1505 W ORANGEWOOD AVE (3)SWIMMING POOL PERMIT NO. SWl2020-00122
TYPE OF PERMIT
Repair or Alteration of Existing
DATE: 11/23/2020
JOB ADDRESS: 1505 W ORANGEWOOD AVE
LEGAL DESCRIPTION: N TR 4731 LOT 30
KIRK L TAROUILL Y PERMIT APPLICANT:
sOILbiNG blvisioN
200 S. ANAHEIM BLVD.
(714) 765-5153
INSPECTION REQUEST LINE:
(714)765 -4626
QUAff!"ER SECTION: 58
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT /ENGINEER INFORMATION:
KIRK LEE TAROUILL Y
1505 W ORANGEWOOD AVE
ANAHEIM, CA 92802-3918
JOB DESCRIPTION: Plumbing and electrical to relocate pool equipment. Split drains and replaster
VALUATION: 1,000.00
OWNER-BUILDER DECLARATION
PROCESSED BY: CMN
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the ollowing reason (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 such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professions
Code) or that he is exempt therefrom 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).
D I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or
through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, 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 th.e purpose of sale).
D I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's
License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's
License Law). D I am exempt under Sec. _____ , B & P.C. for this reason:
Date: Owner:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for worker's compensation, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of pe�ury that I am licensed
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
n 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 permit is issued. My worker's Compensation insurance carrier Date: 7/2/2021 Contractor: and policy are:
Carrier: Policy Number:
action need not be completed If the permit is for one hundred dollars ($100) or less.
i"certify that in the performance of the work for which this permit is issued, I shall not employ any person in
a anner so as to become subject to the worker's compensation laws of California, and agree that if I should
become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shalt forthwith
comply with those provisions.
Date: 7/2/2021 Applicant: ____________________ -I
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENAL TIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATloN, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES.
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 Information:
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 he_reby authorize representives of this
city to enter upon t above (hen • . d operty for inspection purposes.
Date: 7/2/2021
ignature of Applica or fi't/2
The permit shall expire by limitation and bid! me null and void if the building or work has not passed final inspectoin 365 days from the date of permit issunace. A new permit is required to commence or continue work.
NUMBER:
TYPE:
Valuation
Census Code
EXPIRATION DATE:
Fees paid for Permit:
Total:
1,000.00
434
382.00.