1380 S. Sanderson Ave.
BUILDING PERMIT NO: BLD2004-02750
TYPE OF PERMIT
-:enant I.lnprovement (Limited)
DATE: 7/13/~004
JOB ADDRESS: 1380 S SANDERSON AVE
,,~:jf1s~j~'t~;;~~! . .
CITY glE"J/Er;N~HEIM
\~~/~r>i .
BUILDING DIVI8iON
200 S. ANAHEIM BLVD.
(7~4i 7S5 - 5153
INSPECTION REQUEST LINE: .
(714) 765- 4626
CENSUS CODE: 437
QUARTER SECTION: 126
LEGAL DESCRIPTiON: PBK 187 PG 20 PAR 3
CONTRACTOR INFORMi;TION:
COMMERCE CONSTRLJ,~TION CO. LP
131~1 CROSSROADS PK\-jy
CITY OF INDUSTRY, CA ,,17460000
BUSINESS PHONE: 562 69~<1453
JO~ DESCRIPTION:lnstal1 interior partition wall between lunch. room and !ou~~,c per a!JprovAd pla~s
APPLICANT: CHARLIE BENDER
OWNER INFORMATION:
Federal Newport
4425 Jambqree Rd #250
Newport Beach, CA 92660
ARCHITECTlENGINEER INFORMATION:
JIM ROBERTSON
13191 CROSSROAD PKWY.
CITY OF INDUSTRY, CA 91746
VALUATION: 3,000.00 PROCESSED BY: ODe
I _ OWNER-BUIL"iJ"EF:OECLARATION ---~
I hereby affirm, under lJenalty of porjury that I am "exempt from the COlltractc:~~s lic~nge, LaVil for the following reason (Sec- 7031,:5 Business and
Professions Code.Clny CIty o,countywhich requires a permit to constn,iCl. €'(;;;r,imprcve. demolish or repair any structure, prier to its f:--.$uance, also
requ ires the a'pplica nt for such permit ,to file' a signed statement'that he I; lk:..f!iSed pursuant to the proyisjons of the Contractor's, License Law (Chapter
9}(commencing with Section 7000 of Divisiori3 of the Business and Prote$.;.:,bn.:; CtA!t?) or that he is exempt therefrom and the basis for the alieged
exemption. Any violation of.Section 7031;5 by any appjicant for ap,ermit sl..{iects theepplicant to <:.'l civil penalty of not more than five hundreri dollals
($500). . . . . ,. . . "
II '1, as owner of property, or my employees with wages as their sole COt!l(rmsatior., will do the work, and the_strU.-;ture is not inten~ed or offered for
sale (See 70~; Business and Professions Code: The Contractor's Lit;l;::r:s~ :\.:::!w cJOt:l$ not apply to all oWner of pmpef1:Y....-ho builds or improves
. thereon, ana -who does such work himself or herself or through his or h~r 0.';";f_:emtAcyees. provided that such improvements ire not intended or
offered for ~[e. If, .h9wever, the building or improvement is sold Witll one ~':~,:::,:{ of ccmpJetio.n, tl,e cwner-bu~der will have the burdp.nof prov:ng- that he
did flot build or Improve for the purpose of sale). . I;: ..,'
o f, ~s ~he OWner of the propert);', am .exdl.Jsively cuntracting' with IJce!1so?,.,!fi.nl1tractors to ':;Ohstn..:r.;t the:: p:"oje~t (Sec. 7044 . 8IJdirle~~:; allt! ProfessiQit';>
Code: The Contractor's License Law does not apply to :::.:n owner of propert.)!'NhQ owlds or implOVeS thereon. and who mr.tr(lcts forsllch'projecro With..
[jontra;ctor(s) licensed pursuant to the Contrnctor's Ucense L<:lW).~, r
I am e;.:empt under Sec. ... , B & P .C. for this re-~son: _-'-{ ~____~....;..;.....:.
Date: OwnGr: . . - "j,' _. . _ . ,
I . · --WORKER'S COMPENSATION DECLARATION -~t ':~_j ! L.iCEN5SD CONTRACTORS D~CLARATfON!'
J hereby a.ffirm under penalty of perjury one at the following declarations:,;. -,' r I helsby affirm '.mdef penalty of periury that ~ arn-
tJ I tl~ve d will m3intCiin a certificate of consent to self-insure for wcrke";';CorTlQ€;nsation, I. licensed under prCNisions of chapter 9 (commencing
. as provo ,for-by sed. loii 3700 of the Labor Code, for the pe. ;for~E;'IOre. of ~;'.{.~ ';'lOr'~ fa. r VJ~fch i Wlf.h..S er::tion70 OO)~Oj ~~iV$' n?~Ofth,Bll"" ~ss al1u
this. rmit is issued. .' I I ProfeSSIOns Code. . ~~ .
........... ': have and will maintain worker's compensation' insurance, as ie-qt.lireJ ~~, Sect:on 3700 of 7/1~j2004 .e:::::::-t
the Labor Code, tor the performance of the work for which this perl1'?ft: IS '~,"ll.'i:d.' ;,Jiy worker's Date: Contractor
Compensation insurance carrier and policy are; _ . ,1 I
Carrier: . COMMERCE JN~US1RY INS. CO Policy Number. WC3~~;!:i8p'
~IUMBER
723302
This section need not be completed if the permit is for one hundred dollars ($1,u;:'~~cr less. TYPE
o I certify that in the performance ofthe work for which this permit 13 iS$u.:d. I shall ilat TiPE
employ any person in any manner so as to become subject to the worker's crmpt:nsation ia'As I, TYPE
of Callfoml8, and agree that If I should become subject to the worker's Cvlll.(:nsatl:in
provisions of Sectton 3700 of the Labor Code forthwit omp:1 it:, ;:ds~ provIsions Construcion Types:
VN, ,
Fire Sprinklered? .
EXPIRATION DATE
5/31/2006
"
B
cn CONC
'~<;
Date: 7/13/2004 AppliCant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION CQ\i'Ei'AGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALP~r".;.TIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), iN-ADL.lTIoriTOTHE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEC1;ltr,.o 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES, ", . .' '
I. _ .' CONSTRUCTION LENDING AGENCY ;.--0.-'~_.' I
I her.eoy affirm un~er penalty of perjury that there is ': co~str:Jc~ior, JI~.n? ,i.n~:,::)e.~?\':J.()r t~e ~
'- - ';<,,~';:;; <:.l';;.-;,,:'.::;;-~:c::!i~'~','{;:,,!~-f,:;-;--->;".-h;~T~:-:';":;-;':'$;';;,;~, ;:'-;':'9"'::;":: [~':'-..., )U;;',;';::;.... ~S>~ '"- ,;..... ~ . --' ~'- . "-,,, '.' i
Lender's Information:
YES
........'
;-'-'----
I certify that I have read this application and state that the above informatiofi is correct I
agree to co y with all city ordinances and state laws relating to bu-ilding construction, and
hereby, orizer resentives of this city to enter upon the above ment:cned .property for
inspe on s.
Fee~ paid for Permit:
Tot.,:,'
172.33
Dat',: 7/13/2004
Signature ppllcant or Agent
The permitshafl expire by limitation and become null and void if the building or
work has not passed final irispection365 days from the date of permit issuance. A
new permit is required to commence 'orcontinue work.
INSPECTION RECORD
. INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbi ng (DrainlWaste Pipe) .
Electrical Ground Electrode/uter
SelbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable itemS have been signed: .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (l>roundwork) .
Electrical (Underground Condu ill
Pre~lab (Compaction/Membrane.Reinf;
Underpinning (Floor Joist/Gilders) .
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear .
Fire~prinkler (Rough) .
2nd Floor Shear .. .
Roof (SheathinQIDiaphragm'Frame) .
Masonry (ReinfJBond8eamlPre-Grout) .
Rough Plumbing (Top Out)
Rough Mechanical
Rough Sectrical (Dry wall)
Rough Electrical /
Framing (Only after Plbg.. Elec.. Mech.: and Fire) 7.-.7/7 ....JI IL
Insulation (SoundlEnergy) t
Do not tape or plaster. until the fQllowing applicable -
items have been signed: J - .
Drywall . 7/- ~q~JL. T
Penetrations (Fire Rated) Electrical -,
Penetrations (Fire Rated) Mechanical -
Penetrations (Fire Rated) Piumbing -
Interior Lath
Exterior Lath - .
GENERAL ITEMS
Exterior Plaster (Bl'CIWn Coal) -
T -Bar Electrical . -
T.Bar Mechanical
T -Bar _Structural . -
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS Ilate Inspec or
Electrical Final_ l~jm/o:s'~A:1l
Plumbing Final . .- -.
MeChanical Final
Gas Test. . r .
Engineering/Grading Final 71;5-5126 r .-
.Fire Dept. Final 765-4040 -
Wa.ter Engineering 765.5268 . .
.Sub List/Business License 765.519 gh~/()s em€'-
Zoning 765-5139
Building Final *ast inspection- Only ! 't' I3/~J ~~j1-, -
fter Above Complete)
PARTIAL INSPECTIONS Uf/
Buildina Inspections
. Mechanical Inspections
Plumbina Inspections
Electrica', Inspections
CONTRACTOR INFORMATION:
COMMERCE CONSTRUCTION CO., L.P
13191 CROSSROADS PKWY
CITY OF INDUSTRY, CA 917460000
BUSINESS PHONE: 562 699.0453
JOB DESCRIPTION,enant improvement, 3460 1st floor 15342 2nd fioor office remodel
,
VALUATION: 176,000.00 '
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'G License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alt~,r, 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 licer,sed 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 subjH:ts the applicant to a civil penalty of not more than five hundred dollars
($500).
D J, as owner of property, or my employees with wages as their sole compe,lSation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's Ucense LC'w does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf 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 yea.' 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 c>ntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property.....ho builds or improves thereon, and who contracts for such projects with
,aJ(ontractor(s) licensed pursuant to the Contractor'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 perjury one of the following declarations:
o I have and will maintain a certificate of consent to self-insure for worker's .;ompensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
'Et 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 issuea. Myworker's
Compensation insurance carrier and policy are:
Carrier: COMMERCE INDUSTRY INS. CO
BUILDING PERMI'!' NO. BLD2005-02304
TYPE OF PERMIT C
Tenant Improvement (Extensive) ITY
DATE: 9/2/2005
JOB ADDRESS: 1380 S SANDERSON AVE
LEGAL DESCRIPTION: P BK 187 PG 20 PAR 3
APPLICANT: FRED SHADER
OWNER INFORMATION:
FEDERAL NEWPORT
4425 JAMBOREE RD #250
NEWPORT BEACH, CA 92660 0000
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD. <
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 126
,
1
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MJL
Policy Number. WC32828f:8
This section need not be completed if the pennit is for one hundred dollars ($100) 0/ less.
D I certify that in the performance of the work for which this permit is issued,: I shall not
employ any person in any manner so as to become subject to the worker's coropensation laws
of Califomia, and agree that if I should become subje6t to the worker's camp, n3ation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with ase provisions.
Date: 9/2/2005 Applicant: ~
WARNING: FAILURE TO SECURE WORKER'S CO P NSATION C RAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, I NTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending aqe_~yfor the__.
pafivirhi:u ioo--urthe work -jo-rwhICh tms permit 'is issued (Sec.3097 .Civ .C):
Lender's Information:
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of thO city to enter upon the above mentioned property for
i ect' urp se
Date: 9/2/2005
ignature of Appl nt or Agent
1he permit shall expire by limitation and becorre null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new Dermit is reauired to commence or continue work.
LICENSED CONTRACTORS DECLARATI N
I hereby affirm under penalty of perjury th t I am
licensed under provisions of chapter 9 (com ncing
with Section 7000) of Divsion 3 of the Busin sand
Professions Code.
9/212005
Date:
NUMBER
723302
TYPE
TYPE
TYPE
EXPI RATION DATE
5/31/2006
A
B
C8 CONC
Construcion Types:
I FR, ,
Occupancy Groups:
B, , , ,
Fire Sprinklered?
T.I.Area:
YES
8,802
Fees paid for Permit:
Total:
3,874.22
-,
\ '
City of Anaheim
B'uilding Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/FormslTrenches (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 Relnf.)
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 (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out) "
Rough Mechanical "-/6.0'3 r~(.-"""/c.-
Rough Electrical (Dry Wall) /
Rough Electrical /' \ ~ / -,,~
Framing (Only after Plbg., Elef.M~And Fire) ,
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall ~/fr_.c...h- J~- '" 7/4, ..... J.. /2.-'
Penetratio,"s (Fire Rated) Electrical I ,
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical I//} /A f'. ~
T-Bar Mechanical Gf ~ _ I\. X -
T.Bar Structural ; 7. ~
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 765-51
Zoning 765-5139
Building Final (Last Inspection . Only
After Above Complete)
INSPECTOR
PARTIAL INSPECTIONS
q(wfn- ~ fL ~ ~ '--M...S
Buildina InSDecti01l> lJ _
-IL.or; (JA-T .;,,,
..,J(
1/.0.;)
S""""___
,,----
Plumbing InSDections
>~-<. A-D.~
_.r . 19:.0.3 p.
.,./9.t?7 . - / ~~ .4-t~t?
~~A-t"1 Ne&WU4-/ /Sfrh"- e>,k..
14--:--(7 ~
:(;;(; ~:~~ t~::~,{~-