4867 E. Maychelle Dr.
TYPE OF PERMIT
Residential Addition . C I TV .
DA TE:4/15/2004
JOB ADDRESS: 4867 E MAYCHELLE DR.
LEGAL DESCRiPTION: N TR 7911 LOT 1
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- BUILDING DIVISION
200 S'-ANAHEIM BLVD,
(714) 765" 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS COPE: 434
QUARTER SECTION: 166
BUILDING PERMIT NO. BLD2004-01160
APPLICANT: ED CRUZ
OWNER INFORMATION: . CONTRACTOR INFORMATION:
Rosa Zavala ' I
4867 E Maychelle Dr .t
Anaheim, CA' 928.07 'J-
JOB DESCRIPTION;Enlarge bedroom and batl1, 95 sq. ft. (HIH) ~.
VALUATION: 6,393.00 I' PROCESSED BY: . FAN
I ..., , . " . .. OWNER-BUILDER tlECLARATION . .
I hereby affirm under penalty of.perjury that I am exempt from the Contractcr'~ License Law for.the following reason (Sec; '7031.,5 Business and
. Professions Code: any city or county which requ,ires a permit to construct,.~~Jt~r, improve, demolish. or repair any struCture, pdor to its issuance, also.
requires the applicant for such permit to file a signed-statement that he is lice~SeQ pursuant to the proVisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Divisipn3 of the Business and prof~;siqn~'.pode);pr th~t he is exempt therefrom and~hebasis for.the alleged
.exemption. ,Any violation of Sectiqn 7031.5 .by any applicant for a permit sybl~~the applicant to a-dvil'penaltyof.not:more than five hundred dollars .
($500). '. . "'h, '. . .', , . .
OJ" as'owner of property, or,my employees with wages as their sole com~ation, will do:the work~ and the'structure is not intended.or ~ffered for
sale (~ec. 7044 Business and Professions Code: The Contractor's License Lf~Y does.not apply to an own,er ot" property who builds or improves
thereon, and who does ,such work himself or herself or through his or her qwn,employees, provided that such improvements'are not intend~ or'
'-offered fo~~le. If,however, the bl1i1ding or improvement is s~1d with Qney,~~t.of.completion,.the owner-builder w;t1 h_ave t~e bwdenof'proving thathe
did not bU,ildor improve for ti)epurpose of sale). .' '~>. ' '.' '. . . ,'.' .
J!d" _ 1,_ as.t~e owner oft~e:pr, operty,_ am' exdusively contracti.ng w, ith licen.ed 49'i'tractors to conslructthe project (See. 7044 Business"and Professions
Code:. The Contractor's Li~nse Law does.not apply to an owner of prope r!:.Y '#1:10 buildsor improves thereon, andwhorontracts for such projects w.ith
~on, ~rador(s) Iic.:~ed pursuant to the COri~ractor!s license Law).{i:. - . .'
_ !a e:~emptund~rSE:c.'. .. B &'P.C. for this reason: ~I"
ale: - 5-0 1- Owner: . -'
WORKER'S COMPENSATION ECLARAtION'
I hereby ~ffirm underp,enalty of pe~ury orre-of the following declarations: _"w
o I have and will -~i~ain. a certiftcat~:of consent to- self-insure for worker'sfompensation-,'
as provided for by Section 3700 'Of the labor Code, for the performance 'Ofth~'Work for which
" this permit is issued. S ~,~ '
o I have and will maintain worker's compensation insu~ance, as required b;1Section 3700 o"f
the Labor C.ode" for the pert..orm, ance,'Of the work for w~iChthis permit is iSSUe4.'. Myworker's
CompenS?tion jnsuran~ carrier and policy are:.. . . ~. _ '
:Carrier:. " . ". . Policy Number. _': r., .'
This section neOd not ~ completed Iflhe pennilis for ,one hundred dollars ($100)\'r less.
"0 I, 'certity.that irl.the performance of the, work for which~his permit is isSue~' j'$hall nC?t '
emp~QY any person in any manner so as to becorr..e subject to thl? worker's .cotrpe~sat,on laws
of California,: and',agree that-if I should become subject to the worker's'compefisation '
provisiqns of Section 3700 of the lab~r Code, ,.$hallforthwith comply whh,thdfe,provisions.
Date: 4115/2004.' APPlica~~;;'" ()-aua-t'4: .'
VVARNING:FAILURE TO SECUREVVORKER'S COMPENSATION COVE;,Ri"'3E IS
UNLAVVF.UL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENi(\L'fjES AND CIVIL
FINES UP TO ONE ,HUND RED lHOUSAND DOLLARS ($100,000), IN AciprflON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOI'i:,706.-OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I . CONSTRUCTION LENDING AGENCY: ..
1 hereby affirm under penalty of"perjury that there is a construction lefld ing_-agE'.:1cy fOJ the
perforrllanteof the work 'far which this permit is issued (Sec.3097.ciV.C): . I .
Lender's Information: . -- I
r
::.r
ARCHITECT/ENGINEER INFORMATiON;
UCENSED CONTRACTORS DE:CLARATlON
I hereby'afrir'm under penalty of p~rjury that.r~rn'
liCensed u,nder provisiol}s of. chapter 9 (commel1cing
with Section 7000).of'Divsion ~ of~he Business and.
Professions Code. .
4/15/2004
Date:
Contractor
NUMBER
EXPIRATION DATE'
TYPE
Canstrudan Types:
VN,', .
Li.vinQ Area:
95
. .
'"fcertify ih~t1~have: reaci 't~l$ 3iJPIICaliOrl' a.nd state thar'tn-e'~tfbwHi1f~rr'ri~~k>'~'j~\~'iJrie;;{r:f-:/ '''"-- .
agree to comply with ~Ii.city, ordinances and-state laws relatirig to buildingcon.<:trLiction. and
hereby authorize representiv~ of this ~ty to enter upon the abov~ mentioned propertY for
in. n ses.
, ,-' - .
-'~-~~ ~-.----"""-.~'"
Date: 4/15/2004
Fees paid for Pennit:
Total:
0.64
Signat re.of pplicant or Agent
. The permit shall expire ylimitation and become null and void if the building or
work has not passed final inspection 365 days from till> date of permit issuance. A
new' permit is required to commence or continue work.
.
INSPECTION RECORD
;,~'~", .<~:'~,,:
'~
.' . INSPECTOR!i .
. INSPECTION ' . DATE
T emporaryPower POle. . '. '.
Plumbing (DmintWaste Pipe) . ....,,,
'. ElectriCal Ground Electrode/lifer' .. .
setbacklFormslTrenches' (Footings) . .
Do not install' subfloor or pour noor slab until the ....
following applicable items .have been signed: .
. Plumbing (Water Pipe,Sprinkler Valves) .
Mechanical (GroundWork) '. ,'. .
Electrical (Underground Condu it) .
. . Pre~lab (Compaction/Membr_.Reinf.: . .
. l!J).derpinning (Floor Joist/Girders) '. .
Do not 'cov",r or conceal tile work belOW until the
following appljcable items have been signed: . .' .
1 st Floor Shear' .. .' ..;u ~C ., ~.
Firesprir'lkler (Rough) " . '. '. .
2nd Floor Shear. . '. . . . 11 ,;,
Roof (Sl1eathing/Dlaphmgm'Frame). .' Vn~Ol" ?""/~,
Masonry (ReinfJBond BeamlPre-G'9Ilt)
Rough Plumbing (Top Out) , .
Rough Mechanical .'. '.
Rollgh E1ectncal'.....y nail) .' . . . . .
Rough'E'leclrlcal . '. , ./
Framing. (Only afterPlbg:.~Jec..Mech:, and Fire) !Ylb'~ Yb/ ~/""".'
Insulation (Soun.dIEnergy) . j -n.a, ""1M j "h .
po not tape. or pla~ter until the following applicabfe. . (2 . .
.Iems h!'ve been Signed: . ". ....
Drywall . .... .' ~'l.',-o't ILl II
Penetrations (Fire Rated)Electrlcal .. .
Penetrations (Fire Rated) Mechanical ' . . '.
Penetrations (Fire Rated) Plumbing' . .
Interior Lath . . AI '. .
Exterior Lath . . . 'i'-~4'
'. ' . GENERAL ITEMS . " .
Exterior Plaster (Brown Coat) . q-OfMJ<! Iff."
T .Bar ElectriCal .'
T .Bar Mechanical . . .', ' '. . . .
T .Bar Structural. . . . ' .'
-
Sewer . . .
Water Engineerlrg BackfJow . .' I.
Water Service .
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FINAL INSPECTIONS
Electrical Final
Plumbing' Final
""', ... ~~.
Mechanical Final
Gas 1esl
Engineering/Gracling Final 765-5126
Fire Dept. .Final 765'4040 .
Water Engineerlr'lg765.5268
Sub List/Business License 765.519
Zoning 765.5139
. Building FinalClasllnspection- Only \
. . After Above Complele)
PARTIAL INSPECTIONS
Buildina InSDections
MechanicallnSDections
Plunibina,lnSDections
ElectricallnSDections