3163-3165 W. Lincoln Ave.
BUILDING PERMIT NO.
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. BLD2004-03937
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BUILDING. DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5163
INSPECTION REQUESTlINE:
(714) 765 - 4626
CENSUS CODE: 104
QUARTER SECTION: 8
'. TYPE OF PERMIT
. Tract Housing
DATE: 11/10/2004
JOB ADDRESS: 31633165 W LINCOLN AVE
LEGAL DESCRIPTION:
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. CONTRACTOR INFORMfrlON: ARCHITECTIENGINEER INFORMATION:
. . BROOKFIELD SOUTH,L4ND BUILDERS IN03EORGE RICHARDS.
3090 BRISTOL ST #200 . ,:' '.: 555 ANTON BLVD. SUITE 850
COSTA MESA. CA 92626'1000'. COSTA MESA, CA
BUSINESS PHONE: 714 4j'7.~6868
JOB DESCRIPTIONNew Duplex'Bldg Type I - BLDG 9;
VALUATION: 227,569:00 "'~'.;, ...j.;.. PROCESSED BY: FAN
I . ..... . '. . . '. . . OWNER-BUILD~~[:DitLA'RATION' .,. . .
I hereby .affirr'!' underpenalty of perjury. that lam:-ex.emR~.from-the Contracl~rs Lic~nse Lawforthe.fo~lowing reason (Sec. 7031.5 Business and::: .:'-'",
Profession,s Code: any city or county which requires a- pe~mit to construct>~'le"~~:im_p,(Ove,-.demol.sh or..repair "any,structure, prior to its issuance._a!so
requiresthe applicant for such permit to file a signed ~tatement that he.is H~&.,sad 'pursuant to. the-proyisions'ofthe Contractor's License, law(Chapter
9)(c()lTJmencing with Section 7000 of Division 3 of tile_Business a'nd Profe$:t?:ns Code) _or.that he is. exempt therefrom and the basis for the alleged:<
7;;~.0.P..)~ion.An Y.viola.t.ion....o! SeC.tiO.n 70315 by a..nY. a..PPiic~nt.f.or a per mits..l.J.:_.....~~';e..~,ts tfe ap' PI',icant toa. a.:"vil, pena.ttY.Of not more t ha.nflve h.." n. die. d. dOI'.a.rs.
o ': l,as own~'r of probert)',' or my- employees with wages as their $Ole ~~: ~nsati~li: ;:':'fll do 'the work: ;nd the structure is not intendedo'roffered for.
o sale (Sec. 7044 Business' and Profession's Code: 'The Contractor's Lic~n.c;e\ 8W does.notapply to an owner of property who buildsor improves ','i;.;.
. th~reor~.,_,ar.d w~o.doeS s-uch w6~kh.imself or herself or through his',or ~r.~)1i'r1.,~mployees~;p(bVided thatsuch imprcvernent~a~e not ,intended or "_',>/::.:
~~~~~d.t ~f,.~i.:~~i.r~~:~~:~~;.';h~h~."~~~:.~fO;';~f'o..'.em...enhs. sold with onA..'..l"..Ofcomp'etion.....,h. e ow ner-bUilde.r..w. il.ll.ave:he burde.n of p,-o, v in. 9..th~t he\
o -I, a~ the owner of-the property. am exdusiveiy ~ont!rlcting with'licens~'\xmtractorg to construct the project (See. 7044 Business and Prqtessio~s .
C.ode: T..h....e.c.'o n...I~'racto.rSLicense 'la. w'8oes not- aP.PIY,.t~ an owner,of prope_~.k'. -'{I ho bu :I..d s~or im. pr~ves ther:o~,..and:Who oo~tra CIS.. for SUCh.. p r?ject~.\jVith .'
fL~o~tractor(s) hc~nsed pursuant to the Contractor's ~rce~se L~w). . .:: --':'. '. .-'. ~,:' :....., .
L.J I am_<dxe;;:-wI)!!1der Sec. ~__ .:9 & P .C. tor thiS reason: ~,.......:~ -" . . .,' . - ,"" , . ,
Date:'",. " <f!: . Owner: .:'. '. .,;:,..... , .'
.! ...- ." '. WORKE~.~COMPENSATIONDECLARATION'1tt=....:._d I' LICENSED CONTRACTORS DECLARATIOf'.: 1
I hereby affirm un~erp~~alty Q'f perjury one of the following declarat(cns:, _ .11'-' . _,' : hereby affIrm tmder penalty of perjury that I am
o I have ~nd. -will mp.intain a. certificate of consent to self-.ins'ur~ forWOrkc,!_ls_compuns. ation., licensed under provisions'of cn,apter 9 (commencing
. a~pr vided for by Section 3700 of the labor Code, for the pelformance 'of tfJe;wori<. for whir.., Nith Section 7000) of Oi'.slOn 3 of-the Business.and
t.hi' imit is issued. .' '. .'- . . . ~ _ I Professions Code.. . .
.. I,ha..v~,and wi:! maintain ,worker's cQmpensation' insurance, as ~quireC:i~Y Section 3700~f 11/10/2004 CA1~" ~ 'P
the Labor Code, for the performance of the work for which this permit is iss .:ed. Myworker's. Date: . Contractor,' .'
CompenSation insurar1Ce car::nerand policy are: 11 .
Carrier: .O!-D REPUBLIC INS"CO. '. Policy Nurnber. MWF1'j1014\JO<, ' NUMBER EXPIRATiON DATE
-This seCti~n' ne~ not b& cO~pi~~,d if the pennit _is fur one ~U!1dred dOUa1~,($JJ~):.~rJ~5~^ . 8.t~~~8 B 9/3012005
o ,_ !6ertify 'that in'the perfo'rrrl?lhCe o(the work for which this permit is,-~~~-l?d~:l_:'5hall'not .'"
employ any person in'any manner so as to bec:omesubjectto the wor~_ers.-~!9m'pen~2tion laws
of Califom'la, and agree that if I should become subje'ct to the worker's co1ri/:ei1sation':, "
provis'ions' of Section 3700 eft.he'labor Code, I shall forthwith comply with ilJOse provisions.
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APPLiCANT: CHERYL STUMP
. OWNER INFORMATION:
Robert C Timms
PO Box 727
Cypress, CA 90630
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i I $~~~tr~cion Types:
Date: 11/10/2~04 App1ica~t: ; OccuQancy Groups:,
WARNING: FAILURE TO SECU"REWORKE COMPEN$ATIO. COVEkAGE IS~,;:;,~_ R3. U1, , , .
UNLAWFUL, AND SHALLSlJBJECT AN EMP YER TO CRIMINAL PE'NJeTIESANQ.CI.VIL Fire Sprinklered?
FINES UPTO ONE'HUNDRED THOUSAND DOLLARS ($1.00,000), IN AeblTlON TO YHE living Area: .
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR iN SECTIC'il 3706 OFTHE GaraQe Area
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . ...,. '1 '. --'.. Baicony 1 Deck Area:
I CONSTRUCTION LENDING AGENCY;..
. .J_ t\~~:::~~ _('lffirrr.~!)nr:'~_!:~~n"'?Jt-:__r,f,i'''''rf~~f:.t~i.Jh~:'9 ic:. ~ ".:"\f1c:.~r(I~!;_"''' !,;,r~ t'1~ -.l.?:~~' fiC.': t!:l~_ __-'. ~_ _ ~
pertonnance of the work for which.this permit'isissued (Sec.3097 .Civ.C):
. Lender's Information: .
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NO
2,850
889
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I certify that'l have read'~his application and state that, the abo~ information is correct. I
agree to compliwlth all city ordinance~ and state laws relating to building c;.'1nstruction,and
,h~~eby authorize representives of thi::> city to enter upon the above mentiori~\CI property for
inspection .purposes. '. ,., . _ _ '
.~. ~. . . Dalo;11110/2004
. ,- ignature of Applican or Agent - '. '. .
The permit S I expire by limitation and become null and void if th~ building or
work has not passed final inspection 365 days frOm the date of permit issuance, A
new permit is required-to ~mmence. or continue work.'
Fees paid for Permit:
Total:
9.093.83
INSPECTION RECORD
.' Temporary Power Pole '.
Plumbing (DrainlWaste Pipe)
'. 'ElectricalGround Electrode/uter
'. SelbacklFormslTrenches(Footingsj'
Do not install subflOor orpour floor slab until the
following applicableitems',have been signed:
Plumbing (Water Pipe.Sprinkler Valves) 2.-'loC"
Mechanical (Groundwork) ..'
Electrical (Underground Conduit), . .
Pre-slab (Compactlon/Membrane.Reinf.
Underpinning (Floor Joist/Girders)
Do not cover,or conceal the work below . until the
.following'apP'lj.c_~ble items have been signed:"' .
1st Floor Shear' , ..}..'1"J'li
FireSprinkler (Rough) .
2nd Floor Shear ..' . '. , trpr ill'
RQof,(SheathinglOlaphragllYFrame) . . r :...{P".Pf .
. Masonry (ReinfJBood Beam/Pre-Gl'O\It~
Rough Plumbing (Top Out) .
Rough Mechal)ical 11./1, ~.......-'
. ROugh l:lectrlCal(UTY wall) '111 rf J>rJY
Rough Electrical ~ - t' .~ - _ -.-<'"
"Framing . {Only afrer PJbg. EI~c.. r,'lech .- a!ldFirel ~,
Insulation (SoundlEnergy). . .' . I ,." t,'" ~.' ".
Do not tape or plaster, unt.l. the followmg ';Ip~hcable n' . /'
items hav~ been signed:. . .
~ ,Drywall' ..... ,t11IX< :AI~ .
. . ,Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Meci1anical . .
Penelrations(Fire Rated) Plumbing I
Interior Lath .' . .
Exterior Lath .' .
GENERAL ITEMS.
Exterior Plaster (B.-n Coal) , . $"-
T -Bar Electrical
T.Bar Mechanical
T -Bar Structural .
Sewer
Water Engineering Backflow
Water Service'
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. INl;iPECTION
DATE'
INSPECTOR
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17.-t-04 LI..d.-lII. J.:.
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FINAL INSPECTIONS
Electrical F.imil
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Plumbing Final
Mechanical Final
Gas Test
. . . Engineering/Grading Final 765-5126
Fire Dept. Final 76504040
Water E,ngineering 765-5268
Sub List/Business License 765-519
Zoning 765-5139 .
Building Final (Last Inspection- Only .
, . Mer Above Complete)
..' . PARTIALlNSPECTIONS
BuildinQ Insj!!!ctions ."
e{/}'/~I'St L;y</VcJ.I.~. L.-.J~ -i:;..
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MechanicallnSDections
Plumbinalnspections
ElectricallnsDections
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Certificate of Insulation
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Your Home has been insulated with CenainTeed Fiberglass Insulation products, whicb life designed
for (oday's safe1y standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore pennanently noncombustible, so it does not have to be trealed
with flTe-retardant chemicals (hat 'willlikely lose (heir 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 other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionall)' installed in this home
to provide the. foUov.wg thermal performance:
Job I'\ame: Cantada Lane
Tract:
16683
phase:
1
Lot#: 4
Plan: lel!-_ Bldg. #: ____..__
Address: ~_165 ~y-. Lincol!!-.___.._______-'_____________..______.
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Attic Area: ~:!_~_~!?~___________._____lnteriQr Walls:
Knee wans:
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Between Floors:
Exterior Walls: R-l3 Unfaced Batts
Cantilevered: R-\3 Unfaced Balts
Garage Cciting: R- \3 Unfaced Batts
Party Walls: 3 1/2 Sounds Balts
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Title 24 Caulking Includ
dcrior Doors, Windows and sill plales}
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Conchita Ortiz, Secretaryffreasurer -or-- R. Scott Jerkins, president--or--
Lou Merola, Director of Operations Officer
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R- means resistance to heat flow, The higher the R- value, the greater tho insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate wilh )'our . other
valued papers. If you evcr sell this home, this cenificate should be passed on to the bu}'er.
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Certificate of Insulation
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Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safely standards and tomorro,v's energy requirements.
Fiberglass is inorganic and t/Jerefore pennanently nonoornbustible, so it does not have to be treated
with frre-retardant chemicals that wiJIlikely lose their effectiveness over time. It has nol been treated
with chemicals that can cOITode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that CertaniTeed Fiber Glass Insulation has been professionally installed in this home
. to provide the following thermal performance:
Job Name: Cantada Lane Tract: 16683 Phase: 1
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Lot II: ____~__
Plan: _.~.!l.._ Bldg. #: ______ Address: ~!~3 W._~inc,!!!'...______..______,,___._________,
Attic Area: .~!.9.!I.!"-"-'I!.._.___________--_-._lnlerior Walls:
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Knee Walls: ' .
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Betweeo Floors:
Exlerior Walls: R-B Unfaced Batts
Caotilevered: R-B Uofaced Batts
Garage Ceiling: RoD UnfucedBatts
Parly Walls: 3 1/2 Sounds Batts
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Tille 24 Caulking Included (Exterior Doors, Windows and sill plales)
. OJ InSldation CO., Inc.
1)02 1626) 8l2-6 0 Lie.... 11465109
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Conchita Ortiz, SecretarylTreasurer -or- R. Scott Jenkins, President--or--
Lou Merola, Director of Operations Officer
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R- means resistance to heat flow. The higher the R- value, the greater the insulating pO,wer.
Ask your huilder for the fuel sheet on R- values. Keep this certificate with your other
valued papers. If you eversell this home. this certificate should be passed on'to the buyer.