400 S DISNEY WAY 94r 11
City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
400 W DISNEY WAY 094
OWNER:
PERMIT#:
SGN2021-00089
DATE ISSUED:
7/30/2021
DESCRIPTION:
Install (4) illuminated channel letter wall signs for "UFC FIT"
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
Inspector
SET BACK, FORMS,
602
PERMIT
EXPi
TRENCHES
r �
UNDERGROUND
N JT
OMPLE
CONDUIT
604
MASONRY:
REINFORCEMENT,
ATE:
BOND BEAM,
606
PRE -GROUT
FINAL
699
MISCELLANEOUS INSPECTIONS I
Inspectors can normally be reached between
7:30 - 8:00 A.M. and 3:30 - 4:30 P.M.
(714) 765-5153 + 0
INSPECTION REQUIREMENTS
Contractor shall verify with the City Inspector prior
to final inspection if a representative is required to
be on the site to expose any concealed wiring for
final inspection.
INSPECTION REQUESTS
Inspection requests made before 5:00 pm will
be scheduled on the following workday.
=D To schedule your building inspection online,
EDplease go to
http://www.anaheim.net/InspectionReguest.
l�-
You may also request your inspection by calling
(714) 765-4626 and continue with the following
steps:
• Press 1 for inspection function.
• Press 1 to schedule inspection.
• Press 6 for Sign inspection.
• Enter your permit # 202100089.
• Enter the Code number for the inspection
requested (indicated in blue.)
• Press 1 for next business day, or enter date
preferred.
• Select time preference (Request is subject to
inspector's schedule.)
• At the end of your request you will receive a
confirmation number.
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.
signcard
— SGN2021-00089 BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
TYPE OF PERMIT
INSPECTON
New Attached to Structure Sign CITY O F ANAHEIM (714) 765�- 626 QUEST LINE:
DATE: 7/30/2021 QUARTER SECTION: 87
JOB ADDRESS: 400 W DISNEY WAY 094
LEGAL DESCRIPTION:
PERMIT APPLICANT: SARAH SALINAS
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
C S SIGNS
4 TERRASTAR LN
LADERA RANCH, 926940000 CA
JOB DESCRIPTION: Install (4) illuminated channel letter wall signs for "UFC FIT".
VALUATION: PROCESSED BY: EGA
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 Profs
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 ($500).
❑ 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. 0, 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 contracting 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 contractors) licensed pursuant to the Contractors
License Law).
1 am exempt under Sec. B & P.C. for this reason:
Date: Owner.
WORKER'S COMPENSATION
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self -insure for workers compensation, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
pI have and will maintain workers compensation insurance, as required by Section 3700 of the labor Code,
or the performance of the work for which this permit is Issued. My workers Compensation insurance carrier
and policy are:
Carder: OAK RIVER INSURANCE CO Policy Number. CSWC247773
This section need not be completed if t he permit Is for one hundred dollars ($100) or less.
LcY-,JI 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 workers compensation laws of California, and agree that I I should
become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 7/30/2021 Applicant
WARNING: FAILURE TO SECURE WORKER'S 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 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 of the
work for which this permit is issued (Sec.3097.Civ.C):
Lenders 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 represendves of this
city to enter upon the above mentioned property for inspection purposes.
Date: 7/30/2021
nature of Applicant or Agent
The p i shall ex i by limitation and become null and void If the building or work has
not pa ed finet inspectoin 365 days from the date of permit issunace. A new permit is
required to commence or continue work.
LICENSED CONTRACTORS 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 Professions Code.
Date: 7/3012021
NUMBER:
BUS2019.03250
TYPE: C10
TYPE: C45
TYPE: BUS
Quanity:
Electric Sign (Y/N):
Contractor:
EXPIRATION DATE:
3/31/2023
Fees paid forPermit:
Total:
891.00