1214 S. Stadco Dr.
TYPE OF PERMIT
Blockwall/Columns 'CITY
DATE: .7/112003
JOB ADDRESS: 1214 S STADCO DR
LEGAL DESCRIPTION: N TR 3501 LOT 10
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. BUIWING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION.REQUEST LINE:
(714) 765 -4626
CENSUS CODE: 434
QUARTER SECTION: 3
BUILDiNG PERMIT NO. 8LD2003-02559
APPLICANT: RICHARD MIZUHARA
OWNER INFORMATION:
Richard Mizuhara
'1214 S Stadco Dr
Anaheim, CA 92804
,lOB DESCRIPT!ON;inslall 5811 block wall 6' high to cily specs.
VALUATION:. 1,392.09
c= OWNER-BUILDER!?EClf,RATION .-J
J heteby affirm under penalty of perJurf that I am exemptfr<?m the GO'!tractcr'~~ir;ense Law for the following reason (Se-c. 7a31~5 Business and
Professions Code: any city or countywhiC"h requires a permit to construct.. a!t~\r, impftJ'ie, demolish or repair any structure, prior to its issuance, also
requires the appHcent for such permit to file a signed statement that he is lice,"'iscJ pursuant to the provisions of the ContrC:::Ctor's License Law (Chapter
9)(commencing with Section 7DDOot Division 3 of the Blisiness a(l.d Prcfessit".;3 Code}':lT that he is exempt t}1eref:-c(:l and tne basis for the alleged
exempti ~ Any violationot Section 7031.5 by any applicant fOt 3" permit sUbi+~t$ the <:'!ppi\cant to a civa penalty of I')ot mote thsl')five hundred dcUars
~ . '. .
_ I. as ownel of property, or my employees w:th. w~ges as their sole: CG:r.p~115atioti, '.j'..i;:do the work. and the stnJct~re is' r,ot jntendedoi' offer:.:~d for
~,.. (Sec, 7044 Busines~ and Profession-s Code: Ttle Cqr:bactcr's License i.-1W does :.ot apply to an owr.el- cf propertj who -bulldso. improves
"thereon, and who does such work himself or herself or through.hie; or her o..vr:'~'3:iJ~:oyee:.;. provided tha~ such impl'OVemeilts are n01 intended or
offered for sale. If, ~oweYer. the-building orfmprovement is sold with on:;: i>:.::] d c.')mp:etion, the owner-builder will have the burden of proving that he' .
did not build or improve for the purpose of sale). '~: . -
C I, as 'he owner of the propertY, am ~xd~~IY _cont;adir:g with lican~ed ~c-ntractc:-s~o construct ~he project (Se(;. 7044 Btlsiness and Profes..i;)ions
Cooe: The Gontractor's License Law does ~Iot app Of/. -to a:" owner of prop.erty .;~. ho bl;::O:; Of .;lnprc'Jes thereon, uor:i woo ool1trac.1s for such projects with
~ontractor{s) Hc~nsed- pursu~nt t9 the !ltrac . U n. a',^' . t .
Ll ! am exempt under Sec. 'B -_C .fr"!'.s n: "
Date: . Owner: ---.~'-~
L . -- -- WORKER'S. PENSATIO Dr:! ARP.TjON -~:=. JL LICENSED CQ~l:RACTORS DECLARATION]
I h?reby ;:;ffinn on~er penalty of perjury one of the fo.llowin '€-::lar3.tk,;,,:s:: ., . :; .}.., . - I. I ~?reby, aff{rm ,lI~lcle:" penalfy?f,pl::lriury that I. am
o 'have and wI;1 !Tla_ intaln a certificate of ronsent tself-insure 1U-r\\'orKe:'~\cOlnpensi.r:icn, ilcenseo under prOVISIOns o~ chapt~r 9 (commencIng
as prolirded for b\: Sec(ion ;3700 of the Labor Code, fcrth~ pelformance of i~fi \/-.I0rK fer which with Section '"1000) ot Divsi<?n 3 of thp. BU6iness and
this p.e(rr.If is- iss~ed. .. ~ P!'Ofessions Code,
. 0 'ha-ve a I'!d will maintain worker's compensation ,insurance. O3.S required -b~i, Sectivn 3.700 of 7/1j200~
theL2bq!' Code, for tt)e performance of the work for which this permr, ic;.. i~IJ..:.::L My.,,&mrl<er'o:; Date:
.Compensation insurance-carrier and poiicy are: ..' ,~ I
Carrier: . '." POlicy Numbe:: . 'j .. . I NUMBER
This section" need not becompletedlfthe pennit is for onehundre-d dv!lars ($1t1l}i:i....,.jP,Ss. . . TYPE
!f'i...L certify th~t in theperfonnance olthework lorwhic9 thi" permit is is.;,'dL.' she II "o.t .
~ny -per$0n In any manner so as to be me ub.ect to iheworkcr's; c(;r"pensc:b011 IGlwS
of Califomla, and agree that if I should bee e.su e' t hewori<;E::-'s c';mi:d.1<3atton :_,
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Date: 7/1/2003. Applicant: _.'
WARNING: FAILURE TO SECUR NSATION COVE~~\~;E IS :.
UNLAWFUL, AND SHAll SUBJE AN EMPLOY TO CRIMINAL Pl:NAl~'ES AND<;I\dL,
FINES UP TO ONE HUNDRED OUSAND DOL ARS ($1CO,000),IN N)b,"tioN TQ;t\'iE !
COST OF.COMPENSATION, DAMAGES AS PROViDED fOR INSECT:Q~:'~.iQ;; OF'THE.. I.
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . .,.:. 'i '';'''''..'/';,.'',.1,
I. .. . . C~NSTRUCTION LENDING AGENCY -';/;>.:?T=J
I-h~r~~:f,,~ff~m ~nd,~,tp~_na,I1Y Pi. perj~ry that~h~~~ J:;~:;.~8,n~Y~~8~i:m.f:~?~~q. ~~?n~!..r~r.;h~~.::: . ;,1:
penOr!i'.;.o,r"ce ofthewotl< for which thIS Pt?,rrYllt IS l~s:;e~H~~~;<,l~)b'7.\...:'!..Ql;,-' {<.,_,j __--::c..~_' .', -':__:'_n '~~~-,'
LsnOerS'lnformatlon: '" - - - .
CONTRACTOR INFORMP:~ION:.
ARCHITECT/ENGINEER !NFORMATION:
PROCESSED.BY: CAL
-.._-----..--
. .
Contractor
E~PIRATION DATE
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I certify that I h read this application and state that the above information :scorrect..1
. agreeto'co y w' al ity rdinances nd state laws relating to building c.on=?t~uction, and
~ere6y.au, or~e p / se~e o~ t' tyto enter upon theabovementio~ed property for'
lnSpectJO pur se (' ._'
" Date: 7/1/2003
Signature Applicant or Agent
The p mit shall expir limitation and become null and void if the building or
work has not passed mal inspection'365 days from the date of permit issuance. A
new permit is required to commenCe orconlinue work.
- Fees paid for Permit:
Total:
66.58
, INSPECTION RECORD
INSPECTION ' DATE INSPECTOR
Temporary Power Pole ,
Plumbll1!l (DrainlWaste Pipe) " ,
Electrical Ground Electrode/Uter ' '
SetbacklFotmsrrrencbes (Footings) /1/2- {///j
Do not install subfloor or pour floor slab until the ,
following applicable items have been signed;, ' , ' '
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (Underground Conduit)
1 l're-slab (Compactlon/Membrane.Relnf.) '" .
Underpinning (Floor Joist/Girders) , ,
. Do not cover or conceal the work below until the ' ,
following applicabl~,items have been signed:' "
1st Floor Shear , , , ,
Aresprinlder(Rough) ,
2nd Floor Shear , ,
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./BOnd, BeamlPre-Grout) ,
Rough Plumbing (Top Out) ,
Rough Mechanical, " , ,
ROllgh aectrical (Ory Wall) ,
Rough EIlU:lrical ' ,
Framing (Only"atter.Plbg., Elee.. Mech.. and Fire, , , ,
Insulation (SoundlEnergy) ,
Do' not tape or plaster until the following applic;lble ,
items have beel) signed: ' , ,
Drywall' , '
Penetrations (Fire Rated) Electrical
Penetrations (Fiie Rat<ld) Mechanical , ,
Penetrations (Are Rated) Plumbil1!l ,
Interior Lath ,
Exterior Lath
GENERAL ITEMS ,
Exterior Plaster (Brown Coat)
T -Bar Electrlc,al ,
T-BarMeehanieal
T -Bar Structural ,
Sewer ' ,
Water Engineering Backflow "
Water Service
FINAL INSPECTIONS ,Date Inspector
Electrical Final " ' " I, ,
Plumbing Final ",
Mechanical Final ' . "
Gas Test ,
,
Engineering/Grading Fina.l 765-5126 ,
Fire Depl. FinaI765-4040 , .
, '
Water, Engineering 765.5268 .. ," , "
Sub List/Business License 765.519'
Zoning 765-5139 , ,
Building Final ~astlnspection.Only , "
' fter Above Complete)
PARTIAL INSPECTIONS
Building InsDections
, MechanicallnsDections
PlumbinCllnSDections
EllictricallnSDections
PERMIT EXPIRED
,INSPECTION
NOT COMPLETED
OA TE:~1.-'t\b~'
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BY
fLOOO ZONE:
SEE BUilDING PERMIT
FOR ANY COND\\\ONS
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NOT At->F-~j:{bvt=:- V'IOLA1ION OF ANY of'
THE BUll.DING CoOE:S OF THS CITY.
THt:S 'r\O\.-Dr:::R OF -rH I S pE:,RM\"T
PROCEEDS AT HIS OWN RISK.
JUL 0 1 2()G]
@\J\kQ\N~ t:l\V\~\aN Of ANAtlt\M
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