181 S OLD SPRINGS RDCity of Anaheim
BUILDING DIVISION
INSPECTION RECORD
0 SIGN PERMIT
ADDRESS'.
181 S OLD SPRINGS RD, ANAHEIM, CA 92808
OWNER:
CALTANA LLC
PERMIT#:
SGN2022-00015
DATE ISSUED-
02/0912022
DESCRIPTION'.
Installation of (1) non -illuminated wall sign for'Waba
Restaurant Group..
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
Inspector
SET BACK, FORMS,
602
TRENCHES
UNDERGROUND
604
CONDUIT
MASONRY:
REINFORCEMENT,
606
PRE -GROUT
FINAL
699
PARTIAL APPROVAL NOTES
INSPECTION I DATE I INSPECTOR
Inspectors can normally be reached between
7:30 - 8:00 A.M.
(714) 765-5153 + 0
signcard
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
rD
i JhV
_E 1 ED
p3
To access your Inspection timeframe, please go to
www.anaheim.netlbuildinn_ after 7:30 am on the day of
your inspection. Under Online Services, click on the
"Inspection Ini eframes" link or call (714) 765-5153 + 0.
Permit Number: SGN2022-00015
Issued: 02109/2022
www.anaheim. netlbuilding
(714)765.4626
Quarter Section: 213
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 181 S OLD SPRINGS RD, ANAHEIM, CA 92808
Legal Description: P BK 202 PG 41 PAR 11 PM 20241 PAR 11 POR OF PAR
APN: 35405211
Project Description: Installation of (1) non -illuminated wall sign for'Waba Restaurant Group'.
People Associated with Project:
Contractor CORGUZ SIGNS INC 494 S MACY STREET SPACE 56 SAN BERNARDINO, CA 92410
Permit Applicant Isis Jimenez
Owner CALTANA LLC PO BOX 1012
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
eheckmark(s) I have placed next to the applicable Item(s) (See. 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 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 cNli 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 (_) all or (_I portions of the work, and the structure is not
intended or offered for sale (Sec. 70" 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. 70" 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 oursuam to the Contractor's State License Law).
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:
❑ 1 have and will maintain a cer0ficete 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 canner and policy are:
Carder. Policy No.: Expiration Date:
This section need not be completed If the permit Is for one hundred dollars (f100) or lees.
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
x7 workers compensation laws of California, and agree that, H I should become subject to the workers compensation provisions of Section 3700 of the
Labo[Code. I shall forthwith comoly with t*se orovisions.
WARNING: FAILURE TO SECURE WOItKERS' COFAPENSATION 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 ATTORNEYS FEES.
CONSTRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance I hereby affirm under penalty of perjury that I am
Lenders Information:
I hereby certify that I have read this application and state that the information above is correct. 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.
The premit shall expire by limitation a4abecome nulrlind 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,
licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the Business and
Professions Code.
Date: 02/09/2022
Contractor:
Number: SGN2022-OW15
TYPE: 045
Fees paid for Permit:
Expiration Date
$421.00