1209 W. Stella Ave.
CITY OF ANA'~bir1
DEPARTMENT OF
BUILDING AND SAFETY
SPECIAL INSPECTOR'S REPORT
EACH INSPECTOR MUST COMPLETE THIS REPORT AND MAIL IT TO THE DEPARTMENT OF BUILDING
AND SAFETY.
/
WEEKLY ~
TOTAL TIME ON JOB (IN DAYS) 1/2-
JOB ADDRESS --12.0~ w. ~l1LLA lrVb,
GENERAL CONTRACTOR ,A.YlcM-iA-\Z\ INTElZI&r2.~ lb2h) lj€> I-113ft,
..., I " I rq" E ~
SIZE OF BLDG. ,,9,-10 ,:. 2. \ - TYPE OF WALL WtlliD- @HE. NO. OF STORIES 2-S oY2,
TYPE OF WORK: REINFORCED CONCRETE cY MASONRY 0 HI-TENSILE BOLTING 0
FINAL 0
BUILDING PERMIT NO j;LD ~otJ4 -O~ liS
PRESTRESSED CONCRETE 0 WELDING 0 GYPSUM CONCRETE 0
DESCRIPTION OFWORK INSPECTED:~ro\QMB-J> '\O~1=. -IC~\ ~f ~'2. - y~~
-fa~.-\ 14 ~IJ,}Ul,p&PO)('\ t}. N C\+orc - Px21}L, @ t~S\ . IN bl,1 ,t}H 0 Sou '\ ~ v';,{Hlh
~b\^1 6r/dru~9-}; A-R&-A. 1:1) 40 \;1'-11" t'IU ~Qub w&ttf.
~tif7J? WllH (');}L,IB~l;P \otZ<dub W~~o.,Qt.oq,004-) /d~
_1<b9tJ IRl50 . (3) AlvL, p~~~w>) No H~ tllR.. RoIJo-,\t?~~ ~f\ \3oL1
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10
(1'1) (12)
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REMARKS: 'v-I,l1IAtj C\);Hbl'l !J !<tMv&Ntt l'1)
~TrZuelltUaL btJ~, Nf&YL: H~rwLD WJ ,fa. / T Slt \'\1 ~. U,2b)2S8 -ola?:, .
All work on this job to dale has been satisfactorily completed and conforms to the approved plans and requirements of the
. Uniform Building Code. L~. C.fT~ .po,q4--n
I ') ... c. ~ t.../}, toll. -*\ 080 ,
o - 0 :r l...OO-j 'J: c..c.-lI'- I 0 0
Dale I Inspector I 0 No.
JUNt:, -\<'lIb, ~isM, (ctLL) , L11t)2qq-~~
3
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3100
285
2000000
5.25
1
Single
Beam Width (In) b 5.25
Beam Depth ~n) d 11.25
N,~~ ''-~''"' (ilt' "II"
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NolA;n lAInflltllinJ a
Nutuh Dtplh Into !lId. fin] ~.1I
beenl SpIIIII1l1 14
Notch Location from 8e1lll11l1ll) &
AcIIlal Moment at Notch lib-II) 20260
Overoullnc:re88e . 1
NsutlalAlds (from bottom edge) 4.31
Moment of InII1Ia 344
....low8bIe Moment 20599
Moment Check OK
Acrtual Shearsl Notch lib] R, 4950
Allowable Sneer pb) V 6234
Sheer Checlc d, OK
NotcIIA/Jowed? Yu
Single 5.25u x 11.25" 3100 DF Beam with 2.5" x 4" deep notch on top edg-
e' from bearing" &Dowable according to the Information shown above
Remaining notches ant al80 allowable
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_ Engineered Wood Products
V.,...lMII Bid. Notch Dealgn Check
COIIIDI""'on F..a SId. Not"" Awav "olllIuIlIlCIII
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3 . 2.S" x 4" Notch.. Cut. wor.t ca....re...analyl,d
N,,"bar uf Notol1..
\'wwtltm ~{~
Fb<< ShBa BlII\lfng
Horizontal Shear
MOe:
Ply Width (in)
Ii of PIys
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Addles: 1209 Stalls Ava
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T & W Consulting EngiuccJ~
1168 San Gabriel Bin!., #N
Hoscl1Icau, CA 91770
Tel: (626)288-0708 Fax: (C,2()i 2XO-41()6
Job:
By:
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T & W Consulting Engillc~l~
1168 San Gabriel BInI., #N
RosclIIcad, CA 9177()
Tel: (626) 288-0708 Fax: ((,2b) 2~()-41 ()6
Job:
By:
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BUILDING PERMIT NO. BLD2004-03118.
TYPE OF PERMIT.
.Residential Addition C I TV
DATE: 10/4/2004
JOB ADDRESS; 1209 W STELLA AVE
LEGAL DESCRIPTION; TR 2489 LOT 24 ALL -EX W 0.80 FT-
APPLICANT; FONZY KUO
OWNER INFORMATION;
William Clements
1209 W Stella Ave
Anaheim, CA 92802'
.cONTRACTOR INFORMATiON;
.ARCHiART INTERIORS
310 PiMA AVE
WEST COVINA, CA 917900000
BUSINESS PHONE; 625 52~-3659
JOB DESCRIPTION:Add 2 bedrooms and bath dyer garage. Breezeway enc:o:;ed without permit.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION R:EQUESTLINE:
(714) 765.4626 .
CENSUS CODE; 434
QUARTER SECTION; 67
ARCHITECT/ENGINEER INFORMATION;
HAROLD P WU
1168 N. ROSE MEAD BL: #N
ROSE MEAD, CA 91770
VALUATION; 41,300.00
I OWNER-BUILDER DECLARATION
'_hereby affirm under penalty of perjury that I am exempt from the Contractcr:-s License Law for the following reason (Sec.'7031.S Business and
Piufession~ Code:, Clny dty or county which requires a permit toconstruct,2:!t\~r, Improve. demolis~ or repair any structure, pr!of to its issuance" also
requires the applicant for such permit to file a sig"ned statement that he is licc;1sed pursuant to the provisions of-the Contractor's License Law (Chapter
9)(commencing with Section 7000 of-Division 3 of the Business and Pmles:-.;ws Code) or that he is exempt therefrom and the basis for"the alleged' .
exemption. Any violaHon of Section ,7031.5 by. ~my applicant for a permit sub~,ectS the applicant to a civil penaltycf not more than five hundred dollars
($500). ,..:.
D I,as owner of property, or my employe;es with wages as their sele corr:i::~n::oation, will do the work, and the structure is not intended or offered for
sale (Sec.. 7044 Bl,lsiness and Professions Code: The Contractor's license ~~,3W dOl::ls not apply to an owner of prcperty who builds or improves
thereon, and who does such work' himself or hefSelf cr throl,lgh his or he~ owi: emp:oyees, provided that such 1mprovements are not intended or
offered for sale. If, however, thebuilding,or irilprovement is sold 'Nit.!1 on~ ye:;;lf of completion, the owner-bu!lder,wiJlhave the burden of proving that he
did not build or improve for the purpose of sale). \ "
[J I, as the. owner of the, property, am ::lxdusively contracting with li:::enS~(r,bntractoi!')"to construct the project (See. 7044 Business arid Professions
Code: The Contractor's' License 'Law doe..."l ,n.ot apply to an cwner of proP'<3rt;l-:V:10build.s.01' improves thereon, :and who rontracts for such projects with
~OI.ltractor(s) licensed pursuant tathe Con~ractor:s Li'oe:nse Law)~'l ." . -.
U I am 'exempt under Sec. ----.::....__ .B& P.C. forthisteasor:: _: . . _ .
Date;. Owner: .. . :', .
I WORKER'S COMPENSATION DECLARATt9!"~~,__1 L1CENSEil CO~JTRA~TORS DEcLARATION J
I hereby affirm under penalty of p~rJury one ofthe fallowing declarati'Jn~: . I hereby affirm under penaity of perjury that I am
o .'j have and will maintain a certificate of consent to self-insu.re for ',.'Jork~I'~: compensat:on. licensed under proviSions of chapter 9 (commEmcing
as provided for by Section 3700 of the labor Code,:for ihe IJerformance of ~h,~ work forwhidl with Section 7000) of Divsion 3 of the Business and
~h' rmitis issued. '. . : . Professions Coae.
-1-" 1 have and wilfmaintain worker's comper.s:ation insurance, as. required h:; Section_3700 of "10/4/2004
the L or Code, for the performance of the work for which this pern1it ~ Lf'>sud. My worker's Date: Contractor
Compensation insurance carrier and policy are:' ,
9arrier: STATE FUND Policy. Number. 171"!SU7~?004
PROCESSED BY; FAN
This section need not be cOmpleted if the permit is for one hundred d~llar:; ($IGe) or less.
D I certify that-in. the performance of the work for whic this permit is iss~t'-;ll sh<)lI not
employ any person-in any manner so as to become subj et to the worker:::. :;'!":nipensation Jaws
of California, and agree that if I should become subject the worker's comD~;n~ation
provisions of Section 3700 of the L,abor Code, I shall.fo th compiy witt I trils.e.provisions.
Date; 10/.412004 Applicant
WARNING; FAILURE TO SECURE WORKER'S CO PENSATiON COVEP,IGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL PENAl noS AND CIVIL
. FINES UPTO ONE HUNDRED THOUSAND DOLL RS ($100,000), IN AOD: 71 ON TO THE.
COST OF COMPENSATION, DAMAGES AS PROVI.DED FOR IN SECTION3l06 OF THE
LABOR CODE: INTERESTAND ATTORNEY'S FEES. .
I . CONSTRUCTION LENDING AG.ENCY _n_--"
.:..LhE'J:eb,y ,,:;ffjr:m _uoderpena!tl of.perjury)h8t t/1F.!rB i~ a, con ~trtldi0n lend ir>9 8[L'> ndy Jar the
""performance of the work for which this permit is issued (Sec,3097 .Civ.C):
Lender's Information:
NUMBER
806684
TYPE
I
EXPIR~TION DATE
4/30/2006
B
Construciol'l Types: .
VN, ,
Occupancy Groups:
R3, " , .
. LivinQ Area:
,"certify that I have read this appl ation and state that the above information is correct. I
agree to comply with all.clty ordi. ances and'state taws relatlng to building construction, and
hereby authorize re.presentives f this city to u n the above mentioned property for
inspectio.n purpos;es.
'Date; 10/4/2004
Signature of plicant or Agent
The permit shall expire b limitation and become nun and void if the building or
work has not passed fin inspection 365 days from the date of permit issuance. A
ne~ perl1:1itis required'to corTm~ence or continu'e work.
612
__ J.,~______
.Ii
Fees ~aid for Permit:
Total;
2.103.77
INSPECTION RECORD
, , INSPECTION c 'INSPECTOR
' DATE,
Temporary Power Pole ,
Plumbing (Drain/Waste Pipe) :
Electrical Ground Electrode/uter
SelbacklFormSfTrenches (Footings ' ,
Do not install sUbflQoror pour floor slab unlilthe '
following applicable items have been sign~d:
Plumbing (Water Pipe.Sprinkler Valves) ,
Mechanical (Groundwork) , ,
Electrical (Underground Conduit), ,
Pre-slab (Compaction/Membrane .Rei nf.
,Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the ,
following appli(,;"ble items have been signed: " ,
1st Floot Shear, '
FireSprinkler (Rough), , ' , "
2nd Floor Shear ,
Rc:lof (Sheathing/Diaphragm/Frarne)
Masonry (ReinfJBOod Bearn/Pre-Gl'O\It) , ' "
Rough Plumbing (Top Out)
Rough Mechallical ' , ,
,', RolI9h Electrical (Dry Wall) , ,
Rough Electrical " ' ,
Framing (Only after Plbg".Elec..r.-lech..and Fire) ,
Insulation (SotJndlEnergy)
Do not tape or plaster, until the following applicable
items have been. sign,e~: .'. ~ . ,
Drywall ' ' , '
Penl!lrations (Fire Rated)Electrical
Peneltatlons (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbil19 ,
Interior Lath ' ' , ,
'Exterior Lath ,
" '," GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical ,-C' ---c
T -Bar Mechanical ,',
T -Bar Structural ' ' - ,
Sewer ' , ,
Water Engineering Backflow
Water Service .. , ,
FINAL INSPECTIONS
Electrical, Final
Plumbing Final
Mechanical Final
Gas Test
EngioOOringlGracling Fi,naI765-5126
Fire Dept. Final 765-4,040 '
Water Enginee,ring 765-5268
Sub List/Business License 765-519
Date
Inspector
. '
Zoning 765-5139
Building Final ILastlnspection- Only ,', I?
, " ,After Above Complete) ,;,
PARTIAL INSPECTIONS
BOildi'na Instlections " ", ','"
~MP~O~<~ 'cf(4~
.
MechanicallnSDections
,PlumbinQ InsDections
, ElectricallnsDections
,
,
~r.~iFt~'\
.I: .. - ~::~H.f;~\
i '70/ -",J '~l" "p\ . '.
TYPE OF PERMIT C' ITY 7~, '"",i '~i~\'
Reroof' I;; ; ':f :1 ElM
\)ATE.: m&i,2oo5 .\\~!f(?f,(VI . .
. ~o ~t.' -,,'\P .
~ADDRE;,S$:1209 W STELLA AVE '~~Jff}" .
LEG~.E Esd~IPTION: TR 2489 LOT 24 ALL -EX W 0.80 FT- J: .
APPLiCA~T: J [,
OWNER I~FO CONTRACTORINFORMAT10N:
William CI<\me . ARCHIART INTER10RSt
1209W Sle1' A . 310 PIMA AVE . l
Anaheim, C 802. . WEST COVINA, CA 9179(: Gl00 . .
. BUSINESS PHONE: 626523. '059 .
JOB DESCRIPTION: Tear off exisUn9 and re-roo(8 squares cOmpostion Shingler: REF.BLD2004-03118. . .'
VALUATION:.' 1,500.00 .' 1:. . . PROCESSED BY: SAM . .
I " .' . OWNER.BUILDEF Qt:CLARATION ". '. . .... . . ." ..' . · .... .
I hereby affirm under penalty of perjury that I-am exempt from theContracto!"'s,'Ujcense Law ,for the following reason {Sec. 7031.5 Business and
Professions Code: any dty or county which requires a permit to construcf;-~;~~e~ 'ilJ'lprOve}demolish or re~ir any structu,re; priortci"ts"jssU',OI)Ce, -also
re~wires the applicanUor"such permit to Jile a sign~ statement th~t he is.nc<':":f;-;Opurs!Jant to the provi::;ions of the Contractor's,Ucense- La"v(Chapte~
.9-}(commenclngwith Section 7000 of Division 3 of the Business a'ndP(c..~~_~sio!t&:';cde.)?rtt--.athe is exempt thea-sfrom and the basis: foLthp.:alleged
exemption. Any violation of Section 7031.5 by any applicant for a permif'sLlbj/bts the ~'PPIIcant to a' dvnpeQaltyof not mor~ tha n fIve hundred dolla-is-
($500). . .' '. .jot.> . .'
o J, as owner of property, or my employees with wages as their sole ccmrr;':::;stlcn, \:1111 do the work, ana the structlJiC IS not int(>ncied or offeree! for
_,sale (Sec. 7044 Business and Professions Code: The Contractor's Ur;E;:n~~ L~i~)j doe~ rIot .3.pplyto nn oVJ('!erof property who Dui:dsor improvp.s " " <:,
there?n, and ~hod()es such wO,rk h~n:>elf or. he,rself or thr~ugh hiS?( her, 6i:,tn~:;nplo'y~f!3".;!"l"OVi~ed toot ~~h. imp~Vemffit~}lr;~ pot'lnter1d~~{)r" ,','~'.:: ",'_;",
i:;~e~~~ ~t"l:~;'i~~::w.e. :~;h~~ub~I~~~. ~fo~~.erovem. ent IS SOld. W.... ..Ith on.~'Y-f:'~l.:t.;:.f.; .comp\.,e. ';on, th. e owndr.ou:lder WI.l.lh'7~he bl. ".de..n O..f.f'..o.v'n9th~t ne.h.. ..'
[J, I, as t.heowner of ~he p~operty,am'exdu~lveJy contract;ng wlt'ti ,licenso;:d c;:pn!ra'ctor~to construct thepro.!c~t (Sec;, 7044 BtlsirV3S8' ilnri ProfesSions',".>;:: '
COde:. The C6n~ract6r's Li~n~ Law' d'oes.not apply.t?a,ri owr:a~r of pr~~rty\4t-;~b'.Jjl.~~}:,r improves thereon.-Gind"..vno.,oont0'c!~ 'f(JI'-~lJ0'project., ~~;ith "
MontradOI(S)II~ensedpt,lrsuanttotheContractcr'sLtcense Lawk ~ ~ }t.-.'.. . ....' "j'___ ..,.., _::,
...,..JI,am'exemptur:)derSec. '. .... .B&P.C.for,thisreason: ~,4F'.:-...~~_n __,_._
Date: Owner: -" '. ,'.:... ,,~
. G WORKER'S COMPENSATION DECLARATION',=~~__~"':J
.1 t1e(eqy affirm under penalty of pe~jury one' ()f the following declaratio!ls:..' : .' t':" t
,0 I ha~. an.dWilI main.t.air;' a'certificate oi.C9nSenttose....lf.:insUrefGr~Orke:-. ',".or.n p~n~..'atitm,
cls,provided for by.Sectiqn 3700 of the Labor Code, for the performance of !h r. .wor~ fer. whie."
this permit is issued.." '\ -. ,'. '. "', '. -"
~. hay.e and will' maintain worker's compensation insurance, as. reGU.i"'d.OYi. '::.;.eG,t.iop ;3700 of 1/18/2005'
'. e abor Code. for t.he performance of the 'work for which this 'permit is i$ll~~.. Mvworker's I Date:
"'ompensatlon insurance carrier and policy are: . '. ' " '. ~.~ ...; .. \; ,
Carrier: STA~E FUND - Poij~.Nu.m~:f-,.,:!!17y2H~~t)()~'
This section" need not be ~pleted i~ the permit ~s for one. hundred dO,II~ ($1 OO!fr:~$. .
o I certify that in the performance of the work forw'hich this pern"rit is j;:;sue~, I sllalf Flot
empJoy any person in-any manner so as to become subject to the worker'sc~{npensatil)n laws
,of California, and agree that if -) should become subject 'to the wo er's COmpfli1$Cition
provisionS: of Section 3700. of the I.,<;lbor Code, I shall fo ith c ply with tt-J!~e- provisions.
I
Date: 1/18/2005 . Applicant:
WARNING: FAILURE TO S'EClJRE ORKER'S ENSA ION COVER"GE IS
UNLAWFUL, AND ~HALL SUBJECT AN EMPLOYER TO CRI INAL PENf.l,TIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FORIN SECTION,'/lQ6 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ..
r CONSTRUCTION LENDING AGENCY 1" 1.
BUILDINGPrRMIT NO, . BLD2005-00137
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 --5153
INSPECTION REQUEST LINE:
(714) 765.- 4626
CENSUS CODE:. ( 555
QUARTER SECTION:. 67
ARCHITECT/ENGINEER INFORMATION:
IICENSElACONT~~TCRS DEC-LARATI2!!..J
'l"her~bY'.1ff.ir:""!:under pena:ty of rcrjury~"at',i ari,l
iiceneed ur:der rrO";l:iiOriS of chapter 9 (commcr.cing"
with Section700G) of, Divsioh'. oftl1e . siness and
Professions 'Ode'
NUMBER
806684
TYPE '.
EXPIRATION DATE
4/30i2006
B
Construcion Tvpes;
VN,,' .
Ih~reby ~ffirrTl,un~erperialtyo"f perjury_ Ul~~_the~e_1S .a..constr~ctio~1_l0ndll1;t.:3,=r'K.'!..tOUh~~__..:.;:.,-, .co:~.~.'~' ,
'--p~I'fOmlance' onn~ wurK"fo"r whiCh" this permilis-lsSLu3d-(Sec.30fii .Civ"C): '
Lender's Information: " ~
, -:'::~-'-"':~~.::~~-'-
I certify that I have read this application and state that the above infor:mation is correct. I
agree to, comply with all city ordinances and state laws relating to bu~ding construction, and
hereby authorize represenf of t is city to enter upon the above mentioned property for
inspection purposes. .
Dale: 1/18/2005
Fees paid for Permit:
Total:
160.61
Sig nt or Agent
The permit shall e Ire by Jim' ation and become null and void if the building or
work has not passed final inspection 365 days from the date of perniit issuance, A
new permit is required to commence 'or continue work.
INSPECTION RECORD
INSPECTION PATE INSPECTOR
Temporary Po,.,er Pole '. I . .
Plumbing (DrainNVaste Pipe)
Electrical Ground Electrode/uter .
SelbacklForll1Srrrenches (Footings)
Do not install subfloor or pour flOOr slab'unti.1 the
following applicable items have been signed:
Plum,bing (Water Plpe.Sprinkler Valves)
. Mechanical (Groundwork) -
Electrical (Underground Condliit) . .
Pre-slab (Compaction/Membrane.Rei nt. .
. Underpinning (Roar Jo.ist/Girders)
Do not cover or conceal the ,.,ork below until the
following applicable items have been signed: ~
1st Floor Shear
Firesprinkler (Rough) ~:
. 2nd Fioor Shear .' , . m"
Roof (Sheathing/Diaphragm/Frame) ,(' "/ '.
Masonry (ReinfJBond BeamlPre-Grout) /'
Rough Plumbing (Top Out)
Rough Mechariical
. : Rough Bectrlcal-\ury wall) .. .'
Rough Electrical : .
'Framing (Only afterPlbg., Elec., Meen., and Fire) '. ~
. Insulation (SoundlEnergy) ~ ~ .
Do not t"pe or pla~ter . until the following-awlicable . / '//
items have been SIgned: . . ., :i
Drywall" . ~'
Penetrations (Fire Rated) Electrical .
Penelrllitions (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 Backflow
Water Service
'..:,.
FINAL INSPECTIONS . Dale Inspector'
.
Electrical Final . . .
Plumbing Final
Mechanical Final' , . .
Gas Test
Engineering/Grading Final 765-5126 . .
Fire Dept.Final 765-4040 . .
. .
Water Engineering 765-5268
Sub list/Business License 765-519 . . .
Zoning,765-5139 .
Building Final l[-asi Inspection. Only ~LiJ E0 b
fter Above Completel.
PARTIAL INSPECTIONS '.r
BUildinCi~~tions.
~47_4 . . ~(,.. '?Jl{
J)L/ -uCi .
f2._~7X. ~;,' ltl~
Mechanical Inspections
Plumbina Inspections
Electrical Inspections
4