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417 S BROOKHURST STPermit Number: SGN2022-00056 Issued: 05/0412022 www. a n a h e i m. n e Vb u i l d i n g (714)765-4626 Quarter Section: 33 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 Site Address: 417 S BROOKHURST ST, ANAHEIM, CA 92804 Legal Description: S TWP 4 RGE 10 SEC 18 SEC 18 T 4 R 10 FOR SE1/4 NE APN: 12709228 Project Description: Installation of (1) illuminated channel letter wall sign "OnARoll" People Associated with Project: Contractor BLUE SIGNS & MFG 8721 CHAPMAN AVE GARDEN GROVE. CA 92841 Permit Applicant Daniel Hoang Owner AZIZIAN CRAIG B TR C B 1007 PRINCIPIA DR OWNER - BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reasons) indicated below by the checkmark(s) I have placed next to the applicable Items) (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 to the 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 Ilcensure 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 ($SOD). ❑ 1, as owner of property, or my employees with wages as their sole compensation, will do I_) 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 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 ❑ 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' Stele License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects wilt, a licensed Contractor oursuant to the Contractors State License Lawl. I am exempt from licensure under the Contractors. State License Law for the following reason: Date Signature of Property Owner or Authorized Agent WORKER'S COMPENSATION DECLARATION 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 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 workers compensation insumnce, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers Compensation insurance carrier and policy are: Carder: Policy No.: Expiration Date: This%ecdoa need not be completed 6 the permit is for one hundred dollars ($100) or less. ❑ 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 the workers compensation laws of California. and agree that, If I should become subject to the workers compensation provisions of Section 3700 of the Labor Code. I shall forthwitrl comply with those la'pvlslons. j / I 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 ($1D0,000). 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 penury that there is a construction lending agency for the performance Lenders Information: I hereby certify that i have read this application and state that the Information above is comect. I agree to comply with all city ordinances and state laws relating building construction, and hereby authorize representives of this city to enter upon the above mentioned property for Inspection purposes. Date Signature of Applicant or Again The premit shall expire by limitation and become null and void it 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. CONTRACTORS DECLARATION I hereby affirm under 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. Date: 05/M022 Contractor: Number: SGN2022-00056 Expiration Date TYPE: C45 Fees paid for Permit: $588.00 City of Anaheim BUILDING DIVISION INSPECTION RECORD 0 SIGN PERMIT ADDRESS. 417 S BROOKHURST ST, ANAHEIM, CA 92804 OWNER: AZIZIAN CRAIG B TR C B PERMIT#: SGN2022-00056 DATE ISSUED: 05/04/2022 DESCRIPTION: Installation of (1) illuminated channel letter wall sign OnARoll- POST THIS CARD WITH THE APPROVED PLANS IN A CONSPICUOUS PLACE ON THE JOB SITE Inspection Code Dale Inspector SET BACK, FORMS, 602 TRENCHES UNDERGROUND 604 CONDUIT MASONRY: REINFORCEMENT, 606 PRE -GROUT FINAL 699 PARTIAL APPROVAL NOTES INSPECTION DATE INSPECTOR EXR RED 'APL TEE. T Inspectors can normally be reached between 7:30 - 8:00 A.M. (714) 765-5153 + 0 signcara INSPECTION REQUIREMENTS A representative is required to be on the site to expose any concealed wiring for final inspection. INSPECTION REQUESTS Inspection requests made prior to 5:00 pm Monday - Friday will be scheduled on the following workday. To schedule your building inspection online, please go to https://aca.anaheim.net/CitizenAccess To access your Inspection timeframe, please go to www. an a h eim.net/bui ldinn after 7:30 am on the day of your Inspection. Under Online Services, click on the "Inspection Tlmeframes" link or call (714) 765.5153 + 0.