3145-3149 W. Lincoln Ave.
L
CONTRACTOR INFORM.i>fiON: ARCHITECT/ENGINEER INFORMATION:.
. BROOKF!ELD SOUTHu>",D BUILDERS :NCl3EORGE RICHARDS
3090 BRISTOL ST #200 .} 555 ANTON BLVD. SUITE 850
COSTA MESA, CA 926260',6(; COSTA MESA, CA
BUSINESS PHONE: 714 ,,:i}6863
JOB DESCRIPT!ONNew Triplex -Bldg Type II - BLDG 6 ". I..
'yALUATION: _ 329,800.00 '. . . . 'd." . .' PROCESSED BY: FAN . ,
I' , . ". . OWNER-BUILDE!UlECLARATiON '.. . .' . .
I hereby affirm under penalty of perjury that I am exemptfr~m the?ont,acti::!r~} ,\:1(;en5e Law for th~fd!!owjng reason (Sec. 70~1.5 Business and
Pro.fessions COde: anydty or county which requires a permit t9 construct, ~(I~r.~j.mprove,deli1olish_ orrepair.any structure;" prior to itsi~uarice,alsc
requires the applicant fer such permit to fUe" a signed stateme~t that rye is il~:f.;',t~-:ed PtJr~u,ar.qoth'~ pmvisions of the Ccntractor'$'Licens,e'.~?l,^, (C,hap!e.r
9}{c0mmencing with ~~ctjon 7000 9f Division 3 of'~h~ Business and prOfe$.$~;':ps:'Code) or'that'he is exempt therefrom -and the basis 'fo'(the c.;lege<:t< ,.:,'"
exemptton. Any violation of Section 7031.q by any applicant for a permit.sl.!~h~ts the-applJcant to a dvil ,penalty of not more than five hundred dollars:.
($500) .. . . .~ . . . ,F, . . ..... ... . <.' .,
n I, as C?~ner pf property, <:>1' my 'employees with wage~ clS their fiO~,e ~VI11,~~'n~?tion. ....:ili Q,;>}he work, and the structure ~ not in.tended or, offered for
s;?le(S~c. ~044 Bll::.in~ss an~Profess.ions Code:- The Contractor's Uccnse:,~_~~.'N_9oe~':iot apply to an own~r~of propel1y. who bund~ or improvEs,
theIeon"andwho"does such workhimself or,hers~lf or thrOl:"gh his or her OW!~';.e(n?!oyee!';iP;'q'!ided that such impro~e!'Dents are nbt intended,or'. :.:';,.', ~:__;:,,"
. o:-e(~ fo~'sale.. :f, however, thebQHdlng orimprovcment is sold with one ye~&,9f~'Or;;~~.eli''ln. th€::,.o'/mer~builder Will~,~ve}he burden at prov:~g"t~a~ r:ey,,'
dld_notb!Jddorllr~prov~'forthepurposeofsaIB)~ " , ~, :ij..- _' ,', ,'_ :;<. "< __ ' ,,,-:,:""..h':-,
0_ I" as the owner,o~the prcp~rty. am exdusively contracting with liCe!1<:;~((~nt;~.tors tc ~,?"~truct the ~~r()ject (SEC'-. "104~f:Bus;rJe~s. Cind_Prc(~~io~s
Cod.~;: The Conlrac,tor's Ucer.se:_law does not apply to an'owner of. prope_rty-;)t::cbu!fOs 'o-~ improves_ thereon;aild who contracts for such pro.\e?:ts}/'1ith
,as;cn~ra.:.tor(s) i_icensed pursuant.t.o the COI'ltractor'::;.Li:cnse Law). "~' ~~:-,;: \>,. -' .
LJ lameX9_mptunder,Sec. _'-;_' : ,~8&P,C,'fo:thisrer:lson: _~,T' '"
Da~e: . . . Owner: . ,.~:;r~.. -";-.~
r- .',YORKJ:R'S COMPENSATION DECLARAT:mL . <;i-=~_J:f?IiCENSED CONTRACTORS DECLARATION. J
J herebya,ffir:r: undei pe)\~lty of perjury ()n'e of tl1e following der.larations;. J. . I 'I hereby affirm under penalty of perjury that_I, ~m
o I have ar.o wi!! main~ajna c<;rtificate qf oons~nt to' self.ir.su(e lor wcr"~I:':~{;6Inpensaticn, n~€lnsed~~r.der rrovi3io~s ~f c~aptE:r 9 (co~rnencing ,
, as provided f.or by SeCl:icn 3700 of the Labor Code, for the performance ofth:.::twor\<' f,'}r which /' .......Ith Sec~lon 7000) of DlvslOn s otthe BUGmess and
this..;5errnit -is. issued..' , " . _' -J, I Profess!Qns C e.'
ll{l have a old will rnaintainworke,'s compensation io,uranee, a$.requi",,,, bA:S~dk.H131nO of. 11/10/~004
the labor Code, for t~e p'(rformanceof the work for which this permit is i$ller' Myworker's I Date:.
, Cornpensation.insurancelcarrier and policy are: . _ ;; , I
Carrier: OLD REPUBLI1 :_I~S. C,O.- , POIi~~ .N~mber. MWC.::-Ln?~1?,0.:- I
" 'T~issection ne,cd not be ~mPhjted if the pe~it is for olle hundred do:Jars (~_1i~if~_!~~!ess~_ .1
D I.certi~that in ~he performance ofthe.work for whi~h this per:nit is iSS~j?Ji!.:~h,a!i ~lOt' "
employ any person I~ any manner so <;is to become subJect to the "^.-'orJ<~r's.cC:l'perlsat!on}~ws I
of.Galifomia;:and agree that if I should become subject to the worker's ccm~~e;i::>:atIon" I
provisions'of Section 3700 of the Labor Code, I shaH forthwith_co~pIYWit!-;,th~b'3 prCVjsI0ns.__~ I Construcion Types:
. . . . 1" 1.'1N, "
Date: 11/10/2004 Applicant: . j..-" '-.. . occu6ancvGroups:
WARNING: FAILURE TO SECURE WORKE 'COMPENSATIONCOV"XCfdiS.... .. R3, ~ 1: ' ,
UNLAWFUL, AND SHALL SUBJECT AN EM YER TO CRIMINAL PENAL' lEE,. AND CIVIL Fir" "pnnklered?
FINES 'UP TOONE HUNDRED lHOUSAND DOLLARS ($100,000}; I~j 'ADDI'DGN)'i) THE Livir,a Area: .
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SE(::l'i0N 1~706bF THE Garaa' Area
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '". .' . Balcony 1 Deck Area:
_~ii'i'.~_a!fjr"L~Drt@'Jl9Da~~~~~:r~::t~~~.~?~=~~I~~~~~~~~i1",,~~fJhg . ',.1. ' .... .'__>~,._>~_
performant;::e- of the work for which this pernlit is is.sued (See. 3097 .Civ .C):
lender's Information:.' ,
. &UILDI.NG PERMIT NO.
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,_ /; ~;;ri"~:,~~;~'>>,-
.. :~ff~/.j,~tC;~:H
CITYQJr~~N~ ElM
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BLD2004-03943
TYPE OF PERMIT
Tract Housing
. DATE: 11/10/2004
JOB ADDRESS: 31453149 W LINCOLN AVE
LEGAL DESCRIPTION:
APPliCANT: CHERYL STUMP
OWNER INFORMATION:
Robert a-Timms
PO Box 727
Cypress, CA 90630
NUMBER
823168
TYPE
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 104
QUARTER SECTION: 8 .
EXflRATION DATE.
. 9;3012005
B
I certify that I have read this application and state that the above_ information i~ correct. I
agree to comply with all city ordinanc'es and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspecti purposes. .
NO.
4.347
1.352
23
,; ,- ',: i-~ -~; ~ '. .
Da'e:11/10/2004
11,243,34
Sign
The permit shall ire !>y limitation and become null and void if the building or
work has nofpassed final inspection 365 days from the date of permit issuance, A
new permit is required to commence or continue Work.
Fees paid for Permit:
Total:
, 'INSPECTION RECORD
INSPECTION
DATE
INSPECTOR
,
Temporary,Power Pole .1 A "
Plumbing (DrainlWaste Pipe) " il''<Il-tl4 A J "'IL
Electrical GroundElectrodelUfer '.Z1te:'/4 A>JL <9AAA,', 1-
SetbacklFormslTrenches (Footings) "'<'4 t:fJtIb '!.
Do not install sUbfloor,or pour floor slab'i!nli1 the
following applicable items have been signed:
Plumbing (Water Pipe.Sprlnkler Valves) ~...,- ~
Mechanical (Groundwork) ,
Electrical (Underground Conduit)
Pre-slab (CoinpactionlMembrane,Reinf. phs/A
Underpinning (Flcior Joist/Girders)' , '
Do not 'cover Or ci:lncealthe work below unt'! the
following applicable items haye been signed: ' '
1st Floor Shear " ~/11/ 5 "' h1'-
Firesprinlder (Rough) , h
2nd Floor Shear " ' I ':Y!( '" -~ r A. ,r.
Roof (Shealhing/Diaphragm'Framlill ~ L:
Masonry (ReinfJBond Beam, /pre-Grout)" \ "
Rough Plumbing (Top Out) ,
Rough 'Mechanical ' ',,' ~~
Rough Beetrical (Dry wall) , , ~
Rough Electrical ' ;;:;
Framing (Only after Plbg ,Elec Mech and Fire) J~" ~
Insulalion (SoundlEnergy) "/In 4JL'^
Do not tape or plaster until the following ,pplicable
items have been signed: I' ,/1'
Drywall ,II' L I
Penetrations (Fire Rated) Electrical I 'V'
penetralions (Fire Rated) Mechanical
Penetralions (Fire Rated) Plumbing
Interior Lath ' ' ,
Exterior Lath,
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FINAL INSPECTIONS
ate 'In ctor '
11,1 (In'
(, '1-1(:)5 ,JItS ~n..-
(, rt { 6" Jl"< {~ n...
f (1, '(j(l-tJd,j I, /
Cruln 'O~
'.I.:.h {ttr 'Po.<:. ,
Water Engineering 765'5268' G.t ../0':> O~c.. '
Sub List/Business, License 765-519" "7 ~ r ~ ~
Zoning 765-5139 '... p ~
Building Final (Last In~pection- Only "L ',' ".......L5-- '
" , ' )\fter Above Complete), ... " '
PARTIAL INSPECTIONS '<<-~ '
Buildina Inspections ' , ' , , ,'-Z
41,<1-(0"-- (sl:-- l....~ """";''1<--- &-~"'L-- '"
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Electrical Final
Plumbing Finel
Mechanical Final
,
Gas Test, ' '
Engineering/Grading Final 765-5126
, Fire Dept.,FinaI765-4040
,
,',
"
, '
,
..-- Mechanicallnsoections
~
--
IBl'_~/
" GENERALITE ,. / I.
Exterior Plaster (Brown Coat) ~, '
T-Bar'Electrical
,T ,Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backfiow, , ",
Water Service
, "
,
.AI
"
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t-'ZI.I>C: ~ /'
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"
, Plumbina Insoections .
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Electrical Inspections
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Certificate of Insulation
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Your Home has been insulated with CertainTeed Fiberglass Insulation prodllcts, which are de.>ignea
ror today'. safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so il does nol have to be treated
with fl1e-retar&nl chemicals that will likely lose their effectiveness over time. II has not been treated
v.ith chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies thaI eertainT eed Fiber Glass Insulation has been professionally instaUed in this home
to provide the following thenna! performance: '
Job Name: Cantada Lane
Tract'
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Lot #: _____g___.
Plan: 2AR Bldg. #: ...____
Address: 31 ~~~,!::!~~_].!!_____..____________________________
Attic Area: ~=.1_?J?l!'.~..___.._________..____-_lnterior Walls:
Knee Walls:
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Be.tween Floors:
Exterior Walls: R-B Unfaced Batts
Cantilevered: R-l3 Unfaced Batts
Garage Ceiling: R-13 Unfaced Bans
Party Walls: 3 1/2 Sounds Batts
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Title 24 Caulking Included (Exterior Doors, Windows and sill plates)
t F.. OJ Insulation Co., Inc.
. . ~t702 (6Z6) 8l)..6G70 Litense #46570~
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Conchita Ortiz, Secretarynreasurer -or-- R. Scott Jenkins, President-or-
Lou Merola, Director of OperatiQIts Officer
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R-means resistance toheat flow. The higher the R-value, tl:le greater the insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate with your other
valued papelS. !fyou ever sell this home, this certificate should bo passed on 10 the buyer.
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Certificate of Insulation
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Your Home has been insulated with CertainTeed Fiberglass Imulation products, which'are designed
for today's sarety stmldards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire. retardant chemicals that will likely 10'" their effectiveness over time. It has not beel) treated
",ith chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in this home
to provide the follov>'ing thermal perfonnance:
. Job Name: Cantada Lane
Tract:
166S3
Phase:
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Lot Ii: ____!L__.
Plan:__!_~_ Bldg. e: .______
Address: 31~7 W,,!o.i!!!'oll!-___n____________________m_____.
Attie Area: l'o:!..'!_~!9.~m ______________________..lnterior Walls:
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Knee Walls:
Between Floors:
Exterior Walls: R-13 Unfaoed Batts ,
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Cantilevered: R.13 Unlaced Batts
Garage Ceiling: R-13 Unfaced Batts
Party WaUs: 3 1/2 Sounds Balts
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Title 24 Caulking Included (Exterior Doors, Windows and sill plates)
600 S. Vincent.
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91702 (626) 812-6070 Li<<nse ~46S709
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Conchita Ortiz, Secretary/Treasurer -or-- R. Scott Jenkins, President-or.--
Lou Merola, Director of Operations Officer
R- means resistance to heal flow. The higher the R. value, the greater the insulatiog power.
Ask your builder for the facl sheet on R. values. Keep this certificate with your other
valued papers. If you ever sell this borne, this certificate should be passed. on 10 the buyer.
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Certificate of Insulation.
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Your Home has been insulated with ~inTeed F;ber~\ass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
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Fiberglass is inorganic and therefore pennanently noncombustible, so it d6es not have to be, tre.ated
with fore-retardant chemicals that will likely los~ Iheir effectiveness over time, It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may o!her insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionall}' Installed in this home
to provide the foUowing thermal perfonnance:
Tract, 16683
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Phase:
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Job Name: Cantada Lane
Plan: _2.1L. Bldg_ #: _'_ Address: ~J4~~y'. Lin%'!n_._________._.._____...___..____'
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Attic Area: ~~.1_?)'~~.-....---_----_..--.Ioterior Walls:
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Knee Walls:
BetWeen Floors:
Exterior Walls: R-13 Unfaced BallS
Cantilevered: R-O UnfacedBatts
Garage Ceiling: Rot3 Urn.ced Batts
Party W.lls: 3 1/2 Sounds Batts
Tille 24 Caulking Included (Exterior Doors, Windows and sill pl~tes)
J Insulation Co., Inc.
2 (6ufflmo Licen" #465709
Signed
COllchita Ortiz, SecretarylTreasurer -or-- R. Scott Jenkins, President--or-
LOll Merola, Director of Operations Officer
R- means resistance to heat fl.;>w. The higher the R- value. the greatfr the imulatin~ ,power.
Ask your builder f.;>r the fact sheet on R- values. Keep this certificate with your othfr
valued papers. If you evet sell this home, Ihis certificate should be p,,^sed Qn to the buyer.
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