330 E ORANGEWOOD AVE (2)SIGN PERMIT NO. SGN2021-00119 BUILDING DIVISION
200 S. ANAHEIM BLVD.
TYPE OF PERMIT (714) 765 - 5153
New Attached to Structure Sign CITY OF A NA H E I M INSPECTION REQUEST LINE:
(714)765-4626
DATE: 10/6/2021 QUARTER SECTION: 99
JOB ADDRESS: 330 E ORANGEWOOD AVE
LEGAL DESCRIPTION
PERMIT APPLICANT: KAITLYN FISCHER
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
ORANGE COUNTY SIGNS
636 WILLIAMSON AVE
FULLERTON, 92832 CA
JOB DESCRIPTION: Install (3) non -illuminated wall signs for "St Jude Neighborhood Health Centers"
VALUATION: 12,000.00 PROCESSED BY: MAL
'may a,.,.,,, m.um pemamy or pequrymar 'am exempt from the Contractors License Law for the following 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 Contractors 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 pemmit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
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 Contractors 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 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
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 Contractors
License Law).
I am exempt under Sec. B & P.C. for this reason:
Date: Owner:
/ I hereby affirm under penalty of perjury one of the following declarations:
•L�.AI I have and will maintain a certificate of consent to self -insure for workers compensation, as provided for
bySection3700 of the Labor Code, for the performance of the work for which this permit is issued.
I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code,
or the performance of the work for which this permit Is issued. My workers Compensation Insurance carrier
and policy are:
Carrier: ACCREDITED SURETY AND CASUALT Policy Number. 1ATCA160037391
This section need not be completed If t he permit Is for one hundred dollars ($100) or lase.
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in
any manner so as to become subject to the workers compensation laws of California, and agree that 01 should
become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 10/612021 Applicant:
WARNING: FAILURE TO SECURE WORKER'S 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 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES,
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction tending agency for the performance of the
work for which this permit is issued (Sec.3097.Civ.C):
Lenders 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 hereby authorize representives of this
city
tttoo, enter upon the above mentioned property for inspection purposes.
he
7 /w a Date: 10/6/2021
Signature of Applicant or Agent
The permit shall expire by limitation and become null and Vold 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.
LICENSED
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 10,#/2021 Contractor:
NUMBER EXPIRATION DATE:
BUS 202"2541 10 /612022
TYPE: C45
TYPE: BUS
PERMIT EXPIRED
NbPECTION
NOT COMPLETED
DATE:_164(1 zt
Fees paid for erm t:
Total:
585.75