2550 E. Miraloma Way (3)
TYPE OF PERMIT
Blockwall/ Columns C I TV
DATE: 3/9/2005
JOB ADDRESS: 2550 E MIRALOMA WAY
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BUILDING DIVISION
200 S. ANAHEIM BLVD
(714) 765 - 5153
INSPECTION REQUEST LINE'
(714)765-4626
CENSUS CODE: 565
QUARTER SECTION: 121
BUILDiNG PERMIT NO.' BLD2005-00633
LEGAL DESCRIPTION: GOLDEN STATE TR LOT 2 BLK 10 POR OF
APPLICANT: WAYNE WELLS
OWNER INFORMATION:
MESA PARTNERS
.P.O. BOX 1 0008
COSTA MESA, CA 92627 1
JOB DESCRIPTION: Install 8' feet property line wall per approved plans f
11.'
VALUATION: 11,000.00 . 1'1
r--- OWNER-BUilDERbEClARATlON
I hereby ~ffirm under penalty of.perjury,that I am exempt from the Contractor':! License Law for the following reason (Sec. 7031.5 Business and
PiOfessions Code: any city or county which requires a permit to construct, alIbi, 'improve, demolish 'or repair any structure, prior t6 its issuance, also. .
requires the applicant for such permit to file a signed statemer:t that he is !iCE:tlsed pursl,;ant to 'the plovisions pfthe ContrF.lctor's licenSe law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business zr:d Profe:ssldhs Code) or that he is exempt therefrom and the basis .for-the alleged .' .
exemption. Any violation at Section 7031.5 by a,ny app!ica:1~ for a permit subJ~cts the applicant toa evil penalty of not mere than five hundred-dOllars..
($500). . ' 'C' ,\,' . .,...'. .
. 0 I, as owner of pro-Oerty, or my e:rl~!oyees with wages a~ their sole compftnsation, will do the w'ork, and thf: structure is riot intended or offered for
saie' (See, 7/)44 Business ~:1d Professions Code: Tne Contractor's Ucel'i;~ L~.,W does iiot applyto'al1 owne'rof property who builds' or improVes
thereon, and who does such work himself or helself or through his ':lr her owr~:,":!;m'p1cyees, ;)Iovided'that suchimprov&mentsare not intended or . .
offe~ed for sale. If, however, the b'Jilding. or improv6men~ is solJ With one ye~'1 oj completion, the owner.builder will h~v,= the bUiden of proving that he
~id not build or improve for the purpose of.sale). ' . 'I
~, . "as the'owner of the property, am " -c!u1veJY contract!l1~ wiih Hce,n " !-:onttactors to construct the project (Sec. 7044 Business and Professions
Code: TPie Contractor's License Law d es no apply to an ow lec of prope. [/hO buiids or improves thereon, and who oontracts fOi such projectswitt:i
F-iontrador(s) licensed pursuant to th C ntr ctor's Ucen~ 'w).. ji .
l-.J I a e t uI'~ec. " . ,6 P.C. for rt:is r a Dn: i,~
Date: -12:>' Owner: ~ .__.
WORKER'S I: SATION DEC ARA7ION
I hereby affirm:l,mder penalty of perjury one _of the followir.~J dcclarl3tions: . ij
~I h, ave, and will maintain a certificate of cooserHto self~ii:s'ure'forWOiK,;ei,'",t<".:crnpE:nsation, .
a provided for by Section 3700 of the Labor CodE:=, for the performance OfTht 'NCHk lor which
'_ is permit is Issue'd. . . . ;j .' .
o I have and will maintain worker's compensation insu~ance, as' requited 6t ~:ectiol1 3700 of
the Labor Code, for the perlormance of the 'Nark for which this permit Is issl1Gd: Myworker's
Compensation insurance carri~r and poliey are: '
Carrier: Policy Number: \"
",1.-
~iS section need not be completed if thepennitis for one hundred dollars 1$1~~V~r less:. '
I certify that in the performance ofthe -work for which this permit is i 'ed. I shall not
mployany person in any manner s~ as to come sUbj,ect to he worke cc:rnpensation laws
.of Califomia, and agree that if I should bee s bject to the 0 ar's c :1p~:nsa~ron
provisions of Section 3('00 ofthe Labor C I all forthwi 0 p . .tr~:?e provisions,
CONTRACTOR INFORMAfION:
J~
iJ
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
.~.
WICENSED CONTRACTORS DECLARATION!
I I hereby Clffirm under'penalty of perjury' th~t I am
I licensed under p_re-Asians'of chapter 9 (commencing
with Section 7000)-t~f Divsibn3 of the Business and
Professions Codp-.
,3/912005
Date:
Con1.ractor
NUMBER
. EXPiRATION DATE
TYPE
Date' 3/9/2005 Applicant: ,
WARNING: FAILURE TO SECUR WO 'S C MPENSATION COVERAGE IS
UNLAWFUL"AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTiES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN ADDITlONTO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTiON 3706 OF THE
LABOR CODE. INTEREST AND ATTORNEY'S FEES. '
L CONSTRUCTION LENDING AGENCY.,.
U"~er~by amrm uh,der penalty of perjury that ~here is a conslructior: lendjr,gr-t,~ncyfor the'
pe!'fc!"rnvC(,~ of the work for_wh!ch this permit is is,,:ued. (Sr;c.-:309:Z ,Civ. C.)~,"_ ~
Lendar's-roformatiori:--. . --
Construcion Types:. .
VN, .'
.'.
nd stat~,that the above informationi.s correct. I
nd state laws relating to building cCn5truction, and
to enter upon the above mentioned propertyfor
Fees paid for Permit:
Total:
324.78
Date: 3/9/2005
ignature of Applica or gent
e pei'mitshall expire by limitation and become null and void if too 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 work.
INSPECTION RECORD
(
. .
INSPECTION. DATE INSPECTOR
Temporary Power Pole .
Plumbing (Dra.inlWast.e Pipe) .
Electrical Ground ElecirodelUfer .L...
SetbacklFormslTrenches .(Footings) 111 \'11"" .
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 Conduit) . .
Pre-slab (Compaction/Membrane.Reinf.
Underpinning (Floor Joist/Girders) . . ... .. .
. Do not cover or conceal the work below .untiHhe
following applicable .items have been signed: .
151 Floor Shear . .
Firesprinlder. (Rough)
2nd Floor Shear . . .
Roof (Sheathlng/DiaphraamlFramel , ~-
Masonry (ReinfJBond Beam/Pfe-GroUt) 1h iJ,.0
Rough Plumbing (Top Out)
. Rough Mechanical . . .
Rough E1ectncallDry WaHl . ,
Rough Electrical
Framing .(Only after Plbg.. Elec" Mech.. and.Fire)
Insulation (SoundlEnergy) . . .
Do not tape or plaster until the following applicable.
items have'be.en' 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 -Sar Structural
Sewer
Water Engineering Backflow . . .
Water SerVice
-
FINAL INSPECTIONS Date. Inspector
Electrical Finat . .
Plumbing F.inal . . ....
Mechanical Final . /
.
Gas- Test .
. ..
Engineering/Grading Fin~1 765-5126 .
.Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-519 . .
Zoning 765-5139 II
Building Final ~ast Inspection- Only 7"1/0'5 JA~S~'
fter Above Complete)
PARTIAL INSPECTIONS
~.. rin~irs.... .~..... r.t.. h. ....
1t~~;6 ~~:. ~.
. Mechanical Inspections
Plumbina Inspections
Electrical Inspections .