655 S. Webster Ave.
BUILDING PERMIT NO. BLD2005-02152
TYPE OF PERMIT C
Miscellaneous I TV
DATE: 7/12/2005
JOB ADDRESS: 655 S WEBSTER AVE
LEGAL DESCRIPTION: TR 796 LOT 7 S1/2 -EX ST-(AND N 9.5
APPLICANT: JOSE MORALES
OWNER INFORMATION:
JEE-DA CHANG
4249 DOGWOOD AVE
SEAL BEACH, CA 90740
CONTRACTOR INFORMATION:
ASTRO ORNAMENTALS
115 E 58TH ST
LOS ANGELES, CA 90011 0000
BUSINESS PHONE: 323232-2205
JOB DESCRIPTION:Replace 4 flights of stairs with new metal pre-cast stairs.
VALUATION: 15,000.00
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 28
ARCHITECT/ENGINEER INFORMATION:
NOEL 0 DALEY
22539 FIGUEROA STREET
CARSON, CA 90745
PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
J hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason { 00.7031.5 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
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's license Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Arry 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
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 impft)Vements 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 proving 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 o:mtractors 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
,aQontractor(s) licensed pursuant to the Contractor's License Law).
U 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 self-insure for worker's compensation,
as provided for by Section 3700 of the Labor CocIe, for the performance of the work for which
~hi permit is issued.
t have and will maintain worker's compensation insurance, as required by Section 3700 of
t e Labor Code, for the performance of the work for which this permit is issued. Myworker's
ompensation insurance carrier and policy are:
arrier: STATE FUND Policy Number. 196~2002 i
This section need not be completed if the permit is for one hundred dollars ($1 00) or less.
o I certify that in the performance of the work for which this permit is issued, , shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should beco e subject to the orker's compensation
provisions of Section 3700 of the Labor Cod ,I shall forthwith 0 ply with those provisions.
Date: 7/12/2005 Applicant:
WARNING: FAILURE TO SECURE ORK R'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EM LOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED TH USAND DOLLARS ($100,000), IN ADDITlON TO THE
COST OF COMPENSATION, DA GES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND TORNEY'S FEES.
CON RUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agQoi1(.1 for the
performance of the work for which this permit is issued (See.3097.Civ.C):
Lender's Information:
I certify that I have read this application and state that the at;>ove information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
her by authorize representive of this city to enter upon the above mentioned property for
i ion pu oses.
Date: 7/12/2005
Signature of Applicant or Agent
The mit sltall 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.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chap er 9 (commencing
with Section 000 of Divsion 30th Business and
Pro1essio s ode
7/12/2005
Date:
NUMBER
720826
TYPE
TYPE
Contractor
EXPIRATION DATE
4/30/2006
C23 ORN
C23 FENC
Construcion Tvpes:
VN, ,
Fire $prinklered?
NO
Fees paid for Permit:
Total:
306.17
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/FormsfTrenches (Footings)
00 not install subtloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Reinf.)
Underpinning (Floor Joist/Girders)
00 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 Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
00 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 INSPECTOR I
Electrical Final I
Plumbing Final I
Mechanical Final
Gas Test
Engineering/Grading Final 765.5126
Fire Dep\. Final 765-4040
Water Engineering 765-5268 ,
Sub List/Business License 765-5194 I I
Zoning 765-5139 I
Building Final (Last Inspection - Only 7{?'~ -" I
Aller Above Complete) .
~
PARTIAL INSPECTIONS ~
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
Ri'V1.:t.. ...&5 Vi
f'LMJNii'iG DEPARTMENT
APPROVED
DAT~J):1 ,. c,
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THE ISSUANCE
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THE BUll..DING
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F THIS PERMIT DOES
IOLATION OF ANY OF
ODES OF THE CITY,
OF" THIS PERMIT
T HIS OWN RISK.
JUL 12 2005
BUILDING DIVISION OF ANAHEIM
APPROV~
e,U>dco6...j)~ 6''0 BY