421 S CEDARHAVEN WAY (3)Permit Types
BLD ELE MEC PLM
X
Permit Number;BLD2009-01577
Issued:05/18/2009
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:157
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:421 S CEDARHAVEN WAY
Legal Description:N TR 4689 LOT 25
Project Description:Mechanical to replace heating and air conditioning unit.
Valua^on:
Construdon Types:
Total Fees pa idfor Permit;
N/A,
68.40
People Associated vwth Project:
Owner
Contractor
Permit Applicant
JAMES WOODINTR
SERVICE CHAMPIONS HEATING AND AIR C
CARLOS ZAMORA
421 CEDARHAVEN WY ANAHEIM CA 92807-3403
22911 SAVI RANCH PKWY YORBA LINDA CA 92887 0000
Electrical FixturesType Qty Type Plumbing Fixtures Qty Type Mechanical Fixtures Qty
Heating Appliances,including vent
Heating/Cooling Coil
Compressor/Boiler-uptolShp
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 permit
issuance.A new permit is required to commence or continue work.'bid pormit combo
All applicable items below must be signed before ulilities will be released
FINAL INSPECTIONS DATE INSPECTORCityofAnaheim
Building Division
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (7i4)7es-428o
Engineering/Grading Final (7i4)76s-si26
Fire Dept.Final (714)765-5041
Fire Sprinkler Final (714)765-5041
Water Engineering (714)765-4591
Do not occupy this buildinc uniii the finol 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
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 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 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./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Plumbing InspectionsRoughMechanical
Rough Electrical
Framing (Only after Ptbg..Ele.,Mec &Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed.
Dry wall
DrywaM 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 I ELE MEC PLM
X
Permit Number:BLD2009-01577
Issued:05/18/2009
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:157
CITY OF ANAHEIM
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:421 S CEDARHAVEN WAY
Legal Description:N TR 4689 LOT 25
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 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,prior to 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 andthe 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 (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 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).
.)all or (
—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 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 coveted 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
when this application is submitted or at the following Web site:http://www.leQinfo.ca.Qov/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.
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 TOTHE 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:
—A have and will 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.
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:MAJESTIC INSURANCE COMPANY Policy Expiration
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.g.ompensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section3700of^^Tabor Code,I shall forthwith comply with those provisions.
Phone No,:
"ignature of Applicant Date
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affTm under penalty of perjury that there is a construction lending agency for the performance of the work for which this{Se^'.3097,Civ.C):
Lender's Name:
permit is issued
Lender's Address:
LICENSED 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
Business and Professions Code,and my license is in full force and effect.
intractor Signature Date
NUMBER
799170
EXPIRATION DATE
9/30/2009
LICENSE TYPE (St
C20 HTAC 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 pertTBt is required to commence or continue work.
fbid permit combo declare