1199 N EUCLID ST (6)Permit Number: SONM240112
Issued: 09/12/2022
www.anaheim.neUbuilding
(714)765-4626
Quarter Section: 44
Site Address:=1199 N.EUCLID ST D, ANAHEIM, CA 92801
Le al Descrijitlon P 113; K"369 FG 16 PAR 1
APN:.07214075
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(7141765-5153
Project Description: Installation of (1) illuminated wall sign for" Poke & Tea Factory".
People Associated with Project:
Permit Applicant Lavender Fung
Owner V E M STAR LLC 1199 N EUCLID ST
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following reason(s) indicated below by the
cheekmark(s) I have placed next to the applicable Item(s) (See. 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 Ileensure 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"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
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 pursuant to the Contractoes 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:
❑ I 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
Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued.
`� I 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 carder and policy are:
Cerner. STATE COMPENSATION INSURANCE FUND Policy No.:01 85132 Expiration Date:
This section need not be completed If the permit is for one hundred dollars ($100) or less.
❑ I car* that in the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become subject to the
worker's compensation laws of California, and agree that, If I should become sub to the workers compensation provisions of Section 3700 of the
Labor.Code. I shall forthwith comDty with those provision; _ _
Date (1 ' ` v Signature of Applica,, jr
WARNING: FAILURE TO SECURE WORKERS' COMPEN ION C VE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($ 00 0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY 11 LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance
Lender's Information:
I hereby certHy 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 the above mentioned property for Inspection purposes.
The premit shall expire by limitation and become null nd vild If the building or work has not passed
final Inspection 365 days from the date of permit IssuadbeA new permit is required to commence or
continue work.
1 hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commenting with
Section 7000) of Division 3 of the Business and
Professions Code.
Date: 09/12/2022
Contractor. SIGNS EXPRESS MANUFACTURI
Number: SGN2022-00112 Expiration Date 11/11/2022
TYPE: C45
Fees paid for Permit:
$586.00
City of Anaheim
BUILDING DIVISION
Inspection
INSPECTION RECORD
Date
SIGN PERMIT
ADDRESS:
1199 N EUCLID ST D, ANAHEIM, CA 92801
OWNER:
V E M STAR LLC
PERMITM
SGN2022-00112
DATE ISSUED:
09/12/2022
DESCRIPTION:
Installation of (1) illuminated wall sign for' Poke &
Tea Factory'.
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
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.anaheim.net/CitizenAccess
To access your Inspection timeframe, please go to
www.anaheim.net/buildincl 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.