1431 S. Sherrill St.
APPLICANT: BEATRICE; BIRT
OWNER INFORMATION:
Beatrice V Sift
1431 S Sherrill St
ANAHE;IM, CA 928040000 . .
JOB DESCRIPTION:To final expired permit # 4133 lor Bedroom & Family R~c:n .additions.
VALUATION: 4,000.00
I OWNER.BUILDER DECLARATION
I hereby affirm under penalty of perjury that t am exempt from the Contractor's 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, .8150
requires the applicant for such permit to file .8 signed statement that he 1$ lict:';.1sed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commenqing with Section 7000 of Division 3 of the Bu'siness and Prof6$3:~lns Code) or that he is exempt therefrom and the"basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant fo"rapermit sub'ectsthe applicant to a 9iVii penalty of not more than five hundred dollars
~50~,>~ owner. of property, or my' employees with 'wages 'as t~eir saio ~~~plnsation, ~ili do the work, and the structUre is not intended or off~redfor
sal,e (Sec. 7;044 Business and Prof~sior:sCode: TheContractor.is Licel1$t,JY,~w does not applytoan owner of prop~rty who builds or-improves .
thereon, ,an~.,who does such work. himself or herself or through his or her 0'/:;1:_: employees, provided that such improvements are not intended or ,
offered for ~ie.lf, how ev.er, .tne building or improvement is sold with one y_e~r of completion, the oW/1er-bu ilder will have the bu.rden of provirigJhat he
did not bu nd or improve for the pu rpose of ,sale). ,Jf~ _.
o I, as the owner of the prapert'l, am exdusively contracting with licensed ,i:c,j:ract?rs t6 construct the project (Sec; 7044, Business and Professions
Code: The:S~ontractor's.License.Law does not apply to' an owner of propertY::~ho builds or improves thereon~ and who contracts for ~uch projects wit,h
?4ontractof(s) licensed pursuant to the Contractor's License Law).. '
. U I am e ~m t n Sec. . , ,B & P.C for this reas n:
ate: P OWher: ..-
WORKER'S COMPENSATION DECLARATION
thereby atffl:m under penalty of perjury one of ,the following declarations: :
o '1 have" ~nd will ;.na.intaina certificate of consent t6 self-insure for workef"!, compensati,on,
, as provide9 for by Sedion 3700 of the Labor Code, for the performance of tl-;1 work for whid1
this permitls iSsued. . -
o I have ~nd will maintain worker's compensation insurance, as requ;red c~:, Section 3700 of
the Labor Code, for the performanc,e of the work fOI which this Permit is issu~d. Myworker's
Compensation insurance carrier and policy ~re: . .
Carrier: Policy Numb~'H:
. T~S section ~ed not be. completed if the pe-11l'Iit is for one hundied dollars ($1t1~'li or less.
r1J J certifytllat in the performance of the work for which this permit is is~~;;j~ I shall not .
employ uny person inany manner so as to become subject to the workei's'o:-mpensation laws
of Califomia, and agr~ that if 1 should become. subject to theworker~s c-o:m~hsation
prov.isionsof Section 3700 ofthe Labor Code, I shall forthwith comply\vitfj.tt',Sse provisions.
Date: 7/29/2004 . APPlicant':/- v35"D r7 L~'
WARNING: FAILURE TO SECUREWORKE;R'S COMPENSATION COVERAGE; IS.
UNLAWFUL, AND SHALL SUBJE;CT AN E;MPLOYER TO CRIMINAL PE;NALTIES AND CIVIL
FINE;SUPTO ONE HUNDRED lHOUSAND DOLLARS ($100,000), IN:goD!TlON TO THE;
COST OF COMPE;NSATION, DAMAGE;S AS PROVIDED FOR IN SECTION 3706 OF THE;
LABOR CODE, INTERE;ST AND ATTORNEY'S FE;ES. .^
CONSl:RUCTlON LENDING AGENCY
I hereby.affirm under penallY of perjury that'there is a construction'leq9in9 afjencyfor the
performance of the work for whid1 this permit is issued (See. 3097 .CIV .G):'
I_~~~:.,~~:"l~::'~:"!::~-c:;' ~,-_:_- '
BUILDING PERMIT NO. BLD2004-00165.
TYPE OF PERMIT
Residential Addition . C ITV
DATE: 7/29/2004
. JOB ADDRESS: 1431 S SHERRiLL ST
LEGAL DESCRIPTION: N TR 2715 LOT 42
ElM
BUILDiNG DIVISION
200 S. ANAHEIM BLVD.
(714)765-5153
INSPECTION REQUEST LINE:
(714) 765 - 4626 .
CENSUS CODE:' 434
QUARTER SECTION: 22
CONTRACTOR INFORM,TION:
ARCHITECT/ENGINEER INFORMATiON:
PROCESSED BY: MSM'
.-
I certify that I h,ave read this application and state that the above information is correct. I
agree to.comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
;:ect~~7 ~~
Signature of Applicant or Agent
The permit shaJlexpire by limitation and become null and void if ttlEl building or
work has not passed final inspection 365 days frllJll the date of permit issuance. A
i'$w permit is required to commence or continue work.
Date: 712912004
J
LICENSED CONTRACTORS DECLARATION
1 hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) -of Divsion 3 of the Business and
Professions Code.
7/29/2004
Date:
NUMBE;R
TYPE
Construcion Types:
VN, .
Fire Sprinklered?
Contractor
E;XPIRATION DATE;
NO
Fees paid for Permit:
Total:
91.90
INSPECTION RECORD
. INSPECTION. DATE INSPECTOR
, Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/lifer
SetbacklFOl"msfTrenches (Footings) .
. ,Do not install subfloor Or pour f100rslabunlil the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) , .
Mechanical (Groundwork) ,
Electrical, (Underground Conduit)
. Pre-$Iab (Compaction/Membrane.Reinf. . . ,
Underpinning (Floor Joist/Girder$)
Do not cover or conceal the work below unti,1 the
following applicable items have been signed: ' ,
1st Floo,. Shear, ,
Firesprinkler (Rough)' ','
2nd Floor Shear .
Roof (SheathinglDiaphraginlFrame) ,
Mzonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing ,(Top Out) .
Rough Mechanic;!1 , .
Rough Electrical (ury wall) , ,
Rough Electrical ' '
Framing . {Only aherPlbg.; Elee.: Mech. and Fire} .
Insulation (SoundlEnergy)
Do not tape or'plaster until the following applicable
items have been signed: ' .
Drywall ' , .' , '
Penetrations (Fire Rated) Electrical "
Penetrations (Fire Rated) Mechanical ' .
Penetrations (File Rated) Plumbing
Interior Lath . , .
Exterior ,Lath , .
GENERAL ITEMS
ExteriOl" Plaster (BraNn Coat)
T-Bar,Electrical
T.Bar Mechanical
T.Bar Structural ,
Sewer
Water Engineering Backflow ' "
Water Service .
FINAL INSPECTIONS
Electrical Fihal
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126 ,
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Bu$ines$ 'Licen$e 765-519
Zoning 765-5139
Building Final. fLast InspeCtion. Only'
, 'After Above Complete)
PARTIAL INSPECTIONS
BuildinQ Inspections
[Jate
Inspector'
Mechanical Inspections
PlumbinQ Inspections
Electrical Inspections
< i::11 Y 0 FAN A H E I.
APPLICATION FOR BUILDING PERMIT
WHITE COPY - WORK CO.
GREEN COPY - APPl..lCA
CANARY COpy - BUILOING
PINK COPY . ENGINEERING
~ ,~
Dot. ree-el veG
Date Issued
Permit No. _
~-:;-~s
l(/ '3
I..
NEW 0 ADO l8:J ALTER 0 REPAIR 0
Size
Sq. Ft. 2.--
Us. 01 Structure
~
DEMOLISH 0
No. of
Fcm,II..
r.
Zone
Own.r
},toiling Acltlr...
:3
City
Va/uatlon
$
Legal
Description
0c90
Lot '/2.-
~
Block
T,act .:? I J ~
0'..?J/- r: 1
Occupancy Group
Type 01 Construction
F.. S
8. Pt.
F.. S
Roollng
Rooms
TOTAL
ZONING REQUIREMENTS
INSPECTION RECORD
Oat. Roc.lv.d
Zone _ Main Use
Checlc.cl By
BUILDING SETBACK FROM PLANNED HIGHWAY RIGHT OF WAY
Date Cloared
Appl'Oval
FOUNDATlO~L~ATI~
FORMS AND' J&E~S
REINFORCED ~
MASONRY OR CONCRETE
Oat.
Inspectors Slgnatu...
=10
Requ/r.d Right 0/ Way From Center Line ($J
Lot AreQ
MIn. DU Area
Yards: Slae
Lot Area Per DU
Bldg. Ht.
---
)
BOND BEAM
UNDERPINNING
Rear
Front
Coverage
f'I/?r
ROOF SHEATHING
- /- s-
w cU::t
PARKING: ALL PARKING AREAS MUST BE PAVED AND STRIPPED,
BORDER BARRICADES INSTALLED WITH ANY LIGHTS DEFLECTED
PRIOR TO FINAL INSPECTION
ROOFING
~ 17-(,.S
,<It)
Garoges/Carports/Spaces Required
Fence/Wall Ft. High ReqlllrtuJ Along
LANDSCAPING: TO BE APPROVED BY PARKWAY SUPT. AND COM-
PLETED PRIOR TO FINAL INSPECTION
FRAMING
ROUGH EL.ECTRIC
Front_ Ft. ofP.L.. Zone
Per Plot AHoched
GROUND PLUMBIN<0'{CQ.
Se> 'L I
LOT SPLIT ORD. TO BE COMPLIED WITH PRIOR TO FINAL
---
INSPECTION
DEVELOPMENT REVIEW APPROVAL
TOP OUT
LATH OR DRYWALL P/!jpT /0-1 -b S-
INTERlOR
I
Reeloss
PenJ.
Pend.
Pena.
Elf. Dote
Eft. Date
E". Dote
LATH EXTERIOR
/0 -G. ~l
"
C.U.P.
Variance _
Lighting F.. Due?
Park Fe. Due?
No
N.
o
FINAL ELECTRIC
v..
V..
PLASTER BROWN COAT
ftems To B" Compl.ted And/Or Approved PRIOR TO FINAL INSPECTION
---
Parking
larulscoplng
Develop. Review
f)"dleotlon
Fence/Wall
Lot Spilt
Bona To 8" Posted
GAS 3'(0
COMMENTS
HEAT ROUGH J 0
HEAT FINAL
PI'IR T 3- .z'l-"~
SEWER 3 'I C> '7Pt;1'T 3- 3 J-t- r
STRI;ET AND SEWER REQUIREMENTS:
L-ANOSCAPING
),,'veway Req.
WALLS
.Ie/owalk_:
FINAL
:urbs:
FIRE DEPARTMENT APPROVAL,
MUL TIPLE FAMIL Y, COMMERCIAL, INDUSTR/AL-ONL V,
:Jovlng,
;.wer F..,
IMP. PLANS:
BOND:
EASEMENTS:
I h.reby acknowledge ,hot I hov8 read th's applicatIon and 6tat. that
th. lnlormaflon I hove provided Is correct and ogr.. '0 comply with
01/ city orc/lnane.. and .tot. laws regulating bulldlnfl constructIon.
I furth.r under.tond that 0 final Inspection wll, not b. mou. nor wU, 0
perm't for occupancy b. grant.d until 011 condltlon# Ind/cat.d on this
form hove b. fulflll.J.
~
)..d/catlon R.q~
leq.
lot Req.
Posted
Not Posted
~
~.v. 10/62