2374 W. Mystic Ln.
. .';.;
J;;;~i~e~~:;~~:~n' CITY
DATE: 4/30/200"4
JOB ADDRESS: 2374 W MYSTIC LN
LEGAL DESCRIPTION: ~! fR 2563 LOT 54
/~j~HEIM
1:;~?~~4t-;_.',/.
;/;. '~'-:, ':.,~
,.;';..
BU.ILDING DIVISION. .'
200 S. ANAHEiM BLVD..
(714)765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECtiON: 34
BU!LDING PERMIT NO. BLD2004-01306
.....-
. APPLICANT: TESS RA.Z DE CASTRO
OWNER INFORMATION:
. 'TESS. R DE CASTRO
2374 W Mystio Ln
Anaheim. CA 92804
JOB DESCRIPTIONAdd 27351\0 exist. bedroom (HIH)
VALUATION: 18.373.00
l OWNER-BUILDER DECLARATION
I he:reby affirm tinqer'p~nalty of perjufY that.l am exempt.from the Contracto:-L3..UcenseL3~dor the fOllowing reason (Sec~ 7p31.5Busi.nes$ and
Professions C0d.e:: any ~ty. or COllntyV/hlc.h require_s a permit to c6nstruct,a!t~r._ improve, demolish Or repair any structure, prior to.it$,:i~uance, al~q.
requires the.applic3nt for such perri-M-to file a.signeds'tat"emel1t that ~eisHcff.'~ed pur~u~nt.to the provi.siolis ()fthe Cbntrac;:tor's-'License Law (Chapter
9)(commel'lcir.g with Sf=.c~tion 70.0.0. of.Divi~iO~' :5 of the 8usiness~Jnd PJOfeS3!:~rlS CQde),or that he is exempt the,refrom.'and thE! basis for th~ al_lege~
'e~emption. Any viola'ticil of Section 70.31:5 by any applicant for apermitsubi3c:ts the_app~icant'to a d~il pen,altyof not '!lore than five hundred dollars .
($500). '. .. .'. . . t. ..' . . . ... .
o I, as ovmCi of p'ropertj, o~ my employees withwage~ as their soi~comj:;~nsation, will do the workjand thestructute is not-intended oroffered for
.$ale,,{Sec. 70.44 Business:a.nd Professions Code: The Contractor'.s Lice~'se ;_b',v does not apply to an oWflerofproperty who l:iuilds or-improves .
thereon, ard:wtio doessucli work himsp.1f or herself ort!1rough his 0; hE)r owtl.employees~ provi;ded.th?~ such imprt?,Ve.ll1ents are not intended or.: .
o~ered fo~ :sale. If, however, the building or:improve~et:1t is.soid'with Ci!t,; 1:"'1.:.(,f completion, the q~ner-bu.r1der Will hav.e the, burden.'of provin~ t..ha.t he
dldnot uildor.improveforthepurposeofsale),. '. . 1 ' ' . '.. .',' . ...
l,as the .owner of the property, am exdusively.contr.;tcting with ii~enseLl~cOntract'ors to.construct the project (Sec, 70.44 Business and Profe'Ssions
e: The Contractor's License Lawdoe>..s not apply to ,an oW(1er of propertywho b.uilds or improves thereO,n, and who oontracts for:-such projects with
. t:jo~tractor(s) Ii~ehsed pursuant to'thE;l; Contracto(sL.i-cense law),' t '..
l_amexemptu~der.Sec, . "~'" P. or this Ii as ,: ~._~
Date: WOR~;:'~ CO PENSATI. N ~ECLARATION of~--.:J
I her~by affirm. under penalty:,of pe~ury one of the followif\g .qeC]a~tions:. ._-r.,..- .
o . I have and Will maintain a certifi.cate of oonseflUo self-insure for ';'vorkel,~~'cornpensatic;~,
as provided for by Sedion .3700. of the Labor Code, for the performance 0fth.~ work for which
thiS permit is i&sued, . 1 '
o I have ar!d wiHmainlain worker~s:compensation i.nsurance, as required b'~ Section"370t1 ~f
the Labor Code, for the performance of the work for-which this permit is,. i3SU~d, My.workar's
Compensation insurance ca'rrier and policy are;. . . , .'j....'
'Carrier: . ... ..: >.' , . Policy NU,mb~r., .,: .: .,
Thissection:neect not becompleted.if-ti,e pEmnit is for one hundred doJI~s {~1cij;~r les$~;:.." " . TYPE
~ify that in th~' perfonnance of the wor~ for which t~is permit is .'::;s~.w~.,~ ,!_s~?}tn~t/~,.,.-:,.
employ ,any person in a ny, manner, so as to:become subject to the W,9~k~r's.c:1r!1'per'ltatitnl]aWs
'of Califomia, ,and agree that- if I should.becomesu.bjed to the worker's CO(li~,~"n~;atiB~{r.'<:.:,~,;,~:,~-,;
provisions of Section 3700 of the Labor de. I shal ,with cF~prywth t~'f,{provislbn..~..>."-.
Date: -4/30./20.0.4 ' .. , ' - . 0Lt ~:~. .", ",',; .:..
. WA.'lNING: FAILURE TO.SEGl! ORKER'S COM ENSAiIONCOViOru;,GE IS':':~:"~'"
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TOCRIM'INAL:PE;NAI::nES.AND chilL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100;000), 1~~,'):'110N1'P TH~'~
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR1N SEctJG;'li~7C6 OF THE'
LABOR CODE, tNTEREST ANb ATTORNEY.S FEES.. . . ..ii>,..,,::.. '.:'. .
I CONSTRUCTION LENDINGAGENC~-T .
I h ere.by-affirm ul1de r pena lty ,of perjury that"there is a construction: 'l~r;~: iq~ pg;:: ney for the
":,~-=t~~~ce c:fthe.w?rk for~~ch ~~~,permi~_!~_j_~~I?~_~.(~~~~~o.9I~S!Y"~?,::~,;:.Q ,_:
,,:C'lU'-" <:> liliulij'jc~JV;I... .
CONTRACTOR INFORM/:TION:
. ARCHITECT/ENGIN.EER INFORMATION:
....:
PROCESSED BY: .CAL.
I
J ICENSED CONTRACTORS DECLARATION '1
I hereby affirm under penaityof perjury that I am
licensed under provisions of chapter 9 (commencing .
witra Section 700.0) of Divsion 3 of the BUsl,ness and.
Professions 9ode.,
4/10/2004
Date:'
Contractor
NUMBER
EXPIRArioN DATE
Construcion Types:
VN".
Occupan.cy Groups:
f~3,. . .,.
.Fire~Spririklered?
, ~6wel:lin{:tl.Jnits:
- LivinQ Area:
NO
l'
273
--_~__. ,'--.:-~'.-.--._._-----o-~,~--
I certify that I have read this application and state that the above infprmation.ls torrect. I
agree to .oomply with all city ordinances and state laws relating' to bu i1ding construction, .and
hereby al,Jthonze repre n Ves of this dty to ente~poh the above mentioned property for
jnspecti'\fPurpose~. ,P. . (I..,. .
~ LN\J ,oct ~ Date: 4/30/2004
Signature of Applicant or Agent
e 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 perinit issuance. A
new permit is r~quired to commence or continue work.'
Fees paid for Permit:
Total:
1.84
. . ,
.' .' . ..' .' FINAL INSPECTIONS . . Date ,"nspector .
INSPECTION RECORD , . . .
. . ". . . '. INsPECTOR Electrical Final , . ..... ..' '1 ~.'. A
. INSPECTION .' DATE
Temporary power Pole '. .Plumbing Final '. . ',il1.... 'lA!1 l .....
Plumbing (DrainM(;oste Pipe) . Mechanical Final .... t:b 6,a." ~;,A,; :,1
Electrical Ground Electrode/ufer.' .' . .
Setback/FormsfTrenches(Footings)' -7.::fVH Test. .. . . .'. . .'
.
. I .' . ....
Donot install subfloor 9r pour floor slab until the v r Engineering/Grading Final.765-5126. .'
."
following applicable items have been signed: . . .' .
Plumbing (Water Pipe;SprinklerValves) Fire Dept. Final 765-4040 . .' ,
'. . : . .
Mechanical (Grou nclwork) . . . .. Water Engineering 765-5268
Electrical (Underground Conduit) .' .' .
Pre-slab (Compaction/Membrane.Rei nf,) '. . Sub ListlBusinessLicens~ 765-519 . '.
Underpinning (Floor JoistlGirders)d~ w...s::-Il ~ oning 765-5139 . .. '. . .
~ . ,
Do not cover or conceal the work l1elow .untll the V Building Final ~astlnspecliO'" Only, ..' .
following applicable ite(Tls have been signed: .' . fler Above Complete)
1st Floor Shear .' ." Iil 41 o&' .-{/JI,. '. . . PARTIAL I~SPECTIONS . ....
Firesprinkl!ll' (Rough) . . . I Buildinalnspectiolls
2nd Floor Shear . . .
. Roof (Sheathing/Diaphragm/Frame) . . . .
. . . . '.
Masonry (ReinfJBond BeamlPre-Grout) . . .' '. . . .
.
Rough Plumbing. (Top Out) . . '.' .'
Rough M.echanical . . .' .' .
RQugh l:IectricaJllJry. VYilIII . . . . . .'
. . .... ."
Rough Electrical . . . . . . . .' .'
Framing (Only a!ter.plbg., Elec.. Mech: and F,reLtiUIIOk . . .. .
Insulation (SoundlEflllrgy) I Mr(lUll" . .' .
Do not tape or plaster until the following applicable '. . MechanicallnsDections
items have been signed: . . . . . " . . . . . .'
DryWall' . . . . ftlltO on flllU I '. .. -
'.
pen8\l'alions(Fhe Rated) Electrical . . .'
Penetrations (Fire Rated) MeChanical . . .' . ..
Penetrations (Fire Rated) Plumbing. . '.
'.. .' . . .
Interior Lath' ,,,-
EXterior Lath . .'. ~~.u~ ~,I...uJJ . Plumbina Inspections
. . . GENERAL-ITE . .' .' . '. . .
Exterior Plaster (Brown Coal) I'/t.sf~~ -rAAl.
T ,Bar Electrical . .
T -Bar Mechanical. . . . . . .' .
'. '. ' . '. . ..'
T -Bar Structural .. '. .' . . . .
.
Sewer . .. . . , .
Water Engineering Backflciw 'ElectricallnSDections
Water Service . .
. .'