914 N. Monterey St.
-"......~~~~
r.cl:LOING PERM!"} -"1'): 6LD2000-01176'
-\.~;..
!3U!LDI~,jG Dj,V~S~ON'
, ,200 ;i.ANAHEIM BLVD:
(714)765-.5153. .,
INSPECT/ON'REGUESlLlNF.: " .
(71.4)765 - 51~1.
. . CENSUS b(jDE: 4Z4
. QUART!':RSECT!ON: ,31
. TYPE OF PERMIT
Residentia: Addition' .
bATE: 04/24/2000
JOB ADDRESS: 9,14 N MONTEREY ST
- , '" ".i ~
CITY ~;~~':"-':~~~'HEIM
\"~:!t2;i'l'~~;;);' '" .'
. LEGAL DESCRIPTION: N TR 1202 LOT 120
AP.PLlCANT: MI\NSOU R MORAVEJ
OWNERINFORMATION: CONTRACTOR INFORMAIION:
, Arvidas'& RaGlinaitis M H DESIGN &GONSTR!-'CTION CO
91.4 N Montorey St.. . 2901 iO MlRALqMA AVE #9 '.
Anaheim, CA 92801 "ANAHEIM, 928060000 CA
JOB DESCRIPTION extension of kitchen and living' room
VALUATiON: 21 ,600.00
.1 OWNER-BUILDER pECLARATION
'.. I. hereby'affirm underp.enalty.of perjury that I am ex~mptfr.6rT,1 the Contractor':' License Law for the _foJtowin..g reas,on (Sec~-'703r5 Buslpess and
, Professions Code: any city orcountywhichrequires a perrt:lit,toconstruct, elt';',r,: jmprove~ demolish: or. repair any structur,e; prior'to'its jssuancE:/also
- r~,quireslhe appli9Cint for such ,perll1lt to file a signed, statement,that ne_is "I iccil sed -pursua~t to the provisfons o.fthe :Contractor's Ucense.~aw '(Ch,apter .
9)(commencin'g with"SectiolJ.7000_of Division 3.of the Busiriess and P...ofess~;";5 Code) or that he is exempt therefrom and_the basis for theallege.d
exemption.-Any viO~tion 9f Section 7031.5_ by ariy applicant,for a_ permitsub\~\r;ts. the applicaRt to a civil, p'efl~ItY'of not mor~ tha,nfive nl!ndred dollars,
($500). . ..... '. __ .... . . ..., .' "
o ,I, ~s owne r of pro pert~, dr"my employees ~ith ~aQ.es ,a& th eHr. SQle co1l1 P:"?lsati,on, will do' the work, 3rid the S~rllc.ture" is l10tfntend ed or .offeredfOr .
, sa!~ (~ec. 7044 Bu.siness ~.nd ~rofessionsCode: The Contractor's,:LiC,ense l,-:w d'96s.not apply to an, bwner,oh)f(?p~rtY'Nha b~i1ds ar',improves, , I .
thereon, and who does'_such work'him'selfor hersel~Qr through his ar her OW('-flmpldyees, provideQ that suchlmpro.vement~, ~re not ;r:'tefld'edQr offered
for sale,lf,.ho\vevet, the buildlpg or improv.~ment is sold with qne year of cor-,pietion, the Qwner-bl,litderwUl have,{l)eburden of pro'ving thai he dl(:;t not
build or improve for thepurposeof sale). ",' I. . '. ' ,.(_' , ' ,', ,.' .. ,',',' '.' _, :',":" " ~
o "I. :3sthe owner:af'the property, am exClusively contracting' with IjCe~sed':~mtractorsto'c()n!3trucfthe projec,t (S-~c. 7044 Busine~s and Professions,
Code: 'The Contractor's License Law does not apply h,an owner of propeltv',,-"h.o OlJilds or ir'nprov€-sthereon, and who contracts for's\)w pojects with
.~-,oh1raCtor(s)licens~d pursuant to the Contra~lor's Licen"" LaW). . ;. .... . ..' '.' ., ..'. '.' .,"
U l_amexemptunderSec: _,' - , , "B&P,C.fotthis-reason:' _-:....:~ , . "", _: ,',' ,
Date: ,', ' -Owner: .
E WORKER'S COMPENSATION DECLARATION '_,-.-. ~.. '. LICENSED CONTRACTORS DECLARATI~
i-h~reby'affirm Linder'pera1ty of perjury one,ofthe.following' declarations: " l hereby affirmuntjer pt"lnq:lty of,perjury that I',am
o '_I'have ano'wiilr:naintain2 certifiG.~te oi' consent to seri-ins:~re for worker:siGo~npJ9n3ation. " . licensed under pr visio.ns_o'f ~ha'p~er9 (cqmmencing ,
~s.p vided forbySecti?1l3700'ofthe_Labor Code\ -forth'e; performan.ceofth',_.,'.vot1(,~or which with Se~9' 7000 of DivSion.:? of tile Business arid '
, uifpermit is,is,sued, , ' < " . professi~Code.
, .- I..have'a~d wjl~'maintainwbrker'.scqmpensatioriinsurance, as required bY,?eCthn 3700 0-' 04/24/20CO
the Labor.Code, for the' pertonnanc.e of the work for which,thi$ permit isissLle ::::" My worker-',s D e:
Compensation inst:lrarice carri'er;andPolicy are: " ' , ,
Carrier: -CLARENDON Pdlicy Number. 01KROO~';D91
. ARCHITECT/ENGINEERINFORMATION; .
PROCESSED BY: KBT
I
COr':ltractor,
NUMB~R
. 5S1209
TYPE
. EXPiRATIONDATf:
, 0313112002
B
onstruclCi'n Types'
N. , '. .
CCUpanCY Groups:
3, "',,, '
ire Sp(iriklereq?
ivint;:! Area: ,
.NO
288
,
L
-__-I-~" _'~__~""",-."____'.
. , "' ' .
I :::ertify' that I have read this application and state that the.above i'nformation is co'rreet. ,I
agree to .camp ith aUcity ordinances,and.state'/-aws relating -to bLiilding.con:;tructiOl), and
Q~rebyauthor' e, epresentiv'eS of this city to enter upOn the above m~ntioned prope'rty for
ins ect!on pur s. .
.'
Date: 0412412000
Signature of Appli,can.t or en < .
. mit sha/i e.xpire by lil'rlitation and b orne null and void if t~ building or
work has nOt pas~.dfinal iitspec . daYs from the date ofpermitissuance. A
new permit is. require!! to commenCe or continue work. .
FeeS paid for Permit: .
Total: .
. 537 ,37. .~.~,
I;:leclrical.Final
rlumbing Final
Me,,"ariical Finai
Gas Test
Engineerjn9lGr,.iingFinaI76!l.s12~
Fire Dept. Final 765-4Q40
. water Engineering 7~5;5268 .
Sub Lisitgusine.~sLic~nse 7650519
Zonin!! 765-5139
. Building Final Icesllnspection- Only
. A(ler Above <;omple eJ
PARTIAL INSPECTIONS . . '. .'
Be}:F"e~.~kC:JR'~7_d .
'-
"....;-
IN'SPECT/ON RECORD
- " II'lSPECi-I()~ . ,..... . .II'lSi'ECTC)R' :l
" ..- . DATE.
Temporary Power pple .' -." " .' .
Plumbi ng(Drainl\l\'as1e p.pe) . . . .
..
Electrical Ground'EIElotrodeJUfer '- :..... : . :-'
SetbilcklFornisrtrenches (Footings) <1 :7/~,_fI ~-*"'- .' .' .
.Ol> nqtillstall su!,flporor pour floor sla ,unti.lthe :. -.
follOWing ,apphqlble Items have been slg.ned: _' ,
Plumbing (Water Pi])!l.SprinklerValvesl . .' " . '. .
Mechanical .(Grou ndwork) .... - - ' '. .'. . '"
E~ctrical (Un~rgroundConduit) ..' -.'
Pre-slilb ((;O~pactio",Meml:lrane.R~nr.1 a-'7/>I.t) (".4- . .
. .
-Underpi nning - (FI oc;>rJoistl~irders) .: : . ".
'00 not cover orcortcealtl:1eworx belOW. ulltllthe' .
following applicable items have bei?n-slgned: ." . , . . '....'
.. .
1st'Flopr Shear:: -, '., '.,'- . .- ,-.
Fi..espnnl<ler(Rough) :.. . ..-. .
2nd.FloprShellr' .' . . . . . . . . : I ,
Roof{Sbeatl1ingiDiaPhragIJVFram~ , (~,"'.'
MasonrY (ReinfJElpnd' ~am/Pre-Grout) .
Rough:Plumbing.(TOp Out)' . -' ,
Rough,Mechani<:al '-, -.' '. .: ......
Rough l:Iecti"ical (Dry Wall) .' '.' . .' t- - -.
RoughElectriclli,' . ..' " '. ;." ',:" y. I
'Frilming '(Only afferPllJa., .Elec: Mech., an1 '-'ie}' ~ "'V
Insulation.(SpundlEnergy) ..... , .-,?, 17//. IU/I --:- .
.pcihollap"'Or pla$ter until itie f"lIowlngapplicabl" :/
.lemsha"ebeenslgned: . . '-.' . :".' ..',. .'
Diywall, - . . '. ~J, ',,;;1 .
Pen~ratiohs {Fire Rat'1d)EI..ctrical . .' .'
Pen~rations(Fi r& Ratlld)'Mechaj1icill - .
,
Pen~rations {Fi~ Rated}Plumbing. . '.: . .
lnteri.orLat~ '.' .' . .; " .. . .
Exterior Lath . , ..' . . " " .' . ....
.,
'. ' -'.' --.... . ~ENERAL ITEMS . '. . . .
Exterior Plaster (Brown C<lat),. ..' . . ' . .
. .,
T-l3ar'Ele~trical' . . .' -, .. ." '. -'.' , ".
T -Bar M.echanlcal' . . ". '. .. . . . - . ' . .
T,I3.arSlrl!ctural . '. . . .-
.Sewer .. :. " .' .
Water Enghll:ering .Ilac'-'flow . . . .' '. .
Water Service' '.' . . .'
".-". .' .... .
..'
":.
l
-'
,," /',
-~.~,... ~.
FINALIN$.PECTIONS '.'
. Dale
,';
"..~ .:
': .. -- ,'.""'~,~
- .jn.spe~t6r-~. ;.,
-....,;.
,'.
.,.-....
. _'I'
.,.,....-
. ,", ".' -, .;
. ,.,' . . . ,
Mllchanicallnsoections
i"
-',,'-,
..
..
. .
P/'umbinq IrisDe~tio~s . .
,
. , .
~iectricallnSDections
"
'~;:-l~' "-1 rV~~''''''''E'~
'I}Lt\~\/U".. l_Arl\l u.J
. .
II' A ~')~ 0TI' O-'N"
,\~:;:; t- to' '01 ..'J ..'
NOT....COMPl-ETED
. 'DA TE: DlJ;/ZG/O~-
. - . " . :'. '.
BUILDING PERMIT NO; BLD2C04-C1218'
TYPE OF PERMIT . .
Residential Addition C I TV
DATE: 5I28/2C04
JOB ADDRESS: 914 NMo.NTEREY ST
LtGAL DESCRIPTION: N TR 1202 LOT 120
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:.
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 31
APPLlCANT:ARWDAS RAU.L1NATIS
. OWNER INFORMATION: CONTRACTOR INFORMA'r;ON: ARCHITECT/ENGINEER INFORMATION:
AlVydas & Ra'JlinaltlS:
914 N Monterey 5t
ANAHEIM, CA 92B01 0000
JOB DESCRipTiONPermlt lor Expired permit # BLD2000-01176 (HiH) For kitchen and living room. Expires in 6 months. 11/2B/2004.
VALUATION: 21,600.00 PROCESSED BY:OAL
., OWNER-BUILDER DECLARATION
I hereby afJirr.".under penalty of perjury that I am exempt from the Contractoi"'f, License LaV/for the foJlowin~ reason (Sec. 7031.5 Business and
Professions Cede: any dty or county which require;s a permit to construct, a tier" improve, demoll;;h -or repair any structure, prior to its issuance_. also
requ ires the a;'9U~nt for such permitto me a signed statement that he is licer;sed pursuant to the provi$ions of the Co_ntractor's Ucense Law (Chapter
9)(commencili;:with Section7000'of Division 3 of the BUSiness and Professions Code) or that he is exempt therefrom and the basis for the alleged
ex Jon. k.y v!olatJon of Section 7031;5 by.any applicant for a permit subi{~ds the applicant to a civil penalty of notmore than five hUI"Jdred dollars
~~ ' .
I, aso'Yn"er of property, or my-employees with wages as their sole "CClmpensation, will do the work, and the structure.is not intended or offered for
s e (S!=c. 7()4..l. Business and PiofeSsions Code:, The ContractQr's Licen.se Lilw does not apply to an owner of property who 'builds'or improves
t ereon; and v,ho doessud, work ~j~elf or herself or through his or herown.~employees, provided that such improvements are not intended or ',' .
offer~d for sale, ~lf;:however., the building-Qr improvement is sold with one year of completion, the owne(~builder will have the ,burden of proving that he
did not build or improve for the purpose of sale). ..,
.0'. I, as the C'N.ner of the prop'erty, am eXduslvely contmcting with licensed contractors to construct the project (See. 7944 Business and ProfeSsions
Cod,e:' The Ccntra:ctor's License l,.aw does not apply t an owner of property who builds or improves thereon, and who oontracts for sum projects with
~o!1tra~or(s) licensed pursuant. to t~e Con ctor' i nse Law). .
U I am exerr_:lt under Sec. .. r tnis rea n:
Date: Owner: .
WORKER'S COMPENSATION DECLARATION . I
I hereby affirm under penalty of perjury one of the following declarations:
o I have -ant will maintain a certificate of oonsentto self.insure'for~orker;scompensation,
as provided for by Section 3700 of the labor Code; foithe performance- ofthe"worK for which
this permit is issued.
o I have ani: will.maintain worker's compensation insurance, as re-quired by S~ction 3700 of
the Labqr Co.de, for the performance of "the work for which this permit is jssu~)d.' Myworker's
Comp~nsation:nsurance ca rrier 'and policy are:
Carrier: . PCIiCf Number.
tion need not be cOmpl~ted if.th~ pennitls "for"orie hundred dollars {$190~ or leSs.
I certify tratln the performanceofthe'work fOT whicn this permit is Issued,: shall-nbt
e Joy any pe-:son in a ny manner so as' t? become subject to the-workels compensation laws
of Califomia, c~d agreetbat-jf I should become j~ct he wo&.e(s corrlj::z;')satiDo
. proviSions ofSecti~n 3700 of.the La bor Cod ,I s with co I with th~se p isions.
Date: 5/2~20C4 Applicant: /
WARNING: FAILURE TO SECURE WORK R'S COMPENSATIONOC(VE.!fAG'E: IS.
UNLAWFUL,~ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL pgrJ5\.TIES AND CIVIL
FiNES UP TO ONE HUN. DRED. THO. USAN. D DOLLARS ($100,000), IN'AOI1:.TiON TO THE
COST OF C.O,IPENSATION" DAMAGES AS PROVIDED FOR INSECTIO~ 3706.0F THE
LA.BOR CODE iNTEREST AND ATTORNEY'S FEES. .":1 .
r- CONSTRUCTION LENDING AGENCY "
j her~by affirm '.iIlder penalt~ of perjury that there is a construction lending agency'for the
p~rfonnance ;-::_ :he wo;-k for which tl1\5 permit isi::;sued {Sec.3C97-.Civ;C):.t .
Lender'S Inforrr.atlon: -
I certify that !-have read this applica!ion and state that the above information is correct. I
agree" to eornC>t'f with all city Ol'dinances and' state.\aV'{s relating to bUilding construction, and
~nereb hare es::resentives of this city totnter upon the ~bove mentioned propertyfor
~. Date:;5/28/20Q4
. .. Signature of Applicant or A-gent . . l-~
The permit shal/expire by Iimnation and become null and void if the builtling or
work has notpassed final inspection 365 days from the date of permit issuance. A
new permit. is required t? commence or continue work.
LICENSED CONTRA<;TORS DECLARATION
I hereby affirm urider penalty of perjury that-! ~":l.
licensed under provisions ofchapte(9 (commencing
with Section 7000) of Divsion 3.01 the Bu'siness 'and
Professions Code. .. ,.
5/28/2004
pate: Contractor
NUMBER
EXPIRATION DATE
TYPE
"Construcion Types:
VN, ,
Fire Sprinkler~d?
NO
Fees. paid for Permit:
'Total:
,
0.00
INSPECTION RECORD
. INSPECTION . .' . DI\TE' . INSPECTOR
. . . ' .'
Temporary Powe~ Pole . '.' ....
.'
. PIllmbing(DrainlWaste Pipe) .' .
Electrical GroondElectrodelUfer . . . '.'
. Setbll!=kJForl1'l!!fTrenChes (Fpotings I 'c . '. '. "
00 not install slJbflooror poUr!loor slab untiltM .
following applicable ilemshavebeensigned!'
Plumbing (Water Plpe.5prink\er Valves) . .
Mechanical (GraundwOfk) . .. .
Electrical (Undergr.ound Conduit)
Pre-stab(compactionl..~ ._ane.Reil"lf.)
Underpinning (AoorJOist/Ginlers) . '.'
.UO "iltcover .ilr conceal the work below . unt.1 the . . .
following applicable items' have been signed:. ". .
1 stFloor Shear. . . .' . . .
Aresprinlder(Rough) .c
~nd Floor Shear' . .. .' . " . ,.
Rllot(Shealhlng/DiaphragmlFran'!e)
Masonry (ReinfJBond Beam/Pre,Grout) . .
Rough Plumbing (Top Out) .' .
Rough Mechanical .' .
Rough Bectl'ic . rwall, . '. 'c ,
Rough Electrical . . . '.' .
Framing .' 10nly afier Plbg.. Elec.. Mec~ and Firel '.
In$lilallQII (SoundlEnergy) .' ' .
po not tape or pla!'ter. until the following applicable .'
I.tems have been s.gned: ..' , . . . .
DI"jNI/l\1I '. .
Penetfalions (Are Rated) Electrical . c. . I
. Pen!!lralions (F'!e Rated).Mechanical .
Penetfalicins (Fi!e Raled) Plumbing
Il'!teriorLafh .
Exterior Lath '. .' . .
. . '. .GENERAL ITEMS .
ex!erlQrPlaster (BrOwn Coat) . . ,
T.Bar Electrical. ..... . . . I
T'Bar MeC:,hl\nie:al '. . ' '. I
T-Bar Structural. . . .
Sewer ,
Water Engineering Bl\ckflow
Water Service . .'
.'
I
FINAL INSPECTIONS' . . Date . Inspector
Electrical Fin,!' . . ..' . . .' .
. '. ..
Plumbing Fin.1 '.' .
.' ':. . .
.
I' . ."
~echanical Fi,nal .
. .
Gas Test . . .. .
Engineerit19fC rading Final 765-6126' . . "
I .' .'
. . . ". I..' . .
Fife Dept. Finai 765-4040 .'
. ,
Water Eiigin~ring 765-5268 '. . ',.' . ..
,. .. J:. .. . '.
Sub List/Bus',ness License 765-5,19 .
. ,
Zoning 765-5~39
BUilding Fin~1 \l:.st Inspection- Only . ..
.- ") lter.Abov.e Complete). . ..' I
_ '.' .1 . PA~TIAL INSPECTIONS .
BUlldma Inspections. ,
I
I
I
I
. Mechanical Inspections
PlurnbinQ Inspections
, .
, Electrical Inspections
PERttmrr EXfdtRE Di
. . '.".";1
fNSPE Crl(jN.'
NOT COMPLETtr), ,'.
. DATE:~-S--()(o