1239 N. Maplewood St.
BUILDING PERMIT NO. BLD2005-02455
TYPE OF PERMIT CITY
Patio Cover
DATE: 8/5/2005
JOB ADDRESS: 1239 N MAPLEWOOD ST
LEGAL DESCRIPTION: N TR 2021 LOT 9
J:::Lc;:l.ao )-'-6Ilf4-
APPLlCANt:EVONNE MORTON
OWNER INFORMATION:
SlEPH EN WENZEL
1239 N MAPLEWOOD ST
ANAHEIM, CA 92805
CONTRACTOR INFORMATION:
L J HAUSNER CONSTR UCTION CO
505 W 1ST ST
TUSTIN, CA 927800000
BUSINESS PHONE: 714544-3100
JOB DESCRIPTION:Build 310 square foot aluminum patio enclosure ICBO# 5294P.
V ALUA TlON: 5,500.00
ElM
BUiLDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 91
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
hereby a irm under penalty of perjury that I am exempt from the Contractor's Ucense aw for the to lowing reason ( eG. 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 purpuant to the provisions of the Contractor's License Law (Chapter
9){commencing with Section 7000 of Division 3 of 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 hundred dollars
($500).
D I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License l4W does not appJyto an owner of property who builds or improves
thereon, and who does such work himself or helSeJf or through his or her own'employees, provided that 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 purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (See. 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
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. , 8 & P .C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of pe~ury one of the follOWing declarations:
o I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the labor Code, for the performance of the work for which
~hj permit is issued.
'I have and will maintain worker's compensation insurance, as required by Section 3700 of
Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: CLARENDON Policy Numbec 03KR0002926
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o I certify that in the perfonnance of the work for which this permit is issued, I shan not
employ any person in any manner SO as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the ab Code, I sh forthwith co ply with those provisions.
Date; 8/512005 Applicant: "I----:
WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVE AG
UNLAWFUL, AND SHALL SUBJ T AN EMPLOYER TO CRiMINAL PENALT AND CIVIL
FINES U P TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, i'lMAGES 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 construction lending agency for the
performance of the work for which this permit is issued (Sec. 3097 .C[v .C):
Lender's Information:
I certify that 1 have read this application and state that the above information is correct. I
agree to comply with all city ordinancp_'5 and state laws rel::>:ting to buijding l)o~!nK'tjon, and
here auth . e representives of this city to enter upon the above mentloned property for
in~ ion ur s.
Date: 8/512005
Signature of Applicant or Ag
The permit shall expire by limitation a 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.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of D1i ion 3 of the Business and
ProfeSsions e.
8/512005
Date:
NUMBER
326317
TYPE
TYPE
Construcion Tvpes:
V N, ,
Fire Sprinklered?
Contractor
EXPiRATION DATE
1131/2007
B
D3
NO
Fees paid for Permit:
Total;
562.58
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION OATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground ElectrodelUfer
SetbacklFormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
-
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Rein!.)
Underpinning (1'loor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf.lBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele.. Mec. And Fire)
Insulation (SoundlEnergy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical
T.Bar Mechanical
T.Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Depl Final 765-4040
Water Engineering 765.5268
Sub ListlBusiness License 765-5194
Zoning 765-5139
Building Final (Last Inspection. Only
After Above Complete) I D~ r
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections