2586 E. Lark Ellen Ln
TYPE OF PERMIT
Re$idential Addition . CITY
DATE: 11/2212004
JpB ADDRESS: 2586 E LARK ELLEN LN
LEGAL DESCRIPTiON: N TR 9425 LOT 26
?,-';:;0~:::,]i~~~. .
. "1'1~"-4;;~,,c~~:o..~,,;..~
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~ili.1~1)I~ EI M.
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BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REOUESTLlNE:
(714) 765 - 4626
CENSUS CODE:, 434
QUARTER SECTION: 126
BUILDING PERMIT NO. BLD2004-03418
APPLICANT: TOAN LE i
OWNER INFORMATION: CONTRACTOR INFOR~:ATIOW ARCHITECT/ENGINEER INFORMATION:
Toao Q Le DONALD J INMAN
2586 E Lark Ellen Ln (5131 mx HILLS AVE,
Anaheim; CA 92806 BUENA PARK, CA 90621
JOB DESCRIPTIONRoom Addition: 1;t floor family room"exten,sion &'2nd fl.i?r master bedroom e~tension.
"
VALUATION: 36,500,00
, I OWNER.BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractqr's Licens.e La'N for the following reason (Sec. 7031.5 Business and
Professions COde: any dty or county which requires a permit to construct ..7::ter, 'improve, demolish orrepair any structure, prior to its issuance, also
requires the applicant fOJ such permit to file a signec;fstatement that he is !i(enSed purs.uam to the provi:?ions of the .Contraqtor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profe~<'()ns Code) pr that he is exempt therefrom and the basis for ,the alleged
e~emption. ft.n,y v.iolation of Section 7031.5 by any applicant (or,a,permit S'~j~"cts the applicant to a dV'U ,penalty of not more than five hundl-ed dollars
($500), ' .', J, '
o . I, as owner of property, or my, employees with wages as their sole cQIT\pe-nsatioll. will do the work, and the structure is not intended 'or offered for
sale (Sec'. 7044 Business and Professions Code: The Contractor's License':U'lw does.not apply to an owner of property who builds or improves .l
thereon; and who does such work himself or herse!for throuQh his or her c~}n emplcyee~, provided that such improvements are not"intended or~
'offered for sale., If, hoWever, the buil.ding or im'provement hi; ";'old with one y,:Jgr of compietion; the owner-q~ilder will have the bUrden otproving,tha.t he
i:.id at build or-improve for the purpose of.sale)" '1/ , : '
- I;'.as the own~r of the property, am ,exdusively contmctin~ with 'liCen~}:;~~,cO(ttral10rs to qonstrucot"the Pf.oject (Sec, 7044,BUSi~l~s,and.Profe~.sions
~ de: Th~ Contr.actC?r's Licen.se Law doe>s .not apply to an owner Of~)i"cpe.t~jWhO q'Jilds: cr implov~s thereon, a(ld wnocontraclsfor such projettswith .
.~ontract.or(s) lic~n~ed -pursuant to the Contractor's license Law), ,I. " ,. . .' . .. ,-..
LJ.. -exempt-under,Sec. ,B P~C. for this reason: '-';"___:~. _ ' .. _ ..
'Date: 11-'2-2- ..<H' O,;mer: , 1
. . WORKER'S C PE ATlON DECLARATIO~.=t_.;....__1
.1 he~eby affirm under penalty of perjury ~m~ of the followii;g declarations: .. "$. .
o I have ,an_d will- ..rialnlain a c!3ttificate.of .consent to self-inslJre f0r WCTk€l!js cOlJlp19nsat!on,
as providedfor by Se<xion 3700 of the labor-Code, for the performance of.hG work for which
this permit is Issued. : J '
o I have and wH,1 m~intain worker's compensation fnsuranc~, as :equired ~y Se~tiorl 3700 of
the Labor Code, for the perfqrmar.ce of the work for which this permit is !;:;Sl.~d. MY;Norl<er's
Compensation insurance carrier and pOlicy are;. ':i
Carrier: Policy Number.;
jhi s~tian need' not' be oompl~ted if the pennit is for one hund~ed' doUars ($1 D;~'''''_lfsS. . .
I certify that in the performance of the work for which this permitis i~i!;;~d".r~hC3 n not
. eloy any person in any manner-so as tobecorne subject to the worker's C:Jrn:~~nsation !C\.ws
of Califomia, and agree that if J should become subject to ioe WOrK"3r's comdJ.-ns'atiqn
provision.s of Section 3700 ofth~ Lab~r Cod I shall forthwith comply w!th t~0_se pr6visions,
PROCESSED BY: JJJ
.. LICENSED C~NTRACTORS DECLARJ\TION I
. I hereby.affirm under penalty of perJur,y that! am
Ilcensed underprovislons of Chapter 9 "(commencing
with Section tOOO) oi DivsiOn 3 of.-theBusiness and
Professions CodA.
11'/22/2004
Date:
Contractot
NUMBER
EXPIRATION DATE
TYPE
.' Date: 11/22/2004 Applicant:
'WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVE!';o,GE1S
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAi-TJ!;S AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS 1$100,000), IN AmmON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlo;:,3706 OF THE,
LABOR CODE, INTEREST AND ATTORNEY'S FEES" .: '
'jCONSTRUCTION LENDING AGENCY
, hereby affirm l~nder penaltj of perjllry that there is a constr'Jctlon'!<):'1dip.Q r.~er.~yfo(the
performance of the work for which this permit-is issued (Sec.3097 ,Civ.C)'
_ ~'3nd~r's: Irt.f2r~ati?J~_: .
ConstrLic;ion Types:
VN. ,
Occupancy Groups:
R3, , ,:,
Fire $prinklered?
LivinQ Area:
NO
414
I certify that I have read this application and state that the above information is correct. J
agree to oomply with all city ordinances and state laws relating to building construction, and
herebYauth~e. presentives of this city to enter. upon the,abovementioned property fC?r
10"1..100 pu ses, .,
.. .~ .' Dale: 11/2212004
t7. Signatureo! Applicant or Agent
The permitshall 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 for Permit:
Total:
1.249.51
. INSPECTION RECORD
INSPECTION. DATE INSPECTOR
Temporary Power Pole . . .
Plumbirig (DraintWaste Pipe)
Electrical. Ground Electrode/Uter .
Setback/FormsfTrenches .(Footings) .
Do not install subfloor or pour floor. slab until the
following applicable itenishave been signed: .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork).
Electrical (Underground Conduit) I
Pre-slab (CompactionlMembrane.Reinf.)
Underpinning (Floor Joist/Girder~) ..
Do not cover or conceal the work below until the
following applicable items have been signed:
., 5t FloOr Shear . . : J.jf1-!>K t'f1I"L~
Firesprinkler (Rough) . !J . .
2nd Floor Shear -iq-O~ il,. (1"
Roof'(Sheathing/Diaphragrn'Frlme) l.fIl-O" . II"
Masonry (RelnfJBond BeamlPre-Grout)
Rough plumbing (Top Out) .
Rough Mechanical .. . .
I ROugh aectncallllrY wall)
Rough Electrical . . . .
Framing' (Only after Plbg., Elec.. Mech.. and Fire} /.'t().()~ '/U, ./hn. . .
Insulation (SoundlEnergy) n-
Do not tape or Illasler untillhe following applicable
items have been signed: .'.,
Drywall . . r.t.~'(JS (, I.. /Jj
Penetrations (Fire Rated) J:lectricaJ 1/(/
Penetrations (Fire Rated) Mechanical . .
PjlIletrations (Fire Rated) Plumbing
Interior Lath . . ,
. Exterior Lath . . 1/.'lJ.'o.
" GENERAL ITEMS .j
Exterior Plaster (Brown Coal) ~/"t ,/I.. .
T .Bar Electrical .... 'p
T-Bar Mechanical .. . \ .
T -8ar Structural. . .
Sewer ..
Waler E:ngineeriilg BackfJow ..
Water Service .
. FINAL INSPECTIONS
Electrical Final
Plumbing' Final
Mechanical Fina1
Gas Test
Engineering/Grading Final 7SS-5126
Fire Dept. Final 765-4040 ..
Water Engineering 765-5266
Sub List/l!usine5s License 765-51.9
Zoning 765-5139.
BUilding Final ILastlnspection- Only.. <Z~..,
After Above Complete) " v, u
PARTIAL INSPECTIONS
BuildinQ Inspections
Date . Inspector,
1"r(;,.
.
MechanicallnsDections
..;..
. PlumbinQ InsDections
ElectricallnSDections .
TYPE OF PERMIT C
Residential Addition ITY
DATE: 1/11/2005
JOB ADDRESS: 2586 E LARK ELLEN LN
LEGAL DESCRIPTION: N TR 9425 LOT 26
ElM
BUiLDING DIVISION
200 S: ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REOUESTLlNE:
,(714} 7.65 - 4626
CENSUS CODE: 434,-
QUARTER SECTION: 126
BUILDING PERMIT NO, BLD200S'00041
APPLICANT: TOAN LE
OWNER INFORMATION: CONTRACTOR iNFORMMiON: ARCHITECT/ENGINEER INFORMATION:
Toan 0 Le
2586 E Larl< Ellen Ln
Anaheim, CA 92806
JOB DESCRIPTIONRoom Addition. 1st floor family room extension & 2nd floor ,master bedroom extension. (Supplemental building permit #
VALUATION: BLD~~?~if3~18) , , PROCESSED BY: DUe
I OWNER-BUILDER !)ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractcr':i License law for the following reason {Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alt~r" improve, demolish or repair any structure, prior to its issuance, a/so
requil:esthe applicant for such permit to file a signed statement that he is !iceilscd pursuant to the provisions of the Contractor'::;; License law (Chapter
9)(commenc1l1g with Section 7000 of Division 30fthe Business and Professi(j~;s Code) or that he is exempt'therefrom and the basis fof the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit sUbj}:::c,ts the,applicant to a civU penalty of nqt more than five'hundred dollars
~~O?)_~s owner of property, or m/emPJoyees with wages as their sore corrIP~ati'Jn, wiil do the work, and the structure is not Intended 0 r Offere~ f~r
sale (Sec. ,7044 Business and Professions Ccch~: rhe Contractor's license L~,pN does not apolyto an owner of property who buildsor improves
thereon, and who does such work himself or herself or through hiS_Or her owr;'i;lmployees, provided that such improvements are not intended or '
offered far 581&. If, hpwever, the building or Jmprovement is sold with one Yr.k'of oompletion, the' owner':builder will have the burden of proving that he
did not buUd or improve for the purpose of sale). . oj)
o 1,;35 the owner of the property, am exdusively contractingwiih licensed <on tractors to construCt the projec.t(Sec. 7044 Business and Profe~ions
Code: the Contr'actor's License Law does not apply to an owner of propertyf'ho bui!<1S or improves ttJereop, and who ':On tracts for such projects with
~n1ractor(s) licensed pu'rsuant "to the Contractor's LiGense Law). - ;.
I am exempt under Sec. . - ,B P.C. for tl.s reason,: .l
:.1::.. /,.0 O#ner: . , '
- -. . WORKE 1$ CO ,NSATION DECLARATION~__-----.-J LICENSED CONTRACTORS DECLARATiON l
I, hereby affirm under penalty ofpe~u!y one oftha followi~g declaration::;~ J, I hereby affirm under penalty of perjury that I "am
o I have and will maintaiO a certificate of consent to self-insure for wcrher'.~ '~or.1pen$ation, licensed under provi3ionsof chaptef 9 (c.ommencing
as provided for by Section 3700 of the labor Code, for [he perfor'mar.~ of th~ v....orK fQrwhlcn' With SectIOn 7000) of OivslOn 3 of the Business and
this permit is ISsued. I' ProfeSSIons Code.
D I have and will mamtaln worker's compensation Insurance, as reqwi'ed bi Sectbn 3700 of 1111/2005
the Labor Code. for the. performance of the work for which thIS pp,rm!t IS Issut;';1. My wor!;er'os' Date: Contractor
Compensation Insurance carrier and ,poliolare:
Carrier: PolicyNumber. NUMBER' .EXPIRATION DATE
ThiS ,section need not be completed if the pennit. is for one hundred dollros ($1l)D:-tpi: less.
rxr'l certify that in the performance of the work for which thiS permit is issu.;::(~:;'i shall not
~oy any person in any manner s as to become subject to the worker's cOfO'pensation laws
. of California, and agree that if I shou become subject to the worker's cOrTlPEi0!jation .
pro'/1sions of Section.3700 of the Labo Co e, I sh forthwit compiy witi:: th..;~'e provisions.
TYPE
Date: 1/11/2005 Applicant: ,
WARNING: FAILURE TO SECURE OR COMPENSATION COVER-.GE IS
UNLAWFUL;AND SHALL SUBJEp'T AN EM LOYER TO CRIMINAL,PENALf!lOS AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OOO),'IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION $706 OF THE.
LABOR CODE, INTEREST AND ATTORNEY'S FEES,,'
CONSTRUCTION LENDING AGENCY
I hereby a.ffirm under penalty of perjury that there is a cqrtstruction :ending ag,~ncyfor t~e
performance of thework for which this pp.rmit is issued (Sec.309-7 .Civ,C):
- Lender's Information:. - -, "
Construcion T.ypes:
VN, ,
Occupancy Groups:
R3" "
Fire Sorinklered?
UvinQ Area:
NO
414
I certify that 1 have read this application,an~ state that the abaveinformation i3 correct. 1
agre 0 comply with all city ordinances-and state laws relating to build~ng construction, and
her y authorize repreSentives of this city to enter upon the above mentioned property for
ins ection' rposes. '
Date: 1/11/2005
Fees paid for Permit:
Total:
325,22
Signature of Applicant or Agent
e perml ~shall expire by limitation and become null and void if the building or
ork 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
INSPECTION . DATE INSPECTOR
Temporary Power Pole "
Plumbing (Dl3inNVaste, Pipe) .
Electrical Ground ,Electrode/lifer .
SetbacklFormsrrrenches (FootingS) .. 1_1- r;a /.1 .., 1>
. 00 not installsubfloor or pour floor slab until the, ' . .
following applicable items have been signed: .
'Plumbing (Water Plpe.Sprinkler Valves) ,
Mechanical (Groundwork) . "
I Electrical (Underground Conduit)
I Pre-sIaD (Con1pactionlMembrane.Reim.) " '0 I /JI vJ'P
Underpinning (Roor Joist/Gl Ill81's) , . , If I
00 not cover or conceal the 'work betow until lhe
following applicable items. have been signed:
1st Floor Shear ' , ' /.19.f)c Lt1.I"~/J ,
Firesplinkler (Rough) , If I
2nd Floor Shear . ).)4.r;....r [. J.~,
RQof (SheathiIllllOiaphl3gmlFrame) rl~JI.# " .
Masonry (Reinf./Bond BeamfPre.Grout) .
Rough Plumbing (Top Out) . . " ,
Rough Mechanical
RQugh Electrical (Dry Wall) .
Rough Electrical , 1.'M::Ji A
Framing . (Only after Plbg" Elec.. f,1ech.. and Fire) /11
'Insulation (SOlIndlEnergy) ) "'~-;;~ .n... .
Po nol tape or pla~teruntil tne follOWing applicable .
Items have been sIgned; C , ' ,
DryWall " , /-14'0. 'J. /1..
Penetrations (Filii Rated) Electrical (, 4
Penetrations (FIlii Rated) Mechanical , ,
Penetrations (Filii Rated) Plumbing , ' ,
Interior Lath '
Exterior Lath ' /'1-!.-/J. 'I.:/J,.
. , . " ' , GENERAL ITEMS A
exterior Plaster (BlOWn Coat) , IN "",'. I.~fh ,
T.Bar Electrical , ,
T -Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow .
Water Service . . ' ,
~
FINAL INSPECTIONS Date Inspector
E,lectrical Final , " 'Sk:~.jo'\" / A. I" /I,
Plumbing Final .' ,j!!
, " .
Mechanical 'Final , , ,
Gas Test "
Engi.-ringlGrading Fillat 76505126 ' '
Fire Dept. Final 7654040 . ,
"
Water Engineering 765-5268 '
Sub list/Business' License 765.519 z/-es/oS" if'G ,
Zoning 765,.5139 .' '
Bullding'Final, !l:aSllnspection. Only , 3k~1< /"tfI, 1/
iter Above Complete) ,
, PARTIALINSPEC"IONS (f/
Buildina Insoections
Mechanicallnsoections
Plumbina Inspections
, Electrical Inspections