610 S. Sunkist St.
APPLICANT: D":'VID LOI
OWNER INFORM;'TION: CONTRACtoR INFORM;\TI0N: ARCHITECT/ENGINEER INFORMATION:
DAVID LOI -".?;, ,. PHILIP TAGGART
9021 TRINI CIRCLE . . ..1 "" '5131 AIRPORT DR,
Westminster. CA 92683.9000 . . , . . ,5,', . COST)>; MESA.CA 000000000
JOB'DESCRIPTl-ON:jfew Singl~ Fa.mily D.weJling, Pla.n B-1, L!>Jjng area 3~.?)}:f#~.;~~age-a.~ea 99~sf ". _ _ '.
VALUATlpN:239.702.00 ..... . <:~.,,':/'.". PROCESSEDBY:KBT' .'
I OWNER.BUILDE!fuECLARATION
I hereby affirm under oenaJty of perjury that I am exempt frorn the Contr-act~ii~.bgens.e Law fOf the follOWing [eason (Sec. 7031,5 Business and
Professions Code" any ('~ty or county which requires a permit to cor.struct,"a\#f, iniprove, demolish or reppir any structure, prior to its issuance, <'1150 '
requires the applicant for such permit to file a signed statement that he is liG'*nSEfd pursuant to the provisions of the Contractor's L1cense Law (Ghapter.
'9)(cornmencing with Sec[ion7000 of Di~sjon sotthe.Business and profe~'':;;ff'~QSC-Od~) or that hei$'exem~t therefrom and the basis for.the all~ed ,
exernption,"Any vioiatio~QfSe~~iQn 703f.S oy any"applic8ntfor::J p:e~n1j.t':~,~' ,.~tithe,?pplicant toa civil penalty.~fhot ~()re,than"fiv~, ,hundred "doV.ar.s
~($500)..>.' . .' . ..' . ,o}<::; .. .. '. . : . ','.. . ..... .
',:'..EJ.::'~ '.',,':)>as'owner.()f-p~o..perty,.?r.~. ,yern.P.IOYees,w.it~.~.?,._g.es,~~ th.e.i~..:,S~J~.e_po.,.~~rS.'.8. tion....' .w. iH~o the w. ork.~ and the. strudu. r".is. n.6t.i..nte. nd~or-o.:ffere. d.~9~
..s~le (Sec., 7044.-8uslness. ar.dero:e~ston~ Code: :TheContracto~'~. L,JceI1S,~;:~Vf doe~.~Qt appl~ t,~ a~. .owner ~f p~9.P~rty ~ho: bUljds ~r tmprov.e~.. ~'.. ~7~
-~Q~re()!l,,-a~ct \y~:oc!,o'=!ssuch \"Jork hHnse,1f or helSelf.,?r.thrpug~:~I,:>::pr ~~~~-8,~'~~_~n1PI9~es', prov'9,ed that S':J:9t) 1;p1prt)yemt;nts are n9t Intel1ded,Qr~' _, ,..'
d~~'r.te~~~~;Jli~;~~~J~~i1~~f~1~[it:[~1J~1r:2~~~glqlr~~:~i~f=;~!:~Z:~~::~:~:::~~j:: ~~i~:a;::::;:::sO~30:::;e~~: ......
'.._,YcxJ..e:_ The;Co~t~actcr'.s Licen~.-Law does not"appjy'.t?~~fl,_s:ymerPf-:prcpe,-"!#4t/ho.bUildS or improves thereon, and. "Yho contracts fO($~ch proj~cts.\.'Vith
':':~~~~~:~~:o,~.~S) l;ce~~edpursl!antto t.~.e'Contrac:or's'ljCc:~~.~~t(~,.~~<<, :\::~~~r'\::" ,: ":'::'_~~;"':'::"'.' "', '_,,,,,' . .:- ' ': ,..c~~:-~~-;:,'~'. ~."~, .
..L;J....:I,.ar~~.,ee"i}l' ;).~L.ln.d...e,r.,sec._.... _...;.~~:_. :..~.;..,~ ",.C,f,qr7tnlsre~~on::>''-:-.:'-:f...1.' . ". . " . '.. ..--'-
;,Da.te:n#!t~___~~~':~>3r~ '. ~~~~ --.-' - "'''''-'i'~3:J ~
1/<' . "..... WOR!{ER'SCOMPENSATlONDECLARATION..C:'t, '.. . LICENSED CONTRACTORS DECLARATION I .
I hereby Clffirrn,:'under per.alty;bfl~erjury,6ne"of the following declarations: .--_"V' ~:, .. 'c. -.~~' I hereby affirm under penalty of perjury that l-am
[j ;,:'Ij,~ve '~~~f wm,maintai~'a cp.rtifiC'Clte of ron~~t.tO',self-in~ure,'for v~or,k€.~\':;lJfnpens.~tion, IicensecfCmder prcVlsiori~of chapter 9 (commencing .-"
.as:-prqvided fol:bySoction:VOOofthe LaborCode,:for"tile pelforn1an.ca,of ~'*:_work forwnich ~~~;~~~i~; ~~~) of ~jvs'ioi13 Of-the:Business:,~fld .;:.
.:-this.permitjs issLlerj. '.:',; _':'-'~:::'- ._' __ :',--; ,':. " );~~'"'. "':: ". ...
o . I have O.I1~ \Vill m~intafn 'wori<:er's compensation insui'ance, (:lS'reqUire~~!{'Section 3700 of
. the labor .code, for the ,performanc~ of the wprk for which thls.pernlit. is iSS~:t1" My~~rker's,
Compcnsatio,:"insurance~nierandpoficyare:" _.,' . ..' _,._::;,/:' -.'.. ~
Carri~r/" , Policy Numt.er. .... .~. .
. This ~tion need not~;'comPletedif !hepelmit is for olle ilut'd"ddOUa;Si$1..ot~r~...s.
~ee,rJify that in the ~er.formance of the, worK for whic,", this.permit cia 1~~i~-sha!1riQt .
ell.1ploy ~ny person in any manner so as to becpme subject to the wor~'l:!,~~o~ltlp.erisatioh laws
of .G~I !fo mi~', and '~gree that if ! snou Id becomE? su bjeCLtot~e wo ri<er's.?~ffi~~~~.tion . .'_
prOVISions ,of SectIon 3700 of the labor Code, I hall fa lth c;omply w;jJ:l)rn~~'provlsIOnS.
. - . . /;~-:~ ,\ :~~:~.::
03t6::5/4/2004 Applicant: .:~t :~~:';" :".; .
WARNING: FAILURET6sECUREWORKER'S COMPENSATI6N cq~~o!\GE IS ' .
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TOCRIMINALf1EI~)Jfl!,S ANDClillL
.FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,OOO).IN.AD\;j' n0N TO THE;'
COST OF COMPENSATION. DAMAGES. AS PROVIDED !'OR IN st:(j'1'l.btpro~ OFTl:fE\"
L~BOR CODE, INTEREST AND ATIORNEY.S FEES..' ...<ii,k'f~(' '.,,:<,.:.
I ....... CONSTRUCTION LENDING AGENCY i,f,,:~\'
I~ereby 9:ffirm'lJriderper.alty of p~rjllry that.there ~ a construc~.i(mlend:ng~,,{~i::yfo?l~~;'~;:;i;.
perfor.mancecft~le wlJrk for whIch this permit"is issued (Se~"3097.:.CI'v"C): :-\ \ "..~. . .~.
_.l..J)"r1;::>.r.<",ll"f"'Dr..s1tD.... _____. ___________. ___~:_:__~_ <4::- >_:.:.:.
BUILDING PERMIT NO.
BLD2004.01516
.hPEOF PERMIT.
. T rac! Housing
DATE:' 5/4/2004
JOB ADDRESS: 6W S SUNKIST ST
LEGAL DESCRiPtiON: HEINS SUB LOT.3 N 72 FT S 472 FT W
,.
CITY
I certify that Ih~ve read "this'a pplication and state that the ~b'ove information is cOrrect.<1
agree to comply withal! city ordinances and state laws relating to building CC:1Struction,- and,
'hereby 'authorize representivesof this city to en'ter upon the a'bove mentione.:.I,property for
inspection p~rpqse5:' .
Oat'" 5i4/2004
ignature of Applicant or gent
The permit shall expire by limitation and become null and void if the building or
work has .not passed final inspection 365 days from the date of perr.Jit issuance, A
new permit is required to commence or continue work.
ElM.
BUILDING DIVISION
200 S. ANAHEIM' SL VD.
.(714) 7~5. 5153.
INSPECTiON REQUESTLINE:
(714) 765. 4~2~
CENSUS CODE: . 101
.QUARTER SEOTiON: 123
\
I.
5/4/2004
Date:
'.'-i..'
~
Con.tractor;.'-
NUMBER
.,-.;:.
EXPiRATION DATE
'.
TYPE
~;,'J""
~;..~.
. Cons1ruci;n TYP~s:
VN,.. .
Occupancy Groups:
R3, U1, , ,
Fire Sprinklered?
Dwellino Units:
"Li\:,ino.Area: .
Garaoe Area
NO
1
3,201
999
~":" ."
.-,--,:>.,',
-'--_.~-----"~----=-=~~:- -...
Fees paidf~r Permit:
Total:'
6.644.74
..
INSPECTION RECORD
INSPECTION . . DATE INSPECTOR .
Temporary Power Pole .. .
. Plumbing (DrainlWaste Pipe) . . .
Electric.al Grourid ElectrodeiUfer
SelbacklFormslTrenches' (Footings) .
Qo .not .install subfloor Or pour .floor slab until the
foll6wing appljcable items have been signed: . .
Plumbing (Water Pipe:SprinklerValves) .
Mech;inicill (Groundwork) .'. . T
'Electrical (Undergt(lund Condu it) .-n,~.
Pre-s.lab (compaction/Membrane.Rei nt. e 7-1- ot1 '//7Pr
.Underpinning (Floor Joist/Girders) / ".
Ill) not cover or conceal the work below until the .~.
fol.lowing applicable iterris have been signed:
1st Floor Shear '.' . 'I//,tbh..- / 1../),,,,
Firesprinkler(Rough) .. I ;, -
2nd Floor Shear. Illtoh>. f fL.
RoOf (Sheathing/DiaphragmlFrln1e)' . I Jh,V",.-; ?)'AM .
Masonry (Reinf./B(lnd Beln1/Pre-Grout) I'. ' . I'
Rough Plumbing (Top Out) .' . ~'l/o~ '7P. /
Rough'Mechanical '. .' . ~ .'
Rough E1ectrlcallU<Y nalll' ~
Rough Electri.cal " . ..' . . ~. .
Framing {Only after Plbg.:, EJec... Mecn., and Fire) . ~\,'J~
Insulation(SoundlEnergy)' .... " . "-II~" r
00 not tape .or plaster until the following ap'plicable. 7
items have been signed:. '..: -
DryWall '., .'. . .' .' . It/'n.o\ c<fL. \. ,,:::
Penetrations (Fire Rated) Electrical '. f
Penetrations (Fire Rated) MechanicaL .' . .'
Pen!!lraliolls (Fire Rated) Plumbing
Interior Lath, .. . . . . . ' . .
Exterior Lath ..... I~~'~~"
. " . '.GENERAL ITEM .
Exterior Plaster (Brown Coat). . ,,,", '0" _'>:I'. lL.J......J.
T -Bar Electrical . '. . . /
T -Bar Mechanical. . . '.' .
T-Bar.Structural . ~~ //
Sewer '. '.
Water Engineering Backflow. ' '. . "
Water Service . . "f..-u-<1rJ /T
-.-......-:
FINA.L INSPECTIONS
Electrical Final.
PlUmbing Final
Mechanical Final
Inspector
Date
Gas Test
.".;
e: '1.,
tJ/,}
. 1/-2).0'$ /L ,~
Sub List/Business License 765-519 1i-',c'5~Jl.
("l- (;00'1' ,4. VIl-$<llteL- .
-'Lo}.or:-FM'f1l
PARTIAL INSPECTIONS
Buildina Inspections '.
10' ~ot/' r~ N71?UXJ6C>~tI9~
. .~.
. ,
Engineering/Grading Final 76505126
Fire Dept. Final7654040
Water Engineering 765.5268
Zoning 765.5139
'Building Final ILa.stlnspection. 'Only
After Above Complete)
. Mechanical Inspections
Plumbina Inspection's'
Electricallnspectians
-.
i
APPllCANT: l
OWNER INFORMATION: CONTRACTOR INFORM'TION: ' ARCHITECT/ENGiNEER INFORMATION:,
DAVID LOI, PEROCKCONSTRUCT"DNAND DEVELO 'KENNETH E AGEE SE3340 '
601 S SUNKIST STREET , 10331 ARUNDEL AVE r. ," , 3452 E FOOTHILL 626-432-5850
ANAHEIM, CA 92806 WESTMINSTER, CA 9268' 5822 PASADENA, CA 91107 '
, BUSINESS PHONE: 71483'~'0661
JOB DESCRIPTIONl\dd 345sf family room extension and 400sf master bedroam extenstion' and 138sf balcOny
; ,,;.t\
VALUATION: 24,000,00 , '\' PROCESSED BY: MJL
I OWNER-BUILDER1DECLAP.ATION . '
I hereby affirm under pen~1ty of perjury that I am exempt from-tre Contrad;crl~ Ucense Law for the following reason (Sec. "/031.5 Busjn~ss ana
Profession~ Code: a'ny ,CitY 0r coun~ywhich reQ~i~s a permit to'con~Jruct.-'af,~r lnip'roy~...demolish or retx;lirany structure, priorto i~ iss~anc~,,~lso.
reqUire~ the applicant for such permit to file a signed statement that I:le isIic.flnsed_pu~sLlant to the provisions of the Contrac:l:or'S:"license-la\N (Ghapt~r
9}(comtnencing with Section 700o.of Division 3 of the Business and Professt,:hs Coderor that he,is exempt ttlerefromandthe_b,asis for the aUeged
exemption. Any violation otS~cti,on 7031.~ by any applican,t fqr a po/mit~1J~~cts the ~ppl,!cant, to a civil penalty of not, more t}1an~~~:'hundr~~ dol~~_~s
~::::~,o;;2 ~~~~~=~h~rF>~~f:.i;~1e~d~:t~r~:~~;ni~a~~~s~:~:n~~ti~~~~~:'1~p~~~~:ik~;~~rt~i;~~~~e~~~E;i7d:h!j~~;0~~;j,dfO;"
thereon;"1l:nd who does such work ,hi mself or;herselfor through his or ~ ov'/:t'srTlt}l.oyees, providt1djhafsuch lmprov~me8_t:5 are'not i~t~ndiil~r'",:>( '.
offered for ~Ie.",jf, however, the_puiJding or.improvemen~#>,sotd wi,thone y~,~to~,c(;mpJetioh; the owner-buflderwill,tta'ie_the _burden of,p~ovjilg ,~hat h~
did~otbuil~orimproveforth~purp,oseof~le)<,,' "r,j:}:~~,-<:,~;;-_ .:;rr,.: :':~":"'!::;' .' - _ ,c,,'- :"'-:.-- " ' '::"'_-:\~.>~,',::.' ,
D r, as the 'owner of-the property, am exdusively contracting with license9,~n_~rador::;Jo construct the proJect (Se':. , 7044 Business,and ;P:rofe&sions'-
Code: The Coptractor's Licen,se law does not apply to an ownEor of propetty~t:o buiid~,:-9r improves thereon, and who 'contr?,cts for such Projects with
tjontractor(s).liaensed pur~uant tO,the Contractor's license Law). _:(-;1 .;~. ,._": _
I am exempt un,der Sec.;. .....: '-, B &p.C.!orthis reason: ,....-.'lr
Date: ,. ..WOR~;:~COMPENSA~ION~EC~RATION :~' '\ J I
I here.9X,affir~ underE~nalty of pe~U1Y,on~ <?f the ,fpllowing declara~ons:. . '-" . . ::co::: " I
0, I have and will maintain a certificate of ronseJ'lt to self-insure for wcrl~er.-~-..~ompensat;on:
as provi,ded forby Section 3700 of the Labor Code, for the ~rformance of.th;; wof'~ for which I
this' per~it is issued. . _ _ -_:' !{,.__'
o I have and will maintain worker's ,compensation ins~.raJlce, as require-d b~'~,ection370o. 0
the labor Cod'e, for t~e performahc~ of the work for 'which this permit is is..:u::.~t~MY w()-r-ker'~
Compensation insurance carrier and policy are:- . . '. -'~,~',! ':{~r ,',;-:: .
Carrier: STATE COMPENSATION INS FUND Policy Number. 139c589~'{'1,:;'. '
" , - ,...,'..-. .-" ,-' "'--. '.' <'
This section needqot be completed if the pennitis for one. hundred d()liars .($~~1:~~~s.' .
'0.. I certify that in the ~rfonnance pfthe work forwhich this p~rniit~, i~;~.t1f sh~)t~<?~, .
employ any persc:'n in any'm~nner so as to become,. subject to the work~r'~~~~~rt~~sa~~~~..~aws ,
of CalifornIa, and agree that If I should beco e subject to the worker's_'compe<:'5ation":/,~:,'~;;"" .~
provisions of Section 3700 oqhe La, Cod, I ~na!,lfo comply wU~~hfeprovisioi,s, I eo~~tr~~ion T'/oes:
Date: .t1/1.8/2004 ~ Appllca~t: , . ,,'._-, J.i:., "--7;~''-;':-. Fire Spnnkfered?
WARN ING: FAILUR TO SECURE WORKER'S COMPENSATION COVERAGE IS '>'" living Area:
UNLAWFUL, AND S ALL SUBJECT AN EMPLOYER TO CRIMINAL 1:$,iW'oL:j'iES,ANd CIVIL Pati~ Area:
FINES UPTOONE HUNDRED'THOUSAND DOLLARS ($100,000), NAot'(1l01j TQ:,THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR, IN SECTION.o7060F'THE
LABOR CODE, iNTEREST AND ATTORNEY'S FEES, " '",'.}:i/'-i:'
I , , ~__.._'-..c_ CONSTRUC'nON LENDING AGE~j0yl".." ;,j'/" " "::>;cc_,_~, '~~""":'",:"":,:,,, .~, c "" ~~". ''':';'', ,,:..~
l herebyatfirm underpenaltyof perjury that there is a ,construction lending agency.for the
performance ofth~ work for which this permit is issued (Se0.3097 .Civ.C):
Lender's Information:
BUIL~ING PERMIT NO,
BLD2004-04018
,~tf-~)~F:":~~~~
J, ',~", ,','"
I,"~,,:i:-t"""":,' .-_-J'_;.. ",::i~,\ .
l;~ '.:,r-:',' .p"
~\~:c" '"~ .EIM
aR~-~ . ~,in .
"~\~i~~~~~, ,'~f~;
\~.P -...:,,~<<;-- \ :;,-"" ---f'. \,Q
~~ttl{7i~\.~)'oY ~>v.
*TYPE OF PERMIT
Residential Addition
CITY
DATE: 11/18/2004
JOB ADDRESS: 610 S SUNKIST ST,
LEGAL DESCRIPTION: HEINS SUB LOT 3 N72FT S 472 FTW
BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765- 5153 ,', _
INSPECTION REQUEST LINE: '
(714) 765,4626
CENSUS CODE: 434
QUARTER SECTION: 123
"
l
L1CENSEDCONTRAC;ORS DECLARATION ,',"!
":, .1 hereby affirm uf1d.e'rpenaJty of perjury that, I_a,!,.
iiceilsed'uhder' provisiq.~s of c,napter9 {commepcing
With, ,Section 700,0) o,~,' ie, n..3 of the ~usif1ess an, d
~ro"fesslons~"",,-, .'.,.' '-.,
11/18/2004 '_~
Date~, ' . -, -Contractor
NUMBER
588236
TyPE
TYPE
EXPIRATION DATE
2/28/2006
B
'Hie
. I certify that 1 have read this application and state that theabove information!s correct. f
agree to romply with all city, ordinances and state laws relating to building construction, and
herebyauthoriz representi of this city to enter upon the above mentioned property for
i pecti p r ses.
NO
745
138
Date: 11/18/2004
1,679,47
Signature of. Applicant or Agent
, The permit shall expire by limitation and become null and void if the tuilding or
work has not passed final inspeCtion 365 days from the date of permit issuance. A
new permit is requ,ired to commence or continue work.
Fees paid ,for Permit:
Total:
,
INSPECTION RECORD
, IN:r;EC'i'lo),
. DATE INSPECTOR
Temporary Power Pole.
Plumbing (DrainlWaste Pipe) I.
Electrical Ground Electrode/Ufer
SetbacklFormsfTrenches (Footings) .
Do not install subfloor or pour .f1oor slab until the
following applicable ilems have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GrourKlwork) .
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane.Reinf.
Underpinning (Floor Joist/Girders) .
Do.not cover or conceal the work below until the
following applicable items have been signed:. '7J&iir
1st .Floor Shear I tl//s10<t' .
Firesprinlder(Rough). /
2nd Floor Shear . .
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReinfJBOnd BeamlPre-Grout) .
Rough.Plumbing (Top Out)
Rciugh Ml!chanical ~ ~ A
Rough aectricallDry wall)
Rough Electrical A
Framing" (Only after Plbg., Elec.; t,,1ech.. and Fire). f<iIQf"lo:J fA j",.&u
Insulation (Sound.'Energy) . 14.11-0'<;' Jov~
. Do not tape or plaster until the following applicable /
items ,have been signed:. . n.
Drywall . .... 1</"1-7'Oj ~ '-I:f ,. ~
Penetrations (Fire Rated) Electrical I
Penetrations (Fire Rated) Mec;hanical .
Penetralions (Fire Ratl!d) Plumbing .
Interior Lath . . . . . n
Exterior Lath . 'S'" . .
GENERAL ITEMS 1111'.
Exterior Plaster (Brown Coat) (;.,/.'OJ "..~,~~
T -Bar Electrical .' . /
T-Bar Mechanical
T -Bar Structural .
Sewer '.' . .
Water Engineering Backflow
Water Service
FINAL INSPECTIONS .Date Inspecror,
Electrical Final . "
Plumbing Final . ,
Mechanical Final .
I .
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!:ast Inspection' Only '/t.7-0f" I::-U~ .
fter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
';;"-,.
'Mechanicallnspections
Plumbina Inspections,
ElectricallnsDections
1_
..
. '.
,6~~(J2~~
, '1{t-~~?L.-";-::,:~.:.):.
'a!~'i:<, ':;T<'O"~;.'.. .
C'ITY . ..~~~ .' 'j i'~~1 '.E..IM
. .1,V.JJl~_-: ~ < -~ ,
. .' \\ '\.{r($"~ I _" "
DA T.~' 9/.3/2003 ." ;"'w,:~ /. i!
~ - T ~~'-<-: t>J""". .
JOBADQRESS: 610SSUNKISTST <~.";,jX, . .
LEGAL DESCRIPTION: HEINS SUB LOT 3 N 72 FT S 472 FT W "r"
r
:.
\ .
CONTRACTOR I.NFORM/;'i10N. :.
KIRT LAND CLEARI NG IMe .
345 E GARDENA BLvD ., '11 .... ,..
GARDENA, CA 90248 ooq(';
BUSINESS PHONE: 31032,.1641/'
JOBDESCRIPTION:Demolition of 1700 s~ ftbuildin9.": ~''IGl:
VALUATION: 10,000.00 \l,.. . . ..," PROCESSED BY: ODC . .;
I OWNER:SUILDER;@ECLARATION .:,
I hereby affirm under penalty of perjury that I am exempt from the Con\~~6~"r.. License' Law fer the following reason (Sec. 7031.5 Business and _ ._",
Professions COde: any dty or county which requiresa permit to construct,~alIJr, imorove, demolish or repair any structure, pnor to its issuance, also ~",".'
requires the applicant for such permit to file a Signed statement that he is Iic.S,?sed purslJa'nt to the provisions of the Contractor's, License Law (Chapter ..~:,-,~
9)(commencing with Section 70nO of DiviSIon 3 of the Business and profesg:~~i1S CodE::) or that he is exempt therefrom and the basis for the alleged 'S'~:'<~
exemption. - Any violatien of Section 7031.5 by any applicant for a permit Si/ ?cts the applicant to a Civil penalty .of net mo:-~e thanfive hundred dollars . -.-,
($500). . ,I . . '.
o I, as owner of preperty, or my empleyees with wages as their sole comltf-ns ..i 0 the work, and the structure Is not Intended .or .offered for
sale (Sec. 7044 Business and Pr.ofessions Code: The Contractor"$.;..LicenseJ:!~"i.' f}esnot arplyto an owner of pr.operty whe buildser imprOVE;$
. ,thereon" apd who does such work himself-9[ hei'sel~ or m.rOl.igh hi~rorhercjv~it~_mb)~y~e~~bVidedth~t,sUChtmplOve.":lent~'are no!;i~teMed or-:-<--..",:'
. offered tprsale.if, however, the building orJn,provement is soldwltpone Y~~\Of'C<l"ti~eti~,the~wner-buJlder\Vi!lh~vet~eburdenotprovin9lhath~ .
o n~t:'u;~ o~~~. ~:~~~:~r ;~o~~~~: ~~::.~eIY oontra. ding w1.t~~.;i.io~nse~~.." ~.;.ra;~.'.;.'.s.':..t.'.9.}'C. ~n.~!.~. u..,t t.~~~;Oi~~t(S. e~. 7044.~u'~in.--~~~.'-~~d'-;~.ofeSsi~'r.;..
Code: 'The'Contrac~or's License, Law does not apply to an .owner .of propertyrt,'no:blJnCf~})~:ii1ipr~vesth;~iE'on. aild,who:c6nttacts. for:such projects_ with
D~-"~-.."~",.,~",~u.,.,~>",.\.,!;,,/,jii';,i1;i" ." :;' 'i
~ am ~xe~P! underSec~,., ' . B & ,:,.C,.'fo_r, thi.s reas~n:.;,_: ./~~j;-:-,,-:;" _-",-,.i,-,'::":
Date: " -, Owner:. "'C','__ " .~ .'.." .,_'-,;;,;"~_,,,.'~,:'., ,'. ;'.:' .-'.___ ,..:.'
I WORKER'S COMPENSATION DECLARAT!ON .'.....F';,.< LICENSED CONTRACTORS DECLARATION .'"
I.hereby a!fir", under penalty of p"rjury one of the followin9declarations: i{r',<;!,;.:".\<,.; 'In~rebyaffirm underpenalty of perjury that. lam .
o . I have. a. will- ma if.1tain a 6~'rrific~.te of oonsent t.o ~If":"insui"a fO. ..r ''/..orke~.':'*9...0.mp'~,~sa;iio~;'-..)_i~.P.~S.. e:9'~nderp.t.o. \,i~iO.~,S.}). f..f~~.Pt... r:~(~.?~rrle...~9i:1 .'
a~:~o. vid ~ :'~;sb:e~e. ctio~ 3700 .of the.. la~r-,C .ode'for the perrorm~. n,~- of !\1,~9~f'~:~~i~;i;'.~.hfl~f~~:.,_~~.oo~ Of~\VS,IO, ~.3; //...r,~~e B -,~$L _ d
. have and will main~in worker's. c9mpensation insurance, as I~'ciuired b'Sect;C;h~ 3700 of 1~'9~;3/2063:'" - . . ,'. . -. ,
t~e labor Cede,f.o~ th~ performance of the work fer which this permit is is:',}J..,. Mywolker's'~ . Date:, .:' 'Contractor :
Compensation insurance' carrier and policy are:. .' ......L~ .' .
Carrier: STATE FUND. Policy Number.;.<t!?,';X)('t'Ot' EXPIRATION DA1'E
This 'sectio,n~eoo not be completed if the pennit Is for one ~lmdred ~CJllar~~(${QPt~r.I_,~~(~/~i:1(.,~~;,:.. C2t-CJ./~1!200.J '.
o I ce~ify.that in the perforrnanc:e of the work for which this permit is !SS~Pr}fshall nO"~'..'</, ;; HIC
employ:any person..in any manner so as to becom. e subject to theyt9r.k~.~~::'Cq~~nsa.tio;.!J.GlWS
of California, and agree that if I shou Id bec.ome subject th e wo ~er's"~on;~~ation, :,'- - ,
prov",ions of Section 3700 ofthe Labor de, I sh rthwith co ith,!pcli;;, provi; ,so
. "ffi!!\r ..
Date: .9/3/2003 Applicant:
WARNING: FAILURE TO SECUR W RKER'S COMPENSA N'cov:~.iGE IS;,:,;
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMIN~L PENAtir~S'A~Io<:IVII:
FINES UP TO ONE HUNDRED THOUSAND DO~LARS'($100;6oojijNAD.DtrlO~ TO JH:;;*,:,
COST OF COMPENSATION, DAMAGES AS PRoviDED FOR IN"SECTIOOi:'l706 OF TH=',
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . . ';...h' ..." ~,.," ,.ji'B~""~
I, '.' '" CONSTRUCTION LENDING AGENCY.. ""1'''; 'i<.;~~y> .''-
!hereby affirm under penalty Of perjury that there", a oonstruotionlending' afj",i':>'/9rt~e:t~.. .,
'__.Qerfor~'1"I('Il'l_~J\P[tne \!,J0rk_!()r_wh!&.~Jb!~cr."1)I!:..'S_L<::.!'LI",~-:l_{S-:~..30-9-+..t;;"!--G}~_ . ~~'~-"'J .- ..!~, " - ,<-:.
- Lender's Infc-rwation: '
BUILDING PERMIT NO.
BLD2003-03459
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTIoN REQUESTL1NE:. .
(714)765-4626
.
TYPE OF PERMIT
De'molition
, ,
CENSUS CODE: 434
QUARTER SECTION: 123
).3
APPLICANT: RICHARD PINARD
OWNER INFORMATION:
Sangha B hitemational
8752 Westminster Blvd
Westminster, CA ,92683
ARCHITECT/ENGINEER INFORMATION:
.NO
.
information is correct.'-"',
buDding corstruction,'and
vementionecl property for ,':)l~.. ",',',
'I ,",j
Date: 9/3/2003
Fees paid for Permit:
Total:
~.' . - ,"
209.33
I 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 from the date of permit issuance. A
. new permit is required to commence or continue work.
"
., ';"",
:.1;'_
.'INSPECTION RECORD
. .: I{;-:::-INSPECTION ,'",
;?' 'Temporary powlir Pole" .
plumbing (DrainNVaste Pipe) . .
". . Electrical Ground Electrode/Uter
:~ SelbacklFormsrrrenches (Footings)
.... Do.not install subfloororpour floor slab until the
c'. tollowing applicable items'h~ve been signed:
.... Plumbing (Water P1pe.Sprlnkler Valves)
.....M!iCh3nlc:al (GroU'ldwork) .-'-
.... J:/ectrical,(Uilderground Conduit)
" ,f'!8-slab(CompactiO!liMembraoe.Reilir
Urld!H'pinning(Floor JoistlGi!ders)....
Pollot .cover or conceatthework belQWuntil the
fO,lIowing applicable itemsh!3ve been signed: . .,
'. 1'stFloor SI18ar'/\':', ,:,/.,.... ,>'" I' . ...... c;c .
Flresprinkler.(ROliglj)" ..,...........,. .,~
': 2IldFlo'or,SljliarA,\,',:::""" , ,,\.:~ I: .", . i
'ROof(Sl1eathin!ilDiaphtaamlFrame)..::>I', ~ '". .'
;~c!mj(Rielnf:IBond_BeamlPr.c;n:itlt) I .' . "', .'
Rough Plumbing (top Out) , ,';.'.j .:....
ilc:iP9htilh'Chanica',-'~, . .:", ~..
!.I9hBectrlCaI 111:;;",.'..,.,..,."",,-,
Rc:iugh Electrical . ." : . . " ".'
Framing '~(OnJyafterPJbg.~~lec Mech ana Fll:e) .; ,:.;'/,.."' -.;-,
Insulation (SoundlEnergy) ..,.........: .,.." .,
D.O... .not. tape.orPlaster until. the f!l..1I.0.w.. in..g. applicable..' " . . . .
items have been signed:. ..... ,....:: . .,..~.,' I
Drywall~>2,;;:r' e;-"::;-;..)S; _. _, '__'>:~:,c_:;__ ',<;".: ,.:~ _':~:-'-":<,; - <
'PenEltr'ationS (File Raled) I;Iec;trical "," I' '" ;. . '
'-'-'PenetratiOns (File Raled)Mlichanical'.," . " . .,:..: . .".
~[Penetrations (File Rated) Plunibing -V .. ':.:,
Iriteri~rLath::'~ ~.......i . " ~
E>rtenorLath...;.;;,'.".~" -'-"',.: -;; ~
";,;~. . .;>,;,....,:. -'-GENERAL ITEMS";'3 S .
.E>rterlor Plaster (BlOWn Coat)., - -..:;-, '.
:i ;T-Bar Electrical' . .
.; T -Bar Mechanical ·
:. T -Bar ~tructural
; Sewer
., Water Engineering Backflow
'. Water Service
DATE
-
INSPECTOR
I'.
'. ' :~
I
;'.
;';"'~"
. '., '.-
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'. .;':'; '.
.
~.
FINAL INSPECTIONS.
Electrical Final
. Date.
Inspector '
PlumbiQg FI.nal
fi" D~pt.Flrla:1 765-4040; ,
water Engineering 765-5268
"""'-,.."" .,' ;-.--, ..-, ....-...,;.,...
Sii~LlstJaU!llne~!, Ll"ense 765-5~9
ZOrling 765"5,1~9:.;
Buiiding. Fin.a.I.','.ILastlnspect. iOI)' Only' /. 'L"~'."'. ",....0...
.-,;After AboYeComplete) i'
, PARTIAL INSPECTI()NS :': j,,;
BtiilcfincilrlsDec:tiOns > ,'si',f;"'}
~ .:-\ ~-.,'.J:, ,';.r'; ;::;~~~~~~~~~:.: \'
.:. f;j;:~
y ':;t::~i{;~
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Mechanicilllns
~<j" 'oT'
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u , __: . .!,.....~-,'
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. .. ,\;;:;:,q{~l~
, PI~11l6inalnSDeC!i.~ns':
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Electi"icallnSDections .
-~,j'~:~~Mt~~
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Aug 19 03 03:42p
,
KIRT LAND CLEARING INC.
13103665931
p.2
"
..
SOUTH C~AST AlR QUALITY M~NAGEMENT DISTRICT
NOTIFICATION OFOEMOUTIONOR ASBESTOS REMOVAL
COMPLETED BY M n
DATE _'
MAUORMANO FEE TO SCAQMO. ASBESTOS NOTIFICATIONS, FILe: U5641. LOS ANGELES CA 90074.5641
SCREEN BY RECElVEo POSTMARK ENTE~ED BY NOTIFICATION'
ad COMPANY
CHECK't :2-r"! FEE $
O'fINAL RtvlSJON OATes
b<gM'ON 'OAooREO DeMOiJnoN
~
03
NOTIFICATION TYPE
PHON.E
PROJECT #
PROJECT TYPE
..... .... ,J
ReyiSJON 0rliE~ (hiIlhUOhl)
CANtil.LATlON
SITE INFORMATION SITl~NAME '
.I,'!
'SirE~ ,.'''..~q,;'. ,.s~~i
CITY '/.Jlf'lhfi(f/l.
DESCRl8EWORKAND LOCATIOI'-l
BUILOING SIZE (SO FT)
BLOG PRIOR I PRE$ENT USE
RENO\IAltOH (removal)
....-...- """"'-',',-,.-",
~"EllGl1NCV REMO\IAi. PLANNeD RENO (annual)
~. >,
, .,.~,; 'i r.., ","',;~~_
'~'&ijP;t~'(J.\.~"':rfYl!fefJl' "6RbSs it~EE~'"
STATE ZIPeOUNTY t."
NUMSER OF FLOORS I
HOSPilAl. INOUSTRIAL OIlIer OfFiCE 'PuiIuc 8Ul<;, HOUSE
BUfI.DING AGE IYEARS)~..r NUMBER OF DWElliNG IJNlTS I
"
SCHOO<. SlilO UNlV.co..~EGE
2Jp CJ2,(p
y~ NO
YES NO
!
PROJECT DATES
ASBESTOS AMOUNT TO BE
~VED,(in aquare feet)
ASBEST~ REMOVAL FROM
AIlOUNUIF EACH TYPE OF
ASBESTOS {In Sl/u!llll/9Ill)
FLOOR Tlra (VAT) DRY WAU PlASTER TRANSITE ROOFING
,
Cl.ASs I
ClASS 1/
SURFACES
PIFES
--
COI.!PONEi'iTSo'
I
Acousm:'CEIUNG LINOLEUM INSULATIoN FIRE I'ROOFING OUCTlNG
STUCCO
MAST;C
OTHeR
(describe)
CONTRACTOR IHFORMATlON CSLS LICENSE #, 4a6951
os....A REG #
AQMOID# 97440
NAME KIRT LAND CIoEARING, INC. AOORE;SS 345 E
CITY Gardena, STATE CA ZIP 90248 SITESUPVRMark E. Kirtland PHONE 323-321-46(;
WASTE TRANSPORTal 11 I..AADFILL PUENTE LANDPILL
! AODRESS ADDRESS 1955 Workman Mill Read
CITY STATE ZIP CITY Whittier STATE CA ZlP90607
· Asbestos surveys are reQuired prior 10 Dernolllion and RellQvation
C'^_"" I........".j:__~ __.J.. _. ~ ___
Aug 19 03 03:42p
,
KIRT LAND CLEARING INC.
13103665931
p.l
SCAQMD NOTIFlqATION OF DEMOUTION OR ASBESTOS REMOVAl.
MAIl OlllGINAl TO seAOMD. ASBESTOS NOTIFICATIONS. FILE' sml. LOS ANGELEC CA 9007He41
.'
WASTE TRANSPORTER #2 WAST!; STORAGE SITE
..
ADDRESS ADDRESS
CllY STATF. ZIP CITY STATE ZIP
,
-
CONTROLS: DESCRlS! WORK PRACTICES AND CONTROLS TO BE usee AT THE RENOVATION AND OEMOUTION SITE. Procedure # 1. 2. 3. 4. $ or Olher.
~ w/laborSI. Demo w/Cat'. r.nAAer.. uaing wa.ter: fal: du.at CClntl:ol , Clearing the lot.
For aslleG1ClS l'8IltCl'/aIlI c:lreIe the cornllinalion 01 Rule 1403 procedures used. PtCC8Clure 4 and 5 submil p1a1l$ for ACMO p!for approval.
~8ESTO$ D!l'ECTIOH PROCEDURE: CIRCLe THE;PROCEOUflEs AND ANALYTICAL METHODS usED TO oer~INE ASBESTOS IN THE BUILDING:
lU".1, Bull< G.In1pIlng.InspectiOn, PLM, PCM, TEM. Assumed as AsbestOS.pACM, Describe Olller.
'OR llElIOl.ITIONS GlVll THE COMPANY NAME ANOOA TES 01' THE ASBESTOS REMOVAL: ~ a;, S~ "7;1,,)...';::"3
OR ORDWD DEMOLlrlOH SEND A COPY OF THE ORDER AND GIVE THE AGeNCY NAME & PHONE'
,UTHORIZlNG PERSON: ffiU: I
lATE OF ORDER: I OA TE ORDERED TO BEGIN: .
OR EMERGENC'f ASBESTOS REMOVAL GIVE THl! N~ ANtI "MONE NUMB~ OF ll1e PERSON lloClARfNGlAt1TKORIZIHG THE eMERGEh'CV. OJ. TI' ANO HOUR OF I
MfRGENCY ANll C!SCl\IllE '!liE WOllEN, UN!XPECT!D EVENT:
XPLAIN HOWM I!VEIlTWOUlb CAUSE UNSAFe cCt~QmONS. eQUIPMeNT OAMAGE OR UNRI:ASONAllLE FINANCIAL BUIIDEN,
OtmNGENCY PI.A/t DESCRIBE ACTIONS TO ill! F01l.OWEO IF UNEXPECTED A$8ESTOS IS FOUND DURING I:lEMOIJTIOH OR ASllesros MATERIAL eecOlolO
ISl'UR8CD.ORUMBLiO,l'UI.VERJZeD.ORREOlJCeDTOPOWoetl. Work is stopped imnediately. Property owner is cont..ct<>d
CNner ia tolCl to get a licensed .Aabeeto.ll ~tement co. tp reIIl:lVe the Asbestos. if an .
'.
~INlNG CERTIFK:ATlOH: I cenily that an individUal flairied in !he provisions of regulilion AQMO RIJI.l403 a."ld NESHAP win be on site curing th~ :e01O\'3' and .
'ilJenCIIIhaI the /8qllWIJ Italnmg has lleen a;:eompnslleO by !his penon wiU be available for inspection during normal bual.... heu... I
lmpany Name pnnl name of owner/opDralllr Signature of owner/operalor TlllJe of ownerIOll"ralor ~
FORMATION CERTIFICATION: I CllI\lty~'>al L'le al>o~.einformalion is eorroc1 and~ha en;..iose<! an~ult8ll allad\~s. ~ I
URT LAND a.BWNG" INC.- Mark B. Kirtland 4Y/c ~ 1"'4 I
lft1pany Name Prinl namo or ownerloper-nor SJgnalure OHlWn\ll/O alor' TlUIe or own$l/ope 02....:P ~I ~
'Uficalions can not be <lCl:8pled withoullhe required lli8CAQMD Rule 301). Asbe$\oe removals 01 less than 100 SQuare fee! are@llnpll,,,," nolifiealion and rm
I... ma:. d>eeIcs I"'Y8ble III '$CAQMll". F... are per nOllncalion, nOIletu.'ldable. 8I1d vary according to lh$ Plojec\ size. Fees are ilS lollows:
:MOUTION OR ASBESTOS REMOVAl PROCEDURE40RSPl.AN $321.56
FROM looT01.000SQUAREFI;ET $ 28.1lli SPSClALHANDUNGFEE ;27.35
FROM 1.001 TO S.OOO SQUARe Fm $ 87.81 REViSION OF NOnFICATION $11.59
FROM 5.oo1TO ~O.ooo SQUARE FEET $205.07 RETURNEO CHECK CHARGE $ 28.43
MORE THAN 10.000 SQUARE FEET . $321.sG CANCELLA.TIONOF NOTIFlCATION $0.0
:MOUTION OF LESS THAN 100 SO FT ' $ 28.llll AS6I!$TO$ REMQVAl.AT OI/ner. $ 28.68
occu led sl II dwDDin
TENTION: Keep I copy of your notification. slliie.1aw requi/as !hal you provide a COpy a1lt1e demoIIIIon nOllIlcaUon to lluildil19 and 5afAfy bot.. .~ is.uJne. of 0
JlQ/i!ion jlQIIll/l. Farqueatlona call1I09-3lll>-233G. F.llr.~ QlI\venlenca pease meII fill form and fee and do not hand I:CItIY 10 AOMO.
AlL fOllMAND FEll TO: SCAQMO. ASBESTOS NOTIFICATIONS, FILE # 5S641.l0S ANGe~ES CA 90074-5641
,LlPHONE: (901) ""2334 FAX: (909) 39G4342
\06.JC!: J"I~OtII"'PV\U'" .u""'............._........_...__ _~_
PaQ,:2(.l :.
Form REV OIil.;:>OU
. TYPE OF PERMIT
Blockwall/ ColurT)ns
DATE: 12/21/2004
JOB ADDRESS: 610 S SUNKIST ST
CITY
. 4(/~~~~~'~:\:i~'.~:~;~~.)). . .
1/~+/4 _ >. '~,-;", .
g~~~~HEIM
\t~~:~:I~l .
'.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
. (714) 765.4626
CENSUS CODE: 434
QUARTER SECTION: 123
BUILDING PERMIT NO. BLD2004-04466
LEGAL.DESCRIPTION: HEINS SUB LOT 3 N 72 FT S 472 FT W.
CONTRACTOR INFORM/erION:
WESTERN LANDES:G" ?, If~RIGATlON
13041 PALOMAR 8T
WESTMINSTER, CA 8268:',0000
BUSINESS PHONE: 714 a0~.B008
JOB DESCRIPTION: Build 130 lineal feet of 6 foot high block per city standard:"
VALUATION: 4,200,00
r- OWNER-BUILDERD,;;CLARA TION
I hereby affirm under penalty of perjury that I.am e?<empt from the Contract0r~,s License Law forthe following reason (Sec. 7031.5 Business <:snd
ProfesSions Code: any city or county which requires a permit to .corlstruct, 2:~,\!";\rpp~ove, derYlOlish or repair any structure, prior to its iSsuance, also
requires the applicant for such permit to file a signed'statement that he is l:cf':r)~i:-i pursuant to the provisions of the Contractor's License Law (Chapter
9)(co~mencing with Section "7000 of D\v\si'or. 3 of the B~siness and PrOf€ss:!;ni,COde) or that he is exempt therefrom" and "the basis for the alleged
exemp~it')t], Any violation o( Section 70~1.5 by any applicantfor,a peri.'P sV"?J;"('dS the applice.r:t to a dvil pen'altyef not mrJre than five hlJ:"l_ored doilars
($500). .. . .!. " ...
D^,l, ascwnerof property...or my ernployep.s with wages -9$ ttleirS0lr) com~I"':I,-:;ation. w!j! dcihe work, and the struc'(l~re ,is n(">t~htenaeo or"()tfcr~'d fG.lr
sal~ -(Sec,]044" BusinesS,and Proff''ssions Code:" The ContiActor's Ucen~e L;;:'glioes loot apply to an owner of property v~ho' builds O( improves"::.,",
the,repn, and who does such work himself =r herself or throL!gh his 6r her ()W~;-,,-?i/iblcyeeS, provided that such improvements are!"!ot i:"lt€!nded qr j, .'
offered for sa:le. If, h'owever, the building or improvem~nt is sold wm, O:1e yc~\:':;:'f rompletlcn, thF:' owner-builder willlJave the bUidenof provingthat he
didnotbu!!dorirflprovefor,t~e-purposeof..s:ale)." _ ':"." ..., "";:_ .".." _'. '
0,. I,a~,the"bv~ner cfthe property, am exd'Jsively contracting with !icf.'f'lsed ~?:;;~t(cctors to ccn::.truct the proj.;;~t (~e("~ 7044 fyJsiness and Pron~silons
Caae' The Cont'Clctor's license Law does not apply to an owner Qf iJfopenj:\!t"'l') bUild~ or ;mproves thereon, ar:d ....,Iho ccmtrads for such projects with
i2-c:rontractor{s) licensed pursuant to tns C..mtractor's License Law). I
U I am exempt und~r Sec. _ ,8 & P C. for ',nIS rea~on. .__;~___ . _
Date: Owner: ..;:" _ f-,"_:- ___
I . WORKER'S COMPENSATION DECLARATION l-:- J r l.JCENSE:D CONTRACTORS DECLARAT!ON..J
I hereo~l ~ffirm under penCl.lty of perjury one of th~, foi:owlng declarat;ons: f. r I hereby affirm llndel penalty of perjury that I am
o I have" and wil: maintain" a ce'rtificate of oonsent to self-iri3U1e for work€:~"!:"';"i1~pE::nsatlon. lll~ensed under ~rovis'on::.?f C~i::l te, 9 (co:nmencing
" as prov:ded for by Sed ion 3700 qf the Labor Cod'3; fo:- the performance oftht....o(,{ f,.)( .~'1hlch I v/lth SectIon 70001 ul DlWo n,;) he Busmess and
this: permit is issued. ~.', Professions Ccida~
o I have and will maintain worker's compensation insurance, as required:b+Sec~fofl;).IO(> of 12/21/2r04
th."l.Labor Code, for the performance of the work for wh,ich this permit is issu<.,t:l. MywoJker's Date; 'c
Compensation insurance carrier and policy a"re:
Carrier: POlicy Number. EX'';AP];' NUMB R. . . E'XPIRATI N DATE
This tion nef!d not be complete~ if the pennit is for one hundreddollar~{$10dio:}( t~s. 7::~~9 C27 12/31!2006 ..;
rv I certify that in the perfonnance oftl-,e work for which thiS pe-rmit ',s i~L!€{L I shall not I '
e ploy any person inany manner so as to become subject tu the worker's C(l"1p~nsatiorr laws
of CalifornIa, and agree that if I should become subJe totheWOrker's'compF1i.S31ion .
prov:5lons of Section 3700 of the Labor Code, I 5 II WIth amply with trqs~ pre,VISlons. I Construcion Types
'" I., VN, ,
! :;.
APPLICANT: ALBERTO REYES
OWNER INFORMATION:
'DAVID LOI
601 S SUNKisT STREET
ANAHEIM, CA 92806
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
Date: 12/21/2004 Applicant'
. WARNING: FAI!.URE TO SEC R.E WORKER'
UNLAWFUL; AND SHALL' SUBJECT AN Er....1P YER CRIf'vllNAl: PENAL: IES:p..ND CIVIL
FINES,upTO ONE HUNDRED lHOUSANDDOLLARS ($100,000);,JN ADDi;TlOlfTO fHE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT!On37060F THE
LABOR C DE, INTEREST AND ATTORNEY'S FEES, I .
CONSTRUCTION LEUDlNG AGENCY'. ' ' .
~h.s-"~b\ _:!'ff'i..... l!l""d~! ~~e!!,J '~f ;:..~...illrJ !!~?t ~P<:'~ :.; ? C",..st:,"l:cti~r'- !2-rv!;"';,; :~.:".--"':"J f.-v the::. --1
performance of the work fo/which ihis permit is issued (Sec:3097 .Civ.C): . - .
Lender's information:
'"".
I certify that I have read this application and state that the above. information jscorrect. I
agree to comply with all city ordinances and state laws relating to building construction; and
hereby authorize re re." f .es of this city to enter upon the above mentioned_,property for
j nspection purpose . U:('
Fees paid for Permit:
Total:
184.50
Date: 12/21/2004
c;
INSPECTION RECORD
INSPECTION
INSPECTOR
DATE
Temporary Power Pole
Plumbing (DraintWaste Pipe) .
Electrical Ground Electrode/Ufer . .
SetbacklFor/JI$ITrenchesIFootings) .ll/II/"it. : 1..Yo
Do not install subfloor or .pourfloor sial until the (I
following applicable items have been signed: '"
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit),
Pre-slab (CompactionlMembrane.Kei nt.
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below untli the
. following applicable items have been signed:
1 st Floor Shear
Firesprinkler .(Rough)
2nd Floor SlIear .
Roof (Sheatlling/Dlaphragm'Frame) .
Masonry (ReinfJBond BeamlPre-Grout) lo?(!(o() ~ I~ v...
Rougll Plumbing (To'p Out) 11,/ '.
Rougll Mechanical
Rougll ElectrICal (Dry Wall)
Rougll Electrical
Framing (Only after Plbg,', Elec.. Mectt:and Fire) .'
Insulation (SoundlEnergy)
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 Latll
Exterior Latll
" '
,
,
. '
, .
GENERAL ITEMS
Exterior Plaster (BlOWn Coal)
T -Bar Electrical
T -Bar Me'cllanical
T -Bar Structural
Sewer
, Water Engineering Backflow
Water Service
.
.
,
.
FINAL INSPECTIONS Date . Inspector
Electrical Final
Plumbing Final . , '
Mecllanical Final , "
Gas Test ,
..
Engineering/Gr;lding Final 765-5126
Fire Pep!. Final 165-4040 ,:
Water Engineeririg 765-5268
Sub List/Business License 765-519
Zoning 765-5139
Building Final ~ast Inspection- Only z..j-o~ 4W~
" fW Above Completel
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbinq: Inspections
.
Electrical Inspections
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PLANNING DEPARTMENT l
APPf10YED
DATE I JNf.F.~oOV-
BY \J~~r~_)
FLOOD ZONE~~~~
HIS 'I DISTRiCT REViEW,
N~A See st;3.~p t~Tis pa~,e
Clr 6 one on above line
SEE BUILDING PERMIT FOR
ANY CONDITIONS
EXISflNG 6'-0" HIGH
C.ONC.RE:TE E3LOC.K V'lALL
TO REHAIN
NEV'I b'-O" HIGH C.ONCRETE
BLOc.K V'I.t,LL TO HATC.H
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PLAN
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SHADED ARf'A
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EXISTING CONCRETE
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CONCREIE BlOCK
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THE ISSUANCE 01" THIS PERMIT DOES
NOT APPROVE VIO~ATION OF ANy OF
THE BUILOIN<3 CODES OF THE CITY
THE: HOLDER of THIS PERM'T
fOROOEECS AT HIS OWN RISK.
Fi:.8 1 6 2005
BUILDING DIVISION OF ANAHEIM
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VICINITY MAP
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Y1RNIAAVENUE
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SOUTHSTR .
SITE PLAN
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SUNKIST
HOMES
610 Sunml Street, Anaheim, CA
tlTD ftRCtllTtCTS
Arohftecture .
Interior Atchftecture
Program Menegement.
Planning
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Garden Grove. C.4. 9284.3
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IPRo.ECT....NUMBER
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TYPE OF PERMIT
Blockwall , Columns
CITY
l;:~~':i:'i":~~~\
QIi-~" j,iHEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 123
BUILDiNG PERMIT NO. BLD2005.00396
DATE: 2/14/2005
JOB ADDRESS: 610 S SUNKIST ST
LEGAL DESCRIPTION: HEINS SUB LOT 3 N 72 FT S 472FT W
CONTRACTOR INFORMI\TlON:
WESTERN LANDESIGN" IRRIGATION
13041 PALOMAR ST
WESTMINSTER, CA 926S.O 0000
BUSINESS PHONE: 714 89E-8008
JOB DESCRIPTION:Build black wall at rear of property 6' high by 165'Iong, pe- cily specifications.
.
VALUATION: 6,000.00 PROCESSED BY: ENO
I OWNER.BUILDERDECLAAATION '-1
I hereby affirm u~er pena:ty of perjury that! am exempt from th~ GontractO?~ License Law for the foIJowin9 reason (Sec. 7031.5 Business and
Professions Code' any' city or county w hich requires a permit to c(J'iis1rUGt, arti;)f, improve. demOlish or repair.any'slructure, prior tc its.issuance, also
requires_the .applicant for such ,permit to file a signed statement that he Is Ilc-e!lsed pursuant to the 'provisions of the Contractor's License Law (Chai)ter
9)(commencin~ with Section 7000 of Division 3 of the BUs'inessand Professj~ns Code) or that he is exempt:therefrom and the basis for the alleged
exemption. MY violation of Section 7031;5 by any applicant for a permitsub'ectaAhe applicant to a civil pen3.ftyof not more than. five hundred dollars
($500). '" .:i :. .
o I, as owner o.f prcperty, or my employees with wages as their solE: co;nptl/s8tIOr'!, will do the work, and., the structure is not ir.teri4ed 01 offerfld fOf
saie (Sec. 7044, Business and Professions Code: The Contractor's Uc€'ns6 lbw does net apply,toan 'owner of propertywho builds otimproves
the~eoh, 'and who does sLich work himself or herself or through hi$9r her oWf~.-l7rnployee~c:;, provided tha~ such improvements a:-c not !ntendedor
offered for sale.' if, however, t~ building or improvement is sold \{'Ii!~ one ye::!:- of completion, the owner-builder will have the burden of ploving th~t he
did not build or improve for the purpose of :~le}. . j-. '. ~
o I, as the owner of the property, am .exclusively contracting with liCenseC::;;omrac:tors to construct the project (56(:, 7044 Business and Profes.c;ions
Ca~e: The Contract9t"'s License law does not apply to an owner of fJfope;i.y~-hc builds OJ" improves thereon, and who ronhacts for such -orojects wlth
aJ;;ontractor(s) 1icenseo pursuant to the Contractor's License law). i.
[J I am exempt under Sec. __, ,8& P.C. forthrs reason: ~i
Date:' Owner: -'..J-
I WORKER'S COMPENSATION DECLARATiON I.
~' reby affirm und~r pena/tyof perjury one of the following declaration5: j
. . I have and, will maintain a certiflCa~ of ccnsentto $elf-!nsure _for wOrktd:!.. compensCl~joll, '
as rovided for by Section.3700 of the Labor Code, for the performance cf t~~. woik for which
thiS p~rmit is issued. ". - . . J ' I
o i have a nCt will m.aintain worker's compensation ihsurarc:e, as reql.ired by Section 37GO of I 21'14/2005
,the labor CO.de, for the performance of the work. for which this permit is iSSU:Y:, My worker's I Date:
Compensation insurance carner and policy are: ..
Carrier: PoliCY Number. EXE.MPT"
This section need not,be completed if the pennit is for one hl.indroo dollars ($100!;c.,r li'Ss., .
X1 .1 certif>j that in the performance of the work forwhichthis'permit is i8S~~.i I SI13U,t~t.
"ehipioy any person in any manner s-o as to_become subject to the worker's cdTlpensation laws
of California, and ;3gree thafif f should become sub. d to the worker's com~'€nsation :;~:.
provisions of S~ction 3700 of t Labor de, f aU ort~th om~ty with -'.\?S~_ ?r,(.>V'i~i,ons.
APPLICANT: ALBERTO REYES
OWNER INFORMATION:
DAVID LOI
601 S SUNKIST STREET
ANAHEIM. CA 92806
ARCHITECT/ENGINEER INFORMATION:
.,
~
LICENSED CONTRACTORS DEGLAR'" .ION I
I hereby affirm :.Jnderper.alt)' of pt:lrjury that I am ,
licerlsed unCler provisions of chapter (comme:-ncing
with Sec!: n 7000' f 0" n:3 of e Business 3nd.
Profes~i s C. e. -
C27
NUMBE
789179
. TYPE
Date: 2/14/2005 Applicant:
WARNING; FAILURE TO SEC
UNLAWFUL, AND SHALL SU
FINESUPTO ONE HUNDR THOUSA DDOLLARS ($100,000), IN AODlnClN TO.THE
COST OF COMPENSATIO ,DAMAGES AS PROVIDED FOR IN SECTION 37060" THE
LABOR CODE, INTERE$' AND ATTORNEY'S FEES.
L CONSTRUCTION LENDING AGENCY .
1r.?-reb.Y_ affinnunder 'penallY of oerjuryJhat there is a construr;ti.on lendin., ?c~f)Gyf()r thP.
perforl"f'8nce ofthe work for which this perrriit is issued (Sec. 3097.Civ.C):
Lender's Information:
Construcion Tyoes:
VN" .
Fire Sprinklered?
NO
Fees paid ~or p~'rmit:
Total:
184,60
../ Date: 2/14/2005
5i nat of Applicant or Agent
e permit sh I expire by limitation and become .null and void if the building or
rk has nat passed fjnalinspection 365 d;iys from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole ,
Plumbing (OrainiWaste Pipe) , , ,
Electrical Ground Electrod~ '
SetbaeklFOI'mslTrench....(F ti I1f 1610.\ -/JMUI
Do not install subfloor or: pour floor slab until the /.
followjng applicable items have been signed:,
Plumbing (Water Pipe.Sprinkler Valves) ,
Mechanical (Grouildwork) ,
Electrical (Underground Conduit) ,
PRl-slab (Compaction/Membrane.Reinf. ,
Underpinning (Floor Joist/Girders) ,
Do not cover or conceal the wo"" below until"the
following applicable items have been signed:
15t Floor Shear ' '
Firesprinkler (Rough) .
2nd Floor Shear, ,
Roof (SheathingfDiaphragmlFr-..l.
Masonry (RelnfJBond Beam(Pre-GlOYSl '1-/-of ~u.Ji.~
Rough Plumbing (Top Out) t:-
Rough MeChanical , - , ,
Rough l:lectncallDI'Y walll "
Rough Electrical
Framing (Only after Plbg.. Elee.. Mech. and Fire)
Insulation (SoundlElllIrgy)
Do riot tape or plaster 'until the following applicable
items have be,en signed:
Drywall ,
Penetrations (Fila Rated) Electrical
Penetrations (Fire Rated) Mechanical
Perietrations (Fire Rated) Plumbing , ,
Interior Lath ,
Exterior Lath
, GENERAL ITEMS ,
Exterior Plaster (Brown Coat) , ,
T -Bar Electrical ,
T.Bar Mechanical
T -Bar Structural , ,
Sliwer ,
Water Engineering Backflow '
Water Service , ,
-'
FINAL INSPECTIONS , Date, . 'Inspector
Electrical Final , " ,
I
Plumbing Final, 1
Mechanical Final I
<'as Test, I
Engineering/Grading Final 765-5126 i
" I
'Fire Dept. Final 765-4040 . , I
Water Engineering 765-5268 , I
Sub Lis!lBu5ine5s Licensli 765-519 i
Zoning 765-5139, , " ,I
,
Building Final *aSllnspecliori. Only' v~/o-r: '~,Jv'1. 11lI~
fler Above Complele), ' 'JP-' I
, PARTiAl INSPECTIONS"
Buildinalnspections'
,
:,
,
Mechanical Inspections
, Plumbina Inspections
i
i
i
Electrical Inspections