7685 E. Silver Dollar Ln.
i'*
BUILDING PERMIT NO, Bl,02004-03110
. 'A' I:
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765, 5153
INSPECTION REQUESTLINE' ,
(7141 765 - 4626
TYPE OF PERMIT
, Accessory Building (Shed, Garage...)
CITY
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CENSUS CODE: 434
QUARTER SECTION: 202
DATE: 8112/2004
. JOB ADDRESS: 7685 E SILVER DOLLAR LN
LEGAL DESCRIPTION: TR 117 LOT 14 POR OF LOT(AND POR OF '.
APPLICANT: '
OWNER INFORMATION:
MARK A FOX
76B5 E Silver Dollar In
Anaheim, CA 92608
JOB DESCRIPTION;Workshop next to garage.
VALUATION: 4,500,00 PROCESSED BY: FAN
I' , " OWNER-BUILDERPECLARATICN", ,
I herebY'affirm under penalty of perjury that I am exempt from the Contractor~~~ License Law for the following. reason .(Sec 7031,5 BUsiness and
Professions,Code: any dty or county which requiresa permit to construct, ''2lr.:~i, improve, demolish or repair any structure, prior tq its issuance, also
requires th~ applicant fqr such permit to file a signed statem(;:nt that he i5 p;::'e~sed pl1rsuant to the provisions of the Contractor's License U:lw(Chapter
9)(coft1mencingwith Section 7000 of Division 3 of the Business and Profes3:c!ns Cede, or that he is exempt therefrom and the basis for th2 alleged
exemption Any violation of Section 70315 by any appJir.::mpor a p~rmit 8U::.l;f:";tt. the njjplic:::mt toa dvi! penalty o~ notmor€: than fiv>? ~!Jndr~d dollars
~$). '! '
'. ' ,as owner of p:operiy,or my em?loyee~ with wages as tti~ir so~ecomP:',:(lsation, will do the work, and the sti'L:cture is not ~ntend~d, or of~ered for
,ale (Sec, 7044 Busmessand ProfeSSIons Code: The Contractor's LfCeJ1SC L3W does not apply to an owne~ of pr.:>perty who bUIlds or Improves
thereon, and wh,o does such w:)rl-: himself or ~el'3~lf or.through his or !ler ow,~','(';nlploy~~s; prO'.'ided that SL:ch lmpro"f:'m:nts a;~ n:')t Inter:dE.:d 0r
off$red f:)r sale, If, however, thebuildina or improvement ~s ::;-:)(d \I-_';'l' c'ne }'{,!i! of o:)f)'".;:>ietion, \he owner..Luilder ....',;in h.1ve rhe htirdcn cf r~'r6\fing th3t,~''i€':
did not bui:d OJ improve for the purpos~of &:\e). :l ' ..' , ,
[J I, 3<3the ov.:ner ,of the property, am 'eXdusively cvrltrac.ting witi' Hcen:C>Gc }"O:ltractors.tQ construct i\)e project (See:. 70M,Husk,ess cl!',d' ProfG'$Sicns
Code: The- Contractor'~Ucenst3 law does not apply to an:owner r;-t yrOnE 1~.f:Nb') bu~d[, or improves thereG!'''!, ;;md v;;ho contrc;cts for.::uc'1 Qrolect~; with
,a.xontractor(~l licensed pursuant to the Co.ntract':>r's U'~1'3'3 L2>w). .r . . .
LJ ! am ex~rnppt under Sec, , P:C, f ~ s tea!':on'/. _ , -. -, ' :
~....{l-d'i., ',' Owner:, _:.... .' -'--:.~-=-~ ---~--------
,_. . 'WORK~R'S OMPE'TjS^T10~!. DEGl,"-R:1!'i_H__.L __,..c_.._J r liCS'lSlcD (;()NTR.l\,CTORS OECLAR.^<TION-'
! hereby affirm under pen:.1lty of pe,jury ons of the f"'llc~'Jin3 dedi:,aiion=:,: i r--rher(;~;y 3ff.r;;:nt7rld3'.fijEmaiIi c(perl'.Jr'j tlK,tS!1\....I
o I have and will maintain a certificate ofcons:ent to self-insure for WOjk~r"/!r;c'l11pe(:sation, licensed Ul1d?-r j:r<Jvis;"')!is of Ch~ptc\"9tc:oJTimenclng
as proviqed for by Section 3700 of the Labor Coqe, for the perfonnanoo ofth~h"i')p..;,for which with Section 70DO) of DiVsi6n 3 of the Businr::ss Pond
~his permit is issued.. , .~. Professions Code.
D I have and will maintain worker's compensation insurance, as required b~:, Section 3700 of 8/12/2004
the Labor Code, for the performance of the work for which this permj~ is iSSLiE:L Myworker'-s Date:
Compensatior:l insurance carner and poJiW"are:
Carrier: Polic,,! Number.
,
This section need not be completed if the pennit is for one hundred dollars ($1 \)(i!C,:'less.
'["J() certifY that In the performance of the work for which this permit is jssue'~;, I shall not ..'
~oyany"person in any manner so as to become subject to the worke(<3' cc..1ipensation laws
of _Galif?m~,.and agree that jf I should become subject to the worker's cl)mr:e!i;~8UOrl
provisjon~, of Section 3700 of the labor C , I sh II f ,ith comply with th(i'~~ provisions,
Date: , 8112/2004 Applicant: ,
WARNING: FAILURE TO SECURE WORKER'S COMPE SATION COVERi,'GE IS
UNLAWFUL, AND SHALL SUi3JECT AN EMPLOYER TO CRIMINAL PENAl nSS'AND CIVil
FINES UP TO ONE HUNDRED THOUSAI\'D DOllARS ($100,000), IN ADD nON TO THE
COST OF COMPENSATION, DAMAGES AS' PROVIDED FOR IN SECTICN 'JY06 ,OF THE
LAi30R CODE, INTEREST AND ATTORNEX'S FEES.
I CONSTRUCTION LENDING AGENCY L
I hereby affirm under:penalty' ~f. perj~ry that ~~r~ is a constructipn I~Jiding 2;; 'l,;n, cy~for the
perf.oi"mance of the-work fOr ..'-'l1len thIS permIt IS Issued (Sec.3097,CIV.C)~ "_
Le!'ldets-'_nf('lrroatio'1:~_ . .
CONTRACTOR INFORM,0710N:
ARCHITECT/ENGINEER INFORMATION:
MARGARiTO CASTillO
4721 LOS COYOTES DIAGONAL
LONG BEACH, CA 90815
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
.Garaqe Area
176
"certify that I have read this application and state that th~ above information i~ correct I,
agree to comply with all city ordinances and state laws relating to building cor,struction, and
hereby aut-t.'lorize rep tives.of this city to enter-upon t~e above mentioned property for
insp' r sa.
Date: 8112/2004
Fees paid for ~ermit:
Total:
230.96
. Signature f Applicant or Agent
The permit shall expire by limitation and become null and void if theooilding or
work has, not passed final Inspection 365 days frOm the date of permll issuance. A
new permit is required to commence or continue work.
. INSPECTION RECORD FINAL INSPECTIONS. . 'Dale' .Inspectoi
INSPECTION . DATE INSPECTOR Electrical Final . . 411'!Or ., #1), Ii
Temporary Power Pole . Plumbing Final . '. NJU...,
. . .' '.......
Plumbing (DrainlWaste Pipe) . Mechanical Final
. . I ,I. .
Electrical. Ground ElectrpdelUfer .
SetbacklFormslTrenches (Footings) 11 'IV)Y .~ -,est . .
Do not install subfloor or pour.floor slabonti'-the' Engineerif,lgfGracling Final T65.M26 .
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) Fire -oept. Final 765-404.0 ..
Mechanical (Groundwork) . . Water Engineering 765-5.268 . . . . . '.
Electrical (Underground Conduit) . . '.'
Pre-slab (\;ompaction/Membrane.Reinr. Sub List/Business License 765-519.
Underpinning (Floor Joist/Girders) i. Zoning 765-5139 . .... :
Do not cover or conce.allhe ylork below. until the Building Final \taSllnspeciion. Only . ~\Mof' 1lw~
following applicable.items have been signed: .' / .~ fter Above Complele)
1st Floor Shear \ZI(jOY PARTIAL INSPECTIONS .
Firesp.;nkler (Rough) . . Buildina Inspections
= .... ~
heathi . hragmlFrlme)
onry (ReinfJBolid BelmlPre-Grout) .
Rough Plumbing (Top Out) . JJIJ
Rough Mechanical .I"J . . '.
KOugh t:Iectncal ( II) .II; .
.
Rough Electrical' '. 11i..-"1(""'! ~~ .
Framing . 10nly after Plbg., Elee.. Meeh and Flfel />.-Uol<1 .
Insulation (SoundlEnergy) II L-?f..1 . .
00 not tape or plaster until the following applicable /u/. . Mechanical Inspections. . .
items have been signed: . - - -- .
Drywall . . . H".t)~ ',",-1 L 'r '.
. . .
Penetrations (Fire Rated) Electrical . . . .' / . .
" Penetrations (Fire Rated} Mechanical
. Penetrations (Fire Rated) Plumbing . . . ,~.
Interior Lath .
Exterior Lath Plumbinq Inspections
GENERAL ITEMS .;, .
Exterior Plaster (Brown COat) / .7,I-() .. . '.
T -Bar Electrical . .
T-Bar Mechanical .
T -Bar Structural . '. . .
. Sewer .
Water Engineering Backflow . Electrical Inspections
Water Serviee .