690 S. Peralta Hills Dr.
APPLICANT: JOHN BLASINGAME
OWNER INFORMATION: CONTRACTOR INFORM!'TION:
Dan E Brough CUSTOM CARPENTRY
690 S Peralta Hills Dr 32200 JACINTO ST
Anaheim, CA 92807 NUEVO CA 92567 0000 " ,
. , - .;i , - _ '
JOB DESCR!PTION:Buifd 140 linear feet of retaining walls (less than 6 ft. In .he1ght) per city standards as indicated on plans.
VALUATION: ' '10,000.00 "', ~ PROCESSED BY: MSM
I. . ' . OWNER-BUILDER~ECLARATION ' , ',', ,', ,
I hereby affirm under penalty of perjury that I am exempt -from the Contracto<s, UcelJse Law for the following reason {Sac. 7031.5 B_usiness and
Professions Code: any city or county which requires a permit to construct,,~~tir, improye, demolish or repair any structure; pnor to its issuanceralso .
requires the applicant forsucli permit to fil~ a signed statement that, he is IiC::3hsed PUl'suc::mt to. the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Bush;ess and profe~s;~ns Code) or that he is exempt therefrom.and the basis.for the,alleged
exemption., An~ violation o~ S,ection 7031.5 by <\'lny applicant f,or3~errr.it Sl!,:~jrc.ts the appncant to a civil penalty of not m~re than five hundred do:l~rz.
($500)., '. "''I' '. '
O' ,I, as owner of proper:tYt:or my employees with wages 8:S lheir sole Gomp.msation, will do.the work, and the structure is not intended or ott:ere.d for
saie,(Sec. 7044 Busin'ess and Professions Code: TheContractcr's Ucense}l;~.-tI does not apply to an bwner of property 'who builds or improves
thereon, and who does such workhirri~~1f or helSeif or through his or her'o~:Vr1e;mployees, provided that such impro'Jements are not intendedoL,"
o~~red fo~ sale.~ ,If, ho~ever,:the'bul!ding orimprovernent is sold'with ene Y~'c.t of completion, the o:wner-budder Vfill have the .burden of proving thathe
dId not bulldor Improve forthepurpose of sale). . "l', " ., i' , .
o I, as the ewner of the property, am exdusive~f contracting with licen,Je:dAiontradors to constructthe project (See. 704-4 Business.'and Professions
Code:. The Contractor's License Law does not apply to ;:jn owner of propert'>;';Wh') bujl~s or improves thereon, and whocPntracts for- such projects with
a c~ntractor(s) license? P:.'r~iJaflt to the Co~tractor's License Law)._;{ ~
o I am exempt under Sec. ," _' B & P.C. for this reason: _i-iL......_
Date: Owner:i' .~'i1.
r .,'". WORKER'S COMPENSATION DECLARATI9!:!..-21
I herebyaff!rm under pen'alty ofp'Srjury one oUhe followin;J declarritions': :]
o I h'a've 'and will.maintaina certificate of oonsent to self-insure fOf 'Norke~:k..x'mpensatior.,
c::.s provide_d for by Section 37.00 of the Labor Code, for the performance C'ftr!~\Vork forwhk:h
. this permit is ;ssued. i{
o I have and will maintain worker's compensation insurance, ClS required bj Section 3100 of . 9/14/2004
the Labor Code, for the performance of,the work for which this permit is i&;u~~. MyworKer's Date:
. Compensation insuran9S carrier and policy are: , ,. !
Carrier: STATE FUND ,Policy NUmber: 046-0q9~j:l5Rl'
This section need riOt be completedifthe pe~it is for one' hundred dOllarS(~1~'olo{;~s.
D I certify that' in' the' performance of the work for w!1ich this permit is'jsS~~e:~.!,.1 ~hali net
employ any person in.any manner so as to become subject to the worKer's' c:::'mpensation'laws
of Califomia, and agr.ee that if I should bee e.subiect to the workei's ,cc.i'floE:d:asation
provisions'of Section 3700 of the Labo od, h I rthwith comply w;th:!:t,:c:,~,; provisions.
BUILDING PERMIT IliO. BLD2004-03484
!~~~.~;~'i}~ifi,~
1!;\;1i~1~ .. ~. ElM
QK_.~ JM
\'~W;:""'" '
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TYPE OF PERMIT
Blockwall/Columns CITY
DATE: 9/14/2004
JOB ADDRESS: 690 S PERALTA HILLS DR
LEGAL DESCRIPTION: P BK 41 PG 35 PAR 1
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 168
ARCHITECT/ENGINEER INFORMATION:
I
LICENSED CONTRACTORS DECLARATION
J herepy affirm under. penalty of perjury'that I am
licensed under provisiorls of chapter 9 (cori)mencin\;j
with.Section 70 0 PIS 0 3 of the Business and
Professions C
NUMBER
732120
TYPE
. TYPE
, actor
B
HIC
Constrllcion Tvpes:
V N, .
Fire'Sprinklered?
NO
Date: 911412004 Applicant:
WARN ING: FAILURE TO SECUR . COM
UNLAWFUL, AND SHA,LLSUBJE T ANE ~Pl . TO CRIMI~JAL P~NAITIESAND CIVIL
fiNES UPTO ONE HUNDRED , US D DOLLARS ($100,000): IN ,;A[,pm 08 TO THE
COST OF COMPENSATION, DJ\MA ESAS PROVIDED FOR IN SECTJQr~ 3706 OF THE
LABOR COD"', INTEREST AND ATTORNEY'S FEES. '
l CONSTRUCTION LENDING AGENCY..:.
1.~;~~eb't.~~ir!":l~I~d~t'penalty,9! Pe.rjl,!_C'{_IJJ?iJtiJ~_r~ ~<,; ::I t;:OI1.",itfud;oli.leJl(t:j9:arL~2()Y fo~Jn-~
performance or the work for which this p:crmit is issued (See. 3097 .Civ~C); : ~
. Lender's Information:
:~ '.'
I certify than have read this application and state that the above information is correct., I
agree to oomply with all city ordinances and state laws relating to building construction, and
hereby thor" r' sen 'yes 'of this city to enter upon the above mentioned property for
inspedio rpo
Date: 911412004
A
___~__'-'----. _-.c.~__'-._______:,-----,-,--_:~
'.' , j ..: ':'" ;' .:~,
1.,',. ;,,-.:,_,
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''l,',:
Fees paid for Permit:
Total:
435.88
FINAL INSPECTIONS Date Inspector
INSPE;CTOR Electrical F.inal '.. .
Plumbing Final . '. . ..
Mechanical Final . .
.
. Gas Test. '. .
Engineering/Grading Final 765-5126
. Fire Dept. Finat165-4040 .
.
. VIIater E.ngineering 765-5268 .... .
.
. Sub list/Business License 765'519 '.. .
INSPECTION RECORD
DATE;
. INSPE;CTION . . ..
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Elec;trical Ground Electrode/Ufer .
Setbac.k1FormsfTrenches (Footings)..
00 not install subflooror pour floor slab unt; I the
following applic<?ble items have been signed: -
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) .
i:lectrical (Underground Conduit)
Pre-slab (compaction/Membrane.Reinf. .'
Underpinning (Floor Joist/Girders)
00 not cover or. conceal the work below until the
,following app'li,cable items haye been signed:"'
1 st Floor Shear . .
Firesprinkler (Rough)
2nd Floor.Shear . .
~of (Sheathing/Diaphragm'Frarne)
Masonry (ReinfJBOnd Bearn/Pre-Gl'O\It)
Rough Plumbing (Top Out)
Rough Mechanical'
. KOlJIln t:IectrlCaI (ury Wall)
RoughElecirical' '.
Framing (Only after Plbg.. Elec.. r..1ech and Fire)
Insulation (SoundlEnergy)
00 not tape or plaster until the following applicable
items have been signed: . ...' '" .
Drywall .
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Pluinbing
Interior Lath
Exterior Lath '.
. . . . .GENERAL ITEMS
Exterior Plaster (Brown Coal) .
T .Bar Electrical
T .Bar Mechanical
T .BarStructural
Sewer
Water Engineering Backflow
Water Service
.
.
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.
.
.
.
I
;
.
. .
. .
Zoning 765-5139
. Building Final (Last Inspection, Only. . Aizr./'){'
.-. . After Above Compiete) I/]l IU"
PARTIAL INSPECTIONS
I
Buildina Inspections
./ '
. ~'JJ '.,
.J'jo,.
,,",,: '.'
.'
./-U_D~--/?hn. . 'A4-Z.~
. . . =:z:::.6'777-/L A-- .-
U1/0r- rJoL~kl{S ~.sah..n,,(/lj ~~
. ~.fre"AIK~ &W~" ~
. MechanicallnsDections. .
<N"
~.. c, ~. ,: Id.\.(-'....,Q-'\\.
.. (~~ (C1Uv 4'Lf ...-r.......U '~j')G, .
r~"'-' ~Vv '-,,,,,0"""
Plumbinalnspections '. \!)v"0U-'
. I
.
.
.'
.
. .'
'. .
.' Electrical Inspections
.
.
I
I
i
.j
APPLICANT: RAFAEL INIGUEZ
OWNER INFORMATION: . CONTRACTORINFORMAT!ON:
TIM W'USZ CUSTOM CARPENTRY
3111 N TUSTIN AVE SUITE 215 32200 JACINTO ST
Of<ANGE, CA 92865 NUEVO, CA 925670000
JOB DESCRJPTlON:New gazebo, 1305f, Maximum 15ft. high.
VALUATION: 16,000.00
i OWNER-BUILIJEJ;:);,l}=CLARATION
f herebyaffirm Linderpenalty 'Of perjury that I am e.xemp~~rom the Contr3ci:c;;;~_Ljcc'!nse Law for the following reason {Sec. 7031.5 Bu~iness a'nd,:.<-
Professions Code: any dty or countyw'hich requires ~ permit to con~truct, <:l1~i~;:::'ir.lprove, demolish 'Or repair'any structure, prior to _its issuance,also
. requ:res the, applicant for such permit ta file a $ign;:od stdterm::ni that he i~ I!c~;:~:;ed plJrsuantto the p!Ovisions of the Contrador's.License Law (Chapter
9)(commencing witfl Secti6~ 7090 'Of Division 3 of the Bi.lsiness'ari?Profes~_~~~~~~'~'Cocie) or tliat he is e,xempt therefrom and the baSis' fo'r the alleged__ .
exerription. Any violation of Section.7031.5 by any' iDpllcant for o'pb'i:'mii st;~ii~~ts the applicant to a dvA'penalty of not more'thai1 five hundred dollars'
'($500). . ........ .' .~;. ..' ...If" .' '. . .'. '. "' .. .
o I, as Qwner:of property, or my employees with v.;:ages as their:'Sole cO;;,:i\\0;.:ation, will d.o the work, mid the structure is noti_ntended or offered for
sale (Sec. 7~ Business and Professions Code: THeContractor's'UcenSe t&tv:d,ges not a'ppfy to.an'owner of propert.y who buHdspr improves
thereon; and Vi:ho ?oeS,~uch wo~k h~n;~e~ or,herS~lfor tI1r~ugrlhiS?r 110r o'~{;i~j~:~IOYees,. proVided that su~h imp~vemeh~s are.not int~nd~:oc" .
offered for sal~. 11, however, the bUllclng or fmpro'I'?llIent IS ~old With one Y(~'1('o.f completion, the- owner-budder wlIl.have tne bUfden.~;f pr.ovlngth:3the'
did not O_lJild orimprove'forthepurpose.of $ale). , :: ':;1:';~:\':' '. . .' .. --, '. '~,"
0" t.:,as the Qwner of the property, ~m exdusivcly contn~ci:ir:g ",lith ilcer.s~C:-~".:.\"h1;-~ct,)rs tc construct the project (SeC'h Z"044 Busine.ss_ and Profession5_,'<
Code:' __The Co'ntractor'sLicen&.~ Law doE'S not apply to a~ owner of !=,rQPeft~',~.' he. bl.iiids or improves t\1ereo!1, and 'Nho cOntracts fer such projecls Vv!th~':-'
Mon.tractcr{s) licensed pursuanfto the Ccntiactor's License Lavn.li'~t~;, . . . - ':.
LJ !-Brn exempt under Sec,- .-.:-_ ,B.& P.(~. for thIS rea~.'(JU: ___L;;:.;:.:.;t.:..
Date:,: OWner: '~:'1' ,.
-~-_._._'""
;- . . . .,..'~
. L- . WORKER'S C9MPEIiISATION DECLARATION _~,;"
I hereby affirm under penalty of perjury one of the following ,jec!araticJns: '.. 'J _\
O' I have and-wil! iJ;3.intein a certificate of oonsent to 3elf-insure for worke?:~;lr6;lllpensation,
as provide:d for by'~ction .3700 of the L<:'!bor Code, fo!" the perforr'-IZ!:1CG of thE; y;;,crk for which
th!g permit Is'issued. '. , ' j
);;j( I have, a nd wi 11 mai ntai n wo rker's compensation i nsura,flc'-e, 3 s re Qui red o:J: s r;.1ct:C n3700 of
~abor ,coae, for the performance of the work for.whicl1 this permii !si~u;::il..Myworker's
Compen~.atjrJTl insurance carrier and pelicy ~re;_ ? ,. .:>_;, I
Carrier: STATE FUND . POlicy Number. -Qi!6wl1C:(~2l~O'3i~ f.
This sec'tio~ need no~' be completed if the pennit is,for one hund:-ErlJ c1~llar:;;(~~.~;_~),~r5~~. . '
LJ' i certify that in the perrormance of the work fer which this ,::erma is_ j,~Pfid, C~5ba_I!Olot
employ any person'in any manr.er so as to bF.come subje~t to tht' -work~r's_-'CC'_:11pensation :3W~
of Galifomia, and agree that if I 'should, b co b.ect to the WOIKl;:r'S .ccrni:}~1::'s'~(ion .
provisions of Section 3700 of the Labor e, II hwith ::iomply with U:';"se provisions.
Date: 9/14.'2004 Applicant: "L__.-....c-~
Wi'.RNING. FAILURE TO SECUR " ENSATIOI, COVERY,GE IS
UNLAWfUL, AND SHALLS'UBJE~T 'N 'EMP OYER TO CRIMINAL PENA~nESA'iJD CIV!l
FINES UPTO ONE HUNDRED 1i-io OLLARS ($100.000), IN i'.D")7JO'~ TO THE
COST QF COMPENSATION, DAMAGES AS PROVIDED FOH IN SECTIGN'3';,)6 OF THE
LASOR CODE, INTEREST ANDATTOHNEY'S FEES. . '" t ." . .
I '.' . .' CONS",:RUCTION U,NDING AGENC't \~~.7, 1
I h~r2h.:. ~ffirrYt Ll!1;:le: .Qf.ltlflltv'0i.pe~'iur'y lbat l_herc:_~s_'.c C(:nstru_~;,~J.QtlJ~ndJr.:!{:.~~:'''':.,_g..v JQ..:~-~.___i___~_~~_~
_.__e---___,___~'_' "_ '_C"'~'-'--__'''~:'- '--.--' -.-----,--, - -,:~-" - -- - 'l
perfcf"lr.anC!3: .ofth-e ii/ork for which this permit is-issued (Sec.30Bl..Clv,C):_, ".' - ,. '.,~-:#.:: ,'-
..Lerider's Information:
BUILDING PERM!'r NO. BLD2004-03377
TYPE OF PERMiT'
Accessory Building (Shed, Garage...j.
CITY
\".(!~!f~;l;'r;]~lfY'
DATE: 9/14/2004
JOB ADDRESS: 690 S PERALTA HILLS DR.
LEGAL DESCRIPTION: P BK 41 PG 35 PAR 1
BUILDING DiViSION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 168
ARCHITECT/ENGINEER INFORMATION:
MICHAEL CORBIN
3002 DOW AVE
TUSTlN;CA
PROCESSED BY: ,)JJ
I L .L1CENSED CONTRP.crORS DECLARA!'ON' 1
I '. ...' I hereby.affirrn under penalty qf peljury that. J am
I ~!icensed under r:-ovisions of cha~ter 9 (cor,1mencing
with Section,lOQ ivs'. 3 of the Bus~neSs.and
profe$S!~n~s . (; e
9/14/2904 .~_
Date: '.
'~.
NUMBER
732120
rYPE
TYPE
Construcion Types:
VN, , .
Fire Sprinklered?
I certify that 1 have read this 8pplica.tion and state that the above information 1s correct. I
agree to with city ordinances and state1aws relating .tobuilding cor:struction, and.
hereb\l thoriz se' tives of this city to enter upon the above mentioned property for
~. !~ n p , . . . Date: 9/14/2004
-i atur of Applicant or' Agent
The erm shall e e by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permrt issuance, A
'new p~niit is required to commence or continue work.
8
Hie
NO
',j ;;'-";(;(1":
'; . O-JJ -::.~.t ; !':;'il; <]>_
~?- ~:-:."'''' -';'.i: ~'.-
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Fees paid for Permit:
Total:
515,51
"!
.\
INSPECTION RECORD
. . .
. . INSPECTION: . . DATE. INSPECTOR .'
'.T&mparary Pawer Pale ..
Plumbing (DrainlWaste Pipe) . ,
Electrical Ground Electrode/uter
SetbacklFormsrrrel1ches (Footings) . .
Do.nat installsubflQqr ar paur f1aar slab until the .
foliowing-applicable items have been signed: -
Plumbing.(Water Pipe.Sprinkler Valves) .
Mechanical (GroundWork)
Electrical (Undel'!J1"ound Canduit) .. .'
Pre-slab (Cal1lPactianlMembrane .Rei nf. .
Und&rpinning (Floor Joist/Girders)
Do natcover ar conceal the wark belowunt.' the . .
following apRIi.table items have been - signed: ". .
1st Flaar'Shear . , . .
Fireliprinkler(Roug h) . I .'. .
2nd. Flaar Shear .
Roof (Sheathin9lDiaphragm'Frane) .
Masanry (ReinfJBond Bearo/Pre-GlO\lt) .
Raugh Plumbing (Top Out) .
Raugh Mechanical .
. ! Rough E1ectrical.(orv Wall) .
Rough Elecirical' . .
Framing (Only a'fter Plbg., Elec_.l:lech and Fire) , . . ..
Insulation (SoutldlEnergy) ..
0'1 nat tape ar plaster until the fallawing applicable
itemS have been signed:. . .. . .
Drywall ....... .. . .
Penetrations (Fire Rated) Electrical . ..
Penetrations (Fire Rated) Mechanical . .
Penetrations (Fire Rated) Plumbing
Interior Lath . .
Exterior Lath . . . .
GENERAL HEMS '. .
ExteriOr Plaster (Brown Coat) .'
T -Bar Electrical . . . . ..' .
T -Bar Mechanical .
:r -Bar Structural . .' .
Sewer . .
Water Engineering Backflew .
Water Service
,.:
FINAL INSPECTIONS
Electrical F.inal
Plumbing Final
Mechanical Final
Gas Test
EngineeringlGriKling Final 765-5126
Fire Dept. Final 7654040
WaterEhgineering 765-5268
Sub L.ist/Business License 765-519
Dale . Inspector
Zaning 765-5139
Buil~ing Final (last Inspectibn:Only .
. . After Above Complete)
PARTIAL INSPECTIONS
Buildinq Inspections
MeehanicallnSDections
,Plumbina InSDections
Electrical Inspections
APPLICANT: RICHARD MCKEI;HAN
OWNER INFORMATION: CONTRACTOR INFORJv.lTION:
Dan f3. Brougn CUSTOM CARPENTRY .
690 S Per3lta Hills Dr 32200 JACINTO ST
ANAHEIM, CA 928070000 NUEVO, CA 925670000
, , , BUSINESS PHONE: 949 49'1-8859
JOB DESCRIPTIONNew Residential Construction. New 1236si garage and 18:iOSf hobby, office. restroom and storage. ALSO SEE BLD2003-03811. (HiH)
VALUATION: 213,000.00 ' PROCESSED BY: ODe
'r-- " OWNER.BUILDEA;5E'CLARATION'.'." '
!hereby affirm linder penalty of perjury that I am exempt fromthe ContradOi15:license Law for the followjng:rea~on (Sec. 7031.5 Business and
Prof-:,::ssions Code: any city'or county which requires a permit to construct, ah:i~(; improve, demolisher repaj~any structure, prior to its issuance,als'd .
. requires the,", PPh,ca nt for such permit tQ' file a signed s,tatem~nt,thathe ~s nC:',?,:~~ed, pursuant tO",the,' Provis',',a,ns O,f the contract, Of'S" License. La, W.<C,ha, pter
9)(commencing with.3ection 7000 of Division 3 of the Business and Professicn,:; Code) or that ~e is eX~!1Wttr,erefrom and the basis fat the all~g~d_,.
exe;""!1ption. A'lY violation of S.ection 7031.5 by. any applicant for a'permit SL,;bl~ts tfJe:-a-ppncant-to a civi"p~l1a~yof riot more than five hundred dollars' ,
($500) , , " . . 'i'", .' '., " .
o 'I, ~s ow'nerof p'ropertY. or my employees with wagb;;; ;3S thel( ;.>ole COiY;f.i}\~~ation, wiU,9o the W,ork" ~nd ihe st~uctur~ is~not 'intended ot.offemd'f6r
sClle (Sec, 7044 Business and Profess'ionsCode:_ The Contractor's License ~~),w does nptapply to an:~}Wne.r of propertYwho builds orimptove~,
thereon, and_ who does such work himself- or herself or thiOUgh his or her owr.{employees. provided H,at such impro~em~!"tts'are not intended or
offered for sale. If,'however, the, building or improvement is'sold with one Y€:;1"7~of completion,'Jhe owner-build.ef will have,}he burden of,pr6ving that he'
didnotbuildorimprQveforthepu~{)seofsale}'. ' '" t,~', '",:_, ,':' , , ^.
o I, as the oWiier of the property;amexdusively contracting ""it.h licensed i'::Ontrcktors to cODstructthe project {Sec. 7044 Business ~nd,;Professions
Code: The Contractor's Licens.e Lawdoes not apply to an owner ofprop~rty ;:!t:to builds or improves thereon, and who contracts for sucr/projec~.with
~ontractor(S~l!c~n$ed. pur~uant to the,Contractor'sUcense Law}. , r~ .,
U ' I am exempt under Sec. _~, ; 8 & P.C. tor this reason:
Date: " Owner: . J
.1 WORKl:R'S COMPENSATION DECLARATION t:
I hereby affirm 'Jr1der penalty of perjury one of the following declarations: ,t' ,
o I have' an ,'II rnaintain,a certiftCate of consent to' self~insure for Wo(ker.tcompenSa~iOI1,
as provi or by Sedior. 3700 of the Labor Code, for the perform'ance .ofil~__j: WOIK for which
this mit is issued. "', ' ,'!'>, _,_" <
_~ I have and will maintain worker's compensati.onin$urance; as required b~JSeetion'3700'of
the labol,Code, for the performance of the work for which this permit.is issi.l~lMyworker's
Comrensatlon insurance carrier and poliCy are: '
, Carrier:, STATE RJND Policy Numb~r. 046.00(2)58
...~..r"
5\J\LDING ~RMIT NO. BLD200:l.04406
.
>,;"'i:'U,<-::~>,,. .'
[~~h:l)"t't:J'-., ':""_' <!,>'
.. ;f'-,A-;::.< ,,\' ~~~~~'\
"'7!.:h~" ,', " ~,_"O,\ .
;;\~~N~1-t ElM
~t,;jl*",c"""".'"'' - ;'
" \t-,xtf 'i~' ],r""'i}, -f
\. <l~<4J-,:?~~~Z;1~: -t,I
.\. ~t~~~?l.~}~~)f
';
TYPEOFP"RMIT CITY
Residentjal Addition . . .. ...
DATE: 511'2/2004 '
JOB ADDRESS: 6908 PERALTA HILLS DR
LEGAL DESCRiPTION: P BK 41 PG35 PAR 1
BUILDING DIVISION
200$, ANAHEIMBLVO
(714) 765 - 5153 , "
INSPECTION 'REQUEST LINE:
(714) 765 - 4626
, CENSUS CODE: 438
QUARTER SECTION: 168,
ARCHITECT/ENGINEER INFORMATION:
MICHAEL CORBIN
3002 DOW AVE
TUSTIN, CA
I
.' ',.
This sectio:n need not be completed if the permit is for one hundred doliurs ($10(\ O!:,less; ,
o . I certify that in-t~e performanceofthe work for which this 'permi\ is. iSSUC:/t! I-:sb~" not
employ any person in any manner so as to become subject to the worker's ci'npens~'tion laws
of California,' and agree that if I should become subject to the worker's comp:~'.,satiori
provision~ of Section3YOO oftl1e Labor C I shall forthWith com y WithU)se::pr,?visibriS.
e '
Date: 5/12/2004 APPlicant:?- U:. tZ.tEJ.
, WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVER/GE tS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA:j';ESAND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADC'nON TO THE
COST OF COMPENSATION, DAMAGES ASPROVIDED FOR IN SECTION '3706 OF THE, '
LABOR CODE, INTEREST AND ATtORNEY'S FEES.
L CONSTRUCTION LENDING AGENCY
"hereby pffjr~ under penal:tY of perJury that therpL.:: a.sonstructionlending _'l~f':I(~yfor the
. ;_.~...;.-.-~;-_."...."":"~~...::: ~.....,-:,-~"","i-O;,;,,:, i.'''.:....-'''i;i,ji.I.s;..::iUt'l.f\bt:~.)\J9;:...(;iJ:Cf.-- :-- ~,
Lende~s Information:
'certify that I have read' this application and state thatthe above information iJ correCt. I
agree to comply with all city ordinances 'and state laWs .relating to bujlding cor.struction, and
hereby au or.' e representiv of this city-to enter upon the above .mentioned property for
insp' pq
Date: 5/12/2004
Sig ature of Applicant or Agent
Ttie permit shall expire' by limitation and become null and void if the building or
work has not passed,final inspectiol)365 days from the date of permit issuance. A
I'Iew permins required to CQmmence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby. affi~m.under, p_enalty of' perjury t~at I am
licensed under pr.ovisions of chapter 9 (commencing'.
with Section 7000) 0 ' ion3ofth ,/ siness and'
Professio~de.
5/12/2004
Date:
NUMBER
732120
TYPE
,TYPE
EXPIRATION DATE
2/28/2005
B
'HiC
Construcion Tvpes:
VN, ,
Occupancy Groups:
R3, U1, , ,
Fire 8pnnk[ered?
LivinQ Area,:
GaraQe Area' -
NO
1,800
1,236:
s
',...
Fee:s paid for Permit:'
Total:
, 1,338.59
" INSPECTION RECORD
. .-
.. . ., 'INSPECTION . '
Temporary Power Pole '
Plumbing (PraiOlWaste Pipe) , .
EIeCtrical.GroundEleclrodelUfer . .'
SeibacklForinsfTrenclies (Fooling$) .
.. Do noI,install subfloor or pour floor slab until the,
following applicable items have been signed: .
Plumbing (Water Pipe.Sprinl\ler Valves)
MeclNlnlcal (Groundwork) - , ...'
Electrical (Underground COnduit) , .
Pl'Il-slab 'lCOmpaction/Membrane.Remf. ~. Z<.J-a,
. Underpinning (Floor Joist/Girders) , . '
Do not cover, or conceal thewor!< below ,until the
following applicable items have .been signed: .
1st'Floor Shear- ,." -pf?
Fil'llsprinkler (Rough>. . 1/>_ (
2nd Floor Shear ' -,-
,Roof (SheathinalDiaphra!jm1Frame) -,-
Masonry (ReinfJBond E!eamJPre-GlOIlU, ;-l'1-o"" . If ,/ I...i:a7 "
. Rough,Plumbing (Too Out) .= '~, \
ROUgh Mec:hanical .., IT~ ~
Rough Electrical-(Di'v Wall\ ' I,.
Rough,Electrical .:- -,- ",., "
Framing.. ,only after p. Ib9". Elec,: Mech., and Fire) }[fJjfjft
insulation (SoundlEnarav), .' '.!IU1Ii! ~"dl '
Do not tape or plaster until the following applicable/ , .
items have been signed: . ' . '.
Orywall "C:-,.. 1'JtI11<!1. "'I~
'Penetrations (Fire Rated) Electricill ' -, I
Penetrations (Fire Rate,d) Mechanical,
Penetrations (Fire Rated)Plul!1bing "
Interior Lath ' . . .~. -W .
Exterior Lath ' \1X 1111.... II'
'C- ' - : . GENERM ITEMS ( " .
Exterior Plaster (Bi'aWnCoat) 1-1/ A ">'I ~ ~
T .Bar Electrical ,.' , V
T .Bar Mechanical " ..
.T .BarStructural cc.u
Sewer.. '... .,. ,
Water Engineering B.IICkflow
Water Service '
,
DATE
INSPECTOR
, .
,
.
P\~
I ~'
,1.7
,,'
A
.
.
-.
.
'.
.
~,
./
.
FINAL INSPECTIONS,
Electrical Final .
Plumbing Final
, Mechanical Final
Gas Test
Engineering/Gradi.ng Final 7
Dale'
Fire Oep!. Final 7:65-4040
Wate, Engineering 765-5268
.
Sub List/Business License 76s:.51
Zoning 765-51 ~9 ' .
Buiiding FinallLas/lnspection. Only
After Above Completel ,
- . PARTIAL INSPECTIONS,
.. Buildinq Inspections
..
, ./. - 11 -.?4, {lMd.-6-f),-,
C(/ !'L'f/!$ .-;;2
, .. .'
. ' .
.
.
.-
Mechanical. inspections
,
.
-PiumbinQ Inspections
/(((114' ~,. (~~ij{J/&oo/~ efovi .w~ .~Ci '.
'... .
Electrical Inspections
I "
-
BUI,LDING PERMIT NO,
. ,'~J~~,:}j:'f~;)~.
4~f~t'~j~ '
~'~~~~HEIM
~ '\t~-g~:41"'1 .
\Zf~ftl~~~/ ',',
\
LEGAL DESCRIPTION: P SK 41 PG 35 PAR 1 ,\
J i
APPLlCANT:TANIA SOO ~~ , J
ODWNE'ER INFORMATiON: * ' ' CONUTRACTOR INFORM"1"TION: ARI'CCHITEC:/ENBGINEER INFORMATION:
an Brough C STOM CARPENTRY, M HAEL CUR. IN
690 S Peralta Hills Dr 32200 JACINTO STI ,3002 DOW AVE
Anaheim, CA 92807 ,NUEVO, CA 925670000 ' , TUSllN, CA
, BlISINESS PHONE: S4~ "17-.,859 " "
JOB DESCRIPTIONRc:l'odeI4262sf of existing SFD and con\'~rt 298sf of .,t k' hobby room, ALSO SEE BLD2003-Q4406,
,t . . .
VALUATION: 127,860,00 ' I PROCESSED BY: ODC
I " " " OWNER-BUI::'DEtWg~LARATION ' . ' ,
I hereby-~ffirm-under penalty of perjury that I am exempt from the ,Contr<lctor$LiCef~S~1 Law for the following reason (Sec. 7031.5 Business and
Prpfessicns Code: any dty or. county which requires a per,mit to construct, a.~r. illJprove, demolish or repair any structure, prior to its issuance, a[sc
r~:ujres the applicant for such "permit to file a sigQed s~teme;"'lt that h~;3 1i~~:iSe~ pursuanf to the provisions of the Contractor's License Law (Chapte,'
9}{commencing with Section 7000 of C'lvision 3 of the' Bllsi"ess and profes~fnc; Code) o~ that he is exempt therefrom and the basis for the alleged.
exempt!on. Any violation of Section 7031.5 by anyap~acant for f'I per;"l)\i Sti:.jec:.s i.r.e applicant to a. civil penalty of not more,than fIve he,Jndred ~oll.ars
($500), ,', .,'" ' ,." .'
,- 01, as owner of propeny, or my' empJoyee;s wit~ wages8s their sole c"lm~e3$;'ltio." _\.;:~r..:!o the 'Norl<,:;!nd thE'strU,cture is notlntended or offered for
sale' (Sec. 7044 B!Jsiness'and Prof~sio()s Code:, n..,e Contractor's UCf}i,s~.taw eves i_l~?t dO;:'~Y to ~n !",wl1er of property wryo lJuHdsor improves
" thereon, and whQ does Sl!dl v/ork !1imself -or herself or ~hrol'Jh hiS. cr: ,fOf c'^r eJ!lpJoy~eS, provided that such improvements are not intended of
. offered for sale. I.f, however,,!he b;;!lding,.or improvement is 'sord with O'):=- Y;'':iofrompletion. the' owner-builder wj,1 have the burden of proving that I)e
didnotb!.Jild'orimpraveforth~puIposeof~le). _ ~' ,_..:' . . ,'.
o I" as t,~b owner 9fthe pn;perty, am E'xdusively contracting with !i~er'.~- ...~ntractors ~Q ccnstr.uc1 the proj.ect (5e,o., 7044 8usinessancl ProfeS6ions
Code: The Contractor's Uoof!se law-does not :]j)ply to a/"l owner of prr,pen: who beilds or improves thereo~,_ and who nmtracts fo~ such projef":ts 'N~h
r~~~trddOr(S) licer,sed pursuant to the Contractor's U~nse la~).' .~ ." . ' ' .'. .
.-.J lamexemptunCterSec. _ _ ,B&P.C.f,:rthlsre~st..i1~ __+_ . ',' , . _____ . '
Date: . Owner: . . .
c:: WORKER'S COMPENSATION D;;CLARATIPN ..:._L~:_ ~ -
I hereby affirm under penalty of perjury one,of the_ foIJowing.declar.2tlons: ~ :
'W- :I have,._and will maintain a certificate cf ronsent to. self-insure fOI" W0(:\~"'fc':MP,ensation,
as. provided for by Section 3700 of.th(3 Labor Code, for the ~rtorman;;.; \.l~ ~~ Yic.lr.-; for wl"'!ch
~nis "'rmit is iss'ued. ," . . _ .
'\' .,' r,~ve aDd will mai"tain wor'r:er's compensaticnin~urance, as reqUi:~d:'.i:.I ~f':ctio~ 3700 of
labor Ce>de, for uk pertOfrllaOOe of the 'Nork ~or which thi:; rermit :s i&:;t 1}J. M}rworker's
Compensation insurance canie::and.poiicy are: ~
Carrier: STATE FUND POlic.y'Num~er. 046-,f('~~~58'
Thi~ section need not be completed if the pen'!1it is for one hundred dollars (St(j~~; or -:~s: '
o I ,certify that in the performance of the work f?r which, this permit is-~S~l:_"i.~. I shalt not
employ any person in any manner-sQ as to bec me subject to the worker'~_c:;..:,:,pensatian laws
of Califomia,,'and agree that if I shCluldbe. subject to7he worker's comp(:,$.:ition .
provisions of Section 3700 of the labor , I fa ywit omply WIth ~\~se provisions'.
t
Date: 12/11/2003 Applicant: ____
WARNING: FAILURE TO SECURE ORKER'S COM ENSATION COVEF',GE IS
UNLAWFUL; AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA;.TIE~" AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN A[l(;:, nON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIo.",3706 OF THE
LI',BOR CODE, INTEREST AND ATTORNEY'S FEES. '
L ' CONSTRUCTION LENDING AGENCY
...:.Lh~;py,affirl]Lunr.fer_pena'tv ofx::,:>ril'~! th.'1t th~(f'!; b a (':cn~~I!f':tin"" h:N"'~1?- ~..;Ir.:~: f~r:_!b=,_ __ _'--_ .___
performance of the work for which this permit is issued (See. 3097 .Civ.C):
Lender's Information:
BLD2003-03811
.
.BUILDING DIVI&lm:
200 S, ANI',HEIM BLVD
(714)765 - 5153
. INSPECTION REOUEST LINE:
(714) 765" 4626
TYPE OF PERMIT
Residential Remodel
.,
;\'-\ \ 0\ CITY
DATE: 12/11/2003
JOB ADDRESS: 690 S PERI:I,LTA HILLS D'R
CENSUS CODE: 434
QUARTER SECTION: 168
:::J
~
LICENSED CONTRACTORS DECLARATION, .j
I hereb1.~ffirrn undflr penalty of perjury that.1 am
licensed under pro 'Siictlsof<;:hapter9-(commEmcir.g.
with SectIOn z?OO' !Divs' 3 t usinessand
prafe, ssions tad " "
12/11/2003 ~ ..-
Date:
NUMBER
732120
TYP~
TYPE
EXPIRATION DATE
2/28/2005
B
HIC
Construcion Types:
VN, ,
Fire Sprinklered?
NO
<-".
,":';"- -~ ......." ....
", ~
I certify 'that' have read this aPPlication and state that the above information is correct. I
agree to rom ply it all city ordinances and state laws relating to building CC,1Struction, and
~er~~bY ,a.u ho( r resentives of this, city to enter u pan thea bove' nientJonef.l property for
msp.. pu
Dale: 12/11/2003
Fees paid for Permit:
Total:
2,150.66
. Signa ur of Applicant or Agent
The permilshaJl expire by limitation and become null and void ifttle building or
work has not passed final inspection 365 days from the date of perrrjt issuance. A
new permit is required to commence or continue work.
INSPECTION . . DATE INSPECTOR'
..
Temporary Power Pole . .
. Plumbing (OrainIWaste Pipe)
E;lectrical Ground Electrode/lifer. '. .
Setback/FormslTrenches (Footings).
. Do not instal.1 subfloor or pour floor slab until the II
1ol!owing -applicable jtems hav.e been signed': . .
Plumbing (Water Pipe.SprlnklerValves) . II
Mechanical (Groundwork) . \
E;lectrical'(Underground Conduit)
. PIe-slab (CompactionlMembrane.Reinf. .
Underpinning (Floor Joist/Girders) . '. .' V
Do not COver or conceal the work below until the
following appiicable items have been signed: J'>. '"
1 st Floor Shear . -'1--0'-1 qj/,
Firesprinkler (ROugh) . '. . / \
2nd Floor. Shea.r f .-/
Roof (SheathinglDiaphragm'Frame) .~ -';f..tJ<.,/
MaSonry (ReintJBond BeamlPre,Grout)
Rough Plumbing (Top Out) .~. . .
ROl!gh Mechanical
I KOugn Bectrical (ury wall) . .'
Rough Electrical . . ~
Framing (Only after Plbg.; Elec.. t...1eCh.. and Fire) ~/~t1 Y /.
Insulation (SouncllEnergy) . n_ j'''';c ~
po not tape or pl.aliter . until .the following applicable . .
Items h,ave been signed: . .' -'.' - .
Drywall . . . .
Penetrations (Fire Rated) E;lectrical . .
,.
Penetrations (Fire Rated) Mechanical . :
Penetrations (Fire Rated) Plumbing .~
Interior Lath .' /1- /t,; .... _
Exterior Lath . ' '.
GENERAL ITEMS 'J
exterior Plaster (Brown Coat) //~ -v'-/- r2!/
T-Bar Electrical '. ...- f
T.Bar MeChanical . :
T -Bar Structural . .
Sewer . .
. Water Engineering Backflow .
Water Servic.. .'
INSPECTION RECORD
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765.:s126
'" .
,;~.
Fire Dept. Final 7654040
Water Engineering 765.5268
Sub ListlBusi.ness license 765-519
Zoning 765'5139
Building Final ILasllnspeciion- Only
. . )\fter Above Completel
PARTIAL INSPECTIONS
~Uil.d. i?lns;;ztio.ns. .....'.. '. '.' .".' .
~-IP -/) . '5 ~~ j~K/ HIrM .~~'t-
9-1-"y-.:t:Z~'-;tL .cK"n~6#1 .
/~ l.M:?1e.'t?~-/J~""
Mechanical Inspections
PIUr;~ns~. ecti.on,s. .'. .,
A ". .~.'I/I ~,-
. ,'.
~ g,J rwt- (~~
Electrical Inspections
LYDIA WANG & ASSOCIATES, INC.
Interior Architecture
3002 Dow Avenue, Suite 140 "
Tustin, California 92780
(714) 508,1866
Fax (714) 508,1878
June 3, 2004
Building and Safety Division
City of Anaheim
" 200 South AnHheim BI)H!ev.rd "".
Anahiem, CA
RE: WUSZ RESIDENCE
GARAGE CONSTRUCTION
Sir:
This is to confirm that the constructed foundation at the site exceeds the minimum requirement of at least
(1) No.5 bar top and bottom specified in the soils report
There are at least (2) No.4 bars top and bottom @ the north side foundatIon and (4) No.5 bars top and
bottom @ the south side foundation.
Thanking you for your kind attention and consideration for approval.
~"."...
-- -- - - '- - - '. ",
" "
VI"
Mi hael Corbin A.LA.
Pr ~ect Architect
cc: John/McKeehan Construction
- .,.-~ ~.-,- _.- ",.,-
Respectfully,
Me/rns