1428 S. Sherrill St.
~~~i}~~:"'i~>~:,~\', .
t,~"",,~,
CITYa;.&Z~N'~HEIM
DATE: 515/2004 ' \~~;N~:,i/ ' .
, JOB ADDRESS: .1428 S SHERRILL ST ,,~/;t: ,"> .
LEGAL DESCRIPTION: NTR2715LOT32~ ~ ' .~
APPLICANT: EARL COVINGTON ~tJ:;;4:...~{t I
. OWNER INFORMATION: . 'f:.NT~;:~;~M";nON:
Earl Covin~ton . '. /Lr...P ~
1428S Sherrill SI . .' /~'~. .
Anaheim, cA 92804 , . " ' . . i
JOB DESCRIPTIONAddilion of family rbom nd dining room to FD. (HIH) .1
VALUATION; 48,456.00 I PROCESSED BY: PMK '.
IOWNER'BUILDE,dJECLARATION".~
I hereby affirm under penalty of perjury that I alT! exempt from.the Contractor:.~ Licens.e,Law for ,the fOllowing reasQn (8ec.,7031.5 ~usi~ess'and
P"rofessions Code: any dty orcountywhich requires a permit to construct, alt=:;r,improve,:demolisn or repair any structure, prior.to Us' issuance, also. .
requires the applicant for such permit to file a signed statement that he is !iC~I}~'d pur~uanfto',the provisions of the. Contractor's Uce'nse Law (Chapter
9)(commencing with Section 70.0.0 of Division aof.the Business and Profes$;~hs Code) or that he is exempt,therefr()m.and the'basrsfor theaHeged '
exemption. Any violation of Sectioi17o.31.5'by 3r.y applicaqt, for a permitsub~ctsthe applicant to:a dvil penalty of not more.than'five hundreddoUars
. ~l~)'as owner of property.,. or my employees with wageS as their sole com,,";.~sation, Wil; dO. the woik, a, hd Ihe slructure 'is n9,t i~tena.' ed or offered for
,~e (Sec~ 70.44, Business and Professions Code: The Contractor's licenseLl4'w does not apply to a;1 owner of property who builds,or improves;
ther.eoniand who doessuCi1 work ,himself. or herself or through his or her o~~/1~13m'ployees, provided that suchtmproyements are'notintended or . .'
offered for sale. if, however, tfle bUilding,or improvement is sold with_onev';.\-:" Sfcompletion, the owner-builder-will have the-b"urden'ofprov_ing that.he
did not build or improve for t~e purpos,eof sale). ,.' ..' '-'n,---', "'- . '. "_ , . . _,' _'. ."
o '1, as t,he owner of the ~rope~, am exdusive~ pontrnd.il1g with lic~r1$e~ g"lntractors to construct the project (See. 7044 Business and:Professions-'
Code: The (;ontractor's Liqense, La~.v doe, not ap; :1y to an pwner of pwperty'!:t'i,1? bci!dsor improves thereor,.and who contr~cts for such projl?~ts_:^'ith
~on~ractor(s) I,icensed puts ,ntto the ontra, 1 t:ce~is,e ),'t~ ' ' '_, ' , " -, , .-
!;-J I_a empt nder ,e' :R, P.C. for thIS reason: _'\~ ~" .,.".'.,' '. ': ..
Date: Owner. '" ,,,
ORKER' C MP NSATION DECLARATIONt- -I L
I hereby affirm ~_nder pet1alty of pe~uiy one of the following declara~ons:' , Ii '. .
D. I have and 'will ',maintain a :certificate of corisent to -self.i~ure for workc:-"1,_compef1sation.
a~ provided fO/-, by. ,Section 370.0 of the Lapo~, Code,_ ior the performz:nca cf tr.,~ ::...ori< for which
this permit is issued., ' t ' ' .' '
[] 'I have a't~d will maintain wo':ker's, comp~ns~tion insurance; as required ~l:3ection3700 of 5/5/2004'
the Labor. Code, for the performance bf the work for Which this permit is'_i::;s'iJ~j' Myv/or"-er's' Dat~:
Compensiition insurance carrier and policy are: ' . . ' ~.
Carrier: " " , . - :Policy Number. '::,
.. This s_ection ~e~ not be completed if the pe'nnit is for one hUndre(ldOJl~S($1Doj!.lf iess. '
,-0 fcertify that in the perfonnanceofthe work for which this permit is issu:::!:',\ shaU not
employ any pers'on in any manner so as to become subject to the worker's cc,,"npe:nsation laws
'of CalifomiaLand agree that-if I shoUld ,become subject to thew rker~s,co~,.l$ation
provisions, of Section 3.700 oftheL~borCo ,'t sh n forthwit mpty ~ti~:i?:rO~iSiC?ns.
Date: 5/5120q4 APpJj~nt)( ,~,,::,(::-~~-- -~
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION OVER1,CE'iS. .
UNLAWFUL, AND SHALL SUBJEC, AN EMPLOYER TO CRIMIN i f'EN.'l'~TIESAND CIVIL
FINES UPTO.ONE HUNDRED THOUSAND DOLLARS ($100,00 ,IN Ar:>D'OlON,TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FO~;iN SECTI6Npoii OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ,.
CONSTRUCTION LENDING AGENCY,.,
I-~ereby affirm under penalty6f perjury that there is a construction, lending aG.'!"-0CY fo~ the'
performance of the work for which this permit is issued (Sec.3097.Civ,C): . ~
Lender's Information: ,- ' , ' . . ,.
,
--
BUILDING PERMIT NO,
BLD2004-01439
TYPE OF PERMIT
Residential Addition
-
Dale: 5/5/2004
'nt
llbllCome null and void ifthe building or
w9"k has not passed final inspect" 365 days from the date ofperIl'Jtissuance.' A
new permit is required tocomm ce or continue Work.
8UlLO'iNG DtVlSION
200 S. ANAHEiM ElL VD.
(714) 765- 5153'
INSPECTION REOUESTLINE:
(714) 795 - 4626
CENSUS CODE: 434
QUARTER SECTION: 22.
~:1
ARCHITECT/ENGINEER INFORMATION:
'LICENSED CONTRACTORS DECLARATION I
I hereby affirm under. penaity ()f perjury thai I am
licensed u:nder pri;wIsions of chapter_9 (commencing
with Section 7000) of Divs-icin 3_pfthe Bu::;iness and
Professions Code.
Con tractor
NUMBER
EXPIRATIONDATE
TYPE
Construcion'Types:
VN" .
Fire ,Sprinkrered?
NO
o-,,~ _'.-=__>",-,,-,:;
:~"'..c.~~__' ~o..:.
.,
Fees paid for Permit:
,Total:
4.85,
FINAl- INSPECTIONS
. INSPECTION RECORD
ft!./,.? Jtt)';k .,'
,Ll/ {&..--". '.
IA
V,, / / .
-7lK
. INSPEctION
,lNSPECtQR
.
. DATE.
..
Temporary Power Pole..
Plumbing (Drain/Waste Pipe) .
Electrical GroundElectrodelUfer 17~
. Setbac;k1FormslTrenches (Footings) .Y7
[)onot .instalLsubfloor or pour floor.slab until the
following applicable'items have been signed:
. Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) .
Electrical (Undergroun(jConduit).
Pre.-s'lab (Compaction/Membrane.Reinf. . II .
Uroderpinning (F.loor.JoistlGirders), '" ~~ ~J 'it'
Oo,not CQveu~rconceal thewPrK below until tne
fOllo.Wing a. PPlieable.' items have be~n;Sign~ .
1st Floor Shear' .....,. .' . ..tf.Iii!"'_lu,
Firesprinkler (Rough)' .'. . I I.
2nd 1'100 " . . I
RD athin.QIJl!aphragm'Frane) .
Masonry (RelmJBorid Belll1llPre-Grout), /. ,.
Ro'ughPlumbing (Top Out) If .
Rough Mechanical"" . .
Rough Electrical (Dry waU) .
Rough Electrical ". . . -I.
Framing . 10nly aft~rPJbg.;-Elec.. Mech,;andJire)" ~
Insulation (SoilndlEnergy) ~. .' .
00 not tape or plaster until.the followingl ap~/icable
:items l1ave been signed: ,'. _' '.
Drywall. . . '.' ..'\' (J ~ ,~-
Penetrations (Fire Raie,d) Electrical fl.
PenetJ:atlons (Fire Rated) MeChanical .
Penetrations. (Fire Rated) pluinbing
Interior. Lath . . . ." .
Exterior Lath .' . .
/ . . '. GENERAL ITEMS, I.
Exterior Plaster (Brown Coat)
T.Bar Electrical. '. . .,
T-Bar Mechanical'
T -Bar Structural'
Sewer. . ..,., .'
Water Engineering Backflow ." .
Water. Service . . . I.
. .
'.'
Electrical Final'
. .' Plumbing Final'
.
. . Mechanical Final . .
J'y?~, tA
'. .
~.
,
, .
'7
.
.
1
.
. . .... J('7>,1
~
Jf.
Gas Test
Engineering/Grading Final 765-5t26
'. Fire Dept. Final 765-4040
Water Engineering 765:5268 .'
Sub List/Business License 765-519
Zoning 765.5139'
Building Final fLastlnspeet,on.On.I.Y 41 If,
. " '. After Above Complete) 110
. PARTIAL INSPECTI IN.
. ().
~.
.
,
. .
.
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/;:'w:ku"::" r'~xJt8 Ibl~,+ .. a.L
V(i) m~~A'IPm-~77I~ .~,-~,,'- ;<;(~;OFF-
:.'. Me~~Wo~~~'-(}FP~t
. .
. .
. .
.
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PlumbinQ InSDections'
. .
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Electrical InsDections
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-_:
TYPE OF PERMIT
Residential Add\!ion CITY'
DATE: 7/29/2004
JOB ADDRESS: 1428 S SHERRILL ST
LEGAL DESCRIPTION: N TR 2715 LOT 32
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REOUEST LINE:
(714) 765.4626
CENSUS CODE: . 434.
QUARTER SECTION: 22
BUILDING PERMIT NO. BLD2004-02225
J
APPLICANT: ?i " . '-
OWNER INFORMATION: ~ ONTRACTOR INFORtN~TION: ARCHITECT/ENGINEER INFORMATION:
Earl Covington E'
1428 S Sheml/ St ~ '
Anaheim, CA 92804 , . .
JOB DESCRIPTIONMdition w bed room and batH ,oom, 359 sq ft supp.." ~ntal "e'mlt # BLD2004-01439 HIH
VALUATION: 24,160.00 PROCESSED BY: FAN
I OWNER-flUILDERI-o"CLARATION -.J .
I hereby affirm under penalty of perjury that I am exempt frorTI the cqn,tra(fOr:G':'Ucen~e Law for the following reason (Sec. -7031.5 Business and
'Pr""fessions Code: any dty or cC?untywhich require~ a permit to.construct;'~;'ltr~ improve.-demolish or rePClir any structure, prior to its issus'nce,,'also
:,equires the applicant for such permit to tile a-signed statem~ntmat h~ is iic411::fd ourtuant to the provisions of the C"ntrador'!'-- License LClW (Chapter
. 9)(c<?mr'nen?ing vvithSection 7000.of Divis:.or~ 3 .of the Business and Profess!lr:.;Code) or that he i~ ex~~pt therefro~n and the basi$ for the alleged
. eX,e. i9n.. My \J.io~atio\"l of Section 7031.5 by any <:!pplicar'it fer:3 permit :;l;~~::r(;ts.~~e :::lppllcant te a dviJ penCllty of net more than five hundr17d doilam.
($5 ). .\, .... .
{j I, as .owner of preperty,or my employp,e.:> wit~1 w~ge:;: a:?their'::-..oj~ C0lr;~:'.t:;sation, wi:ide:the work, and the $to:uctL:re is not it/tended or .offered far
sale (Ser;. 7044 Business and Professions Code:. The Contr2Gtor's License U~~!I.' dce.,:> not applyt.o an .owner .of property wh() builds cr.!mproves
therE-on, .ami 'who does sudl work himself or heltt:M ortl1it'l!gh his' or hdr:0w!~ I';rnployees, provided that '$l!Gh imp~ve'"!'1ents are net 'intended or
Qffered fer sale. If; Ilowever, the buildir::.J or irr.pru"em~.lit [::. sold with ~)ns y%>'!' of comple!ion, the owner-builder VolPI have the bllrdeIi of ;::-roving that he
did not bun::] 01 Improve for the purpose of sale) I '
o I, as th~ owner of the propert'j, am t)(~U !vely ccntrad,ng WIth 1l~.e,l~ed \ )"miraciors to construct the project (Sp.c. 1'Q44 Husil.eSS allCi Pmfess\One
Code: The Contractor's License Law dops apply to an eWlIer of 10P~<' /1" h~(: =~.l':is c., imp'Qves thp.real'1, 8nd who ccntracts for such projects ',vith
F!1'cmtradi)r(s) !icel1S~ pursuant to the-~o < actor's Ucpnse law). II .
U 13m exempt under Sec. __ &CQlhis,easor. __.._ ___ __. ---":"-'_._'
Date: Owner. 4.~~_ '" ._,
I WORKER'S CO Pl?NSATIQ,N DECLARATIO~___j._.~L~ .---:-:-cl LICENSED CCNl'RACTORS DECLAR_AlION i
I hereby Glffrrm under penalty of perjur/ one of the folhJw!rg declarat!On~: (I j' I hereby affl!"fTI IJodar pe%lty 'Jf perJlJr/ that \ am
o I have and will maintaIn a c.ertificate of consent 1V seft-insure fo:- wor;"~:'t ct,rns;.e.nsaticn, i licensed under provj~ions cf chapter 9 (-;ornil1.;nc.~n2
....::; provideti for by Section 3-"00 of the labol" Code. for the !:'ei'fci:nance of!;' ~ ~.,.or'!( fer which I '.'lith S~tion 700m (01 D,VSIOIi.3 of :he BL:sines5 .and
thIS permit 1S issued. . ProfesSlons Code.
L 1 I nave and will maintain worker's compens::!tion InSlIrance as ,enu:!ea ~~. Sectiol\ SlUOof 712912004 __~_
the Lc:bcr Code,for the perfermance of ~he work for y!hich this pem'l!t j$.i~i.l('::L iviyworkcr's Date: Contractor
.Compensation insurance carrier and policy are;
Carrier:' Policy Nunmer. NUMBER EXPiRATION DATE
, .
... .,
~.is ~tiOl'l need not be completed if the permit is' for one hundrea dollars {S1C!t or jess,
lSJ'.' certify that in the perfonnance of 'he' . rk for which this per ,it is ISSt;.~.-'1. I shaH not
employ any ~rson in any manner ~o as to .come SUQject to U", w;ori<er's:'f!Iii~;n~nsation laws .
.of Califomia; and agree that if J should be mesu ject to the w rkfr's cOITis:,"(:r,'i ~io ...' ,
P~CNL'ijOns_ofSection 3700 ofth~ Labor e, I I 'forthwith rfp"IY\!'Jith t!',i,:.'T.l"roVjSiO~S: . ~o~struCion Tvpes:
Date: 7/29/2004 Applicant: ~ Occupanev Groups:
WARNING: FAILURE TO SEC EWORKER'S COMPENSATION COVE<<:tGE)S' R3, , , ,
UNLAWFUL, AND SHALL S'UBJECTAN EM PI. OYER TO CRIMINAL PENtf~j IIOS AND CIVIL Fire Sprinklered?
FINES UP TO ONE HUNDRED lHOUSAND DOLLARS ($100,000), IN ADi'} jIO~. TO THE Livin~ Area:
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTi(A\t.;~70$ OF THE New I Additional Area:
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
, CONSTRUCTION LENDIN~ AGENCY
I hereby a~irm under penalty of perjury that there is a con~struction lending ~::;.~!1cy fer the
pdrformance of the ,work 'for which this permit is is~ed (Sep.3097 ,eN. C): . I
, ;,e\\~~r'5 Information: ___~.__~_.___ f ~__
TVPE
NO
359.
520
Signature of ApPlicant .or Agent
The permit shall expire by limitation and
work has not passed final inspection 36
. new permit is, required to commence or
Fees paid fo~ Permit:
Total:
441.75
orne null and void if the building or
d ys'.from the date of permit issuance. A
inue work.
INSPECTION
DATE '. INSPECTOR
.
FINAUNSPECTIONS
Electrical Final
INSPECTION RECORD.
Temporary Power Pole - .
Plumbing (DrainlWaste Pipe) .
Electrical Ground Elec\rode/Ufer" I' : . ./
SelbacklFormsfTrenches (Footings) ~,. ;::rr,
:
Do not install sublloor or pour floor. slab l\Illil the" ~A.
following applicable items have been signedY. . .' II. ;~-
Plumbing (Water Pipe.Sprinkler valves) , V
Mechanical (Groundwork) " .
Electrical (Underground conduit)
p':l'-slab (Compaction/Membrane.Reinf. ' n . ~ '
Undl!rpinning(FloorJoistIGin:lers) v1o/_11 "'^~
Donat co'(er or conceal the work bel.~ untilt 0'\, '11..:
following applicable ilems have been signed: ., j
1st Floor Shear . . [.!::.
Firespri\lkler (Rough). ' I. . I.
2ndFI
RooffSheathinaa:/iaphragmlFrame) .'
Masonry (Reinf./Bond BeamlPre-Grout)
Rough Plumbing (Top Out) ,
Rough Mechanical .. . .
Rough Electrical (uryWall) . JIIVP~lt Ox))...Y-;;/';7.j 1.,.,':~MI--:-vI
RoughElectricaJ' . . ., . . /'-' - l."'9'i " '~idlL
Framing. (.on,yahe,p'b9..,E,eo,Mech..andFile.l171"-p ~I.,,'.' I'h. jJ"';.' . JOt. / tJ ~,
Insulation (SoundlEnergy) . . ". .. R"" \1
Do.not tape.or plaster until the following applicabl' Mechanical Inspections
items have been signed: _" '.'
DryWall ' . \..U Ifon'fltJd< --.. -
Penelrations(Fire Rated) Electrical ., f
Penetrations (Fire Raled) Mechanical
Penetrations (Fire Rated) Plumbing
Interior lath
Exterior lath .. . ,^ 'J _-:!i M.f"""',
. GENERAL ITEMS' 'I .
,Exterior Plaster (BraNn CoatI
T .Bar Electrical.
T-BarMechanical
T-Bar Structural ,.
Sewer' .
Water Engineering Backflow
Water Service :
Mechanical Final
. .
~. ~d2"
IJ, . !V\>"" Iv
rll. w I~\\. /
. <lIAf .r' Jlt~?
Plumbing Final..
Gas Test
.
Engineering/Grading Fimil 765,-5126
.
Fire Dept. Final 765-4040
.
Water Engineering 765-5268
Sub listJBusiness license 765-519
" Building Final ILast Inspection- Only
. , Alter Above Complete)
'11./nlr't
(i ,
u'rb(
Zoning 765~5139
PA~TIAlINSPECTIONS
.
BUildi~. _.Ins;pctions... '. - '. t..... ~.. ,.
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. Plumbinalnspections
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Electrical Inspections
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EPARTMENT I
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(lnltJald
C' IN C:~ OoV;r/;; To
l~~ -5, ~l~\{;\
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CITY OF AHAHEllv
.(PPLCCATlOH FOR BUILDING
.
PERMIT
(--"frl
)wn.r
Nt9He--II'--'I
\rchltect or Englne.r -:>
) (UIL) --1(.
;J-.Y .~,Lh-;{'/.>I /I
1-1 ;; ?S-J- 3-
f! /.. ,.r-
~drlr.s.
lad.....
/
"> U/ILi (~ ;Z
IV.).$- .f 1-/{-/71>1
"'7h7 > ) j 6- J.-
~on"(Jctot
Phone
:1t. R.c;.,....d
ZONING REQUIREMENTS
Dote Cleared
)ne _ Mo/n Use
'eek.d 8 y
JILDING SETBACK FROM PLANNED HIGHWAY RIGHT OF WAY
tqulr.d Right of Way From Cent.r Line ($)
'f Area Ble/g. HI.
n. DU Area
,rcls: Sid. Real' Front
,f Area Per DU Coveroge
,RKIN~: ALL PARKING AREAS MUST BE PAVED AND STRIPPED,
IRDER BARRICADES INSTALLED WITH ANY LIGHTS DEFLECTED
~IOR TO FINAL INSPECTION
---
roges/Corports/SpaC"$ Requr,..d
ltcelWolI Ft. High Required Along
NDSCAPING: TO BE APPROVEO BY PARKWAY SUPT. AND COM-
ETED PRIOR TO FINAL INSPECTION
---
'nl_ Ft. ofP.L. Zone
P.,. P 'ot A 'tochea
T SPLIT ORD. TO BE COMPLIED WITH PRIOR TO FINAL
---
;PECTION
VELOPMENT REVIEW APPROVAL
:10$$
r.p.
lance _
htlng F.. Due?
k F.. Due?
Pend.
Pend.
Pend.
c(f.Dol.
Efl.Datft
Eff. Dote
Yo.
Yo.
No
No
tS To 8. Compl.ted And/Or Approved ~ !.2. ~ INSPECTION
dng
d$coplng
.Iop. R.v/ew
'cation
Fence/Wall
Lot Spilt
Bond To Be Postt:a
COMMENTS
STR~fT AND SEWER REQUIREMENTS:
rway R.q.
't'o/lc_:
"
'g'
:f1t1on R.qt
. F..,
IMP. PLANS:
BOND:
EASEMENTS:
...
Posf.d
Not Posted
10/62
~-
2:
WHITE COpy . WORK COP'
GREEN COPY .. APPLlCANl
CANARY COPY. BUILOING
PINK COPY .. ENGINEERING
NEW 0 ADD !kYAt. TER
Oat. receIved "'
Date I.sued
Permit No. ..
../ I..
I .; ,
/;~
,
o REPAIR 0
DEMOLISH
No. 0/
FomHI<r.s
r.
Zone
o
I
She
S..F,.
Us. of Structure
U
Valuation
S .::; 0'7.7'
Logol
Vescrlptlon
Occupancy Group
Lot.
;,J..
Blocle
Troct
Fee S
B. P,.
Fe. $
Type 01 Construction
Rooflnrl
Room.
TOTAL
INSPECTION RECORD
Approval
Dot.
Inspectors Slgnatur.
FOUNDATtON: LOCATION
FORMS AND MA TERIAL.S
REINFORCED
MASONRY OR CONCRETE.
r.-/k:
I.p-..... jt<.... ( ,'C
aOND SEAM
") ..:....1 r t;;;
(,,~
" /.
UNDERPINNING
ROOF SHEATHING
ROOFING
FRAMING
ROUGH ELECTRIC
GROUND PLUMBING
Oe-yo. r-<:/
TOP OUT
~~
LATH OR DRYWALL
INTERIOR
LA TH EXTERIOR
PLASTER SROWN COA"
FINISH PL.UMBING ,-
FINAL. ELECTRIC
G~S
P.,zA TROUGH
HEAT FINAL
SEWER
LANDSCAPING
WALLS
FINAl-
FIRE DEPARTMENT APPROVAL:
MUL TlPLE FAMIL Y, COMMERCIAL, INo'
I hereby acknow/edg. that J have r.aJ thl. appllaotlon and .tat. that
tt,. In{ormatlon I have provlatta Is correct and ogr.. to comply with
011 city oralnanc.$ ana stat. laws r.gulatlng building con.truction.
, lurth.r under.tand that a (Inal Inspection '141111 not b. maJ. nor will a
p.rml t for OCCupancy b. SJronted until al1 conditio". InJIt::at.J on this
(orm hay. ~b.?fillu/fllle~..// .
'" //L.tUL4.t<.. /f' c-.fi!:< -f' ~
Slgnofl/r. o'_PermI.!f. Or ArI.n!, Y pi I
:.2 ,.."-,>-<-p-/.c,, -;r;;))5<f./
Addr... Phon.