7695 E. Silver Dollar Ln.
BUILDING PERMIT"NO. BLD2004-03362
TYPE OF PERMIT
Non Residential Addition" C I TV
DATE: 911/2004
JOB ADDRESS: 7695 E SILVER DOLLAR LN
LEGAL DESCRIPTiON: TR 117 LOT 14 LOTIN LOT(AND LOT IN
APPLICANT: GENE "SECREST
OWNER INFORMATION:
DaviQ G Kalb
7695 E Silver Dollar Ln
Anaheim, CA 92808
CONTRACTOR INFORMATION:
" SECREST OF CALlFORI~:A
121 S CANYON CREST DR :
ANAHEIM, CA 928080000:
BUSINESS PHONE: 714974-4280
ARCHITECT/ENGINEER JNFORMATION:
SHUCRI I YAGHI
112 E. CHAPMAN AVE. "0"
ORANGE. CA 92866
JOB DESCRIPTIONl\ddltion to SFD
VALUATION: 28,000.00
I OWNER-BUILDER PECLARATION
I hereby affirm under penalty of perjury that I am exemptfrom the Contractor'? License Law for the following reason (See, 7031.5 Business and
Professions Code:"any city or county which requires a permit to construct, alth. improve, demolish'or repair any structure; prior to its issuance, also
requires the applicant for such, permit' to file a signed statement thathe is lice~sed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business andProfessicns Cede) or that heis exempt therefrom and the basis for the alleged
exemption. A,ny violation of Section 7031.5 by any applicant for a permit subjkcts the applicant to a evil penalty.of oot more than fiVe hundred dollars' .
.~~ . .. . . i . .. .
D I, as owner of property, or my employees with wages as their sole .compt-nsation, will d0 the work, and the structure is nct intended qr offered for
.sale (Sec. T044 Bus.iness and Professions Code: The Contractor's License l)3W does not apply to an owner of property who bu{ldsor improves
thereon, and who does such work himself or herself or through his 9r her ow~cmployees, proVided that such improvements are not intended or
offered for sale. If, however,~he building or improvement is sold with one Y<"l,(r of oompletion,.the- ownp;r-builder will have the burden of proving that he
did not build or improve for the purpose of sale). , I'. . . .
, "
D I, as the owner of the property, am exdusively contf"?lding.with licensed !.'Ortractors to construct the project (Sec. 7044 Business and Profession~
Code: The Contractor's License Law does not ':!pply to an'owner.of property li:hO builds or improves thereon, arid who contracts for sud1 projects with
~<?ntrad?r(s) licensed pwsuant to the Contractor's License Law). -'l .
U I am exempt under Sec. , B & P .C. for this reason: _J, .,'
Date: Owner:
r . 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 work~r:~ ccmpensa'lion,
as provided for by Sedion 3700 of the LabOr Code, for the performanre oftf'~ ""0;-''< for which
this permit is issued. ' .
o I have and will maintain worker's compensation insurance, as required b~ Section 3700 of
the Labor Code, for the performanceof the work for which this permit is issue':.!. Myworker's
Compensation jl'}surarice carrier arid polrcy are: :
Carrier: Policy Number. EXEMPT
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE: "
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 202
PROCESSED BY: PMK
9/112004
Date:
ThiS section need not be completedi'fthe pennit is for one hundred dollars ($100;' or less.
.0 I certify. that in the perfonnance'ofthe work for which this permit is iSStle~. I shall not
employ any person in any manner so as to beco e subject to the worker's compensation laws
of California, and agree that i( I should becom bject to eworker's compensation
provisions of Section 3700 ofthe Labor Co ,shall hwi comply with !!1r:se provisions.
NUMBER
317073
TYPE
Cohstrucion Tvpes:
VN. .
Fire Sprinklered?
Date: 9/1/2004 Applica '.
WARNING: FAILURE TO SECUR ORK 'S COM ENSATION COVER:,GE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
. FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDrnON TO THE
COST OF COMP'ENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . .
I CONSTRUCTION LENDING AGENCY.
I hereby .affirm under penaltY of perjury that there is a construction lending ahen~yfor the'
performance of the work for which this permit is issued (~ey.309? ~Civ.C): il. 1. C'
Lerfoennnformatiol.C-' ' . ,....'. . ,.
____.: ~o='''''_'---'_",,,,_-;..
, . . ,
I certify tha't I have read this application and state that the above information is correct. I,
agree to comPI.YWit I city ordinrn. c and.state laws relating to building construction, and
hereby -authorize se. es of thi. to enter upon the above mentioned property for
insRedion pur ses.' . .
Date, 9/1/2004
'/ 'Signa of Applicant or Agent
The mitshall expi~e by limitation and becoll1l1 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.
Gontractor
B
EXPIRATION DATE
9/30/2004
NO
~-'-.___;~,..:..._ ___,:_~-: ~_.C'.___
Fees paid for Permit:
Total:
987.59 .
. 7r'
. . INSPEC.TION DATE' INSPECTOR Electrical Final .~ ~/"-b< ~
.' .
Temporary Power Pole PI.umbing Final 2,-2-' Z,\ ~
Plumbing (DrainlWaste Pipe) Mechanical Final Z--vo, ~ .(',
Electrical Ground Electrode/Uter Gas T e~t ,A- Il /
SetbacklFormsrrrellches (Footings) . ' '.
Do not,install subflooror pour floor slab until the Engineering/Grading Final 765-5126 '. '
following applicable-items have been signed:.
Plumbing (Water Pipe.5prinkler ValveS) Fire Dept. Final 7654040 . "
Mechanical (Groundwork) . Water E,ngineering 765-5268 ' . r
EIeC!:rical (Undergroun~ Conduit), . Sub ListlBusinessLicense 765-519 $"~~6't 1/1. .
Pre-slab (CompactionlMembrane.Reint .~,
. .
Underpinning (Floor'Joist/Girders), Zoning 765-5139 . . .'"
Do not cover or conceal the work below until the . ~ast .Inspection. Onl'~ ~ ~ i7fo( 14, '.' / --"
followrng'apP'lj_c~tlle.items have been'signe<;1:": , , Building Final fter Above Complete
1st Floor Shear ' . '1-'7 -0 ,fj , . PARTIAL INSPECTIONS'
FireSprinkler (Rough) . " Buildinalnspectioils
2ridFloor Shear . "1'
RQof (SheathinalDiaphragm'Frame) 4 Z-t>';? ~ . ,/
/\ -' . ..
Masonry (ReinfJBond Beam/Pre-Gl'O\It) ~ .
Rough Plumbing (Top Out) .
Rough Mechanical . , . .
Rough E1ectrlcallllrY Wall) , . . .
Rough Electrical. ". , t, . "
Framing' (Only af", Plbg, Elee. Meeh anQ Fi'el b-f,;'-04~ .
Insulation (SoundlEnergy) , .' ' . Mechanical Inspections
,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)Plumbil1ll ,
. .
Interior Lath . .Plumbina Inspections
Exterior Lath .
.' ' GENERAL ITEMS ~/
Exterior Plaster (Brown Coat) 'II. I, V-I # .
T .Bar Electrical, . .
T -Bar Mechanical, . , " . . ,
.
T -Bar 'Structural '. ' ,
, . .
Sewer . . . . . . ' '.
Water Engineering Backflow , . ElectricallnSDections
Water Service '.
. "
INSPECTION RECORD
FINAL INSPECTIONS
, Dale
In eclor