321 W KATELLASIGN PERMIT NO. SGN2021-00030
TYPE OF PERMIT
New Attached to Structure Sign CITY OF A N A H E I M
DATE: 3/22/2021
JOB ADDRESS: 321 W KATELLA AVE 120
LEGAL DESCRIPTION:
PERMIT APPLICANT: JAMES KAKALLIS
OWNER INFORMATION: CONTRACTOR INFORMATION:
CENTERLINE SIGNS
' 10833 CHERRY ST
LOS ALAMITOS, 90720 0000 CA
JOB DESCRIPTION: Install (1) illuminated blade sign for "PF Change".
VALUATION: 500.00
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
QUARTER SECTION: 87
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: AEG
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 Profs
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).
❑ 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 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 Contractor's
License Law).
C I am exempt under Sec. B 8 P.C. for this reason:
Dale:
Owner:
under penalty of perjury one of the following declarations:
❑ I have and will maintain a cert'fiicata 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.
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: EXEMPT Policy Number: EXEMPT
tion need not be completed If the permit is for one hundred dollars ($100) or lees.
rtity that in the performance of the work for which this permit is issued, I shall not employ any person In
�a5nymanrer so as to become subject to the workers compensation laws of California d agree that if I should
ubject to the workers compensation ons of Section 700 oJ� L r ode, I shall forthwith
comply with those provisions.
Date: 3/22/2021 Applicant:
WARNING: FAILURE TO SECURE O ER'S COMPENSATIGN COVERAGE IS UNLAWFUL, AND;
SUBJECT AN EMPLOYER TO CRI PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS ($100,000), ADDITION TO THE COST OF COMPENSATIoN, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES.
I hereby amrm 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):
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 buiIT construction, and hereby authorize representives of this
city to enter upon the above plentione�,propeytsr lb^pecbon purposes.
— '� Date: 3/22/2021
tur ignae of Applicant or Agent
The permit shall expire by limitation and become 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.
I nereby am m unaer penalty or periury that I am ucensea
under provisions of chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code.
Date: 3/22/2021
NUMBER:
BUS2016-02134
TYPE: C45
TYPE: BUS
Contractor:
EXPIRATION DATE:
5/31/2022
PERMIT EXPIRED
INSPECTION
NOT COMPLETED
DATE:
Few paid forPermit:
Total:
589,75