530 N. West St. (2)
BUILDING PERMIT NO. BLD2005-03164
TYPE OF PERMIT CITY
Residential Remodei
DATE: 9/30/2005
JOB ADDRESS: 530 N WEST ST
LEGAL DESCRIPTION: VINEYARD LOTS LOT B-7 NL Y 70.54 FT
APPLICANT: ALBERT FERNAN DEl
OWNER INFORMATION:
JOAN NE M KELLOGG
530 N WEST ST
ANAHEIM,CA 92801
ElM
BUiLDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 62
CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
ALBERT FERNANDEZ GENERAL CONTRACTOR PARTNE
12771 WESTERN AVE #L
GARDEN GROVE, CA 92841 0000
BUSINESS PHONE: 714891-8610
JOB DESCRIPTION:Remove existing wood siding and replace with stucco
VALUATION:
3,400.00
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's'Ucense Law for the following reason ( eC.70 1.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requ ires the applicant for such permit to file a signed statement that he is l(cen~d pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professior,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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their soJe compensation, will do the work, and the structure is not intended or offered for
-sate (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improv.es
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-builder will have the burden of provin'g that he
did not build or improve for the purpose of sale).
o 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 apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
Dram 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 wiJl maintain a certificate of consent to self-insure for worker's 90mpensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
~ermil is issued. :
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. Myworker's
Compensation insurance carrier and policy are:
Carrier:
PROCESSED BY: JNJ
poUcy Number. EXEMPT
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o l certify that in the perfollTlance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worke~s compensation laws
of Califomia, and agree that if I should become su 'ect to the rker's compensation
provisions of Section 3700 of the Labor Code, I "fort i amply with I se provisions.
Date: 9/30/2005 Applicant: (?j
WARNING: FAILURE TO SECURE WORKER'S COM
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER iC CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLAR ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
J hereby affirm under penalty of perjury, that there is a construction lending agencyfof the
porl'o:'m~nce of the work fe:' which this permit is issued (Sec.30S7.Civ.C):
Lender's Information:
I certify that I have read this application and state that the above information is correct. I
agree to comply w~h all city ordinances and state laws relating to building construction, and
herebyauthoriz repre nti es of this city to enter upon the above mentioned property for
in ection p ses.
Date: 9/3012005
Signat e of Applicant or Ag t
The permit shall ex re by limitation and ecome 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.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsi 3 of the Bu ess and
Professions Code.
9/30/2005 C
Date:
NUMBER
750651
TYPE
EXPIRATION DATE
6130/2006
B
Construcion Tvpes:
V N, ,
Fees paid for Permit:
Total:
141.91
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground ElectrodefUfer
Setback/FormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water PiDelSprinkler 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 FloDr Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/DiaphraamlFrame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (SouncllEnergy)
Do not tape or plaster unlilthe following applicable
Items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath lo\\O\d( 1.
GENERAL ITEMS ~
Exterior Plaster (Brown Coat) 1ffJ)Pvf) ~ A
T .Bar Electrical
T .Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Gradina 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 ...
After Above Complete) ,{-2'-<5 r'~
?/
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections