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475 N MULLER ST (2)Permit Number: SGN2021-00152 Issued: 12/27/2021 www.anaheim. nettbuilding (714)765.4626 Quarter Section: 46 Site Address: 475 N MULLER ST, ANAHEIM, CA 92801 Legal Description: APN: 07207125 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 Project Description: Installation of (1) Illuminated wall sign for "ADT". People Associated with Project: Contractor REYNER SIGN & LIGHTING 25 OAKBROOK COTO DE CAZA, CA 92679 Permit Applicant Bruce Rayner Owner OWNER - BUILDER DECLARATION 1 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 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 Iicensure 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 U potions 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 wntmcting 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 Contractors State License Law). I am exempt from Iicensure under the Contractors, State License Law for the following reason: Date Signature of Property Owner or Authorized Agent WORKER'S COMPENSATION DECLARATION I hereby affirn under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -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. 9-1-Rave and will maintain workers wmpensaKFUNDolicy , squired by Section 3700 of the Labor Code, for the performance of the work for which thif permit is Issued. My workers Compensation InsuInd policy are: Carrier: STATE COMPENSATION INSURANCE icy No.: 9273373 Expiration Date: This section need not be completed lf the permit Isred dollars ($100) or less. I certify that in the performance of the works permit is Issued, I shall not employ any person in any manner so as to become subject to the workers compensabon laws of California, and agcomeau o Me workers compensation provisions of Section 3700 of the Labor Code 1 shall forthwith wmoly with those D Data V' •- C •' WARNING: FAILURE TO SECURE AND CIVIL FINES UP TO ONE HUI AS PROVIDED FOR IN SECTION 3 ZR COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES OUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES THE LABOR CODE. INTEREST. AND ATTORNEY'S FEES. C STRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION 1 hereby affirm under penalty of pe ry that there is a wnstructiefilimding agency for the performance I hereby affirm under penalty of perjury that I am Lenders Information: licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and I hereby certify that I have read this application and to tha),'information above is correct. I agree Professions Code. to comply with all city ordinances and stale laws fing ildidg construction, and hereby authorize representives of this city to enter upon the a e'men nod property for inspection purposes. Date: 12/2712021 Contractor: l 777 ZI Number: SGN2021-00152 Expiration Date 2(lWO22 Date �nd t of Applicant or Agen TYPE: C45 The Dremit shall expire by limltatl come null and void lf the building or work has not passed final inspection 365 days from apermit issuance. A new permit is required to commence or continue work. Fees paid for Permit: $588.00 City of Anaheim BUILDING DIVISION INSPECTION RECORD SIGN PERMIT ADDRESS: 475 N MULLER ST, ANAHEIM, CA 92801 OWNER: PERMIT N: SGN2021-00152 DATE ISSUED: 1227/2021 DESCRIPTION: Installation of (1) illuminated wall sign for "ADT". 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 TRENCHES 699 PARTIAL APPROVAL NOTES INSPECTION DATE INSPECTOR Inspectors can normally be reached between 7:30 -8:00 A.M. (714) 765-5153 + 0 signoard 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 E? PIF ED INSPECT110t`..4 NOT COMPLETED DATE: _j._1 l Z Z Z To access your Inspection timeframe, please go to www.analheinn.net/buildiMafter 7:30 am on the day of your Inspection. Under Online Services, click on the "Inspection Timeframes" link or call (714) 765-5153 + 0.