225 N. Plantation Pl.
BUILDING PERMIT NO. BLD2004-02979
ElM
BUILDING DIVISION.
20.0. S.ANAHEIM BLVD..
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSvS CODE: 565
QUARTER SECTION: 122
TYPE OF PERMIT
Blockwall/ Columns CITY
.DATE: 7/30./20.0.4
JOB ADDRESS: 225'N PLANTATION PL
LEGAL DESCRIPTION: N TR 3390. LOT 10.3
APPLICANT: TENPA DORJEE
OWNER INFORMATION:.
. TENPA DORJEE
225 N Plantation PI
Anaheim, CA92806
JOB DESCRIPTION:lnslall 123 sq It retaining wall as per engineering.
VALUATION: 984.DD PROCESSED BY: .CAL
I . .. .. . .. OWNER-BUILDEJtDECLARATION . ......
I her~by affirm under penafty of perjury that I a'mexempt from theGontract(J(~ Ucense Law for the following reason(Sec. 7031.5 Business and
Professions, Code: any.city or county which requires a permit to construct. aji:~r. improve, demolish or repair any. structure, prior to its issuance, also',
requires the applicant f,or such permit to, file a signed sta~ement that.he is lic:e_:1sed 'pursuant to the proVisions o.fthe Contractor's LiCense Law (Chapter
9)(comlTle!1cing with Section 7000 of Division 3 of the Business ahd Pl'ofessi'J')$ COde) 01' that he is exempt therefrom and the basis for the allegeq
exemptiC?n.Any violatlori of Section 7031.5 by any applicant for a permit,sub,ects the applicant to a civjl penalty of not more than five hundred dollars
$50 .. . . '.
I, as owner of property, or my employees with wag'e~ as t!J-eir sole cO:-:~"Y',ns:::ltion, wi!! do the work, and the structure is not intended or offered for
a '(Sec. 7044 Business and Professions Code: The Contractor's License L.aW does not apply to an owner of property who builds or improves
I eon, and wlio does sum work himself or herself.or throUgh his or her o';.,.l:~mployees, provided that such improvements are not intended Of
offered for sale.,- If, however,' the building or ,improvement is sold with one ye'-!r' of completion, the owner-builder wjJJ have the burden of proving that he
did not buUd or impl"Ove for the purpose of sale). ~ , " .
-'0' I, as the owner of the property, am eXdusively contracting with licerisec::::o,.,tmdors to construct the project (Sec. 7044 Busj~ess and 'professions
Code: The Contractor's license _Lawdoes not apply to an owner of pro~e!1,! .Jlho builds or iniprovesthereon, and who 'contracts for such projects witt)-
,a...yontra~or{s) licensed pursuant to the .Contra.ctor's-License Law).
U 'I am exe~pt under. Sec. , B & R.C..,for this rea Ol"'l:,
Date: Owner:'
CONTRACTOR INFORMt:rlON:
ARCHITECT/ENGINEER INFORMATION:
LI
LICENSED CONTRACTORS DECLARATIO~ .
\ hereby affirm'under penalty of perjt,;ry that I am
licensed,under provisions of ch.apter 9 (commencing
with Sec.tion 7000) of Divsion 3 of the Business'arid
Professions Code;
8/13/20.0.4
Date;
Contractor
WORKER'S COMPE SATION DE~LARATION
I hereby affirm undr:::r penaltyof perjury one of the' following declaratic!)s;
D' I have and will maintain a ceJiificate-of cons€!nt to self-insure for ';>lor:-"~;~~,ctim}Jensation,
as provided f6r by S'ection_3"(OO of the L,abor Code, for the perfyrmance (lft!l:: WOrtZ for which
, this p~rmit ~' issued. , "
0, .\ have and will maintain worker's qOl'!lpensation insurance; as ~quired b/ S~ction 3700 of
'the labor Code, for the performance; of the work for which this pennit is:iSsi.IE,d My worker's
Compensation in sura nee carrier al'ld poliOf are:
Carrier: Policy Number.
NUMBER
EXPIRATION DATE
This section need not be completed if the pennit i~ for ,one hundr,eeI 'd<:,llars{$1 iJO~ cr less. '
~rtifythat.in the perfonnance ofthe work for which thIS per~itiS 'i~!)e'J, I shall not
ffflrPI~y-;ny person,in any manner 'so as to become subject to the wbr.k~~.s_:cCmpensation laws
of Califomia, and agre~ that if _I should become subject to the woi1<er'se:qrrt;:>enSation
provisions of Section 3700 of the Labor Code. I shaJJ forthwithconl_ply Voiith,U".ose provisions
Dale: 8/1312004 APPlicant:~2:,~ ~e.d:U5-Vt,
WARNING:. FAILURE TO SECUREWORKlfR'S COMPENSATlq~ COVERAGE IS
. UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN;t\L PENA'.T1ES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($10q,o.oQ), IN ADD!TION TO THE
COST OF COMPENSATION; DAMAGES AS PROVIDED FOR liotSECTlON 370.6 QF THE
.LABORCOOE, INTEREST AND ATTORNEY'S FEES. ..:
. CONSTRUCTION LENDING AGENCY
I hereby. affirm under p~na ttyofperjury that there is _ a :construs!jonlehd ir,g 3;;~ncy f.or the
perform~nce ?fthe work for which this_ permit is issued fSeC:3097_,C:\f .C:: .
" 't.ender's"irlforma-tion: - - " . '-- ,- ~ -- --.- -
. . TYPE
Construcion Types:
VN. .. .
Fire Sprinklered?
NO
" 1 certify that I have read thisappliC~tion and state that the above information is correct. I
agree to comply with 'all city ordinances and state laws relatif}g to bu~di\"lg construction. and
hereby authorize.representiv'es of thjs city to enter upon the above mentioned proPerty for
jn~ct~n purposes. , '
. ~' .i::::.-b~ ' Dale: 8/1312004
. ,.~ Signa.ture of 'Applicant orAgent
. The permitshaJl expire by limitation and become niJlI and void if the building or
. w.ork has not passed final inspection 365 days from the date of permit issuance. A
new. permit is req~ired to commence or continue work.
fees paid for Permit;
Total:
93.87
INSPECTION RECORD
INSPECTION , DATE INSPECTOR
,
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Gr"und Electrode/VIer ,
Setback/FormslTrenches (Footings)
Do not install subf/oor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) .
Mechanical (GroundWork)
Electrical (Underground Conduit) ,
pre-slab (CompactionlMembrane,Reinf.
Underpinning (Floor JoisVGirders)
Do not cover or conceal the work below untIl the,
o fol\o~jng applicable items -have been signed: "
1 st Floor Shear
FiresprinkJer (Rough) ,
2nd Floor Shear', ' ,
Roof (sheathinalDiaphragrn/Frlriie) ,
Masonry (ReinfJBond BeamlPre-Grout) , ' , ..
Rough Plumbing (Top Out)
Rough Mechanical' , , "
Rough BectricallDry wall) ,
,Rouah Electrical
Framing {Only-after Plbg.. Elec... f,,1ech:. and Fire} , "
Insulation (SoundlEnergy) ,
po not tape or plaster until the following applicable
Items have been signed:, " . . ' .
Drywall , "
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire ~ated) Plumbing
Interior Lath , ,
Exterior Lath .'
, GENERAL ITEMS
ElI;terior Plaster (Brown Coal) ,
T -Bar Electrical ,
T -Bar Mechanical
T -Bar Structural
Sewer :
Water Engineering Backflow .. , ,
Water Service
FINAL INSPECTIONS Date In'spector
Electrical Final , ,
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126 . ,
Fire Dept. Final 765-4040 .
Water Engineering 765-5268
Sub LisVBusiness License 765-51,9 ' "
Zoning 765-5139 , .
Building Final ~a.t Inspection' Only '7~7-") ....y/J
fter Above Complete) <..;><f .
,
PARTIAL INSPECTIONS
BUildin:;:nsaElcti~ns " ' , . _. '" .
15/lbl ~-:1 ~)....
. ~ ~L1 . N> ~rv-. ' 'B'.
q,(-z:z>(,,4- Fav~-./ .' .
Mechanical Inspections
Plumbina Inspections'
Electrical Inspections
?
t
"
~
,
~V)
J ~
r-<
? ~~ fe,
I-Jot ;-;-,~/-,
~N,
~1-
~~.
-I'll ~ .
I~IW.P"'MIT PPOC!:EPS AT'HI
D~~
\?lJ)
JUl 3 0 2llO4
LDING DIVISION OF ANAHEIM
APP:V(!nCh'{(t
5 {It 6.)
....."
.
~
~1
-..J-
Ill'S-
'"
~~
.+:
~
.\,
'~
'(">~">5...
~t'+-
~c;.~,
'\:I~
). ~
t 'S'
~
p~.
7'prY5
Sf')_
J
\
'"
\J\I
V)
"
,tf.5I1I.$:J. A?S-:2-
d/. if. (;, ~
PLANNING DEPARTMENT
APPROVED
DA T E ---2Le? _ /Y/ -
Z N\NG ACI)ON
BY ( ~~l
(In!tla.t~) .~.
FLOOD ZONE
'':''1.-
HIST IC DIS RICT REVIEW:
/ See, tamp thi6 paie
Circle one () above line
PERMIT FOR
ANY CONDITIONS
(, ( jI&e-k?VaII /ls .9?p?J/J
TYPE OF PERMIT C ITV
Blockwalll Columns
ElM
BUILDING DIVISION
2IJO S. ANAH.EIM BLVD.
(714) 765- 5153
INSPECTION REOUESTUNE:
(714) 765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 122 .
BUILDING PERMIT NO. BLD2004-02979
DATE: 7130/2004
JOB ADDRESS: 225 N PLANTATION PL
LEGAL DESCRIPTION: N TR 3390 LOT 103
APPLlCANT:TENPA DORJEE
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
TENPA DORJEE
225 N Plantation PI
Anaheim, CA 92806
JOB DESCRIPTION:Addition of 41 LF of 6' high block wall fence at side yard.(,er city spec)
VALUATION: '984.00 PROCESSED BY: MSM
I OWNER-BUILDER OECLARATION
I-hereby affirm under penalty of perjury that I am exempt from the Contractor~~~ License law for the following reason (Sec. 7031.5 Business and
Professions Code: anydty of county which reql)ires a permit to construct, aitr.fr, improve, demolish or repair any structure. prior to its issuance, also
requires the applicant for such permit to file a signed statement that he Isliceilsed pursuant to the'provisions of the Contractor's License Law (Chapter
9}(commencing with Section 7000 of Division 3 of the ,Business and Professi<'~s Code) orthat he is exempt t~refrom and the. basis forthe alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit'sublptsthe applicant to a dvil penalty of not more than five hundred doUars
~~.' . ! .
.M". . I, as oWner of pro~erty, or my emPlOY. ees w. ith wages as their sole com~r:.n$atio,n, will do the work, and the structur.8 Is !'lOtintended or offered for
~e (Sec. 7044 Businessand Professions Code: The. Contractor's License ,t.,lW does-not apply to an owner of property who bUilds,or improves
thereon, and who does sU,ch work hims:elf or herself or through his or her oWf'::employees, provided that such improvements ar.e not intended or
offered for sale,' If, however, the bl,lilding or improvement is sold with Of)e y~i.:- of completion, the owner-builder will have the burden of proving that he
did not build or improve' for .the pUfpose of sale). .
.0 I, as the owner of the property, am exdusjvely contracting with licensed /:ontractors to construct the project (Sec. 7044 Business -and Professions.
Code:- The Contractor's. License law does not apply to an owner of property ',\'ho bullds or improves thereon, and Wh0 contra.cts for such projects with
~ontractor(s) licensed pursuant to the ontr or's License Law). ' '
U I am emp under Sec. . -:for this reason:
Date-' Owner:
WORKER'
I hereby affirm under penalty of perjury one t e followin9 declarations: .
o I have and . will maintain a certificate of consent to self-inSUre for worker'~: compensation,
as provided for by Section 3700 of the labor Code, for the pelformance C'fthi~ 'Nork far which
this. permit is issued. .
o I have a'nd will maintainwtHker's compensation insurance, as required b): Section 3700 of
the .L,abor Code. for the performance of the work for which this permit is issu':::i. Myworker's
Compensation lnsurance.earlier and policy are:
Carrier: Policy N~mber:
This section need not be Completed if the pennlt is for one huntlred dollars ($100) or less.
M I certify that in, the perfonnance- ofthe work for which this permit is issued. I shall not
~ptoy any person In any -manner so as to became suoject to the workers co:-npensation Jaws
.of Califomia, and. agree that if I should become subject to the worker's compe:1Sation
pravision$ of Section 3700 of the Labor C an rthwith comply with thc~:;: provisi,ons:
Date: 7/3012004 Applicant:
WARNING: FAILURE TO SEC COMPENSATION COVEP,'GE IS
UNLAWFUL, AND SHALL SUBJE TAN YER TO CRIMINAL PENA~TIESAND CIVIL
FINES UPTO ONE HUNDRED THOUSAN DLLARS ($100,000), IN ADm'l1ON TO:THE
COST OF COMPENSATION, DAMAGES AS OVIDED FOR-IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending ag;ncy for the,;o:
~Qfr:nanooofthe work forwhich this germit is i$.SJf'!'.rlJSI;"r.. 3097 Civ.~~:_~ __'- ~
~-Lei1der's Infonnation: , .._
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Oivsion 3'ofthe Business and
Professions Code.
713012004
Date: Contractor.
NUMBER
EXPIRATIONDATE
. TYPE
Construcion Types:
'{N, ,
Fire Sprlnklered? NO
I certify that I have read this application and state that the above information j;,correct. t
agree to comply with all city ordinances and state laws relating to building cO(1'~truction, and
hereby authorize re resentives of this city to enter upon the above mentioned property for
,ins ection purpo ,
Date: 7/30/2004
Feesp~id for Permit.
Total: 72.45
re of Applicant or Agent
The per . s all ex 'r. by limitation and become null and void if the buDding or
work has not passe fj al inspection 365 days from the date of permit issuance. A
new permit is requir commence or continue work.
INSPECTION RECORD
INSPECTION DATE INSPECTOR.
Temporary Power Pole
Plumbi ng (DrainlWaste Pipe). .
Electrical Ground Electrode/Uter ..
SelbacklFormsfTrenches. (Footings) "-J6~*
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) . .
Electrical (Underground Conduit) . .
Pm-slab (CqmpactioIVMembrane.Reinf.
Underpinning (Floor Joist/Girders) .
Do not cover or conceal the work below until the I
following applicable items have been signed: . . ..
1 st Floor Shear
Fimsprinkler (Rough) .
2nd Floor Shear .
Roof (Sheathin!liDiaohragrn'Franel
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical .
Rough ElectrICal (pry Wall)
Rough Electrical
Framing (Only after Plbg.. Elec. Mech. and Fire} . .
Insulation (SoundiEnergy) .
po "(It tape or pla!'ter. until the following applicable
,tems have been sIgned: ..
Dtywall .
Penetrations (Fire Rated) Electrical .
Penetrallons(FimRaled) Mechanical .
Penetrations (Fire Rated) 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 . Inspector
Electrical Final .
Plumbing Final . ..
Mechanical Final . . . .
Gas Test . . .
Engineering/Grading Final 7115~126 ..
Fire Depl. Final 765-4040
Water Engineering 765-5268
Sub List/Business License765-519
Zoning 765-51.39 .
~
Building Final ~asllnspection. .only 7-7.0<; d{\:-
fter Above Complete)
. PARTIAL IN P TI N /
S EC 0 S
Buildinalnspections. . ~
B~17-o4r~~';i-. {}lA. . .
Mechanical inspections
Plumbing Inspections
Electrical Inspections