8688 E. Silver Ridge Ln.
TYPE OF PERMIT
Residential Remodel.
~":'.. .,' ,
CITY ~ilHE'M
\~?*'~,~;:~?!/ .
,,:<~.~}- ';"';"-<
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 232
BUILDING PERMIT NO. BLD2004-03637
DATE: 9/28/2004
"JOB ADDRESS: 8688 E SILVER RIDGE LN
LEGAL DESCRIPTION: N TR 15074 LOT 37
APPLICANT: DAN ESHKOL
OWNER INFORMATION:
Kurt Odegard
8688 E Silver Ridge Ln
Anaheim, CA 92808
ARCHITECT/ENGINEER INFORMATION:
DAWN M PASOL
1201 N TUSTIN AVE.
ANAHEIM. CA 92807
CONTRACTOR INFORM.'TION:
SHORELINE CONSTRUCTION
12116 SEVERN WAY
RIVERSIDE, CA 92503 (JQdo
BUSINESS PHONE: 90973,,9905
JOB DESCRIPTION:Add freestanding exterior fireplace in rear yard.
VALUATION: 2,500.00
I .OWNER-BUILD!;:R.PECLARATION
t hereby affirm und~r penal_ty of perjury that I am exempt from the" Contractor~s License Law for the following reason (Sec. 7031.5.Business and
Professions Code: any city or'countywhich requires a permit to cons~r!.JCt. ?.tt;~r, improve, demolish or repair any structure, prior to its issuance, also
requires the applica ntf<?r such permit to' file a signed statement that he is licsbsed pursuant ~ the provisions of the Contractor's License Law (Chaptei
. 9)(commencing wi~h Section 7000 of DiVision 3.of the Business and Profess;~.r;s Code) or that he is exempt therefrom and the basis for the alleged
exerpption. Any violation "Of Section 7031.5 by any applicant for a parmit :!Hlb!ects the npplir.anUo a dvU penalty of not more than fivehundrp.d dollars
-~. ...
o I, as owne'r <?fproperty, ormy employees .wi~h wages astheJr sole cnm~msation" Will do the work, and the structure is not int~nded or offered for,
sale {Sec; 7044 BusinessandProfessionsCode: The Contractor's License 4'9'N does not appJyto an owner,of property who builds or improves
thereon, and who.does SOdl work himself or herself-or through his or her m...'.~ nffipJoyees, provided that. such improvements are not intended Of
offered fpr sale.' If, howeve'r; the building or imprcvem'3nt is sold 'v/ith'one ye~l of romp~etion, the owner-builder will have the btircien of.proving' that he
did not build or improve' for thi3' purpose of sale). " ; .'. '.. .
[] I, as.the owner of the property, am exdusively contracting with licsns~tj b::ntradors to construct the project. (See. 7044 !3L:siness and Professions
CoP'e: The Contractor's 'license Law does not apply to an 0yvner ofpropei'::J,:",hO builds or improves thereon,' and who contracts for such projects with
Montractor(s) licensed ptfrsu~nt to ~he COl.1tractor's License Law}: . ! . : . . . '
U I am exempt under Sec. ,1,-', ~ B ,& P.C. for this reason: '- , ," '
Date: Owner:
""
c= WORKER'S COMPENSATION DECLARATION ,
I hereby affirm under penalty of I'erjury one of tne following declarations; i-
o I have and will.maintain a certificate of consent to self-insure fer warK<-~<:_carnpef1sation,
as prOVided-for by SAction 3700 of the l.abor Code, for the performance ofth;! 'NOrk for which
'this permitis issued,' - . " . . . 1 '.'
-hi'.. I have and will maintain worker's compensatiSln -insurance,.~.s requiiad br Sec.tion. 3700 of
~,Labar'Codej for the performance of the work for which thi..~ permit is iss;.JI--'j Myworker's
Compensatibn insurance,carner and potiC)" are: . . '.
Carrier: EXEMPT .' '. Policy Number: EXEMj:.'"Tj- NO EMPLOYE'
i
This section need not be compl~ted if the pennit is for one hundred dQllar~ ($1 (.q or less.
o I certify that in-the perfonn~nceafthe work far which this permit is. issue\'! ~all,not .
employ any person in any manner so as to become subject to the worker's c:;:npensation laws
of Califomia, 'and.'agree that in ShOUld'b..ecame subject to the w.::~ornj::("..,~")Sation
provisions. of Sectio~3700 of the Laboi.?Ode, I Sh~fl-~~~~~~ns.
Date: 9/28/2004. Applicant: ~ ~ "
WARNING: FAILURE TO SECUR WORKER'S COMPENSATioN.COVEP,\GE IS
UNLAWFUL, AND SHALL SUBJE T AN EMPLOYER TO CRIMINAL PENAI.TIES AND CIVIL
FINES UP TO ONE .HUNDRED THOUSAND DOLLARS ($100,000), IN ADDiTION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO~'i:;706 OF THE
. LABOR CODE, INTEREST AND ATTORNEY'S FEES. . ' .
L . CONSTRUCTION LENDING AGENC':, "
~~"";;.~y',~J~~iincl~:"i~;=;<z~~~d-,~:;'f;t:rj~cth~~Jher~"!-:o...l.~"-?o:::cl::~;:.-;.:'....;:c-~d::",","" ::."J,..,:::,-":/ fo, .~~e
perfarman're of the w<?"rk for whiCh 'this permit is issued (Sec.3097 .Civ,C):
Lender's Information: .
PROCESSED BY: MSM
---1
~
LICENSED CONTRACTORS DECLARATION. I
I hereqy affirm under penalty of perjury that I am -
Irt;ensed under proviSions of chapter 9 (ca~me 'n9
with Section 7000~ot Divsion ~ e Bu' san
profeSsJo~ Cflde.
9/28/2004 YJ-
Date: Contractor
NUMBER
742331 .
TYPE.
TYPE
EXPIRATION DATE
11/30/2005
B
C53
Construcion Types:
V1HR. ,
Fire Sprinklered?
NO
,.,
I certify that I have read this'application and state that the above information is correct. J
agree'to comply' with all city ordinances and state laws relating to building'construction, and
hereby authorize representives~f thi' . I' u~Jiloe above mentioned property for
.i~(!Bcttonpurposes: . .~~ . ~..
~ . .~ Date: 9/28/2004
. Signature of Ap'plicant or Agen . .
The permit shall &xpire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permitissuance. A
new permit is required to cOmmence or continue work.
Fees paid for Permit:
Total:
233.64
INSPECTION RECORD.
'. INSPECTION c' . . DATE INSPECTOR
Tempora'yPower Poll; .'
Plumbing (DrainlWaste Pipe) . .
Electrical Ground Electrode/Ufer .J J
SetbacklFormSfTren.ches (Footings).. . I1.ZR-l)
Do not install sUbfloor."r pourtloor sl'lb until the
following applicable if~ms have been' signed: '.
Plumbing (Water Pipe.Sprinkler Valves) . . .
Mechanical (Groundwork)
Electrical (Un~rground Conduit) . ."
Pre-slab (Co"!pactionfMembr"",,.Reinf.
Underpinning (Floor Joist/Girders).. c... .
Do. not cover or .conceal the wort< belDIN until the .
following app'lk;aqle items have been signed: . . . '.,
1st Floor' Shear . .... .
Fin.Sprinkler (Rough) . '.
2nd Floor Shear .. . .
Roof (ShealhingfDiaPhragm'Frane) ~ tH
Masonry (ReinfJBond BeanlPre-GlO\Itj J YI.l ~.
Rough Plumbing (Top Out) c
Rough Mechanical
, l'lOugn ElectriCal (Dry Wall} .
Rough Elecirical .' . .
..
Framing - {Only after Plbg.. Elec.. t".lech and Fire)
Insulalion (SoundlEnergy) .
Do not tape or plaster until thelollowing applicable'
items have been signed: ". '. - .
Drywall '.. . '. . .' .
Pehetralions (Fire Rated) Electrical
. Penetralions (Fire Rated) Mechanical . .
Penetralions.(Fire Rated) Plumbing .....
Interior Lath
Exterior Lath . .'
GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical ' '.
T ,Bar Mechanical
.T-BarStructural .
Sewer .
Water Engineering Backflow . .
Water SerVice
. .
FINAL INSPECTIONS Dale Inspeclor . ..
Electrical Fjnal
Plumbing Final
.
Mechanical Final'
Gas Test
Engineering/Grading Final 765:5126 ,
Fire Oept. Final. 7654040 .
. .
Water E.ngineering 765'5268 . . .
Sub L.;st/Busines$L.icense 765-519 .
'.. .
Zoning 765-5139 . ..
Building Final ~ast Inspection. Only . ~~9..v( ~II' ",.L,/.
fler Above Complete)
PARTIAL INSPECTIONS .
Bui/dinQ Inspections
Mechanical Inspections
,PlumbillQ Inspections
Electrical Inspections