2065 S MARGIE LNPermit Types
BLD'■ELE MEC PLM
X
Permit Number;BLD2009-01319
Issued;04/27/2009 CITY OF ANAHEIM
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:67
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:2065 S MARGIE LN
Legal Description:N TR 2575 LOT 52
Project Description:Mechanical for residential remodel:Change out furnace and coil.
Valuation:
Construcion Types:
Total Fees paid tor Permit:
N/A,,
136.73
People Associated with Project:
2065 MARGIE LN ANAHEIM CA 92802-3235
22911 SAVI RANCH PKWY YORBA LINDA CA 92887 0000
RICHARD VVIOLETT
SERVICE CHAMPIONS HEATING AND AIR C
Owner
Contractor
Permit Applicant CARLOS ZAMORA
Mechanical Fixtures QtyQtyTypePlumbingFixturesQtyTypeElectricalFixturesType
Heating Appliances,including vent
Heating/Cooling Coil
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
fold Dissuance.A new permit is required to commence or continue work.
Ail applicable item below must be signed beiore utilities will be released,
FINAL INSPECTIONS DATE INSPECTORCityofAnaheim
Building Division
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (7M)765-4280
Engineering/Grading Final (7i4)765-si26
Fire Dept.Final (714)765-5041
Fire Sprinkler Final (714)765-5041
Water Engineering (714)765-4591Donotoccupythisbuildinguntilthefinalinspectionshavebeenmade.
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 INSPECTOR Building Final (Last Inspection ■
Only After Above Complete)Do not pour concrete until the following applicable items have been signed;
Plumbing (Ground/Underfioor Drain Waste)FINAL INSPECTION must be approved by the Building Division.
PARTIAL INSPECTIONS
Electrical Ground Electrode/Ufer
Setback/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
Firesprinkier (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 Masfer-2008.xls
Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-01319
Issued:04/27/2009 CITY OF ANAHEIM
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:67
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:2065 S MARGIE LN
Legal Description:N TR 2575 LOT 52
OWNER-BULDER DECLARATION:|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,prior to its issuance,also requires the applicant for such permittofileasignedstatementthatheislicensedpursuanttotheprovisionsoftheContractor's License Law (Chapter 9)(commencing 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 ot a civilpenaltyofnotmorethanfivehundreddollars($500).
I,as owner of property,or my employees withwages as their sole con^iensation.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 properly 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 irrprove 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 LicenseLawdoesnotapplytoanownerofpropertywhobuildsorimprovesthereon,and who contracts for such projects with a contractor(s)licensed pursuant to the Contractor's LicenseLaw),
I am exempt under Sec.,B &P.C,for this reason:
WORKERS COMPENSATION DECLARATION:1 hereby affirm under penalty of perjury one of the following declarations:I ha^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'h this permit is issued.w
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.Myworker’s Compensation insurance carrier and policy are:
Carrier:HARBOR SPECIALTYINSURANCECOM ycyNDmber:HN30601801
This section need not be completed if the permit is for one hundred dollaraTS'fbojorless.
I certify that in the performance of the work for which this perrijnt is(issued,I shall notofCalifornia,and agree that if I should become su ploy any person in any manner so as to become subject to the worker's compensation lawscttothe^orl^r's compensatii^provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions.
Date:04/27/2009 Applicant:
WARNING:FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINESUPTOONEHUNDREDTHOUSANDDOLLARS($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OFTHE LABORCODE,INTEREST AND ATTORNEY'S FEES.
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 application andsta^hereby authorize representatives of this city ti Jhe above information is correct.I agree to comply with all city ordinances and state laws relating ot building construction,andinterupontheabovementionedpropertyforinspectionpurposes.
r\xi 4/27/2009/
Signature of Apraicantfor Agent Date
LICalSED contractorsdeclarationV^\
\y I here by affirm u nder penalty of perju ry tha lam licensed under provisions of chapters (commencing with Section 7000)of Divsion3 of the Business and Professions Code.
04/27/2009
Date Contractor
\TYPE(s)'●C20 HTAC
NUMBER
799170
EXPIRATION DATE
9/30/2009 C36
The permit shall expire by limitation and become null and void if the building or work has not passed fkial inspection 365 days from the date of permitissuance.A newpermit is required to commence orcontinue work.,.u ,^futd permit combo dedare