2167-73 W. Lincoln Ave.
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BUILDING PERMIT NO. BLD200S-00746
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BUILDING DIVISION
200 S ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE'
(714) 765: 4626 .
CENSUS CODE: 437
QUARTER SECTION: 39
TYPE OF PERMIT
. Tenant Improvemenf(Limited) CITY
DATE: 3/17/2005
JOB ADDRESS: 2167 -73 W LINCOLN AVE
LEGAL DESCRIPTION: SEC 8 T 4 R 10 POR SW1/4
CONTRACTOR INFORiI.\AT!ON:
DAYSTARBUILDERS Ike
31103.RANCHO VIE.JO RD'#D2401
SAN JUAN CAPISTRANOCA 926750000
. j
. BUSINESS PHONE: 9497'28-0888. _. .
JOB DESCRIPTIONRepcHr and replace damaged -parapet portion of roof. R~placs with same materia' and dimensions.
VALUATION: 12,000.00. .. 'r PROCESSED BY: JNJ.
I. OWNER.BU!LDE~DECLARATION
I' hereby affirm unper. penalty of perjury that I ,am exempt from the ContractrJr's License LaW for the following reason (Sec. 7031,5 Business and
Professions Code:'any etyor countywhich requires q permit to cone-truet, :i:):,or"improve, demoliSh-or repairany struc,tllre, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he: is li<.,ier.sed pursuant to the provisions of the' Cont-rador'sLicense Law'(Chapter
9)(commencing with Section 7000 of pivisipn 3 of the Business and Prof~~,:':>J1$ Code) or that he is exempt therefrom and.thl;! basis for the allegi:ld
e~ernption, Any violation of Section 7031.5 by any applicant for a permit slJPiects the applicant to a civil penalty'cf not more than five hundreq dollars
($500).. . .' .r. . . .. .
o !, as owner of property, or, my employees with wages as their sole corr(;)ensat:on, wll.l'90 the work, and the structur~ is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's LiomseLaw dot's not apply to an owner .of property who builds or improves
thereon, and'who does such work himself or herself or through hiS or hp.r oh,il-7'niolovees, provided that such improvements are not intended or
offered for sale. If, ho~ever, the building or improvement is sold with 011& Y~~::.ll' of ';-'.o~pietion. !he ovmer":builder wifl have the' burden of proving that'he
did not build or improve for the pUrPose of sal,e), : .
o ,I, as,the owner of the properly, am exdusive,ly 'contracting with licen~€:~ contractors to construct the project (See. "(044 Busin~s and Professions'
Code: The Contractor's License Lawdoes not apply to af1 owner of j:::-bpert:!wno bu:lds cr improves, thereon, and who contracts for such projects with
~ontr~ctor(s) iicensed pur$uant to the Contractor's License Law}, '
,U. I am exempt under/Sec. . B & P~C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLAR....T!ON ,
I hereby affirm under penalty of pe~ury one of the following dec:aration~; ,
o I have and,will maintain a certificate' of consent to se,lf-insurefor \'''orkel~:' compensation,
as provided. for by Section 3700 of the Labor Code, for tile performance (;r tf", ,,',.-)..:-; for whictl
this permit,is issued. '. ,
-:..F1:::;t have and will maintain worker's compensa~ion insurance, as !equired (:; Section 3700 of 3/17/2005
~ Labor Code. fo'r the performance of the work for wh'ich this permit is issl'id. My wt:lrker's" Date:
Compensation insurance carrier and ,policy are:
Carrier: STATE COMPENSATION FUND Policy Number.. 1635006.
This ~ection need not be completed if the pennit is for one hundred dollar~ ($1 O~) Or Jess.
o I certify that in the perfonnance orthe'work'for which this permit isisSu-=:d, ~,shall'not
employ any person in any manner s a 0 become subject to the worker's c::fnpensation'laws
of California, and agree thatif.i sho Id be me subjecl.t ne erker's cor.;P4nsation '
provisions of. Section 3700 of the L,:! br Co n ,wit Iy.' h!;~se provisions.
.APPLlCANT: DIANA ARNOLD
OWNER INFORMATION:
HUNG NGUYEN
2173 W LINCOLN AVE.
ANAHEIM, CA 92801
ARCHITECT/ENGINEER INFORMATION:
l
NUMBER
418620
TYPE
TYPE
EXPIRAnON DATE.
1/31/2007
HIC
B
Dale: 3117/2005 Applicant:.
WARNING: FAILURE TO SECURE ER'S COMP SATIO "k,\GE IS
UNLAWFUL, AND SHALL SUBJECTAN EMPLOYER TO CRIMINAL PENAcTlES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OOO),IN ADCnlON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' . ..
I .CONSTRUCTION LENDING AGEN.CY .____
J h~~~t.y :;;ff!:-;r: t:Pd.::r p'..r:::f."/c; p-Z~'..l:-:'" ~hd th.::-c ~:.l -:";::Is!r;.;~~t-~':::;.~~ :rJ,..:'".;;y'f,.~..tr.e
Construcion Types:
VN, ,
Fire Sprinklered?
NO
performance of the work for which this permit is issued (See.3097 .Civ.C):
Lende~slnfonna~on:
Date: 3117/2005
Fees paid for Permit:
Total:
217.50
plicant or Agent.
. The permit shall e by I . atk>n 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 ymrk:.
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FINAL INSPECTIONS Date Inspector '.
Electrical Final , '5" ./'l--C'l .0-'"
Plumbing Final ' . '
Mechanical Final , , "
Gas Test , ,
Engineering/Grading Final 765-5126 ,
Fire Dept. Final 765-4040 . '.
Water Engineering 765-52,68 ,
Sub List/Business License 765-519
Zoning 765-5139 ' .'
,
Building Final ,Il-ast Inspection. Only 'SY7~f tffA -7,
. fter Above Complete)
INSPECTION RECORD
INSPE;CTION .
, DATE
,
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/l,lfer ' '
Selback/FormslTrenches (Footings) ,
D9 not inst;lJl subfloor or pour floor slab until the
follo.wing applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (~nderground Conduit)
Pre-slab (Compaction/Membrane.Rei nf.'
Underpinning (Floor Joist/Girders)
!-Xl not cover or conceal the, work below until the ,
following ~pplicable items have been sig~ed: - _
1 st Floor Shear.
FiJesprinkler (Rough) ,
" 2nd Floor, Shear' ' , '
Roof (Shealhing/DiaphragInlFrane) .
Masonry (ReinfJBond Bean:l/Pre-Grout)
Rough Plumbing (Top Out) ,
Rough Mechanical
I'(OlIgh l:IectrlCaI
Rough Electrical .
Framing (Only afterPlbg" Elec.. Mech..and Fire)
Insulalion (SoIlndlEnergyl
po not tape orpla~ter. until the following a:pplicable
Items have bee!1slgned: .
Drywall
Penetrallons (Fire Rated) Electrical
Penelrallons(Fire Rated) Mechanical
PenelraliQltS(Fire Rated) Plumbing ,
Interior Lath _ ;,
Exterior Lath ~.~( '::1""1
GENERALITE 'v
Exterior Plaster (Brown Coal) , iii
T -Bar Electrical
T -Bar Mechanical
T -Bar Structural "
Sewer
Water Engineering Backflow
Water Seniice
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'INSPECTOR
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l>ARTIAL INSPECTIONS
Buildina InsDections
MechanicallnSDections
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Plumbina Inspections
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ElectricallnSDections