3159 W. Lanerose
. BUILDING PERMIT NO. BLD2004.01509
TYPE OF PERMIT CITY
Resideniial Remodel .
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPE.CTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: . 434
QUARTER SECTION: 11
. DATE: 5/27/2004
JOB ADDRESS: 315~ W LANEROSE DR
. .
. ..
LEGAL DESCRIPTION: SEC 23 T 4R 11 W 330 FT NW1/4
APPLICANT: RYAN RUDNICK
. OWNER INFORMATION: CONTRACTOR INFORrv'ATION: .
Rya~ S RudniCk
3159 WLanerose Dr.
Anaheim, CA 92.804
JOe DESCRIPTIONRe.lssue expired permit for wlndm11/48949.
ARCHITECT/ENGINEER INFORMATION:
BERNARD ADAMS
11022 E. ACACIA pARKWAY
GARDEN GROVE, CA 92640
VALUATION: 2,000.00
I OWNER.BUILDEI'ioECLARATION
.1 ~ereby affjrm under penalty of perjury that I am exempt from the Contra.cto--:s License La~ for the following reason (Sec. 7031.5 Business and .
Professions Code: any dty.or county which requires a p~rmit to construct, Cl:'::er, improve, demolish pf repair any structure:. p~k?r to its issuance, also. .
requjres t~e applicant fpr such permit to file a signed statement that he is li?:~t1Sed' p.ursuant to the provisions of the Contractor's. License law (Chapter.
9)(commencing w;th'Section 7000 of D.ivision 3 of. the Business a nd Profeg'si,~nsCode) or that he is exempt therefrom and'the_basis for the alleged.
exemption. . violation ~f.Section-7031~5 by any applicant for a perin:t sG!.::i€:cts 'the applicant to a civil' penalty of notrDOre tharffive-hundred dollars'
(50Q).... . . . . . .
s-ovv:ner: of property, or my employees with wages as their sole comf~nsatior:, will calhe work;and the structure is not intended or offered for
sale'(Sec. 7044 Business and Professions Code:- Th? Contractor's License ;:...av: doe_s notapplyto,an 'ownerof property who ,builds orimproves.
the reon,. and -who does such work hi rnself -or he rself ~r throug h his or her 6";_,': employees, provided that such i rnprove ments a renot' intended 0 r
'offered fo~sale. If;however, the_building or. improvement is sold 'with oneY(2r"of compietion, the owner-builderw!llhave theburdell of proving that he
did not bUild or !mprove for the 'purpose 'of 'sale). ": 1"', ' .,'" .
:'0 I, as the owne~'ofthe property, am exdusively contracting with licen;;E:(.,f.:;ontractors tc ton5truct The project (Sec. 7044 l3usineSs arid Professio,ns
Code:, The Contractor's -Ueense. Law do~ not apply to"ano~..,er o~ IJropert'l'....vho'bul:ds or imprOVes thereon, '::tnd who contracts_f9r sudl projects with
r:::1ontraclor(S).licens-ed pl.J!"suant to the Contractor.'s'Licerse Law). ' .
~'Ia .~xemptu. ndetSec.., ". -;8 & ,P.C,'forthj~ reason:.. . \-.
. a: - -,;1. . . Owner: 2 ~. _ /' c:-;;;-"
WORKER'S COr;(PI:NSA~1fbECLARATION' ~~.-~
I hereby affirm.under pellalty of perjlJry one of the following. declarations: " .
o . J have a~d will ma intain 'a ~ertificate of conSent to self-irls~re'for worker;. compensati~n,
as' pr:ovlded for .by-Section 3700 of the Labor COde, for the performanCe 'ofbl};; work for which '
. this permit is issued. . , ,
o I-have and will m'aintain worker's cOfTlpens;::t~ion insurance, asreqlli~d..:-i Section 3700bf
the _ Lab~r ~od a, for the performance of the work for wh ich th is permit .isissll:.~. My wo rker's
Compensation insurance carrier and policy are: . .. .
Carrier: . Policy Nu mber:.
, This section need n<?t be, completed if thep~nnit is tor one hundred dollars {$1 O/j 01' :25S.
o I certify that in the perforrnanceofthe work forwhichthis'pe'rmit is.isslJr;j,1 shall not.., .
employ any person in any manner sq as to become s.ubject to the worker's ct?iTlpensation laws
of Califomia, and agree that if I should become subject'to the worker's corrrp~:1sation
. provisions 0~Section,3700 of.the La~aU forthwith comply Wi~,1i-03ffPr~,~ision.s.
Date: 5/2712004 '. Apphcant:. 'i!f}' _.Z-- 2- .'
WARNING': FAILURE TO SECURE WORKER'S CQMPENSP:'l"ION'COVEFoAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA~:nESANOCIVIL
FINES UPTO.ONE HUNDRED THOUSAND DOLLARS ($100,000), IN PDFmON T() THE.
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF. THE
LABO.R CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
I.hereby affirm under penalty of perlury that there is a construction lendin'S a..:~ncy for the;
'performance.ofthe work for whldl this permit is issued (Sec.3097 .Civ.C): '
:':;;,id~r's ::irC;'"i;;atiG(;: ~_._---_.
PROCESSED BY: ODC
liCENSED cOf'!TRAcTORS DECLARATION"l
I hereby affirm under penalty of-perjury tha~'1 am
licensed under provisions of chapter 9 (commencing
with.Rection'7000) of Di'VsKm3 of the Business and
Profess:ons Code.
5/27/2004
Oa'te:
Contractor
NUMBER
. EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
I certify that-I have Tead 'this application and state that the above information!s correet. I
agreeto.oomply with a city ordirianc,es,and state laws relating to building cO:1Structiofl"l a-nd
hereby authoriZe resentives of.this city to enterup<>n the above mentioned property for
inspect.lo ses. .
Fees paid for Permi,t:
Total:
0.00
Date: 5/27/2004
gnature .of Applicai:lt or Agent
The.Pl!fmitshall expire by limitation and becomenuU and void if th<' building or .
work has .not passed fj nal inspection 365 days from the date of permit issuance. A
.new permit is required to commence or continue work. .
INSPECTION RECORD
, '> INSPECTION: . .' . [lATE INSPECTO~' ..
T~mporarvPower Pol~ . .. .
Plumbing.(PrainiWastePipe). ...
Elel:trical GfOund EkK:tmdelUfer . .. .
.. SetbacklFormslTrenChes (Footings) . :.. .
Do not. install.subfloor or pour floor slab until the ...
following applicable items have been signed. '. .
Plumbing (Water Pipe.SprinklerValves) '.' , .
MechaJlical (Gfoundwl:lrk) ..... . ..
,
E(ecttical, (Underground Conduit)
Pre,slab (cOll1lJactloniMembrane.Reinf. , . , " c-
,
Underpinning (f'lQOr J()jstlC3l.rders) , . ,
..',
.Do not cover or conceal the work below until the "
'.!ollowing"pplicable items hay" been signed: ' "
1st Floor Shear
Firesprinlder(RoulJh) . " --:-
2nd Floor Shear . . .
". Ri:iof ($heathing/DiaphralJmlFramll) , , . .
Masonry (Reir\(JBond Beanl/Pre,Grout) . " ~.
. .
Rough Plumbing ,(Top Out) , ," ',. .
Rough Mechanical ' , :. . . ' .
KDugh ~ectrlCalllJFV walll , ,
Rough Electrical . ". .
. Fraining (Onjy afterPlbg., Elec.. Llech... and Fire) '.
In$Ulation (SOUndlEnergy)
.
Do not tape or,plaster until the'followiAg applicable ,
i.tems,have been signed: ' .' ' . . , , '.
Dryw;!lll' '. . . . .
Penetrations (Fiie Rated)Electrical . . ,'. '"
I
Penetrations (Fire Rated) Mt!chanical , ' '. .. ,
Penetrations (Fire Rated) Plumbing , . '
Interior Lath " , . '. .
exteriOr Lath . ' " . .
,', . GENERAL ITEMS
, exteriOr Plaster {Brown Coat) , "
.'T-SarElectrical , , '.' < ,
T-Bar Mechan,ical " " "
T -Bar Structural . ,
,Sewer e' . , . ,
.Water Engineering Sackflo,,",
. Water Service .. . , :
FINAL INSPECTIONS
. ..
. .
. .
Date
, ,
Inspector
". . .
.
Electrical Final'
Phlmbing ,Final
Mechanical Final
,
.
.
:
.
Gas Test
"
Engineering/Grading Final 76S-5126
Fire PeptFinal7654040
Water E:nginellring 765_5268
.
.
Sub List/Susiness License 765-519 ',,', : . . '.
Zoning 765'5139': "I ' ,'. /!- .'
Building Final ILastlnspection. Only ,,-it, f. APJ,VJ j
)l.fler Abov.eComplete). --., 'TI m;.. '
, .
..' PARTIAL INSPECTIONS
Buildinalnspections
. ,
,.-. " .
. Mechanical Inspections
Plumbin-a Inspections
. Electrical Inspections
. .
APPLICANT: FWAN RUDNICK
OWNER INFORMATION:
Ryan E Rudnick
3159 WLane,rose Dr
Anaheim, CA. 92804 . . ,\'
JOB DESCRIPTION:Tear offwoa,J.shakes and install 24 squares 0140 year cC!TIp.shingles.
VALUATION: . 3,600.00
1 OWNER.BUILDER DECLARATION
J hereby ,affirm underpenalty of perjury ttlat ~ am exempt from the Contractcr) License Law for the following reason (Sec. 7031.5 Busl,nessand
Professions Code: any city or cQuntywhich requires a permit to construct,-a\i*'r, improve, demolish or repair an,ystructure, prior to its "issuance, also
requires the,applicant for such permit to file'a signedstaternent that he is lice:1sed_pursuant to the provi::?ions of the Contractor's License Law'(Chapter
9)(commeqcing with Section7000of Divi,sion' 3 of the Busin_ess and Professk~s Code) or that he is exempt therefrom anc;l the basis-for th~alleged
,'exemption. .Any violation of Section -703f.5 by ~ny applicant for'a permit-s~~€!cts thea pplicant to a evil penalty of not more than' five hundred dollars
~~O~)""~r.of prop'e~. Qr,my,emp"o;~~ with w~ges ~s'their Sole.~~m~i.~ation" wii,'~o the work, a~d the structu~e is not i~~i1ded or Off~red (or
~.u;~~ Business and Professions Code: The Contractor's License law does not apply to an owner of property who buUds or improves
thereon, and who doe~ such work hirrn1elf or helSelfor through his or her ow:i employees, provided that such improvements are'not intended or,
offered for sale. If, however, the_,buildin.J or1mpr6vementis sold with one'yp-,~i of completion, the owner:-builderwill have th~ burden of proving that he
didnot buil,d or improve for tt1epurpose of sale). ,:' _ _,' , '. , '
0' .'1, as the owner Qfthe.property, amexdusively contracting with Iicense~ :ontradors to constructthe project (Sec. 7044 Business and ProfeSsions
Code: 'The Contrador's License, Law does not apply to an owner of prOpp.rl.>'NOO builds or improves thereon, and, who contracts for such projects.With '
~9ntractor,(s) lice~ed pursu'ant'to'theCbnt~actor's License La~). '. I .
I am exempt under Sec. " B & P~C. for this reason:
l:> - -",,'I Owner: ..
. WORKER'S COM PENS DECLARATION
I. hereby affirm under penalty, of perjury one 9f the following -decl~rat!Ons: , .
o ,Fhave and will- maintain a certificate of cxmsent to self-insure for worker'::_compensation,
as provided for by SectiOn 3700 ofth~LabQr Code, for the performance of th) woi'k for which
. this permit is issued. .
o "have and will nia[ntain wOrker's.co'mpensation jns~rance; as i'equire~ t) Section 31.00 of
the lab9r Code, for the performance Of the work for whiChlhis permit is issu{d.. Mywor~er's _
Compen~tion insurance'carrier and peliCf are:
Carrier:
.BUILDING PERMIT NO. BLD2004,02178
TYPE OF PERMIT CITY
Herool .
. DA TE:5/27/2004
JOB ADDRESS: 3159 WI..ANEROSE DR
LEGALDESCRIPTION: SEC 23T 4 R11 W330 FTNW1/4
CONTRACTOR INFORMATION:
Policy Nu mber: .
This seetic)n need 'not ~ completed if-the pennit is for one, huridrect -dollars ($1 G,O; br leSs. . .
o I certify that in. the perfQ'!f1ance of'th~ work for which ttJis permit is issue.j. I shall not
employ 'any person,in any manner so as to becor:ne subject to -the worker's cC.:T1pensation laWs
'of Califomia, .and agree tha,t if J should become subject to the worker's compensation '"
pr.oVis!OnS ,of Sectio~ 3700 ofthe ,~e,1 shall forthwith ~omPI~ with those. pro~lsions:
Date: 5/27/2004 Applicant: - ~ . /'"" ~
WARNING:'FAILURE TO SECUREWOR~S COMPENSATIOtft(JvEPoIGE IS
UNLAWFUL,AND SHALL SUBjECT AN EMPLOYER TO CRIMINAL PENA!.TIES AND CIVIL
FIN!,S UP TO ONE HUNDRED lH.OUSAND DOLLARS ($100,000), IN ADC.jTIONTO THE.
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR. IN SECTION 3706.0F THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY .
I hereby affirm under pena_Ity',of perjury-that there !S a construction lend ing a~.~ncy for the
p~rformance of the work fo hichthi~ permit is .issued'(Sec.3097 .Civ;C):
;,,;,;;';~;.'.:.-tr.1VT1'--i;:;"~~;:: -
I:certi . that I h e read this applicati~nand state that the above informatic;n is correct. I
agree' co y with__all city ordin~mces-and' State laws r~lati~g to buRding construction,-and.
~ hereb', au orize representives of this city to e~ter upon t~e above mentioned property for
inspe .. ,n purpo~s. . ,
~ .c::- 4;;r Date. 5/27/2004
. ,. Signature of Applicant or Age')t. .
.The. permit shall expire by limitation and become null and void if the building or
work has .not passed final inspectlon.365 days from the date of permit issuance. A
neVi perinit is required to commence or continue work.
BUILDING DIVISION
200. S. ANAHEIM BLVD.
(714) 765-.5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTiON: 11
ARCHITECT/ENGINEER INFQRMA TION:
PROCESSED BY: ODC
LICENSED CONTRACTORS DECLARATION
I hereby affirm .under-penalty of perjury that lam'
licensed under, provisions of chapter 9 (l?ommenc!ng
with Section 7,000) of Oi.vsion 3 of the-Business and
Professions Code,
5/27/2004
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
ConstruCion Types:
VN, ,
Fire Sprinkler~d?
NO
Fees paid for Penni!:
Total:
0.50
.. '. ..... . . . DATE . . , 1 Electrfcal Final' .' .'
.' , .' INSPECTION '.. ..C. . INSPECTOR.
Temporary power Pole .' . . :PlumbingFinal
Plumbing (DrainiWaste Pipe} . . .' .'
Mechanical Final
E"ct:ricai GrOund.Electrode/orer . I. . . . '.' ,
Set6acklFormsITrenChes (footings) '1' Gas Test '. .
Do notinstaUsubfloor or pour. flo.or slab until the Engineering/Grading F.inal
fOllo",ing applicable items have been signed! . . Fire Dept. Final 765-40.40.' .
Plurnbing (Water Pipe.Sprinkler Valves) .' .
Mechan.icai (Groundwork) . . '. " I. Water I;ngineering765.526
I;lectricai (Underground Conduit) . '. . .' . Sub LisilBusiness License
P....slab(CQll1P~tion/Membrane.Reinf. . '.
Underpinning (Floor Joist/Girders) . . .. ,. Zoning 765-5139 . ~
.Do IlOt Cover .orconcealthe work below until the 1 Building Final C ~ast'"specti
'followingapplicable it.ems have been signed: . . . . . . ........ fterAboveC
. . ... .
1 stFloor. Shear. . .: :,'PARTIAL
Fimsplinkler (Rough). .'. .
: . ~i1dinalnsnections
2nd FIOCil',Sbdrl'. . : 1 .' I. I .
. . . . .
ROof (SlJe;ithill61D1aohragm'Frame) J -'\.I 1 .... .'. . .......
M;isoorY \ijeinfJBl:Ind Beam/Pre,Grout) .'" ..
Rough Plumbing (Top Out} . .. . ":--\ ....
RoughMechlllnical .'. . . . . . ". '.
!<O\I9h t:IectrlC.. all) . . 'c' . .
RciughElectrical'. . . '. ." . . . '.
Framing .. (Only..aft.r~lbg.cEI.c... Mech and Fire) . .' .
In$Ulation(SOUll!l/Ellergy) . . .... . . .'
.' . . Mechanicallnspecti'
Do not tlIIpe or plaster' until the following applicable ..'
i.tems have been signed: '. .... . .~
DryWall . . .. ..' . . .. . .. .
Penetrations. (Fire Rated) ElectriCal . .'. .... . .
Penetrations (fire Rated) Mechanical . . ' . . .'
Penetrat;~(Fim Rated) P.lurilbiilg '.' . .
Interior Lath . . . . .'.
'. .........
Exterior Lath . '. . '. PlumbinQ Inspection
'. " . '. . . GENERAL ITEMS .
Exterior Plaster (Brown Coat) . . . .
T -BarElectrica.1 ". ..' . .
T'.Bar Mechanical . . . ,. .'. .
....
T -Bar Structural .' . .' . .. :. "
Sewer.. . '. ." . .' . . '., ..... ....
Water Eng'ineering Backflow .. .' Electrical Inspection
Water Service' .
" . . ..
INSPECTION RECORD
FINAL INSPECnONS
. Oat"; Inspector .
765.5126
8
765-5.19
on-:Only. .
amplete) .
INSPECTIONS
'.
ons
S
5
...;
PERMIT EXPiRED....
'. .IN S PEcr ION
NOT.COMPLETED.'
DATE:C(0/0\ . ..