138 S GILBERT ST (2)BUILDING PERMIT NO. OLD2007-02532 efq . BUILDING DIVISION
4(� 200 S. ANAHEIM BLVD.
AQVIO-0,i!o (714) 765 - 5153
TYPE OF PERMIT
Blockwall / Columns
DATE 11/14/2007
JOB ADDRESS:
136 S GILBERT ST - -
CITY
LEGAL DESCRIPTION: P SK 115 PG 40 PAR 6
EIM INSPECTION REQUEST LINE
(714) 765 - 4626
_CENSUS CODE:_ __ __565__ _
QUARTER SECTION: 33
PERMIT APPLICANT: JOSHUA SCHULER '
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
DONALD F RALSTON TR OAKWOOD CONSTRUCTION 00
136 S GILBERT ST 576 EXPLORER ST t
ANAHEIM, CA 92804.2347 BREA, CA 92821-0000
BUSINESS PHONE: 714 529.8300
JOB DESCRIPTION: Block Wall: 60 linear feet by V high per city specifications.
VALUATION: 6,000.00 ; PROCESSED BY: CJH
i nracy amrm unser penny or perjury mni i am exempt Tram me lionrrarxors License raw mr im roxovAng reason (sac. 7031.5 Business and Professions Code: any city or county
which requires a perml ioconstruct 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 Contractors Lfcene Law (Chapter e)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or eel ire is exempt
therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any appli%int for a permit subjects the applicant to a civil penalty of rat more than five hundred
dollars ($500).
rofeI, as owner of property, or my employees withwages as theirsote compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044 Business and
sslons Code: The Contractors License Law does not appy to an owner of property who builds or improves thereon, and who does such work himself or herself orthrough his or
her own employees, provided that such Improvements are not Intended oroltered for sale. If, hullover, 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).
❑ 1, as the owner of the property, am LSiro
exclusively contracting with licensed contractors to corct the project (Sec. 7044 Business and Professions Code. The Contractors License
Law floes not appy iD an owner of property who builds or Improves theison, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law).
❑ I am exempt under Sec. , B 8 P.C. for this reason:
Date: _ Owner.- !
WORKER'S COMPENSATION
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 workers compensation, as provided for by
Section 3700 of the. abdr. Code, for the performance of the work for which No permit is issued.
M I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for
No performance of the work for which this pemdt is issued. My worker's Compensation insurance carrier and policy
are:
Carrier: STATE FUND Policy Number. 046-0006779 '
This section need not be completed 9the pefmk Is for one hundred clothes (8100)orlow.
I cerl fy that in the performance of the work for which this permit is issued, I shall not employ any person in
manner so as to become subject to the workers compensation laws of Cafibmia, and agree that if I should
become subject to The worhees compensation provisions of Section 3700 of the Labor Code, l shall forthwith con
with those provisions.
Date: 11/14/2007 Applicant:
WARNING: FAILURE TO SECURE WORKEO COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL P ALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000), IN ADDITION TO TRE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. Im m
I CONSTRUCTION LENDING AGENCY I
for which this permit is issued
Lender's Informedon:
I certify that I have read this application and state that the above information is correct. I agree to comply with all
city ordinances and state laws relating to building construction, and hereby authodw representives of this city to
enter upon the above mentioned property for inspection purposes.
yDate: 11114/2007
Signature of Applicant or Agent
permit shell expire by limitation and became null and void if the building or work has not
seed final inspection 365 days from the date of permit Issuance. A new permit Is required to
commence or oonthue work.
LICENSED CONTRACTORS DECLARATION
hereby affirmu
r penalty o perjury at am ice��
under provisions of chapter 9 (commencing with Section 7000) of
Divsion 3 of the Business and Professions Code.
11/14/2007, �•a ��/.�
Date: Contractor.
NUMBER EXPIRATION DATE
762828 513112009
TYPE • 8
VV N, ,ucien Tyle$:•- R M IT EXPIRED
INSPECTION
NOT COMPLETED
_-DAT- ZL14 /:)-0.08-
Fees paid for err :
Total:
154.68
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4. 7 ---------
-AhePIT)
no..final'- inspection_-_
6_W':_1't0mpIetet These plans may not
reflect
-7.
_r-qnditWn&_-_-
'kiro _M-
A Alp SOLID FENCING
Z - FENCING
PRO�D
Fancin approved su0JMr1.Ao_C00E-SEG-T.I0N-
0
THE ISSUANCE OF
requiring all fences/ block walk and trasth,
I
NOT APPROVE VIOLATION OF ANY OP vil y
Or THE CITY. enclazurag 604tal4int 92lid sUrfacce which aro visible to an
_M
F_BUIIp IN
t__ b..
7 i Ing
pub! either
r
-rHE HoL*U-E.-W--CFr--TI�-Irs—PLr'--.-----"-'-"""-
ne
shrubbery which will coroon
PROCEEDS AT HIS OWN -RISK, vines or fast growing r either clinging
the fence
. ..........
apportUnItler.
NOV 14 2007
Planner, to In
I 'Divicion
D;LtI.
--.--.---.-BUILDING-.-DI-V-1-S-1.0-N--OF.-ANAH�IM
APPROVED
_-
V-
60
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