410 N LAKEVIEW AVE (7)SIGN PERMIT NO. SGN2021-00115 BUILDING DIVISION
200 S. ANAHEIM BLVD.
TYPE OF PERMIT (714) 765 - 5153
Replace Attached to Structure Sign CITY OF ANAHEIM INSPECTION REQUEST LINE:
(714) 765 - 4626
DATE: 9/23/2021
JOB ADDRESS: 410 N LAKEVIEW AVE
LEGAL DESCRIPTION: P BK 110 PG 48 PAR 2
PERMIT APPLICANT: DANIEL HOANG
OWNER INFORMATION: CONTRACTOR INFORMATION:
LAKEVIEW PLAZA INVESTMENT BLUE SIGNS & MFG
°/INVESTMENT
QUARTER SECTION: 167
ARCHITECT/ENGINEER INFORMATION:
o CONCEPTS 8721 CHAPMAN AVE
ORANGE, CA 92865-1929 GARDEN GROVE, 928410000 CA
JOB DESCRIPTION: Installation (1) illuminated wall sign "Miss C" to replace existing sign "Angel"
VALUATION:
PROCESSED BY: DMH2
-- -• -•,-•. •••-• • �••• _��w �� �� �= win, ncw� a ucense yaw ror me ronowmg reason (Sec. 7031,5 Business and Professidns Code: any city
county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed
statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Profe
Code) or that he is exempt therefrom 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 the work, and the structure is not intended or offered for sale (Sec. 7044 Business
and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or
through his or her own employees, provided that such improvements are not intended or offered for sale. lf, however, the building or improvement is sold with one year of
completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale).
I, as the owner of the property, am exclusively wntracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's
License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's
License Law).
I am exempt under Sec. B & P.C. for this reason:
Date: Owner:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certi ica[e of consent to self -insure for worker's compensation, as provided for
Wor
ecbo 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,
he can
of the work for which this permit is issued. My worker's Compensation insurance carrier
and policy are:
Carrier: EXEMPT Policy Number. EXEMPT
This section need not be completed if t he permit is for one hundred dollars ($100) or less.
I certify that in the performance of the work for which this permit is issued, I shall not employ any person it
any manner so as to become subject to the worker's compensation laws of California, and agree that if I should
become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 9/23/2021 Applicant: L_�`<
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVE-kVk IS UNLAWFUL, AND;
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP T NE HUNDRED
THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATIN, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
work for which this permit is issued (Ssc.3097.Civ.C):
Lender's Information:
I certify that I have read this application and state that the above information is correct. I agree to comply with
all city ordinances and state laws relating to building construction, and hereby authorize representives of this
city to enter upon the above mentioned property for inspection purposes.
Date: 9/23/2021
Signature of Applicant or Agent
The permit shall expire by limitation and become null and void If the building or work has
not passed final inspectoin 365 days from the date of permit issunace. A new permit is
required to commence or continue work.
I LICENSED CONTRACTORS DECLARATION I
,vivuy minrn unuer penalty or Pequry that I am licensed
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 9/23/2021
NUMBER:
BUS1998-053733
TYPE: C45
TYPE: BUS
Contractor:
EXPIRATION DATE:
1113012022
PERPAIT EXPRED
INSPECT1rDN
N OT COMPLETED
DATE:
-I I '� 3 /ZZ
Fees; paid or erm t:
Total:
585.75