612 W VERMONT AVEPermit Types
BLD ELE MEC PLM
X
Permit Number;BLD2009-01546
Issued:05/14/2009
INSPECTION REQUEST LINE:
\1^A)765 -4626
Quarter Section:74
Site Address:612 W VERMONT AVE
Legal Description:
CITY OF ANAHEIM
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Project Description:Mechanical for air conditioning unit,furnace,and heatint/cooling coil change out.
Valuation:
Conslrucion Types:
Total Feespaid tor Permit;
N/A,
68.40
People Associated with Project:
Owner CONNIE SERRANO 612 W VERMONT AVE ANAHEIM CA 92805-5030
1180 N FOUNTAIN WY #F ANAHEIM CA 92806 0000Contractor
Permit Applicant
WEST COAST ENERGY
MARTIN WAYNE
Electrical FixturesType Qty Type Plumbing Fixtures Qty Type Mechanical Fixtures Qty
Heating Appliances,including vent
Compressor/Boiler-up to 15 hp
Heating/Cooling Coil
1
1
1
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 permitissuance.A new permit is required to commence or continue wort<.,,,^^fi.'i'J combo
All applicable items below must be signed before utilities will be released.
FINAL INSPECTIONS DATE INSPECTOR -City of Anaheim
Building Division
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control
Engtneering/Grading Final (7i4)76s-si2s
Fire Dept.Final (714)765-5041
Fire Sprinkler Final (714)765-5041
Water Engineering (714)765-4591
Do not occupy this buildino until the final insnoctions 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 Building Final (Last Inspection -
Only After Above Complete)
DATE 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.&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
Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-01546
Issued:05/14/2009 CITY OF ANAHEIM
INSPECTION REQUEST LINE:\714)765 -4626
Quarter Section;74
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:612 W VERMONT AVE
Legal Description:
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 thecheckmark(s)I have placed next tothe applicable ilem(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 islicensedpursuanttotheprovisionsoftheContractors'State License Law Chapter 9 (commencing with Section 7000)of Division 3 of the Business andProfessionsCode)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 apermitsubjectstheappiicanttoacivilpenaltyofnotmorethanfivehundreddollars(S500).
-I,as owner of property,or my employees with wages as their sole compensation,will do (_)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 toownerofpropertywho,through employees'or personal efforts,builds or improves the property,provided that the improvements are not intendedorofferedforsale.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).
)all or (
an
—I,as the owner of the property,am exclusively contracting with licensed Contractors to construct the project (Sec.7044 Business and ProfessionsCode: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 1 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 requestwhenthisapplicationissubmittedoratthefollowingWebsite:h{tD://www,leQinfo.ca-aov/calaw.html.
By my signatire below,I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf.
1 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 UNLAWFU L,AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),IN ADDITION TO THE COST OFCOMPENSATION.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 consent 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,
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
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 subjecttotheworker's compensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section3700oftheLaborCode,I shall forthwith comply with those provisions.
Policy Nftl3-0000552 Expiration 6^^{i9'l0
Phone No.:
y'Zi
Signature of Applicar^'^1:7
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 COr^RACTORS 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
Business and Professi^s Code,and my license is in full force and effect.
/Contractor Signafyp^
NUMBER
685478
EXPIRATION DATE
3/31/2010
LICENSE TYPE
C20 HTAC
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 newf)ermit is required to commence or continue work.
fbid permit combo declare