1118 S. Pointe Premier
BUILDING PERMIT NO.
BLD2004-00471
TYPE OF PERMIT
Retaining Walls
.....
CITY
, DATE: 2/26/2004
,JOB ADDRESS: 1118 S POINTE PREMIER
, LEGAL DESCRIPTION: TRACT1376~:LOT ,11 POR OF LOT
APPLICANT: SCOTT DOUCETTE
OWNER INFORMATION:
Premier Pointe
1118 S Point Premier ',.
Anaheim, CA 92807
CONTRACTOR INFORMAfiON:
i
AMERICAN PACIFIC HDr,:ES, INC
4959 PALO VERDE ST #B10'
MONTCLAIR, CA 9176300:)('
I certify that I h~ve readtAis application and state that the above informatio.n is correct. I
agree to oomply with all city ordinances and state laws relating to building cOllStruction, and
.herebyauth . e r: tives of t is city to enter upon the above mentioned propertyfor
~~. pur
Date: 2/26/2004
atu cant or Agent
The permit shall expire by limitation and become null and void if thli building or
work has, not passed fi nan nspection 365 da~ from the date of pernli! ,issuance. A
new permit is required to commence'or continue work.
~.
BUILDING DiVISION
200 S, ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 c 4626 '
CENSUS CODE: 565
QUARTER SECTION: 287
ARCHITECT/ENGINEER INFORMATION:
DALE L FORBES
1800 E, 16TH STREIOT
SANTA ANA, CA92701 "
I
LICENSED CONTRACTORS DECLARATION
here ya irm und~r pen~lty of pF'rjury that I am
ItCenS,ed under provic:on~apter 9 (commencing
with Section 7000) of Di~,on Th tl". usiness and
Professio~ C~
2/26;2004~,~'
Date:
NUMBER
785551
TYPE
TYPE
Construcion Tvpes:
VN, ,
Fire Sprinklered?'
Con tractor
S
HIC
EXPiRATION DATE'
,10/31/2r.P4
JOB DESCRIPTION Retaining walls: 267 sJ.
VALUATION: 2,670,00 ',. PROCESSED ay: CDL "
j ,c, ',' OWNER-BUILDER,),ECLARATlot.j' ,
1 hereby affirm under penq.1ty of perjury that I am exemptfrom the Contracto:-'h:L:cense Law {or: the following reason (Sec. 703_1.5 Business and
. Professions Code: a.nydty or county Yth!ch requires a permit to construct, al~:\::; irn;>rmfe. demolish.';)r ~epair any structure, priolo to its issuance, also
requires the applicant for such'permit to file a signed statement that he is lice'r~;=;:e.Lt ~ursuant to the provisions of the Contractor's L:(:enst;l La_w (Chapter'
9)(commencing with Section 7000 of Division 3 of the Business and Professid'.sGode) ()r that hp. is exempUherefrom and t:'e basb-forth_e'alleged
exemption. An~' violation cf Section 7031.5 qyany applicant fQr a permifsui;;~cts the applica_nt to a civil penalty of not more t.han fjv~ hundred dollars
($500), ,I. " " ,
o I, as owner of property , or my employees with wages a3 their, sole comp~i~C:;l3tio'n, will de the work, and the ~truc~re is not intended 'or.offere-d for
sale (Sec. 7044.Bllsiness and _Professions CocIe: The Contractor's Licp.nsei-,_~!V' does not apptyto all owner of property who builds or improves .'
thereon; a.....d who does sudl.work himself or herself or through his or her f)\w~cm~,jOY6eS, provided that'suchhnprovements are r;A ,intended or
offered for sale. If, however, the building or improvement !s _mid with one }'>:'-7 -=:'f ',,':'I'J'lfJtetio:1;the .owner~~uilder will hav~ the ~urden .)f proving tha't-he .
did not build or imprcvc for the purpose of sale). '.' '. f, _ . .: . ;
o "I, as the 'owner of the property, 'am exclusively contr-3cting with licensed,i..'1r.traci.:.:HS to cO:nsJru~t the project (Sec.-: 7044 Business and Professions
Code: The.contractor's License Law does not apply t9 an owner. of property;'~k;'o OUn(Js' cor impro~s t,heroo!). and who co~triJ::.L. for slJdl projects \\'ith'
a contractor(s).Iicense<.l pursuanttotheContractor's:.License Law}. ;' . .
D .I am. exempt under Sec., " , ,B & P.C, (c)r th!s rea'5on: ___~" !
,DalE>: WOR~;:~ COMPENSATION DECLA~T!~r-
I, hereby affirm under pe,n3lty cf p~~ury one of the following declarati9~s: ')'
D I have andwillmaiiltain s 6ertificate of cx:msentto',self-insure for worKer'JcvmpE:nc51tfon,
as provid-ad for by Section 3700 of the ~abor Code, for.the performance (\f~'Il; W1..,rk for which
this permit is iSsl,l~. , , '- , J, ' _ .
o ,I have and will maintain worker's comp'ensation insuranc~, as requi~d !'",._';;~sci.!on 3700 of
: the Labor Code, for the performance of the work for which this permit is'issui!.. 'Mvworker's
Compensation insurance carrier and policy- are: . i
Carrier: STATE FUND . Policy Number. 1643S(T' ~L~03
This section- need not be completed if the pennit is fa( one hundred dollars ($1(JN;~~";j.~ess. .
D, I certify that in. the perform~nce ofthe.work for which this permit is, iSSl,l~~{::I,,~ha!l.no~
~mploy any person in any manner so as to become subject to the Worke,r's'Q::';:1yc';:<>ationlaws
of California, and agree that if I should become subj ct to er's coq,p,',,: i~ati'Jn
provisions of Section 3700 oft.he La~~) G ~s I fort wit witli th~:~,C provisions.
Date: 2/26/2004 ' Applicant: X. __.
WARNING: FAILURE TO S,ECUREWORKER' OMPENSATION COVEFPGE is ,
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL 'PENAl; !"!:8 AND. CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN ADD,nori/ To"rHE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOl'i.370a OF THE
LABOR CODE, INTEREST AND ATTORN,EY'S FEES, ' .. '",
I CONSTRUCTION LENDING AGENCY __
I h~re~y. affirm under pen?ltt ~f. ~erj~ry tt)at ,!~~r~ is a c~~stru_~ti~o~ ~end~~~~~~. :!Efy.for~e. .
~Iollnance or lJa! WOIK (Oi wfilCll tillS pbflTnllS l$;..;ueu i",,>c"';'vv.u .vl';;.vl.- - .. , _n_.___
Lender's Info'nnation:'
NO
.....,.'...; >
;-.j
Fees paid for Permit:
Total:
181.30
---
INSPECTION RECORD
, INSPECTION ' I.' 'DATE INSPECTOR
Temporary Powe,r Pole ~-.'
, Plumbing (DrainlWaste Pipe) , "
Electrical Ground Elec,trode/Ufer ' , L
,SetbacklFormsfTrenches (FootinQ$) ""'"' tk4' .:.(r ,,'
Do not install, subfloor or pour floor slab unti I the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valvl's) , ,
Mechanical (Groundwork) , ,
Electrical (Underground Conduit) ,
Pre-slab (CompactionlMembrane.Reinf. "
, Underpinning (Floor Joist/Girders) , '
Do, not cover or con9"althe work ,below until the ,
,', following applicable ~ems have been signed:
1 st Floor Shear, ' , "
Firesprinkler (Rough) , ,
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) 'J
Masonry (Reinf JBond BeamlPre-Groutk 1234 [!4.; "
Rough Plumbing (Top Out) , , , '
Rough Mechanical ,
Rough l:Iectrical (Dry Wall) , ,
Rough Electrical ' ' , , ' ,
Framing, (Onll after Plbg.. E/ec.. Mech.. and Fire)
Insulation (SoundlEnergy) " ,
po not tape or'pla~ter until thefollowing applicable ,
Items have been Signed: . '.' - .
Drywall ' ' " ' "
PenetrationS (Fire Rated) Elec:irical', '
Penetrations (Fire Rated) Mechanical , ' "
PenetrationS (Fire Rated) Plumbing ,
.Interior Lath ' " .' ,,' ,
Exterior Lath " , '
, " GENERAL ITEMS I
exterior Plaster (Brown COat)
-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 I, , '
" , "
Gas Test , " , "
Engineering/Grading Final 765-5126 , ,
Fire Dept. Final 765-4040 " '
, '
WilterEngineering 765-526,8 ,
Sub list/Business License 765-519
;Z:oning 765-5139 , "
Building Final ~ast Inspection- Only., './d!. /.1 - ~'
, " fte, Above Complete) ~ ') C;v '
PARTIAL INSPECTION~
Buildina Inspections
, Mechanical Inspections
, Plumbina Inspections'
Electrical Inspections
APPLICANT: KEN WORDEN
o.WNER INFORMATION: CONTRACTOR INFORMA'j'ION: ARCHITECT/ENGINEER INFORMATION:
Premier DPointe' AMERICAN PACIFIC HOtiES, INC
3450 E La Palma Ave 4959 PALO VERDE ST#B10""
Anaheim. CA 92806 MOt-lTCLI,\IR. CA 91763001)0
JOB DESCRIPTION:Retainlng walls on 1158, 1169, 1188, 1198Pointe Premi.i..TotaI1978 square feet In reference to GRA2003-02095
. . .~ ; .' . . '.
VALUATION: 59,340;00 'PROCESSED BY: CAL
, . OWNER-BUILDEROECLARATION
1_ hereby affirm under.~enalty gf perju~,that I arn'~xempt from the Contractor',*~Lice.f!se- Law forthe {ollowing reason (Sec. ~03.1.5 B.uslness and
. Professions Code: anydty o~ countywhich requires a permit to construct, a~'~l improve. demoli~h or repairany'st~~cture, priorto'its issuance-..also
~.requires the applic:int for such permit to, fife a ?ignod statement thathe is n~€I~Se~_Pllrsuant_to the provjsio[is cttha'Co/ttrador's ~,icenS:e,law (Chapter
9~(commencing with Section 70GOnf Oivisipn 3 o~ the Business and Prcfessid<nS Code) or that he is exempt'therefrom and the basis for theaUeged.
'exemption. Any ,violation ,of Section 7031.5.by any applicant for a permit subib{:ts the applicant toa evil penalty of not more tha,n five hundred dollars
($500),. ." " . """. . " ' ,L. ' " ,,', "
0, I,asowner of property, or my employees, with wages as t,heir sqle camp~f\saUon,wil\ do,the W9rk, 'and the structure is n6t intended or qffered for
. sale (Se~. 7044 Business anq Pr~fessions. Code: The Contractor's' Li,cense tpVi does not apply to an owner of property w~o builds or improves" '
ther:eon, andyw'tlo does,such work, hi,mselfor he'lSeif o'r through his or her 6wn\~,mployees.provided that such irnprrivementsare not intehdedor-, , , '
. offerect'-for'sale:, If, however,. the- building 'or improvement is sold with erre yer',?f compfe,tion, th~ owner-builder will I).aye the burd~n ofprovirJg. that he
did not build or Improve forthepU'lposeofsale). . " ,,' . " t::> " ", ,- ',,'_, .
o I" as'the.owner Of the prop_erty, am exdusively contracting v/ith Iicensed~ntradors, to ~on::;truct theprciject,<"S,ec. 7044 Business and Professions
Coda: Th'e~tontractqr's-Ucense I-aw does not apply to an owner of property !,yhO builds or improves thereon. and who .oontracts for such projects with
",,'1' , - ," ,,-' _.', ,'.' ' '. .
~on~a-~;or(s) Ii~~'nsed pursuant ~ot~e-Contractor's uce~se La~>.. ' y
U 'J am exempt 1J9der Sec. .' ...,' B &,P.C. for thiS reason: J '
Date: c' '., Owner~ .
i ,:WORKER'S COMPENSATION DECLARATION]"
I herebtaffirm 'under penaltY'of perjurY 'one of.the '(allowing declarations: .~! '
o I haye and, will maintain.a certific;3.te of oonsent to self-insure forwbrker's.;~'.)mpensatian,
as provided for by'Sedion'370b of the'Labor Code" for the performance of thE;'wotk for which
i,his permit isiss.ued; '._' _, '. I .
0, I have a,nd will ma.intain worker's compensation insuranc'e, as'required by~s~ction 3700 of
the Labot Code,. for the performance 'of the, work far which this permit is iS$U~~" Myworker's
Compensation insurance <:a_trier and poIiCf.are: [
Carrier: ..STATEFUNO PoliCfNumber:, 1643507-2003
, . '. I
This section need not be Completed if ,the pennit is for one .hundred-dollar5($10,9}~OtlesS.
. OJ'certify th<;l! in t~e perfom,anceofthe work,fo~whichth.is permit.is i~_u~'J,J'_shall not ,
employ any persoriin any manner so as to become subject to the worker::;'::_G.qm:_P.ensatianlaws
of C'~lifomia, and ~gree ,that if .I.should becom~,$llbjec::t to the worker~scom/k4rlsation .
provisior:t5of Sl?Ction 3700 of the. Labor Code all forthwith comply wittj,th~~~ rovisions.
Date: 4/~ 1/2004 Applicant: c..---:>.I "
WARNING:FAILURE TOSEC . E ORKER'S COMPENSATION;!':QyJ;~J<(GE IS' ,
UNLAWFUL', AND SHAl-l- SUBJECT AN EMPLOYER TOCRIMINAI(PE&ALill=S AND CIVIL
,FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000):lN't\I?QtTIONTOTHE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION,s706 OFTHE
LABOR CODE. INTEREST AND ATTORNEY'S FEES, ' ' .',\ '
CONSTRUCTION LENDING AGENCY" .
I. hereby 2mrm under' penalty of perjury that th~re is a constr,u,cHo~ lendin9.8!;i!'lncy,for the
.-~<:::Ffo-rr:!,3:nc.e---cfthe-w~r.k:,for-V','hid:t--thi!S'pa;-ffiit.fs-;S-S!da--d {S.sc-3C97,-Gi'/..G~:::"- i '- ' _ _. __.-_
Lender's Information: "
BUILDING PERMITNO,' BLD~004-011~,9
TYPE OF PERMIT
Retaining Walls
DATE: 4/21/2004
JOSADDRESS: 1118 POINTE PREMIER
LEGAL DESCRIPTION:
~,'
BUILDING DIVISION
200 S, ANAHEIM BLVD,
'(714) 765 - 5153
INSPECTION REQUEST LINE:
(714)765- 4626
CENSUS CODE:- 434
, ,QUARTER SECTION:~7.'
LICENSED CONTRACTORS DECLARATION
I hereby a irm under penalty of perjury that l.err
licensed under provisionsofohapter 9 (commencing
.with Section 7000}'of Oivsion 3 of the' Business and
profes,~ ~.
4/21/~00 ~
Date:'.' . - . . . Contractor. .
NUMBER
785551
TYPE
B
EXPIRATION DATE
10/31/2004
ConstrucionTvpes:
VN, .
I certify that I have read this application and state that the above information is correct. I
agr~e to oomply,with all city cirdir'lances and state laws relating to buDding construction; and
herebY authorize' representives of this.dty t6 enter upOn the above mentioned property Jor
ins~~e---________ ' ' Date:4121/~004
- \" ..,. , Signature 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 continue work.
Fees paid far Permit:
Total:
1.247,00
INSPECTION RECORD
INSPECTION .'
Temporary Power Pole .
Plumbing (Dtain/Waste Pipe)
Electrical ,Ground Electrode/Ufer
SetbacklFormsfTre"ches (Footings). .
Do not install subf.loor or pour. floor Slab until the
fOllowing applicable" items have been signed:' -.
Plumbing (Water Pipe,Sprinkler valves)
.'. MeChanical (Groundwork)
Electriclll (Underground Conduit)
Pre-$lab.(CompactionfMembr_.Rllim..
Underpinning (FloOr JoiSt/Girders) ,.' .
!'o. not cover or conceal the work below'untlrthe . '. .
.' following ap~licable items. have. been signed:.. '
1 st Floor Sheat .
Fireslninkler(Rough) ",,' . .
. 2nd Floor Shear . . '.
Roof (SheathiI1!llDiaphtagmlFr;lll1e)
MlISonry (ReinfJBorid BearnlPre-Grout) ~
Rough Plumbing (Top Out). .
RoughMechanlcal.' '.
ROugh eectrlcal (DrY Wall) .
Rough Electrical'
Framing -".(OnlyafterPlbg.; Elee.. r,;1ech ,and Fire)
. Insulation (SoundlEnergy)
Do not tape or plaster until the f.ollowing applicable
items have been sigryed:" . '. , '
Drywall .... '.' .
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations. (Fire Rated) Plumbing
. .' Interior Lath . .
.' . Exterior Lath . ..
DATE
r
I .
'.~
.
'.
'. .
GENERAL ITEMS
Exterior plaster (Bra.vn Coat) , .
T .Bar Electrical .
. T .Bar Mechanical .. .
'T .Bar Structural
Sewer..'
Water Engineering Backflow . .'.
Water Service
. .'
.
FINAL INSPECTIONS Date
." Electrical'Flnal . .
INSPECTOR .
plumbing Final .
. . . '.
Mechanical Final .. '.
InspectOr
. "
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cc-
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. .'
.'
.-:
. .
Gas Test. . .
Engineering/Grading Final 765..012.6
....
Fire Dep!. Final 765-4040
". ..'
Water Engineering 765-5268 ". '.
'. Sub List/Business License 765-519 '. . '. .' ' .
. '"
Zoning 765.5139 ~ ;:: '. .\
Building Flnall~a"t InspeftiOn' Only" .,,&:,. "" /11..' '. A '.
'. " . After..;tIovejCompletel .fY"l LIM.I.
.' , '. " . . " PA~tIA~SPECTIONS~ ,U;"1{
BUlldma.lnSDectlons "~.." ". .... ." .7'
. h'~itK...' - ~ /ri_ ~. . .
174.~ 4:-'~.st:PH...r~"/.e'/I./Lh.J... ---
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_ 1M ..ClI/l.,p::ff"~.JI:IIWr'l~
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. . MechanicallnsD~etions . . "'-;r-
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Plumbina hlsDections '.'
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EI&ctrlcallnsDections
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