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1708 W CRONE AVEPermit Types BLD ELE MEC PLM X Permit Number:BLD2009-02023 Issued:06/25/2009 INSPECTION REQUEST LINE: (714)765 -4626 Quarter Section:48 Site Address:1708 W CRONE AVE (AT&T Cabinet) Legal Description:TR 2377 LOTS 234^35 CITY dP^plEIM BUILDING DIVISION 200 SI.ANAHEIM BLVD. (714)765-5153 Project Description:Electrical to install 10Oamp AT&T pedestal. Valuation: Constfucion Types: Total Fees paid for Permit: N/A, 136.73 People Associated vwith Project: Owner MARJORIE I THOMAS HARPER ELECTRICAL CONTRACTORS INC BARTLEY HARPER 25151 MAMMOTH CIRCLE LAKE FOREST CA 92630-2518 704 DRY GULCH PL NORCO CA 92860 0000Contractor Permit Applicant Electrical Fixtures Qty TypeType Plumbing Fixtures Qty Type Mechanical Fixtures Qty Meter/Disc Sw -under 600 V,up to 200 amps 1 The permit shall expire by [imitation and become null and void if the building or work has not passed final inspection 365 days from the date of permitissuance.A new permit is required to commence or continue work.fbid permit combo All applicable Items below must be signed before utilities w,ill be released. FINAL INSPECTIONS DATE INSPECTOR Final Gas Test Building Division Electrical Final Plumbing Final Mechanical Final Cross Connection Control (7i4)7C5-i28o Engineering/Grading Final (714)765-512g Fire Dept.Final (714)765-5041 Fire Sprinkler Final (714)765-5D41 Water Engineering (714)765-4591 Do not occupy this building until the final inspections have been made Sub List/Business License (714)765-5194BUILDINGPERMITDOESNOTAUTHORIZEELECTRICAL,PLUMBING,OR MECHANICAL INSTALUTIONS -SEPARATE PERMITS ARE REQUIRED.Zoning (714)765-5139 Building Final (Last Inspection ● Only After Above Complete) INSPECTION DATE INSPECTOR Do not pour concrete until the following applicable items have been signed: Plumbing (Ground/Underfloor Drain Waste)FINAL INSPECTION must bo approved by the Building Division. Electrical Ground Electrode/Ufer PARTIAL INSPECTIONS Setback/Forms/Trenches (Footings) Do not install subfloor or pour floor slab until the foilwing 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 InspectionsDonotcoverorconcealtheworkbeiowuntilthefollowingapplicableitemshave 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) Plumbing InspectionsRoughMechanical Rough Electrical Framing (Only after PIbg.,Ele.,Mec.&Fire) Insulation (Sound/Energy) Do not tape or piaster until the following applicable items have been signed; Drywall Drywall Penetrations (Ele.,Mec.&PIbg.) 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 BLD ELE MEC PLM X Permit dumber:BLD2009-02023 Issuedr 06/25/2009 INSPECTION REQUEST LINE: (714)765 ●4626 Quarter Section:48 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Site Address:1708 W CRONE AVE (AT&T Cabinet) Legal Description:TR 2377 LOTS 2S4&235 OWNER -BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Lawforthe following reason(s)indicated below by the checkmark(s)I have placed next tothe 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,priorto its issuance,also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant tothe 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 apermitsubjectstheapplicanttoacivilpenaltyofnotmorethanfivehundreddollars(S500). I,as owner of property,or my employees with wages as their sole compensation,will do (_)all or ( )portions of the work,and the structure is not 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 that the improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the Owner-Builder will have the burden of proving that it was not built or improved for the purpose of sale). I.as the owner of the property,am exclusively contracting with licensed Contractors to constnjct 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 oftheimprovementscoveredbythispermit,I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entiretybylicensedcontractors.I understand that a copy of the applicable law.Section 7044 of the Business and Professions Code,is available upon erquestwhenthisapplicationissubmittedoratthefollowingWebsite: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 with 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. Signature of Property Owner or Authorized Agent Date 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; I have and will maintain a certificate of cronsent to self-insure for worker's compensation,issued by the Director of Industrial Relations as providedforbySection3700oftheLaborCode,for the performance of the work for which this permit is issued. 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.My worker's Compensation insurance carrier and policy are: Carrier:SOUTHERN INSURANCECOMPANY Name of Agent: 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 worker's compensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section 37g.0-of tbp Labor Code,I shall forthwith comply with those provisions. Poltey Expiration Phone No.: X- Sf^attire of Applicarif Date L Permit Number:BLD2009-02023 DECLARATION 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: UCENSED CONTRACTORS DECLARATION: I hereby affirm under the^nalty of perjury that I am licensed under provisions of chapter 9 (commencingwith Section 7000)of Division 3 of thelicenseisinfullforceandeffect.Business and Pr ode,and 7^Con trattor^gnature 7Date NUMBER 779882 EXPIRATION DATE LICENSE TYPE fSt 11/30/2009 CIO The permit shall expire by limitation and become null and void if the buildhg 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