1220 N. State College Blvd.
~".
,
;..
....CERTIFIC~TE . OF ,'OC.CUpANqY
..... . City' Of Anal1eim'.
'~iS ~truct~re has b~en inspe~ted pursuant to to ~~ CBC-2001 Edition as adopted and'
amended byTheCili of Anaheim, . ~~~""0'~~,&" (/~: ,
Any change in the Char~cter?f occupanc! K:bt$;:~Qf~"~hiS bJdln 'S1t~.. ;g.~laoe'the building,in a different division
or group of occupancies requires a new "rtitia~r~of upancy.:\ ~\"'r;~ '1fl~' .',.
Ii ~ ~l!t!l ' '\'. ' "
DES~RIPTION OF OCCUPANCY: , I~ f'~ ., '~~~{~{r~~~ .~ . "
OCCUPAN?Y CLASSIFicATION: A2.1 ~1 r.. . "~il~~)~~ ~IT:BLD2003~01217 "
,....NO.OF :8T<?BIES: 2/'... ". ...... \.i ,.?W{;tlq~ R ,EA: 8,,124 .
CON~TRUCTIONTYPE:. VN.'FIHE.S'~~I~./ ....
", : BUILDI~GOWNER: INSTITUTSQ ~ .' 'r!'
. BUILDING Am:iRESS: 1220 N STATE COL '~~~e~i1i D."
.':- -,"..;.,.' '. ';'-:.". . .. ,',.' -', '. ",- .
, . 01\;E OFI~$UANCE:1 012612005
:PROCESSED BY:. Jose,Jjimmez.
.- ;
JUUEA. SEAY, C..'
BUILDING OFFICIA .
. OFFICE COpy. .
. fbldc<ifo .
'" '."..
.',
TYPE OF PERMIT
Non Resic:ential .4ddition
~--~"-~ ....."~...
BLD2003~1217 ., /t~:~:~~~~;, . J ..
efT" ~\~~.t~HE.M
1220 N STATE COLLEGE BLVD .. .\~{.t~~~'~t/i .
EUILDING DIVISION
200 S.ANAHEIM BLVD..
(714) 765.5153
INSPECTIClN REQUESTI.INE:
(714) 765 - 4626
l?l.:1I.0ING PERMIT 'lO.
DATE: 101812:J03
JOB ADDRESS:
CENSUS CODE: 431
QUARTER SECTION: 111
LEGAL DESCRIPTION: SOUTH PLACENTIA TR #2 LOT 4 POR OF '
CONTRACTOR 1~;Fom".^:T10N:
F T R INTERN.'; TIONAL i::;C;
5 PARK PlAZA #1240 .'~
JRVINE, CA 92614 J000 . ~I _ __
BUSINESS PHCNE: ~-l9 2ft-c17D
JOB DESCRIP110NAddltiori to the eXlstign.church ~t$iamic !i\~tit\J-j'i r;~ C'rc.n(t~:c.0t.;lty): Phas~ I! - refer to BLD200Q-03444 fur tile 1st Phas~.~ COR No.
VALUATION: ~5il3S~oo.oc . . . 1 PROCESSEG 3Y: CD:' .
fn. . ".' OWNEf~B;;jL:)i:;(J:'~ECL.ARATION'
~J heJ"eby ajf~qn w,aer ~enal[}' of p~nvrlthat.l <JiJ'! exerr.pt fiQr.11h~;'~,,:,!.r.~;c~~~~;f:~:_lq?~-:.se~aw ff'r: the f01~;)wing reason '{S<,:c. 70~1.e Busrness ~n~'
Prc:c~&icns Cod?' any city or .county wh:Ch requires a p,:rm:: to c,:,...:;~r'F;t. jE;\:;,_:~i=.ro':~, <j~r'!'Vlic:;!-:. or./r:-:polrany s\n.:ctl:JrQ, prior to. its i~uCtnce. also
rbC!t1:r.;:s the applicant rOf such per,,;;! to file a signed statem:?:\ ~h.;,t i.._~ .~... :;;.} :..;~pursu;;ntt~:J;j7l?1\~._0siCn$cf the Contractor's License law (Ch~pter
9!{co.r"!n:~i1C:'1~ V!:th.S'3ctlon 7000 of Dh.isior. 3 of tt-,e- 8:U$ir,t.~s '::r'!'i ?:':",;;"'"~:;~';\:: C~tln~ 0, t!-li,~h5!(_9Xem:li.tQe_rejicrr.-,and the basis fCI,:t0e alleged
~i.~iT.::!j..lI":, ~~1 .Jio~"')iio'l'of S~cl;;c..n 7031.5 by ;'l:r.y appiiol,.t fi.:( a :=O<':::"(l1;! ;:;..;::~t.-,; '.h~ opplicar:i to.a, ~Jvil,per,Cllty of p:-trr.o.,-a than fiv~ hundred -jo:!a;s
($5',)0). , ' . , _ .f'-~',':-,: ',..':.~ .., :
CJ :" a,::: O\'o'nci:;f rd~E-rty. or. r.,y employees l1tifr. wages ~s th"~i~ c;...:~~ '~L:-t:~;i:~~E3.~io... 'NH~ '.jl)the ..vcr.k. ;;ill.....; ..!"'.a:;.tl:.i~~:..i;q is, not'in.tsr'i'j~ or d:er~Hl.;.:;r':_,
:';;'113 (S3C. {:J44S.t:~;':~ss aftd Profcssior.~ Cede!; The Cor.t;act~;..':; :....;.~.,......,~~.':;P?h' .;ce.s l";1jt a;1yIY;'o <i3r1 J\"";;~i-pf ~i!':'P~rtl wh::, :':uHct;;_ox ;'!lr-rd\'e~
. ~ho:'!;son, ant ',~,:ho CC€l~ ~_uch ......,:.;-:-:. i1:1I13~jf.or he:sc.~f or trr~.u!;h Ii;:; (..i l;::,:- y '.;:,!'~~lr~~k.yoe:;, ;;n)Vjde~ t.f'I<;t~IJc.h U,:,:'''''''~r1'''ert..:r~..€; n(.t ;':::~:ldzd f)(
tJ~::!re1 ~or sc:le. ..1f,hC'..,'Vz'!~i, the lJlil_ldln9 or irrprCVeil'l..:,;1t ;S $oi':;; .:/!h ':'.:. :'~i ~p~:l.J')rr.pl~iicrj. the O""I1?r.bl)ild~r :...,j,! :"~'/~ :h~ bUI-jen -.:tP"ovin;; ;ilat =_::.;'
'(lid r'C~bujlti b":'::TIp(<;,j~.> f::r a",e f"UI":>o::>e or $l?!e). . ! f ~
j-j' I. ::;'3 theoWd~1 of a"A :';IC?~'.~. 8i":"l ''''hc)l'~l~/~(:I ~-:'ntl<'l~!I~~ ....x \ ';":: ..:.:_:;: ..t'::."-'.i:::~-:'::\~J'c.on~t,~'c~ tho'ptc;,:..;t iSei:. 7('L;' Busine3s eUl'::l.ProfsJs;')lIJ
'?)(l3.. .Th~,e::J;i::...~Ci;.r'b!:..:~~$(. LaN d:';~~11Ut_C'PP':~: !-)-.:;:n ov.~r>,=r :! :-,':;i,.;;~.!',: '_~~ .)!..!'j;d.::::':.;::'rx:)\t~-$ '.:iI~:<3~n, c;"r~ ';...~,(l ccr,tr;1crs for SUdl.r;~?;Gct3 '..::~h ,
?tt1~~.~~~~~~~~~~~CZ;:r(~;~~?l~:~ ~:~.~~'~. ~~,~~.~c~~~~ .~;:~:~~~~;:::~'. . _ __ .:~,l ~'_ ...~ .~_._ _'.. . _'~___"__'
D3tC':_:'".._...;...._.... . . ;:"I';(I.:r: __ ______ _~...;...___~,_~_..._.~_..:.:.....~~.:: ~_".._.,~._,..~.__~._. __:~.__:'"
l~'C~- ~~~=~,..~-=-~~/Ok:-s.~R.:-_~9l~.?EN.?ejjON .,i~Lti:i~~~::~~:if=.:.:=-_'=~,.~., r-. UCEffi~gi C?CNr;~CTORS OEC~A~.T!O,.!_.j
Ul-eiai,y affilTIi lJ'j(;e:- pB.-;.::'i:y cf";J"~ri..;rf (Joe of the fOllCtMUg =Ct:3i~t::':;:.j... l, . ..:. !.' !he,'tloy .:ui'!:-m under ~n(l:lty ~:perj~:y ~'-7tl ~rn
O. 'hav~ z.;-'C! .;;,11 :n.'3;;,:~::.j;! 3 'A:i"'jik;-'lti:; of ror:~ntio ~r.-irn.di"-e f',,:! ,...-:.-~\9.,.~),;c.:"p,s:'!.~~~ticri> ; l!G€r.s'.:'u IIr:dof',:;r.':wi!o';lc.m; ofchepter S(com,':1e;lc[r.~
~~ prcvided fer by ~5e~~:o.' :5700 of if'oJ L3~r Scd~, jOr'the. pnr:_ci":r.r.:'o.:~'" r/ :;":I~l..~....(.;-k f(".~'!"'fd1 i .....i',ll 3cr.~i0'1" ,-C;jm ,:.fOi...."$km;) of the ,:'Ju'$ir.~ss an..;
tl".is pe:mit ~c; issued. ' ',..: ..: ;:... . . I P(OfC%ll'nS C~Y1~" . ~/. .
~ .: have.'.C:l;,".... ".':';.!~ ~13.;11!:;11: v;o!t.er.'<; ..Cl):TI. (Jo.nsatio .'.i..n~L=(a 0 leg. "'. ..;'('<':C::'~:~d ;....~~... ,:....:.'.".....t~~;1 3700 Of', ;0/~/Z.'OO~" _~ _~~~ ~~~ _
tho. L:3:bor Co~e, for tl1$ ;J~rfc~mance af thP. V'/v;i\fo('.\,hi6:i t1,,~ ;.:~t~;:"":! k.' j,c: ",,!:.,,-__'i':iy,".)rkt->f.::- D:Jt'~: Con1.r<l..:tol"
CompensaUc;"l ir'!Sti'r.aI~(;.l::: ~'<;I,;;eri:rid potio; ar~:. -.' -- . I
C'errier:STATE FUND Policy NU:,l~"l!: :J.a~'~;Oj1;; I r:i.JMSER. EXPIRATION DATE
-h' . 't. ed.."." .,c'ffh. . 't. for. h "d I . ....: .' ! 4:S50eS ~1!30i2~04
I :sseclOl'lne r:otf)~c:ompl~..z:.ul ep'3r:n1Is .000 u~'tJre..1 c:<=l:3~:"'i;;".'fl~!S:. i TYPE A .
~. I certify that In trlF! perfomlance ojth~ ....~;Jrk ror\vhich~his CCIrr::! is ;s.~Li~;:h.;::~~.1t t1t?t . I TY~= 8
~rr-.,~_\'.:)y any per~cn in. anymanr:cr SO.as t9bE'come eubject to tr:e !:orke"::;~S'ij:t;;.i;.?Il~a[io:) :G:'fIsl T.'vPE C"iO
cf.Califomi~, and ag!'"f:e that.if I should ;~secori:c subject tothewcrXl'.;f'S cf,r~;;;-; .'!~atkm. ~vP6-' --21 .....R'I>I
~"';'isicn3 of Secticn 3"100 cf the La:r!j~e, ~hWit~ :":::. I _Y~ .....,i!h .,.,-1; n:<i;iCO:;.',JO,..1. iS~~~....tr~ic:::>n Tvpe;:;'.
Datt": 10/8/2003 AppIiQnt:.,_" ' '.d'~~.L-"S.\..;. Fir~,SprinkJerf!d?
. WARi"ING: FAILURE TO SECIJREWORKER'S CO'~PENS~-riON CG'J,,:<pe IS . ~Iu;"ber.of S!0,i.s
UNLAWFUL, AtJD S~IALL SUBJ=CT AN EMPLOYER TO Q1{;f\.HNAL PEN/\j,~~'FS I.r,lp r.!'.,/il. :,.J,e\y I.-:':ddjt:on~i Area:
;;INES UPTOC;lJE HUNDREO 11-\i)USANO DOLLARSJS100.0CC}, INI-::"';{'i(;S TQ:';'rit -.
COST OF COMPENSATION. DAIV'AG'=S AS PROVIDE6 .FOR :N Sf.CTIU~t:.~;;~ .)F:.i,iE
LABORCODE;INTEREST AND AHORNEY'SFEES. if" ..
f CotiSTRllCTION :'!:NDING AGENCY--:~) : .. . A;:-,.,
I herp-by' affirm unqer penalty of pcrj~jrYthat tr.:;re is a cO.lstr~ctio~ le~~,-~.IC~(~~:~;:;'ior ti")e :",";,y;~':~ '..' ...
~~iI9.'J?Y'.J2@ ottb:Q.x:!.pr_!s,,-~'!.:-.:'!::(t'~.~1,.;t;.i$_;::_En::,iJ j~.; .;.j_t;:j~'.~.:.~;~D20;T,GJ.tfJ:"-' ~'J.....:.';' _~, -;, i : ____..__~~_~,~_,"^_._'"___
L~l')der'.:; :r.form.2;j('tl:'
APPLICANT: TIM CABALLERO
6WNER.lNFORMATION:
Institute 0 Islamic'
PO Box 1236
are". CA ~2822
ARCHITECTIENGlt~EER INFORMATiON:
STEVEN L PHILLIPS
5PARK PLAZA SUITE 124.0
IRVINE. CA ~2614
,
..
YES
2
.&,124
.:-';'-.
I certify that I have read this application and state-that the above information i-s correct." I
; agree to romply withal! Gity ordinances and _state laws relating to building carstruction, and
herebY authorize representives of this city to enter upon tl:1e above mentioned property for
II1;:A~,~rpo#~ Dato: 10/8/2003
. . -Signature of Appli or Agent
The permit shall expire by Ii tion and become null and void if the building or
work has not passed fina. Inspection 365 days from the date of perm:! issuance, A
new' permit is required to commence or continue work..
---Fees paid for Permit:
Total:
8.943.14
INSPECTION RECORD
, ,
INSPECTION . 'CC -~ . DATe: INSPECTOR] ,
.
Temporary Power Pole . 1
Plumbing (Draill/Waste Pipe) , -,- 1
Electrical Ground Electrode/lifer, .
SetbacklFormsfTrenches (Footings) , IbtL'I'O q
Do not install subfloororpourfloor slab until the
following' applicable items have'been signed: . t
. Plumbing (Water Plpe.sprini<lerValves) '. .
Mechanical (Groundwork) ~
Electrical (Ul1derground Conduit) '1
Pre-sl3b(CorI1pactionlMembrane.Rei nt. Ib/3Dh>1 '.
Underpinning (Floor Joist/Girders) ..
Do not cover or conceal the work below until the
fOlI.owing applicable items have been signed: "..
1 st Floor Shear .
~ -.
Firesprink/er (Roughl '. .
2nd Floor Shear . .
Roof (Sheatl1ing/OjaphragmfFranel ." . - -e- li
Masonry .(ReinfJBond Bean/Pre-Grout) . -'I
Rough PliJmbing (Top Out) .
Rough Mechanical . " ': -1'
Rough 8ectrical(Drv Wall) .. . . ' (~
-t
Rough Electrical .' . ',' - "
Framing' (Ol)ly after Plbg.._t:lec,: r..1ech.. and Fire) 1",11 UP! 'J;
..1.
Insulation (SoundlEnergy) . -.'
Do not tape or plaster until the following applicable .. (-
items have been signed: . . .... .'. . .' I
Drywa!l .- .' . . , . 1101,/oA 7. ..
Penetratiol'l!l(Fire Rated) Electrical .
Penetrations (Fire Rated) Mech3l1ical
, Penetratiol'l!l (Fire Rated) Plumbing
Interior Lath ,c--
ExteriorLath . I"':>''''''
GENERAL ITEMS '. --7,
Exterior Plaster (Brown Coal) [10
T-Bar Electrical' . .
T -Bar Mechanical . , . ..
T-BarStructural. , -,-
Sewer -,-. . . I. .
Water Engineering Backflow . . '.
Water Service C--
r
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final r'-w ~
.Gas Test
Engineering/Grading Final 765'5126
Fire Dept Final 765-4040.
Water Engineering 765-5268
Sub ListlBusiness.License76S-519
Zoning 765-5139.
Building FinaIILast.lnspection. Only'
. . .. After Above Complete)
l~ c
I!::::' ~ I
. -.", v .'_" ',,__,' , .
p.'. mbin~Decti~.' ........, ( ...~. ......
. 'iJ~ . (1Y<' . '. '2~~. '.
~ '
r"
.:...'-
.
Electrical hlsDections
..
,;",.",.,,:....,..._._-,,~........~........-----"'...'--"'"'"....-....
.:.;)ILilING i'ERMiT NO.
i~~~<'~~!i~l~\. '.
CITY ~.~~HEIM
\~lJf:jf~f)/ . '.
,
LEGAL DESCRiPTION: SOUTH PLACENTIA TR # 2 LOT 4 POR OF
6LD2003-02768
I:3UiLD1NG C'IV:SiON
20'0 S.,ANAHEIM BL\/:J.
.(714) 765,5153
INSPECTiON i<EQUEST liNt::
(714) 765.4626
CENSUS CODE: 649
QUARTERSECTION: 111
TYPE OF PERMIT
Demolition
DATE: 7/11/2003
'JOBADDRESS: 1220 N STATE COLLEGE BLVD
,j
\
CONTRACTOR INFoRMttr;C>N:
F T R INTERNATIONAL \;:,,; .
5 PARK PLAZA #1240 ~
IRVINE,CA.92614'OOOO I
.' BUSINESSPHONE: 949201.3170
JOB DESCRIPTION:DemolWon of 6014 sq ft Building. . ' t '.' . .
VALUATION:' 30,000.00 '.' <'.iL. . . PROCESSED BY: ODC.< .
I .'. . '.' .'. ". OWNER-BUILDERPJ,g:LAR,\TI0N .' . .'. '. . ....."'.) ~
I hereby aff.irm ur,der penalty of perjury that I am exempt from the C?!1trac;tcr .~dc::!nsc .LdIN for the folloVJ_[l'}g reClso;:l'(Sec~!p~~';.5<I;JU&Ir!eesand
Professions Code: ~ny ciW{l( coulltywhich require~ a per~it.to cor.s~rucf;"'i~-l:r, impf()\:e,-deinoli~h, or repal~,any str~clure;pt!S~::~9)~~:i,~um;:;e, alc;o.
requires:the appl:cantfor such permit to file, a sign~ $ta_t~r,'ent that he i:.; ii..-;;('€:.'C' plJi~uant to the'provisions of the G(mt'a~i?r's_ ~i9f.l.lse:_Law.{Ch3pt~r _
9)(c.omm.:til::..bg 'J:.'itl, Sc::.t:on 10C09f ub.i$lcn 30T l.ne BU:;'~!1ess:and F-rof~~~;n', Code) or that he.Is exerr.pt th_:;,~jromar.d.,th~,b."3,sjs:fortl1eaJ.lE:fj~r1
exen.!=.'l!on. !~r,~i 1j;(\:3ti,)r. ~; Sec::!ir,r: 70:1'! 5 l;y :Jr.y. applicai'"ltfor ape~m!t ?:&bt;!.:~ ~he applicar:.tJoa civil pena:ty of ncJ rn()'rethanfl'lehu:1dred ~_:::1I3rs
($500). . "', .. .' 'c;,J. . c'. . '. c">>">" ..
[J I, as.owner_of property,~r r:"~ ~f":lrJloye~ wit:, W2'~~~ ~~s tl1~:I:,,5()le.c~\:r.):;:'~.::;:l.'?~,':";J -,;o,thc.wor,<~. a:1d the strlichJrek;'l!qf,in~_~_nded OrOffi:.>ied icr
sal.a (S~c. 7044 Business ~nd Pr()f,cssiuns Cede: .'"1"",,; C.c.ntre:(':to;'s'Ucenl;~~\~W dO-,,::.,:;ot apply to anCWt~sr-qt proper~t\~/~f),~!?Ui.I~~:.Clr_imprO'J~z,
therec:.." :and who does such work:hifnself, orl':erse!f or through hh.. cr,hd,t~f~~_~r''''lp_:,,"'l:!(.:}:'';0rvvided thateuch i...i'ro'Jam€wt3~'i6;'r:tot h,tar:\ded or.
off'olred for sale. .If..however; t"e bililding -or improvement is sold \Vith.vl')~,~,~"k ,...r::.,c'-rr:pl.etion. :;.:", ~'!mer.build~r V'/H_I hci.\ie:.~':'-,el:luic~n of proving thal!1e
didricitbUil.dorimproveforthepulposeofsale).': . ." :- . ',. -. .'- .' ,. ,- . -". . .
o I, as the ownsr of the property, am ~xdusivel'Icontracting wtth:licel~,'::~, .;.....,.r3:!.Oi"S to c(\~:.;tn..:"t the rroject (Sec._'O.'l..~'~:";";;;'._Ie.~~ and Pr'(jfess:on:-:
Code: 'The Contractor's ,License Law does not app-ly.to an owner\:;f PiCj:.';,.,':~t :.:~:..; ;.",;irls I)r impro\le.<; 'tho;:,reon, 'ar.d wh('l~'"tr.~6t<) fur su~n projp.cts \,itll
~ohtmctor(s) licensed pursuant to the'<?ontractor's Ucen~ Law); . ,,' . ' ">:,>
U lom'exernptunderScc. .8&P.C.forthisreason:.' _.>'[ .... .. . :. _ ..' . '. .~-'-_~
Date: Owner: ,- . __'~:~~__. . . ..:.' ,." . ..
,. . WORKER'S COMPENSATION DECLARATiON -~l-..:.-=-~! FC:CENSEU C~BAC-~I)~!>-DECL~.Ri',ii(,~;.~~
I hereby affirm und.er pe~al~.of perj~ry one of the following de~laratio~~: . t;",~,,"~ ;. __ .. . ~ ~ i ~ere~y Catfirrn'I:J~rle: Pl?ll?I.~ ':'If pl'lrjury..2t .,I;/m .
o I have and WIll mcllntafn a certiflCa~e ofo:",sent tose/f~I,nsurer?rworkl)l:l~<)!:"pt.';;su!lon,. . IIC~rls....ounderproV.$_:on...o.f chaptet.-~ (COflJ.-_nl..O.:_l!)
as provided fo~"Sedion 3700 of the Labor COde, for the perforrr.ance of t.~ ?_......::: i:'" for, which. _ ~\-"'l~~ ~~~tion(000) CfDi.wic)n j of the- EU,5ine~s al"ld '
.~s per,~sl!~d. . . . _, .' . . r. '. . prc'leSS;~i1~O~, '.
~veand wUl maintain worKer's compensation insurance,: 3:3.req":.ra,..j b';~Sec:::jn 3T00 ilf i 1f)1712o.~
the Laber Cod e, for t~e performance ofthe.~ork for which this perm,tis ;~u'~l My'w.)..(.er'~' I DatA: .... - ... ;
Compellsation insurance carner and policy-are: '. 'f ,.
.Carri,e~: STATE FU'ND ,.'. poricyNumb<;}r: 149COC'\::'-; , 'j
This section need not be completed if the pennit is for one hundred dol:ars ($10\1,:;: k::;j; _, I
O. I c~rtify that in the performance ofthe work for ~hich this pen-pit ~}~'~:;..;.~~:{::.h:ll/'hcit
employ any person in any manner so as to become subject to the Worke(s;'-'~~?:_p'iii?Citi_of! .!aws
of CaBfomia, and agree that ifrshould become subject totheworker's-com~..~d:,~::3:,~Q:1 '
.previsions of Section 3700 of~he Lab<f~ shall fo_rt ith,~O. mP1Y~r;.-.'.. i;,'~:r?,A4iy:i3.."
. Daie: 10/7/2003 . Applicant: L. ~/'ZJ' ., .
. . .. -\
WARN ING: FAILURE TO S~CURE WO~KER'S C9MPENSATI C9v~;'k:;;t.' .'3 .... "
UNlAWFU~, AND SHAll SUBJECT AN EMPL9YER T9 C INAL PE"K'i',f,SAND CIVil.
FINES UP T9. .oNE HUNDRED "TH9USAND DOLLARS ($100,0005; IN AD['jj")N T9 THE
COST .oF C9MPENSATIClN, DAMAGES .AS PR9VIDED F9R .INS~CTI9~;!2;)6:0'F THE
LAB9R CODE, INTEREST AND ATT9RNEY'~ ~EES. ~., ">_ r.c""':,',~ "c. j
I . . CONSTRUCTI9N _<::NOINu AGENCY '" ~..< ....".,,,,K,.."~',~..'
I hereby a,ffirm underpenatty of perjury th::it there is 3 construction lendin~ ;:o~::trldY:fbnr,9.;rji~:;;,1
:o-~nm:.~nr.p-!'{~.!-H:,~'~;"k_fcrv/i;i('h .thic:: .;.-::.rm:t i"':. i~-:.'o.d ::S~:~':~n~:: ('::"i..:-,.~.:~,.,,:- _";A~;~::21'_-c.:-'-iO.(~-;'-::,">:'~
LenCfer's Infdrmation: :.. I
. APPlicANT: NizAR M9URADI
OWNER INFORMATION:
'Institute 0 Islarnic
P9 Box 1236
Brea, CA 92822
ARCHITECT/ENGINEER.INFORMATlON:
NU~BE,~
465086
riPE A
TYPE B
rtPE C;C
-VPE::" ~21 (p.\I\1
C.cnitrucion Tvpes:
~!N~. ' .
Flr~ Spri~i<!ered?
;,., ,
NO
(.
_.~.:..;"...
,~._-.._~~~-'-..~"-~
,j)' '-r,~;i;,'
-,,1.<:
.. .
I certifytl.1at I have read this applk.ation and state that the above informatio~:g correct I
agree to comply~ith all city ordinances and state la~s relating to. buBding co,str:uction, and
\ .~~py .author" . repreSentives of this dty to e~ter u~. ttle above mentione!. property for
"\ IOSp 10 rposes. . .
Dat.. 10/7/2003
Signature of pplicant or Age
The permitshall expire by' limitation beco~ null and void if the building or
work has not passed tinal inspect" 365 days from the date of permit issuance. A
new permit is required to com nce or continue work.
.',.
Fees paid for Permit:
Total:
273.88
INSPECTION RECORD
.
. INSPECnON DATE INSPECTOR 1
Temporary Power Pole. .
Plul11bing (OrainlWaste Pipe) .
'Electrical Ground Electrode/uter .
SetbacklFormslTrenches (Footings)
Do not ins.tall subfloor or pour floor. slab until the
following applicable items I)ave been signed: ..
Plumbing (Water Pipe.Sprinkler Valves)
Mechanic,al (Groundwork)' . , . .
Electrical (Underground Conduit)
Pte-slab (COl11PactionlM"",brane.Reirif.
Underpinning (Floor Joist/Girders) . .
Do not cover'or conceal the work below. unt.lthe
following applicable items have been signed:,
151 Floor Sheaf ..
Fitesp""lder(Rough) , . .
2nd Floor Shear . , , .
Roof ISheathing/DiaphragrnlFrame) .
Masonry (ReinfJBond BelKlllPreoGrout)
Rough Plumbing' (Top Out)
Rough Mechani,cal .: '. , '. , ..
Rough Electrical (DryWall) . .. ,
Rough Electrical ~,.
Framing (Only after Plbg.. Elec.: Mech..and Fire) . ..' -------~.:~
Instllation(SoundlEnergy) '~ .
1
Do hot tape or plaster' until the following applicable
items have been signed: '.
Drywall, .' .' . .'
Penetrations (Fite Rated) Electrical, .
Penetrations (Fite Rated) Mechanical I ' ' l
Penetrations (Fire Rated) Plumbing, ' I
Interior Lath . .
Exterior Lath . ' I
GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical '<
T~Bar Mechanical .
T-BarStructllral
Sewer
Water Engineering Backflow . .,
Water Service
.
FINAL INSPECTIONS'
Electrical Final
Plumbing Final .
Mechanical Final,
Gas Test
Engi!19l!ringlGrading Final765-5126
Fire Dep!: Final 765-4040
Water Engineering 765.5268 '
Sub List/Business License 765-519
Zoning 765-5139 ,
Building Final' (Last Inspection. Only \
' After Abov.e Complete) ,
PARTIAL INSPECTIONS
, ,
BuildinQ'lnspections
Mechanicallnsoections
Plumbina Inspections
Electrical Inspections
/.;..1'..:....'
" "I -'. ,
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SOUTHWEST GROUP
--
ENGINEERING CONSULTANTS, INC.
. . .
~-
October 12, 2003
:::ity oJ Anaheim
i[,uilding Department
Sl~.iI>jei:t:
ISLAMIC INSTITUTE OF ORANGE COUNTy
1220 N. STATE COLLEGE BLVD.
ANAHEIM, CA 92806
'1'0 whom it may concern:
rhe following deviations from the plurnbing plans are acceptable per 2000 UPC and where
approved by the local authorities.
1. T~\e \lse of the no hub cast iron pipes with stainless steel couplings in lieu of "Clamp"
AU" or "Orange Shield" coupling is acceptable.
,i. The !lse ofthe 2"x 20 mil. pipe wrap tape by Christy's and Wonder, in lieu of the
polyethylene plastic tape is also acceptable.
l'kase call if you have any questions. Have a great day!
~;incer~
J""'~~fR-\
" ~ .~.~ .:: t,~'~
I toy . ee, P.B.
Principal
I?.' 'lrtmstJ'IItlspa\OO662-4(no Imb-ptpnvT'apj.dac;
': ",
.'1
15707 Rockfield BlVd.' Suit.e 235 . Irvine' California 92618
Tel (949) 588.6869' Fall (949) 588.6861 . E-mail: swgeng@aol.com
SOUTHWEST GROUP
ENGINEERING CONSULTANTS, INC.
August 21, 2001
City of Anaheim
Building Department
Subject:
ISLAMIC INSTITUTE OF ORANGE COUNTY
1220 N. STATE COLLEGE BLVD.
ANAHEIM, CA 92806
To whom it may concern:
The use of the 2"x 20 mil. pipewrap tape by Christy's and Wonder, in lieu of the
polyethylene plastic tape indicated in the plumbing plan, is acceptable where approved
by the local authorities.
Please call if you have any questions. Have a great day!
. ee,P.E.
Principal
g: \transmitlspaI00662-3 (pipewrap).doc
15707 Rockfield Blvd. . Suite 235 . Irvine' California 92618
Tel (949) 588-6869' Fax (949) 588-6861 . E-mail: swqenq@aol.com
SOUTHWEST GROUP
ENGINEERING CONSULTANTS, INC.
October 22, 2003
City of Anaheim
Building Department
Subject:
ISLAMIC INSTITUTE OF ORANGE COUNTY
1220 N. STATE COLLEGE BLVD.
ANAHEIM, CA 92806
To whom it may concern:
The following deviations from the plumbing plans are acceptable per 2000 UPC and where
approved by the local authorities.
1. The use of the no hub cast iron pipes with stainless steel couplings in lieu of "Clamp-
All" or "Orange Shield" coupling is acceptable.
2. The use ofthe 2"x 20 mil. pipe wrap tape by Christy's and Wonder, in lieu of the
polyethylene plastic tape is also acceptable.
Please call if you have any questions. Have a great day!
g: Itransmit\spaIO0662w4(no hub.pipewrap).doc
15707 Rockfield BlVd.- Suite 235 - Irvine - California 92618
Tel (949) 588-6869 - Fax (949) 588'6861 - E-mail: swgeng@aol.com
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