1009 S. Mountvale Ct.
TYPE OF PERMIT
Residential AdditionC ITY
DA TE:5/18/2004
JOB ADDRESS: 1009 S MOUNTV ALE CT
-~.~- '.
LEGAL DESCRIPTIGN~ .N TR 12701 LOT 126
. . . .
. BUILDING DIVISiON
20013. ANA1-lEIMBLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765- 4626
CENSUS CODE: 434.
QUARTER S,i=CTION: 216.
BUILDING PERMIT NO. BLD2004-01787
APPLICANT: CYROUS FANNYAN .
OWNER INFORMATION:
Cha rtes Agalaba
1009 S Mounlvale Ct
Anaheim,CA 92808 . .
JOB.DESCRIPTION:Extend living room S.ft: 136'5.1.
VALUATION: .9,160,00 PROCESSED BY: FAN
1 .' . OWNER-BUILDEFi6ECLARATtON . . . .. .1
I'herebyaffin:n under pena_lty of perjury that I am exempt from the'Contractor3-Ucense-:'LaWfofthefollowingreason (S~c. 7031;5 Busines;s and _ _.
Professiqn.s Cod.e:'any-dtyor cmmtywhich requires a permit to construct, eit;~r, i_mprove, demoJrshor- repair any ,structu;e,.prior to'Hs issuance, :also
requires the applicant for such permit to file a signed statement that he is lJce,:~sad-~ursuant to the-provisions of the Contractor's Licen'se Law (Chapter'
9){comrnencing \"Ii~h Section 7000 of Division 3 of the Business and Professi(hs-'c_Qde) .or th,at he is exempt therefrom and the basis fQr the alleged,
. exemp~iQn. ,Any violatiQn .of. SectiQn 70'31;5, by'any applicant far a permit suc:;:~cts' ~heapp]iCant tQ-a, .dvii penalty of nQrmare tha 11 five hundre<l dQlIars-
.~~)~s Q~ner-af pro"perty, "~r my e~PIQye~ ~ith wages as 'their SQJe 'camp~nsatiQn"-win, do-th,e WQr!<,'-and the st;utt~re ,is net i~tendedbr ~~ered for'
sale ~Sec.,7044 BusiQess and p'rofessions Code: ,The C'ontrader's Licerisa L1j)wdQes net a ppi'yte an,Qwner .of prQperty whe builds ef'improves.
thereon, ,and whod..oes such w.ork himself .or herselfer thr.oligh.his .or her a...ir';.~mpleyees; p~evid8d that such improvements 'are, not intended .or , " .
.offered far., sa Ie. .If, hewever, the building .or impravement is sold with oneYF::4~!" ('! -completian, the .owner~builcjer wil(have the 'burde n '.of prQving that he
did not build or impr.ove fer the purpose' of sale). , , ' , 'l_ . " , "
o I, "as the owner .of tile property,_ am exdusively cant~cting with ticens~d <I;n~ractors t.o.,c.onstructthe project (Se('., 7044 3usiriess andProf5ssiaf,s
.cade: ,The Cantract.or,'s License Law d.oes nat apply t.o an .owner .of property \11hO builds .or impr.oves ther'e<;>n; 'and wh.o contractsf.or such projects with
FLt(.ontractoi.(s)licerised pur~Lia:nt to the Co.ntract.or's i~ e Law). '
U I am ,exempt under Sec. ","8-&8 :fa isreasen- i
Date:' - Owner:
CONTRACTOR INFORM,"nON:
ARCHITECT/ENGINEER INFORMATION:
. M F MARZARA .
WORKER'S COMPENSATION DECLARATION.. I. r
i. hereby ~ffi-rm under pen-allY of perjury eneefthe followin'g declarations: . ;: _.'. "
o I have .anc1wil! maintain a gertifrcate .of ~nsent to_self-ipsure f.or,werker;~:;CG;l)per>sation, ,.::
as pr.ovided f.or by Sectien 370.0 .of the Labor Code, fer the pe'rformanqe oftll-:_ werk ferwhich
this pe'rmitis' issued_ , . " '. " >':. - .
. OJ-have 8 ':ld wilf maintain warker's' campensati.on,insurance, as ,required b~','::)ection 37QOof
the Laber Cede, far,the perfermance .ofth~ w.ork fer whiCh th.is permit is issU~~_, Myw.orker's-.
Com'pensation illsurance.carrier and policy are: :,
Carrier: Pcilio:(Number:
Th~s section n'~ed not be completed if the pennit is for ooe'-hundred dollars($1frC;'~:jr less. .
I\"ill certify that in th~. perf.onnance .ofthe work f.or which t~ispermit is issu~(:,i:$halln~t!~,;\;\:~
ernp'layariy per:s.o~ in any manner s.o as to becom~ subject t.o the warker's-:~9rp~nsati()n~.la~,s?
.ofCaHfolTlia, and agre:e:'that if 1 ~I:l.o~Jd bec.ome subje / a, thew.orker's caml?,=)~~.tion .:~
provisipns .of Sectio-n, 3700 .of the Lab.or C.ode, I s .orth hcemply w" . :1-$~'pr?visions.
Date: S11 B12004 . . . Applicant: ' ::
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVE",.G~JS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENAL';ES AND CI\/Il.
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ApJj:, :iON TO tHE.: .
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlOii ii06 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ...._.'..,t".
I CONSTRUCTION LENDING AGENCY . "_ "".
I hereby affirm- under pe,naJty of-perjury th~t there is a c.onstructien lend,ing .a:g..n,py f.or.the
perf.ormance of the w.ork far whid1 this permit is issued (Seli3097.Ci~':_C):,',~". . 1 :~';i, <f<:. - ;,0'<' ,';,':,:0 :~~:'k ""
"" 1,._~QQ.$I~{tlr.ioIJT'..aJtQI]~__" _____._.~___~_ .___ _ ' ,:: "' . ';;\-"~:-".:;>-;......~tj-' '
I
LICENSED CONTRACTORS DECLARATION . t
./ herebyatfirill under penalty .of perjury tilat I all)
licensed under pr.ovisions of ~hapter.9 (q.ommenc:ing
with Sectian '(000) .of DiVsi.on 3'.ofthe Business .and
Professians Cede. "
5/18/2004.
Date: Cantract.or
NUMBER
EXPIRATION DATE
TYPE
","',
,
Canstrucieri Types:
Vj'l" . '.
.LNiriQ A~ea:
136
~:':.-
-~"._~--
. " . " " ' , . .
I certify that I have, read this_applicatian and state ttra~ the ab,ove infarmatien i;, c.orrect. I
agree t.o 00111 ply with all City ordina esand state laws relating tobuilding'c.ori-:;tructi.on, and
here by _authoriZe representives is city t.o, enter U RO the above menti.oned prope rty fer
inspection purposes.
Fees paid-for Permit:
'Total:
0.92
. Signature .of Applicant gent
TJie permit shaH expire by limitation and become null and void if the :Juilding or
work has not pasSed final inspection 365 days from the date of permit issuance. A
new permit is required to qommence or continue work.
Date: 5/18/2004
-. . Inspector..
. INSPECTION RECORD FINAL INSPECTIONS . . . Date
. INSPECTION '. INSPECTOR Electrical Final t (211'0" /'-) ~
. . DATE
Temporary Power Pole . . .... Plumbing Final . ',:., " ~ :
.'
Plumbing (DrainlWaste Pipe) cc- '. . l,/$'~'i ~~ .""
EleCtrical Ground ElectrodelUfer . .', Mechanical Final . . L
Gas Test . . '-)._0\ '"T / 6,
SetbacklFormsrrrenches (Footings). ~, . , '. "-
Do not install subfloor or pour floor slab until.the' ,r . Engineerin9tGrading FinaI765-51~6 '. ' . ,,' /
.
, following. applicable items have been signed: ' " '. ,
. .
Plumbing (Water Pipe.Sprinkler Valves) Fire Dep!. Final 765-4040 , .
Mechanical (GrouildwOrk) . ' . .'. " Water Engineering 765-5268 ,'.
Eledri,cal(Underground Cohdu it) . . ,
Sui) List/Business License 765-519 . .
IPre~lab (CompaCtion/Membrane.Reinf. $;:1 ...
Underpinning (Floor Joist/Girders) . ,r, .' Zoning 765-5139 ',' , , /),"',
Do not cover.or conceal the work below until the . . '.' Building Final ~ast InspectiOn-'Only -, ~ .
following applicable items have been signed: ',', .
1st Floor Shear'.' , . " -.3 -04 ~ Iter Above Complete) !,tS-
- PARTIAL:, INSPECTIONS . /
firesprinkler (Rough) " ' . . . ' '
2nd Floor Shear ' '" " '. . ' , . , Buildinq Inspections
ROof (Sheathing/Diaphragm/Frame) 11I-5-04 ~ ..
, ,
Masonry (ReinfJBohd BeanlPre-Grout) . " ....' . .' " '. . ".' .
Rough Plumbing IT 01' Out) .', ,:
Rough Mechanical . '. .
Rough Electrical I ury vvall) , . . .
Rough Electrical' . . ' ~' '.
framing' '(Only after Plbg.. Elee.. Meen" and Fire) /; -3-04 " . , ,. .. ,
Insulation (SoundlEnergy) . " .. ~.Q... -c
Don'ot tape or plaster ,until the following applicablr Mechanical Inspections
items have been signed: -', . ' ". , '. ,
Drywall' , ....,...", ' , " "
Penetrations (Fire Rated) Electrical .;Y , ,.
" , ,,'
Penetrations (Fire Rated) Mechanical I ' , . ,
Penetrations (Fire Rated) Plwnbing , , ,.
Interior Lath ',' ' , ' ,
.
Exterior Lath , . .f"-r:l Plumbinq Inspections
, ". . GENERAL ITEMS ' '/./ , . , " "
Exterior Plaster (Brown Coat) 'r;...na . ,
T -Bar Electrical. '., . 7?' . . .
T .Bar Mechanical ' ' .. . . .
T -Bar Structural . . ,
Sewer . ."
Water EngineerlngBackflow, . ElectrlcallnsDections
Water Service .. .. . .
. .