2032 Minerva Ave.
TYPE OF PERMIT
Blockwall/ Columns C I TV
DATE: 8/19/2005
JOB ADDRESS: 2032 W MINERVA AVE
LEGAL DESCRIPTION: N TR 2711 LOT 68
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 41
BUILDING PERMIT NO. BLD2005-02610
APPLICANT: KRYSTINA TSENGS
OWNER INFORMATION:
KRYSTINA B TSENGS
2032 W MINERVA AVE
ANAHEIM, CA 92804
JOB DESCRIPTION:Bulld 6' ft. high block wall by 78 linear ft. per city specification".
VALUATION: 1,300.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Lii~ense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or 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 civil penalty of not more than five hundred dollars
($500).
~s owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is oot intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the bUrden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed con1ractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law d s ot apply to an owner of propertywhc builds or improves thereon, and who contracts for such projects with
,surontractor(s) licensed pursuant to t ractor's. Law).
U I am xe pt under Sec.
: . X o.wner:
WORKER' 0 P
I hereby affirm under penalty of pe~ury one f e following declarations:
o I have and will maintain a certificate of consent to self-insure for worker'scornpensation,
as provided for by Section 3700 of the Labor Code, for the performance of the wo* for which
this permit is issued.
D I have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit Is issued. ~J1yworker's
Compensation insurance carrier and policy are:
Carrier:
CONTRACTOR INFORMATION:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENo.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
8/19/2005
Date:
Contractor
Policy Number:
NUMBER
EXPIRATlo.N DATE
This section need not be completed if the pennit is for one hundred dollars ($100) or I~s.
~ _~certify that in the performance of the work for which this permit is issued, I shall not
~y any person in any manner so as to e subject to the worker's c m en tion laws
of Califomia, and agree that if I should b
provisions of Section 3700 of t Lab
TYPE
Date: 8/19/2005 Applica
WARNING: FAILURE TO. SE o.MPENSATlo.N C VERAGE;,1S
UNLAWFUL, AND SHALL S ER TO CRIMINAL PENALTIES AND CIVI
FINES UPTo. o.NE HUND 0 1HOUSAND 0 LLARS ($100,000), IN ADDlTIo.N TO. THE
COST OF COMPENSATIO, ,DAMAGES AS PROVIDED FOR IN SECTlo.N 3706 OF THE
LABo.R CODE, INTEREST AND ATTo.RNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agencyfor the
performance of the work for which this permit is issued (Sec. 3097 .Clv .C):
Lender's Information:
NO.
formation is correct. I
building construction, and
ioned property for
: 8/19/2005
Fees paid for Permit:
Total:
133.28
A
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodelUfer / /
Setback/FormsfTrenches (Footings) ~ JAJ.)c...5'3v-J
Do not install sublloor or pour 11,1011 slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Rein!.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout) <t~o-; 6Z (10'2> t.1/
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (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 Back1low
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765.4040
Water Engineering 765-5268
Sub List/Business License 765.5194
Zoning 765.5139
Building Final (Last Inspection - Only "-;2..1-~ {Z'PoIp"t {I
After Above Complete) I
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbina InsDections
Electrical Inspections
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THE ISSUANCE Or THIS pE MIT DOZS
NOT APPROVE VIOLATION F ANY OF
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