2241 E. South St.
BUILDING PERMIT NO. BLD2005-03831
TYPE OF PERMIT
Blockwall / Columns C I TV
DATE: 12/1/2005
JOB ADDRESS: 2241 E SOUTH ST
LEGAL DESCRIPTION: N TR 1987 LOT 62
APPLICANT: WILLIAM PARK
OWNER INFORMATION: CONTRACTOR INFORMATION:
WILLIAM L PARK
2241 E SOUTH ST
ANAHEIM, CA 92806
JOB DESCRIPTION:Build 6' by 72 linear It. of block wall per city specifications.
VALUATION: 4,300.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUESTLINE:
(714) 765- 4626
CENSUS CODE: 434
QUARTER SECTION: 113
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
hereby affirm under penalty of perjury that J am exempt from the Contractor's Ucense Law for the following reason Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter. improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to tile a signed statement that he is licensed pursuant to the proviSions of the Contractor's License Law (Chapter
9)(oommencing with Section 7000 of Division 3 of the Business and PrOfessions Code) or that he is exempt therefrom and the basis for the alleged
~exen;\tion. Any violation of Section 7031.5 by any applicant for a permit subje,;ts the applicant to a civil pena~yof not more than five hundred dollars
I, as owner of proper:tY, or my employees with wages as their sole compe~sation, will do the work, and the structure is not intended or offered for
ale (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves
hereon, and who does such work himself or hemelf or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed cOntractors to construct the project (Sec, 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyw:lo builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Cont ctor's License Law).
W I am exempt undpr Sec. ~ & P. . for this rea :
ate: Owner:
WORKER'S C M ENSATION DECLARATION
I hereby affirm under penalty of perj ry one of the following declarations:
o I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the pertormance of the wolk for which
this permit is issued. '
o I have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: Policy Number.
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
R I certify that in the perfonnance of the work for which this permit is issued, I shall not
~Ioy any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become ject to the worker's camp Ion
provisions of Section 3700 of the Labor Code:-..! s all forthwith comply with e provisions.
Date: 12/1/2005 Applicant:
WARNING: FAILURE TO SECUR W ER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJ T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDI110N TO THE
COST OF COMPENSATION. AMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST A D ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance ofthe work tor which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
I certify that I have read this application ~,nd state that the above information k-=~rr~t. I
agree to comply w~ aIr city ordinances and state laws relating to building construction, and
hereby au erize re resentives of this city to ente on the above mentioned property for
in eet' pur: Q
Date: 12/1/2005
Signature of Applicant or Agent
permit shall expire by limitation and become null and void if the building or
w k has not passed final inspection 365 days from the date of permit issuance. A
new oermit is reauired to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000} of Divsion 3 of the Business and
Professions Code.
12/1/2005
Date:
I
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
NO
Fees paid for Permit:
Total:
133.28
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temoorarv Power Pole
Plumbina (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer Jj
Setback/FormslTrenches (Footings) I2J~Ic; ..\A...I o~ik'
Do not install subf/oor or pour flool slab until the
following applicable items have been signed:
Plumbina IWater Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) -
Masonry (Reinf./Bond Beam/Pre-Grout) M L. oJ
Rough Plumbing (Top Out) " /
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
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) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical
T -Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backf/ow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control (714)1654280
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only /v~ /,C:
After Above Complete) 1.#1
/
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
PlumbinQ Inspections
Electrical Inspections
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THE {SSUANCE OF 7H1S PERMIT DOSS
NOT APPROVE VIOLATION OF ANY OF
THE 8UIL!:)~':',il':: ('~(':"'F-S OF THE CITY.
THE He" ,"_.,- THIS PERl\!I1T
PROCE~~_:..J,J i'.l,T r-iIS OWN RISK.
DEe 0 1" Z005
BUILDING DIVISION OF ANAHEIM
APPROVED
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