707 E. Simmons Ave.
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BUilDING PERMIT NO.
TYPE O'F PERMIT
New'Residential ConstructiOn
CITY
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l<~~'l,{~Z'~~i;;\;
"JN~HEIM
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BUILDING DIVISION
200 S. ANAHEIM ,BLVD.
(714) 765- 5153
INSPECTION REOUESTLlNE:
(714) 765 - 4626
EtD2004-Q3350
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DATE: 12/20/2004
JOB ADDRESS: .707 E SIMMONS AVE
CENSUS CODE: 101
QUARTER SECTION: 99
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APPLICANT: SHAIK YALUS 1
OWNER iNFORMATION: CONTRACTOR iNFORwt4.TION:
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SHA!K M YAGUS -!
2224 S SpiNNAKER j
M~"'.HEtM,GA 92802 '. '. . ..J .'. . . .
. JOB DESCRIPTIONNEW 668s1 SINGLE-FAMilY RESIDENC;o (SECOND U~li r ORDINANCE). IOngin"lIy issued as 2224 S. Spinnaker St.).
Vr\LUATION: 42,000,00 .. :;1 PROCESSED BY: GAQ
C .: -:- OWNER-8UiWER,DEGLARATiON .' '
I hcretl'/.affirm under pl:'lna!ty of perjury that (am exempt from the ,C::.)o~:,,~,~~15 ijcense La'l'lfor the ~ollowjng reason (Sec. 703.1.3. Business anD
P/'Qfes!;!OnS,Code..;;Jny city or county which requires a permit_to C~f1~~,fr:~!,~);'3~fr;. imprfJve,dE":r.r,O(jsh or repair any structure, priOr tq i1..... i~uance,'als:)
req:.nres: the applic.;antfor 8udl permit to fi!e.a signed staternent t:iat h[.;}i/;,!j~~~n:;.s:d pur.5uant to the provisions of the. Contractor\s Uc.(~nse L<1w (Ch<'lptel'
9){~ommencing with Section 7000 of Division 3 of the Busin~s:::: .i:nd P(6t0~,~~~ns Cede) or thstile is exempt.therefrom and the basis for the alleged
~',(cmption. Apyv:O:8tion of-Section 7031.5 by c.ny Cl.r>plicai)t for a pf>m~i~:=(\}i}lects U1e appllca/ltto a civil per:attyof not more thanfiveh~ndrer.i dollars
($5;)0).. , ,.', . ".'(~_;:{:~l,.. . '. . -. " .
O. 1. .~s :)l;Yner.cf proper:t'j I Cor my employees vvitn wagt::'!s as theii SQf62~~/lZ~J',~c.at;o!"':, ,'NW ::l0"t~'e work, and the strlx;ture is not Jntenu:c oroffeiw1 for
sde{Se~, 7044.B1Jsiness and Professic'ns Code: T;--.e (;Otlt(()ci(:r~;,; LiC~nf~/!;c'-", qO'7"s. notapply to aft O,wner of proper~' who buiids or/mp"oves .
tltNP.9n,':)f)d ~oi;~O daes5.uch w(lr~ hims~;f or herce:'f orthrolJgh 7'::;:; vrhe,~'s:~C~~ employee$', pr~.wided that such improvements'are not interi\.1ffi.f .cr .
"offered fer saie. lr, hOW€lVE'lr.' :he toL1ildiilg or improvement!~ $'Sdd with on;c___~4fiPf <"..cmpl,etioo, the 0wner-builderwll1l18ve;the burqenof P(ov!~g1hat he
did not bUtf~i Vi" improve fo; the purpose of sale). ',: . :>"1;'.. . '.' '. .
CJ I, i3sthe O~r1er::lt tJ,t" pi'op~rty, am exdusively (;ontradi;ig'~'I;!r.I!cer.50:~<)),1t:<-ictc,n: toconstrlict.the project (Sec. 7044 8lJsins$s and Profe.ss.ioc;s,
Cod;.:;: The CO!ltractor'~ Licfmre t~w doe.<:: not appiy to an owner bf :)'-Cp~it~rr\l ho b~JiJ.js' 0;': il)lprCVes thar.eol1., .3~d who .C.1ntracts for such projects ...~it.h
p._contractcr(sj nt:~ilSa:l f1u.fsuant to the Contractcr'~ U~;,;se La'/..<~~~': :t,. . .
LJ I C:l:m'exem~t u"der Sec.. . .' ,B & ?:c.:. for thl~ i~:a~n: _.:....~-~,___~.__._~__ _____~
Do.:te: _ Q\.vner: __-.;__________.~,;:;::"d;~_.__:__.___ ~
r-- . ,,-_,WQf.KER'S COMPENSAYiON id...~EATiGN-SW::=_:..:.. -j !,IICENSED CCN1~CTbR~..Q.ECL"RATI()N-=:J
1 hflreoy.affirm u:",dsr penalty of periulY one of the ioiiowinQ de(;lar~ll'')n$:.' ::.,,:)~:.:,- ,I .' I hereby affjrm .u,:der penattyof p.e~jllr''jth~!. l-a~
o I ha"/El a(1d w!l: rr~ir!rGlin a certiticate of con$en~ t~) self-insure for \o'ic;rk~&~ C0r{l~'t,ns?t!on, : lIcensed ur:~&r Pf:"l'.'IS/Or:S c-r cha~!er 0 'co~lmsncl::~
as"~rovlded for by .St;.d.i,.,n 3.(00 of the Labor c-orl~1 fot' the petforrr!<C1ncf!dt8~ W(lIK for Wi~jGh I WIth Se-..:;tioil i'OOO) of Divsion 3 of the Susjn~s: and
thi:-= permit iSls5U~~L " .' . :.,:,:,~i~ ... . 1 Prpfl;:ssicns Coett.
[J : !;;3Ve and will maintZ!!n worner's compemation insurancp., as reqi.a:~;l~\' .Se.:;iion 370.0 of! 2i2212CQ5
ti1C L~bor Cqde, for the.pe::rtorrnaiice of the wcrk.foc which this penn;! is i~$J~f";;;I. My';'v'orkcr's I' Oate:
Compen~..a1ion insurance earlier 3r1d policy are: '}
Carrier: Poli(~y Nurrtba'-r; .~. j NUflJ.8-5.R
10:$ section need Ilot be wmpletediffuepennit is for one hundred do:l..rs (S10i~ '='> less. I TYPE
[J : certify tl"lat l:1 the p&rfom)ance of the 'work fonvhlch ttw; rJemllt If:, IS~;j~,j, I ~,.2~ net I
p.mploy any persc-n in ~I1Y :n2nner sa as to becom-e subject ~o the'N('),~eT's 1:1)mJ::er.::atIO;"lI~ws
of California, and agree that if I should beconle $ubJect 10 the worker's ccm~,tns;:,t:':r, ~
p(Ov;sions Of t";ectlon 3700 of the labor COde; I shaff forthwith corl"tplj;,.'ith t!.f3~ p(ovisions. I. Const~dbn !\lpe~:
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Date: 2/2412005 Applicant:. _...._.....~-::f!-___.J Occ1JPancv GIOUDS:
WARNIN(3: FA!LURE TO SECURE WORKER'S COMPEN~ATION CO\JSftD.GE 1S . t R3;". >', .
. UNLAWFUL, AND SHALl,SUBJECT AN EMPLOYER TO CRlfv'liN~L PE.~..Jl.,~..f~TI..ES A!\rD GIVt~ I Fire Spri"kr~red7 NO
FINES 1,) I-> TO ONE HUNDRED THOUSAND DOLLARS ($1(jf.l,C.oO), IN ADrtnqN TO lHE [lwel!mq Umts: 1
_ ~QqT .o~.Q_<)M.rr:.N~;AT:O!i.-.:D!\MAQr;.g-,"~G P8k'L\:tDE1.:U:.f:,R !Nlir;.G;TiO;.,t :l:;"[J6. or.TU~...:.::.1 Li'linq .11.P'~~ -'-'- ,_~ ~_____~__ _ ~~~~~__ _~~__
LAlJOR CODE, INTEREST AND ATTORNEY'S FEES. ~,., . '. , .'. J.'_" ,. . _ . ", ,
I CONSTRUCTION LENDiNG AGENCY ._-~_-=~ - ," -. ,,"
f hereby affirm under penalty of perjury that there IS a conmruction lendlnf) a::jencyfol' the . -
performance of the work for which this permit is Issued (Sec. 3097.Civ.C): I
Lender's Information:
LEGAL DESCRIPTION:
N TR 2691 lOT 21
ARCHITECT/ENGINEER INFORMATION:
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COl1tracior
EXPtRATiON n.ATE.
I celiify that I have read this ~ppJication and state that the above informatlc-l1 is correct., I
agree to oomply with all city'ordinances and. state laws relating to building cOl1struction, and
hereby authorize repreSentives of this city to, enter upon the above mentioned property' for
inspect,ion purposes, . " .
Fees paid for Permit:
Total:
3.()74,37
Date": 2/22/?005
Signature of Applicant or Agent
Th& permit shall expire by limitation and become null and void if the bl)ilding or
work has not passed final inspection 365 days from the date of per mil issuance. A
'new permit is required to commence or continue work.
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INSPECTION RECORD
FINAL INSPECTIONS
, Qate
. InspeCtor .
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.,NSPECTlON .
INSPECTOR
. Il~;'. ()'< ~J '-'LA
.' 74-d5'" //./ -"" :.u.-A
~/~'S" 4~
c7l:.'y s.r.{/~ .~~
EngioeeringlGrading Fina 765-5126
Plumbing Finlll.
DATE
Electrical Final
Temporary Power Pole .
Plumbing (OralnM/lIsle Pipe) .
Electrical Ground E'ectrode/Uf~r. ';. 41 d" L~ /
Selbac.k1FormsfTrenches (F9<'tmgs) . I ~ !tr(( ~ I/.
00 not irn;tall subfloor or pour floor slab unti!the-j, . _
following applicable items have been signed:.~ --. "
Plumbing (Wllter Plpe.Sprinkler Valves) 'SltJ '1
Mechanical (GroundwOrk) ..,' ,
Electrical (Underground Conduit) .
pre-slab (CompaclionlMem.brane.Rei nt.,
Underpinning (Floor Joist/Girders) . .
00 not cover. 0/". conceal the work below until the
following applicable items have been signed: .
1st Floor Shear . .
FiresprinkJer (Rough)
2nd Floor Shear
Roof (Sheathing/Oiaphragm'FrlWlle)
Masonry (Reit1fJaond BelWlllPre-Grout)
Rough Plumbing (Top Out)
Rough -Mechanical
: Hough !:lectricallDrY wall)
Rough Electrical .
Framing /OnlyaherPIbg,Elec Mech andFore) 5'/"'.-o.~
InsuJalion(SoundlEnergy) S-/7, ~L
00 not tape or plaster until the following applicable' . .
items have been signed: . . -'.
Drywllll :s-z')-o .J- ,,;-
Pl/Iletrations (Fire Rated) Electrical ..' ..
Pl/Iletrations (Fire Rated) Mllchanieal
Penetrations (Fire Rated) Plumbing .
Interior Lath
Exterior Lath
Mechanical Final.
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Gas Test
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Fire Oepl. Final 765-4040 .
. Water Enllineering765.5268 .. .
.. Sub List/BusinessLicense 765-519 tZ7_0~ iS05 ~
Zoning 765-5139 . . . .. . ,
Building Fimil ILast Inspection,. Only "'./A ~c-. .@A' /~J
. . After AboveCompletel 'Y77~J. ~
. . . PARTIAL INSPECTIONS ....
Buildina.lnSDections
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Mechanicallnsoections.
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. GENERAL ITEMS
Exterior Plaster (Brown Coat) ; 4.-0"5:
T .Bar Electrical
T -Bar Mechanical
T -Bar Structural
Sewer . . .
Water Engineering Backflow
Water Service
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/1' /Y / L" PlumbinQ Insoections .. L ;"......1
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hi' ;a_,;, 7--z...x'Oi'""P /0 h6J- r~ J J!
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Electrical InsDections
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