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327 S MAGNOLIA AVE (4)Permit Number: SGN2021-00130 Issued: 11/03/2021 www.anaheim.net/building (714)765-4626 Ouarter Section: 20 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 Site Address: 327 S MAGNOLIA AVE, ANAHEIM, CA 92804 Legal Description: S TWP 4 RGE 11 SEC 13 SEC 13 T 4 R 11 E 200 FT S 3 APN: 12604218 Project Description: Install (1) illuminated wall sign "Clouds Hookah 8 Smoke" People Associated with Project: Contractor MARTINEZ ELECTRIC 1928 TYLER AVE UNIT F SO EL MONTE, CA 91733 Permit Applicant Alexis Conde Owner YOU JUNG HUI TR ROMA 9811 GARRETT CIR OWNER - BUILDER DECLARATION hereby affirm under penalty of perjury that I am exempt from me 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 applicanlfor 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 ficensure 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 (_) 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' 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 Contractors State License Law). I am exempt from ficensure under the Contractors, State License Law for the following reason: Date Signature of Property Owner or Authorized Agent WORKER'S COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to sell -insure for workers 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 insurance, 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: Carrier: Policy No.: Expiration Date: This section need not be completed if the 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 in any manner so as to become subject to the workers compensation laws of California, and agree that, 91 should become subject to the workers compensation provisions of Section 3700 of the Labor Code. I shall forthwith comply with those orovisions. Data Signature of Applicant 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 ATTORNEYS FEES. r^mayor rr+Trnu t cunlaln ernoatcv IF LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that there is a construction lending agency for the performance Lenders Information: I hereby certify that i have read this application and stale that the Information above is correct. I agree to comply with all city ordinances and stale laws relating building construction, and hereby authorize represenlives of this city to enter upon the above mentioned property for Inspection purposes. Date Signature of Applicant or Agen The premit 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. I hereby affirm under penalty of perjury that I am licensed under provisicns of chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pmfassinns Cnd r Date: 11/03/2021 Contractor: Number: SGN2021-00130 TYPE: C10 Fees paid for Permit: Expiration Date $589.00 City of Anaheim BUILDING DIVISION INSPECTION RECORD 0 SIGN PERMIT ADDRESS: 327 S MAGNOLIA AVE, ANAHEIM, CA 92804 OWNER: YOU JUNG HUI TR ROMA PERMIT#: SGN2021-00130 DATE ISSUED: 11/03/2021 DESCRIPTION: Install (1) illuminated wall sign "Clouds Hookah & Smoke' POST THIS CARD WITH THE APPROVED PLANS IN A CONSPICUOUS PLACE ON THE JOB SITE Inspection Code Date Inspector SET BACK, FORMS, TRENCHES 6021 UNDERGROUND 604 CONDUIT MASONRY: REINFORCEMENT, 606 PRE -GROUT FINAL TRENCHES 699 PARTIAL APPROVAL NOTES INSPECTION DATE INSPECTOR Inspectors can normally be reached between 7:30 - 8:00 A.M. (714) 765-5153 + 0 .....card 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 PERMIT EXPIRED INSPECTION NOT COMPLETED DATE: \,`' 3 l �� To access your inspection timeframe, please go to www.anaheim.netlbuilding after 7:30 am on the day of your inspection. Under Online Services, click on the "Inspection Timeframes" link or call (714) 765-5153 + 0.