1065 N. Pacificenter Dr. (2)
,',-.;r
, ',I
CONTRACTOR INFORrc~ATION: .
C C S ENTERPRISES i.
2271 NBATAVIA V
ORANGE, CA 92865.()OO)
BUSINESS PHONE: 714 U:74242
JOB DESCRIPTIONAdd door i~to 're~ption/seating room on second fiooi, y. '
VALUATION:. . 2,000.00 .' . . J..' .' PROCESSED BY: AEM . .
I . ..... OWNER-BUILDEiR DECLARATION ". '. .
I hereby affirm under penaltY of perjury that I a'm' exempt from the Contr(:idfi':s ~icenseLaw for the following reason (Sec. 7031.5-Business and
Profess~ns Code: any dty or county which requires a permit to construct,J,;ter, 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:nlcinsed pursuant b t,he !7,rovisiohS of the Contractor's License Law (Cryapter .
9)(co~epc.iQ~with Secti~n 7000 of Division 3 of the Business and prOfe3~,!On.S Code) or,that he is'',exempt therefrom and the basi,sfor the.alle,g~d .'
, _7.;;~)~ion. Any violation of Section 703.1.9 by any applicant,f~r,a permi,t ztt';ects the applicant to a ~vU penalty O,f~t m::l'r;~ ,th~n five_ hundred d01l3.rs
D I, as owner of property, or my emPloyeeS with wages as their sole-c.c::-i.:.en~aticn; will do the wOik, and,,:;ie sti!Jct(.~r':) is not intended or offered ;or
"sale (Sec. 7044 ,Business and Profession3 Coce:' The- Contractor's uceris'l, Law doe~ not apply to an 'owner of property who, builds or improves
thereon, and who does such work hims-,~tf, or !1erself or through his or her:~;- ,1 employees, provided thafsuch impro'v-ements.are not intended or
'offered for sale.' If, however, the building or ilJ1provement is sold \Nith cne"l\~2I-:of CXH"I'pleti..::'1"the owner-build!9r will have the bUrd~n of proving t~lat he
did not build or imprOve for the purpose of sale)., . : ""J' .. ~ '"" '_.: ,.' . ' .
o I, as the owner of the property~. a~ ~xc!usively contracting Wlthlic'&n';,,:.ltc::m~tctors to construct the project ($.ac. 7044 Business and' Professions
Code: ,The, Contractor's, licenSe Law does not apply to an ownt:lr 0f prore~~,~+ who buUds or improves thereon" a11(-I" who rontracts lor such projects wtth
~ontrador(s)licensed pursuant ~o th17 C~ntractor's License Law). I' ' ~~' ~ .
U I am exempt under Sec. . . , B & P.C. for this reason: ____,'.._:__..
Date:, "Owner:, . _.... .'1_ .
I . .... WORKER'S COMPENSATION DECLARATIO!L_'\.. . '.' I
I he:rf?by affirm under penalty of p~rjury6ne of the following declaration~, ,,' "t:, , .
o I have and will maintain a cert;ficate of oonsent to self~jnsure.fol wor;,;:;)~~~ compen~ation,
as pro\iided for by Section 3700 Of the labor Code, for the performnl"c:=:: Of:~'3 "'fOrk for which
this permit is issued. '. 'l'
"~ I have and willrnaintain worker's compensation insurance, as reC:;ltire,::i:;,/ Section 3700 c,f
~,Labor C9de, for the performance of the work for which this permit ~iss~, 1. My worker's
CompenS;ation insurance carrier and. policy are: .
Carrier: STATE.COMP . .PolicYNumber. 046-00:"J,~50
. BUILDING PERMIT iIoU. BLD2003-04512 .
,-
TYPE OF PERMiT . .
Tenaritlmpravement(Limited) CITY'
DATE: 11/19/2003
JOB ADDRESS: 1065 N PACIFICENTER DR
LEGAL DESCRIPTION:P BK 253PG 41 PAR 7
:1
!
APPLICANT: RICHARD CURRIER
OWNER INFORMATION:
Sf Pacific Properties Inc
201 Misston St .
San Francisco, CA 94105
. BUILDING D;V;-Sim!.
200 S. .A.NAHEI~1 BLlin.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765- 4626
CENSUS CODE: 437
QUARTER SECTION: 150
ARCHITECT/ENGINEER INFORMA110N:
'C'~
, , . .
J certify that I have read this a pplication and state that the above information is correct. I
agre.e to rompl-y with all city ordinances and state laws relating to building construction, and
~ereF~. horize epresentives of this dty to enter upon the above ment;one~ property' for
msp ,on pur s. . , .
. .'. Date: 11/19/2003
Signature of Applicant or Agent.
. The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 daY$ frOJTl the date of perri.!t issuance. A
new permit is required to commence or continue work. .
LICENSED CONTRACTORS DECLARATION=:]
I herepy affIrm under pen~lty of p~rjul'y that i :]m
licensed u,l'der previsions of chapter 9 '(commencing
with Section 7000) ~Ion 3 of the 'Business and
Professions 1~ _" . .~ _'
11/19/2003..K..-." . . . <::._
Date: Contractor
NUMBER
615325 .
TYPE
TYPE
~XPIRIITfON DATE'
3/31/2005 .
B
C9
Construcion T yoes,
VN" . .
Fire Sprioklered?
NO
""'
~,,,'.::."
This section need not be completed if the pennit is for one hundred doliars fS1 ~'~''J,".orles'~cr-''\
o ! certify thatin the perfo'nnanc~ of the work for which this perm~~ is ,i~ti;,~~,J. ~hai~, not::;',. '
employ any .person in any manner so as to becomesublct;t to thework~r$,('__,~mpens<::!tiOft.laws
ofCalifomia, and ~gree that if I should become subject to the:WO:ker~~;col11t-~~~ation_,~...'~-'
provisions of Section 3700.ofthe Labor Code, I I forthwith r~..t;(:epro.~iSia2s:'
Date: 1'1/19/2003 Applicant: . . ~.-'i:'-' . '.
WARNING: FAILURE TO SECUREWOR ER'S COMPENSATION COVE~,:..i3E!S. ".
. UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENc',',TIES:AND CIVIL
FINES UPTOONE HUNDRED THOUSAND DOLLARS ($100,000), fNAI-lLI.T.b~JTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SE(~fls>;tl06.oF niE
. LABOR CODE, INTEREST AND ATTORNEY'S FEES. . .. . ~. }<. '
I . CONSTRUCTION LENDING ,,,,GENCY .--__..a:V..
" ,','. ',,:, , ".,: ,,-'"
J h'ere,by~ffirmIJliderpena!ty of perjury ~ere. is C;fon~~~!Jcti?n len_d~n9 ,ar~,f}~~1!:!the~' . ~'r'.'."'~";' ,:~~~;:--,__~~,.,;,-~_;;.;::
:)'=!rfo~~:1.~_F'~jhn,l.!,:":,,k-__ft;"r..::,..'Mcl:~t-t':::;=;. <:.<..llj IiiWi' i:'~.5ua;--:Giv'\.'J~ u_ - -'" , ~
Lender's Information:' . ' " . , ~'.' "".' ~
. .:
,',,,
Fees paid for Permit: .
Total:
14);'96
, -INSPECTION'RECORD
i_-
INSPECTION , , DATE : INSPECTOR'
Temporary Powe.r Pole , , ,
Plumbing (DrainlWaste Pipe) , " I
Electrical ,Ground Electrode/lifer,
SelbacklFormslTrenches (Footings)
Do not install subfloar or ,pour floor slab unti I the
following' applicable items have been sighed:
Plumbing (Water Plpe.Sprinkler Valves)
MeChanical (Groundwork) ,
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Rernf. ' ,
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' .
Roof (Sheathing/Diaphragm/Frame) .
Masonry (ReinfJBond BeamlPre-Grolit) . ,
Rough Plumbing (Top Out)
Rough Mechanical .'
Rough E1ectncal (ury wall) ,
Rough Electrical .A ../
Framing (Only after Plbg" Elee.. Meeh aM Fire) z,,04b_o >rr~'-"
Insulation (SoundlEnergy) . . , .
00 not tape or plaster until the following applicable .
items have been signed: .' .' . A ./A
Drywall . . . . .. '/.16-0' . I/' , I .
Penetrations (Fire Rated) Electrical \ '\
P8I!1lIrations (Fire Rated) Mechanical
Penlllrations (Fire Rated) Plumbing .'
Interior Lath '.
Exterior Lath .'
. . GENERAL ITEMS .
EXterior Plaster (BRlWn Coat)
T -Bar Electrical
T -Bar Mechanical
T-Bar Structural. . . .
Sewer
Water Engineering Backflow .
Water Service.
.
FINAL INSPECTIONS Date ~. ',,Jnspectof
. Electrical Final . .
, ..
Plumbing Final . .'
.
.. Mechanical Final . . . '.
Gas Test .
Eligineering/Gr3ctilig Filial 765-5126 . :
Fire Dept. Final 765-404.0 ,
. Water En$lineerin$l765-5268 . . .
Sub ListiBusiness License 765-519 '"
.
Zoning 765.5139 .
Building Final ~ast Inspettion. Only' 7...$-01 -r..~,
fter Above Complete)
PA~:rIAL INSPECTIONS .'--.
Buildina Inspections
Mechanical 'Inspections
PIOmbina Inspections
Electrical Inspections
.
,
BUILDING PERMIT NO. BLD2004-03232
TYPE OF PERMIT
TEmant Improvement (Limited)
CITY
. g<~~i\~:t~~g.(~\
11',,"A'''..' 'l'h'.<.'~..
;7;>..~/:i*t' "(';;":~~:rr~'f;,\'
"'iN. ElM
~~~~~~r/
"'<( .. 0!.L,:"'(f~\f.'
~"""':!':~,~ ~~~~?>."
BUILDING DIVISION
200 S. ANAHEIM BLVD. .
(714) 765- 5153 ,..
INSPECTION REOUESTLINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 150
DATE: 10/11/2004
JOB ADDRESS: 1065 NPACIFICENTER DR 150
LEGAL DESCRIPTION: P BK 253 PG 41 PAR 7
CONTRACTOR INFOmAMION:
C C S ENTERPRISES
2271 N BATAVIA ST ,
ORANGE, CA 92865 OOOD i
BUSINESS PHONE: 7146:']" 4242
JOB DESCRIPTIONfenant Improvement. T! office, 112978f.
VALUATION:' 300,000.00 .J PROCESSED BY: JJJ
I OWNER-BUILDE8DECLARATION.
. I hereby affirm under penalty of perjury that I am exempt from the Contract~'-fs LiG~:m~e .Law for the following teason (Sec. 7031.S,Buslness and
Professions Code:"any city or counWwhich requires a permit to construct;a;.~r. improve. demolish or repair any structure, prior to its issuance, also
"requires the applii::a~tf6r such permit to file a signed,_statement that he is ':(dhse~ 'pursuan,t to the, provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Divisi.on 3 of the Sus.iness,and Prcfess'p'''\s Code) or that he IS exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit su~;jects the applicant to a dvil penalty of not morethan fivE'! t)undred dol!ars
($500), . '., . . i, .
.0 I, as ownero{property, or my employees with wages as their role cor:::i~nsation, will do, the.work, and the structure 15 not intended or offered for
. sale (Sec. 7044 Business and Profession.sCode: The Contractor's Ucen.,€.t~w does not apply to all owner of property who bUilds or improves
thereon, and who.does such work himself or herself or througl'.-hisor .~er a":(~:l.~employees, provided that such imp,rovements are not intended or'
offered for sale. If, however; the building or imprcverl1ent is,sold with O:1e Yd~r of gJnipletio~, the owner-t>uild~ will hav~ i.he burden of provtng that he
did not build or improve for the pu rpose of sale). .:" .
o '!. as the owner of the. property, am exdusively contractm.n wltt.liCC(l5~v.i<xmtradors to construct the pioject (Sec. 7044 Busines.s and, pjofe~ions
Co.de: The Contractor's L!cense Law does not,app!y to an owner ot' prot~d~~;,':ho builds.or improves thereon,'and who oontracis fcirl';ud1 projects witr.
. P-4ontract~r(s) Jice:ns~'pursuant to the Contractor"~ License Law). . . 'J.:. . . . ,
. U I am exempt under Sec. . ' B & P .C. for this reason: .----t'
Date: Owner: .
I WORKER'S COMPENSATION DECLARATiON ~r:~ J
I hereby affirm under penalty of perjury one of the following ceclarat!of1s: r
o I have and,willmafntain a' certifj~~te of oo'nse0t ~o serf-insure f\?r.\vorkGr;p ct:mpensation,
. as provided for by Section 8700 of the Labor Code, for the perforIT'ar,ce at lr..cWOrk for which
ihi permit isissued. . !
. 'I have'a. nd ~i11 mai'ntain worker's compel1satio~ insurance, ae reqUired bit Section 3700 of
th . Labor Code, for the performance of the work forwhich this per:r.it is iss~;,..d. Myworker's
Compensation insura nce ca rrier and poli.cy are: . i
Carrier: STATE COMP . Policy Number. 046-iY,C'i150
"'(his. section need not be completed if the i>ennit is for one huncJred dollars ($t~.h or l-ess.".:' .
. ',"',C '.] .-, < ..,
o I certify that in the perfonnanceofthe work for which thi's ~rfplJis iss~'~,d,.J.:shan':1ot
employ any person in any man':lerso as to become.subje.ctto th~ wo.rker'~ <;:;~;npensation laws
of California, and agree that if I should become subject to the worke(s ccm~:1,msati6n.:
provisions of ~ection 3700.0qheLabor~~;:~s~~=~~~~mp ~vith tjf;:-~ViSions. .
Date: 10/11/2004 APPlicarl.\!~<l/z. /'.,,7 e. .;X .
WARNING: FAILURE TO SECUR~:S COMPENSA IONGQo~.jAGE IS
UNLAWFUL, AND SHALLSUBJECf AN EMPLOYER TO CRIMINAl:"'PE~i"'l::nES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OQO),,/NASfjI1l0N'TOTHE.
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO\3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.' . ,
I CONSTRUCTION LENDI,NG AGENCY .-_.
1 ~~'k.~1-:'11_7ff.;"~~I.J.r..':!e-".~<:>!,,_~,lt~/..,;:.f._~!..'r--:.:. ih?t-~~1--~-"'!!':0 :" -:'- %':"';'::!~~l~~l0f!'!-.;':.'~.!~g,,-::'{;~;::(;:,' fc:, t!-:c
performance of the work for wt)id1 this permit isis.sueti (S~c.3097 .Giv.C).
lender's Information:
APPLICANT: RODNEY STONE
OWNER INFORMATION:
Sf Pacific Properties Inc
201.rv1ission St
.San ~rancisco, CA 94105
ARCHITECT/ENGINEER INFORMATION:
RICHARD KORCHIEN .
8530 VENICE BLVD
LA, CA 90034
,.
LICENSEll CONTRACTORSDECLARATIcm-l
I hereby affirm under penalty of perjury that' lam ~
licensed under provisions of chapter 9 (cornmencing .
with Section 7000) of DiVSion~.... ~e Sines. sand.
Profess~:oos o~~. .d'.,/. ~
10/11/2 4~~~ -/ /
Dat~: . . Contractor .
NUMBER EXPIRATION DATE
615325 . 3/31/2005
TYPE B
TYPE C9
Construcion Types:
I FR.
Occupancy Groups:
B. , . , .
Fire Sprinklered?
T.I.Area:.
YES
11,297
.- ?~~,...
"
. ..
I certify that i have read this appiicati6n and state that the above .information is correct: I
agree to oomplY,with all city ordinances and' state laws relating to building construction. and
~er y ..authorIZe represenbves of jilis...9!Y to enter upon the above mentioned property for
sp ction pur s. / /,,/,',1>
~..-;~~ Date. 10/11/2004
Signature of Applicant or Agent
The per . shall expire by limitation and become null and void if the building or
work has not passed finalinspection 365 days from the date ot'perr.;it issuance. A
new permit is required to comm~nce or continue work.
Fees paid for Pe:rmit:
Total:
4,435,86
INSPECTION RECORD .
FINAL INSPECTIONS
Date
Inspector
.. INSPECTION .'. .... DATE INSPECTOR electrical Final "Z--2,'j-d{ :::[11 '. .
Tem'poraty 'Power Pole . . Plumbing F,inal .. n.-~~ -r'/'7/'
Plumbing (DrainlWaste Pipe) . . .. .' Mechanical Final . ~
. .. . ")-U.4'l .
. electrical Ground electrode/Ufer . . t..../.
SetbacklFormslTrenches (Footings). Gas Test
.
Do not install subfloor or pour floor slab until the Engineering/Grading Final 765-5126 -c
following" applicable it~ms have been signed:
Plumbing (Water Plpe.Sprinkler Valves) Fire Dept. F.inal 765-4040 2':ZJ-d{ .fJ..K...
MechanicaJ.(Groundwork) . . . Water engineering 765-5268
electrical (Underground Condun) .1.
Preoslab (CompactionlMembrane.Reirif. . .Sub list/Business license 7ii5-519 /a-'/G."'I E)(fJ.;/'-"
Underpinning (Floor JoiSt/Girders) Zoning 765-51.39 1/
Do not cover or conceal the work below until the Building Final ~ast Inspection- Only )../8'-0,. ';;/.. .~ 1.
following applicable items have been .signed:.. . . fter Above Complete) .r~_ ~Ah
1st Flo.or Shear ... ,
PARTIAL INSPECTIONS
Firesprinkler (Rough) . . . .. .. . Buildina Inspections
2nd Floor Shear . .'. .
.
Roof (Sheathing/DiliphragmlFrame) .... ..
Masonry (ReinfJBond BeamlPre-:Grti\lt) .
.. .
Rough Plumbing(1"op Out) .
. Rough Mechanical . ..
Rough l3l!!'triCaI (Dry Wall) .. . -c-
.. . . . .
Rough Elecirlcal . ' I
Framing '{Only after Plbg.. Elec.. Mech and Fire} .. .
Insulation (SoundJEnergy) . 7 .. . .
po not tape or pla$ter. until the following applicable .. Mechanical Inspections
Items have been signed: .' .... -. _:.- . . . .
Drywall .. . /, .(0'-"'''. 'V./.r-z.. I . . .
Penetrations (Fire Rated) Electrical I '\ .
..
Penetrations (Fire Rated) Mechanical :
Penetrations.(Fire Ratel!\ Plumbing . . . . . .
. .' .
Interior Lath .. . . Plumbil1Q InsDections
Exterior Lath . . .
.. GENERAL ITEMS . .
l;xIerior Plaster (Brown Coal) it ..
T -Bar electrical - . I .:iu '. . ..
T -Bar Mechanical .... III . .
.,
T 'Bar Structural. '. . Ii
Sewer . . . .
Water Engineering Backflow Electricallnspection$ .
. .. ,
. Water Service .. . '.
APPLICANT: RODNEY STONE
OWNER INFORMATION: CONTRACTOR INFORMA'nON:
Sf Pacific Properties Inc 9 C S ENTERPRISES I
201 MissionSt 2271 N BATAVIA ST .:
San Francisco, CA 94105 ORANGE, CA 928650000 i
, BUSINESS PHONE: 71463/4242
JOB D~SCRIPTION:renant improvement - ~ffice, suite 40.0; r~move various ifl~7.i"iOr walls and install low height furniture partitions
VALUATION: 50,000.00 L . PROCESSED BY: KBT
I . OWNER-BUILDEFiTOECLARATION
i hereby affirm under penalty of perjl.;lrl that I am exempt from the. Contrar.:tcf~ License Law for the followil1g reason (Se.c. 7031~5 Business and
Pl'QfessiQns Code: ~ny .city or county which requires 8. permit to COI11:\truct, ~.r.~r,impt.ove, demolish or repair any structure, prior \0 its issuance,also
. r-equires theappli<.ant for such permit to file a signed statement that !:P.: iailf,DJ-i'sed pursuant'-lo the proviSions of the Contracto.r's L.icense:law(Chapter
9)(commencing<with Section 7000._of DiVlsiun 3 of the Business,and Profess~1rs Code) or,that he is exempt therefrom and,th~ basis for tGe alleged .
exemption. Any l!iclation of Sectio(l7031.5 by,any applicant for a permit SU~:i'.0CtS the applk",ant io a dvil penalty of r.ot more than five hundred dollars
. ($500). .. . .; . . .;: ..' . .
o I;. as, cw. n~.r of pruperty, or my emPIOyeeS,~~.'_i.th,Wag. es as their sole com..r4t.;1s~tion, 'NfIl dp the work" and the structure is n. at int.eRdedorOffered for
sale (Sec. 70,44 Business and Professions:Code: Tr1~ Contractor's License,~.tiW does noiapply to an owner of property who builds or improves
thereo!1"anJ who dop,.s such work him"elf or herseifortr,rough his or her Q\:Yfl'emp!oy,ees, provided that such improvements are not'interided,()-r , ' _,'
offered far sa'ie; Jf, however, the building or,linpr':)vement ;l; sold with CmeS;(i{ ofoompletion; {he owner-builder will have the-burde,n of proving that he
didn~tbuji,d,t:'r:_irr'Pr>':)Ve fer the purpose 0f-SCllel. ,'. " _I": ' , '_ . _ " , . " ,
[J 'I;, as:ih~_owner of the property, ~ni t::xclusi~elY ~on.trc:ctin:J \}!Ith iice'r.o<-ld1bntradors to COI:struct the proj13ct (Sec. 7044 Bus:ness :!fld Professions
Co.ie: The Contractcr's License Law dQ€snot:app!y to Dn OW!1er of propert>~f,r}IC biJi~ds or impr6ves.thereon. and who;;ontracts for'suq, projl?ctswith
r4r:ntractbr~srHcensed pursuant to U;e Co;'~tr6.;tc"'s Licer..~ !.2W). 'j;;' .,
L.JI am'exempt ~ndcr Sec.;,g.~ PC. f0r ~hi~ leason:
Date:'.'-. " Owner:. "-. '. . - ,::!~;.'
L~-=-__\iyORKER'S {:OMPENSAiION pEg(A~~=\(L-_:=J .
I hereby affirm .unde_f:,perlalty o.f perju'!'Y. one of the follc',ving _decJ8Iat:on,s: , i'.1-. ...
o i nCilve arid w;U malntail] a certlfrcste: o'~ con~ntto.se!f-in:,;u;efor'~/orj.,et.':::6c.mpensdtion,
as prcvidt'd fer by Sedlor: 3700 of tne LDr.cr Gode, fo" the performance oftr~WC:1< for 'uhidl
~s~rm!t is issued. , . r.
[rl'" I have. a nd will mai'ntain worker's compensation insurance, as require,d J)~~:;.;3ct!on 3700 of
the Labor Code; for !f1e:...perfor~lar.ce of ihe work for whiCh this permit :s -:~;::'ft MyworKer's
Compensation in5LlranCe~~nier and JY.>licy aie: '('.
<::ar.rier: STATE COMP<<. Policy Number. C005,15;'::f~~,05
This section ne~ net ~ completed if the pennit is fo; ')11(: hundred dOllars ($'j~I}j--~or iess.
[J I certify that in the,pp'rfollYlsnGe ofth-a work -ro; which !h:s permit is"jS3~'~),j,)'i_'shatj not -I
employ any person ln any manner so a's to become subject to the wo:rke~~. -;~:\:;.;,pensation laws
of Califomia, and agree,that if I should become subject to the worker's compt-nsation
provisions of Section -3700 of the Labol Co ~ I 'shall forthwitn campi l~itf) thbe;e provistons.
BUU:.l:1ING PERMIT NO,. BLD2004-04515
TYPE oF' PERMIT . C
. Tenant Improvement (Limited) ITY
DATE: 1/26/2005
JOB ADDRESS: 1065 N PACIFICENTER DR
LEGAL DESCRIPTION: P BK 253 PG 41 PAR 7
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765~ 4626
CENSUS CODE: 437
QUARTER SECTION: 150
ARCHITECT/ENGINEER INFORMATION:
RICHARD KORCHIEN .. .
8530 VENICE BLVD
LA, CA 90034
UCENSED CONTRACTORS DECLARATION~J
. ,I hereoy affirm L;nder penalty of perjury that i am
iicensedunder provi$icnsof chapter 9 (commencing
with Section 7000) fD:vsion 3.-0. fth(Ye', . :ness ~md
P~fessi(ms C' '. - .
. . ,
1126/2005 _
Date:
NUMBE~
615326
TYPE
TYPE
Contractor'
B
C9
EXPIRATION ElATE
5/31/2005
>"i
Construcion Tvpes:
I FR"
Occupancy Groups:
B, , , , .
Fire Sprinklered?
,.' '! ~,
Date: 1/26/2005 Applicant:
WARNING: FAILURE TO SECURE WORKER'
UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMINAL PE'NA,'r!ES AND CIVIL
. FINES UP TO ONE' HUNDRED THOUSAND DOLLARS ($100,000), IN ADD/nON TO THE
COST OF COMPENSATION,DAMAGES AS PROVIDED FeR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .. '>,.. .
I CONSTRUCTION LENDING AGENCY ,'._
t hereby affirm under penalty of perjury that there is a construction lendinq aQsQ,Qyfor the
p~r.f9rrnG!'lce_ofJh~~~or.!s_ for~~ighJhi_~_pf.!rr!tit ,s:~$ll~_~.JSeq,_~Q97 ,Civ.C,J:. .:J_ '. _~_~_ _
Lender's Information:
r
I
'1 certify that I t'!ave read this application and state that the ~bove information ;scorrect. I
agree to comply with all cIty ordinances and state laws relating to building' ccnstruction, and
'herebyauthor' e representives 'of thi city to enter upOn the aboYe mentioned property for,
inspect. ur. ses.
A
. YES
Date: 1/26/2005
1,005,64
.,
. ignature 0 pplicant or Agent
Tile permit. I 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 issuance, A
. new permit is required to commence or continue work.
Fees.paid for Permit:
Total:
INSPECTION RECORD
, IN$PECTION , OATE INSPECTOR "
Temporary Power Pole ..
Plumbing (DrainlWaste Pipe),
Electrical Groond ElectrodelUfer
SetbacklF!>rmsfTrenches (Footings)
Do not install subtloor or pour floor slab until the
following applicable items have been signed: '
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groondwork)
Electrical (Undergroond Conduit) , ,
Pre-slab (CoJllllactionfMembrane.Retnf.
Underpinning (RQQr JmstlGirders)
Do'not cover or conceal the work below until the ~,
lollbwing applicable iiems have been signe(j: ' , ' ,
1 st Floor Shear , ,
Firesprinkler (Rough)
2nd Floor Shear .
Roof/Sheathing/DiaphragrnfFrame) " ,
Masonry (ReinfJBorid BeainlPre-Grout) , ,
Rough Plumbing (Top Out) ,
Rough Mechanical ,
Rough E1ectrlCallurv walll
ROUgh Electrical "
Framing (Only after Plbg., Elec.. Mech.. -and Fire)
Insulation (SoondlEnergy)
po not tape or pla~ter until the tal/owing applicable
Items have been ~Igned:. . ..
Drywall ' ",
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) ,Mechanical ' .
Penetrations (Fire Rated) Plumbing ,
Interior Lath
Exterior Lath
(>ENERAL ITEMS, ' ' "
Exterior Plaster(Brown Coal)
T -Bar Electrical IZ, t O,r I] lt1/lAf7 ,
T-Bar Mechanical 1'1., ~, ,j' Ilt . ",I
~
T -Bar Structural g I{ I,~ I; ~.{.~
Sewer 1" ,
Water Engineering Backflow'
Water Service '
FINAL INSPECTIONS'
Electrical Final
Plumbing Final
Mechanical Final'
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 7654040
Water Engineering 765-5268
Sub List/Business License 765-51
Zoning 765.51~9
Building Final ILast Inspection- Only
, ,,' ' After Above Complete)
PARTIAL 'INSPECTIONS
Buildiilalnsoections
;/64 I<..
Mechanicallnsoections
PlumbinCf Insoections
EleC!tal ~ections
,<(.-II) OJ, 'U!! J1fL
'f _ /' " _ _ .",
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