1066 S. Mountvale Ct.
BUilDING PERMIT NO;.BLD2004-01164
TYPE OF PERMIT
Residential Addition C I TV
DATE: '611812004
JOB ADDRESS: 1066 S MOUNTVALE. CT
LEGAL DESCRiPtiON: N TR 12701 lOT 107
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BUiLDINGDIVI$ION'
200 S. ANAHEIM BLVD.
(714 j 765' 51.53
INsPECTION REOQUEST LINE:
(714) 765- 4626
CENSUSCODEO: 434
QUARTER SECTION: 216
APPLICANT: SAAD. KARAM
OWNER INFORMATION: CONTRACTOR, INFORMATION, ARCHITECT/ENGINEER INFORMATION:
Saad ~ram . BEN MANESH .
1066 S Mountvale Ct 6911 HAVENHURST AVE.
An"helm, CA, 9~808, ' . VAN NUYS, CA 91406
JOB DESCRIPTION Room Addition. Add 19051 to 1st floor (dining! I"mily room ',xtension) "nd 11651 to ~nd floor (new bedrOOnl) (HIH)
VALUATION: . ~0,500.00 . . . . PROCESSED BY: HRO .
I '. . ....... , . . . OWNER-BUILDERDECLARATION '.' . . .' .--.--J
I hereby affirmu.nder penalty of perjury that I am exemptfrom the Contractor'-; Licens& Law for the folloWing reason (Sp,c. 7031.5,Business and
Professions, Code: any City or countywhicb-requires a p~rmit to construct; alkr,' improvp., demolish ,or repair aiw structure; priorto its issuance, also
. requires the applicant for'such permit to file a signed statement that he.is lice';ssd pursuant to the pruvisions'of the Contractor's License law'(Chapter
9)(commenclflg with $ection-7000 of Division. 30fthe Busin~sand Professiohs_ Code) or that he is exempt therefrbin a~d the basis for the alleged
~xemption. Any violation of Section 7031.5 by any applicant for a permit subjects theappticant to a dvil p~naltyof flat more than fi~ hundred dollars.
($500). . . . . . '. '( . . .....: :.' .' . . '.'-
r1-\ I, as owner of property, or my employees with wages as their sole comp€\nsation, .will do the work; and the_os. tructure is not intend ed_ or offen:ld for- ,
;ale (Sec. 7044 Business and Professions Code: The Contractor's Licens.e l~'':i does not apply to an owner of property whohiJilds or irlJproves. .
thereon, and who does.such ~ork himself or helSelf or through his or.her owrll)mployees, provided ~hat such il1)p'rovements are not intend~or
offered for ~Ie. If',however, the bUild.ing,qr improvement 'is sold with one yee:tpfcompletion"the owner-builder will have ~he' burden of. proving'that he
did not build or improve forthepurpose of sale). . , .' . . . .
o I, as the ownerof the property,_am exdusively contracting with,licensed :bntractors to c~nstruct the project(Sec., 7044 Business and P~ofeSsions"
Code:' The Contractor's License 'law.c;Ioes not apply to an owner of property (~.hO buifds or improves thereon, and who .oon.tracts for: such projects. with
~_ - ontractor(s) licensed,' pursua. .nt to the Co.ntr.actor's License Law); "
, . I, am eX~!lJpt OIJ5fer Sec. " ~'." P:C. for s reason:}
ate: tin _lIS_I> 't Owner: '. '..
WORKER'S CO PENSATION DECLARATION
I hereby affirm unde~ penalty of perjury one of th~ following declarations:. .
D l-have !3nd Will maintain a certificate ofronse. ntto. self-insure,forwork.e'r'~\Comp.ensation,
as provided for by Section 3700 of the Labor Code, for the performance oftt"l4 work for whi.ch
this permit is issued. . - . j .
o I have and will maintain worker's compensation insurance, as reqUired b);! Section 3700 of 6/18/2004.
the labor Code" for the performance of the work for which this permit is issue\i. My worker's Date:
Compensatipn insurance' carrier a,nd policy are: .
Carrier: .. Policy Nu mbe.r.
This section_need not be compl_eted!fthe permit is fur one hundred dollars ($100)'or I~s.
D I certify that in the perfonnance ofthework forwhich this p~nnitiS_.f.Ssue;j, i s~all' not' .
. employ any person in any manner so as to become subject to the work~(s. co:npensation laws
of Califomia, and agree that if I should-become subject to the worker's compe:1satibn
provisions of Section 3700 of the labor Cod I shaD forthwith comp[Y'w1t~thi'seprovisions.
LICENSE!} CONTRACTORS DECLARATION
I hereqy affirm under,penalty of perjury that'l am.
licensed under proviSiqnsof chapter9 (commencing..
with, Section 7000) of Divsion 3 of the BUsiness and
Professions Code. .
Co.ntractor
NUMBER
EXPIRATION DATE
TYPE
D"le: 6/18/2004 Applicant: .a
WARNING: FAILURE TO SECURE RKER'S COMPENSATION COVERAGE/IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAl PENAlTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IrfI\DDIT10J<lTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEq'tON 370~ .OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. N' 1
I CONSTRUCTION LENDING AGENCY
. I hereby affirm Onder penalty of perjury that there is ~ .construction_le~d iri~f ag.:;ncy tor the
performance ofthe work for which this permit is issued (Sec.3097,.,Civ;C),/ ~__"____'.
Lender'S.lnformation: -- . . .
Construcion Types: .
VN, ,
OccupancY Groups:
R3" "
'Fire Sprinklered?
Livi~Q Area:
NO
306
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I certify that I have read. this application arid state that the ab.oveinformation i~ correct. I
agree to oomply with all city ordinances and -state I_aws relating to building construction, and
hereby authorize representives'of this city to enter upon the above mentioned property"for
f(":'~~JLv .... " D"te:6!18/~004
. Signature ofApplica'nt or Agent
The permit shall expire by limitation and become nidi and void if the building or
work has not passed final inspection 365 days from the date of permit issu3l1ce. A
ne":,,.permit is required to commence or continue work.
'F~e5 paid.tor Permit:
Totol:
58~;05
. INSPECTION RECORD
. . '. . . ... INSPECTlml . .' . . DATE . . INSPECTOR
. Temporary Power Pole. . .. '., . .
plumbil)ll(DrainiWaste Pipe) .... . .
.Electrical GrOund Elec:trodelUfer '., ... .'. . . . "
SatbaekffOrmsffrenChes (Footings) , .
DO not ihStaltsubfloor or pour floor slab lJ"tlUhe
following applicable items have been signed: . .'
pltnnbil)ll (Water Plpe.SPrinkler Valves) ,. '.' ,
. fvlechanical ((;rounclwOrk) .
. .
. I E/eclri~al (Underground Conduit) .,. . . .
. Pre-slab (COI11pactlon/Melnbrane.Rei nt. .' , '.
Underpinning (Roor .)OistlGl rders)'. .'
1!J<lI'1i>tcover or concealthework below untIl the .'. .
folloiNing.applicableitems have been signed: .. .
. .
1st Floor Shear . ..... . '. '. . . " . .'
. Fiiesprinkler (Rough) ;-,
2nd Floor Shear' . . ......
.ROof (She;ithillg/lliaphragrillFrame) . '.
MaSonry (ReinfJBond Beam/Pre,Grout)
. Rough Plumbing (Top Out) '.
Rough .Mechanical .' . .' .' '.
I Rough 6ectrICaI all) .' . .
Rough EI.....ri.cal . '. . .
. .
Framing' (Only after Plbg".. Eiec.. r.;lecli.. and Fire)
In.sulation (SoundlEnergy) . . '. . . . . .
. Do not tape or.plaster untilttle following applicable . .'
. itemsbave been signed: . '. . . ..' . .
. DrYwall . . . . .
Penetrations (Fire Rated) Electrical
. Penetrations (Fire Rated).Mechanical . . .'
PenetratiOns (Fire Rated) Plumbing .
Interior Lath '. . . . I. .
Exterior Lath . . . .' .
. . . GENERAL ITEMS .
EicteriQr Plaster (Brown Coat) . '.
.
. T-Bar Electrical . . . . . . . .
T-BarMechanical , .' . . .'
. T -Bar Structural , .'. .. .
'. Silwer '. . . . '.
Wllter Engineering Backflow . '. . . " ,.' .
Water Service' .' . . .
. .... .
FINAL INSPECTIONS .'. '. .... .' Date Inspector .'
'E,ectrical Final . . . ;.,
. . . . .. '. . '. . . .
plumbing .Final . I
Mechanical Final .. . . . '.' .'. . .
. ,
Gas Test .' . .
. . . I
Engineerilig/Grading Fina.l 765-5126 : ' . I:
. . . . 'd," '. .'.
Fire Oept: Final 765-4040 .
Water Engineering 765-52118 . .'. .' . , . . d
...
Sub ListlBuslness Uc~nse765.519. ;. '. . ..'..
..... ". '.
Zoning 765,5139 . ..' .' : '
Building Final~astlnspection' Only .'
.. ' Iter Abov,e Complete) . .
, . PARTIAL INSPECTIONS
Buildina Inspections
. Mechanical Inspections,
. ." .
Plurrrbina Inspections
'. . . .
Electrical Inspections .
. d
PERMIT' EXPIRED
. , .
INSPECTION '.'
NOT COMPLETED
Df\.TE:3hlos- ."
APPLICANT: SMD KARAM
OWNER INFORMATION:
Saad Karam
1066 S Mountvale Ct
An.heim, CA 92808
J08 DESCRIPTION: Build 491101 3 fthigh (147 sf) retaining wall per city star lards.
;VALUATION: 1,470.00
I' OWNER-BUILDEf' DECLARATION
thereby affirm underpenaltf of perjury that l.am exempt from the Ccntractt)~'s License Law for the following reasor1 (Sec. 7031:5 Business and
Pf9fessions, q9.de: any dty or county which requires a permit49: c.onstr.u:::t, ::;\;er, impr-oye,del1')Olish or rePair any structure, prior to its issuance, also.
requires the~'ppr _ nttor such permit to file a signed statemeQl that~'ls Jie,(nsed p~~3uant to the provisions of the Contract:or's_~lCer,s'e law (Chapter
9)(commenci with Section 7000 of Division 3 of the" Business an~_:P;:?fess:\>ns CoCie) or that he is exempt therefrom and the basis for the alleged
exemptio Anyviolation of Sectfon 7031.5 by any applicant(qr ap-elmi~':::V;'iccts the applicant toacivil PenaJtyof not rnCfre than five hundred doltar~
'500 _.. - - . \.
,. as-owner of property, or ITlY ~mployees with wages as their su~~cor.:;:~)ns'8.t:on~ wm'do the work, arid the strur;tllre is noUntended or offered for
sale (Sec. 7044 Business and ProfessicnsCode: The Contractor's Ucen::<:: LaW rioes not apply to an owner of property who builds o r.-im proves
. thereon, and who does such vvork himself or herself or through his Ornei 0.....\ employees, providedtnat such improvements are not intended or.
offered for sale. If. however, 'the building or improvement is sc.la.with on,e yi~;)r of cornpletion, the owner-builder will have the' burden of proving that_he
rjid not buildor,improve for t~epurpos:e,ofsale). \r. '.r -,
[J I, as the owner of the property: am exdusivelycontracting Witl:Ui~€:ns.eL"'!ccntradots to construct the project (See. 7044 Bu::;iness aild Professiong
Code: The Cohtractor's License Law does-not apply to 811 owner::'lf pr0peit~:vVho buiids or improves thereon, and who contracts for suw projects with
on~r~dor(s)ncensed pursu.a.'nt to the Contractor's License Law). .
aii}'ex,e.'mpwncter.sec. , .B & P. or thlse;-son: ___.
Date:. ~~W_ 'Owner:
WORKER'S CO NSATION DECLARAt!ON
ereby affirm under penalty of iJerjuryone of UJe following declaraiioi"1s.
0,1 hav~and win maintain a certificate of consent to self-ihs\.ire for wvrker~,~ comp~nsation,
. as provided-tor,by Section 3700 of the LabOr Code. for the periormanre of ~i+~ work fo{";';'hich
this permit' is issued.
o I. have and will ~aintain worker's compensation insurance, asrequirec l,l.' Section 3700 of
the Labor Cod e, fo r .the performance of the workJor wh ich th is perm it is i.%u; u. M y wor~r's
Compensation,insurance carrierandpoticy are: . j
Carrier:. poliC)' Number.
BUILDiNG PERMIT NO. . BLD2004-00749
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CITY o;m;fi~r!J~H ElM
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TYPE OF PERMIT
Blockwall/ Columns
DATE: 3/18/2004
JOB ADDRESS: 1066 S MOUNTVALE CT
LEGAL DESCRIPTION: N TR 12701 LOT 107
CONTRACTORINFORMA TION:
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765-5153 ,
INSPECTION REQUEST liNE:
(714) 765 - 4626.
CENSUS CODE: . 434
QUARTER SECTION: 216
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ODC .
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This section need not be complete~ if the pennit is for on~, hundted ~ollar5 ($": ~'.,:~ or les,S:_:, :;~
01 ce~ify that in the.perforrn~n?e 9ft!1e-work for Whi{h:tl}l~"P'~[~it is l<>t'i,::'~, I sh~][6Qt
employ any person in any manner so as to_become subjectt<i:tl:te wpr,l>e_r's:"c~nlpen~atipn taws
of Califomia, and agree that if I should become ~bject to th~wp_i:ker;.~~~o~:nsatlc.in ',>.
provisions.of.Section 3700 of the Labor.,code, I.shall forthwith COQiplfwith"t;'l~)S~ p'rqvi.?ions;
~f 1.. .
Date: 3/.18/2004 Applicant: ... .' .
WARNING.: FAILURE TOSECURW RKER'S COMPENSATiONCOVEf\;.\GEc,l$ .~~'
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA:'TiE$-';~1i5 CiVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OOQ1,XNAD'r:>'TlON'ri:J'!TI;!E
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN $ECTlqfi 3706"'Ot'%.THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ~.. l. ..}.
L CONSTRUCTI9N LENDING AGENCY~. r;L.~
I hereby affirm under pena'!=Y of. perJury ~qh~r~ is a ~onstructionL~ndi!:g E.Q~r~_c~;:f.f:?~~; .,',
performance _ofthe work for which this pErrriut IS Issuec (See. 3097 .CI'v C): _, . .(_ .~-:~.~:~~-'-. "....::'~
Lender's lnformatior:i~:..._.~___'~_~'. , .. _.'L __i _~~.
I certify th.at I have read this application and state that the above information'is correct. i
agree to oomply yvith all city. ordinances and state laws relating to buUding corlStruction, and
hereb ut . e representives of this city to enter lipon the above mentioned property for
insp i ~.. . Date! 3118/2004
. .. Signature of Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed tinal inspectiOn '36S'days from the date of permit issuance. A
new permit is required to commence or continue work.
LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty, of perjury that I am
licensed under provisions of chapter g..(commencing
with Section 7000) of Divsion 3 ofthe.Business and
Professions Code.
3/18/2004
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
V N, ,
Fire_ Sprin~rered?
NO
't~.
Fees paid for Permit:
Total:
0.50
INSPECTION RECORD FINAL INSPECTIONS Dale Inspector
INSPECTION . . DATE INSPECTOR Electrical Final . .
.
Temporary Power Pole Plumbing Final' . . .
. . .'
Plumbing (DrainNVaste Pipet,..........---....... Mechanical Final . .
Electrical Ground Electrgd'elUfer /J/ r
SetbacklFormsfTrenches..{Footings ) li"'V<6" '~-,1 - Gas Test . .
Do not install subfloor or pou'rflo until the .1 Engineering/Grading FinaI765-5126 . .
following applicable items have been signed: '.'
Plumbing (Water Pipe.Sprinkler Valves) Fi~e Dept. Final 765-4040 . .
Mechanical (Groundwork) . . . Water Engineering 765..5268 . .' '.
.' .
Electrical (UndergroundConduit) ". Sub ListlBusiness License 765-519
Pre-slab {Compaction/Membrane.Rei nf. .
Underpinning (Floor JoistlGirders) . . Zoning 765..51~9 '. . '. , . "#
'. .
Do nptcover or conceal the work' below until. the Building Final '~asi.lnspection. Only ~/'-l/"S ~VVL .
following applicable items have been signed: . .../ fter Above Complete)
1 st Floor Shear . . . PARTIAL INSPECTIONS
Firesprinkler (Rough) .. I .
Znd Floor Shear . Buildina Inspections
Roof (SheathinglDiaphragrnlFraAIfM-.. . .
Masonry (ReinfJBond BeatllPre-Gro of( /. . . . ....
. .
Rough Plumbing' (Top Out) . . . /. . .'
Rough Mechanical . . . .
KOugh Electrical (Dry Wall) . . '. .
'RoughElectrical . . . '.
Framing' (Only after Plbg.. Elec.. tJiech.. and Fire) .
Insulation (SoundlEnergy) . . '.
. Do not tape or plaster. until the following applicable Mechanical Inspections
items have be~n'signed: . '.
DryWall . . . . .
Penetrations (Fire Raled) EleCtrical ....
. . . .
Penetrations (Fire Rated) Mechanical .
PenetrationS (Fire Rated) Plumbing . '.
Interior Lath .
. . . . .
Exterior Lath' . . Plumbinalnspections
GENERAL ITEMS .. . .
Exterior Plaster (BroWn Coat) . . '.
'T -Bar Electrical . . . .
T -Bar Mechanical' . . . . . '.
T-Bar Structural . . . .
Sewer ' . . . "
Water Engineering Backflow , Electrical Inspections .
.
Water Service . . .
. .
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FEE 03 '04 05 1
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