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322 N. Syracuse St. BUILDING PERMIT NO. BLD2005-00297 TYPE OF PERMIT Hesidential Addition DATE: 4113/200 5 . JOB ADDRESS: 322 N SYRACUSE ST LEGAL DESCRIPTION: . N TR 2775 LOT 58 APPLICANT: KIMBERL Y MARTYNOW OWNER INFORMATION: . Way ne L Woodan;! . 322 N Syracuse St Anaheim, CA 92801 CONTRACTOR INFORMATION: BETTER LIVING CONSTRUCl1ON 31878 DEL OBISPO SAN JUAN CAPISTRANO, Cf!. 926750000 . BUSINESS PHONE: 949 842-6709 JOB DESCRIPTION;Add family room, 348 sq. ft. VALUATION:. 23,400.00 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 , QUARTER SECTION: 19 ARCHITECT/ENGINEER INFORMATION: EDMUND C FOERSTEL 915:A CALLE AMANACER SAN CLEMENTE, CA 92673 PROCESSED BY: FAN OWNER-BUILDER DECLARATION hereby affirm under penalty o~ p!3rjury that I am exempt from t.he Contractor'~ Uc~nse Law for the following reason (Sec~ 7031,5 usiness an _. Professions. Code: any city or county which requires a permit to construct. atter, improve, demolish or repair any structure, prior to its issuance, also .requiresthe .appJica':lt for such permit to file a signed statementthat he is'licen1sed pursuant to the provisions of the Contractor's License Law (Chapter. 9)(commencing with Section 7000 of pi.vision.3 of ,the Business arid Professiol).s Code) or that he is exempt therefrom and the basis for the alleged exemption. Any'violation of Section 7031.5 by any applicant for a permit subj~.cts the applicant 'to 'a civil penalty of not more than five hundred dollars ($500), ';, . . . o I, ,as owner of property, or my employees with wages as tDeir sole comperisation, will do the work, and the structure is not intended or offered for sale (Bee. 7044 Business and Professions Code: The Contractor's Ucense La,w. does not applyto.an owner of property who builds or improves, thereon, and who does such work himself or helSelfor through his or her own e,mployees, provided that such improvements are n'at intended OJ . offered forsale. If,'however, the building .orimprovement is sold with one yea,': of completion, the owner-builder will have the burden of proving that"b~ did not build or improve for the purpose of. sale). -~ . 1:. ., ,:.., O. - ~, as the owner of the property,. am exclu~ively contracting with licensed cbntractors to construct the project (Sec. 7044 Business and Professions Code: The Gbntractor's Ucen~ Law does not app~ to an owner 01 prope.rty~ho builds or improves th'ereol), and who contradts for such projects with ~ontractor($) licensed pursuant to the ContraCtor's Ucense Law). ~! . U I am exempt under Sec; :, B & P.C. for this reason: .J- Date:. Owner: .j' I WORKER'S COMPENSATION DECLARATION I herebyaHirrn under penalty 'of perjury one of the following declarations: ! o I have and.wi/l maintain a certificate of consent to self-insure for' worker'st'ompensatiO!1. as provided for by Section 3700 of the Labor Code, far the performal1ce of the work for which this permit is issued. ". 1 ~ L;have and will maintain workeris compensation ins~rance, .as. required by Section 3700 of the Labor Cod~, for the performance of the wack for which this permit is issued, My~orker's Compensation insurance carrier and policy are: I Carrier: STATE FUND Policy Number. 434592 . . , Thi~ section need not be Completed if ~e pennit is for o!"9 hundrect d~llars ($100) ~.'ess. )(j'1 certify that in the performance of the work for which this permit is issued;1 shall not . ' 'ffiltploy any person in any .manner-so as to b me subject to the worker's compensatiqn laws of Caliiomia, and agree that if I s ould b me su~.ect to the worker's COnlperlsC!tlon provisians of Section 3700 of the ~ bar \ 1 hwith c'omply with those provisions. Date: 4113/2005 Applicant: WARNING: FAILURE TO SECUR WO ER'S COM ENS :nON COVERAGE IS UNLAWFUL, AND SHALLSUBJ T AN EM LOYER T INAl PENALTIES AND CIVIL FINESUP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF.COMPENSATION. MAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST A ATTORNEY'S FEES. CO STRUCTION LENDING AGENCY , Jjl.eJ~bya.ffirmu-"der penaIty.of perjury that there is aconstructionlending agebcyfor the __. performance of the-work far which this permit is issued (Sec. 3097.Civ.C): Lender's.lnformatian: I certify th -I have read this application and state that the above information iscorrect. I agree t comply with all.city ordinances and state laws relating to building construction, and ereb authorize representi.ves of this' city to enter upon the above mentioned property.for . i Date: 4/13/2005 Signal per a1lexpir~ tionand become null and void if the building or or~ has not pllSsed final inspection 365 days from the date of permit,issuMCe. A W permit is required to commence or continue work. Construcian'Tvpes: VN, , . Occupancy Groups: R3, " , LivinQ Area: B 348 Fees paid for Permit: Total: 988.32 INSPECTION RECORD ". INSPECTION . DATE INSPECTOR Temparary PaW<lr.Pale Plumbing (Drain/Waste Pipe) '.' . ~ " Electrical.Ground Electrode/Uter . 4-r'2./t% Setbackll'ormsfTrenches (Footings) . A- (1(0< 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 Candilit) '. Pre-slab (C~mpactionlMembrane.Reint.J 4.MitK Underpinning (floor Joist/Girders) !J? not cover .or conceal the wark below until lne following applicable items have. been signed: . - 1 st Flaar Shear . ~tHo:S /' Firesprinkler (Rough). 2nd Flaar Shear' . . . ~J Roof (Sheathing/Diaphragm/Frame) (,';Jv~ MasOnry (RelnfJBand Beam/Pre-Grout) . Raugh Plumbing (Tap Out) . Raugh Mechanical . , ~. . i ROugh f:lectr.cal. (uy ...."1 Raugh Electrical ; ~ . Framing (Only after Plbg., Elee.. Mecn.. and Fire) (,,1>Zf~ / insulation (SQUndlEnergy) . 1 J ,.,1"6 pa nol tape .or pla~ler untillhe fallowing applicable Items have been signed: .' _ , -' .:.. Drywall . . 111-1/CS Penetratians(Fire Rated) Electrical I Penetrations (Fire Rated) Mechanical, Penetrations (Fire Rated) Plumbing . . Inlerlar Lath . . .... 'Exteriar Lalh I GENERAL ITEM . ~ Exterior Plaster (Brown Coal) . . ,,, '''10:> T-Bar Electrical I , T-Bar Meehanical :. T -Bar Structural. . Sewer . Water Engineering 'Backfl.ow Water Service . FINAL INSPECTIONS .'. Dale Inspector Electrical. Final . . !<{{1-1 I 'l.. _ Plumbing Final . Mechanical Final .' Gas Tesl . Engineolring/Gradlng Final 165-6126 Fire Dept. Final 765-4040 I. . Water Enllineering 165-5268 . . Sub List/Business License 765-519 F3l,'1ID5" l;us (fCn- . Zaning 765-5139 .' Building Final iaSllnspeelion. Only . . t/~,>! .-IV-- . . fler Above Complete) PARTIAL .INSPECTIONS Buildina Inspections .~~e' L~~ Mechanical Inspections PlumbinQ Inspections Electrical Inspections