2247 E. Standish Ave.
BUI1;.DING' PERMIT NO.
BLD2004-0170 1
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BUILDING DIVISION
200 S, ANAHEIM BLVD.
(714) 765 - 5153 ,
INSPECTION REQUEST LINE:
'(714) 765 - 4626
CENSUS COQE: 434
QUAR'TERSECTION: 113
TYPE OF PERMIT
Residential Addition
DATE: 614/2004 '
JOB ADDRESS:
2247 E STANDISH AVE
LEGAL DESCRIPTION: N 1:R 1987 LOT 69'
APPL!CANT:ROBERTO RODRIQUEZ
'OWNER INFORMATION:
Roberto Rodriguez
2247 E Standish Ave
,Anaheim, CA 92806
JOB DESCRIPT!ONMd 118651 to 1st floor and 754s1 2nd floor (HIH) 'I
VALUATION: 130,562,00 t, PROCESSEDSY: HRO
I OWNER-BUILDERrOECLARATION ,
I hereby affirm u-nd~r penalty of perjury that lam exempt from the Contractor ,'License LawforthefoJlowing reason (Sec., 7031.5 Business and "
Professions Code: any, city or county which requires a Perm"" to construct, C!11 .,r. improve" demolish or repair any structure, prior to-i'ts issuanc_e, ,alg-a
requlr~ the,applicant for s~ch'permit tofile:a signed statement that he.is liC;'j1.s7d pursuanfto,the proV\~i6nsofthe C6ntracl.or'sLiGense l.aw (Ch~pter
9)(comme_ncing ~v.:tn Sectiol'J.?OOO of Oivision'3 of the Busine&s and Profee$:)n$COde) or that he ,is 'exempt_ therefrol)1 and the b,asis'for ti:'lealJeged
7$;;'o)~~on. AnYV.iolation ~f ~e~tion 7031.~ b: ~nY,~PP1ican.t fora per~f~ sLJje~ts t.he a ~PJicant to a. dvU p~neftyo.f not: ~o~e than five hundfed dOIl~:rs
o '_,,:as ,owner of property, or my emr10yees with wages as their sole ccmr~!1sation, ,will do <!he work,a,nd: the-str':lcture ,is nO~,jntende9:C1rpftered.rQ~-,
sale~~ec., 7,044 Busines:S and Professions C9de: The Contractor's License i:bO'-'" does not a pply to an owne,r:of pro~fJrty who buildsorjm'prove~ '
ther~n', and who ,does such work himself or herself or through,his orher Q\V;\"remployees, providp'c\ that such imp'rovel"j1ents ~re nor"lRtended'?r
~~er ot~~rM~~~'i':~:;'~:~~~;h~:ub~'~i:~;r,:~rovement Is sold with one ""f'OI completion, the owner-builder ";"1 h.aV:1 th.burdenOIPrOVin\ltnat he
,I: ,as' the_owner of the, property,. am exc!usively contracting W\lh_licensed':contra.ctors to. construct the proJeQt(Sec 7044 _ Bcisine$~ .<i~d Pfofe~iqil.S
Cod~;. The 9oritractor's License Law d<:>esnot apply to an ownerofproperty:l.iho builds or improves thereon,-aOd,who,contr~c~{or sucn pr~jects~Jith'
, ,a.s;onlrad:or(~) licensed pursuant. t<:> the ,Contractor's L.icense.~w).' t" . \. . ."
U l,~m exempt under. Sec.. .. > . B & P.C. for-this reason: ....d'~"
. Date;C,- t::!. '"7-ClO"-{Owner: ea.~16TO 1i2Q{)?1 C;;U5'~ '.
,I ... . . . ,WORKER'S COMPENsATION DECLARATION. i
~
I hereby affirm- under penalty of perjury one of t~e following declarations: .
o .' have andwW maintakl a certificate 'of cOnsent to_ self-insure-.for w()rker~~ cbmpensation,
as provided for by Section 3700 of the Labor Code, for the performance of th~work. for whidl
this' permit is issued. . . ,,' ' -~
o J have a'n.d'will m-aintain worker's c~mliensation'insurance, as required~? Section 3700 of
the Labor Code, forthe performance of the work for-which this permiLis ISSi.dd. Myworker's .
. Compensation insura nee 'carrier and Po'Hey are: ~.
C . Poli'cy Number;
....arrrer:
Thj~tiOn need not be completed if the permit is for one h.uridred doll~rs ($10(} fJf less.~;-,. ^'
I~ ,I.certify that in thEfperfonnance of.the work for which thispermi\is isSU~~d:J~hEl~t _.'
emploY any person in aNY manner so as- to become subject to the worker's c.;lmpensatJon../aws
of Califom,ia, and agree th.at if I shou!d become subject to the workerf~ com~~!,~s:ation:::"'.-:, '
'provisionS'Of: Section 3700 of the ~aborCode,1 shall fo~hWit~ comply with t~?S~ provisions.
Date: 6/4/2004 " Appll";'nt: -b ~~" b:,f]/Zf ~iflSj.. ,. ,,', .
WARNING:, FAILURE TO SECURE WORKER'S COMPENSATION CbVE,~~G'E IS':,:,
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRiMINAL PENA'.TrESANbj:::IVIL
FINES UP TO ONE HUNDRED lJ-IOUSAND DOLLARS ($1O'a,OOO),IN ADqT)ON TO T/;iE
COST OF COMPENSATION, DAMAGES ASI'ROVIDED FOR IN SECTiC"1.'i.3!.06 OF T/;iE
LABOR CODE, INTEREST AND ATTORNEY'S FEES, ' , . '
'I CONSTRUCTION LENDING AGENCY .
'hereby affirm under penalty of perjury that there is aco":struc.t!?n'lending~:;:~~'i1CY for the,
~.J?~~!~~~--9fthe work for which this ~~~t,ish:;S\.led (Se{,'..39~F.~S:;iV.~): 1-
i.....ml'J€r-s lr<onnd[lon~
CONTRACTOR INFORMr,TION:
i
ARCHITECT/ENGINEER INFORMATION:
I
LICENSED CONTRACTORSDEC,-!,-RATION r'
I hereby affirm untJer petlalty of perjury that'_laT
licensed under. provisions'of chapter 9 (commencing.
with Section 79'00) of Dlvsion 30ftne &usines.s and
Profession.~ Code. .
6/4/200'4
Date:
Con~~tor
NUMBER
EXPIRATION DATE
. TYPE
Construcion Tvpes:
VN, "
Fire Sprinklered?
Dw.mnQ Units:
Livinj:! Area:
NO
1
1,940
I certify that I have read thi~_appHcatjolJ and state that the above information is correct. I
ag'reeto CQlTJply with.all city ordinances and state laws relatjng"to buDding cOllstruction, and
hereby authorize representives of this dtyto enter upon the above-mentioned property for
insp,ectiof) purposes. ' .-
}- R06~e.'7a f!!(y)121 c;UCJ"? Oat,,: 6/4/2004
, Signature of Applicant or Agent . .'
The. permit shall expire by limitation and become null and void if the building or
work has, not passed final inspection 365 days frilm the date of pern~t issuance. A
new permit is required to commence or continue work.
Fees paid for Permit:
,Total:
563.06 '
. INSpECTION RECORD
'. IN5~ECTION" .QATE ". .
, . . . INSPECTOR .
'. Temporary Pow!>r Pol!> . . ,
. PII,ombill9 (DrainlWastl! 'Pip!>) .. . .
.' Ellllltrical GrOulld ElilctrodelUfer . . ,.
Selbaek/Formsrrr!>..ctulS (Footings) ..' ~ &OJ;. . 1\ A':
. Do nolinstall $ubfloor or pour floor.slab uhli' thE V.'
following applicable items have been'Signed,' .
Plumbing (Water Plp!>.Sprinkler Valv!>s) '. ".
. MtiChanical (GrounClwork) .. '.' .. . >. .
..
Elllctric:al (Undergr.ound Conduit) '. '. '.
Pre-slab (Compactlon/Membrane.Reint.. <[1;').01,:; '1..r .
Underpinning (RoorJoistlGI~<<$l . ,. ". ..[j .
'..
'. .Do!lilt coverQrconcealthe workbelowunlil the' .
'/ollo,iVingapplieaple ilems have been signed:'. ....
1st Floor Shear . " 1~l4 '-C __'
Flrespiink/<< (Rough) . . ,'.1 .
2nd FlOor ShUr' . .' ~ ...~. -.
ROof (Sheathlng/Diaptuagm/Fr~!>) IP ..
"'---
Masonry (ReinfJaondBeamlPre,GnlUt) c'-. .
, R9ughPlumbillg (Top Out) . . '.
RoughM!>chanical' ' . , .' " .
I Rough Bl!Ctrlcal all). . ,
Rough Electrical. '. . '. .' . ..
- . Framing (Gn~ aner Pfbg.. Elee.. Meen. and Fire" ."
. I Inw/atlon(SoundlElllJrgy)' . " . . .
. I po not lape or pla~ler untilt!)e following appliCable ..'
.temshave beens.gned<. . _ . ". . .
Drywall . ..... ." . ..' .'
PenetralIQIlS(l'lreRat!>d)E1l!CtRc;a1 .
P!>Retrallons (FireRaled).Mechanical. . .'.
. PeIletratiOns (Fire Rated) Plumbing. " . . ,
Int!>rior.Lath . , . .
Exterior Lath '. '.' ." '" . ."
.. '.' ". GENERAL ITEMS. . "" . .
Exterior PiaSter (Brown Coat)
T -Bar 'EI!>ctrieal " '" . ,
T -Bar Mechani~t .' ..
T-Bar .Structural '.... ,. ,
Sfiw!>r" . '.. '
.' Wat!>r EnginHringBackflow ..... . . '
Water Service ,- , ,
...' " ,. - '. - . . "
FINALINSPEC'OONS". ... .,' Dllte i'" . inspector
EI!>Ctrical Final . . . '. .: ,'.,' .:. . .
.'
Plumbing Final. ..', .' '. ..
;"'!>ehanical Final .
. ..
Gas Test . .' .
.- . .
Ell9ineeriIl9'GradingFjnaI765-6126' . .' .
. .........., . .'
. '.' . '. .' . .
Fjre Dept. Final 76.5-4040 . . . '"
Water Engin!>ering 765-5268' . .' , "
.'
Sub ListlBuslness Lie!>hSe 765-5.19 . .'
. ..... ,
Zoning 765-5139 .. .. . . :
Building Final' ~asllnsi>ection.dnIY .' . . . .... .
~-. -c' .' fter Above Complete)... . .'
'. PARTIAL INSPECTIONS.
,BUildinqln~ectiOI:'S
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.. "~'" 4'Y
t~.~...
fi . . _ - .... .
.' MechanicallnSDections
PlumbinalnSDections
. ElectricallnSDections