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157 S LA PAZ STPermit Types BLD ELE MEC PLM X Permit Number:BLD2009-01602 Issued;05/20/2009 INSPECTION REQUEST LINE: (714)76_5 -4626 Quarter ●'«clion:191 Site Address;157 S LA PAZ ST Legal Description:N TR 6734 LOT 5 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Project Description:Plumbing to replace water heater. Valuation: Construcion Types: Total FeespaidforPermit: N/A,, 136.73 People Associated with Project: Owner Contractor Permit Applicant DANIEL PSCHOPENTR ORANGE INSTALLERS TIMOTHY NOCK 157 S LA PAZ ST ANAHEIM CA 92807-3924 905 E CHALYNN AVE ORANGE CA 92866 0000 Electrical Fixtures Qty TypeType Plumbing Fixtures Qty Type Mechanical Fixtures Qty 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 vwark.fbld_pGrmit combo All applicable Items below must be signed before utilities will be released. FINAL INSPECTIONS DATE INSPECTORCityofAnaheim Building Division Final Gas Test Electrical Final Plumbing Final Mechanical Final Cross Connection Control (714)705-4280 Engineering/Grading Final (714)705-5120 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-S194 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 INSPECTIONSSetback/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 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.xls Permit Types BLD ELE MEC PLM X Permit Number:BLD2009-01602 Issued:05/20/2009 INSPECTION REQUEST LINE: (714)765 -4626 Quarter t.ection:191 CITY OF ANAHEIM BUILDING DIVISION 200 S.ANAHEIM BLVD. (714)765 -5153 Site Address:157 S LA PAZ ST Legal Description:N TR 6734 LOT 5 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 nexttothe applicable item(s)(Sec.7031.5 Business and Professions Code:any city or county which requres a permit to construct, after,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 (S500). I,as owner of property,or my employees with wages as their sole compensation,will do ()all or ()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 anownerofpropertywho,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 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'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 Contractoi'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 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:httD://www.leainfo.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,DAMAGES AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES, affirm under penalty of perjury one of the following declarations;I herel /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, 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;DELOS INSURANCE COMPANY 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 compensatic^laws of California,and agree that,if I should become subject to the worker's compensation provisions of Section3700oftheLaborCo^,I snail forthwiffTBomply with those provisions. Policy NaiDKRM12006530 Expiration Phone No.: iJi ■// X7SignatureofApplicant DateI 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: UCENSED CONTRACTORS DECLARATION: I hereby affirm under the penalty of^erjury that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of theBusinessandProfession!my license is in full force and effect.le. 2^0^L^tfactoTsignalJre i/Date NUMBER 511971 EXPIRATION DATE LICENSE TYPE (S) 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 vrork. fbid oermit combo declare