228 N. Paseo Rio Blanco
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TYPE OF PERMIT C
Residential Addition . ITY
DATE: 5/13/2004 .
JOB ADDRESS: 228 N PASEO RIO StANCO
LEGAL DESCRIPTION:N TR 8080 LOT 30
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BUiLDINGDIVISiO'J
200 S.ANAHEIM.BLVD.
(714) 765- 515$
',\'
INSPECTION' REQUEST L INf::
(714) 765" 4626
BUILDING PERMIT NO. BLD2004-01697
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CENSUS CqOE: 434
QUARTER SECTION: 190
CONTRACTOR INfORMl'1'iON:
FIRST CONSTRUCTION AND MAINT
1601 SANDALWOOD AVE ...
. FULLERTON, CA 928350mO
BI:JSINESS PHONE: 7~4 520692
JOB DESCRIPTION New 585 sf addition and expansion of bedrooms to SFD. iU1H)
"
VALUATION:. 39,371.00J PROCESSED BY: ODC
I . ". OWNER.BUILDER"bECLARATION '. .
I hereby affirm under penafty of perjury that I am exempt from the. Contrado?mcense LClw for the following reason (Se6.'7031.5 Business and.
Professions Code: any dty or countywhicb requires a permit to construct, ?1:.~rJ ,improve, dernoli~h or repair any structure, prior to its issua-n.ce, also,
'requires the' appiicant for such permit to file a signed statement th(:lthe is liC{:..r\sed pwsuant to the provisions of the Contractor's Uc'ense ~.~w(Ch.apter
'9)(commencing with Sectlor.7000 of Division 3 of the Business al).d Profe.c;s'ir.:';s Code) or that he is exempt therefrom and the basiS for thealJeged
exemptiQI1. Any violation of Section 7031.5 by any applicant for a permit Sl!t-j;3'cts' the applicant to a dvU perialtyof not more than five hUndred dollars
($$00). . ". . .1 .' ... . .
o I,'ns'owner of property, or my employees with wages as their sole comp'7i!1SaUOn, wll! do the work. and the ,structure is not intended or offe,redfor
~ale (Sec. 7044 Business a~d Professions Code:' Th.e Contrac.tor's licer.se L{!W does not apply to. an owner of property who buildsor improves',
thereon. and who does sum work himself or herself or through his cr he; owr>employees, prov!ded that such ,improvements are not intended or
offered for sale. If. however, the building or imprqvement is sold with Orie 'jG(.;of completi<:>n. the,owner-:builder will have the,burden of 'proving that he
did not bulld or. improve.for. tha Pt!iPoseof sale). i\. .
.0 . I. as the owner oftha property.- am exdusively contracting with licensed ".t:,ntractors to'cohstruCt the IJroject (See.: .7044 Busines.s and Professions
Code: The Contractor's License Law does not apply to an owner of propertY\\'ho bUild,? or improves thereon, and who' oontracts for su'ch projects with.
~ontractor(s) licens~.d pUf?,uant'to the Contractor"s License Law). \ P- ,
U. I am exempt under Sec.' :; B & P .C. for this reason: " .
"Date: .. Owner: :i'
I WORKER'S COMPENSATION DECLARATION'. J:.::'
I hereby affirm under penalty of pe'rjury one of th.e following> decla'rations: :
-0 I.have and will ma intain a certifICate of consent to seJf~insurefor worKe:-'4 :(;omnensation,-'
. as provided for by Section 3700 of the Labor Code, for the performanCe of th~ \\'on< for which
this permit !" issued.' :
D I ha.;:) al'ld.wiil maintain worker's compensation insurilllce, asreqUlred b~"Section 3700 of
t~eLabor Code, for the pc::dormance of the 'No. rk for wrdch tllh> 1'8. ,.rmit 1s. iSSllli~.'MYWOrker's .:1
Compensation ;nsura carrier'and po.licy are: .' , :'j.'
. Carrier: -... Policy Number. .=XEMrYI\~ . I
This seetio eed not be comPle~d it-the pennit is for on.e '~undred doUars ~$1(-~~ t".It.3~. . '
ertify that in the perfonnance of the work forx0. h thl;> permit IS iSS1li:::li: shall not I
employ any pelson in any manner so as to becom, s ject to the orker'~ ,^~-0peD~sation laws
of Califomia, and agree that IT I should become ~bje to the wo er's COl7l~1s3.tlon I .. .
provisions of Section 3700 of the Labor Code, shall 0 . c m Iy With th0,e prt;lviSIOns, Construclon Types:
\/r-J,
Fire Sprinklered?:
Livi(lg Ar'ea:
APPLICANT: lOAN CREANGA
OWNER INFORMATION:
Alaa M N q,srat
.228 N Paseo .Rio Blanco
Anahelm,CA 92801'
'<'>.,
ARCHITECT/ENGINEER INFORMATION:
-1
NUMBE
598245
TYPE
TYPE
B
HIC
D"te:' 5/13/2004 . Applicant:.
WARNING: FAILURE TO.SECUREWO ER'S COMPENS",
UNLAWFUL, AND SHALL SUBJECT EMPLOYER TO C I INAL PEN'" rlES AND CIVIL
FINES UP-TO ONE HUNDRED THOU NO DOLLARS ($ ,OOOl,lN ADO:U.ONTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED' R IN SECTION {Y060FTHE
LABOR CODE, INTERESt AND ATTORNEY'S FEES. . .' . I'"
I . CONSTRUCTION LENDING AGENCY ,. _ "
:. ,h~reby.affirm und~,r pena~y of .~~rju,?, th~t there .~a ,cl?nstruction: I.endinf] }~;~1.'.~,\cy,.fdr the
-'pl';nCr,i1aii~'of trle wcffif"for--o'wilicil.-tilis p~mli[ is i5::KJcJ \Sid~.'::05j".(,;i....~(;)":-.:,..""... '~.~',..
Lender's Information:
i-"
NO
585
I certify that I have read his applica on and state that the above information is correct. I
, . ,.1 . .
agree to comply witt-vall city ordina ces and ,state laws relating to bu Uding corstruction, and
hereby authorize r~t>re ntives, . City to enter upon the above mentionee property for
inspe '. ri pur . ~$. .
Fees paid for Permit:
Total:
3.94
Dale' 5/13/2004
Signature of App cant or Agent
The per . shall expire by r ationand become null and void if the building or
work not passed final i pection 365 days from the date of pemlit issuance. A
new permit is required to cOmmence or continue work.
INSPECTION RECORD
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final.
Gas Test
Engi,neeringlGrading Final 76505126
Fire Dept. Final 76~-4040 .
Wate.Engineering 765.5268
Sub List/&usiness License 765'~19
Zoning 765.5139
INSPECTION . DATE INSPECTOR
. .
TemporatyPower Pole. . . .
Plumbing (DrainNVaste Pipe)
"'lectricll! Ground Eleclrodlill.Jfer. . . :
Setback/FormslTrenches (Footings) , <;.tlf~ .
L<" C/'
Do nOI installSubflooror pourflQorslab until the' . .
following applicable items have been signed:
'.
Plumbing (Water Pipe.Sprh,l<ler \/;lives) . ,
Mechanical (Groundwork) .
Electrical (Underground Conduit) ,
Pre-slab (CoinpactionlMernbrane.Reinf. 1> -t'J-ll rf
Un~pinning (Floor,Joist/Gird~s)
Do not cover or cOnceal the work below until the
following applicable items have'been signed:. .
1st'Floor Shear' . . ,... AIt(~.;....... .
Firesprinkler(Rotigh) .
2nd Floor Shear " .
. .
.Roof (SheattlinglDiaphralU!vFrarnel. r) .
Masonry (Reinf./Bond B!larnlPre-Gl'OlIt) . . .
Rough Plumbing IT op Out) . . . .
Rough Mechanical . .' . '. .
Rougn l:IectrlCaI\Dry Wahl .
Rough Electrical . V-ff<7~~ - /
Framing , (Only a~er PI . jnd F"e) .
Insulation (SoundlEnergy) . " i'?"-1.
po not tape or pla!'ter. until the follow,lng applicable/'""
Items have been. sIgned:' , . .
Drywall " " 'il-/f-tl
,Penetralions(Fire Rated) Electrical . . .' . .r -
Penetrations (Fire Rated) Mechanical .
Penelrallons(Fire Rated) Pluinbing .
Interior Lath ." . . ' .'
ExteriorLath . . . . P
. .... '. . GENERAL ITEMS . . .
Exterior Piaster (Brown Coal)
T .Bar Electrical.. . .'
T.Bar Mechanical
T.Bar Structural . . '. . . .
Sewer.
Water .Engineering. Backflow .' '. . .E
.
Water Service. . '. .
. . .
Building Final (La,tln'pectio,,'. Only
'. '. After Above Complete)
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PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections .
lumbina Inspections
lectricallnsl)ections