608 Scott Pl.
TYPE OF PERMIT C ITV
Blockwall/ Columns
BUILDING DIVISION
200 S. ANAHEIM BLVD.
. (714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 21
BUilDING PERMIT NO. BLD200S..o0877
DATE: 4/1/2005
JOB ADDRESS: 608 S SCOTT u-.i
LEGAL DESCRIPTION: N TR 5108 LOT 20
APPUCANT: MAGDALENA ARIAS
OWNER INFORMATION:
Magdalena Art'as
608 S Scoll Ln
Anaheim, CA 92804
JOB DESCRIPTION: Build 96 lineal feel of 6 foot high block wall per city star.1ard.
VALUATION: 5,000.00 .J
OWNER-BUILDERDECLARA TION
1 hereby affirm under penalty of perjury that I am exempt rom the Contractc'(S License Law for the .following reason (Sec. 7031.5 Business and
Professions Code: any dty or COUJ:'ltyw.hich 'require~ a ,permit to construct a,1t.er, improve, demolish or repair any structure, prior to its. issuance,also.
reqUires the applicanffor such permit to file a "signed statement that h~ is lich':,sed pursuant to the provisions of the Contractor's UcenseLa~ (Chapter
9){commenclng withSectlon 7000 of Division 3 of the Busines~ and ProfessicnsCode) or that he is.exempt therefrom and the basis fq.r the alleged
exemption. Any violation. of Section 7031.5 by any applicant for a permit stibjectS the applicant to a dvil penalty afnot more than five hundred dollars
($500). . ... "
Q. I, as owner of property , or my employees with wages as their sole corr.?".::nsation, will do. the work, and the structure is nat intended or offered lor
sale (Sec. 7044 Business and Professions Code: The Contractor's UcenseLaw does not apply to an owner of property who bl!iJds or improves
thereon, and who does such work himself or hemelf or through his or har oY';n'employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one y~ar of completion, the owner.builderwill have the burden of proving that he
dld'notbuUdor'itnproveforthepurposeofsale). .' ..~" ,
19) l.,asthe owner oHhe property,amexdusively contracting w~h'ncens.... contractors to construct the project {Sec. 7044 BUSin.~ss and"Professions
~'\de: The Contractor's License law does not apply to an owner of properr ,who builds Dr improves thereon, and who contracts for sum projects with
'~ontractor(s) licensed pursuant to the Contractor's License !...aw). 1
U lamexemptunderSec... . . ,fort sr . son: ~; ., .
Date: Owner: ~
WORKER'S COM ENSATI DECLARATION \
I ~ereby affirm onder 'penalty of perjury one of the foUowing declarations: ;J ,
o I have and will maintain a certIficate of oonsent to- self-insure for warke(s: compensatiol'1,
as prOVid-ed for by Section 3700 of the labor Code, for the peiformance of tHe work for which
this permit is issued. '1 .
[j I have and wi." maintain worker's compensation insurance, ?s require~ ~y Section 3700 of 4/1/2005
the Labor Code, for the performance cfthe work for which this permit is iSS'hd. My worker's Date:
Compensation insurance carrier and rxllicy -are:
Carrier: POlicy Number:
This section need not be completed if the pennit is for one hundred dollars ($1 00). '" less.
. . . -t
1 certify that in.the performance of the work for which this permit is iSSllE~d, I shall not
. y any person in any manner so as to become subject to the workets sbmpensation laws
f Califomia, and agree that if I should become subject to th,e worker's compensati'ttri .
rovisions of Section 3700 ofthe Labor Co: f shall forthwith comply with t\1O ro'Vtsions;
. J
CONTRACTOR iNFORM.'iriON:
ARCHITECT/ENGINEER INFORMATION:.
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under proviSions of chapter 9 {commencing
with Section 70DO} of Oivsion 3 of the Business and
Professions Code.
Con~ractor
NUMBER
EXPIRATION DATE
TYPE
Date: 4/1/2005 Applicant:
WARNING: FAILURE TO SECURE
UNLAWFUL, AND SHALL SUBJEC AN MPlOYER TO CRIMINAL PENALTIES AND CIVil
FINES UP TO ONE HUNDRED 1H USAND DOLLARS ($100,000), IN AD~mON TO THE
C:OST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlo.'; 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
\ I he'ret?yaff~muhderpelJalty of.perjury that there is a. con,stf~;$1~ lendingagel}cyfOi the
peliorrnance of the work fgi1Nhich this permit is issued (Sec.'3007 .Civ .C): \
. Lender's tnformatlon: ~~ ,~<--" . - ;
;;F.- '~::.Y--".---"'~_. . ' (' " . .
Construcion Tvpes: '
VN, , .
..
.... ...."~",
",-'vc" . ._.>." ~
. --. ..---.--.--- ~
I certirY.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, a'1d
h,ereby autho' e representives of,thiscity to enter upon the above mentioned property for
i -- pectio r' sas.
Fees paid for Permit:
Total:
125.79
.
'" i:;,4 Dale: 411/2005
ignature' of Applicant or Agent ,
The permit shall expire by Iimilatklll and become null and void if the building or
work has not passed final inspection 365 days from the date of permitissuance,A
new permit is required to commence or continue work.
iNSPECTION RECORD
INSPECTION . DATE INSPECTOR
Temporary Power Pole'. .
Plumbing (DrainlWaste pipe) .
Electrical Ground Electrode/Uter' .
SelbacklFormsrrrenches(Footings ) ~-hlo.,
00 not install subflopr or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
MechiIRical (Groundwork) .
Electrical (Underground Conduit)
Pre~lab (Compaction/Membrane.Rein!. .
Underpinning (Floor JoistlGinlers)
: 00 not cover or conceal the wor!< below until the
followingapphcable items have been signed: .
1st Floor .Shear .
Firesprinlder . (Rough) . :
2nd Floor Shear .
Roof (ShealhII'l!llDlaphraamlFrame)
Masonry (ReinfJBood BeamlPre-Gn:ltit)
Rough Plumbing. (Top Out) .
Rough Mechanical' .
tlOU9n l:Iectr all) ,
Rough Electrical
Framing (Only after Plbg!, E!ec.. Mech.. and Fire)
Insulation (SoundlEll8rgy) , .
Do not tape or plaster until the following applicable
Items have been signed: . ,
Drvwall
Penetrati<illS (Fire Rated) Electrical "
Penetrations (FiAl Rated) Mechanical
Penetratloris{FIAI Rated) Plumbil'lg
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 765-5126 . . ,
....
Fire Dept. Final 765-4040
Water Engineering 765.5268 '
Sub List/Business License 765-519 . .
.
Zoning 765.5139 . '.
Building Final lta5t Inspectlon- Only :!://-tJt; ,~# u:/
fter Above Complete} ~
PARTIAL INSPECTIONS
Sui/din" Inspections
Mechanical Inspections
Plumbina Inspections
ElectricallnSDections
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PLANNING DEPARTMENT
DATEAP4~L. i~D
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