143 S. Linhaven Cr.
BUILDING PERMIT NO. BLD2005-o1213
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 40
t(
TYPE OF PERMIT
Blockwall/Columns ,CITY
DATE: 4/27/2005
JOB ADDRESS: 143 S L1NHAVEN CIR
LEGAL DESCRIPTION: N TR 14697 LOT 43
APPLICANT: ROSE INGUITO
OWNER INFORMATION: CONTRACTOR INFORMATION:
ROSE INGUITO
143'S Linhaven Cir
Anaheim, CA 92804
JOB DESCRIPTION: Build 5 lineal feet of six foot high block wall per city standard
V ALUA TION: 2,000.00
, ARCHIT.ECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's.License Law for the follo~ing reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, improve, demolish ,or repair any structure, prior to its issuance, _also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor'$ License Law (Chapter
9)(commencing with Section 7000 of Division 30t the Business and Professions Code) or that he is exempt therefrom and. the basis for the alleged
exemption: Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundredoollars
~)~s ownerot property, or my employee'-with wages as their sole compensation, ~ill do t~e work; and the struCture is not intended or offered tor
~'sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves
thereon, and who does such work hi mself or herself or throu~h his or her own employees, provided.th~t such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he.
did not build or improve for the pUlpos.e of sale).:, .
o .1, as the ownerof the property, am exclusively. contracting with licensed cohtractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License law does not.apply to an owner of property who builds.or improves thereon, and who contracts for such projects with. .
~ontractor(s). ~icensed pursuant to the, Go~tractor's License Law).
U I am exempt under Sec. , B P .C. for treason:
Date: Owner:
WORKER'S E TION D CLARATIO
I hereby affirm u~der penalty of perjury one of the following declaratJons:
D I have am;! will maintain a certificate of consent to self-insure for worker'scompensation;
as provi.ded for by Sect ion. 3700 ofthe Labor Code, ,for the performance of the work for which
this permit is. issued.
D I have and will maintain worker's compensation insurance, as require.d by $ectio'n 3700 of
the Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compen'sation insurance C?lrrier and policy are: .
Carrier: -Poiicy Number.
This section need not be completed if the pennit is for one hundred dol!ars ($100) or less.'
D.Aertify that in the performance of the-work for which this permit is issued, I shall not
~ any person .in any man~er so as to bec6m~ !Subject to the worker's compensation laws
of Califomia, and, agree that if I sho,uld become. subject to the worker's compensation
provisions.of SectiQn3700 of the bor de, I shall orthwithcompl wit~thoseprovisions.
,....
Date: 4/27/2005 -A, lica .
WARNING: FAILURE TO SECUREWO GE.lS,
UNLAWFUL, AND SHALL SUBJECT AN MPLOYER TO CRIMIN TIES AND CIVIL
FINES UPTO ONE'HUNDRED THOUSAND DOLLARS ($100,000), DInON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a ~onstruction fending agencyfpr the
performance of the work for which this permit is is~ed'(Sec.3097.Civ,C):
Lender's Information:
'LICENSED CONTRACTORS DECLARATION
I hereby affirm under penaltyof perjury that I am
licensed under provisions of chapter 9 (commen~ing.
with Section 7000) of Divsion3 of the Business ~nd
Pro.fessions Code.
4/27/2005
Date:
Contractor
NUMBER
EXPIRATION DATE,
TYPE
Construcion Types:
VN, ,
I certify that I have read'this application and state that the above information is correct. I
agree'to comply with all city ordinances and state laws relating to building construction, and
hereby th9rize representives of .this ci.ty to entar upon the above mentioned property for
inspect' purP9se~. ('
T...;/V'
Qate: 4/27/2005
Fees paid for Permit:
Total:
125.79
Iic~nt or Agent
Urn tion and become null and void if the building or
work hli not passed fina ection 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 (Drain/Wastl' Pipe). . . ..
E"'drical Ground EIl'ctrodl!/Ufl'r .., I
SetbacklForrnSrrrl'nches (Footings) . 'if14J>: 1&
Dl> not install subfloor or pour floor slab until the ..
following appl1cable ilems.have been signed: .
Plumbirig (Watl'r Pipll.Sprinkler Yalvl's)
. Mechanical (Groundwork) .. .
Eledrical (Undllrground Conduit)
P....-siab (CornpactiOf!!Membrane.Reinf.
Undl'rpinning(Rilor Joist/Girders), .
Dl> not cover or conceal the work below until the
following applicable items. heave been signed:
1 st Floot Shear . . .
Fi....sprinkler (Rough) .
2nd Floor Shear . .
. Roof (Shealhing/DiaohragmlFr-a\ , . , . A
Masonry (ReinfJBond Be/lll1lPr ) '1:J.11{(}<,
Rough Plumbing (Top oun- .. . . .
Rough Mechanical .,
Rougn. t:IectrlCaI iI) -
Rough Electrica)
Framing (Only after Plbg., Elec.. Mech and Fire)
Insulalion (SoundlEnergy) .
Do not tape or plaster until the following applicable
items-have been signed: " .
Drywall . I .
P8!letrations (FiI:e Rated) Electrical , .
Pl'netrations(R.... Rated) Ml>chanical ...
Pl>netralions (Fi.... Rated) Plumbing .
Interior Lath .. .
. Exterior Lath. .
GENERAL ITEMS
Exterior Piaster (BlOWn Coat) . .
T .Bar Electrical . .
T .Bar Mechanical
T -Bar Structural .
. Sewer .
Water Engineering. Backflow .. . --,--
Water Service . .
FINAL INSPECTIONS . . Dl;lte Inspector
Electrical Final. .
Plumbing Final .... . ' .
Mechanical Final .
Gas Test ., .
Engineering/Grading F.inaI765-5126
Fire Dep!. Final 765-4040 . . ..
., '.
Water Engineering 765-5268 . .
Sub List/Business License 765.519 ,
Zoning 765-5139 ;, ,r I
Building Final . ~aStlnspection.OnIY ~/:3/ 6' D.
. . . . fter Above Complete) '" c.. t;.u"L{L
PARTIAL INSPECTIONS .
Buildina Inspections
Mechanical Inspections
Plumbinci Inspections
Electrical Inspections
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