1750 W. Lincoln Ave.
PUBLI(>WORKS DEPARTMENT FEES
--TRAFFIC ENGINEERING FEES--
BUlLD#OS" - .., ~
PROJECT SITE:. I 7 :s-- ().W L,......, Ce-"l..- A V
SIZE: S -- 08 \0 )Je k.l .
~RAFFIC SIGNAL FE)j;S:.
279-412-F724-3017 ..
-
~RANSPORTATIONIMPACTAND IMPROVEMENT FEES:
- m~412-F724-1818. cy 2-3 XI. C g-
-
o TRAFFIC SANTA ANA CANYON FEE:
278-412-F724-2001
o EASTERN TRANSPORTATION CORRIDOR FEE:
101-412-F724-6704 .
TE # <1 ~
$22-
,$7/1
. COMMENT:
REVIEWED BY: ALFRED Y ALDA (714) 765-5183 A'1
--DEVELOPMENT SERVICES FEES--
RIGHT OF WAY REVIEWED BY DATE:
o . OLD ZONING CODE (i.e. in plan check or entitlement prior to July 8, 2004)
o NEW ZONING CODE
DEDICATION
CREDIT
STREET IMPROVEMENTIREP AIR
SEWER CONNECTION FEE
ACCT #
CITY SEWER ASSESSMENT
ACCT #
DRAINAGE ASSESSMENT FEE
ACCT #
GRADING:
WATER QUALITY MANAGEMENT PLAN (WQMP)
LAND SUBDIVISION:
REVIEWED BY:
00
-
r/ 0/
DATE: I t8!2POr;
TYPE OF PERMIT CITY
Demolition
. BUILDING DIVISION.
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 47
BUILDING PERMIT NO. BLD2004-02214
DATE: 5/28/2004
. JOB ADDRESS: 1750 W LINCOLN AVE
LEGAL DESCRIPTION: SEC 17T 4R 10 S 185 FT N251 FT
APPLICANT: EFRIN GUTIERREZ
.OWNER INFORMATION: CONTRACTOR INFORMATION:
~fren Gutie,rrei
, 1750 W Lincoln Ave
. Anaheim, CA 92801. . .. . .
JOB DESCR1PTION:Remove 2nd floor office! storage:built without-permits. "El ...onejo fetiz"
. ARCHITECT/ENGINEER INFORMATION:
VALUATION: 4.000.00
I OWNER-BUILDER ,;:ECLARATION
I hereby affirm:..!r.d~:r penalty of-perjury that I am exempt from the-Contrador....:....icen:;.e Law for the followingreas.on(Seo.'.7031.5 Business and
. Professions C('l.-:h~: iElny dty or O:;"Ol.lntyw:iich requires 8' permit 'to constluct, <:)It.-.;, improve, demolish or repair ~ny structur~" prior to. its Issuance; also
requires the 'app1if.....:li':.t for such perrr.it ~n fil~,] J;:gnlSrl ~.tatem~nt that he is !ice",::-.ed pursuant to the provisionsof theCcntractor's License Law (Chapter
9){commencing ..vJth S~;::tl()'n 1000 of Ci'.'isior: 3 of thi) 8usil1ess ar:d ProfE:::S~lC":3 Code) or that he is exc;,rli;::~ .therefrom and the basis for the alleged
exemption. 'i violation ofSectibn 703'L5 ~lyanY'<lPt'!lcaT1tfor::l p8imit SU!:j"~::~S ~he applicant to a dvil penalty of not mote thantive hundred dollars
($500 . ;. ..
, as owne.r of property.,or my employees. with wages as their sole C()mpfl~<:;ation. will db the work. and the structure is notintencled or offered for
sale (See, 7044 ,Business a-nd ProfessionS: Code; The Contr8c~or's license l/.w does not apply to an owner ofpropert';,who, buildsor imjJroves"
thereon. and who does'.such wo~k himself or heISe/for through his or heio...\..-:,:~mplcyees; provided that such-improvem.ents 'are f"lotir.tended or ,
offered for sale. If, however, the _building or improvement is sold, with one ye~j, I')t -completion, the owner-bu!lderwill have the burden of proving that'he
did not build or improve for the purposeofsale). , '. ' -. , ,
o r, as the owner of the property. qm eXdus~ve!y contracting with licens~d ~..:.ntra(;tor3 to cbnstr1lct the pruject '(Sec: 704A.-Gus;ncss and Profession:;
qode:, The Contractor's License law does not applY to an owner at propert;/.\o'~o builds or improves thereon, and '.......ho QJntr,;lc~ for such projects'wjt~ .
ontractor(s) licensed. pursuant t C ntractnr's license: Law). "" . .
. am exempt ,'nde' Sec. _ 'B&P~.c., ~~;,~. . '_~__."'."_
Da .~~.....o . Owner: . __ _=::~ . ~~.~,_
WORKER'S C r. ENSA ON DECLARA N . ilLlCENSED CONTRACTORS DECLARATION. I
l,he!eby affin1i under penalty-of perjury one of the following declarations: -~'~, I-herpby affirm 'under penalty,of.-perlt1ry that'l am.
,0 I have 'and will maintain' a c~rtificate of consent to' self~insureforwo:'kt~r':; ':;t)mpeh3ation, licensed under. provisions of chaptl1r 9 (commencing
as provided for by Section~700of the Labor Code, for the perforllianes,::>fth:; ::;Q~r\ fer l:\l!lich with Section 7..000)' of D:\.I'Sion ,;3 of the Busir.ess dnd.
this 'Perm'it is issued. , ': ProfessionsCod&.
o 'I hav9 iJnd will maintain worker's:compensation insurance"as f?qiJired I)).~ ~G';:tjt:)n 3700 ot 5/28/2004 _ _'.
the LaborCo~p., f()r the performance of the work for.which this lX:i"mit is i~:"'f/~. ~".j'y worl\er's Gate:
Cornpen&:tion,insurancecarrier and policy are: ' '
'Carrier: . '. .' , . . 'PoHcy Number.
PROCESSED BY: ODC
I
Contractor
. !'lUMBER
EXPIRATION DATE
. This section need not be complete'd if the pennit is for one hundrM d:)lI~s {$iC~':,..r :~G" .
[]I certif'lthat in. the ,perfonnanceof the work fOf'wYhich.thlspermjt-~,,> I,ssu_e.!, I ~nail net.
employ any person inany manner so as to. become subject,to theworke(~ c.C'11pe-ns'?\tlon, laws;
. of California, and a_9ree that if! shouJdbecome subject to the worker;s ~omJXnsat!on.
)rovisions of Section 3700 of the La~orCode 'shall forth : ply wL~h ~"..:;se prov'isions.
Date: 5/2812004 Applicant:
WARN ING: FAILURE TO SECURE WO .R'-.GE IS
. UNLAWFUL, AND SHALL SUBJE.CT AN MPLOYER TO CRIMINAL PENA~.TIES.AND CIVIL
FINES UPTO ONE HUNDRED lHOUSAND DOLLARS ($100.000), IN'ADO~ON'TOTHE
. COST.OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlci; 3106 OFTHE
. LABOR CODE, INTEREST AND ATTORNEY'S FEES. '
I CONSTRUCTION LENDING AGENCY...
I hereby'affirm under penaltY of-perjury,that there is a construct!onlen~il1~~~.i~r.cyfcr the.
performance of the work for whidl this permit is _issued '(Sec.3997 .Ci~;~): ,',
;_,~:::::.:',:: ::"",?"'"~~:;C~: --
TYPE
Construcion Types:
III N, ,
Fire-Sprinklered? NO
I certify that! have re~d this application and state that the above information is correet. I
agree to . mply with all city ordinances and.state laws relating tobu~ding cor,struction, and
hereb utho' repre~n .s city to enter upon the above mentioned property for
insp ses.
Fees pajd for Permjt:
Total: 140.39.
Date: 5128/2004
S' ature of Applica t ent
The per it shaJ expire by Iiniitatio and become null and void if the building or
work has not P1lSsed final inspection 365 days from. the. date of permit issuance: A
new permit is. required to commence or continue work.
. . '. INSPECTION RECORD
Iy . <INSPECTION , .... 'DATE
I :remporaryPowef Pole
I Plumbing (Drain!Waste Pipe) '.
'Elect.ricalGrciund ElectrodelUfer '. ...... . '.
; Sl!lbacklFormsfTfenChe$ (Footings) . I. '.' . .
. p" not installsubfloor or pour floor slab unti!.the'
following applicable Items have been Signed: '.
. Plumblng.(Watiir Plpe.5prinkler \failles) ..' , .
lVIec:hlInical (GraunClwork)' ,.' ','
!:.lec:trical (Undergr.ound Condu it)
. Pre-slab (COIl1pactionlMl!I11brane,Reinf. .,... 7 ..
underpinning (Roar JOist/Girders) .', .
.!-'o. not taveror taneealll\ll work below until the' '. '
'followlng appllcable.items have been signed: .'. .
15tFloo; Shear '. '. . '. ..'
Firesprinkler (Rough)
2nd Floor Shear'"
ROof (SheathinglDiaphragm'Fram!l1 "
Masonry (RliinfJBond BeamJPre,Grout) '...
Rough Plumbing (Top out) . ,
'ROugh IVllichanical . .
Rough 6ec:trlCalalll ' "
I Rough Electrical '. .
. Framing .".,' (9n1y afterPlbg.;"Elec.. r-:lech",and Fire)
Insulation (SoundlEnergy) . .' . . . '..,.
.po not tape or'pla~ter until the followlAg applicable
I.tems l:Iave beens,gned: . . . . -. .' .
Drywall .' ". .... .
Penetrations (Fire Rated) Electrical '. .'
.' Penetrations (Fire Rated).Mechanical .'
.Penetrations (Fire Rated) Plumbing '.
Interior. Lath . '.' . '.
Exterior Lath . '. . .
.' '. . ..' GENERALlTEMS
Exteri(lr Plaster (Brown Coat) . .
.T-Bar Electrical . .
T'Bar Mechanical' . .
T -Bar Structural ..
Sliwer ....
Water Engineering Backflow .
Water Service .
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,INSPECTOR '-h
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FINAl:,. INSpECtiONS' . . . Date Inspector'
Electrical Final '. . .. . ,'. . . .
Plumbing .Final . .... .... .'
.' .' . . '.
Mechilnical Final '. . .' ,
Gas Test ..' . . .
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!:nglneefing/Grading finaI16$-5126. .. . .' '.
Fire Dept. Final 765-4040 " .' .
WatetEngin!lllring 765-5268 " .... .
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Sub 'List/BuSiness License 765-5.19- . . .
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Zoning 765-51.39 .' . .... .
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Buiidlng Fin;ll ~ast InspeeliOn- Only . (z;/u/o+-
Iter Abov.e Complete):
I>
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G.~~.
'. u...."Il~.
. PARTIAL. INSPECTIONS
, Buildinalnspections
.
, . Mechanicallnsoections
'.
.' Plurnbina Inspections
, Electrical Inspections