2049 Sierra Pl.
TYPE OF PERMIT
Blockwall/ Columns CITY
DATE: 31161Z005
JOB ADDRESS: 2049 W SIERRA PL
LEGAL DESCRIPTION: N TR 2197 LOT 101
BUILDING DIVISION
ZOO S. ANAHEIM BLVD.
. (714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: .434
QUARTER SECTION: 37
BUILDING PERMIT NO. BLD200S-00730
CONTRACTOR INFORMATION:
my KIND CONSTRUCTiON
1201 N MOUNTAIN VIEW
SANTA mA. CA 92704 OOuO
. BUSINESS PHONE: 714554.432"-
JOB DESCRIPTION: Build 61/ineal feet of 6 foot high block wall per citY stand~"d'.
VALUATION: 2.700.00 I .
L OWNER-BUILDE~~tmC:lARATlON
I hereby affirm under penalty of perjury that I am exempt from the Contractct\~ License law for the following reason (Sec. 7031.5 Business and
Pr'Jfessions Code: any City or county whiCh requiresa permit to construct, a~(-r,irnpl'ove, derTlOlish or repair any stmcture, prior to its issuance. also
requ ires ~he applIcant for- such permit to file a signedstate~nt that h~js !ictil~<;.e~1 pUfsuant 10 the provisions of the C.l~!1tractor'$ License Law ,(Chapter
9)(commendngwith Section 7000 of DiVision 3 of the Business and PrQfessich& Code) or tl':at he'is e,xempt ~herefrom and the basis for the c!tleg6d .
exemption. Any violation of Section 7031.5 by any appllca'nt for a permit SIJi;i~ct~ the aoplic?nt to a dvil pehaltyof I'ot ffiOi:7thanfive hunored dollars
($500). . .,.. . . ..
o I; as owner of property, or my employees with wag~s a.s their sc.le comp~ifl$,ation, will do the work., and the structure Is not intended oroffere:d for
sale (Sec. 7044 Business and Professions Code: The Contracto(s Ucens:e L:~w does not applyfo an owner of propertyw~o bt.:ikis or improves
. thereon, and who does such work himself or herself or through his or 'h~r owy'"employees, provided that such improvcrN~r:ts <.'!re not intencieq Of, .
offered for.sale~ If,however,.the building or!mprovement is sold with one; ve~;r Of ccmplst!c:!, .the owner-builder will have the burden of Droving. that he
did not build or improve for the purpose of sale). "j _, . . ,
01, as the' owner of the property,' am excfusively contracting with iicenscd ~br.tht::~or3 to co'nstruct thE'< p~oject {See 7044 Bu&ln~ss [lnd F-:-ofessions.
Code: The Contractor's License Law does not apply.to .an owner uf property ~1;h6 bU':T'ds or improves thereon, and who contract:;. i'or such proje0\s with
~tfontractor(s} licensed pursu~nt to the COl"tracto!",s ~.ice~se Law). t
LJ I am exempt under Sec. ' , B & P.c.. for thiS rec:lson:, __.~L_,_._-..:...._._._
Date: , Owner: . -"" . _ -.:..1--~-
" WORKER'S COMPENSATION DECLARAT10~~_r=.~_----.i
I hereby affirm und,er penaltY of perjury one of the, following declal'ati(Jit$:' .
o I have and will maintain a certificate of consent to self-insure fo; worker'-s\';OlTlpei:satiGn,
as provided for by Section 3700 of the Labor CQde, for the j)erformahce ofthe\vDr'r<: for whkh
~'S permit is issued.' . " . . ~ .
I /laye and will maintain wort<e.rrs compensation,insurance, as requlreJ b/SCCtiC.rl'3700 of I
. tr. I .bor Code, for the performance of the work for which this permit is iss;.:s.:f Mywork?r's
Compensation insurance carrier and policy are: . 'I '
Carrier: : . Policy Number. EXEMP r~; . NUMBE . .
This section need not be completed if the pennit,is for OM hundred doli~rs ($10C) vr I(:$s. I ~~~5
o I certify that In the perfonnanceofthe work. for which this permIt IS i$t.eJ.! sha!, not ~
employ any person in a ny manner so as to become subject to the worker's cO(~..1r-ensat\on laws
of Caiifomia, and agree that if I should be me subJe the rker's c0mt:'p.j";<;a~ion
provisions of Section 3700 of the labor; 0 eo, J sh~U 0 hwit mply' wHh ir.~~~ pfOvisiol"s. 1'Col1Strucion rypp-:~.
VN, ,
Date: 3/1612005 Applicant: '"'-
WARNING: FAILURE TO SE U KER'S _OMPENSATION COYEPAG~ is.
UNLAWFUL. AND SHALL SUBJECT m EMPLOYER TO CRIMINAL PENAl.TlcS AND CIVil
FIN ESUPTOONE HUNDRE. D tHOUSAND DOLLARS ($.100.000). iN ADDj,;ON TO Ti'IE I
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ,\706 OF THE
LABOR CODE. tNTEREST mD ATTORNEY'S FEES. .
.1 . . CONSTRUCTION LENDING AGENCY -"---'--1
I hereby affirm under penalty of perjury that there is ?- constr,;ction ler"'(jinQ ::!;I~t..n;YL~l_!f'~. _ 1 .~
f.€::ri6'-11IdnC'~ ofine work Torwnicn tnis permIt, is i~suea (Sec.:-s097.Civ.C):
Lender's Information: .
APPliCANT: JAVIER NOLASCO
OWNER INFORMATION:
. EDNA SALAZAR
2049 W Sierra PI
Anaheim. CA 92801
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SM1
-,
__LICENSED C9NTRIl.CTORS DE:CLARA TION _J
I hereby affirm und~r penalty of perjury that tam
licensed undir pro"'~r-tS \.if cl1~r 9 ~ornmenning
\.-.ith Se~tion TOOO 0 .OiVSic.fn fOJfle IJ~ine:ss and .
ProfeSSlon~ C(),' ,
3/16/2005 _ ! . -.:;.-
Date: Contractor
EXPIPJ!..ION DATe
5(~112\106
B
Fees paid for Permit:
Totat:
125.79
Date: 3/16/2005
. i Sign ure 0 ppli ot or Agent
The peJ\mit shall expire by limitation and become null and void if the building or
work ha\;lriot passed final inspeCtion 36S days from the date of permit issuance. A
new permit is re.quired to commence or continue work.
INSPECTION RECORD
, ,INSPECTION ' O,ATE' INSPECTOR'
Temporary power Pole , ,
Plumbing (Draih,waste Pipe) " ,
Electrical Ground ElectrodefUfer r
SetbacklFormsfTrenches (Footings),
Do not installsubflQor or pour 110 or slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Grou ndwork) , ' ,
Electrical (Underground Conduit)
P",-.slab (CompactionlMenlbrane.Rei nt.
Underpinning (Floor Joist/Girders) , ,
Do not cover or conceal the work below until the ,
fOllo;.ying app1i,cq!:>le items have-been ~igned:" ,
1st Floor Shear ' , ,
Firesprinkler (Rough)' ,
2nd Floor Shear ' " , '
Re>of (SheathhiglDiaphragnvFrame)
Masonry (ReinfJBOnd Beam/Pre-G~t) <l<1",~
Rough Plumbing (Top Out)
Rough Mechanical
,Rough E1ectrreall Dry Wall} , ' "
Rough Electrical ' ,
Framing, (Only after Plbg._ Efec.. Mech and Fire)
Insulation (SoundlEnergy) , ,
Do not tape or plaster until the fOllowitlg applicable
items, havebeen signed: ." . .
Drywall , , ,
PenetrationS (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical ,
penetrations (Fiie Rated) Plumbil19
Interior Lath ,
Exterio,. Lath " , ,
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical ' ,,'
T -Bar Mechanical, ' ,
T .BatStruclural ,
Sewer
,Water Engineering Backflow ,
Water Service , "
"
FINAL INSPECTIONS Date: Inspector '
Electrical F,inal I, , ,
Plumbing Final I ,
, , '
Mechanica" 'Finai, I , , '
Gas Test ! ,
:Engineering/Gradlng Final 765-5126 , , " '
. . I .
,
Fire Dept. Final 7654040
, ,
Water E,ngineerin~ 765-5268 "
Sub LiStlBUSjneS~License 765-519- , ,
Zoning765-5139) " .-
" 1p;f-1*( ~Oi':~
Building Final ~ast Inspection- Only "
lte, Above Completel , ,~
, PARTIAL INSPECTIONS
Buildina Inspbctions '
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Mechanical Inspections
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