122 W. Sycamore St.
BUILDING PERMIT NO. BLD2005-03219
TYPE OF PERMIT CITY
Blockwall/ Columns
DATE: 10/7/2005
JOB ADDRESS: 122 W SYCAMORE ST
LEGAL DESCRIPTION: ORIGINAL CITY LOTS LOT 3 EL Y1/2
APPLICANT: INGRID VILlAK
OWNER INFORMATION: CONTRACTOR INFORMATION:
AUGUSTTVILJAK ..:\
1248 N LIGHTHOUSE lN .1
ANAHEIM, CA 92801 0000 I i
JOB DESCRIPTION:lnstaIl70' linear feet of 6' feet hi9h biock wall per city standards
VALUATION: 7.000.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765. 4626
CENSUS CODE: 565
QUARTER SECTION: 72
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I ereby affirm under penalty of perjury that am exempt rom the Contractor's Ucense Law for the following reason (Sec. 7031.5 usiness 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 isliceosed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 70aO 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars
~~. .
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Law 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 employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner~bunder will have the burden of proving that he
did not build or improve for the purpose of sale).
~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 appl to an owner of property ho builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contract License Law).
U I am e?<-ertl )tAll<c1er Sec. , B .C fa is. reaso .
Date: J, 10\ Owner: ~
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the foltawing declarations:
=EJ I have and will maintain a certificate of oonsent to self-insure for worker's compensation,
'as provided for by Section 3700 of the Labor Code, for the performance of the .....ork for which
this permit is issued.
o I have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carlier and policy are:
Carrier: Policy Number.
This section need not be completed If the pennlt is for one hundred dollars ($1 00) or less.
<f!J I certify that in the performance of the work for which this permit is issued; I shan not
employ any person in any manner so as to become subject to the worker's compensation laws
of CaBfomia, and agree that if I should become subject to the worker's 0 nsation
provisions of Section 3700 of the Labor Code, I sh forthwith camp wit those provisions.
Date: 10/7/2005 Applican'
WARNING: FAilURE TO SEC REWORKER'S COMPENSATiON COVERAGE IS
UNLAWFUL, AND SHAll SUBJECT AN EMPlOYER TO CRIMINAL PENALTIES AND CIVil
FINES UP TO ONE HUNDRED 11-1 OU SAND DOLLARS ($100,000), IN ADDIT10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY,
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance 01 the work for which this permit is issued (Sec.3097.Civ.C): _~,
- Lender's Infoonation: .
I certify that I have read this application and state at
agree to comply with all city ordinances and stat \a
hereby authorize re~ sentives of this ci to e er
inspection purpo
e above information is correct. I
relating to building construction, and
on the above mentioned property for
Date: 10/7/2005
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 days from the date of permit issuMce. A
new permit Is required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
10/7/2005
Date:
NUMBER
TYPE
Construcion Types:
V N, ,
Contractor
EXPIRATION DATE
Fees paid for Permit:
Total:
132.73
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground ElectrodelUfer . I (" ,
,
SetbacklFormslTrenches (Footings) r~A% # ~ L J
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
Roof (Sheathing/Diaphragm/Frame) .
Masonry (Reinf./Bond Beam/Pre-Grout) fAU11 ~1 1A_"<~
Rough Plumbing (Top Out) .
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mee. 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
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 - Only /1-..1:L,.
Alter Above Complete)
INSPECTOR
PARTIAL INSPECTIONS
Buildinq Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
J
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~
4
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,..
.
I
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PLA~NING DEPARTMENT
APPROVED
DA. T E 1117 tflfj'hD 'J
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'. ST . Ie OISTRI~ REVIEVV.
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. See st<lrr~ pp.~e
lro. one on above line' I
UILOING PERMIT FOR
_'. ,ANY CONDITIONS
--V\IUU ~ I 0 Ue. f).JC0~ t7 F ew ~()VVV1
v7-0 lvi j/.Av1 ~ U
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PROPoeED 6" THK.
61...OCK j,o,jA1...1.. (70'-0" 1..0NG)
ePI..OT
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P I.. A N
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122 SYCAMORE ST. , ANAHEIM,
ESTHER I INGRID VII...IAK
(714) '156-2'1"1'1
CA "12805
Joe oddrIrM.
to~.
TYPE OF PERMIT".' C'ITY'
Residential Addition
, " #,(.~\~:~~.1.:,,~~;;;.:..
,7, W>Y .<"I"'~~
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t''''J' ","; "':'~""~\ .
€>ir~N~"''"\H ElM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 7$,5 .'5153
INSPECTION REQUEST LINE:
(714)765-4$26
CENSUS CODE: 434
QUARTER SECTION: .72.
. BUILDING PERMIT t:lO. BLD2004-01,366 '
DATE: 5/18/2004 ,
JOB ADDRESS: 122W SYCAMORE ST
LEGAL DESCRIPTION: ORIGINAL CITY LOTS LOT 3 EL Y1/2
, APPLICANT: FRED AMBATALI
OVYNERINFORMATION: CONTRACTOR INFORMP.TION: ARCHITECT/ENGINEERINPORMATION:
August T Vnjak
1248 N Lighthouse' Ln
Anaheim. CA 92801
JOB DESCRIPTIONROOfn Addition. New. 2-car garage. SEE BLD2004-00423. :.
VALUATION: 13.000.00 PROCESSED BY: DEF
I OWNER-BU"lLDERDECLARATION ":"
.1 hereby affirm underpenalty of perjur.ythat I am exempt from the Contrador's_Ucense Law f.or the following reason (Sec. 7031.:5 Busjn~ss an~,::
Pro, Jessionsco98,: a0Y oty or c?untYW~jCh, reo quires a permit to-cQflstruct, a,',t~r. ~Il1P~ove, ,demolish or repair any struct, ore, prior, _to 115 i~uanc,?~,:~ISO
requires.the appUcant for such permit to file a signed statement that he is Uc~psed . pursuant to the provisions.of the Contractor's License Law{.Chapfer
9)(co,mmenqin~ with Sectio'n.-7000of Qivision 3 of t\1e BusJness and Profes'sfitns Cod~).oJ tl)a't he is ~xempt therefrom 'and the ba$i~ for the~Jle~ed
exemption. Any-v,io.lation of Sectipn 7031,5 by any applica-nt for a.perrnilsub}acts tl1e applicant to 8_ civil penalty of n9t mere than fi'{e ~undr~?JjoUars-'
r~l:~.o*Z{ ~~~~:~hdrp~~I:;.~~~e;~:.ithT~:g~~~ia~~~s~:~;n~~~~~~::~~:;P:~:::~:~~r~i;~~~~e~i~~i7~:nodr~~~~0~~;Od lor
thereon. ~n.(t"who does'sLlch work himSelf or necsetf or through-his or he(o~~~ 'employee&:, Provided that such improvement~are not intended or, .'
offered for Sale; 'If, 'however,the building ori.mprovement is sold with one ye~r.of CX?mpletion, the own"er~bullder will have the burden ot'proving th8t,he'
didnotbu~~orimpro)Jeforthepurposeofsale)~, ' ,-, _ "~~' ,'. ' . '. , ,.' .->e;,:__,'
Oi; a.,s' tljeowner ofth.e property, am'exdusively contracting with: licensed f~ntract'2r? to construct the project (Sec. 7044ausiries~ ~tid Prof~~'ions '.
Code: Th~~;Contractor-'s Li<:;ense lawdoes noiapply to an owner of propertY:~'/ho builds or improves'thereon, . and .who .oontracts. for such Pf'ojects"W~h
~ntra~'9r(s) licensed pursuGtnt to. the Contra~tor's Uren~ Law). . ' ...,
U' I a e e un er-Sec, -. B C, for is_teaso ,':A
te: . Ct Owner: '",
. WORKER'S COMPENSATION DECLARATION' '..'
j herebi affirm under penalfy of perjuJy one of. the foll'owing de'clarations: . \, : .
o (h~ve and will maintain a certificate .of ,<:on~nt to 'self~insure for work~r';~compensation,
as provided for by Section 3700 of the labOr Code,' for the performance of th4;-work for whicJ1,
this permjt is.issued.,, ' , ' __' . __' ': . . Ji, _ _ '.
0' I h~ve and wi." ~a,intaln worke(s comp~nsation insurance, as required b~r Sectio~,3700.0f
the Labor Code, -for- the' performance of the work for which this permit.is i:::'$l.:€fd.. Myworker's '
c.ompensation insurance carrier and policy are:. '1',.. .
Carrier: Policy Number:' V'.
This seCtion need riot be Completed if the permit is for one hundred dollars ($1 Of)~ or less.. .
0' Ice~ify'tha~ in the performance ofthe workfor which thi~ peflnit is issue~, I, sha II not .. .
employ any person in any'm~nner SO as,to become subject to the wor~eJ's'cdfnpe(}sation laws'
of California, and at'lree:that if I should, becom~ subject to. the worker'corr,;:;';:" .zaticn
provisions of Section 3700' of the labor Code, :allforthwlttJ.c p ~ith ,,\)seprov!sions.
Date: 5/18/2004 ApPlicantX,', . . c." t .
WARNING:' FAILURE TO SECURE WORKER'S COMPENSATION COI1ER.'GE IS
UNlAWFUL: AND SHALL SUBJECT AN EMPLOYERTOCRI.MINAL FENA~TTE9 AND CIVIL
'FINES WPTO ONE HUNDRED 1l-IOUSAND DoLLARS ($100.000J.IN ADDiTION .TOTHE .
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 370lfOF THE
LABOR CODE. INTEREST AND ATTORNEY'S FEES.
I . '. ' CONSTRUCTION LENDING AGENCY.,."..,";., .
I,hereby affirm under penalty.of perJurY that there is a 'construction leti(jing'ag~ncy for the.
performance 01 the w.ork lor which this permit is Issued (Sec.3097 ,C(v .Cr
Lender's Information:
.r '. LICENSED CONTRACTORS DECLARATION
I hereby a irm under penalh'of.perjury'that' I am
licensed. under provisions of qhapter 9 (commeqcing
'with Section 7000) ofOivsion 30fthe l?usiness ;and
PrOfessions Code. .
5/18/2004
Date:
Contractor'
NUMBER
EXPIRATION DATE
rYPE
CQnstnicion Types:
VN;""
Fire Sprinklered?
Garc~~Qe A,rea .
NO
534
. . - ___'_.~_ ____. - . . ..... ^--,-,.___.,,__,:"'__ J.
I certify that I have read this application and:state tha't the above information '03 correct. 'I
agree to oomply with all city ordinances arid state laws relating to bunding c:oru:>trllction. and
herebyauthorizerepre.se ives of tl1is city to ter upon :e above mentioned property for
. i,nspection purposes. .
Fees paid f9F Permit:
Total:
148.25
r
Date: 5/18/2004 .
Signature 01 Applicant or Agent
. The permits hall expire by limitationaOd become null and void if the building or
work.has not pas...d final inspection 36S days 'from the date of perrrJl issuance. A
new permit is required to commence or continue work. .
INSPECTION RECORD'
,
INSPECTI()N " ,DATE INSPECTOR
"
TemporaryPower,Pole ' , ' "
Plumbing (DrainlWastePipe) . ,
Electrical Ground Electrode/Uter "
Selbacli1FOI'msfTrenthes (Footings) , ,
Do not install subfloor or pourfloor slab until the
follp-.ying applicable items have been signed:
Plumbing (Water Plpe;SprinklerValves) " "
Mechanical (Groundwork) ,"
Electrical (Underground Conduit)
P~lab (Compaction/Membrane.Reinf. .'
Underpinning (A9OI' JoistJGlrd~s)., ',-. ,
Do ,not cover or conceal the work below until the ,
fOllowing applicable items have been signed:' ,
1st Floor Shear , , " , ,', '
Firesprinkler (Rough) " ' "'. ,
'2nd Floor Shllar , , j ,
"
Roof'(Sh9a1hing/DiaphragrnlFrame) 'A 7.0, '.
Masonry (ReinfJBond BeamlP.re-Grout) "
Rough Plumbing (Top Out) ,
Rough Mllchanical, ' , ' , ' ,
I KOugh'f:lectrlC8IlllrY wall) ,
Rough Electrical ,
Framing (Only after Plbg'., Elee.. Mec!).. and Fire). ~~- 'I--:- ,.
. Insulallon(SoundlEnergy) 'MivllS_ p.,t,e;, , I~
po,not tape or pla~ter' until the follo.wing applicable ',' !
Items have been signed: " '" " . ...
Drywall' ",,' " q,t7Aff~n7--: ,
Pen_rations (Fire Rated) Electrical r.
Penelrallons (Fire Rated) Mechanical
Penetrations (Fiie Rated) Plumbing , , , , I
Intllrio. Lath, , ',' ~", I
Exterior Lath " , " ' '.411_ ~I'
GENERAL ITEMS ' .,' . ~
Exteril:lr Plaster (Brown Coat) " , :.
T -Bar Electrical . ' " ,
T -Bar Mechanical
T -Bar Structural", " , ,
Sewer .' . , ,
Water Engineering, Backflow' ' :'
Water Service ' , ,
-
FINAL INSPECTIONS
Electrlcal',Final
Plumbing Final
Mechanical Final'
Gas Test
Engineering/Grading Fin!ll 765-0126
D,ele'
.
Fire Dept. Final 765-4040
Water Engineering 765-5268,
Sub ListlBusiness Licens1l765-519
Zoning 765.51,39
BUild,ing' FinallLasllnspeclion. .only Zo,',' ~,
, " After Above Complete) r, '"'"
, ,PARTIAL INSPECTIONS, '" '
BUildinQln~ctions ,". . .,' , ',',"," ",L.~
!o}b '1't.< ,'/~'. ~ iJd'4.;g/;.6:t~
MechanicallnSDectioris '
, \."
Plumbin(JlnSDections
Electrical'lnSDecti,ons
.