7350 E STONE CREEK LN (5)PR7P7e;rmltTypes
BLD ELE MEC PLM .
X
Permit Number: BLD202340964.
Issued: 03/01/2023
www.anaheim.net/buiiding
(714)765-4626
Quarter Section: 203
Online
CIN OF ANAHEIM
ay BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) AS - 5153
Site Address: 7350 E STONE CREEK LN, ANAHEIM, CA 92808
.Ligil D"et(ptlon: N TR 8560 BLK LOT 49
APN:35633126 "
Project Description: Residential EV Charger Level 2
Living Area: Number of stories: Valuation: 0.00
Garage Area: Construction Types:
Carport Area: Occupancy Groups:
Balcony / Deck Area: Fire Spdnldered:
Cool Root Total Fees paid for Permit: 0.00
People Associated with Project:
Contractor MANOS ELECTRIC INC 5753 E SANTA ANA CANYON RD,SUITE G528 SUITE G528 ANAHEIM, CA 82807
Permit Applicant MANOS ELECTRIC INC 5753 E SANTA ANA CANYON RD STE G528 ANAHEIM, CA 92807 0000
Type Electrical Fbdures Qty Type Plumbing Fbdures Qty Mechanical Fbdures City
EV Charger 1
The permit shall expire by limitation and become null and void H 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.
Permit Types
BLD I ELE I MEC I PLM
X
Permit Number: BLD2023-00964
Issued: 03/01/2023
www.anaheim.net1building
(714)7654626
Quarter Section: 203
CITY OF ANAHEIM
Site Address: 7350 E STONE CREEK LN, ANAHEIM, CA 92808
Legal Description: N TR 8560 SLK LOT 49
APN: 35633126
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
WORKER'S COMPENSATION DECLARATION:
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.
I hereby afliinn under penalty of pedury one of the following declarations:
1 have and will maintain a certificate of consent to self4nsure for workers 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 have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which
this permit is Issued. My workers Compensation insurance carrier and policy are.
Cartier. SECURITY NATIONAL INSURANCE COMPANY Policy No.: SWC1378469 Expiration Date: 3/8/2023
Name of Agent Phone No.:
I certify that In the performance of the work for which this permit is issued, l shall not employ any person In any manner so as to become subject to the
workers compensation laws of California, and agree that, it I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code, I shall forthwith comply with those provisions.
MANOS ELECTRIC INC 3/1/2023
Signature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is Issued
(Sec.3097.Civ.C):
Lender's Name:
Lender's Address:
LICENSED CONTRACTOR'S DECLARATION:
1 hereby affirm under the 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, and my license is In full force and effect
MANOS ELECTRIC INC
Contractor Signature
NUMBER EXPIRATION DATE LICENSE TYPE ISr
979740 04/30/2024 C10
'Date
3/1/2023