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1920 W CATALPA AVE (2)Permit Types ele'T MECBLLT PLM X Permit Number;BLD2009-01290 Issued;04/23/2009 CITY OF ANAHEIM INSPECTION REQUEST LINE; (714)765 -4626 Quarter Section:45 BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Site Address:1920 W CATALPA AVE Legal Description:N TR 3139 LOT 13 Project Description:Mechanical for residential remodel:Change out 14 seer air-conditioner. Valuation: Construcion Types; Total Fees paid for Permit: N/A,. 0.00 People Associated with Project: 1920 W CATALPA AVE ANAHEIM CA 92801-3516 22911 SAVI RANCH PKWY YORBA LINDA CA 92887 0000 RUBY M CRAIGOwner Contractor Permit Applicant SERVICE CHAMPIONS HEATING AND AIR C CARLOS ZAMORA Mechanical Fixtures QtyQtyTypePlumbingFixturesElectricalFixturesQtyTypeType Heating/Cooling Coil Compressor/Boiler -up to 15 hp 1 1 The permit shall expire by limitation 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 wori<. All applicable item below must be signed betore utilities will be released. FINAL INSPECTIONS DATE INSPECTOR Final Gas Test Building Division Electrical Final Plumbing Final Mechanical Final Cross Connection Control (7i4)76s-4280 Engineering/Grading Final (7i4)765-si26 Fire Dept.Final (714)765-5041 Fire Sprinkler Final (714)765-5041 Water Engineering (714)765-4591DonotoccupyIhisbuildinguntilthefinalinspectionshavebeenmade. BUILDING PERMIT DOES NOT AUTHORIZE ELECTRICAL PLUMBING.OR MECHANICAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED. Sub List/Business License (714)765-5194 Zoning (714)765-5139 INSPECTION DATE I INSPECTOR Building Final (Last Inspection - Only After Above Complete)Do not pour concrete until the following applicable items have been signed: Plumbing (Ground/Underfloor Drain Waste)FINAL INSPECTION must be approved by the Building Division. Electrical Ground Electrode/Ufer PARTIAL INSPECTIONSSetback/Forms/Trenches (Footings) Do not install subfloor or pour floor slab until the following applicable items have been signed: Building Inspections Plumbing (Ground/Underfloor Water) Underfloor Rough Gas Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) Floor (Joist/Girders) Underfloor Insulation (Raised Foundation Only) 2nd Floor (Floor Nailing) Mechanical InspectionsDonotcoverorconcealtheworkbelowuntilthefollowingapplicableitemshave been signed: 1st Floor Shear Firesprinkler (Rough)(Fire Dept.) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Rough Mechanical Plumbing Inspections Rough Electrical Framing (Only after Plbg.,Ele.,Mec.&Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Drywall Penetrations (Ele.,Mec.&Plbg.) Interior Lath Exterior Lath GENERAL ITEMS Electrical Inspections Electrical Service Meter Exterior Plaster (Brown Coat) T-Bar (Struct.,Ele..or Mec.) Sewer Water Engineering Backflow (Testable Only) Water Service Permit Backs Master-2008.xls Permit Types BLD ELE MEC PLM X Permit Number:BLD2009-01290 Issued:04/23/2009 INSPECTION REQUEST LINE: (714)765 -4626 Quarter Section;45 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Site Address:1920 W CATALPA AVE Legal Description:N TR 3139 LOT 13 OWNER-BULDER DEaARATION:|hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec.7031,5 Business andProfessionsCode:any city or county which requires a permit to construct,alter,improve,demolish or repair any structure,priorto its issuance,also requires the applicant for such permittofileasignedstatementthatheislicensedpursuanttotheprovisionsoftheContractor's License Law (Chapter 9)(commendng with Section 7000 of Division 3 of the Business andProfessionsCode)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 dviloenaltvofnotmorethanfivehundreddollars($500). I,as owner of property,ormy employees with wages as their sole compensation,will do the work,and the structure is not intended or offered for sale (Sec,7044 Business andProfessionsCode:The Contractor's License Law does not apply ot an ownerof property who builds or improves thereon,and who does such work himself or herself or through hisorherownemployees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold with one year of completion,theowner-builder will have the burden of proving that he did not build or improve for the purpose of sale). 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 LiceLawdoesnotapplyotanownerofpropertywhobuildsorimprovesthereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's LicenseLaw). I am exempt under Sec. nse B &P.C.for this reason: WORKERS CONPENSATION DECLARATION:|hereby affirm under penalty of perj ury one of the following declarations: I have and will maintain a certificate of consent to self-insure for worker's compensation,as providedfor by Section 3700 of the Labor Code,for the performance of the work forwhichthispermitisissued. V /|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 otis permit is issued.My\/worker's Compensation insurance carrier and policy are; Policy Number;HN30601801Carrier:HARBOR SPECIALTY INSURANCE COM This section need not be completed if the permit is for one hundred dollars (SI 00)or less. I certify that in the performance of the work for which this permit is issuptfTlshf of California,and agreethat if I should become si^jectto the worke lOt employ^ny person in any manner so as to become subject to the worker's compensation lawscomp^sation provisiyns of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Date;04/23/2009 Applicant: WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE>S U UP TO ONE HUNDRE D THOUSAND DOLLARS ($IDO.OOO),IN ADDmOI«OJ:He<CODE,INTEREST AND ATTORNEY'S FEES, r^kAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES ^STOFCOfiitPENSATION,DAMAGES AS PROVIDEDFOR IN SECTION 3706OF THE LABOR CONSTRUCTION LENDING AGENCY:|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 applicati ind stal t the above information is correct.I agree to comply with all city ordinances and state laws relating to building construction,andherebyauthorizerepresentative^f this cilytOi^nterluponthe above mentioned property for inspection purposes. 4/23/2009 SignatureTjf-AppttCant or Agent Date LICEH8ED CONTRACTORSDECLARATION I hereby affirm under penalty of perjury that I am licensi\under provisions of chapters (commencing with Section 7000)of DivsionS of the Business and Professions Code. 04/23/2009 Date fontractor NUMBER 799170 EXPIRATION DATE 9/30/2009 TYPE (sp^ C20 HTAC C36 The permit shall expire by limitation and become null and void if the building or work has not passed fnal iispection 365 days from the date of permitissuance.A newpermit is required to commence orcont^ue work.,u .^iDld permit combo_dedare