1056 N GROVE STy*ermit T^es
BLD ELE MEC PLM
X
Pemiit Number:BLD2009-02031
Issued:06/26/2009
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:150
Site Address:1056 N GROVE ST (Temp.Power Pole)
Legal Description:
CITY OF ANAHEIM
BUILDING DIVISION
200 s.Anaheim BLVD.
(714)766-5153
Project Description:Temporary power pole:Install temporary power pole for construction.
Valuation:
Construcion Types:
Total Fees paid for Permit:
N/A,.
136.73
People Associated with Project:
Contractor POWER PLUS TEMPORARY UTILITY S
Permit Applicant BRANDY MCGUIRE
1005 N EDWARD CT ANAHEIM CA 92806 0000
Electrical Fixtures Qty TypeType Plumbing Rxtures Qty Type Mechanical Fixtures Qty
Temp Power Pole/Pedestal (includes meter)1
The permit shall expire by Gmitation and become nuD and void if the building or work has not passed f hal inspection 365 days from the date of permit
issuance.A new permit is required to commence or continue woik.fbld_permit_combo
1
All applicable items below must be signed before utilities will be released.
FINAL INSPECTIONS DATE INSPECTOR
Final Gas Test
Building Division Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714)7C5-J280
Engineering/Grading Final (714>765-5126
Fire Dept.Final (714)765-5041
Fire Sprinkler Final (714)765-5041
Water Engineering (714)765-4591
Do not occupy this building until the final inspections have been made.
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 applicabie 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 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)
IVIechanical InspectionsDonotcoverorconcealtheworkbelowuntilthefollowingapplicableitemshave
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 plaster until the following applicable items have been signed;
Drywall
Drywall Penetrations (Ele.,Mec.&Pibg.)
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 Master-2008.xls
Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-02031
Issued:06/26/2009 CITY OF ANAHEIM
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:150
BUILDING DIVISION
200 S.ANAHEIM BLVD.
{714)765 -5153
Site Address:1056 N GROVE ST (Temp.Power Pole)
Legal Description:
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
checkmarks)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 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 Qwner-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'Slate 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 entiretybylicensedcontractors.I understand that a copy of the applicable law,Section 7044 of the Business and Professions Code,is available upon erquest
when this application is submitted or at the following Web site:httD://www.leainfo.ca.oov/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 ATTORN EY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
^ave and will maintain a certificate of consent to self-insure for worker's compensation,issued by the Director of Industrial Relations as providedyrorbySection3700oftheLaborCode,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:OLD REPUBLIC GENERAL INSURANCE
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
3700 of the Labor Code,I shall forthwith comply with those provisions.
Policy n^:^GW37450902 Expiration
Phone No.:
Signature of Applicant Date\
Permit Number:BLD2009-02031
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 penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of the
Bu^ess and Professions Code,and my license is in full force and effect.
A1\I)
Sir;Contractor Signature
NUMBER
523596
EXPIRATION DATE LICENSE TYPE (S)
1/31/2010 B CIO
D31
The permit shall expire by limitation and becx>me 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 oermil combo declare