER SECTION: 19
.TYPE OF PERMiT. .
Residential Addition CITY
DATE: 512012Q04.
JOB ADDRESS: 303 N LA REINA ST .
. LEGAL DESCRIPTION: N TR 3007 LOT 1 .
. APPLICANT: RUBY AQt..iIRRE~'1/tl)qSP< -3(",40
OWNER INFORMATION: . CONTRACTOR INFORMAflON:
. Ruby G Aguirr.e .
303 N La .Reina 8t
Anaheim,.CA 92801
JOB DESCRIPTIONRoom addition (HIHl
VALUATION: 21,000.00
I' OWNER-BUILDER9ECLARATION
I hereby affirm under penalty of pertury that I am exempt from the'~ontractcr'.~_licen5e Law for the following' reason'(Sec. 7031.5. Busili~ss and.
:Professions Code: ,any qty or county which requfres a permit to construct, aJt<r, improve, demoJishorre~ir any structure, priortoits iss'uance,' also
"requires-the applii::ant for'such permitto file a signed statement that he is Iic€!r~sed pursuant to the provisions qfthe 'Contractor.'s,.License Law (Chapter
9)(commen9lng with Section,7000 of Division 3 of theB,usiness andProfessic;1s Code)or"that he is, exempt t!1erefrom and the basis for the_~\leged
,(;~~. tion, Any violation of Section 7031.5 by any applicant for a permit .units the applicant to .-dvil penatty of not more than five :hundred doilars
n,,' as owne/:"of prope,rty, or my employees with wages as their sole compi.psation, will 00 the work, and the, structure: is not iDtended oroffered'for,
sale (See.7Q44 Business and Professions Code: The Contractor.'s License L;Jwdoes not apply.to an owner of property who builds or improves, " ,
'thereon, and who does such work himself,orherself or' throug h his 9r her ownlempioyees, provided that such impr6veni~~ts are not intended or , ,
offered for sale. 'If, however, the 'build ing _or improvement is sold with one yea'-of completion, the owner..buiJder will have the burden of proving.that he
did not build or improve.for thepurpose.of sale). ',j.' '.' . ,;. ,
.' 0 _I,as the, owner of the property, amexdilsively contracting witli .licensed I..:,:mtractors to construct the project (See. 7044 Business_an<J professions
Code: The G9ntractor's -license Law does not apply to an' owner of-property ~':'ho builds or'improves thereon, and who co:1tracts for such projects with'
'. EJ~ntractor(s) I,icensed, pursuant t'o the Cont~actor's License Law). ,- , ' '.
'1 am.ex mp _under See.., . , ,', & P C. fo i reason:~ '_I
Date:'~ 0 Owner: , A '
ARCHITECTIENGINEER INFORMATION:
PROCESSED BY:CDL
WORKER'SCOMPENSATI N DECL:ARATION
I hereby affirm wider penalty 'of perjury one of the' following deClarations:
D I have -arid will maintail1 a certi~cate of eonsent to self-insure for wtJrker's:compen,satioll,
as providep for by Sedion 3700 of the Labor Code,for the peiforry;ance ofthf'WOrk for wh'id:l
this. permit is issued. . . ~
. 0 "rhave and will maintajn worker's compensation insurance, as required by:SeCtiol13700 of
the Labor Codel for the performance of the work for which this, permit is i~:sLJe':. Myworker'3
Compensation insurance carrier and policy are: ' ,.
Carrier: Policy Nu mber:
.;.._.
~
LICENSED CONTRACTORS.DECLARATION
I hereby affirm unde~ penalty of.perjury that I am
licensed under provisions.!;)f chapter 9-.(commencing.
'with Section 7000) of Di~ion3'ofthe Business and
Professipns Code. ".'
5120/2004
"Date:
Contractor' ,
NUMBER
EXPIRATION DATE
Th.s~ection need not be,completed if the pennins tor one hundred.dollars ($100) Jr _less.
>~ Icertify th~t in the pE;lrfonnanc~:~fthe work for which this permit ~s issue('~'l,.~~~" ~t
employ any person in a'ny manner so as to become subject to the workei"'s~~~npensation laws
'of California, and .agree that if I-should become 'subject t~,t!1e worker's compe..s3'tion '
provisions of Section 3700 of the Labor God ,'I shall forthwith_com~ly with thcseprovisions:
Date: 512012004 APplicant: .
WARNING:, FAILURE TO SECURE WORKER'S C MPENS~ ION COVERPG.~ IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL-lES AND CIVIL
FINES UPTO ONE HUNDRED ll-iOUSAND DOLLARS ($100,000), IN ADDr.10N TO THE
COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SEC'nON :'706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I . ... .. CONSTRUCTION LENDING. AGENCY . .., .
I hereby aff.irm LJnder penalty. of perjury that there IS a construction lending a!;~,....cyfor ttie
_ .p'erf,?rm~nce of.~e work for whi'ch this p~rmit is: issued (See.3097 ~Civ:C):
L.,;r:c.~r'$~jlf.:"-I.I3.~'vll: ~- -- -- -~.- .--------.....::....
TYPE
Construcion Types:
VN, ,
Fire $prinkleret:l? NO
Qwellinq- Units: 1
LivinQ Area: 3.12
I certit)' that I have ;ead this appli~ation and state that the above' information ie correct. I
agree to oomply with'all cityordinances and- state laws rela~ing to building con;truction. and
hereby authorize representives'of,this city to enter upon the above mentioned pro~rty for '
in~pectio pur-poses.
Fees paid for Permit:
Total: 2.10
,
Date: 5/20/2004
~ignature 0 ppJicimt or Agent.' '.' .
TIie.permit shill I 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. .
-
. . . INSPECTION RECORD . . FINAL INSPECTIONS .' Date Insp~r
INspEcnON .' . . I Electrical F,inal. . . . f';,Mfv{ .A!~.
..' . DATE INSPECTOR
T einp~>rary PoWer. Pole . '. Plull1bingFinal . . . c' I. .
. .' .
Plumbing (DralnlWaSte Pipe) .' Mechanical Final C;;(2.Y'" '-Afl_X
Electrical Ground ElectrodelUfer ~ A .
. . .: .
SetbacklFor.rns/Trenches (Footings) 22 _ --- . Gas Test . .
Do:not install subfl06r or pqurfloor slab until the .fI')/ EngirieeringlGrading Final 765-5126 .'
. following applicable items have been signed: '.
Plumbing (Water Pipe.Sprinkler Valves) . Fire Dept. Final 765-4.040 .
Mecha'nical (Groundwork) '. .,. Water Engineering. 765-5268
Electrical (Underground ClltldUit) . .
. ,h~IIil""
Pre-slab ((;ompaclionlMembrane.Reinf. - . . Sub .ListlBllsiness License 765-519 T'~V
Underpinning (Floor JoistlGirders) .. 'l1~/6 ....^ . Zoning 765-5139 .' . , . .
. ". ~ .
.Do nol cover. or conceal the work below uhtil the. Building Fina.1 ~ast Inspection- Only 4~1r- .--
following applicable itenjs have been signed:' . . fler Above Complete)
1 st Flllor She/lr . . . . .' '. PARrlALINSPECTIONS .
FiresprinkJer(ROugh) .' . . . .
2nd Floor Shear . . I ~7:nh~s~~~/NSU' A~~.
RO~~D1aphlligmlFrame) , '~.-'::
Masonry In JBond BeamlPre-Grout) . I '. f ", ..~
Rough Plumbing (ToP. Out) . .Pt~ 5#F-P:n~ .NA7l--0~j;J
Rough Mechanical,. . '.. . .
ROugh Bectncal (DryWall) . . .
Rough Electrical' ..... .. . . ..... .'.
,Framing (Only afterPibg-., Elec.; f..lech:. ar]d Fire) . . .
Insulation (SoundlEnergy) '. -
Pllnot tape qr pla~ter until the following applicable Mechanical Inspections
Items have be;en signed: ; - -. . . .' . '. .
Drywall' '.' . . .'
!,eroetrations (Fire Rated) Electrical . . .,.,-, . " . .' . .
Peroetrations (Fire Rated)l!IIechanicaf . . '.
Peroetrations (Fire Rated) Plumbing . . .-
Interior Lath . : .
. .
.~ Plumbina InSDections .
Exterior Lath '. Ir(}l!NtJ
, . . '. GENERAL ITEMS . . .. ....
.
Exterior Plaster(BiOWn Coat) . 1/11 I.... .' .
T -Bar'Electrical , I .
.
T -Bar Mechanical '.' :-c- . .
. . .' .
T -Bar Structural . . . '. . . '. .
Sewer . " . .
Water. Engineering Backflow Electrica'Inspectlc)ns . .
Water Service . -C"
I. . .