2108 E. Lincoln Ave.
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BUilDING PERMIT NO. 'BlD2003:01551
TYPE OF PERMIT
Tenantlmprovl'ment (limited)
DAT'Eo 7/30/2003
JOB ADDRESS: 2108 E llNCOlN AVE
lEGAL DESCRIPTION:
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CITY "~"<'NI.HEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765. 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: ' 437
QUARTER SECTION:
E;')f.f: 1-30-ot.l
APpliCANT: ANTONIO ALVEREZ
OWNER INFORMATION:
NMC ANAHEIM lLC
18801 VENTURA BLVD #300 ~
TARZANA, CA 91356-3362 i
JOB DESCRIPTION:Relocate hOO(l, add cooking a~pljances, remodel kitchep ,,,,binds for "Cancun Juice"
"
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,CONTRACTOR INFORMA'fION:
ARCHITECT/ENGINEER INFORMATION:
V AlUA TION: ' 6;000.00.
I . . OWNER.BUILDERPECLARATION
J hereby-affirm under.penalty of perjury that I am exempt from the Contractc~:;'Ucense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any dty Or C:OUl,tyWhich requires a permit to construct, a~~~.':i~prove, demolish or repair.any structure, prior to its issuancej also
requiresthe_,applicant for such 'permit to file a,signed statement that he i.s.licerysed pursuant to the provisiollS of the Contractor's~icens,e Law,(Chaptet
9)(commencing with Section 7000 of Division- 3 of the _Business and ProfeSSic;iS Code) or that he is _exempt therefrom and t~e ~.~si~:forthealleged.
exemption. Any violation of Section 7031.5 by any applicant for a permit slJbj ~cts the applicant to <;I. dvil penalty of not mor~JhCl,ry_~ye hlJ_ndred dollars
($500). ,'.' '-i ' " '., , ,>
o 1, as. owner of property, or my employees with wages as their sole cornp.:~i'''s3tlon, will do.the work, and the structure is notJntended or offered for
sale (Sec. 7044 mess and Profeg,sions Code': The Contractor's License Ljw dcas not applyt.o an o",,!ner of property who builds_or improves>
thereon, a ho does such work himself or herself or through his or he:- owr:'€.:mp!oyees', provided that such improvements are not intended 0:-
offered Sale. -If; however, the building or improvemen~ is sold with or,? Y'€G-'r of completion, the owner-builder will have the burden of proving- that he
id build or imprdveforthe pu'rpose of sale). ., d; ..'.. . .
I, as the owner.of the property, am exdusively contracting with licensed (.~ntr&dors to construct the project {Sec.._ 7044 Business and Professions
Code: The Contractor's lice.nseLaw does not apply to an owner of propen:y I,i:m build~ or improves thereon; and who oontracts for such proj.ectswith
dor(s) licensed pursuant to the C tractor's License Law). '
exempt under Sec. P .C. for this reason:
S Owner: "
WORKER' C PENSATlON DECLARATION "_
I hereby affi':fT1 under penalty of perjury one of the following.declarations: ..". ~ .
o I have and will maintain a certifICate-of 'consent to seW-insure for worker';~,'~ompensatj'onf
as provided for by Section 3700 of the Labor Code, for the performance of1hE'~wor:k for whicli
this permit is 'issued: . . ,. <
o I, have ~nd will maintain worker's compensation insurance, as required by Sectk>n 3'7009f 7/30r2003
the Labor Code, for the performance of the Viork for which this perm1t'is issueJ. . My .",'orker's Date:
Compensation insuranpe carrier and poliqt are:
Carrier; Polley Number.
PROCESSED BY: ODC
LICENSED CONTRACTORS DECLARATION ',"
I hereby, affirm und~rpen~lty of perjurytha~ I am
. licens-ed ',J (1der provi3ions of chapter 9 (commencing
with Section 7000) of DiVsion 3 of the BusIness and
Profession!'; Code,
C.ontraCtor
NUMBER
EXPiRATION OA TE
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ThissflCtion need not be'completed if the pennit ismi onehundred dollars ($100)' :.-,....
o ..1 certify that in the perfciimance.of the work for which this permit isiSSU'~C(Cs,~~a,}~not . .
employ any person in any manner s.o as to become subject to the worker'sc;p;'"iIP~Q$,~tion laws
of Califomia, and agree that if I should become subject, to the worker's.Cdcn~;isatf,Qn
p~ovisjons of Section 3700 of the La Code, ,I sha ~ with comply Wiu?t~XJse -pdiy!sions.
Date: 7/30/2003 Appiicant: " {;I?~~
WARNING: FAILURE TO SECUR WORKE S COMPENSATION COVERAGE?i~"o:
UNLAWFUL, AND SHALL SUBJE" AN EMPLOYER TO GRIMir:JAL PENAL "jE~Aijp CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN i\9l?qoB':tS6 THE
cos. OF COMPENSATION, DAMAGES AS, PROVIDED FOR IN SE.CTI~J ::706t\lr.THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' . '<; ,,,,;:;"'t;
I CONSTRUCTION LENDING AGENCY '. i' ' ;:~
!,hereby affirm utld~r penalty.of perjury th~tthereis a constructionJendill~ag~;;;oYf()tthe
. perforMance .ofthework for which this permIt is.lsS!Jed (Sec 3097..Civ.CY~ ..' .. ',~'
... .l....eJld.e!~c:.lnfo:TJ"latiofl: ,....'~ ~.,...;,
TYPE
Construcion Types:
VN. ,
Fire Sprinklered?
NO
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f certify that 1 have read this application and state that the above information:s correct. I
agree to comply with all citY ordinanceS; and. sta.te laws relating to bu~din9 construction, and
here y authorize representives of this dty to enter upon the above mentioned. property for
insp dion s. '
Date: 713012003
Fees paid for Permit:
. Total:
248.10
Signa of A ficant or Agent
permit shall expire by /imitation and become null and>void if the building or
work has not passed finalinspection 365 days from the date of permitissuance; A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION. DATE . INSPECTOR
Temporary Power Pole .
Plumbing (Draln/Waste Pipe) .
Electrical Gl:ound Electrodel.lJfer .
SelbacklFOr.mslTrencheli (Footings) .
Do not Install sub floor or pOUr floor slab until the
following applicable items .have been signed:
Plumblrig (Water P1pe;Sprinkler Valves)
. Mechanical (~roundwork)
Electrlca/(Underground Conduit) .
Pre-slab (Compaction/Membrane.Reinf.]
Underpinning (Floor Joist/Girders) . .
:DO not cover or conceal the worn below unt.1 the .
following applicable. items have been signed: .
1 st Floor Shear . .'
Firesprinkler (Rough) .
2nd Floor.Shear' . .' . .
Roof (SheathinglDiallhraam'Frame) . .'
Masonry (ReinfJB!lfKl BeamlPre.Grout) '.
Rough Plumbing' (Top Out) . '.
Rough Me.chanlcal . .
KOugnJ:lectrlCallury wall) .' .' .
Rough Electrical '.
Framing. (Only after P!PQ.. Elec.. Mech.. and Fire)
InsUlation (SourQ'Energy) . '.
po nottape orpla.;ter until the following applicable
Items have been signed: .'.
Drywall
Penetrations (1'1re Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Pllimbing :
Interior Lath
Exterior Lath . . .
. . ..,' ". GENERAL ITEMS
Exterior Plaster (Brown Coat) . . .
T -Bar Electrical . .
T -Bar Mechanical
T-Bar Struct.ural . . .
Sewer .
Water'Enginilering Bacldlow . .
'Water Service'
FINAL INSPECTIONS . Date Inspector
Electrical Final, . . .
Plumbing Final . . .
MechanicarFinal . . . '.
.
Gas Test . .
.
Engl.-ring/Grading Final 76505126 . . . '
Fire Dept. Final 765-4040 .'
. ". .
Water Engineering 765,5268 .
. ..'
Sub List/Business License 765-519 . .
Zoning 765-5139
Building Final. itast Inspecf60n, Only
fter Above omplete)
PARTIAL. INSPECTIONS
BUil~ '~ections
-Jj '. '1__ );,~ ~-()1 ~~
'Mechanical Inspections
. PlumbinQ Inspections
ElectricallllSDections
. PERMl"T EXP\RE6
.... .INSP~- CT\ON
'NO' '1' 'C'(\.'\f.'J. LETEO
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