7571 E. Martella Ln.
BUILDING PERMIT NO, BLD2003-01.481
TYPE OF PERMIT
. Residential Addition
DArE: 6/1212003
.JOB ADDRESS: .7571 E MARTELLA LN
LEGAL QESCRIPTION: P BK 75 PG 1 PAR 3
CITY'
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BUILDING DIViSION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARtER SECTION: 202
APPLICANT: MAUREEN SMITH
OWNER INFORMATION: CONTRACTOR INFORMATiON:
David Smith.
7571 E Martella Ln
Anaheim,CA 92808.
JOB DESC;RJPTlONSecond fioor room addition
. ARCHITECTI.ENGINEER INFORMATION:
.LANE CURTIS
4214 SPINDRIFT WAY.
NEWPORT BEACH,GA
VALI:lATION: 40,000.00
I OWNER-BUILDER DECLARATION
I"hereby' aff1rrhunder penalty of perJury that I am exempt from the Contractor';,: License Law.tor the following reason (Sec. 7031.5 Business and
Professions Code: any "dty or Gountywhlch requires a permit to construct; altr~r, improve, demolish or rePair any,structure, priOr to its issuance, also
requ ires, the :appJica nt for such permit to file' a signed stateinen~ that he is liC2(1sed' pursuant to, the .provisions of the Contractor's License Law' (Chapter
. 9)(commencinQ'with Section 7000of,Divislon 3 of the Business and Professi(ns Code) or that he is exempt therefrom C:l':1d the basis for the alleged
exemption. Any violation of Section 7031.5 by any applica'nt f.or a permit SL:!;l..ects the applicant to a dvil penalty'of not more than five hundred dollars
-~ ........... . ......
o I, as owner of property, or'my _employees :with wages as their sole comR'~~risation, will do the work, and thes1rudure is not intended or' offered for
sate (Sec. 7044 Bosinessand Professions Code: The ContraQtor's License L:3w does not apply to an owner of propertywho builds or improves
thereon, and Who does sudl work himself or herself or through his,or her ow;; employee...., provi,ded that" suchi!l1Provements are not intended 'or .
offered for , If, however, 'the building or improvement is sold with one ye;;,r of oompletion, the owner-builder will have the burden of proving that he
did'no IdorimprovefOrthepurposeofsale).,. . " . .
I, as the owner of the property" am exdusiVely contracting with Licensed ,:en tractors' to construct the proj_ect (Sec._ 7044' Business and Professions
Code: The Contractor's Lieense law d,oes not apply to an owner of propertY'.vho builds OiJmproves thereon, and who cont.8cts for such projects -with
ontractor(s) licensed pursuant to the Contractor's Lieense Law)~ '
" am xernpLunder Sec. . ' , B & C for thi ..reason:
ala: (P /.) 0::5 Owner:
WORKER'S CO PENSATION DECLARATION
I hereby affi;m under penalty,of perjury one of the fallowing declarations:
O. I have and will maintai,n'a.certifi~teof oonsentto self":insureforwcrker':..~tompensatio~,
as provided for by Section 3700 of the labor Code, for th'e performa'nee ofth;) work.fcrwhich
this pe-rmit is issued~ "
'0 I haye a.lid .will ma'int~in ~orker's compensation i-nsurance, as requi~d '0) Sectio'n.3700 of
the labor Code, for the pet:formance of the worldorwhich this permit is iSSI.1E_j. Myworker's
Compensation insuranCe carrier .and policy are: ' . ,
. Carrier: , ' ' Policy Numbe,r""
.pROCESSED BY: ODC
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that J am
licensed under pro'visionsof chapter 9 (commencing
with Section: 7000) cf Divsion30f.the Busi"ness and
Professions Code.
6/1212003
Date:
Contractor
NUMBER
EXPIRATION DATE
. .
This section need not be completed if the pennit is for one'flundred dollars ($1f.1G; or less,
"0 I certify th~t in the -Performance of,the work for which this perrnitisissue~,_",: 'shall not
employ any pers.on in any man'ner so as to become subject to thE:;l worker'_stf5:ili'ipen~atiQn laws
of California, and agree.that,if.1 ~hould become ~bject to the'worker's corr.~?'~.satio.n
,provisions of Section 3700 ofth~ labor Code, I shall forthWith comply-with.th\~~e provisions.
Date: 6/1212003' '. Applicanl: .1----U. 8~ . ':
, ,- .,' .' ". . '"
WARNING: FAILURE TO SECURE WORKER'S COMP:NSATION C:OVE;~;'i3E IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE!'iAl1t:=S AND CIVIL
FINES UPTO ONE HUNDRED lHOUSANDbOLLARS($100,000), IN AP[1!','ION to THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTIl::JN).?06 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES"j. Fe
I CONSTRUCTIONLENDINGAGENCV ~: -~,
I her~by affirm under penalty of perjury ,that there _is a construction lerid,ing,?,g.:-',ni~Yfor: the
performance ofthework for which this permit is is-sued (Sec.}097,.Civ;C):,.(,. -:1,:;':--'
L{'!':E!So,-,'s'-l:':-fctmz:t!.::m;'., .' "_' '-'~-~ /,,:.". _'.''C' ..,__c_...~'r"io;j;:<
TYPE.
Construcion Types:
VN, , .
Fire' ~prinklered?
UvinQ Area:
NO. .
326
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I certify that I have read. this application and state that the above _information is correct.' ,
agree to comply with all city ordinances and state laws relating to building cor:struction, and
hereby uthorize repre:sentiv~s of thisdty to enter upon the above mentioned property for
~nspeion purppse. ~ _ I ~ '.
~ \ ~ .Date: 6/12/2003
Signature of Applicant or Agent .
The permit shall expire by limitation and 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 contjnuework.
Fees paid for Permit:
Total~
992.86
INSPECTION RECORD
INSPECTION. . . DATE . INSPECTOR
Temporary Power Pole . . .' .
PlumbIng (OrainlWasle Pipe) .'
Electrical Crotlnd Electrode/lifer. . .
. .
SetbacklFormsfTrencheo; (Footings) .
. Do . not instaJl.subfJoor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) .
Mechanical (Grotlndwork) .
Electrical (Underground Condu it)
Pre-slab (compaction/Membrane.Reinf. .
Underpinning (Roar Joist/Girders)
Do not cover or conceal the work below until.the '.
following applicable items have been signed: '. . .
15t Floor Shear. . .' '.
Firesprinkler(Rough) '. ..'
2nd Floor Shear . .
Roof (Sh8athing/DiaohraQrn'Frame)
Masonry (Reinf JBond BeamlPre-Grout) . '.
Rough Plumbing (Top Out) . . .
Rough Mechanical . . . . '.
ectrlCaI ani
Rough Electrical .
Framing (Only after Plbg.. Elec., Mech.. and Fire)
Insulation(SoundlEnergy) .
Do not tape or plaster until the following applicable
items haY~ been signed:: . " - .
Drywall . '.
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical .
Penetrations (Fire Rated) Piumbing
Interior WIth .
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 . .Date Inspector
Electrical Final . .
Plumbing Final. .'
Mechanical Final . . .
. '.'
GaS Test .
.
Engineering/Grading Fi.naI765-6126 .' .
Fire Dept. Final 765-4040 .
Water Erigineering765-5268 .
'"
Sub list/Business License 765.519 .
.
Zoning 765.5139
Building Final ~astlnspection. Only .
. fter Above Complete) . . .
PARTiAl INSPECTIONS
BuiJdina Inspections
Mechanical Inspections
PlumbinalnsDections
Electrical Inspections
" .
:1
PERMIT EXPi r\L..J
. .
INSPECTION
NOT COMPLETtO
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