1375 N. Miller St.
"
BUILDING PERMIT NO, BLD2004-02674
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TYPE OF PERr>1IT
Tenant Improvement (Limited)
CITY
DATE: 8/26/2004
.JOSADDRESS: 1375 N MILLERST
LEGAL DESCRIPTION: KRAEMER. TR LOT 2 BLK K POR OF LOr.
APPLICANT: MICHAEL BATES
OWNER INFORMATION:
Toy CitY Pl'Qperties "
20431 Via Trovador
YorbaLinda,CA' 92887
CONTRACTOR INFORMArION;
INDUSTRiAL PROCESS f.QUIPMENT,
1700 INDUSTRIAL AVE
NORCO, CA 92860
BUSINESS PHONE: 951 80,'9192
JOB DESCR!PTION'fenant Improvement. Install AutOmated Powder Coating 1i;1e.
BUILDING DIVISION
200 S;ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765 - 4626'
CENSUS CODE: 437
QUARTER SECTION: 143
ARCHITECT/ENGINEER INFORMATION:
'.
VALUATION: 150,000.00
I OWNER-BUlLDER;QECLARATION . I
I hereby affirm under penalty pf perjury that I am exemptfr.om the Contractcr'(' License Law for the following reason (Sec. 7031.5 Business and .
Professions Code: any dtyor county which reql..liresa permtt to constn.ict,a~J;,improve. demolish or repair a,ny structure, prior to its issuance, aiso
.. requires the-applicant for such permit to file a signed statelnent that he lsiic;e~sed pursuant to the provfsidns of the Contractor's License Law (Chapter'
9)(commencing with Section 7000 of Division 3 of tl)e Business and ProfessJdfls C'_oue) at 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 evil penaltyqf pot more than five,hundred dollars
($500). . " - . J. . . .
o I, as owner ofproperty '. or my employees with wages.as their sOle cOnip?ns3tion, will do the work, and the structure is 110t ~ntended or offered for
sale (Sec. 7044 Businessand Professions Code: The Contractor's License t.j.1w dqeS not apply to an owner of property who -builds or improves'
thereon, and who does suCh work himself or herself or througr. his or her o,^;r;:employee~, provided that such Improvements are not intended or'
offered for sale. If, however, the building or improvement is sold with one yea} ot completion, the owner-builder witl have the burden of proving that he '
did'not buiJdor-improve for the purpose.of sale). _.;, ' . "
o I, asthe 9wner ofthe_ property,"am exdusively contracting with licensei!/hntri:3cto:-s toconstructthe project (Sec. 7044 Business and ProfeSSIOns
Code: The Contractor's License Layv doe5.not apply to an owner of propert';-\~ho b'uilds or'improves thereon, and who contracts fat sum projects. with
iUi.. ontractor(s).Jicensed_ ~ursuant to the Contractor's License Law). -t.!
U I am. exempt under Sec. , B & P.C. fo:- this rea!>:on:
Date: Owner:
r-:- WORKER'S COMPENSATION DECLARATION ----;-,
I hereby affirm under pehalty of perjury one of the following declarations:. ,
o fh,ave and-will maintain a certificate of oon&ntto self~insure torwor:~,er;~:,:::cmneF1sation,
as provided for by Section. 3700 of the Labor Code, for the performar.ee of tHe work for which
this permit is issued. ~
o I have and.will 'maintain worker's compensation insl!rance, as required l:;~ Section 3700 of
the Labor _Code, for the perform~nce of the work for which this permit is issuc:~j. My worker's
Compensation insurance carrter and policy are; j
Carrier: STATE COMPENSATION FUND Policy Number. -1317733;04
PROCESSED BY: DOR
--.-J
This s~tion need not be completed if the pennit is fo:- one h,undred' dollars ($1Q9 or less.
. ~rtify that in the perfonnance ofthe.work 'for which.this permit is is~ui~ ,'shall not
employ any person in any manner'so as to become subject to the worker's cQmpensation laWs
. of California, and agree that if I should become subject to the worker's com~:;~sation
provlSi~ns of Section 3700 of the, Labor Code, I shall ,forthwi:h comply.with tt-~ro'v'isions.
Date: 8/26/2004 . Applicant: ~\t ~ ~ 7'0' .'
WARNING: FAILURE TO SECURE \ ORKER'S COMPENSATION COVEF.AG", IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO:CP.lMINAL PENA.'.'nES AND CIVIL
FINES UPTO ONE HUNDRED Tl-I OU SAND DOLLARS ($100,OOOl,IN ADDi'f10N TO THE
COST 'OF COMPENSATION, DAMAGES AS PROVID~D FOR IN SECTION ,3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES, I
CONSTRUCTION LENDING AGENCY '/
I h,ereby affirm under penalty of perjury. t at there isa construction len~j[1g'~g~ncy for the .
V.;:-;-f.lY.'~--,',:>r:ce oftt-r':nvOi'k k:- "',hic.'i 'ii,:spermfi is issuad fSec.3GS-r-~-C-r,i:C):-.- . >~- .
lende~s Inforrr\ation: . I.
, certify that I have' read this a pplication' and state that the above informatlCn i.s correct. I
agree to.romply with all city ordinances and state laws relating to building construction, and
hereby author~e re'presentives of this City to enter .upon the above.mentioned property for
inspecl;on purposes. .~. ~ _
~ - r> - -.;7 8 ,. ':d Date: 812612004
" - 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 insPllCtion 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
LICENSED CONTR.4CTORS DECLARATION
i hereby affir.m undG( penalty of perjury that I am
licensed under provisions of chapter-9'(commencing
with-Section (000) of Divsion 3 of the Business-acnd
professio.xode., _ ~A ~
8/26/2004 ~ /'
Date: .. Cont~actor
NUMBER
463072
TYPE
TYP~
EXPIRATION DATE
9/30/2004
B
C43
Construcioil Types:
"I N, ,
Occupancy Groups:
S1" ".
Fire Sorinklerect?
YES
Fees paid for Permit:
Totai,
2.141,93 .
INSPECTION RECORD '
, " , INSPECTION ' , ' DATE' INSPECTOR "
Temporary Power Po'e
Plumbing (DrainlWaste Pipe)
Electrical Grou!lCl Electrode/Ufer "
SetbacklFormsfTrenches (Footings), ' ,
Do not install subflooror pour floor slab until the, ,
following applicable items have been signed: ,
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) ,
,
I Electrical (Underground Conduit) , '
I pre-slab (CompactionlMembrane.Reinf. "
Underpinning (Floor Joist/Girders) ,
! !J<> not cover or conceal the work below until the ,
following applicable items have been signed: ' , ,
1 st -Floor Shear " " ' "
FireSprinkler (Rough)
2nd F'oor Shear ' .
RQof (Sheathing/Diaphragm/Frane)
Masonry (ReinfJBondBean/Pr~""'t) , , I
Rough plumbing (Top Out) ,
Rough Mechanical ,
, I RQugn 8ectrICaI (Ory wall)
,Rough Electrical , I
Framing' 10nly aher Plbg, Elee, Mech, and F"el
Insulation (SoundlEnergy) , ,
Do not tape or plaster until the following, applicable
items'have been signed: -"
Drywall , , , ,
,PeI"Ietrations (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
Electric~1 F,inal
Plumbing Final
Inspector
Mechanical Final
Gas Test
Engineering/Grading Fina'765-5126
Fire Dep!. Final 765-4040
Water E,ngineering 765-5268
Sub list/Business LiCense 71;5-519
Zoning 765-5139
Building Final (Last Inspection. Only , \ ,I'I..J..4-:
, After Above Complete I Il~'
PARTIAL INSPECTIONS
Buildinci Inspections
MechanicallnspectiOriS
,PlunibinQ Inspections'
Electrical Inspections