115 W. Sirius
TYPE OF PERMIT CITY
Patio Cover
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 89
BUILDING PERMIT NO. BLD2005-02168
DATE: 7/13/2005
JOB ADDRESS: 115 W SIRIUS AVE
LEGAL DESCRIPTION: N TR 3178 LOT 3
APPLICANT: CLAUDIA SALAZAR
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
FRANCES Y TRUJILLO TOP NOTCH CONSTUCTION COMPANY
115 W SIRIUS AVE 13209 E GARVEY AVE
ANAHEIM, CA 92802 BALDWIN PARK, CA 917060000
BUSINESS PHONE: 626338-:1038
JOB DESCRIPTION:Build patio cover 492 sq. ft.
VALUATION: 4,500.00 PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt iTom 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, a tte r, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licen!ied pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions 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 subje(~ts the applbant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compensation, 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 property who builds or improves
thereon, and who does such work himself or herself or through his or her own !!mployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed ccntractors to construct the project (Sec. 7044 Business and Professions
COde: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided 10r by Section 3700 aI the Labor Code, for the performance of the 'Nark for which t
this permit is issued.
~-' have and will maintainworker's compensation insurance, as required by Section 3700 of
~Labor Code, for the performance of the work for which this permit is issued, My worker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND poncy Number. 1649321 NUM ER EXPIRATION D
605817 11/30/2006
TYPE 8
TYPE HIC
TYPE C8 CONC
Date: 7/13/2005 Applicant:
WARNING: FAILURE TO SECU WO COMPENSATI
UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER TO CRIMI AL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDI1l0N TO THE
COST OF COMPENSATION, AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST, D ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (See.30g? .Civ.C):
Lender's Information:
C-onstrucion Types:
VN, ,
Fire Sprinklered? NO
Date: 7/13/2005
Fees paid for Permit:
Total: 412.67
I re of Applican 0, Agen
Th per' I expire by Iimitatio become null and void if the building or
w k has not passed final inspection 365 days from the date of permit issualCe. A
new Dermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainJWaste Pipe)
Electrical Ground Electrode/Ufer A J
SetbacklFormslTrenches (Footings) i&f'/\ Tdif" I
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit) , ,
Pre-slab (Compaction/Membrane Rein!.) 14.J,.b; V
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele.. Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown 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
Engineering/Grading Final 765-5126
Fire Depl. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139 / J
Building Final (Laotlnopectlon - Only Iris J A)J. 05i?(
After Above Complete)
. /
PARTIAL INSPECTIONS
Building Inspections
MechanicallnSDections
Plumbing InsDections
Electrical Inspections
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