3646 W. Savanna
TYPE OF PERMIT CITY
Reroof .
DATE: 4/15/2005
JOB ADDRESS;. 3646 W SAVANNA ST 106
LEGAL DESCRIPTION: TRACT NO 743 LOT 24 AND TRACT NO .
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765,5153
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 2
BUILDING PERMIT NO. BLD2005-01060
C;ONTRACTOR INFORMATION:
GOLDEN CONSTRUCTION
3812 FRANCES AVE
CHINO, CA 917100000
. . BUSINESS PHONE: 909468-2294
JOB DESCRIP.T10N: Reroof 60 squares with SUR over existing one layer; for entire building on 3646 w Savanna
VALUATION: 9,000.00 PROCESSED BY, JNJ
I . . . OWNER-BUILDER DECLARATION.
I hereby affirm under penalty of perjury that I am. exempt from the Contract?r's License Law for the following reason (~ec. 7031.5 Business and . .
Professions_Code: any city or county which requires a p~rmit to.construct, alter, improve, demolish.or repair any structure, prior to its issuance, also
requires the applicant for such permit to me a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and P rofesr,ions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty ot not more than five. hundred dollars
($500). . . . .
o I, as owne! of property, or my employees with wages as their sole comnensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's license,law does not apply to an owner of prop~rty who buifds or improves
thereon, and who does such work himself or herself or through his or her o1/'n employees, provided that such improvements are not Intended or
offered for sale. If, howeve-r, the building, or improvement is sold with one YElar. of completion" the' owner-builder will have the burden of proving that he
didnotbuild or improve tOl: the pUlpose of sale). ':.
o .1, as the owner.of the property, am exclusively contlactlng with licensed~contractors to construct the project (Sec. 7044 Business and Profe$;$i6ns
Code: The Contractor's Licen'se Law does not apply to an oWner of propertywho builds or improves thereon, and who contracts for such projects with
~omractor(s) licensed pursuant to the C~ntrabtor's License, Law).
U I am exempt under Sec. , B & P.C. for tflis reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION \
I hereby. affirm under penaltY of perjury one of the following declar~ions: I
o I have and will maintain a certificate of conSent to self-insure for worker':~compensation,
as provided for by section 3700 of the Labor Code, for the performance of the work for which
~hiS ermit is isslied. ..: .
ave and will maintain worker's compensation insurance, as required by Section 3700 of
t e Labor .Code, forthe,p_erformance of the work for which this permit is issued., Myworker's
Compensation insurance carrier and policy are: . I:
Carrier: STATE COMPENSATION FUND Policy Number. 564-0000065
This section need not be completed If the penn!1 is lor one hundred dollars ($1 00) or less.
o I certify that in the penorrnance of the worK for which this permit is issued, I shall not
employ any person,in any manner so as tq become subject to the workers compensation laws
of Califomia, ~nd agree that ifl should become subject to the worker's' cOn1pensation
provisions of Section 3700 of the Labor C?de, I s~all forthwit~ comply with those provisions:
~~~N~~:2~~~LUf.!E T~~~~E-::;:E S C ~PENSATION COVERAGE IS .
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINESUPTO.ONE HUNDRED lHOUSAND DO.LLAR8 ($100,000), IN ADDITION TO THE
COST OF CoMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OFTHE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that,there is a constnJction lending age,nbyfor the
periormance of tl1eworlCforWhich thispermit is issued (Se.c.309T.Clv.C): '" - ;
lender's Information:
APPLICANT: HUN KIM
OWNER INFORMATION:
Prince Casa Pacifica properties L1c
3634 W Savanna St
Anaheim, CA 92804
ARCHITECT/ENGINEER INFORMATION:
LICENSED. CONTRACTORS DIOCLARATION
hereby a irm under penalty of perjury that 'I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsio'n 3 of the Business and
Professio Code.
4115/20
Date:
NUMBER
702267
TYPE
TYPE
TYPE
EXPIRATION DATE
2/28/2007
B
C39
HIC
Construcion Tvpes:
VN, ,
I certify that I have read this application and state that the above information is correct. I
agree to oomply with all city ordinances and state laws relating to building construction. and
hereby authorize representives of this city to enter upon the above,m'entioned property for
i ection purPoses.
Date: 4/15/2005 .
Fees paid for Permit:
. Tolal:
374.49
Si . ature 0 pplicant or Agent
permit shall pire imitation.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.
INSPECTION RECORD
"
, INSPECTION ' , DATE INSPECTOR
Temporary Power Pole
Plumbing (DI3/nlWasle Pipe) ,
Electrical Ground Electrode/uter
, SetbacklForrnslTrenches (Footings) -,- ,
Do hot install subfloor or pour floor slab until the
following applicable ilems have been signed: '
Plumbing (Water Plpe.Sprinkler Valves) , ,
Mechanical (Groundwork) , ~
Electrical (Underground Condu it)
PI1I-slab (COmpaction/Membrane.Reinf. -:-
Underpinning (Floor Joi!ltlGirders), '
Do not cover or conceal the, work below until the
following applicable items have been signed:
1 $t Floor Shear,' , ,
FiJesprinkler (Rough)
2nd Floor Shear c' ,- ( , . /",." I~
Roof (ShealhiMlOlaphragmlFrame) -In
Masonrv (RslnfJBond BeamlPre-Grout)
RoUbh Plumbing (Top Out)
Rough Mechanical ,
RougllEfectrical iIIV ,
RoUbh Electrical -,-' -,-
FramIng {Only after P!bg.: Elec.. Mech.. and Fjre~ , , '
Insulation (SoundlEnergy) ,
po not tape or pla~ter untU the following applicable
.tems have been s.gned: ' , ' ,
Drywall ' -,- ,
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanieal
Penetrations (Fire Rated) Plumbing .
Interlor,Lath
Exterior Lath . C
, GENERAL ITEMS '
Exterior Plaster (BlQWn Coat) ,
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 '. .
EngineeriitglGrlllding Final 765-5126 "
, "
Fire Dept. Final 7654040 , '
Water Engineering 765-5268
Sub List/Business License 765-519
Zoning 765-5,139 , n
BUlldingFinal jl;ast Inspection- Only !;'(\l\th" ~.'<nI\.,
. ' fler Abov~ Complelel ...OUO""
'PARTIAL INSPECTIONS
, ,
'BuiJdinQ Inspec~
,,~0k>llJ' ,
Mechanical Inspections
Plumbinq Inspections '
Electrical Inspections