3356 W BALL RD (3)Inspection
City of Anaheim
Date
BUILDING DIVISION
i
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
3356 W BALL RD 110, ANAHEIM, CA 92804
OWNER:
RAVIKUMAR JAYANTHI TR
PERMIT#:
SGN2022-00094
DATE ISSUED:
08/02/2022
DESCRIPTION:
Install (1) non -illuminated wall sign and (1)
non -illuminated freestanding directional sign for
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
Inspector
SET BACK, FORMS,
TRENCHES
602
UNDERGROUND
604
CONDUIT
MASONRY:
REINFORCEMENT,
606
PRE -GROUT
FINAL
699
_7,
PARTIAL APPROVAL NOTES
INSPECTION DATE INSPECTOR
Inspectors can normally be reached between
7:30 - 8:00 A.M.
(714) 765-5153 + 0
signcard
INSPECTION REQUIREMENTS
A representative is required to be on the site to expose
any Concealed wiring for final inspection.
INSPECTION REQUESTS
Inspection requests made prior to 5:00 pm
Monday - Friday will be scheduled on the
following workday.
To schedule your building inspection online, please
go to https:Haca.anaheim.netICiti2enAccess
To access your Inspection timeframe, please go to
www.anaheim.netlbuildina after 7:30 am on the day of
your Inspection. Under Online Services, click on the
"Inspection Timeframes" link or call (714) 765-5153 + 0.
Permit Number: SGN2022-00094
Issued: 08/02/2022
www.anaheim.net/bu ilding
(714)765-4626
Quarter Section: 7
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 3356 W BALL RD 110, ANAHEIM, CA 92804 _ `T
Legal Description: P BK 124 PG 2 PAR 2
APN: 07921031
Project Description: Install (1) non -illuminated wall sign and (1) non -illuminated freestanding directional sign for "Davita".
People Associated with Project:
Contractor SUPERIOR ELECTRICAL ADVERTISING INC 1700 W ANAHEIMABCDE11168829 LONG BEACH, CA 90813
Owner
RAVIKUMAR JAYANTHI TR
10120 SUNRISE LN
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that 1 am exempt from the Contractors License State Law for the following reason(s) indicated below by the
eheckmark(s) I have placed next to the applicable Items) (See. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, after, Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for the permit to file a signed statement that he
or she Is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she Is exempt from licensure 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).
0 I, as owner of property, or my employees with wages as their sole compensation, will do"all or U potions of the work, and the structure is not
intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through
employees' or personal efforts, builds or Improves the property, provided that the Improvements are not intended or offered for sale. If, however, the building or
0 I, as the owner of the property, am exclusively contracting with licensed Contractors to construct the project (Sec. 7044 Business and Professions Code:
The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed
Contractor oursuant to the Contractor's State License Law).
I am exempt from licensure under the Contractors, State License Law for the following reason:
Date Signature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for worker's compensation, Issued by the Director of Industrial Relations as provided for by
fSon 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
1 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
it Is Issued. My worker's Compensation insurance caner and policy are:
Cartier. TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Policy No.: UB5K0946
.This section need not be completed If the permit Is for one hundred dollars ($100) or leas.
❑ 1 certify that in the performance 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
worker's compensation laws of California, and agree that, if 1 should become bjeat to the worker's compensation provisions of Section 3700 of the
Labor I forthwith comDly with those oro i
Z
Date Signet ofscant
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEY'S FEES.
LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lender's Information:
I hereby certify that I have read this application and state that the Information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon Use above mentioned property for inspection purposes.
Date Signature of Applicant or Agen
The premit 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 Issuance. A new permit is required to commence or
continue work.
LICENSED CONTRACTORS DECLARATION
1 hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the BusiMss and
Professions Code. w.... -f/..._ 0
Date: 08/022
Contractor. SUPERIOR ELECTRICAL ADVER
Number: SGN2022-00094 Expiration Date 4/1/2023
TYPE: C45
Fees paid for Permit: $1,209.00