1400 S. State College Blvd.
BUILDING PERMIT NO.
BL02005-01262
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CITY @t";;;~'N~HEIM
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BUILDING DIVISION
'200 S. ANA....EIM BL ~D.
(714)765- 5153
INSPECTION REOUESTLINE:"
(714) 76~ - 4626
CENSUS CODE: 437
.QUARTER SECTION: 116
.
TYPE OF PERMIT, . .
Tenant Improvement (limited)
DATE: 6/15/2005
JOB ADDRESS: 1400 S STATE COLLEGE BWD
LEGAL DESCRIPTION: N TR 14701 LOT 1
CONTRACTOR INFORMA'rION:
CASE & SONS CONSTRlICTION INC
17736 BUENA VISTA AVE'
YORBA LINDA, CA 92886 WOO
BUSINESS PHONE: 714 99~.2206
,JOB DESCRIPTION;enantlmprovement, 5432sf office/ showroom remodel
VALUATION: 225.000.00
APPLICANT: TED CASE
OWNE,R INFORMATION:
Mart Realty Holdin'g Company
1350 S State Cellege Blvd
Anaheim, CA 928060000
ARCHITECT/ENGINEER INFORMATION: .
PROCESSED BY: MJL ' '
L OWNER-BUILDER DECLARATION
! hereby affirm under penalty of perjury that I am exempt from the Contractc('" Licepse Law for the following reason {Sec. 7031.5 Business and
Professions Code: any ,city or countywhich requires a 'permit to construct, art~r. improve, demolish or repq.ir any structure, prior to its Issuance. also
! ~qlJires th~applicant for such permiUo file a signed statement that he is Iice)sed pursuant to the proVisions of.the Contractor's License Law (Chapter
9Ycommenci':t9with Section7000 of I?ivisioil 3d the Business and Professi9.n.s Code) or that he is exempt therefrom and the basis for the alleged .
ex.::mptian.. Any violation of SeCtion 7031.5 by any applicant for a permit subY3'cts the applicant to acivU penalty of not more than five hundred.dollars
($500). ,,' , . ' 0
o l, as owner of pr-operty, army e'T'ployees with wages a.s their 'sole com;>~nsation, will do.the work, and tlie structure is not intended or, offered for
sale {Sec. 7044. Business a nd Professions Code: The Contractor's license L,law does notapply to an owner of property who builds or .improves
thereon, and who does such .work him$elf or herself or through his ,or her "own employees, provided that such improvements a re not intended or
offered for sale. If, however, the building or improvement is. s9ki with one_ ys?r of co-mpletion, the. owner-builder will have the burden of proving that he
did no"t build or imprQve for the purpose.ofsale). t ' .
o I, as the owner of the property, am exdusivefy contracting with licensed 6ntractors to construct the project (See. 7044 Business and ProfeSsions
Code: The Contractor's License Law doe's not apply to an owner .of propertv'~'/ho builds'or improves thereon, and\vho oontracts for such projects with
[jontractor(s) licensed pursuant to the Contractor'~ License Law). ,. ! . ".
I am 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:
o I have and will maintain a certificate of consent to ~If-insure for worker;3compensation,.
as provided for by Section 3700 of the Labor Code, for the performance oft1",i work for which
this permit is issued. .,. :
Nl have and wili maintainwor\:<er's, compensation insurance, as required b? Section 3700 of
--tfie Labor Code, for the performance of the work for which this permit ;3; issl.l~. Myworker's .
CompenSation insurance carrier and policy are:
Corrier:STATE FUND Policy Number. 0009237,2004
. This section need "otbe completed if the_ permit is fo.r one hundrect.dollars ($1001 or less. .
'K.; certify that in the perforrnal:lce of the .work for which-this permil-is issued, I shall not
~y any person in any manner so as to become subject to the worker's (";)mpensation laws
. ofCalifomia, .and agree that if I shoUld 'become subject to the wor1<er's comi=..::r.sation .
,provisions 01 Section 3700 ol\he Labor Cod~~ith ~~with \r.ose provisions.
Date: 6/15/2005 ,~ Applicant:. ~ .
WARNING: FAILURE TO.SECU WORKER'S COMPENSATION COvEnr,GE IS
UNLAWFUL. AND SHALL SUB cr AN EMPLOYER TO CRIMI!'lAL PENALTIES AND CIVIL
flNESUPTO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDiTION TO THE
, COST OF COMPENSATIO~, DAMAGES AS PROVIDED FOR IN SECTICl:" 3706 OF THE
lABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY .
. I hereby affirm under pena.lty of perjury that there is a construction lending a::jency for the
performance of the worl< for ~hjch,this permit is issued (Sec.309'? .Civ.C):
Lender's Information: .
I
Contractor
NUMBER
518124
TYPE
TYPE
TYPE
EXPIRATION DATE
9/30/2005
B
ASB
C33 PAIN
Construcion Types:
III N, ,
OccLtPancv Groups:
B, , , .
Fire.Sprinklered?
T.l,Area:
YES
, 5.432
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I
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I certify that I have read this appliCation a-nd state that.the above information is correct. I
agree to rom'ply with all city ordinances .and state laws relating to building construction, and
hereby authorize represe tives of this. City to enter upon the above mentioned property for
inspedi urposes.
Fees ,paid for Permit: .
Tota.l:
2.043.20
Signature plicaolor Agent
permit shaH expire by limitation and become null and V9id If the building or
work has not passed tinallnspection 365 days from the date of permit issuance. A,
new permit is requi~ed to commence or 'continue work.
Date: 611512005
"
.': INSPECTION RECORD . . FINAL INSPECTIONS. Date Inspector
INSPECTION DATE INSPECTOR Electrical Final (1J of.:.) I R-Ie-of _-=:1 -( ,L_,
Temporary Power POle ~ Plumbing Final , e-ry-t1j ---I-
,..:.
Plumbing (DrainlWaste Pipe) r.,,/I.o "i. c., chanical Final fr!8-e .....-::1 U~Y'
Electrical Ground ElectrodelUfer 7 -
SetbacklFoi'msfTrenches (Footings) . Gas Test . /0 It I
Do not install subfloor or pour floor slab until the Engineering/Grading Final 76S-5126
following 'applicable items have been signed: " it-n.oft t. ''''J'. J"-1.r ,..
Plumbing (WaterPlpe.5prihkler valves) j Fire Pclpt.Finai 765~O40 ;;.,
Mechanical (GrOUndwork) . Water Engineering 765-5268 {
Electrical (Underground Conduit) BU5 -
Sub L.ist/Business License 765-519
. Pre-slab [Compaction/Membrane.Rei nf. l'/~QJ
. -
Underpinning (Floor Joist/Girders) I. . Zoning 765-5139 I ' r .
Do not cover or. conceal the work below unfilthe Building Final ll;ast Inspection- Only '8-/9 OJ ..;;;f1 (
following applicable items have been signed: fter Abo"e Complete)
1st Floor Shear . . PARTIAL INSPECTIONS
Firesj)linkler (Rough) .' '..SuildinalnSDections (9 :v.n.jJ
2nd Floor Sh.ear .
Roof (SheathiMTDiaphranm'Framel If /..~);;;;'-lU}lA AML '{I'~~_t'
Masonry (ReinfJBond BeamlPre-Grout) . LA !lie f)~...I- t::I<;J "" /Ito~1 ^~ <lJ.'i#-~/.~,
Rough Plumbing (Top Out) ^ - u W,,~~~Lt-l n.(... -.: 1<.<." I :!foa...-- . \/,- "- ,.,1/ %L5
Rough Mechanical 1> '2.<>-Q/ r~L.,J;.j,
ROugtiEfectncal (Dry-walll .' _7 I T . . ' I {
Rough Electrical '-z,i> '0:: 1<:--..+' \:7
Framing, (Only after Plbg.. Elec.. Mech and Fire) 7- - 6S~ . .
Insulation (SoundlEnergy) 'di, ./05 .j~a" MechanicallnSDections
po not tape or pla~ter. until the followin!l ,bplicable
Items have been sIgned: _ .
Drywall -:-. :?(r"'F -=-r , .
Penetratiqns (Fire Ral~d) Electrical 7
Penetrations (Fire Rated) Mechanical --,.- . . .
Penetrations (Fire .Rated) Plumbing ,.
Interior Lath. . .
. .
Exterior Lath .. . . Plumbina InsDections
. GENERAL ITEMS .
Exterior Plaster (Brown Coal) .
T -Bar Electrical ' ' -- 'j./. or :--...~ -l .
--
T ~Bar Mechanical (+6' ~Y( /( .
.
T -Bar Structural ii'-I-6f> ..;:~ :( 7.
Sewer . ~
Water Engineering Backflow . ElectricallnsDections "A": /" /
W~ter Service -- ,--:: ld '^ A'
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