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1580 S DISNEYLAND DR (34)City of Anaheim BUILDING DIVISION INSPECTION RECORD. SIGN PERMIT ADDRESS: 1580 S DISNEYLAND DR 103, ANAHEIM, CA 92802 OWNER: WALT DISNEY PARKS AND RESORTS US INC PERMIT#: SGN2021-00144 DATE ISSUED: 12/02/2021 DESCRIPTION: Install (1) illuminated wall sign for'Pele Soccer. 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 TRENCHES 699zj 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://aca.an'aheim.net/CitizenAccess To access your inspection timeframe, please go to www.anaheim.netibuilding 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: SGN2021-00144 Issued: 12/02/2021 www.anaheim.neUbuilding (714)765-4626 Quarter Section: 76 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (7141 765 - 5153 Site Address: 1580 S DISNEYLAND DR 103, ANAHEIM, CA 92802 Legal Description: S TWP 4 RGE 10 SEC 22 T4 R10 SEC 22 POR OF W 1/2 APN:08219027 Project Description: Install (1) illuminated wall sign for "Pete Soccer". People Associated with Project: Contractor SUPERIOR ELECTRICAL ADVERTISING INC 1700 W ANAHEIMABCDE11168829 LONG BEACH, CA 90813 Permit Applicant John Crispis Owner WALT DISNEY PARKS AND RESORTS US INC PO BOX 313 OWNER - BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractoes License State Law for the following reason(s) indicated below by the checkmark(s) I have placed next to the applicable Item(s) (Sec. 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 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). 1, as owner of property, or my employees with wages as their sole compensation, will do"all or U portions 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 13 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). 1 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 self4nsure for worker's compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Me � I h ve 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 p issued. My worker's Compensation insurance carrier and policy are: Carder TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA Policy No.: UB51(0946 This section need not be completed If t ermit is for one hundred dollars (5700) or less. ❑ 1 cerrdy that in the perforans o he work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers compensation laws of alifo ia, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of the Labor Code. I shall forthwith m th th o isions. Date `Signature of Applicant WARNING: FAILURE TOCURE 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 ATTORNEYS 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 1 have read this applicati d state that the information above is correct. I agree to comply with all city ordinances and stat a relating building construction, and hereby authorize representives of this city to enter upon 0 ab ve mentioned property for inspection purposes. The premit shall expire by limitodh 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 chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. Date: 12/02/2021 Contractor: SUPERIOR ELECTRICAL ADVER Number: SGN2021-00144 Expiration Date 4/1/2022 TYPE: C45 Fees paid for Permit: $599.00