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2117 E NYON PLPermit Types B'D E'.E MEC PLM X Permit Numbef':BLD2009-01584 Issued:05/19/2009 CITY OF ANAHEIM INSPECTION REQUEST LINE; (714)765 -4626 Quarter Section:114 BUILDING DIVISION 200 S.ANAHEIWI BLVD. (714)765 -5153 Site Address:2117 E NYON PL Legal Description:N TR 2350 LOT 38 Project Description:Upgrade and relocate 200 amps service. Valuation: Construcion Types: Total Fees paid for Permit: N/A, 136.73 People Associated with Project: Owner RUTH IRENE STEVENS 2117 E NYON PL ANAHEIM CA 92806-4636 2763 N BUTLER ST ORANGE CA 92865 0000Contractor Permit Applicant M PS ELECTRIC INC MICHAEL S\A/EENEY 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 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.. t All applicable items below must be signed before utilities will be releasedINSPECTORDATEFINALINSPECTIONS City of AnaheimBuildingDivision Final C3as Test Electrical Final Plumbing Final Mechanical Final Cross Connection Control [7i4)76s-«2bo Engineering/Grading Final {ruirsB-sns Fire Dept,Final (714)765-5041 Fire Sprinkler Final (714)765-5041 Water Engineering (714)765-4591 Sub List/Business License (714)765-5194thishmiHinfiuntilthefinalinspectionshavebeenmsoerinnnlOCCUDVPERMITDOESNOTAUTHORIZEELECTRICAL,PLUMBING,OR^MECHANiCAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED^ INSPECTOR iZoning (714)765-5139 Building Final (Last Inspection - Only After Above Complete)DATEINSPECTION concrete until the following applicable items have been signedDonotpour FINAL INSPECTION must be approved by the Building Division.Plumbing (Ground/Underfloor Drain Waste) Electrical Ground Eiectrode/Ufer Setback/Forms/Trenches (Footings)|| —Qo not install subfloor or pour floor slab until the foilwing applicable items have been signed: PARTIAL INSPECTIONS 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) Do not cover or Mechanical Inspectionsconcealtheworkbelowuntilthefollowingapplicableitemshave been signed 1st Floor Shear iFiresprinkler (Rough)(Fire Dept.) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Rough Mechanical Rough Electrical Framing (Only after PIbg.,Ele.,Mec &Fire) Plumbing Inspections insulation (Sound/Energy) plaster until the following applicable items have been signedDonottapeor Dry wall Drywall Penetrations (Ele..Mec.&Plbg.) Interior Lath Exterior Lath Electrical InspectionsGENERALITEMS Electrical Service Meter Exterior Plaster (Brown Coat) T-Bar (Struct.,Ele..or Mec.)V n ZOQ"\Sewer Water Engineering Backflow (Testable Only) Water Service Permit Backs Master-2008.xls Permit Types E.D E5.E MEC PLM X Permit Number:BLD2009-01584 Issued:05/19/2009 INSPECTION REQUEST LINE; (714)765-4626 Quarter Section;114 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765-5153 Site Address:2117 E NYON PL Legal Description:N TR 2350 LOT 38 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 statementthatheorsheislicensedpursuanttotheprovisionsoftheContractors'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 whothroughemployees'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: )alt 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:http://www.leoinfo.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 TO THE COST OF COMPENSATION.DAMAGESASPRC^DED FOR IN SECTION 3706 OR THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. I her^y 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 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 thispermitisissued.My worker’s Compensation insurance carrier and policy are: Carrier: Name of Agent: 1 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 theworker's compensation laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section 3700 of theLaborCode,I shall forthwith comply with those provisions. EXEMPTPolicyNo.:Expiration Date: Phone No.: T'/f ^O ? Da e 'V.Signature of Applicant DECL ARATION REGARDING CONSTRUCTION LENDING AGENCY: I hereby affirnTUnder 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: 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 theBusinessandProfessionsCode,and my license is in full force and effect. ontractor Signature iat( NUMBER EXPIRATION DATE LICENSE TYPE fSt 3/31/2010912878 CIO 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. fbid permit .combo,declare