1411 S. Scarborough Ln.
"~'I
BUILDING PERl\lIT NO. BL02004-01467
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aUILDING DIVISION
200 S,.ANAHEIM BLVD,
(714) 765. 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE': . 434
QUARTER SECTION: '42
TYPE OF PERMIT
Residential Addition CITY
DATE: 413012004 ,. ,,:: ,
'JOB ADDRESS: 1411. S ~CAf1\50ROUGH LN
LEGAL DESCRIPTION: N TR 6091 LOT 36
APPLICANT: ROMEO MENDOZA
OWNER INFORMATION:
ROMEO MENDOZA
1411 S Scarborough, Ln
Anaheim, CA 92804 "
JOB OESCRIPTION:110sq ftroom extension/bathroom remodel & trellis: (H;:~)
VALUATION: 7,403,00 ..!
I ' OWNER.BUILDf:~DECLARATION
I h_ereby al}"irm under penalty of ,perjury that I amexemptftom.the Cor;tractc:is Ucense La::J'forthe following reason (Sec: 7031.5 Business and .
Professions C,ode: any city or county which,requires a permit -fo construc,_~, a_ :,~r. improve, demolish or repair anystructljre, prior ,to _its issuance, also
requ_ires the _applicant for such,permit to file a s.ignerJ statement that he'j.8 Itc.,,!nsed' ?ursuant to the provisions of the Contractor's License Law (Chapter
9)(Q-9mm,enCing with Section 796.00-' Division.~ of the Business and Profess:+n$ Code) or that he is exempt therefrom and the: basis .for the alleged.
exemption. An}lviolation 'of Section 7031,5 b'ii anY,applicant for _a,permit SUf:!j6ctsthe ::jpr!.i~:mt to J civil penalty of not more tha n five hundred d.oJfflrs'
$50 ,"i '
,; as OV-Jner of property, or my employees with w.ag€.s as the'r sole COjTl:~nsation:.wm do the work, and the structure is. r'-'?tif1tendedor offered fo::
s ._', (See, 7044 Business and Profcss!oi1sGod~: The ~ontrac~or'si..iGense ::aw does :1otapplyto,an ownl7r of p:-opi::lrty wh6 btijjds or improves ;'
thereon,. afldwho does ~uch work.himself, or herself cidhrougti h:s or t\lsr ~":,:I ~lnJlloyees, provided .that. such improvements are not intended or _"',_,
offered for 53-le."' If, however. the' bUilding or improvement is'sold wiU) one yi;1/ -of cor'J1pletion. the owner-bui!d~r Wi!f have the tr..lrden of pro\(ing that tie
dld'nQtbuddor.m'prove for the pU!poseof sale), ;, ' . -
EJ .J. Cl:::' the owner of the ropel~' duslvely contracting ,,^,iUl license'~~rontiadl.'rs t? CO:lstrUGt the proJec.t (Sec, 7044 Business- and Plofessions
Code: The Contractor's U ..nse w oe not apply to an own::];'" of prop'7,1./who builds I,,' .([(proves thereon, and who contracts fo" such projects with
~6ntraa/Jr(s) licensed pu ua 't t to ntractor's License Law) 1 '
LJ I am exempt under. B & P ,C, fOI thi~ reasoO' ~. _n_ ~_.
'Date: ner:..'.. _::1 '
[ ,WORK R'S COI\IIPENSATIONDECLARA':;OI>!. "~,-~;J
li1er~py affirm l!nder penalty f pt)~ut): one of the following declaratibn::: '_j
0.': ihave and wi" maintain ;;: certificate'.of cqn.sent.to self.'inst;~e ~u, ,.o.;(jrk~;_';;cornpE::t"lsatiQ(l.
.as prcvided for by Sedion3'700 of the'Labor Code, for thepe-rfonriance of t;-.:; work for whk:h
this'pe::rmit-i$ issued.. '. .;.
[] , j' hav9 and Willm.ainta;'n worker's c,ompensatlor;r insorance. e$ !e'-1uirerl b::J 3ection 3700 of
the Labor'Code, for the performance 'of the work for which this -pc"rnlt is iSSUt:.j, Myworker's
'Coinpen~tion insurance,carrier an.d policy_ are: . i
Carrier: . Puiicy' Number:.
CONTRACTOR INFORM;\TION:
!
ARCHITECTIENG,INEER INFORMATION:
PROCESSED BY: CAL
LICEIliSED CONTRACTORS DECLARATION !
I hereby aftir,"' l.:ln<.ier penalty of perjt,lry that I am ': -
Iicensed_ under tlrov~sions of chapter 9 (commencing
with Section 7~OOrof Divsfon 3 of.the_ Business and
ProfessionS Code, .
4/3012004
Dale:
Contractor
NUMBER
ExP'RATION DATE
, ,
Thi~-. n ,need not be completed if the Ilennitis fur ~me hundrectdollars ($1~(: ~ I~ss.
'certify.that'in the perfo_lTnance of the work for which ti)IS per,rnit is, i_5$w:,j" ( shall not
ploy any person in .any manner so as to become SUbject ,to,.t_~l1_:y..lor~,efs ~ropenS9tion laws
of Califomia, and agrei:dhatif I should beco'@ sub'ed to ttl,e~~orker'$ cOrPjt:nsation
provisions of Section 3700 of the Lab r CO/je, '_; Sh'~J forthwith .~t{mp'tY :wlth l~::~5tprovision-s_
Date: 4/30/2004 Appil~ . /' ~.
WARNING: FAILURE TO SECURE MPENSATIONCOVi;K,\GE'iS
UNLAWFUL, AND SHALL SUBJECT R TO CRiMINAL PEr~A!'rIES AND CIVIL
FINES UP TO ONE HUNDRED THO SAND DOLL S ($100:000hlNADr'h0N TO THE
COST OFCOMPENSATlON, DAMAGES AS PROVIDED FOF.lIN SECTJO;{3706 OF THE
'LABOR CODE, INTEREST AND ATTORNEY~S FEES, c ,
I 'CONSTRUCTION LENDING AGENCY ,~. __,
I nereby affirm under penalty of perJury ,that there is a construction l~fldjng:::1!::~hcyfort.he
. p~ff<?rMance of the work fot whid) this ~err:n:t !S~i~~~,,~l~ec,30P7:9~:f)},: ",._.~.
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TYPE
Construcio-n Types:
VN, >
I....
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I certify that I have read 1s,Plication and state that the above information \8 correct. I '
agre. e to'comply ith. all.p.' i .i 0 . inances and state !3WS relating, to building COj'lstruction, and
hereby authorize pres'en ive o~ t 's city 10 enter upon the above mentionec 'property- for'
inspection purpo, . i t1" ,'" '
, ' Date: 4/30/2004
ignature of Appli nt or Agent
The permit shalexpire by limit tion and become null and void if the. building or
,work has I)ot PllSsed final inspection 365 days from ttie date of permit issuance. A
new permit is required to commence or continue work.
Fees paid fot Permit:
Total:
0.74
.INSPECTION RECORD
. INSPECTION.' ". . '. DATE INSPECTOR. I
.' '.
Temporary Power Pole . : .'
Plumbing (DrainlWaste Pipe) . . .
Electri"al Ground Electl'OllelUfer ~ .
. SetbacklFormslTrenches(Footiilgs) 11(lIJor'l' (1M
. . Do not install suQfl<)Or or pour floor slab until the. {
following applicilble items have' been signed:" .' .'
Plumbing (Water Pipe.Sprinkler Valves) .' ,
Mechanical. (Groundwork) '. . .
E.lectriCal(llnderground Conduit).
Pre-sla.b (CompactionlMembr:ane.Reinf. 71/1OJ-< 'I c;1lIA .
Undel"pinning (Floor JoistlGirders) .' . . \
Donot cove.r or conceal the woll< belCWJ until the . . I
following applicable items. have been 5;9. ~
1st Floor Shear' . . ". . , . '
fll'Elsprinkler (Rough)' . ..' .
2nd Floor Shear " . . . , >
RoQf (ShElathing/Diapl'iragmlFrame) Ie\! jlA .'
Masonry (RelnfJBoild BeamlPre-Grout)
Rough Plumbing (Top Out) . .'. . .
Rough Mechanic.' . '. .... . .
Rougl1 l:IectricallDry wall) . .
Rough Electrical . '
Fr;lming (Only after Plbg ,Elec Mech and Flfel ,., J UI I .
Insulation (Soul1dlEnergy) (]A- 'j ilUl.I '. .
Do nat tape or plaster until the following applicable i ' .
items have been signed: .' I,
Drywall . 1\1Z4D<t- K" ,,,,
Penetrations (Fire Rl!led) Electrical
Peneti'ations {Fire Rated) Mechanical . '.
PenetratiOns (Fire Rated) Plumbing . .
Interior Lath . . . ,/' ..' ,
Exterior Lath ,. . IlIfRl/J4 ~ .
. GENERAL-ITE 51 ". ~
Exterior Plaster (Brown Coat) .. IG-c<( .1.,.", I
T -Bar Electrical ' . . . . .
T-Bar Mechanical . , . .
T -Bar Structur;ll . . . . .
Sewer . .
Water Enginllering Backflow .
Water Service' . .'
FINAL INSPECTIONS Date lhspe t r.
Electrical Final . . .' . f--"l-'OS" .A
Plumbing Final . . - '7 ~I'K )w ~'-' .
. '. . . 1'-'
. .., . . f ..IJ-O" ~
Mechanical Final .
Gas Test , .
..'.
Engineeri"g/Gradinl1 final 7.65~126 .'
Fire .Dept, Final 765~040 . . . .' . .
Water. Engineering 765:5268 ., " .
Sub List/Bus1/less LicenSe 765-519 . .' ....
Zoning 765.5139 , r
. .
Building Final ~ast Inspection. Only.' H(-c1S . VI If
.' . .' Iter Above:Completel '.V'.
. PARTIAL INSPECTIONS
. Buirdina Inspections
. .
. Mechanical Inspections
.' PlumbinalnsDections ".
ElectricallnsDections