400 W DISNEY WAY (43)City of Anaheim
0
BUILDING DIVISION
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
400 W DISNEY WAY 169
OWNER:
STC GARDENWALK LLC
PERMIT#:
SGN2021-00136
DATE ISSUED:
11/09/2021
DESCRIPTION:
Installation of illuminated wall sign reads *Cabe
Edina"
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
Inspector
SET BACK, FORMS,
TRENCHES
602
UNDERGROUND
so4PERMIT
E
CONDUIT
MASONRY:
REINFORCEMENT,
606
OT COM
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
signeard
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
P I rS1c-tahttps://aca.anaheim.net/CitizenAccess
-ION
LETED
I1z
To access your Inspection timeframe, please go to
www.anaheim.net/building) 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.
Permit Number: SGN2021-00136
Issued: 11/09/2021
www.anaheim.net/building
(714)765.4626
Quarter Section: 87
She Address: 400 W DISNEY WAY 169
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Legal Description: P BK 349 PG 43 PAR 4 PM 349-43 POR OF PAR 4
APN: 08255115
Project Description: Installation of Illuminated wall sign reads "Cabe Bulba"
People Associated with Project
Contractor
SAM'S SIGNS
1717 POTERRO AVE SOUTH EL MONTE, CA 91733
Permit Applicant
Sky Sam
Owner
ANAHEIM CAPITAL PARTNERS LLC
321 W KATELLA AVE 191
Owner
ANAHEIM CAPITAL PARTNERS LLC
321 W KATELLA AVE 191
Owner
STC GARDENWALK LLC
10722 BEVERLY BLVD 9
OWNER - BUILDER DECLARATION
I hereby alarm under penalty of perjury that 1 am exempt from the Contractors License State Law for the following reason(s) 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 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 (_) 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 am 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' 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 followinq 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 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 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 carder and policy are:
Center: Policy No.: Expiration Date:
This section mad not be completed If the permit is for one hundred dollars ($100) or less.
� r ify 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 forthwith comply with those provisions. Q I
Date Signature of Applicant �-
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE I UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). I DITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEYS FEES.
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 state that the Information above is cored. 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 enboned property for inspection purposes.
n.
The premit shall expire by limitation and t
final impaction 365 days from the date of
continue work.
Hgen
and void if the building or work has not passed
nice. A new permit is required to commence or
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
Pmfecsinns CMe.
Date: 11/0912021
Contractor:
Number: SGN2021-00136
TYPE: C45
Expimton Date
Fees paid for Permit: $589.00