115 S. Mohler Dr.
TYPE OF PERMIT
Blockwall/Columns CITY
DATE: 7/14/2005
JOB ADDRESS: 115 S MOHLER DR
LEGAL DESCRIPTION: LLA 0000578, PARCEL 2
ElM
BU1~mNG'!;)IVjSION,
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTlINE:
(714) 765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 202
BUILDING PERMIT NO. BLD2005-02158
APPLICANT: BRENT SEPULVEDA
OWNER INFORMATION:
CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
SEPULVEDA BUILDERS STEPHEN L WEBER
518 CARLISLE PL 3434 W. ANTHEM WAY #118
ORANGE, CA 928690000 ANTHEM, AZ 85086
. BUSINESS PHONE: 714222-j150
JOB DESCRIPTION:lnstaIl390' linear feet of 6' feet high perimeter block wall pe[ city standards; REFBLD2005-01479
VALUATION: 30,000.00 i PROCESSED BY: JNJ
I OWNER-BUILDER OECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, altel;' improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any appficant for a permit subjer,:ts the applicant to a civll penalty of not more than five hundred dollars
($500). '
o I, as owner of property, or my employees with wages as their sole comper!sation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La~ does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own ~mployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one yeariof completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale). 1
o I, as the owner of the property, am exclusively contracting with licensed cOntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyw~o builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law). :.
Dram exempt under Sec. , B & P .C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: .r
o r have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 at the Labor Code, for the performance of the work for which
this perm it is issued. '.
Eve and will maintain worker's compensation insurance, as required by S,"" tion 3700 of
or Code, for the performance at the work for which this permit is issued" My worker's
ompensation insurance carrier and policy are: \'
Carrier: STATE FUND Policy Numbec 1419298-01)
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provi . ns of chapter 9 (commencing
with Section 7000) Divsion 3 of the Business and
Professions e.
Contractor
7/14/2005
Date:
This section need not be completed if the pennit is for one hundred dollars ($100) Or less.
o I certify that in the perfonnance of the work for which this permit is issued,: I sharr not
employ any person in any manner so as to become subject to the worker's compensation laws
of Calitomia, and agree that if I should become subject to the worker's compensation
provisions 01 Section 3700 of the Labor Co ,I shall forthwith comply with those provisions.
NUMBER
695401
TYPE
EXPIRATION DATE
10/31/2006
B
Construcion Types:
VN, ,
Date: 7/14/2005 Applicant:
WARNING: FAILURE TO REW KER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED TI-lOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ~706 OF THE
lABOR CODE, INTEREST AND ATTORNEY'S "E~S, ~
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec. 3097 .Civ,C):
Lender's Information:
I certify that r have read this application and state that the above information is correct. r
agree to comply with all city ordinances and state laws relating to building construction, and
hereby au horize representives of this city to enter upon the above mentioned property for
insp." 0 p poses.
Date: 7/1412005
Fees paid for Permit:
Total: 303,67
Signature at Applicant or Agent
The p mit 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 issualce. A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/uter
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
followIng applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough) \,
2nd Floor Shear \ I
Roof (Sheathing/Diaphragm/Frame) .i (P "r; If;l/.Y->-
Masonry (Reinf./Bond Beam/Pre-Groutl/C ~(/;H>( t./o, J' -
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
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 Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765.4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765.5139
Building Final (Last Inspection - Onl~ //ti) /l." #rP1
Aller Above Compl'\l'lf "If"
,
PARTIAL INSPECTIONS
Building InspeJrnsr / J/~
~tl-t>r-. ;474'7mi5~,~
Mechanical Inspections
Plumbing Inspections
Electricallnsoections
04/27/2005 10:50
7142880733
SEPULVEDA BUILDERS
PAGE 02
CERTIFICATE OF COMPLIANCE
PAYMENT OF SCHOOL fACILITY FEES
ORANGE UNIFIED SCHOOL DISTRICT
726 W. Collins, Orange, CA 92867
(714) 628.4500
Developer/ Applicant Name:
Address;
Sepulveda Builders
518 N. Canisle Place
Orange, CA 92869
Phone: 714-288-0732
Owner Name:
Address:
same
Phone:
n., '"".,.,'',,''..'''
.
.. ':".','?,,;"/:""
PROiil.~cf
Address/Location:
Type of Project;
Lot #:
Tentative Tract II:
No. of Dwelling Units:
lIS
-ttiS. Mohler, Anaheim
NSFD APNII: SEe 36 Parcel #2
181 Single Family
o Multi Family/Condos/ApI.
Total Square Foot(Jge:
Multiplied by Applicable Fee:
Other:
1.000
$2.24
:Xl!'EsltiE~~iiA:1. .
Applicable Fee Level: [gj 1 0 2 0 3 0 4
Total School Facility Fees: $2.240.00
Total School Facility Fees:
,n,"
. ..'i:ili::Q~M~~it1Al"" ....
'":':;'
Total Square Footoge;
Multiplied by Applicable Fee:
$0.36
Total School Facility Fees;
.. . ffr:s:W~IVEOI:.
,,':':"-'.','
,,~ .
NO [gj YES
REASON:
Fees originally paid 4/25/05 for2,816 sf, correct figure is 3,816 sf
:: ~:i : . ' "
.." ,"
'."."""
The above repres!mtofions as fosqua'e foota
late, determined that st,Jch rep,esentations
terminate and the appropriate City/Cou
e are true and correct. Developer/Applicant agrees that if it is
nof true, then this Certificate of Compliance shail automatically
shall be notified.
"",;"",""::,.,,"
Developer/Applic':1nt Signature:
This certifies that the above named Developer/Applicant has paid school tacility fees in compliance with
Education Code Section 17620 ef. seq. a d GOvernment Code Section 65995 et. seq.
Date: aprll27, 200S Name:~' .. Title: Executive Secretary
NOTICE: The 90.doy pE!Jlod in which you may protest the fee described here n wlll begin on the dote this fee is pold. However. if the fee
was imposed by the City or County os a condition o'f approvol for Your project, and you how:; received the requisIte notiCe. the 90...day
protest pertod began CIt the time you, project wo, approved by the Cay Or County.
certificate of compliance
Rev. 02-24-04
CERTIFICATE OF COMPLIANCE
PAYMENT OF SCHOOL FACILITY FEES
ORANGE UNIFIED SCHOOL DISTRICT
726 W. Collins, Orange, CA 92867
{714} 628-4500
Developer/Applicant Name:
Address:
Sepulveda Builders
518 N. Carlisle Place
Orange, CA 92869
Phone: 714-288-0732
Owner Name:
Address:
Parcel #2
lIS .+l+S Mohler Drive
Anaheim, CA
Phone:
Address/Location:
Type of Project:
Lot #:
Tentative Tract #:
No. of Dwelling Units:
same
new
APN#:
[gJ Single Family
o Multi Family/Condos/Apt.
Total Square Footage:
Multiplied by Applicable Fee:
Other:
2816
$2.24
, 'IH:sfpENTIA.ti
Applicable Fee Level: [gJ 1 0 2 0 3 0 4
Total School Facility Fees: $6,307.84
Total School Facility Fees:
. COM"MERCIA(:. .
'.;h>;>
Total Square Footage:
Multiplied by Applicable Fee:
$0.36
Total School Facility Fees:
~ NO 0 YES
REASON:
The above representations as to square footage are true and correct. Deveioper/ Applicant agrees that if it is
later determined that such representatio s are not true, then this Certificate of Compliance shall automatically
terminate and the appropriate City/Co shall be notified.
Developer/ Applicant Signature:
This certifies that the above named Developer/ Applicant has paid school facility fees in compliance with
Education Code Section 17620 et. seq. and Government Code Section 65995 et. seq.
Date: 4/25/05
Name:
NOTICE: The 90.day period in which you may prates t e fee desc. ed herein will begin on the date this fee is paid. However. if the fee
was imposed by the City or County as a condition of approval for your project. and you have received the requisite notice, the 90-day
protest period began at the time your proiect was approved by the City or County.
certificate of compliance
Rev. 02-24-04
PUBLICWORKS DEPARTMENT FEES
. --TRAFFIC ENGINEERING FEES--
BUILD # DS; -.0 C) t:I ", '. I
PROJECT SITE: /IS ...s 1'Vt 111, ~DV-.
SIZE: S.
TRAFFIC SIGNAL FEES:
279-412-F724-3017
TE# 90
TRAFFIC SANTA ANA CANYON FEE: Iyz&" - 71'-2-
278-412-F724-2001 ...
.,p/e;3
$//2-
~/1.3
TRANSPORTATION IMPACT AND IMPROVEMENT FEES:
.' 278-412-F724-1818
EASTERN TRANSPORTATION CORRIDOR FEE:
101-412-F724-6704
COMMENT: .~ ""5 ~ r,V"~.
REVIEWED BY: ALFRED YALDA (714) 765-5183 A '1
--DEVELOPMENT SERVICES FEES--
RIGHTOFWAY '2.,1' MoH-LE(REvIEWEDBY . ~ DATE:IJ,~/'!:?
o OLD ZONING CODE (i.e. in plan eheek or entitlement prior to July 8, 2004) Y I ..
Z NEW ZONING CODE
I
DEDICATION ~\ ~
E.t h6~ ~I C{.
CREDIT
-
. STREET IMPROVEMENTIREPAIR tNPVLO\,E.. . . ~~. Ot\-! ~. . ..
.'f1:>IZ. t-h ~ ~ . l .
~EWER ~ONNECTlON FEE 1> 250 (MIN) ACCT #
((j?:J6o/ltc.. )
ClTYSE. ERASSESSMENT~ 5g7.40 ACCT#
$1,"~":6 Ac-) e.lf
DRAINAGE ASSESSMENT FEE
It
GRADING: UIt .2co1- () 2247
ACCT #
C Af'/P)
LA~SU~IVISION: LL/f-_.CJOO()~($
REVIEWEDBY:ft1I;tJ //20 'O~
~-CtJI63(#?V)
~~).
WATER QUALITY MANAGEMENT PLAN (WQMP)