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2340 W. Lincoln Ave.
TYPE OF .PERMlI, Demolition. ,. DATE: 09/06/2001 ~OB ADDRESS:. 2340 W LINCOLN AVE CITY I AtGtjl:5\'<<" . ", . . . 1!~@1:"'>' ."" ,", ",i~~i.tt</.~~~~'!~:{.~~ " . ;,,'~...!:).."f;f;'mf/:'A :<'~-\." ~ ....~-_'1:.::t.t!:~~.:.. . '.,.', . "lJ.' "I{'A~'kf?^";, ElM ~) l.~...;~..,I':M -' ~'.'.\' \~:,Jtr.,>r'. ,;';::,: ,..:,i~)rf7' ;1 _',', . ,,~~,"".1'~0-::':.~,:::;_r:.,~"'P','/ '. ~"'~~~"-:.;.. I ~_..,;;;:;..,.J ~!ij~{~tr~~~f. . .;, BliILOiNG DIVISION. '200 S. ANAHEIMBLVD. . (714) 7,65' 5153 . INSPE<fTlON' REQcr~&t!@g:" .(714) 765. 4626 BUllDING.PERMIT NO. BlD2001-03182 . . '. . . . GENSUS CODE: 437 QIJARTER SECTION: 33 LEGAL DESC.RIPTION: SEe 18T 4R 10W1/2 NE1/4 NW1/4' . . , '., APPUCANT:GREO GILSON OWNER.INFORMATION: CONTRACTOR INFORMAflON:.< An_ah sin,. Red evelopme ntAgenc;y TH R.EE 0 SERVICE CO (~:.'f!i' ", . 201 S Anaheim.Blvd #1003 .1515 EMISSION .Anaheim; CA 9280!) . . . .' POMONA, 9)7660000 CAe. . '~OB D~SCRIPTION:Demolish 3,205 sq. ft st(uctuni. .,,} ". .VALUATION: 25,OOO.00~:t." PROCESSED BY: .CAL . OWNER-BUILDER DECLARATION .' . . . I hereby affirm, unde r penalty of perj Liry that ~am ~xem~t from;the . ",ontract9f:['" License ,Law fo~ the fol'loWing reason (Sec: 7031.5 Busin.ess and Profes,~ions C9de: any city or cou,ntyJ.;'Dich require,sa permit' toJ~onstruct,'aJ~ ,~\.improve,dem,6'lish ,orrepairany s~j-ucture, prior to It(jS;!?uance, ,alS,~ ): requirestheappliCC!,nt.for ~uGh pennit,to fi.le'a sign~ $tatem~,nt th~t h~ is liceJ:~ed. purS'll~nt .~"theprovi$ions,ofthe Contrac::tC!r's'Licehse~aw (Grapter' .: 9)(cornm'~r'cing,w!tf:l Section 7000 of. Division 3 of. the Bu~ine:ss al1dProfess$e~ C0ge1:of that he is'exerrjp! therefrom and t,~e.has!~!o.r!h,e'allege,~ ~xef!Jpt!on.Al)yviolation of Sectio,! ~031,5 ,by any applicant tC)r a.permit sul;U~ts~he 'applicant to a civ~ penalty,of not more,!han five ,hundred. do!lar.~.: ($500). .' .',' . ""i,;': .., . .,:,;':"i~t' ./V " '. ......, '. ..... c. .... ",' 'i" :0 ~,I,-as owne{Qf property, or r'ny.employeeswithwagesas.their Sc3JeconJPi[nsationJ. '\~iirdo fhewor;{','and tti~~tn.!cture is noti,nte,n.ded c,r-offered for sale ,(S~c" 7.044 B~sin;ess.a,rid,.pr.6fes~!o~sGo~e:" Th'e G:ontractor's Lioens~M~w'dp_~B;qPtapplyto,an ow~e:r,,?f prOPE:l.rtywt,l?'::~U!,ld5,;Or,'i~prO\liS:s j:' :: the,r~on,and who does sv~,wor~J;'i,mse~ or.,h~ls,elf or throu.g~.his.()~~h~r o~,;;~mp!o~~es, pr,ovided that s~p~"imp,"?v~~,e,r;-t,~am ri?fJrtend.~ orJ{!' " ',,'. pffen~d:for.:sale. If, however, ,the building or improvement ,is sold wi~~:>'p!l',e y.;:;tr oFC4mpl,eti(.)IJ,~:the ownel"-bui1de'r,wi!I,;hf."e;,~l)e' bllrden,qf:.pf,jvin,g~h~th0l '!? didt1o.t buUd0r improve for the pu'rpos~,ofsale).: ." ,'. ::'::' :~'f :~""g:r ':'~<J': :'>:" ',' ,""," "':'::""-':,'~,;'\':~':,, ';";';':'" -: "',.-,>',:'--::' , ';'-' ';-:\' [];" I;; as the,owner 6fthe property, am,exdu~iyelycorltracti~~;with i,ice.n~e'cl:',*>tltrr.;.;:tOtg,:to (;9nstr~9t t~,,~ pr9j,ecttse,c;.':?D:44':Bu~i,l1.es~'a9~fProfG'S5,i9n$. Code:' The.contractor's,license'law does'not applY to an o,w:nec@f'property{l.,hfJbLJlldS~ cr irnprovestp~mmn, end\~'tlo (ontract<;:'for s'Jc:h p::ojecls'~.ijth .... <D-;ontra?lor{S)'IiCens~. J:>ursuant' tb'the'(';o,ntra(:t~'r'~~ice.ri~Y.;;W~:"~~'" :;;t;,i,,::\' "';:..'>:.~;%~: ::;' " , f, ' ' , ',,' ',."'" ,;.':" ';,.' ' . LJ J,amexemptur.derSec.:______~, B&'P:C..fortt)isreason~' ". ,'~ . {,~ Date': ,,' " bwner: " , . ,'~~'~::-'n,~,--'u:'-:>7-:-;~":", " -_.~~::-:-;-:--.- I. .c' 'j ..... ..... . . WORKER'S COMPENSATIONDECt.AAA'rION ';:~2C;-::-.:r 11. . I.JCENSEriCOI"HRAC1~~~~~~1-A~ r;g~"J~,\ ,1 hereby affirl\l u,nder 'penaltY of perju'ry ~ne of thE(following declar,atio~:": ',,'<jl, ::~ ".!I ,'",'<:', -:::-',: " 1 h:~reby.affir.m under pen~I.tY:'of-,p~!juryth?t-ra.-n,:,,~;':J . []:' . I have and'Wiit rriai,ritain a certificate of oohsent tcself.:insure fQ.r'worl;!~t'.H;0~Pf:~cotion:<: 'l!c.ens~,~:uriger'WoV,is.io.ns,Qfctf-l~t6( g',comI1'pneJI".1,i" "/:', , S providedf9r 'by 'Section'3700.ofthe LaborCcxje, for.,!h*?performapce,<?fth11I1.o'rk-'fo'r~\:;y~lrdi\ wit~'Section 7000 of l)i~ion,3,.ai:f ~ Busi ,~'3 and' .p' . 'ispe:,miti&'issued.,',"',' " ',' . ,"i:,:':" . ,:' .,", ",,:.[.' . ":,,!'f:;",,, ' ~,rofessiorsC6d ~ I have and will 'maintain worker's compensation,insurance, as~quired byiSection'3:70dcbf. '.' l.abor Cod'e,'for the perf<;>rf'!1ance,o,f the wo~k for whi,ch this'perrpit is"issue'~:, "fv1yw6rker'? 'Compensation:insurance carri,er and ponGy are': ,'" ," . ,'}'" '~:,:' ,.' Carrier: .'STA TECOMPENSATION' FUN D' PQliGYNu mber. 048-01 U!i IT oqo81)4 This secti~n neednot be c;orI1Plete,d ifthe'(lerTnit iSforon~ hundred'dOI,iars'($:10~~[o~ I~~... )'::'/','; .' Qpl~~e:'7. '~.i:6~ :~~~~~~;~;~O:~ht6~~~~~e.r~~~iZJt~~f::!Jjiir~.e..i..~.':ct.1'~~~.::.'.'.:.'a.if;'.~.~i.'.~;.~~.a.l.: ?J~,';/. of Cal ito m ia~and 'agree that if l shou Id become su bject 'to !heWoiKt3:r's:,cqP;p~fsatiBrt!:~i~ ;,}/t' provisro,ns ofSeeti.on 37?CJ ofthe'lab?r '0' e~ I_sha~~,::forth~ith ,,: Iy ",::)&~~~((~"6v!~~~~s~:(,: 'ConstnJcion Types: , ,: , ,,' :,' "i';,'"" .~S;;,\' :';'"i'\'/- V:N,. '..... ,.' Date:, 09/06/2001, , ' Applicant: . I ". . ,:t ;y" <,':,,></ ",>,,',;{.< Flre,'Sprinklered? . WARN ING: FAILURE TOSECURE WORKER'SC PENSATld~cq0!';Ri.~~I:>~~:,tY;;.. ., UNLAWFUL, ANP SHALL SUBJECT AN. .EMPLOYER JO C;RIMIN~P~rjN.WE:>/A\j~:~IYlk , FINES U PTO ONE HUNI'l RED THOUSAND DOLLARS (~100,OOqJ" IN!,dD/f\O-N;r<;/ 'hi'''' .' COST OF COMPENSATION, DAMAG. ES AS PROVI DED FOR I. N,S.,EC;Tt~t! 3~qP.!;!!j,.'ff!E:: LABOR CODE, INTEREST. ,AND ATTORNEY'S FEES. . ,:'. ),::'i/" },,(>t 'll' ;'r".'t.,.'.t,."; . I ......,. .....;.. CONSTRUCTION LENDINGAGENC't'{:): i(//'f,:'Y I hereby aff.irrT)un.der penalty. of perjury thafthers, is a'constn-iction l~nij!n9. ~9.(:~,cVJpr\thEf',:, performance ofthe\vork fo r' which this permit is issUed (Sec.3DS7 .CiV.C};', ,~,,; .-?-':,~,; ~,:::~L,:;':'<:::.;,~: ~ ,L~hd<i~"!nfciln~tion:: ',' . ~ -'., .' c' ,_,OA -- .'''; . _:' r''''-'':;,:f;',~l.:.i2._~~~~'''':' , " ARCHITECT/ENGIr;EER INFORMATION: 'F NUMBER 252618 . TYPE -;-:;.; ~:::<' EXPIRATION bATE 07/31/2002 'C21 CI)A,N.,. ;',"" ,NO y"M-' , '~~ 4-, ,~.r::~..,.,~i::~~:;r, "'.' ..~"..~ .,'!:" , 1 certify that I ha)Je read:this'cipPHcatioli and.statethat th',e aboVe infonna1io.n.is co~rect.. ,I agree:to.co,mplywith'all city ordinances ,and,st,ate laws:relating tobUitdingcolIstruction, and hefeby authoriZe represen.tive$ at'this city to enter upon the above mentIoned property fc:r i~POse~ . 4' . -" ~ . Date: 09/06/2001 CS S oa ure of Applicant or Agent . Tile permit shall expiieby limitation and become null and void if the building or work has not passecl final inspection 365 days ftom:the date of permit issuance, A ',: new permit IS required to cOmmence or',continue work. ' ,.,'.> Fees paid for. Permit: 'Total: "',',,' 393.50" . "',, . INSPECTION RECORD . .. INSPE.Cl:OR . '.' . . '. .INSPECTION., . DATE TemporillY:PQWer Pole . . '. P,lunibing{Drain/WastePipe) . . '.. '. ..' ElectricaIGroundElectrode/Uf~r '. . ... .SetbacklFormsfTrenches (Footings) '. ..' [)Q not install ~ubfloor or pour floor.slab until the . following applicable.items have been signed: .', Plumbing (Water Pipe.Sprinkler Valves) . ". lVIechimical(GroundWork)' '. .' .. Electrical (Underground Condu~) , . . .... Pre~lab (Compactior1/Membrl!J1ll.Reinf. \J.nderpinning (FloorJoistlGimet:s) , . Oo'notcoverorcon~al the work. b.elO\\iuntll the... . 'following applicable items have' been signed:,. ... . . 1st Floor Shear ..' ,. .. FiresprinkJet:(Rough) '. . 2nd AoorShear, . .' . . ' .' .RoOf (Sheathing/Diaphragm/Fraine) MaSonry (ReinfJBondBeam!Pre-Gl'Out) ,'Rough plumbing (Top Out) .'. Rough Mechanical .... . ..... . .... i .' Rough Electrical (DrywallJ' . . . . ". . . Rough' ElectricaL . . '. . Framing . (Onl,{afterPlbg..EleG...Mecli.. and Fire) - . -,,' Insulation (Sou nillEnergy) ..... .' . Do not tape or plaster unlil. the following.applicable'. . " '.., jtemshavebeen signed:'.... . .. . '. .:.. '.,.' DryWall ..... ". '. . '.' . 1 .. PenetratiOfl$(Flre Rated) Electrical. ". . '. . i .......,' I ' . . Penetrations (Fire Rated) Mechanical . '.' .PenetrationS (Fire Rated) PlUmbing .' .... Interior l,ath ' .' . .' EXterior Lath . . . ..' ..." GENERAL ITEMS ~erior Plaster (Brown Coat) .' . T-Bar'Electrical" -," . ,T..Bar-M,i'chanical" '- ".- T -Bar Structural . . Sewer., ' .. WalerEngineeringBackflow '.. Water Service, . . . . : . ." . . . J .. .' .' '. . . '. .'. '.' '. . . . 1 f . .1" Date inspector FINAL INSPECTIONS ElectricaJ.Final Plumbing Final . r>1~chariicai Final. Gas Test En!li~ringlGrac:ting Final.765-512a '. Fire o&pt.Final 765-4040 .' Waier Engineering 765-526& Sub ListlBi!siness License 765-519 'Zoning 7~5-5139 ,. 'Building Final 'IL,slInspection, Only . .. '. After Above Complete) . . PARTIAl-INSPECTI9~S BuildinalnSDections .'. . Mechanical Inspections 'I . '. I.' PltimbinalnSDections . I'" . , .1. . . " . .' '. . 1 . Bectrlcallnspections ~'. . . -<:' ... ..' PER-M.IT'EX PI Hs'Q INSPECTION" . ',' - " .'." '. NOT COMPLETED ... ..~'c..~'~it6)- I '-,;' FILE No.696 09/06 '01 13:02 ID:THREE D SERVICE FAX:909 620 5040 SOUTH COAST AIR QUALITY MANAGEMENT DISTRICT NOTIFICATION OF DEMoUTION OR ASBESTOS REMOVAl. MAlL FORM AHD FEE TO SCACMD, ASBESTOS NOTIFICATIONS, FILE' 55141, LOS ANGELES CA 90014-5641 SCREEN BY RECEIVED POST1IARK ENTERED BY NOTIFICATIoN' PAGE 2 AQIIO IlSE ONLY COMPl....I:TEDBY C.L. Clark COMPANYThree 0 Service Co. I,,!tIONE(909) 469-26 0 OATE8-1O-01 CHEeK # 2513 FEES 85.47 PROJECH D21-1555 ~ DAres REvISION OniER (hlghllghQ C""ceu;.nON NOTIFICATION TYl'E PROJECT TYPE o.ce..o OEMOunON RaiovAnOH (removal> E>il:I\GENCY REt.tQ\IAl. PlANNEO ReNO (annual) SITE INFORMATION SITE NAME Anaheim Redevelopment Agency SITEAODRESS 2340 West Lincoln Avenue CROSS STREET Brookhurs t Street CITY Anaheim STATE CA ZIP 92801 COUI'ITY Orange OESCRI6EWORKANDLOCATJON Demol'sh and b .ld. ~ remove U~ ~n s BUILDING SIZE (80 FT) 3,205 BLOG PRIOR I PRESENT USE NUMBER OF FLOORS I BUILDING AGE ('1VIIS) 19 NUI,IBER Of' OweWNG UNITS ( _AI. 1I<oosn<w. Ot/Ier OFFICIO Pt.8.Jc I/l.OO, HOUSE Sa<ca. 5>l>' u''''~G. SITE OWNER Ci ty of Anaheim CITY Ana he i m REQUIRED BUILDING INFl.'RMATION STATE C A ASBESTOS PRESENT? AODRESS201 S. Anaheim Blvd., Suite 1005 liP 928)5 CONTACT Stephen Stoewer PHONE 714/765-433i YES NO ASBESTOS @ NO ASBESTOS ;YeS) NO BUILDING TO BE YES Ne SURVEY? . REMoVED? V DEMOUSHED? PROJECT DATES START 8-27-01 END 9-26-01 WORK SHIFT (day, swlng, nighlJna FRIABLE CLASS I CLASS II TOTAL AMOUNT (add row) N/A SURFACES PIPES COMPONENTS ACOUSTIC eBUNG UNOLElJM INSULATION FIRE PROOFING DUeTING STUCCO MASTI( ASBESTOS AMOUNT TO BE REMOVED (in Square fMI) ASBESTOS REMOVAL FROM AMOUNT ~ fACH TYPE OF ASBESTOS On squall feel) FLOOR TILES (VAT) DRY WAU PlASTER TRANSITE ROOf'ING CONTRACTOR INFORMATION CSLSUCENSE# 252618 OTHER (describe) OSHA REG # N/A AOMD 10 # 82245 NAME Three D Service Company. IDc. ADDRESS 1551 Ea seMi Ss ion Boul eVa rd CITY Parona WASTE TRANSPORnR 11 STATE CA liP 9 1 766 SITe SUPYR Bob Makshnoff PHONE909/469- 2 60: N/A LANDF~ Frank R. Bowman Landfill ADDRESS 11002 Bee Canyon Acess Road , AODRESS CJT'f STATE I liP I CITY 1530 0004 5924 8857 Irvine STATE CA I liP 92618 c:::nJ.:lED ~-~XL NO.: 7000 . Asbestos sur.eys an! required prior to Demo/ibon and Renovation ,~crms. instructions, and the Rule 1403 can be Obtained from AQMD web site http://www.aqmd.gov 03ge 1 ~f 2 Fcrm R~'I ~C6'O