2010 W. Minerva
TYPE OF PERMIT
Residential Addition CITY
DATE: 1211/2003
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JOB ADDRESS: 2010 W i~INERVA AVE
LEGAL DESCRIPTION: N TR2711 LOT 74
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~UILDlNG DIVI81QN
200 S, ANAHEIMBLVD,
(714) 765 - 5153
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,iNSPECTiON REQUEST (JNE:
(714) 765 - 4626
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BUILDING PERMIT NO. BLD2003-04603 ,
CENSUS C()DE: 434
QUARTER SECTION: 41
APPLlCANT:YOUNG KIM
OWNER INFORMATION:
YOUNG KIM
. 2010WMinervaAve
Anaheim. CA 92804
JOB DESCRIPTIONRoom addiTIon 289 sq.ft.
VALUATION:, 20,000.00 , : ~ 'PROCESSED BY: ODC
I '. ' OWNER-BUILDF.f;,~:EGLARAT!ON,. , ',' "
I hereby, affirm under penalty of"pe,rjury.that I am~x€:lmpt from the contradO;i" License.Law for ~he following r8?son (Sec. 7031.5 Business arid .
. Professions Code: any oty or county which req,uires'a permit to yonstlUCt, ?i; , r" improve, demolish or repair any structure, .prio~ to its issuance':. also-
requires the applicant for such permi.t to file a signed statement that he is !iC~,sed ,j:.'ursu::mt to the provisia,:s of th~ Cont.ractor's.l.icem;e Law-(Chapter
9)(comme;ncing with Section rODO of Division 3 of the Business and Profess_iqr:s Cpde) orthat he is ,exempt the:'Y3from.ar.d the basIS for the alleged
ex;~)ti~n. lat,ion 0 .se"2!f.:Z/ by any applicantfor a p,~rr.1it .,,"[cts,' tha applicant to, a@,'w,iI-pe,.'.',nOllYCfnotnicrethan""ehUn,dreddollars
. , I . ow pro~. >or '. ..~s WitO~"'ir solecc,....:.tr.::::o:tio;1. will do the work, and the structure-is ncUntendedoroffered ~or
sale (Sec.. ~ Busi. essand Profes$ionsCo7T'h:~n~;;;r's Lice:'\S.: ~:f;lw.~oe3 (l-:>t alJr:y_~o an: o,w7er of property '.-vho. bL:iiclsbr,improves
thereon, and_ who does such work' himseif,or herself or through :li~ or hp.- r;..,;tc.'r.p~o>,ees._ providl:Kfthat such improvements'~re nO,t,inf.en_ded or
u~ere,d for sale,: !f. however, the buildil!gor improvement is sold ViithQ~eYf;',I. r I) ,f. c..'1mDh:::~jGn, the 'awne~-hLlnd.er w'H1 ~a\I'3, the bL:Jr,aen o",i, proving. th.at.he
did not bund orlmprove for the purpose of sala}. _. ' , ." .. .. .. ......
eJ. I, as th'e owner 'of the property, am exdusively contracting with licensee.:' {'t~nti8dors to ~onstiut')t the proJect {See. 7044. Bll'$lness and Professions
Code: The Contractor's License L~wdoes:not apply to an ~wner of Pr:op~!ty1.?nc bUildS 0'- improves thereon, and who ':.Onir8cts~or' such p(ojects with
,J4ontra'tor(s) licensed pursuant to theContraClor's Lic;~~'e LaVl):," . ",
(';;;., I exemptunder.Sec.. .. ,B&P.C.foflhlsreas I.~__. __~_ __ _ _.' _' _ .... . , .' .,'
Date:", ' - ~R~;:~ CO EKSA DEe . !1C)11'~1~~~1 ~YCEr"SE;~ CO!fif:lACTORS DECLARATioNl
I, hereby affirm under penalty -of perjury one ofth follQwii1g eclarations: ,:}, ;.. I !1dreby alti~m l.lr,d~f penalty. of perjury, thatl3m
,[J i_h~ve and. Will 'ma~ntain a certificate of ronsent to self-~nsure for WO~k3...,~ ::vil~p<:;r,sati~li, .1 !iCense~~~r.de~~r~,'1iSio~,s-?f chapter 9 (co~men:j;ig
as provided for by Sedlon 3700 of the Labor Code.. for the pe,(orm3n{.e ':"1 W,''I: \..,;q~ fOI which, I With Se.;,I()(~ 7.... 0) ot OJ 1SJUn 3 of the BuSiness Clnd
1hispermit. is issued. ,,'. "l I Professions Code.
D I have and will ~ain~in,worker's compensatiun insurance, as lequi;cd :)l':=;6~(ion3700 of ' 12!~/'20C'Z'
the Labor Code, for the performance of the work for which this perrprt b is:.:..:;V -Myworkli;!"'~ Date:
Compensation insurance carrier and policy are: . \.
Carrier: 'Policy Number. -t . .
This'section need not be completed if the pe,!,".i~ is for one hundred doll&r3 ($~ ii~A-.....; h;!l$&.
o I ~ertify that in the performance of the work' for which this permit is ,:issc;: ::;;) shajll10t ,.'
employ any person in any manner so as to become subject to the worker's C~,1,-r.t~nsatjon I~ws
of Califomia, and agree that if I should become subject to the worker's, ccm:-~J,~~atian' c.';
:::~j~:1;~::tion370:p::j::tl r pode, I shall forthwith c~;:.:~cri41'
WARNING: FAILURE TO SECURE WORK CO " NSATIONCOVE'~ IS,",. .';',
UNLAWFUL, AND SHALL SUBJECT AN E RLOYER TO CRIMINAL rF.:~Jr,:'TI"S ANDCWIL
FINES UPTO ONE HUNDRED lHOUSAND DOLLARS ($100,000); iN ADt/",,:< T~jiff.',
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTIO. .~7Q6 OI7THF.
LABOR CODE, INTEREST AND ATTORNEY'S FEES,1.::(,
I CONSTRUCTION LENDING AGENCY _ .~T--'.,
I, h.ereby aff.irm under penalty of; perj~ry that ~h~r~ is a, c?nstruction l~ncijnlYJgj~il.1for)he:'~,/:
PGrformaft~nfthe .......orkkr wt:uch thJS p~rmrt[s IS.~u'.?d lSec.30g?_.C~v~g.)~~>./'\,.:l<\; ,__
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CONTRACTOR INFORM:rION:
ARCHITECT/ENGINEER .INFORMATiON:
Contractor
NUMeER
EXpIK'.TiCN DATE
TYPE
Construcion Types:
VN, ,
"Fi,:e ~prinklered?
: LiviilQ Area:
NO
289
Date: 121112003'
Fees paid for Permit:
Total:
983.13
INSPECTION RECORD
INSPECTioN. .
. . . DATE INSPECTOR
TemporarY Power Pole . .
Plumbi ng (DrainlWaste Pipe)
Eleclrical.Grou!,!d Electrode/uter .
SetbacklForlnslTr.enches (Footings) . 2"'U.~ rl/.~...
))p nct install subflccr. .or. pcur. flcor. slab unti !.the . u:::::.
following applicable Items. have. been signed: '. . .
Pluinbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) . .
. Eleclrical(Underground Conduit)
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Pre-slab (CompactianlMembral1e.Rei nt. .?_M'......; . 7H Y44
Underpinning (Floor Jaist/Girders) . ./ (
))po not cover .or conceal the warK. below unfilthe <---
followin'g applicabie items have been signed: . .
1 st Floor Shear . . hI-ex. .~//;;
Firesprinkler(Rough)
2nd Floor Shear . '. . /J . '.
Roof (Sheathing/Diaphragm/Frane) '-;;(1/
Masonry (ReinfJBond ~anlPre-Grout). .
Raugh Plumbing (Top Out) . .... . .'
Rough Mechanical .
Rough 8ectrical (Dry Wall) . .
Raugh Electrical -c' ,
Framing.. . (Only after Plbg. Elec.. Mech.. and Fire) "J-rl/-C'l ~
Insulation (SciundlEnergy) ~.IIA~ Cd~
Do not tape or plaster. ufitil the following applicable i, I
items have been signed: . . , , .
Drywall DAUi. i:,J'
Penetrat.lans (Fire Rated) Electrical I
Penetratians (Fire-Rated) Mechanical. I
Penetrations (Fire Rated) Plumbing .
Interior Lath .
Exterior Lath' . . .' U>/"-- \J ";".u I
.' GENERAL ITEMS ~ .V" . I
Exterior Plaster (Brown Coal) . - LA I
T -Bar Electrical . .
T -Bar MechaniCal. . . '.
T -Bar Slructural.
Sewer '.
Water Engineering Backflow . .
Water ServiCe
FINAL INSPECTIONS . Date Inspectcr. .
Electrical Final '. . . .' .
Plumbing Final , -. .' '.' '. .
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Mechanical Final . .
Gas Test. .' -, -
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EngiflellringfGrading Final 765-5126 . .
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Fire Dept. Final 765-4040
Water Engineering 765-5268 . .
Sub ListJBusiness License 765-519 ~../D,jy. (7);:'''(;,
ZOl'ling 765,5139 . . .
Building Final ltast Inspection. Only '.'
fter Above Complete)
PARTIAL INSPECTIONS ' '
Buildina Inspections
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Mechanical Inspections
. Plumbina Inspections
Electr'ic;:lIlnspections
PE.RM\1 EXP\REl)
.\NSPECT\ON ".
NOTCOMPb-~1~g
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