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1920 E CLIFPARK WAY (6)Permit Types PLMMECELEBLD X Permit Number: BLD2011-04205 Issued: 10/27/2011 BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 CITY OF ANAHEIM www.anaheim.net/building (714)765-4626 Quarter Section: 105 APN: 23406313 Legal Description: N TR 6409 LOT 173 Site Address: 1920 E CLIFPARK WAY, ANAHEIM, CA 92805 Project Description: Plumbing to replace water heater. Living Area: Garage Area: Carport Area: Balcony / Deck Area: Number of Stories:Valuation: Construction Types: Occupancy Groups: Fire Sprinklered: Cool Roof: 0.00 Not Applicable No Total Fees paid for Permit: 136.73 People Associated with Project: 27919 SMYTH DRIVE200708091257395690 VALENCIA, CA 91355Contractor PAYLESS WATER HEATERS &AMP; PLUMBIN Permit Applicant CARLOS ZAMORA 1920 CLIFPARK WAY ANAHEIM, CA 92805Owner RANDOLPH AREIAS TR Type QtyElectrical Fixtures Type QtyPlumbing Fixtures Water Heater 1 QtyMechanical Fixtures 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 work. All applicable items below must be signed before utilities will be released. FINAL INSPECTIONS INSPECTORDATECityofAnaheimFinalGasTest Building Division Electrical Final Plumbing Final Mechanical Final Cross Connection Control (7i4)76s-i28o Engineering/Grading Final (714)t65-5126 Fire Dept.Final (714)765-5Q41 Fire Sprinkler Final (714)765-5041 Water Engineering (714)765-4591 Do not occupy this buildino until the final inspections have been made Sub ListySusiness License (714)765-5194BUILDINGPERMITDOESNOTAUTHORIZEELECTRICAL.PLUMBING.OR MECHANICAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED.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/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 follwing 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./Sond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) PlumBlrrg'InspectionsrrTTTTrTTRoughMechanical r \P LRoughElectrical I hi Q nrFraming(Only after PIbg.,Ele.,Mec.S Fire)0 I iur\-J U I L_Insulation (Sound/Energy)m CflMOi^y-'I V I I i Do not tape or plaster until the following applicable items have been signed: -L I C.IJDrywall Drywall Penetrations (Ele.,Mec.&PIbg.)DATl; Interior Lath Exterior Lath Electrical InspectionsGENERALITEMS 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 MECBLDELE PLM X Permit Nifmber:BLD2011-04205 Issued:10/27/2011 INSPECTION REQUEST LINE: (714)765-4626 Quarter Section:105 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765-5153 Site Address:1920 E CLIFPARK WAY Legal Description:N TR 6409 LOT 173 OWNER -BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reason(s)indicated below by the checkmark(s)I have placed next to the applicable item(s)(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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors'State License Law Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt from licensure 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). )portions of the work,and the structure is notI,as owner of property,or my employees with wages as their sole compensation,will do (. intended or offered for sale (Sec.7044 Business and Professions Code:The Contractors'State License Law does not apply to an owner of property who, through employees'or personal efforts,builds or improves the property,provided Uiat the improvements are not intended or offered for sale.If,however, the building or improvement is sold within one year of completion,the Owner-Buiider will have the burden of proving ftiat it was not built or improved for the purpose of sale). J all or (. !,as the owner of the property,am exclusively contracting vwth licensed Contractors to construct the project (Sec.7044 Business and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon,and who contracts for the projects with a licensed Contractor pursuant to the Contractor’s State License Law). I am exempt from licensure under the Contractors'State License Law for the following reason: By my signature below I ackonowledge that,except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit,I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors.I understand that a copy of the applicable law,Section 7044 of the Business and Professions Code,is available upon request \Atien this application is submitted or at the following Web site:http://www,leqinfo.ca .aov/calaw.html. By my signature below,I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply v/ith all applicable city and county ordinances and state laws relating to building construction I authorize representatives of this city or county to enter the above-identified property for inspection purposes. DateSignatureofPropertyOwnerorAuthorizedAgent WORKER’S COMPENSATION DECLARATION: WARNING:FAILURE TO SECURE WORKERS’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 OR THE LABOR CODE.INTEREST,AND ATTORNEY’S FEES. I hereby affirm under penalty of perjury one of the following declarations: ITiave and \mII maintain a certificate of consent to self-insure for worker’s compensation,issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued. 1 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 and policy are: Carrier: Name of Agent: 1 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 theworkerscompensationlaw^of,California,and agree that,if I should become subject to the worker’s compensation provisions of Section 3700 of theLaborCode,I shall forthvwtn cojnply with those provisions. AQW002992 8/1/2012PRAETORIANINSURANCEPolicyNo.:Expiration Date: Phone No.: V igriature of Applicant Date Permit Number:BLD2011-04205 DEOIJVRATION REGARDING 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 Name: Lender's Address: LICENSED CONTRACTORS DECLARATION: I hereby affirm under the penaky^fberjury that I am licensed under provisions of chapter 9 (commencing vwth Section 7000)of Division 3 of theBusinessandProfessionsCo^.ano my license is in full force and effect. /a ^7 reConlractorSignatureDate EXPIRATION DATE LICENSE TYPE fS^ 8/31/2012 NUMBER 836216 C36 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 work. fbid permit combo declare