112 S. Shakespeare St.
TYPE OF PERMIT C
Residential Addition ITY
DATE: 8/3/2005
JOB ADDRESS: 112 S SHAKESPEARE ST
LEGAL DESCRIPTION: N TR 6569 LOT 25
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 122
BUILDING PERMIT NO. BLD2005-02080
APPLICANT: FRANCISCO NATERA
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
FRANCISCO NATERA
112 S SHAKESPEARE ST
ANAHEIM, CA 928060000
JOB DESCRIPTlON:Addition of 203 square feet to existing single family dwellirg.
VALUATION: 19,685.00 PROCESSED BY: CDL
I OWNER-BUILDER I)ECLARATION
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: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he islicer:sed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professiol)s Code) or that he is exempt therefrom and the basis for the alleged
lexe:;:J)tion. Any violation of Section 7031.5 by any applicant for a permit sUbi"cts the applicant to a civil penafty ot not more than tive hundred dollars
I, as owner of property, or my employees with wages as their sole comps1satian, will da the work, and the str.ucture is not intended or offered far
s Ie (Sec. 7044 Business and Professions Code: The Contractor's License Uw does not apply to an owner of property who builds or improves
th eon, and who does SUch work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. It, 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 bund or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed o)ntraclors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon,. and who contracts for such projects with
FLQontractor(s) licensed pursuant totheCon!ractor's License Law). '
Ute mpt under Sec. ,. IS reason:
Date: - tJ Owner:
WORKER'S 0 A N 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:'worf< for which
this permit is issued.
o I have and wlll 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 issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: Policy Number:
LICENSED CONTRACTORS DECLARATION
I hereby a irm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
PlDtessions Code.
8/3/2005
Date:
Contractor
NUMBER
EXPiRATION DATE
~hi section need nol be completed if lhe penn!t is for one hundred dollars ($100) or less.
I certify that in the performance of the work for which this permit is issued I shall not
lay any person in any manner so as to become subject to the worker's com.., pensatlon laws
f Califomia, and agree that if I should become subject to the worker's comper,sation
provisions of Section 3700 of the Labor Code, 1 all forthwi comply with those provisions.
~
Date: 613/2005 Applica :
WARNING: FAILURE TO SECU E WO KERS C ENSATION COVERA3E IS
UNLAWFUL, AND SHALL SUB CT AN EMPLOYER TO CRIMINAL PENAL1.IES AND CIVIL
FiNES UP TO ONE HUNDRE "!HOUSAND DOLLARS ($100,000), IN ADDlllON TO THE
COST OF COMPENSATIO ,DAMAGES AS PROVIDED FOR iN SECTION 3706 OF THE
LABOR CODE, INTERES AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performanpe of the work for which this permit is issued (Sec.3097,Civ.C):
Lender's Information: - --
TYPE
Construcion Types:
V N, ,
Fire SorinKlered? NO
UvinQ Area: 203
I certify that 1 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 buUding conS'.truction, and
hereby authorize represel'li:ives .. . b enter upon the &bove me,iiiotted pfopeny f6l
in ion purposes
Signature of Applicant or Agent
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.
Date: 8/3/2005
Fees paid for Permit:
Total: 831.96
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter
SetbacklFormslTrenches (Footings)
Do not install subtloor 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 Rein!.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been sign
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReintJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the folio ing applicable
Ite s have been signed:
Drywall (f.lf.~
Penetrations (Fire Rated) lectrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
City of Anaheim
Building Division
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Depl. Fi 5-4040
yvater'Engineerif)g 765.5268
Sub ListlBuslness License 765-5194
Zoning 765.5139
Building Final (Last Inspection - Only oj _ A
Alter Above Complete) -'\ '14"
ECTOR
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Exterior Plaster (Brown Coal) Electrical Inspections
T-Bar Electrical
T.Bar Mechanical
T.Bar Structural
Sewer
Waler Engineering Backflow
Water Service