2117 S. Spinnaker St.
TYPE OF PERMIT.
Palio Cover
-"!'~_._~
DATE: 6/18/2004
JOB ADDRESS: 2117 S SPINNAKER 5T
LEGAL DESCRIPTION: N TR 2691 LOT 4
BU!LDING (YVrS'If:lN
200 S. ANAH~iM 8'-'/D.
(714)760 - 5153
. INSPECTiON REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 99
. BUILDING PERMIT NO. . BLD2004-02503
APPLICANT: EVONNE; MORTON
OWNER INFORMATION: CO~TRACTORINFORM"TION:
Dane ne Dalton SOUTHERN CAlIFORNll', R00!\:S li~C
2117 S Spinnaker St . 14104 E FIRESTONE BLVD
Anaheim, CA 92802 SANTA FE SPRINGS,OA [06070000
'. .... . BUSiNESS PHONE: 800 60;'-5223
JOB DESCRIPTION:inslaIl216 sf patio enclosure per ICBO # 1968 P
VALUATION: . 4,000.00 PROCESSED BY: ODe
I ..... . . .' OWNER-BUILDEIi.DECLARATION.... . ..... . '.'
I hereby affirm under penalty of perjury that I am exempt from the Contractur's Licens,e law for the follov.,,:lng reason {Sec._7031.5 Business ~nd
P'rofesslqns Code: any dty or county which requires a 'permit to construct. alt~~r, .improve. derflC)lish or repair any structure, prior to'its issuance:' also
requires the appJicantfor such permit to file a signed statementthathe.is fiC~1sed purSllant td.the provisi.ons of the Contractor'~ Lic,enseLaw (Chapter'
9)(COl"J\lTI~ncin9with Section 7000 of Division 3 of t.he_Business and Profess;~ins Code) orthat he is-exempt th6refrom_~nd the ba.sis for. the_alleged
exemption:- Any vio'lation of Section 7031-S'by ~ny applicant for a penilitsub:ects the.applic.ant to'a d.viJ penalty afnot Illote than fiye bundred d,olJars
~~ ..... . . '" .' .
o I, .as. owner of property,or my employees with wages as their sole_ c,?mpi~!1sation, wi!! do'the'work, and the structure is not intended or offered for
sale (8eo,7044 Buslness and Professions Code:' The Contractor's License Law does not applyto'anowl1erof propelty.whQ builds_ or improves .
thereon" and. who does such work himself orherseff orthroug.h his or her OWl';' employees, providedthat suchirnprovements are.not intended or
ofr'ered for sale. _ If., however, the bUilding or'improvement' is sold with one ye:3-r of completion, the 0wner-builder will have the burden of proving that-he
did notbuild'or improve for the purpose of sq.le). .
o I, as the owner of the propertY.- 'am exdusiv~iY' contracting w~h licensed<".,ntradors to r.anstructthe project (Sec. 7044 Business and ProfesSions
Code: The Contractor's License Lawdoes not apply ~o an owner of p,ropelty;:vho builds=dmprqves thereon. and who oontracts for ~ud1 projects w~h'
: ~ontractor(s) Ii,cense~ pursu~rit,to the Contra~tor's Lice~se Law).' .
~LJ ,I anrexemp.t under Sec.: . ,8 &, p,~; for thIS reason:
Date: Owner: '
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under'penalty of per jUIY one ofthe rollowing declaraUoils:
D.' I have and 'wHl maintain -a ~'ertifi~ate of_ oonsent to 'Self-insure for worke/, 'compensation,
a~ provided for by Section,3700 of the Labor Code, for the performance of-th'~ work for whidl
this ~rmit is issued.- ..
o ,', .have andwill maintain worker's,compensation insurance, as required O'i" ,Section 3700 of
the Labor Code. for the performance of the..workfor which this permit is iSSl.:~:t_ Myworker's
CompensatiOn insUrance carrier and policy ,are: .
Carrier: . Poli(j; Number:, ,E?<EMPT:_
This Section need not be completed if the pennit is for one hundred dollars ($1 OuIor I.ess:
0.-' certify that in 'the ,perfonnanceof the work for which this p~r'rT\it-is i~'U~'.1, I shan ~\ _
employ any person in any manner so as to becomesubject.to theworkets cf)mpensatiti".Jaws
of California, and agree that if I, should becofTIe- su bjed to the W?r1<er's com!>.~nsation ','.'
. provisions of Section 3700 .cfihe la,bor Code,-I shall forthwith c:omply Wi~. ttose tJrovisions.
. ARCHITECT!ENGINEER iNFORMATION:
L.ICENSED CONTRACTORS DECLARATION
I hereby affirm und.er penalty of perj\Jry that:' am .
licensed under provisions of chapter 9 (coinm'encing
with Section 7000) of Oivsion, 3 of the Bus!ness and
Professions'Code. .'
6/18/2004
Date:
Contractor
NUMBER'
827937
. TYPE
B
. EXPIRATION DATE
1.2/31/2005
Date: 6/18/2004 Applicant: '
WARNING: FAILURE TO SECURE WORKER'S COMI?ENSATlONCOIiER'IGE IS <G;,;:.
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN."'-TiES AN):iCIVIL
FINES UP TOONE HUNDRED THOUSAND DOLLARS ($100,000), IN MDmON TOTj;E
COST OF COMPENSATION','DAMAGES ASPROVIDEDFOR 'i.N'S'ECTIC,.; 3706QF,THE
. LABOR CODE, INTEREST AND ATTORNEY'S FEES, . ,'" ..,
I . '..' . . CONSTRUCTION LENDING AGENCY,,__::,-
I hereby ~tfirm ur.d~rpenaltyofperjury.that.there is a ';onstrlJctionl-enc!,i~~g_~G_e-~~y_~or,!;~~
-performance oi tJ:ae woridor Whrd'.-this perinn is issuea_\::;€.c.3v~i' .CIV.C;;: -, - ,_:"':'-
I,.ender"s Information:
Construcion Tvpes:
VN. .
Fh e Sorinklered?
Patio Area:
NO
216
! certify that I have' read this application and &tate that the above . informatiol)' is correct. I.
a~ree to oomply with all city ordinances and state laws relating .to b\Jadlng, construction, and
hereby authorize rE:lpresenti~es of this city to enter upon the'above_mentioned property for
i~pedion purpo.ses.
Fees paid for Permit:
Total:
189.43
Dale: 6/18/2004
'Signature of Applicant or Agent
The permit shall expire by limitation and b~ome null and void If the building or.
work has notpas~d final inspection 365 days from the date of permit issuance. A
new. permit is required to commence or continue work.
INSPECTION RECORD . .
, . . .' . . . PATE
.. INSPECTION . '. . INSPECTOR
Temporary Power Pole' . . '.
. PlLlmbing (DrainiWaste Pipe) . . .'
Electrical GrOund EhlctrodelUfer '. .
Setbacl(lI"ormsfTrenChes (Footings) . ' . ",
DO n.ot install subft60r or pour floor slab i.,"tilthe
fol/owin~i-applicabJe.items' have, been: sigoed{. . .'
PllJmblng (Watilr Plpe.Sprinkler ValVes) .. . '. .
, Mechanical (GrOundwork)" . .' . . . . .
I Electrical (UndergrOUnd Conduit) .. .
. I'Ie-Slab (\.;ompaction/Memllrane.Reim.
I Underpinning (Floor Joist/Girders) .... . .
\JO I'Ipt.cover or conceal the. work bel.ow until the .
'.followll)g applicableitel]1s have been signed: . .'
1stF.loorSh"ar , .' .. .' .
. .
Filesprinlder (Rough) '.
. 2nd Floor. Shellr' . .' . . . . .'.
ROof (S""alI\iIlg/Diaphragm'Fram!l) .
Masonry (ReinfJBClnd BeamiPre-Gl'OIIt) . .
Rough Plumbing (Top Out) '. '.'
Rough Mechanical' ' . '. .
, Rough 6l!Ctrlcal II}
Rough Electrical . ." .
. Framing. (()nlyafter Plbg.. Elec.. MectLand. Fire) . .'.
In!5Ulatlon (SoUndlEnergy) '. '.
PO not tape or.pla~ter until the followingapplic!,ble ....
I.tems have been signed:. ..... . . '. . .'
DryWall . .... ".
Perietrations(FiI1l Rated) Electrical .
Penetrations (Fi", Ratep).Mechanical. .
. PenetratiOns (File Rated) Plumbing . , .
Interior Lath : . . . . ,
Exterior Lath, . , ... ,," ,
. . "" GENERAL ITEMS
Exterior Plaster (Brown Coal) .
T -Bar ElectriCal , ... "
T -Bar Mechanical" . ,
T -Bar Structural . ", "
Sewer, " . ' . ,
Water Engineering Backflow ,
Wat"r Service' . ,
FINAL INSPECTIONS' O~te '. Inspector
Electrical final . . . d, .' .,:
. " . '
. , . . " ., ,~.
Plumbing final , '. "
"
Mechanical Final , ,
Gas Test , : ' '.' '. ' ,
.
Erigineering/Grllding Final 765-5126 ,. ,
Fire Depl. Final 765-4040 . .' , . .
"
Water Eiigineer,ing 765-5268 . .:... .
Sub ListlBusinessLicense76S-519 . .
. .
Zoning 765.5.139 . ..' . :
. .. . .,
Buildlng Final . ~asUnspection. Only.' '.
.. . .. fler Abov.e Complete). . .
.' . .. PARTIAL INSPECTIONS
BuildinQ Inspections
. Mectlanicallnspections .
Plurnbinalnspections . .
Electricallnspecticins
Pr-,.-" A\' r')fnt' K-'..;- D
)c..K\V!1 t.\riL .
INSPECT!ON
NO T'.t 0 M PLETED ....
DATE: I.