2311 S. Mira Ct.
TYPE' OF 'PERMIT
Rep~ir
CITY
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BUILDING .O:\'ISfON
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 . 4626
CENSUS CODE: .'. 434.
QUARTER SECTION: B"
BUILDING PERMIT NO. BLi~2004-00854
'.'
DATE: 8/20/2004
JOB ADDRESS: 2311 S MIRA CT 1'25
LEGAL DESCRIPTION:
,
CONTRACTOR INFORMA',iON:
'j
HAR BRO, INC. ,:
2750 SIGNAL PKWY I
SIGNAL HILL, CA 90806-0CfjO .
BUSINESS PHONE: 56252818000
JOB DESCRIPTIONFire damage repair of units 124,125,126 '"
VALUATION: 160,000.00 !
I' OWNER-BUILDER lli=CLARA nON <
-I hereby affirm under penalty:of perjl.!ry that I am exempt from the Contractor'i% L.icen~~e,v.i;._aw for-thefollgwing reason (Sec. 7031.~ Business alld:~~'~,:-,' .
Professions Code: any dty or county which requires a permit to construct, alt~t,)rlil,p~.~)\;r~~mOHSh or repair anys~ru~ture. prk:~ to lt~issLlahce. also .
requires the applicant forwch permit to.file ;:I signed statement that he is Jice:~'~~(J>:.J.i'sual'1t fo t!~Jfpr?'1.~io-i1s of. theCon.tra~,?~'s License Law (Chapter
9)(commencing with Section-7000 of Division 3 of the Business and Profcs~j\?hs'Coderodhat he is exempt iherefrom and ~he basis for the a\\egcd'~
exemption. Any-violation otSection 7,031:5 by any applicant for a permit suhl;:;~ts:the applicant to a ov'ii r~nalty df.not mdr~ than ~Ive hlJndrt;d d,o~l~r~
'($500). , . '0'. . '. '.
01, as owner of property, or my employees with wages as their sole com!=t~;,;sc:uon, 'wiH _dO:; the work" and the:~tructure ~s noti,ntended or offer.ed ,~9r
sale-(Sec. 7044 Business and Professions Code: The Contractor's Lic~nse 4'y~ dce$ 110t apply to"cm bwner.uf 'properry_\yh6 hui!c1s or ImproVe~;{;,
thereon, and who does such work hirT'.self or helSelf or through his or her o\','lh~rnp;oyees, provided that suc.::h _ir0provernerl~S arel)ot inteIJded 0(':';
. ?ffered for sale. If, however, the b~ilding or improvement is sold with one ycl'Jf c.o!TlpJ~tipn,,'the,owner-bl!i!der will hava.-th~,:Q\.!!'den .of proving th~n:Je
didnotbuUdoriniproveforthepurposeofsale).., _ ,<;t'- "~.,_,,"___-";" ~"", ,.^, '" ;"' ',_ __-:-
p I, asthe C?wn i:l~.9t" the property, am.. exdusively contracting with'licensed fi.!..n. Ira. ct.OI:S tc'c~nst(uct ~I;l~ pr~jec.t (S. '3C: 7044. . 8l.!~ness. an9'profeSSi9:n....-$."
, Code: The Contractor's License Law does not apply tc an owner of property :rh<,bt.:;;;';!.3 0'- improves thereon, and Wtl0 rontracts for SiJCh project5,witn
~ontractor(s) licens:d pursuant tv tile Contractor's Lice~se' Law). ' ~'.. ,: ... '.' "::'..
W I am e:xempt under Sec. j'. ,B&P.C.forthlsreason: __-'::_":"'_:\.!.' . , .' .'. .' ..'
Date: Owner: -JL.: ....
.1 WORKER'S COMPENSATION DECLARATiON J_~_::'l
! her~by affirm under penalty of perjury one ofthe following declarations: . F _-, '., .
o I have-and will maintain a certificate of consent to self-insure for worke:..J,C:or:we"sation:
<;lsp'.ovided for by Sedion 3700 of th_e Labor Code, for'the performance Oft~;:i,j,~w0tr<~forW~liCh
thi's oermit is issued. .' . ....' "
m 'j hav~ and will maintain worker's compensation insurance, as required b;'iScittion 3700 of
~~'Labor Code, forthe performance of the ,work for which this permit is !SSUf:\:L- My worker's
. Compensation insurance carrier and policy are:. . .,\'-. :
Garrier: STATE COMP . Policy Number: 046-000~,?g~_ , ,_'
. . '.'. ,',' , ,~'. "_' ,.', ',.;;--c.';,: ':
This section need, not be completed if the pennttis for ~)Oe hundred lionars 1$100~o.t~~~#!::,2..:,;;:,;::_ ;.
o I certify tha t in the petio nnance ofthe work for' which this pe rmit is issue'~,:_i,.~~a )[;r,q,t:;-;"':<
employ any person in any manner so as to become sUbJectto the worker's c~n9.<fr-~sWi~i6in~vvs'
of Califomia, and agree that if I should beco e subject to the worker's t.:Orlipt"!ilsatl'~i"t ~;',:':"":-
provisions of Section 3-700 of the Labor Cod I shall forthwith.comply with til~sepr6V!sions. l,consttuciorrTvoes:
Date: 8/20/20.04 APPJicant:~ '!i. _~~"_~~:~_. ", (~ir~'s~rinklelC.d?
WARNING: FAILURE TO SECURE WOR S COMPENSATION COVER,~GE.J~i"""
UNLAWFUL,AND SHALL ;3UBJECT AN EMPLOYER TO CRIMINAL PENAI:TiE~At-lD'I;;I'/Ii.
FINES UPTO ONE HUNDRED THOUSANDDOLLARS ($100,OOO),IN ADDi'T1~iI!J'1.tP THE;
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 370ij'iill' THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ,:':"']'..\
L__ CONSTRUCTION LENDING AGENCY '. _._~'<."
'I-,h~reby aff!rm urid~r pena_~ty, cfperjvrythc'~ ~here, i~_~ ~()n.strLJctionler.~;_itig;~tr.y~.n~xi~~ ,.:. ,', L.;.~
. -;:..::::n,-;'f'?.aTl::..c -~; ~1;8' ~'.iGf~,iury..r.~uililiS lJe-Clrlll i~-,ssuei.j {::;ec.-3U9;- .GIV:C): .... '.' _.--~ T-
Lender's Information:
APPLICANT: ALLISON PRIDY
OWNER iNFORMATION:
"Kerney A Tindle
2311 S Mira Ct #126
Anaheim, CA 92802
ARCHITECT/ENGINEER INFORMATION:
CHRISTOPtlE; HANSEN
17371 IRVINE
TUSTIN, CA 92760
. PROCESSED BY: GAL
I" .LICENSED CONTRACiORS DEGLARA.TIO~
",. '__'_' "Ir.erc?y:aff!rlTl ~lnder penalty of'perjtlry that I am:'
I: licen.s ed~u'n dei~0..'Si.on3 '3 f '.;ha.pter 9. (co~mencing
withSect:on7000" Oivsion3-ofthe Business and
Profe~sior1\if~. . .~,' ,
8/20/20046.._ _-:::-.. .
Dat~: ' Contractor .
NUMBER
:~=~~:'"
'TYP.E
B
HIC
EXPIRATION DATE
9/3.o/20Q4
. :'-,.
, ;~ .
NO
I certify that I'have read th'is application and state that the ab,ove information i3 correct. 'I
agree to comply with all City ordinances and state lawsrelating to building construction, and
herebyauthoriz representives of this city to enter upon the above mentioned property for
ihspection pur s.
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Date: 8/20/2004
Fees paid,for ,Permit:
Total:
2,344.76
ignature 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 continue work.
INSPECTiON RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole. '.
Plumbing (DraintWaste Pipe)
Electrical Ground ElectrodelUfer ..
SetbacklFormsrrrenches'.(Footings) .' .
.Do not install subfloer or pour floor slab until the
. following applicable. items have been sighed: .
Plumbing (Water Pipe.Sprinkler Valves)
. Mechanical (Groundwork)
Electrical (Un~rground Conduit) . . . .
Pre-slab (Compaction/Membrane.Reinf.
Underpinning (Floor Joist/Girder:s)
Do not cover or con~al the work bel.ow until the
following applicabl.e items have been signed: .
1 st Floor Shear . /
Firespri nkler (ROug h) . j:
2nd Fioor Shear . /) /1' /">
.
ROof (SheathiIlglDiO!Phragm'Fr"ame) .~ -,tj ~c, . Ir or'L.. _
.Masonry (ReinfJBond BeanilPr&-Grout) I j
Rough J>lumbing(Top Out) . I .)
Rough Mechanical '. -----
ROugh BectrlCaI (Dry Wall) . .
Rough Electrical ..nA
Fr.aming . (Oniy aner Plbg.. Elee.. Meen and F-iref, ~."" (l_'/, . :-?
Insulation (SoundlEnergy) f. -z.,~t!t /'~
po n"t tape. or'pla~ter until the fOllewingapplicable '!.-/. .
Items hav~ been slgned:'- ....1 _
Drywall '. '. 0"1.'1-'" "7. fA...c..
Penetrations (Fire Rated) Electrical . . ./
Penetrations (Fire Rated) Mechanical. (/
Penetr"a1ions(Fire Rated) Plumbing IA~~
Interior Lath '.: I/zw/ .
Exterior Lath
. . GENERAL ITEMS
Exterior Plaster (BraNn Coat)
T'Bar Electrical .'
T-Bar Mechanical .
T -Bar Structural.
Sewer
Water Engineering Backflow . . .
Water Service .
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FINAL IN~PECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas'Test
Engineering/Grading Fina.1 765-5126
.i-. 0
. ..,ate
-"3t-a5'"
-;J.d-:5"'
-~-c;
Inspector
Fire Dept. Final 765-4040
Water Engineering 765:5268
Sub List/Business License. 765-519
Zoning 76.5-5139
Buildi~g Final ILast Inspeelion- Only _..... J ~
. After Abov~ Complete) J/~
PARTIAL INSPECTION.S
Buildintllnspections
tr27~~tJqw,ljc.L :"4c..t.4~B4Stfkc.tCn
.' ..' ~~~pS:~' ................
. Electrical Inspections
Mechanical.lnspections
. .
'Plumbina InsDections