1352 N. Miller St.
TYPE OF PEORMIT
Ten~nt Improvement(Limited)
DATE: 3/31/2005
JOB ADDRESS: 1352 N MILLER ST
CITY
-",.
l:,~;)g-\i:~~,::\ . .
,-. . . ~d~HEIM
\~::iJ~!f~&t/
9L1ILDING DIVISION
200 S.ANAHEIM BLVD.
(714) 765.5153
INSPECTioN REQUEST LINE:
(714) 765. 4626
CENSUS CODf: 437
QUARTER SECTION: 14:3
BUILDING PERMIT NQ.
BLD2005.00550
LEGAL DESCRIPTION: KRAEMER TR LOT 2 BLK KN 132 FT S
..
).1
'1
.,
APPLlCANT:OSCAR PALAFOX ,\
OWNER INFORMATION: CON. TRACTOR INFORi...j!ATION:
Nell T Genovese J
19692 Live Oak Canyon Rd . )~
. Trabuco, CA 92679 '. ~ .
JOB DESCRIPTIONNew 300sf storage cover and detached haodicap rostrer
VALUATION: 40.000.00 . ',i . PROCESSED BY: MJL
~ . . . . OWNER 8UJLDE, : DE_CLARATION. _-:=:1
I hereby affirm under penalty of- perjury that I am ~xempt from the Contract r':;. Ucens~ Law for the following reason (Sec.-7C31.5' Business and
Professions Cede: any city or county which requires a permit to ('6nstruct.;i.,~~" improve, dem:Jlish or repalr'any'structure, prior YO its issuance, also
.requires the~.PPlical1t for such permit to file a sigred statement th. .at.he is li,.~:~., need pursual'i.t to th~ prO\.1s.ions O.fthe contractvr'.s Licen.se Law (Chapter
9)(comm~ncing with Section 7000 ofDivisiofl 3 of the BL!sine~s a~l.d P.rof~~ionr; Cod~) or i.hat he is exompt therefrom a"d the basis for the ailegeci
exemption. Any violation of Section 7031.5 by any applica~...t for a pennlt st.,,:.j:?;cts the ;3 ppl!caflt to a dvii. penalty of l"!ot mQre th~n five hundretl,dolla'rs.
-~ . ." ...... t ..... . .
C2'" I, as owner of property, or my employees with wages as [heir..';:c_Je con?peusatb0, w;i! d0 tns work, .ard the:: strlldure is not intended or offered for
sale (Sec. 7044 Bljsiness and professions Cede: The Gontr;Jctor's ,Ucensoe:.lLaw does nct apply to a11 owner of property ,,\hbbuilds o. Improves .
tt),ere.cn, and ,^,'ho does suer. work hil'f\Selt or herself c.r. through.hi$o: h~r {)~;rl eJ~p]cyee2-, plovicad that such improvement.s.~fe not intended or
offered for $a!e.. If, however, the- biJilding or improvement !s sold ,V-Jith one ~!,',!c:rcf '::Otr!pletion. the ownerRblJilcer will "have the bu;~en of.provj~lg th&fne
did not build or im;:::.rove fe.-the rJurpose of sale). ,.~' , . . . "
o L as the ow~er of the property, am, exdl!sive.ly ccntractin9\;.)lth !k::e'lt:.<.~J (X.irdrz(:f:ors to (;,'ln~t(l..:ct ll-;e project (See., 7044. Btisines~ a1ld Professions
Code:" heContract'?r'& Uce"~e'l?\o\.' does not apply to ,m ownercf rrvC'3Ii,yW1.1L: builds or lrn~rov-e::;, ther~on, ::ndwno'~ntracLs fer SUcrl projects Vv;t~
r-'fQf:t:3ctor{s) licenssd PUfSU8Dt ~o tne.Con~ract.;H's License r~~W). . .J':~
.L_J. 1:,m}-eX~P%~.S6c.__~, It. P. . fc . .1is rc:~:;or.: --:1--- _ __________ .~~.___." _ .~~_.._.
Dale:~'2.R-j; .. Owner: ... ___'~,'" ______._._"__~
L..":' T- ~~~ WORKER'S {;Q.!'!..St!S ION Dj;gLARATjOJ.Lj_._.~._-_J r-TicENsEDCor..i-RACTORS DECLARATION
: hsr-eby.r:ff.l:mlind~r.Pi?nc:lty of perjury one of the .following decl;)rations: . W'.. ". I ,j hereby ati.irm :'!f'H'ier pel!<'!ity of perjury that I :-~!Tl
~ .. . . I-. ! Ecenscd under pr::lvlsions of cnpp1,~r 9 (commencing
~~ . aveand will ma. !ntaln a certific~te of ccinsent icse[f. ;11$lJre ;or wor~'.::Js ccrnpE:.n~i:1tion, I
~s :::rovid,~ tOLby Scd.:ipn 3700 of the Labor Cl,Xle, fcrtfle perior:n:nc-.: of !le \~;:>rX for W!'lth w;th Section-70CD) of Divtiofl::S of the BU3iness'alld
this_ permit is is$ued.. ....' "', . Prcfessicn~ Code. '
[] 'have and wiil maintJin worker's compenS<:ltioil j"l<::;uranG:;!,;)srequ="re;~{yf.e.ct!'J!l3700of I 3,':;1/2005
the Labor Co~e, forthe performance 'of !he work for.vfhich fhi-':> pel"mit ,s is.::4.::d. My worker's I Date:
Compen&'ttion insurance C3rrierand policy are:- ..j'
Carlier: . "", .' Peli':l Nl~ rnber. ".}. I NUMBER
Thls.~ection need. not be completedifthepennit is for one hundred. dc-lIars {$j~\;ior \<::$5.- I TYPE
lf2j::A>certifY thGitin the perfonnance. of the Work fer; whlcil this permit is r~~{j;ld, 1 shall not
~pioyany, person "in any manner soas to become subJef~t to the wo:'kerri:.,:d:J;:,;"Ir.ens~tion laws. " '. .
of Califomia, and agree that If I should become slibfed, tQ thewDrker's coo';;,:::::o;::ltit:..lj' I
provisions of-Section 3700 of the Labor Code..! sha orthwith,C'..... ')iy w;t:itr:;.'~a prov!s:ons. Ccnstrucion Types:-
. . JV N. .
Date: 3/31/2005 A.ppJ;cant: .~_ - :;;<.~.~_____ Oc.cliPZmcyGroups:
WARNING: FAILURETOSECIJ~W.o~KER'SC: PENSATIONCO\tEF!KG~'IS . "1:..8., '. ,
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYI;RTO CRIMINAL PEN,;".r!:::S ANO CIVIL' r"~ Spnnk,ered?
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($'100,000). IN ADli":T10p~ TO THE I New / Additionai Area'
COST OF COMPENSATiO~I. DAMAGES AS PROVIDED FCR IN SECTi'::f; 3706 OF 1':,1'. I
LABOR CODE..INTEREST AND ATTORNEY'S FEES. . '. . '
! . '. '.' .' CONSTRUCTION LENDING AGENCY""'.-'''.._c _ --1
!'hereby aff:rm under pen.ally of perjury that .there is a constructicn !~J1-jing "l,~:-er.1'; fur ~
pef!,')~~~~~_.9.!~h~_~~rk.f?rwh!9~.~_t-i~.p'er::nitb1SS!ed<'~er:.3097.Chi:r.}: i.~ >. "t"_"__
Leryder'sJntormatlon: -
ARCHITECT/ENGINEER INFORMATION:
CClltmctor
E>~P1RATION DATE
NO
375
---------.-;""'-=---'~._--' :~."-,,--'-~'-----'
f certify that I have read this appl1catfon and statethat the above' information is correct; I
. agree to comply with all city ordinances and state laws relating to building construction; and
hereby authorize r,epresentives 0 this city to enter upon the abovementioned property for
. inspeCtion putpo s. .
, '~,
Oak 3/31/2005
, ~ees p~id for permit;..
Total:
1,515.56
Si ature 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 d;lys from the date of permit issuance. A
new permit is required to commence or continue work.
'.
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-519
Zoning 765-5139 '
Building Finai, fLast Inspection. Only
. After Above Complete)
PARTIAL INSPECTION
Buildina Inspections
INSPECTION RECORD
.
, INSPECTi,ON, .
'.' , DATE INSPECTOR,
, ,
Temporary Power Pole ,
Plumbing (DrainlWaste Pipe) "111.(/0"( {oJl4 Le,', '
EIe.ctrical Ground Electrode/uter,
.. SetbaeklForrnsfTrehches (Footings) ifil'l lor '1Jl1t\;r.:
Do not :install subfloor or pour floor slab until the
following'applicable items have been s.igned: .
. Plumbing (Water Pipe.Sprinkler Valves) .
,
. Mechanical (Groundwork) , . " ' . .
" "
Electrical (Underground Condu it)
, Pre-slab (Compaction/Membrane.Reinr.
Underpinning (Floor Joist/Girders)
Do not cover or conoeal the work below until tne "
following.applicable items have been signed: ,
1st Floor Shear' ,.. , " . . ,
Firespri nldel' (Roug h) , . .
2nd Floor Shear '.
Roof (Sheathlng/D1aphragmlFrame) .' 1.>n3;"; I17A44:t
Masonry (ReinfJBond BeamlPre-Grout) I~ ,
Rough Plumbing (Top Out) ", 1/74V tr
Rough Mechanical' . . .
Rougn t:lectrlCaI tury nail) ~
Rough Electrical IrhAlJr
Framing (Only after Plbg., 'Elec.: Mech:. a(1d Fire)
Insulation (SoundlEnergy) , 1../1t,16r Vlkl> '
Do not tape or plaster until the following applicable'
items have been signed:' . ' , . ,
Drywall . {,f (') 1,[< Ih,;1l
Penetrations (Fire Rated) Electrical v' .
Penelrallons (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing . .
Interior Lath ' . I'
Exterior Lath .' .' ~/J ImAI /1 h .
. '. .GENERAUTE ' "
Exterior Plaster (Brown Coat) , I.. IV':>!, 7)//1,/,1'; ,
T -Bar Electrical ' .
T -Bar Mechanical
T-Bar Structural .
Sewer .
Water Engineering Backflow
Water 'Service '. ' .
.
FINAL INSPECTIONS'
Electrical Final
Plumbing Final"
Mechanical Final
Ga~ Test
Engineering/Grading Final 765.-6126
. .
Date
Inspector
V7.J.t!:6
Mechanical Inspections
Plumbinci Insoections
Electrical Inspections ,