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7350 E. Paseo Tampico TYPE OF PERMIT C Residential Remodel ITY ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 196 BUILDING PERMIT NO. BLD2005-02433 DATE: JOB ADDRESS: 7350 E PASEO TAMPICO LEGAL DESCRIPTION: N TR 7734 LOT 40 APPLICANT: SYLVIA ACKER OWNER INFORMATION: SYLVIA ACKER 7350 E. PASEO TAMPICO ANAHEIM, CA 92808 JOB DESCRIPTION Bathroom remode1.(Ref.BLD2003-04491) VALUATION: 4,000.00 I OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professions 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 permit sUbjects the applicant to a civil penalty of not more than five hundred dollars ($500). I\J...I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for ~ (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). D I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with ontractor(s) licensed pursuant to the Contractor's Li w). I am exempt under Sec. , B & P.C. r this r s n: ate: ,...p--c ~ 1"1')- Owner: WORKER' CO ENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consentto self-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. o I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Myworker's Compensation insurance carrier and policy are: Carrier: Policy Number: This section need not be completed if the pennit is for one hundred dollars ($100) or less. 15<J I certify that in the performance of the work for which this permit is issued, I shall not ~oy any person in any manner so as to become subject to the worker's compensation laws of California, and agree that if I should become subject to t orker's compens ion provisions of Section 3700 of the Labor Code, I shall f with amply with those rovisions. CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: PROCESSED BY: ENO LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 8/3/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Date: 8/3/2005 Applicant. WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDIllON 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 pena~y of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec.3097.Civ.C): Lender's Information: Construcion Types: V N, , 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 ordina s and state laws relating to building construction, and hereby authorize representive this ity to enter upon the above entioned property for inspe . n purposes. Date: 8/3/2005 Fees paid for Permit: Total: 129.03 Signature of Applicant or Age t permit shall expire by limitation and become null and void il the building or w rk has not passed Ii nal inspection 365 days Irom the date of permit issuance. A new permit is required to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground Electrode/Ufer Setback/Forms/Trenches (Footings) Do not Install subfloor or pour floor slab until the following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1 st Floor Shear Firesprinkler (Rough) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele., Mec. And Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior lath Exterior lath GENERAL ITEMS Exterior Plaster (Brown Coat) T-Bar Electrical T-Bar Mechanical T-Bar Structural Sewer Water Engineering Backflow Water Service FINAL INSPECTIONS Electrical Final Plumbing Final Mechanical Final Gas Test Engineering/Grading Final 765.5126 Fire Dept. Final 765-4040 Water Engineering 765-5268 Sub list/Business license 765-5194 Zoning 765-5139 Building Final (Last Inspection. Only f'ri-l After Above Complete) -pe.tl INSPECTO DATE PARTIAL INSPECTIONS Buildina Insoections cfie 0 [.vi. D"7- C) .p+T-f fi,v.....aP-( s~ /14 I Mechanicallnsoections Plumbina .Insoections Electrical Insoections JOB DESCRIPTIONl3athroam remodel. VALUATION: 4,000.00 " " PROCESSED BY: AEM I, " , OWNER.BUILDEr.i.DECLARATION, " , " L.hereby affirm under penalty.,?f perjury, that I am exempt from the Contracto1:s license Law for the following rea$on (Sec. 7031.,5 Business. and Professions COd e: a ny city or ,county w~ich r~ uires a perm it, to construct, si"'s r, improve, demo lish or !"epa ir any structure, prior to. its issuance,. also . requires:the applicant for siJch permit to tHe a signl?d statement that he is lic('f"Ised pursuant to the provisions oft-he Contractor's License Law (Chapter 9)(c;iommencing with 8ection7000 o,t Division 3 of the Business and Profesz~)ns Code) or that he is ex"empt therefrom and the basis for the alleged exemption. Anyviqlation of Section 7031~5' by any applicantfdr a permit-su::;zcts the-applicant ba dvil penalty of not more than five'hundred dollars ($500). ..' .', " 'I, " " D I,as owner-of property, or my employees with wages as, their sole com::ensation, wifldo the work, and the structure_ is not intended or offered for- sal,e (Sec. 7Q44 'Business and. Professions Code: The.Contractor's Licenso'L-aw does not apply to an owner of propertY who builds or improves ther~on, and Who does suct:l work _~imself or herself or._through his or her. 0\.";1 employees"provided that such improvememtsare not intended or offer~ for sale._lf, however, the building or imp'rovement is sold with one 'IF"~r of oompletion, the owner-builder will have the burden of proving that he did not build or improve for the pUrPQse, of sale). 'f . . '. . o i. as the (lwner of ttie property, am f:xdusively contracting with licenseJQntractors.to construct the project (Sec. 7044 Business and Professions Code:' The Contractor's License Law does not apply to an owner of propert.~:who builds or improves thereon, and who contracts for sum projects with" ~oritr~ctor(s) lice~ed' pursuant to.~he Cotltractor's License Law). ~ '- U I am exempt under Sec. ,B & P.C. for thIs reason: _. Date: OWner: ' _. I WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of pe~ury one of the fol.'owing declarations. "... .. . D J ~ave,and_wili'maintain a certificate of.consent to self-insure forwockG;;':. G:Jmpensation, as provided for by Section,3tOO of the labor Code, for the pelformance Ofm~wb:1< forwhidl this permit is issued. . . D I haVl':l: and will maintain'worker's compensati~n insur~nce; as required t'.' Section 3700 of the Labor Code. for the perforr'i1ance of the work for which this permit is issu!;d, Myworker's Compensation insurance ca.rrier and policy are: Carrier: NO EMPLOYEES Policy Number. EXi;MP', BUILDING PERMIT NO. ~LD2003-04491 ""j - .t/~ ". , ..~~~~:?7~;;~. . Ii", -"~. ~ "," " ',' ,.' ,~\\ ~ """,', "'ai~"'\ G.. '~c ' 1- ,.., ..... ':- ~[, \ ~U~'"'''' ''l,' ;~i:.r<~ ,.,!:if <:,-/" o~,,~-:jJ) TYPE OF PERMIT CITY Residential Remodel ' DATE: 11/18/2003 JD.B ADDRESS: 7350 EPASED. TAMPICO LEGAL DESCRIPTION; N TR 1734 LOT 40 i" APPLlCANT: DANE PETERSON OWNER INFORMATION: Alan A Acker . 7350' E Paseo Tampico Anaheim, CA 92808 CONTRACTOR INFORM/,TION: DANE P PETERSON 26762 CORRANZA DR' MISSIONVIEJO, CA 9269) 0000 BUSINESS PHONE: 9490\33-7067' ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714)';>65.5153 . INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE:, 434 QUARTER SECTION: 196 ARCHITECT/ENGINEER INFORMATION: I ~i~n need nOt be completed IUhe pennit Is for one hundred dollars {$1b;.', or leSs. ..f3r 1 c~rtiiy that in th~:~rforrnance oOhe work for which this permit is}~~rf-!i, I ~an not employ any person 'in any man ner ,59 as to beco e subject to th . workets'q'"l1pensationlaws 'of Califomia, and agree that-itl shoulq.beco suo cttO thew rker. cO!ll~-nsation . provisi.ons of Secti.on 37000fthe labor Cod I shall forthwith ithtf_JSe 'p~ovisions. Daie: '11/1812003 " ~Plicant:..t"", ~, . WARNING: FAILURE TO SECUREWORKER'S COMPEN ATION Ccl,VEIl':'GE is' .UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE~1~;'1 nES:AND CIVIL l'iNES UP TO ONE HUNDRED 'THOUSAND DOLLARS ($100,000), Ir-iADti1'lqN;TO THE' C,OSTOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOf; ~706:.pFTHE LABOR CODE, INTEREST AND ATTORNEY'S FEES. ~, 'c_ :,),t' ' I . CONSTRUCTION LENDING AGENCY;.? ,t"- I he~eby a~irrn~.Q<:J'?r penalty f?cf_2.~rl~[Y that then~ is_a cOllSotruc:tioq Ip,n.dirlQ ~:'7ir;~ykr the -:Pertormance otthe work forwhidt this permit is issued '(Set.3097.Civ.C): . Lender's Information: . ion and state th'at the above information is correct I ceS and state laws refating to buRding cOllstruction, and his city to enter upb':l the above mentioned property for Date: 1.1118/2003 Sign ure Applicant r: gent . , The permit shall expire by Iimitatipn and become null and void if the building or work has not passed final inspecition365days from the date of permit issuance. A ~wpermit is .required to commenCe or continue work. LICENSED CONTRACTORS DECLARATION I hereby affirm under pena'lty of perjury that 1 am licensed under pro 'ions of cha ter (commencing with Section 7000 of .vsion 3 fU e Business and Profes::?io~ ~ 11/18/200iLL . Date: NUMaER 392097 TYPE ,TYPE EXPIRATION DATE 2/29/2004 B HIC Construcion- Types: . VN, , Fire Sprinkle red? NO Fees paid for Permit: Total: 191.43' , INSPECTION RECORD . . " . DATE INSPECTOR . INSPECTION ...--, Temporary Power Pole .. . Plumbing (DrainlWaste Pipe) . . Electricai Ground Electrode/Ufer . . .. SetbacklFormsfTrenches (Footings) . Do not install subfloor ar pour floor slab until the . ,. following applicable .items have been signed: .,. Plumbing (Wat!!r Pipe.SprinklerValves) Mechanical (Groundwork) . Electrical (Undervround Conduit) . Pre....lab (CompactionlMembrane.Reinf. .' Underpinning (FlOOr Joist/Girders) Do not cover or conceal the work below until tne following applicable items have been signed: 1 st Floor Shear . . Firesprinkler' (Rough) . . 2nd .Floor Shear . . Roof (Sheathing/Diaphragm' Frame) ..' Masonry (ReinfJBond BeamlPre-Grout) . . ROl'gh Plumbirig (Top Out) Rough Mechanical' . . . . KDugn.t:lectrical (....y ...011,. Rol'gh Electrical ^ , Framing {Only after Plbg., ElecAAech. and.Fire) 'iz...p;.., {'!/~. Insulation (SoundlEnergy) Do not tape or plaster until the following applicable . it~ms have been signed:. . Drywall 17 11'7,~ 'Y.1 . . PenetrationS (Fire Rated) Electrical Penetrations (Fire Rated) Mech,lRical . Penetrations (Fire Rated) Plumbing Interior Lath . . . ExteriOr Lath . .. GENERALlTEMS . . Exterior Plaster (Brown Coal) . T -Bar Electrical T-Bar Mechanical T-Bar Structural . . Sewer Water Engineering Backflow Water Service . FINAL INSPECTIONS ...,p:;1le Inspector Electrical Final . . , ~.. . Plumbing Fina.1 . . '. Mechanical Fim;1 . .. Gas Test . . Engineering/Grading Final 765.0126 . Fire Dept. Final 7654040 . .. . . Water'Engineering 765-5268 . Sub ListlBusiness License 765-519 . Zoning 765-5139 . . Building Final ~ast Inspection. Only 1fUO( -r:;;,..., . . fterAbove Complete) . PARTIAL INSPECTIONS tuL --1 . . . ,- :" BUlldma InspectIons Mechanical. Inspections PlumbinQ Inspections . Electrical Inspections J?-c3" cJ~ Cd; f' Ofrl~~ I ~3S-0 E;:/~ h O/rl--aA~ ~ 92 J>~ B\d '2..C03 - toiL\: ~ \ ae'VJo3- \QS-r- t> \ 111 J.-OC~' 0 \ <rro ~O~~