2511 E. Lizbeth Ave.
~.
,"'_,'c__:._
.'.,'c-__'
'-~". '
'_,~......;.;...;.. ,','" .....7
. BL02~04-01454 . . tSif(~*~~~;t~\
C ITY Q:ffi1'ht;-~~H ElM
\\ \\~'l~~.;o"d.:;'rci~,~
'\\' .:r.,::y.... ,'t'!;.~~>1-:;~'i;.- /1
'~~~1F,:~;)f
-_.,-
BUI~QIMG P!iiRMlTNO,
'. -~. t'. ....,,'
-.,"L'..l"," .
TYPE vFPERM1T
Residential Addition.
. .
DATE: 4/29120(14
JOB ADDRESS: 2511 E L1ZBETH AVE
BUILDING DIVIS:qN
.~ ~oo-s. AN;.\HEIM B!-VD~ .
(714) 765- 5153
!NSPECTION REQUEST LINE:.
(714) 765 ".4625
CENSUS CODE: 434
QUARTER SECTION: 124
LEGAL DESCRIPTION: N TR 4425 LOT 23
APPLICANT: BOB ASACHIKA
OWNER INFORMATION:
RabeitT Asachika.
2511 E Li<b.eth Ave
Anaheim, CA 92806 . .
. . JOB DESCRII?TIONEnc1ose existing over hang to create closet i? master bed'f"m. (HIH)
VALUATION: '1,700.00 . .0. .
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury,that.l am exempt from the Contractol~s L}.:::.E,mse Lawtor the fotlowing reason (Sec. 7031.5 Busines:;> and
Professions Code: any ,dty or county which requtres a per81 it to construct, al~1r,' improv~, demolish or rep.3\r ~ny structure, prior to its issuar1Ce, also .
requires the applicant for such permit to file a signed statement that he is licbllsed pursua,nt.to the, proVisions of the Contractor's.License Law (Chapter,
9)(commencing' with'Section 7000 of Division 3 of the Business and Profes$i?t1::; Code) oxtl")gJt h;~'js E:l>;:empt therefrom and the basis ~orlhe alleged
. exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a dvil,penalty of not more thar:l five' hundred dollars
($500). . ....;. . .... . .
fll. !, as owner of property, or my empfoyeeswith w~ge~ as th,eir sole comr,~nsation, '!ViII do the wNk, anQ the structure is notinten~:ledbr offered for
sal-e (Sec. 7044 Busi~ess and Professions' Code: The Contractor's License lbw does net appl-yto' an owner of property who build:sor.improves .'
~hereon, ,and who does such work himself or. helSslf or throug'h his or her oW~'employe~s, p'rovided that such improvementsarenot-intended Of.. "
. off,eredfor sale. 'If,'however,. the building or improvement is sold with one ye;:r'of completion, theowner-bl,Jilder will have the burden of proving thafhe'
did'not build or improve for the pUl'Pose of sale). ,:~; , "
LJ I. asthe,,owner of the property, am exdusively contracting with licensed ,'corltra:ciors to construct the P{C~.ct (See. 7044 Business and Profe~ions
Gode:, The'Contra.ctor's license Law'does not apply to an'owner of propelt/vhoiJuiids or ill1proves,lhereoJ"l.and who oontracts for sl;l,c!1 projects,with
~. . ontractor(~)lice. nsed pu. rsuant to the Contrac.tor's uce~se Law). .
.1 ~m exempt under Sec. '. . & P.C. th reason:
Date:' -~ -.9 'f . Owner: .
CONTRACTOR INFORMf\.T!ON:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ODC
,
"
~
I hereby affim\Under.perialty of perjury 'on's of the folt0wing declarations: , ~ .
o I have 'and wiJlmaintain a certificate of consent to ~rf-insure for worke,~'~ ~l1mpell::>ation,
as provided for by Sectiori.3700 of the Labor Code, for theperformanc;:e oftJ;)~ work for which
this permit is issued: ,
o I have and will maintain worker's compellSation insurance, as re'quireci VI Section 370001
the Labor Cod,e, for the performance of the. work for which this permit is. issu;d. MY-',f,jorker's', >
Compensation insurance carrier and policy-are: '
. Carrier: Policy Number:
'--Llc~~isEU CONTRACTORS DECLARATION' F
I her~by,'affirry1 unde~ penaJ.tY of perjury,that I am
licensed under provisioo1S of chapter"9 (commencing
with Secti9n ';0000) of Div.:;ion'3 of the' Business an<;l ,
P~fessions Code. .' ,
:\/29/2004
Oat€::
Contractor
NUMBER
EXPIRATION DATE
This sectio,nneed not be.completed,if the pennit is for one hundred dollars (.~10(i.) or.,I~~ "
o I certify that in th~ perto rrnance' of the work for which this permit is j}sur~.~d.- I ~~.'JJ not:;
employ ?ny person in any manner so as to.became subject to.tJle warke.f.s c-~rripei:1~'atiorrlaws,
of Califomia, and agree that if I should become subject to the worker's cor.:-.;.~;,saff()n '. ,
provisions of Section 3700 of the Labor Code,l shall f with compfy'wi!t' t~~SiP;:Ov.isions.
"
TYPE
Dale: 4/2912004 . Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVE~:'\<3E;JS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE&,.J. f1ES:ANDCI\fIL .'
FINESUPTO ONE HUNDRED lHOUSAND DoLLARS ($100,000), INAElDlllON:::tO THE .
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIQroI370~'OF THE
LABOR CODE, INTEREST AND ATTORNEY's FEES."
CONSTRUCTION LENDING AGENCY
Construcion Types:
VN" '.,
FIre Sprinklered?
'NO
~~~~e~,affi~~._~~~~."p:n;lty~f. ~e~j.l~ry Iha~ !~.~,.~ is a ~o~strlJ~~.!io~.1~n9~~fJr-t1~:~cy .f?r-tre
~",.....,"";'I;"":' v. uiC n>,),1'\. ;(u"W.a...11 u"::' ,",l;ilntll~ 1~s.u~U \~ec.61..r;;.( .\...IV.\...): " .
Lender'S Infdrmation:
I certify that 1 have read this application and state that the above infomia'tlon i~ correct. I
agree tocomp!y with all city ordinances and state laws relating to buMingc:ons,truction, and
hereby authorize rep~sen ives of this dty to enter upon the above mentloneJ prOperty for
. inspectiOn rposes
Fees' paid for Perr:nit:
. Total: .
0,50
Dat.: 4/29/2004
Sighatureof Applicant or Agent
The permit Shall expire by limit~tion and become null and void it thu building or
wOrk has not passed final inspection 365 days trom the date ot permit issuance, A
new permit is required to commence or c,o~inue work. .
INSPECTION RECORD
" INSPECTION" ' DATE INSPECTOR
Tempor;lry Power Pole'
Plumbing (OrainiWa$te Pipe)
Electrical GrOUnd ElectrodelUfer
SelbaeklFormsftrenches(Footings) -0
Do not install supflOor or pour f1oor,slab until the
fo1\owing applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
M!ichanical (GrciUndwOrk)
EIec.trical(Underground Conduit)
'Pre-s ab (Compaction/Membrane. ei
'Underpinning (Aoor"JoistlGil!lers)
Do ,not cover or co,ncealthe, work beloW until the
fo1\owing applicable items have been signed:
1 st Floor Shear
Firespiinkler' (Rough)
2nd ,Floor Shear
Roof (Sheathlng/tiiaphragmlFramll) ,
Masonry (R8lnfJBondBeamlPre-Grout)
Rough Plumbing ,(Top Out)'
Rough "Mechariical
, ,Rough ElectrIC aU '
Rough Electrical
Fi'lIrnilig '" (Only after PIbg:, Elec"," MeCh, and F;
Insulation (SoundlEnergy)
po noltape or pla~ter until the foil
Items have bllenslgned:' '"'
Drywall ~ (,"
PenetrationS (,",1'8 Rated) E!ectrical
Penetralions,(FireRaled) Mechanical
Penetratiol1$(Fire Rated) Plumbing
interior Lath
exterior Lath ' , -I
GENERAL ITEMS,
Exterior Plaster (Bra;vn Coal)
T-Bar Electrical
T-Ba,r Mechanical'
" "T-Bar Stnictur;ll
Sewer '
, Water engineering ,Backflow
Water Service
FINAL INSPECTIONS "- Date ' ,~.nei 0" r
. ~,.;J:r~.
Electrical Final, . '11-:1: ...,
, )__.";<,, /" I
Plumbing Final , (d '"
Mechanical Final' ",
Gas Test
Engineering/Grading F,iilaI765-5126 ' '
,
~" '. ' 4' ,
Flte Dept. Fmal 765-40 0 ,
Wate,r Engineering 765'5268 " , ,
SubListlBu~iness License 765-519 I'~'" ex,e
Zoning 765'51,~9 ,
,
Building 'Final *ast Ins~ection. Only: ' i.(/!J"odf' a ~'VA' '
fter Above Coinp/e~l
PARTIAL INSPECTIO~S
. .
. .,.'
Bulldma Inspections
//
Mechanical Inspections .
---~ . . ,-' '.
lumbina Inspections
Electrical Inspections