1168 S. Pointe Premier
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TYPE OF PERMIT
Retaining Walls
CITY.
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765- 5153
I',SPECTION REQUESTLINE:
(714) 765.4626
(;!O~:SUS CODE: 565
QUARTER SECTION: 287
BUILDING PERMIT NO.
BL02004-00470
. DATE: 2/2612004
JOB ADDRESS: 1.168 S POINTE PREMIER.
lEGAL DESCRIPTION: TRACT 13760~OT 8!OR OF LOT
APPliCANT: SCOTT DOUCETTE
OWNER INFORMATION:
Cheng-Che Chou
3291 E Miraloma Ave
. Anaheim. CA 92806
CONTRACTOR INFORMAilON:
ARCHITECT/ENGINEER INFORMATION:
DALE L FORBES
1800 E.16TH S1 REET
SANTA ANA, CA 92701
JOB D!OSCRIPTloNRetaining walis: 558 s.f.
VALUATION: . 6.696.00 .;. PROCESSED BY: CDL
I. .......... . OWNER.BUILOEi15?CLARATION . . . ......
. I hereb.y affirm under penalty of perjury that I am exempt from the Contrar~or'tll;:e'ise Law for the .following reason (Sec. 7031:5 Business and
Professions Code: any city or ~untywhich require.$ a permit to construct, .~~.::)t,:'jmprove, deroolish or repair any etr~cture, pr~r to its ;~ua!1ce, al~Q'
reauires theapplicanffor such permit to file a _signed statement that he is \i~:~'ri~ed pursuant to. the plOvisions of the COli tractor's License Law (ChapJer
9)(commencing with Section 7000 of Division 30f the Business ar.d Proft>.s5!?~,S Cod*;l) or that he is exempt thp.refrc.m nnd the basis fer the.aJleged ~
exemption. Any violation of Section 7031.5 by any applicant tor a perm't e!.'bH....~ the 'appliea'lt to a dvi! penalty cf r.ot more than five, hundred dollars
($500). ' .
o I, as qwner of pro~rtY, or my employees with wages as their soiE:: cc'r"p;:~.5_.,:;~i.:;n, wiil do th~ WOII{, and the 5tructure is ~not intended or offered'for
sale (Sec. 7044 Business and Professions Code: The c.ontrc:ctor's License- }~.I;tI ~'1oesnot.apply fO an owner ofpr:operty who bIJik.i3.:>r improves .
thereon, and who does such'work ,",imself or herself or through hisor her oW'"'i!..,.:.j;p1oyee.C::j provided that such impro.vement3 ar~not- intended or
offered fer saie. If, however;the building or improvemant.is sold with cn~vc.';} of completion, the owner-builder wi!! have the burden of ;::>roving th2~he
did not buifd or improve fer the purpose,of sale). . " 1.. .'.
o .1, as the own~r of the. property, am "exdusively contracting with nc.ens.~'::tJl1~ra~or::: toconstructthe pl'ojec.t ($ec.7C44 3'J$ineSSo and Professions
Code: The Contractor's License Law does riot apply to ao owr:p.r of properlj ~{~;v bl.lild~.or improves t:'er~cr'l. :3nd 'lhhd :ontractsf0;such proJects with
Mcntractor(s) lice~ed pursuant to the Contractor's License_law)..; . .
U lamexemptunderSec. --...,;,.~ ,E;l&P.C.forthisreason: ___('_
Dat~: Owner: .
L. WORKER'S COMPENSATION DECLARATION _,:,':~
I hereby affirm under penalty of perjury one of the 'follo.wing declaratio,ns: I
o I have and wiil'maintaina certificate of oonsen.t to seff-'irlSure (or wod"--:;.-",l:;0nl:Jensaticn.
as provided for. by Sedion 3700 of ~he Labor Code, for the perform~nce"of :!1-{".'o,~< for which
this' perm~ is issued.. -,:-. . .
, .0.1 have andwill rnaintidn WOrker's, compensation inslJrr:.ncp, as ~qLiirec b/:,ecti9n 3700 ~t I
the Labor Code, for the pe~ormance of the. work for which this permit is iSs:.;.<,;:, r-..~y v:orker's
Compensation insurance carrie'r and policy are: . ~ . .1
;::arrier: STATE FUND Policy Number. 1643507-:,~r]{!3
Thiss~tion need not,be completed if the pennit Is for one hundred dollars ($10~; ~'lless.
o I certify thatin the perform::ince of the work for whiCh thiS permit is i$Sue:.'_' shall not
employ any person'in any manllcr so as to become to the workets c~".~pl:."":lsation laws
ofCalifomia,-and ~greethat if I should become su ect t tn wf r'~ compf.:~'!1.9ri
provisions of Section 37QO,ofthe labor n~ fort 'ith ih;:}:~8-ro:visions.
Date: 2/26/2004 ' APP~: . .'.~f':~'
WARNING: FAILURE TO SECURE ER'S COMPENSATION COVERi.\li, I~L
UNLAWFUL, AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL f'ENf\f;:;~SI)ND CIVIL
FINES UPTO ONE HUNDRED TH.OUSAND DOLLARS ($100,000). IN AD!::' :ii:9~j TO THE
'COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOl\! ;;~2~~flF THE
LABOR CODE. INTEREST ANO.ATTORNEY'S FEES. . .' .'i;~:;>',
I '. '. CONSTRUCTION LENDING AGENCY . ~_. ~:.o{M'\
I hereby affirm under penalty.Qf-perjury that there is a construction lendin9, -af!: ,~~"J9r the
performance of the WOrk for whictl this permit is issued (Sec. 3097.Civ.C): "', ~.' ;.
L-e!"ldp.r's !t.~formatlcr'l: _'_,'L.L",:.-.::~,.'",,_._--,-----c
AMERICAN PACIFIC Horv':cS, INC
4959 PALO VERDE $T #B10' .
MONTCLAIR, CA 91763 0(\')
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ContraCtor
NUMBER
785551
TYPE
TYPE
EXPIRATION DATE
10/31/2004
B
Hie
Cdnstrucion Types:
VN, ,
Fire Sprinklered?
NO
Fees paid for Permi~:
Total:
277.79
Date: 2/26/2:004
u . I'1t or Agent
The. It s I exp re by limitatiOn arKfbecome null and void if thelluilding or
work has not pasS\ld final inspection 365 days from the date of permll issuance. A
.new permit is required to commence or continue work.
INSPECTION RECORD
" . ,~ DATE INSPECTOR 1
,INSPECTION - ,
Temporary Power Pole
Plumbing (DrainJWaste Pipe) , '
E~ctrical Ground Electrode/uter ' .
SetbacklFormslTrenches (Footings) '~ .IL ~ (I
Do not install subfloor or pour floor slab Until the
following applicable items have been signed: ' ,
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) -
, Eklctrical(Undel9round Conduit) ,
Pre-slab (Compaction/Membrane.Rei nt. , ,
Underpinning (Floor Joist/Girders)' , -
Do not Cover,or,co~ceal the wort< below until the' ,
'. following applicable Items, have been Signed: , '
,
1st Floor Shear ' , '
Flresprinkler (Rough) , ,
2nd ,Floor Shear '
Roof (Sheathing/Diaphragm/Frame) j
Masonry (Relnf JBond BeamlPre-Groutl: 23A I~ ' '
Rough Plumbing '(ToP ,Out) ..
Rough Mechanical "
Rough Electrical (DrY wall) ,
Rough Electrical " , ,
Framing . (Oilly after Plbg.. Elec.." Mech.. and Fire) , , ,
Insulation (SoundiEnergy) , , ' ,
00 not tape or plaster unlil the following applicable '
items ,have been'signed: _
Drywall '
Penetrations (Fire Rated) Elecirical
Penetrations (Fire Rated) Mechanical
Penetrations(Flre Rated) Plumbing ,
Interior Lath " , ' " "
Exterior Lath , " ' , , ,I
" " GENERAL ITEMS
Exterior Plaster (Brown Coat) ,
T -Bar Electrical
T -Bar Mechanical ,
T ,Bar !ltructural " ,
Sewer
Water Engineering Backflow
Water Service '
FINAL INSPECTIONS Date Inspector
Electrical Final " ~ . - ,
PlumbingFina' ' ," , ' ,
Mechanical Final I
Gas Test ' "
"
Engineering/,Grading Final 765:5126, ' '
Fire ,Dep!. Final 7654040 , ,
Water Engineering 7,65-5268 , "
Sub List/Business License 765-519
Zoning 765.5139 ' "
H
Building Final ~ast 'Inspection- Only I~t~.... . -r7 ,\,
Iter Above Complete) ~-v4- ,
PARTIAL INSPECTIONS /
" ~dinQlnSpectio~s.. "
.\rJ,~ eMU ~k;
Mechanical "ns,D&ctions
Plumbina Inspections
Electrical Inspections