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2015 W HARTFORD PL (2)Permit Types BLD ELE MEC PLM X Permit Number;BLD2009-01603 I ssueo'?05/20/2 009 INSPECTION REQUEST LINE: (714)765 -4626 Quarter Section:39 BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Site Address:2015 W HARTFORD PL Legal Description; Project Description:Plumbing to replace water heater. Valuation: Construcion Types: Total Fees paid for Permit: N/A. 136.73 People Associated with Project: Owner Contractor Permit Applicant DENNIS MITSUOSHOZI ORANGE INSTALLERS TIM NOCK 2015 W HARTFORD PL ANAHEIM CA 92801-5370 905 E CHALYNN AVE ORANGE CA 92866 0000 Electrical Fixtures Oty TypeType Plumbing Fixtures Oty Type Mechanical Fixtures Oty Water Heater 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.Ibid,permit combo All applicable items below must be signed before utilities will be released. FINAL INSPECTIONS DATE 4NSPECTOR Final Gas Test Building Division Electrical Final Plumbing Final Mechanical Final Cross Connection Control (714)765-4200 Engineering/Grading Final (7i4)705-si26 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 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 PIbg.,Ele.,Mec.&Fire) Insulation (Sound/Energy) Do not tape or piaster until the following applicable items have been signed: Drywali 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.xls Permit Types BLD ELE MEC PLM X Permit Number:BLD2009-01603 Issueo';05/20/2009 CITY OF ANAHEIM INSPECTION REQUEST LINE: (714)765 -4626 Quarter Section:39 BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765-5153 Site Address:2015 W HARTFORD PL 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 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 and the 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 ($500). I,as owner of property,or my employees with wages as their sole compensation,will do (_ 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 construct the project (Sec.7044 Business and Professions Code:The Contractors'Stale 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 Contractoi's Stale 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 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 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;htto://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 prodded is correct. I agree to comply with all applicable city and county ordinances and slate 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 ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certifteate 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;DELOSINSURAj Policy n8PKRM1200653Q I certify that in the perfofrnance 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,it I should become subject to the worker's compensation provisions of Section 3700 of the Lajspr^ode,I shatNorlhwith comply with those provisions. Expiration'NY Name of Agent:Phone No,: ■ignature of Applicant Date 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 Marne;'* Lender's Address: UCENSED CONTRACTORS DECLARATION: I hereby affirm under^the p^enalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of the Business and license is in full force and effect. ■U:>-o9 C|<^ntractor Signatur^e Date NUMBER 511971 EXPIRATION DATE LICENSE TYPE (SI 6/30/2011 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 permit is required to commence or continue work. fbid permit combo declare