201 S STATE COLLEGE BLVD (5)Permit Types
ELE MECBLD PLM
X
Permit Number:BLD2009-02096
Issued:07/02/2009
‘NSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:103
Site Address:201 S STATE COLLEGE BLVD
Legal Description:ANAHEIM EXT LOT 11 POR OF LOT(AND
CITY OP ANAHEIM
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Project Description:Electrical to replace canopy lighting.
Valuation:
Construcion Types:
Total Fees paid for Permit:
N/A,,
136.73
People Associated with Project:
Owner EQUILON ENTRPRS LLC TAX DEPARTMENT-PROPERTY P O BOX 4369 HOUSTON TX 7721
982 N BATAVIA ST ORANGE CA 90278 0000Contractor
Permit Applicant
ARGOS SIGN AND MAINTENANCE CO INC
ROBB LEWIS
Electrical Fixtures Qty Type Plumbing Fixtures Qty TypeType Mechanical Fixtures Qty
Receptacle,switches,lights 18
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.fbld_perinil_combo
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 (7i4)76s-J2ao
Engineering/Grading Final (7i4)755-5126
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 Sub List/Business License (714)765-5194BUILDINGPERMITDOESNOTAUTHORIZEELECTRICAL,PLUMBING,OR
MECHANICAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED.Zoning (714)765-5139
INSPECTION DATE Building Final (Last Inspection -
Only After Above Complete)
INSPECTOR
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 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 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.&Plbg.)
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)
-/7WaterService
Permit Backs Master-2008.xls
Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-02096
Issued:07/02/2009 CITY OF ANAHEIM
INSPECTION REQUEST LINE:
(714)765-4626
Quarter Section:103
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765-5153
Site Address:201 S STATE COLLEGE BLVD
Legal Description:ANAHEIM EXT LOT 11 POP OF LOT(AND
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 thecheckmark(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 Section7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500).
I,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 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 forthepurposeofsale).
I.as the owner of the property,am exclusively contracting with 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 alicensedContractorpursuanttotheContractor’s State License Law),
I am exempt from licensure under the Contractors'State License Law for the following reason:
)all or ()portions of the work,and the structure is not
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 theimprovementscoveredbythispermit,I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensedcontractors.I understand that a copy of the applicable law.Section 7044 of the Business and Professions Code,is available upon request when this applicationissubmittedoratthefollowingWebsite:httD://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 constructionIauthorizerepresentativesofthiscityorcountytoentertheabove-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.DAMAGESASPROVIDEDFORINSECTION3706ORTHELABORCODE.INTEREST,AND ATTORNEY'S FEES.
I hereby firm under penalty of perjury one of the following declarations:
1 have and will maintain a certificate of consent to self-insure lor worker's compensation,issued by the Director of Industrial Relations as provided for bySection3700oftheLaborCode,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:STATE FUND 1620348 5/1/2010PolicyNo.:Expiration Date:
Name of Agent:Phone No,:
I pacify 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 theorkar's compensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section 3700 of thejLaborCode,I shall forthwith comply with those provisions.
r\
Co
Signature of Applicant Date
Permit Number:BLD2009-02096
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:
LICENSED CONTRACTORS DECLARATION:
y'ifTlb^under the penalty of perjuiy that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of the
and my license is in full force and effect.
I hej
Business and Professions C
Contractor Signature'V Date
NUMBER
725795
EXPIRATION DATE LICENSE TYPE (S^
8/31/2010 CIO C45
D40
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 ofpermitissuance.A new permit is required to commence or continue work.
fbld oermit combo declare