3133 W. Lindacita Ln.
BUILDING PERMIT NO. BLD20ll3-.!l31S'f
TYPE OF pERMIT C T
Residential Addition I Y
DATE: 9/2/2003,
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JOBADDRESS: 3133W ~jNDACITA LN
LEGAL DESCRIPTION: N TR 2611 LOT 111
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BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765- 4626
CENSUS60DE: 434
QUARTER SECTION: 9
APPLICANT: JAMES NOLAN
OWNER INFORMATION: CONTRACTOR INFORr.1A'I'ION:
Craig Zabodyn BELMONT BUILDERS INq
3133W Lindaeila Ln' 6616 SAN HAROLDO WAY,'
Anaheim, CA 92804 BUENA PARK, CA' 90620 GiGO
, ' , BUSINESS PHONE: 562 4a,~:7888
JOB DESCRIPTION; Add family room and bedroom i'
. ~
VALUATION: 38,765,00 \' P,ROCESSED BV: ODe
"I OWNER.BUILDER!~ECLARATlON ,--I
I hereby affirm under pel1alty of perjury that I am exempt from tt1e Contra:cf.or'~ LicE:ll1se law for the following reason {Sec. 7031.5 Business and:' .
Professions Code:ahy city;!)f county Which requires a permit to consti"uGt~ aa!/r, 1:T1proV~, demolish, or repair any structure, prior to its' issuance, a"lso
requires the.apPlica, nt for sUch, p,errnit to, JlI,e, a S,igned s,tatement t, hat he, is nc~, :,iCSed pur5,ua,n,t tathe PJOVl, ,'Sions of the Contractor's License ~aw (Chap,ter
9)(commencing'withSection 7000 of Division 3 of the'Business and Pr6fess\.'~IS Code) or.that heis exempt therefrom and the basis for the alleg~
exemption. .. Any violationo~ Section 7031,5. by any applicant for a per~lt SU1~!;~t;ts the a pplic:ant to a civil, pen'alty of not m~re th,a ,n five, hundred dO~,!ar~
($500), ,,"'. '
D', I, as owner ~ property, or my employees with wages as their sore com(xi:'1Saticn,WHI'CJo" the work, and the stru~ture is noti~t6nde~ or 9f(e,et;j'for '
sale (See, 7044 Business and Professlo':ls Cod,e: The Cont~ctor's' Ucens~ Fr'# does not appl~ to an owner of property who ,buIlds ()r Improve~ "
.thereon~ and who'does such work hi~elf or herself or through his or h~r oWr,;employees, provided that such improvements are-notintended or
. offered for ~Ie,_ _If, however, toe building 'Of improvement is sold with one Yf)~'+- of completion, the owner-:-builder will have the Durden of proving that he
didnof,buildo~improve'for.thepuJPos'e-.ofsale), , .. J . _. . "
O. I,asthe owner of"the property, am exdusively contracting with Jicense<! ~!:>ntr<3ctors to construct the project (See. 7044 Business and Pmfe.ssions
Code: The Contractor's License Law does not apply to an owner of propei't'jhho builds: or improv&S thereon, and whooontracts for such projects with
~ontract:or(s) license? purs,uant 'to the Contractor's 'Ucense Law),
~ I am exempt onder Sec: ,B &P.C, for this reason: ----.J,:
Date: ", Owner: "
I WORKER'S COMPENSATION DECLARATION ~(.
I hereby affirm under penalty of perjury one of the following declarations: ' ':
o -. I have ~nd will n1airitai~ a certifICate 'of consent to self-insure for work'31~!ccmpi:msation,
as provided for by'Section 3700 of the labor-Code, for the performance oft!.i~W-ork fo-r wilich
this permit- is issued, .
[J J have and will maintain worKer's compensation insurance.-as required bY:Section3700 of 91212003'
the L~bor Coo'e, for the performance of the work for which this permit is'issue.i,' Myworker's Date:
CompensatIon insurance carrier and policy are: ., '_ ",
'Carrier: ' .' PoUcy Number. EXEMF-TJ . ,""
Thi~ s tion need not be. cOmpleted if the 'permit is tor one hundred dollars ($1Jj(~~;C$~" ;:':':)'
. I certify that in the perfonnance of the work for w,hich thi!?pe'rmit is 'i~:ll?~,.ij~~:3Ji _n~f" :.',-
employ any person in a ny manner so as to become subject to the wor~er's c.?;~ps't.~!~ !aws
of Califo mia, _and agree that if,l shou ld beqome su bject to the wo rker's cQmp~ ,1~t!O~rr :\:_',::';:';:;
provisions of Section 3700 of the Labor Cod , shall forthwith comply With th~.iitl?rQVisio.ns.:"
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Date: 912/2003,' Applicant: - ':'_? it:~"" ',., '
WARNING: FAILURE TO SECURE WO. KER'S COMPENSATION COIiE~:p,~:\E.)? <:
UNLAWFUL,AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE;NAdiE'SAND CIVIL
': ,FINES UP TO ONE H,UNDRED TI-iOUSAND DOLLARS ($100,000), IN AD, :pr~"9N,T"O,.T!;ff
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION: _" ,;:if'm!'
LABOR CODE, INTEREST AND ATTORNEY'S FEES, , ':> ,,4;}" ,'} ,.
I CONSTRUCTION LENDING AGENCY.":,l;,:,,,' JF .
'I hereby affirm underpenarty of perjury that there is a constructi(),n lend,in,gag-€{:.I\;y.,!,prthe'
'?--"'tfl7~:,)~~~ o:.~~he~'..;:o:,~.--fc!'" ~...'h~:h ~'!$'p-::'!'-..:t:~ fsi.:cd{~~c-.;:.~C{)1'.-C;~'.-::'7; .-,----:./--::: ,~-"",;";-
Lender's Information: .
ARCHITECT/ENGINEER INFORMATION:
-:=J
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury fhaU,am
licensed under provisions of chapter 9 (commencing
with Section 7000 of D" 'ion 3 'of the Busihess and
Professions C
<..--........'
CQ~dl
'NUMBER
607841
TYPE
TYPE
'EXPIRATION DATE
12/31/2004
B
HIC
Construcion Types:
VN, ,
Frre Spril,kiere'd?
L\vin~ Area:
NO
576
,t''''
"
I certify that I have read this application and state that the above information i~; correct. I
agree to CQmplY with all city_ordinances ar:Ki state laws relating to building cOn.,;-truction, and
hereby autho.(. e representives of this city to enter uPon the .above mentioned property for
inspec:qo r ses,
Fee~ paid for Permit:
Total:
1,330.87
Date: 9/2/2003
Signature of Applicant or Agent.
The permit shall expire by Iimitati()nand become null and void if the building or
. work has not passed final inspection 365 days from the date of permit issuance. A
new permit is 'required to commence or continue work.
'If
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INSPECTION RECORD FINAL INSPECTIONS . Date . Inspector
,
. . Electrical Final 1/_U-o::1 . L'77;/it Ph"
. INSPECTION DATE INSPECTOR
Temporary Power'Pole . Plumbing Final. '. .
. . .'
Plumbing (DrainlVVaste Pipe) . --,- I-;~!-~tj ~~IZ
Mechanical FInal . . .?'/~ ..
Electrical Ground Electl'l:ldelUfer ,
SetbacklFormsfTrenches (Footings) ~"""_.LN, Gas Test . .
Do not install subflaor or pour floor slab until th., Engineering/Grading Final 765-5126
following applicable itenis.have been signed:.
Plumbing (Water Pipe.Sprinkler Valves) . Fire Depl Final T65-4040 . . . . .
Mechanical (Grollndwork) . . Water Engineering 765-5268 I ". .
Electrical (Underground Conduit) .
Sub List/BusIness License 765-519 Iz~-Q~ .$5.e .
P~-slib (Compaction/Membrane.Reinf. A .
Underpinning (Floor Joist/Girders) '. 19'7d~ I?T/ Zoning 765-5139 ..
. -- .
Do not cover or conceal the wOrK below' until tn. , . v/", .. . Building Final ltastlnspection.Only '2?~ /"
following applicable items have been signed: '
1st Floor Shear . . '.' ~t1..?~ _.::...--- ' . . fter Above Complete)'. . .
. . . ." . '.PARTIALINSPECTIONS '. ,y .
Fi.esprinkler (Rough) Ii' /' .
2nd Floor Shear . ,. ~. SUildi"; Ins=s . . .... '. ..' _. .
Roof (Sheathing/Diaphrallm/Frame) i'~ 1\1 ~-.:-'.'-Cf. '.. ..~$ah c)R.~~
Masonry (ReinfJBond Beam/Pr.c;rout) n 'h
Rough Plumbina (Top Out), . . .
Rough Mechanical . . .
I Rough 8ectrICaI (Drv Wall) . .:
Rough Electrical ' .' . . '. , .' . "
Framing /Only.atterPlbg.. Elee.. Mech.. anqFue) 'iJ-'/603 ~______ . .
Insulation (soundlEnergy)'., . I/IIY"",,~ \ . K.... II, Mec:hanicallnspections
po nQttape.or pla~ter until the follOiNing4Jp(/1icablel .
.tems have been sIgned: . . . I. . . . . :
Drywall 'tJ?fl-o;? ~ ---- .
. .
. Penetrations (Fi" Rated) Electrical v
Penetrations (Fire Rated) Mechanical .' . . '.
Penetrations (Fire Rated) Plumbing . -,- .
Interior Lath . ,
. GENERAL ITE~'. .Plombinq.lnsDectlons -
Exterior Lath
. . ,r . .
Exterior Plaster (Brown Coat) . . .
. T -Bar EieclricaJ
T .Bar Mechanical . . . . . .
T-Bar Structural . . .
Sewer . . .
.
Water Engineerlng.BackflOw . Electrical Inspections .
Water Sel'vice .
. . .
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