537 N. Parkwood
TYPE OF PERMIT
Residential Remodel
CITY
f(~;~'~i;\:,<,>~':;'~';":'\ '
f(,:-l,~rr' " ~".,l'<-}"
€l/~'1'Ja~:";l'N'j "j';;/:l;
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BUILDiNG DIVISION
200 S, ANAHEIM BLVD.
(714) 765 - 5153
iNS PE CTION' REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 46
BUILDING PERMIT NO. BLD2004-04219
DATE: ,11/1912004
, JOB ADDRESS: 537 N PARKWOODST
LEGAL DESCRIPTION: N TR1591 LOT 103
I
CONTRACTOR INFORMATION:
REVCO SOLAR ENGINE~RING. INC
26631 CABOTRD ,
Anaheim. CA 92801 LAGUNA HILLS. CA 9265::'0000
: . I
JOB DESCRIPTION: Install new solar photovoltaic system on roof I
VALUf,TION: 8,000.001, , PROCESSED BY: JNJ
I, ',OWNER-BUILDER ,DECLARATION '
I hereby affirm under penalty of perjury that ,I am exempt from the ConlractC!I:js Lic~nse Law for the following reason (See; 7031.5 Business an~
Professions Code: any dty.or countywhich requires a permit to construct, 'eller, improve, demolish or. repair any structure, prior to its issuance, also
. reqUir,eS the ~pplic:ant for ~uch permit t~'~I~ S,gigne.:::l state.rnent that h:= .j~.IiC~';lSc, d,' iJ~r5-uant to the'plO\isions,ofthe Contractor's U?enS6 L3V1(Chapter
. 9)(commenclng With Secbon 7000 of DIvISion 3 of the Busmess<lnd PrOie.,.:;sj H:?Coae) or that he IS exempt tnerefrofTI and the baSIS for the alleged
exemption. Any violation qf SeCtion 7031.5' by any applicant fur a permit 5U . ect~ the applicant to a dvif penalty of not more thar. five hundred dollars
($500). , , '. ','.
o 1, 2S owner of property, or my' employees with_'wages as their sole,ccmphl1saiion, wW do the work, and the str!Jcture is not intended or off~red for
sale: (Sec. 7044 Business and Professions Code: The Contractor's LiCAOSO UdW dOElS not apply to an owner of p:"oparty who builds or improves .
thereon, and who does such work himself or herself or through his ,or he;oiN~empl(Jyees, provided that such improvements are not intended or
offered for sale. If, however; the building or improvement is sold withot\€: ye-~r,of completion~ the owner-bu'i1der will have the burde:n d pro'iing th~i he
did not build or jmproV'e for the purpose of sale).:' 1 ' _ . .' "
D , I, as the owner ofth'e property: am exdusively contracting' wjthlic-enSE:;dko~ltradc'rs to constnlct the: project (S".:lc. -,044 8u"Sinp.ss and Profession~
Code: The Contractor's License Law does not apply to an owner of pror'ert;4Nho bui!ds, or ;inprQves thereon, Clnd ..../ho contrac.ts for s~1ch projects with
a contractor(s) licensed pursuant to the Contractor's License Law).' ~ . . . . .".
.0 I am exempt under Sec. ,8 &. P.C. for this reason: -L ___
Date:' , Owner: '. -,---L-
I WORKER'S COMPENSATION I:!ECLARATiON---.r---i
i hereby 8,ffirm und~r pen<;3lty of perjury one cf the following declarations: ~
o .1 have and ....vill,maintain a certificate of mnsent to SeIfMinsure for wod(Cr'fco~penSa[iO::l, .
as piOvided for by Section 3700 of the l.aborCode,. for the performarce ofthr: 'NO!'k for which
this permit is !ssued. '. t,
~ have and will maintain worker's compensfjtion insurance, as' required hi' Section 3700 of
the Labor Code, for the perfonnance'of the work for which this permit is issu~ci. My worker'':)
Compensation insurance carrier and policy are: " ~
Carrier: STATE ;=UND Pulicy Number. 046-001.ti2~4
,
This section need not be' completed if the permit is for one hundred do!!ais,($10C~ crless.
o I certify that in the pt;lrfonnance of the work for which this permit is i,~uel~,1 shall not
employ any person in any manner 'so as to become subject to tile worke/s ~.:,\mp~nsation laws
.of C~I~omia, and ~gree that if I should become subject to t~eworl<,cr's C?Mp'JnsaUon. '
prOVISions of Section 3700 of the Labor. de, I shall fo It omply ,WIth tt::fse ~(OVISIOn$.
,
Date: 11/19/2004 Applicant: ,
WARNING: FAILURE TO SECU EWORKE ' COMPENSATION COVEI~rGE IS
UNLAWFI)L, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA."YIES -AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100;000), IN ADC!TiON TO THE
COST OF' COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIONI3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '
I CONSTRUCTION LENDING AGENCY f
I hereby affirm under penalty of perjury that there is a construction Ie:nding aU3ncy ior the
performar.ce oftrye work forwhich this permitisissued..(Sec.3097 .Civ.C):' If
.....-' .
APPLICANT: STEVEN SCHNIERER
OWNER INFORMATION:
Rogalio B Tiquia
537 N Parkwood St
ARCHITECT/ENGINEER INFORMATION:
~
. LICENSED C9NTR!-CTORS DEGLARA TIOt:!-..!
I hereby affirm ul1der penalty ut perjury that I C:lrn
licensed ;;nder provisiuns of chapter!3 (commencing
'with Section 7000 fOb/sj.:)., 3 of the Bu ' ess and
PflJfessions
11/19/2004
Date:
NUMBER
387219
TYPE
TYPE
C34
B
EXPIRATION DATE
, 2/281.2006
Construcion Types:
'IN,
Le:;:,;.:.u~_,:;;'1firv,41Fi'i0'f";:'"
I'certify that I have read this application-and state that the above information is correct. I
agree to comply with all city ordinances anq state laws relating to building construction, and
hereQY horize representives of this city to enter upon the above m~ntioned property for
insp 0 purpose
Date: 11/19/2004
Fees paid for Per~it:
Total:
145.17
Signature of Applicant or Agent
he permit hall expire by limitation and become null and void if tM building or
work has ,not passed final inspection 365 days from the date of permit issuance. A
new permit- is required to commence or continue work.
INSPECTION RECORD '
INSPECTION- DATE' INSPECTOR
. Temporary Power Pole
PI!lJ1tbing IDrainlWaste Pipe) ,
Electrical Ground ElectrodelUfer , ,
SelbacklFormsfTrenches (Footings)
, Do not install subfloor or pour floor slab until the
following applicable items have be'en signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit) , ,
Pre-slab (Compaction/MembrMe.Reinf. .
Underpinning (FIOOI" JoistlGirders) , ,
Do not cover or conceal the, work below 'until the
following applicable items have been signed:
1st Floor Shear ,
Firesprjnkler (Rough) , ,
2nd Floor Shear ' ,
" Roof (Shealhing/DiaphragmlFrame) , . ' "
Masonry (ReinfJaond Beam/Pre-Grout) , ,
Rough Plumbing (Top Out) ,
Rough Mechanical ,
RQugh ElectrICal (Ory wall) , , , ,
Rough Electrical ,
Framing (Only after Plbg.. Elec.. ;J,ech.. and-Fire)
Insulallon (SciundlEl!8rgy)
Do not tape' or plaster until the following applicable
items have been signed: ' , '
Drywall , ' ' , ,.
Penetralions (Fire'Raled) Electrical
Penetralloris (Fire Raled) Mechanical
Penetralions (Fire Ral11d) Plumbing , ,
Interior lath " , -
Exterior Lath ' '
" GENERAL ITEMS .,
Exterior Plaster (Brown Coal) , '
'T ,Bar Electrical , ' ,
T-Bar Mechanical " '
T -Bar Structural ,
Sewer , ,
Water Engineering Backflow ,
Water' Service , ,
FINAL INSPECTIONS Date Inspec;tor
Electrical Final
Plumbing FiI,al "
Mechanical Final" -
Gas Test ,
, ,
,Engineering/Grading Final, 765-5126
Fire Dept. FinliJ765-4040 '" " ,
Water Englrieerlng 765;5268 I,
Sub List/Business License 765-519 ,
Zoning 765-5139 "
Building Final ' ~astlnspection. Only' (zf,'({,
fter Above Complete)
_ PARTIAL INSPECTIONS
Buildina InsDections
MechanicallnsDections
PlumbinalnsDections
ElectricallnsDections
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CX?
~
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PLANNlliG DEPARTMENT
APP'. pn\lr::.o
1 i _"-' , {.~
DA TE _12-./'lJ9'-1
BY /1.. ,Z:~'::;{:ZN(_JQl)
~/~~ tln;tiall:l
FLOOD ZONE 7C
HISTORIC DISTRICT REVIEW:
~ S~\p.o this pa~e
~e one en above line
SEE BUILDi~jG PERMIT FOR
ANY CONDITiONS
O~ ~ flD\l~ ~\-u,to \J :t.
...p.....0.s loco..,~ 0" +IlL ~ s'
'* 'lock as S~.
Location:1i37 N Parkwood St., Anaheim, CA 92801
1-story, comp roof
50'
tHt ISCUAltCt O~ 'fI1tS peP-lilt 00;:$ ItO
APP~OV~ VIOLA1'ION OF ANY OF TH
BUILDING coo,s OF THE CITY. THE HOLOE
OF THIS P<RMlT PRV",~~S AT HIS OWN RIS
DEe 0 9 2004
<
BUILDING DIVISION OF ANAHEIM
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Junction Box
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22' 6"
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REVCO Solar Engineering, Inc.
Title: Site Diagram, Grid-Tied PV System
Customer: Roger and Riah Tiquia
Drawn by: H.D. Boesch Date: 10/21/2004
System: 12 x 185W, 1 x 2.8kW Inverter
Related Drawings: TIQUIA-1, -2,-3
DWG NO. TIQUIA-4
(
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~
9
,-
PlANf'W,IG DEP,~RTrv1ENT
A,ppi:!G\n=o
~ ~ .. "-'" '" ''''''''
D" T E __ i '::~1:9_'t a;~r;;
BY _5dd&t ~;,'''Cfj ,_'s,fJ_!
FLOOD Z 0;,* E ~.../'
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i
HI~'S Di'~'''',~'- ".':V'f:W: i
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Cil-r;lJ (!-',.:; :~" a.bove liri.; I
I, "E~ 8"1" r"o',- cr,' C,' ",T FO'" '
'-' t:.. "-' ,--.,jl.,',--1 '. ,__,-,,('h. 1 . "I
. A:'-!Y CC\I~):'T-:(~~':3 !
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6.[~"- \,,\"""'\-v~.\\<c,~ rCL~C~S
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Location: 537 N Parkwood St., Anaheim, CA 92801
1-story, comp roof
50' 6"
Junction Box
~~
"
(
22' 6"
)
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DC Disconnect
Inverter
. AC Disconnect
Main Entrance Panel
.....
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REVCO Solar Engineering, Inc.
Title: Site Diagram, Grid-Tied PV System
Customer: Roger and Riah Tiquia
Drawn by: H,D, Boesch Date: 10/21/2004
System: 12 x 185W. 1 x 2.8kW Inverter
Related Drawings: TIQUIA-1, -2,-3
DWG NO, TIQUIA-4
.
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"
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G-
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CONTRACTOR INFORMATION: ARCIiITECT/ENGINEER INFORMATION:
TCP NOTCH C ONSTUMION COMPANY
13209 E GARVEY AVE ' ;1,
BALDWIN PARK, CA 917:060000
BUSINESS PHONE: 626 ~B8-3038
JOB DESCRIPTIONlnstall,308 sq, ft, open patio cover. :!
VALUATION: 4,500,00 ':L PROCESSED BY: EMA
j , , ' OWNER.BUIL[jE~ DECLARATION' " ' '
! hereby affirm under penalty of perjury that I am exempt from th~ Con~ract1""s Uc~nse law for the tollowing reason (Sec. 7031:5 Business and
Professions Code: arrt dty or county which requires a permit to.com>t(uct. i::lI:er, imp-rove, demo!i.sh or repair any structure, prior to its issuanc.e. also
requlres the applicant for such permit to file a signed statement th,l:!t he j~l!f{ensed pursuant to the provisi~nsof the. Contractor's Licens~ Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profes~tlOns Code) or that he is exempt therefrom ancJ.the basis for the alleged
exemption. An.y violation of Section 7031,5 by any applic'ant for a permits:.lbjects the'applicant to a dvn penalty of 110t mote than five hundred dollars
($500), . ' . '1/. '. .. ,
o I, as owner of property, or my employees with wages a~ their soieGorn~:ensatlon, will do the work, and the structure is not ir:tended or offered for
sale (Sec. 7044 BuSiness and Professions Code: The Contractor's Ucens,qil..sw ~oes not apply to an owner of property whl? builds or improves
thereon,. and who does such work himself or herself or through his or her ()~J:r. employeE's, prov!ded that such improvemems are notintendec: or .
Qffered for sale. If, however, the building or improvement is saki with Oqe;~~iarof completion! the owner-butlder'wm have the burden of proving that h2.-
did not build or improve'for the purpose of sale): . ..' . ':~J; _ _ ' .' ..< ' . . . .'
o I, as the owner of the property, am_exdusively contracting with lic_ens:?-;;i;co~~ractors to construct the proje~t(~~9i:--?044 Business and Professions
Coder The Contractor's Li~nse Law does net apply to an owner of prope'~,:whb buHds or improves ther.eoo, 'a~_Wt)b contracts for such projects with
F ~ontractor(s) lic;~nsed pursuant to, the Contractor's License Law). '
L] I am exempt under Sec. _- , B & P .C. for th1s reason.,. __If,>>
Dala: Owner: ;;',-'
j WORKER'S COMPENSATION DECLARATION -~_---1
I hereby'affi~m under penalty of perjury one 91. the following declar&tiohs: Ii
o I have and will. maintain a cdrtiflcate ';[consentlo self-insure for WOrkf:'(s cbmpensation,
as provid 'for by Section 3700 of the LabOr, Code, for the performance o~ ;'r1~ work forwhiGh
this mit is issued. ' ~
I' have and will ~aintain worker's compensation insurance. as re..quired~~Y Section 3700 of
the Labor Cede, for the performance of the work for which' this permit is isS:J~:-:t Myworl<er's
Compensation insurance carrier and policy are: _ - , ,.;
Carrier: STATE FUND . Policy Numbec 164932))
BUILDING PERMIT NO, BlD2004-03472,
. , ,~?j$~'(:~~{~t ... .
CITY ~(~~~tfl~/; ..,H ElM
\~l~~;f~Z3~Sry'
TYPE OF PERMIT
Patio Cover
DATE: 9/14/2004
JOB ADDRESS: 537 N PARKWOOD ST
LEGAL DESCRIPTION: N TR1591 LOT 103
APPLICANT: TONY CORNELL
OWNER INFORMATION:
RogeJio 8 TiQuia
537 NParkwood St
Anaheim, CA 92801
BUILDING DMSION
200 S. ANAHEIM BLVD:'
(714) 765 -5153
INSPECTION REQUEST LINE:
(714) 765" 4626
CENSUS CODE: 434
QUARTER SECTION: 46 '
'-(
This se<:;tion need not be completed if the pennit is for one hU"dreqdolfars ($1~(1 or'l,es~. .....
o .1 certify that in the performance of the work for whjCh:ihi~'permit. is issiJ4d,I,-shall not' "
employ any person in any manner so as to become subject to H)ejt,orker's d)trfpensation laWs
of Califomia, and _agree that if I,should eco subje 0 . worker's compbnsation . , '
proviSions of Section 3700 pfthe La r Code, to ith comply wi1h.t::-:~se provisio~S'.
Date: 9/1412004 Appjicant,
WARNING: FAILURE TO SECU,REW K 'S COMPENSATIQN CQVER"'GE is ..
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM(NALPENA~ T1ES AND C;IVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN AD[;1l10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FORII'J, SECTIO~i 3706 OF THE
LABOR CODE. INTEREST AND ATTORNEY'S FEES, "', '
I CONSTRUCTION'LENDING AGENCY ,~,
I hereby affil:m under penalty, of perjury that there is a constnJctionle(ldlng ;:)~;~ncyforth~
_.;":~f'?r(f'':''i:-Jnce ,oftne.work forwh:ch this ;:>.;<:.rmlt is iS$LIP.d_ (3ec.30a7)';::iicJ: >.L
, Lender'$lt'1formation:
'1 certify that I have read this application and state that the above information is correct.. I
agree to oomPJy with city.-e' ances and state laws relating to bunding construction, and
hereby a r ' S this city to enter upon the above mentioned property for
i~~ecti n purpo .
~~ Date: 9/14/2004
Signatu~e of Applicant Or Agent
The permit shall expire by limitation and become n~lIand void if too building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
LICENSED CONTRACTORS DECLARATION, J
hereby affirm UI"'.de-r penalty 0 perjury that I am
licensed '.. rovisions of pt 9 (commencing
with Sa tion 700 3 he Business and
Profes 0 S Cod
9/14/200
Date:
NUMBER
605817
TYPE
TYPE
TYPE
Contractor
EXPiRATION DATE
11/3,0/2004
B
C61 AWN
C8 CONC
Construcion Tvpes:
V-N, ,
Fire Sprinklered?
,
r.
NO
'...........,&.
, ""
,:_~! ~"\' '.-
Fees paid for Permit:
Total:
507,67
-'
INSPECTION RECORD
'. INSPECTION . . DATE. 'INSPECTOR
Temporary Power Pole
Plumbing (DrainlWastll Pipe) .... .
. Electri.cal Ground Electrode/uter ..
SetbacklFormSrrrenches (Footings). . .
Do not install subflooror pour floor .slab until the .
following applicable items have been signed:
Plumbing (Water Pipe_Sprinkler Valves) .
Mechanical (Grouridwork) .' .
Electrical (Underground Conduit)
Pre-slab (CompactionlMernbrane_Reinf. .
Underpinning (Floor JoistlGin:lers) . .
I Do nolcover or co nceal1he wori< below untillhe
following applicable items have been signed:'. . .
1 st Floor Shear . .
f'ireSprinkler (Rough) '.
2nd'FIoor Shear '. '.
RQOf (Sheathing/Diaj:lhraam'Frame) .
Masonry (ReinfJBond BeamlPre-GRl\Jt)
Rough Plumbing (Top Out)
Rough Mechanical
I Rough Bectr.callDry Walll . -
Rough Electrical ,
Framing (Only after Plbg.. E!ec..~.:lech : and Fire)
Insulation (SoundlEnergy) .
00 notlape or plaster unlilthe following applicable
ilems have been signed: . . " .
prvwall . '. . .
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) MecIlanicai . .
Penetrations (Fire Rated) Plumbil1\l
Interior Lath ....
Exterior Lath.. . .
GENERAL ITEMS. -
Exterior Plaster (BlOONn Coat) . '. . . .
T -Bar Electrical
T -Bar Mechanical . . ,.
T -Bar Structural . . . . '.
Sewer
Waler Engineering Backflow . .
Water-,..;vlce .....
FINAL INSPECTIONS Date. Inspector.
. Electrical F.inal . . .
Plumbing Flcal .
Mechanical Final .
Gas Test . . . . . .
EniJlneeritlg/Grading Final 765-S126
,1. . .' ..
Fire Oept. Final 7654040 . .
Water Engineering 765-5268
Sub List/Business License 765-51g. .
Zoning 765-5139 . . . :
'. . .. . \*~ \vi.- ~~...
Building Final ~asllnspectlOn'Only .
. fter Above Complete)'
. PARTIAL INSPECTIONS I~. r 'r-.
..,,,,'
Buildina Inspections
Mechanicalln'spections
.Plumbina Inspections
. '.
..
. Electrical Inspections
TYPE OF PERMIT
Patio Cover CITY
DATE: 11/24/2004
JOB ADDRESS: 537 N PARKWOOD ST
LEGAL DESCRIPTION: N TR 1591 LOT 103
ElM
BUILDING DIVISION'
,200 S, ANAHEIM BLVD. '
(714) 765 -5153
INSPECTION REOUESTLlNE:
(714) 765.4626
CENSUS CODE: 434
QUARTER SECTION: 46
BUILDING PERMIT NO. BLD2004-03472
, APPLICANT: TONY CORNELL
OWNER INFO'RMATION:
Rogelio BTiquia' .
537 N Parkwood SI
Anaheim, CA 92801
CONTRACTOR INFORM/mON:
TOP NOTCH CONSTUCT!ON COMPANY
13209 E GARVEY AVE '
BALDWIN PARK, CA 9170d 0000
BUSINESS PHONE: 626331:-3038
JOB DESCRIPTION: Inslall 286 square feet of enclosed palio iCBO# ER-43f3-P-K122 and 48 square. feel. open patio OQver ICBO 2228P.
VALUATION: 3,340.00 ~ PROCESSED BY: SAM
1 OWNER.BUILDE ,DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracto~~i~ License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to .construct, ar.~r, improve, demolish or repair any structure, prior to its, issuance, also
requires the~ppli:ant for ~uch permIt t<? ~~ a signed state.ment t~at he is liC~I~sed pursuant to the. provisions of the Contracl:,?r's li~ense law {Chapter
g)(co~encll1g With Section 7000 of DIVISIon 3 of the BUSiness and Profess~.ios 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 permitsut4ects the applicant to a dvil penattyof not more th<;ln five hundred.dollars
($500).' " i( , " , . .
o I; as 'owner of property, or my employees with wages as their sole com8;-~'1Sation, wlll do the work, and the structure is,notintended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License l~.iw does'notapplyto an owner of property who builds or improves
thereon, and who does such work himself or h.erself or through.his or her cW;:l'employees, provtded.that lliuch improvements are not intended or . "
offered for sale. If, however, the building or improvement is sold with one y(;bf of corrlpJetlon, the owner-builder wijl ha'\('~ the burden of proving that he
did not build or improve far the purpose of sale). ~.'. .,
o I, .as the 'owner of the property, am exdusively contracting with licensed"'bntractors to conStruct the project (See. 7044 Business and Professions'
Code: The Contr~cfoj"'s licen~ law does not apply to an owner of pr,?pertY~.~lho builds or'improves thereon, and who contracts for such projects with'
P-J1ontractor(s).ligensed pursuant to the Contr,,!ctor's License !-aw). .
U 'am exempt under Sec. , B & P.C. for this reason:
Date:' ' Owner: . '
I WORKER'S COMPENSATION DECLARATION "
I.hereby C\.ffirm under pe1)alty of. perjury one of the following declaratIons:, }! (
tJ I have and will maJntain a certifICate of oonsent to self~insure for worker'~',.(;;ompensation:
as provided for by Section 37.00 of the Labor Code, for the performance ofth'~vvork for which
~mit is issued. ' !
ve and will' maintain worker's compensation insurance, as required by Section 3700 of
, e Lab9r Code, for the performance of the work for which this permtt is issu~<J' Myworkefs
CompenSation insurance carrier and poliO; are:, l'
Carri.;r: STATE FUND Policy Number. 1649321 i'
This section need not be completed if the pennitis tor, one hundred dollars ($1 ~O!: 0/ iess.
o I certify that in'the perfonnance of the work for~hich this permit is iSS.~.j,;1 shan not
employ any pers.on in any manner so as to become subject to the wor~r'$:~9C:I1iPE!'nsation laws
of Califomia, and agre.e that if I should becc wbj~ct to the worker's cc'~nsation
provisions of Section 3700 of the Labor Co e, all fo with comply Wl,th t("Jse provisions.
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
'hereby affirm under penalty of perjury that I am,
licensed under provisions of hapt.er9 (commencing
with' Section 7(00) of Oi 0 Business and
Professions Cod e.
11/24/2004
Date:
NUMBER
605817
TYPE
TYPE
TYPE
EXPIRATION DATE
11/30/2004
B
HIC
C8 CONC
,Date: 11/24/2004 Applicant:
WARNtNG: FAILURE TO SECUR R'SCOMPENSATION COVEJ':^GE is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMiNAL PEN4LTIES AND CiViL
FINES UPTO ONE HUNDRED THOUSANDDOl.LARS ($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 ~rjufy that there is a construction lendingafle,'lcyfor the
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lender's Information:
Construcion Types:
VN, ,
Fire'Sprinklered?
NO
I certify that I have read this 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
herebyauthoriZ eresentives of this city to e"nter upon the above mentioned property for
i pedion pur se. '
Date: 11/24/2004
Fees paid tor Permit:
Total:
543.89
Ignature of Applicant or Agent
The 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 permit issuance, A
new permit is required to ,commence or continu~ work.
.INSPECTION RECORCl
. INSPECTION . DATE INSPECTOR
Temporary Power Pole .
Plumbing (Drain/Waste P,ipe) , .
Electrical Ground Electrode/lifer .' ..
SetbacklFormsfTrenches (Footings)
00 not .install subfloor or pour floor slab until the
following applicable items have been signed: '
Plumbing (Water Pipe.Sprinkler \lalVes)
Mechanical (Groundwork)
Electrical (Vnclerground Conduit) .
Pre-slab (Compactionl...~..w. ane.Relm.
Underpinning (Floor JoistlGinlers) .
00 not cover or conceal the work below unt.1 the
following applicable items have been signed:
1 st Floor Shear ,
Firesprinkllll: (Rough).. '. .
2nd Floor Shear
Roof (Sheathlng/OIaphraamlFrane) , .
Masonry (ReinfJBond BearnlPr.Grout)
Rough Plumbing (ToP Out) .
Rough Mechanical
I ROugn electrical (Dry waU) .
Rouah Electrical .
Framing (On)y after Plbg., Elec.. r..lecl1. and Fire)
Insulation (SoundlEnergy)
po not tape or pla~ter until the. following applicable
,tems have been sIgned: .'
Drywall
Penetrations (Fire Rated) Electrical . '. .
Penetrations (Fire Rated) Mechanical .
Penetrations (Fire Raled) Plumbing .
Interl,or Lath .. .
ExteriorLath "
, GENERAL ITEMS
fExlerlor Plaster (Brown COal)
T -Bar Electrical . , ;.
T -Bar Mechanical , .
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service .
FINAL INSPEC,IONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test'
Engineering/Grading Final 765./1t26
Fire Dept. Final 165-4Q40
Water Engineering 165-5268 '
Sub ListlBusiness Lic,ense 165-51
Zoriing 16?-5139
Building Final (Last Inspection. Only ,
Afle( Aboye Completel
Date
Inspector
PA~TIAL INSPECTIONS'
ections
~
"..
Mechanicalinsi:lections ..
Plumbina Inspections, ,.
. ()IoV.qW WlW