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7125 E. Mockingbird Way APPLICANT: CHARLES RAMIREZ OWNER INFORMATION: CHARLES RAMIREZ 7125 E MOCKINGBIRD WAY ANAHEIM, CA 928070000 JOB DESCRIPTION:Close existing (1) 6'x5' sliding glass door in the family room. VALUATION: 500.00 I OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, alter, improve. demolish or repair any structure, prior to its issuance, also requires the appticant 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). o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered 10r 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 herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one yea; 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 contractors to construct the project (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 contracts for such projects with ~ontractor(s) licensed pursuant to the Contractor's License Law). U I am exempt under Sec. ,. r t . reason: -Date: no/" Owner: ~ WORKER'S CO NSA ON DECLARATION I hereby affirm under penalty of perju one of the following declarations: D r have and will maintain a certificate of oonsent to seff-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. o 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. My worker's Compensation insurance carrier and policy are: Carrier: Policy Number. This section need not be completed if the permit Is for one hundred dollars ($100) or less. o I certHy that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worker's compensation laws of Califomia, and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Cod~ orth ith comply with those provisions. Date: 9/19/2005 Applicant: t::. h WARNING: FAILURE TO SECUREWO ER' OMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 1HOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec.3097.Civ,C): Lender's Information: BUILDING PERMIT NO. BLD2005.()2067 TYPE OF PERMIT Residential Remodel CITY DATE: 7/6/2005 JOB ADDRESS: 7125 E MOCKINGBIRD WAY LEGAL DESCRIPTION: N TR 8464 LOT 23 CONTRACTOR INFORMATION: I certify that] have read tnts application and state that the above information is correct. I agree to comply with all city ordinances and state laws relating to building construction, and hereby authorize representives of this city to enter upon the above mentioned property for insp [on Date: 9/19/2005 ure of Applicant or Agent The p it S I expire by limitation and become null and void if the building or wor has not passed final inspection 365 days from the date 01 permit issuance. A new permit is required to commence or continue work. ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714)765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 210 ARCHITECT/ENGINEER INFORMATION: PROCESSED BY: MSM LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury thaf I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 9/19/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Construcion Types: V N, , Fees paid for Permit: Total; 160.61 City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground Electrode/Ufer Setback/Forms/Trenches (Footings) 00 not i!lstall subfloor or pour floor slab until the following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (CompactionlMembrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1 st Floor Shear Firesprinkler (Rough) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical INSPECTOR Framing (Only after Plbg., Ele" Mec. And F e) Insulation (Sound/Energy) Do not tape or plaster until the fo owing applicabl items have been signed: Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath lb\\b GENERAL ITEMS Exterior Plaster (Brown Coat) T-Bar Electrical T-Bar Mechanical T-Bar Structural Sewer Water Engineering Backflow Water Service -( FINAL INSPECTIONS DATE , Electrical Final Plumbing Final Mechanical Final Gas Test Engineering/Grading Final 765-5126 Fire Depl. Final 765-4040 Water Engineering 765.5268 Sub List/Business License 765.5194 Zoning 765-5139 Building Final (Last Inspection - Only I ;, / After Above Complete) 70 PARTIAL INSPECTIONS lil~S~~~ MechanicallnSDections Plumbing InsDections Electrical Inspections