110 W BALL RD (17)SIGN PERMIT NO.
TYPE OF PERMIT
New Freestanding Sign
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DATE: 7/7/2021
JOB ADDRESS: 110 W BALL RD
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CITY OF ANAHEIM
LEGAL DESCRIPTION: TR 2090 LOT 1 FOR OF LOT
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
QUARTER SECTION: 86
PERMIT APPLICANT: PATRICK FARANAL
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
NATIONAL SIGN & MARKETING CORP
13580 FIFTH ST
CHINO, 91710 0000 CA
JOB DESCRIPTION: (EPR) Installation of (1) digital preview board, (1) staggered menu board and (1) order point with attached ladder canopy. "El
VALUATION: 15,000.00 Polio Loco" PROCESSED BY: AEG
OWNER -BUILDER DECLARATION
lherebyy affirm under penalty of perury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or
county which requires a permit to construct, after, 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 9Xcommencing with Section 7000 of Division 3 of the Business and Professions
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 !mom" 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 Contractors
License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors
License Law).
❑ 1 am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
WORKER'S COMPENSATION DECLARATION I
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 workers compensation, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is Issued.
Phave 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 Cartier
and policy are:
Carrier: TRAVELERS PROPERTY CASUALTY CO Policy Number. UB9M69819321
This section need not be completed If t he 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'd I should
become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Comply with those provisions.
Date: 7/7/2021 Applicant
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALLI
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.
I --CONSTRUCTION LENDING AGENCY 1
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):
Lender's 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 representives of this
city to enter upon the above mentioned property for Inspection purposes.
Date: W7/2021
Signature of Applicant or Agent
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am licensed
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 7f7/2021
NUMBER
BUS2000.03588
TYPE: B
TYPE: C10
TYPE: C45
TYPE: BUS
Contractor.
EXPIRATION DATE:
1/31/2022
Fees paid for emit:
Total:
1.264.00
The permit shall expire by limitation and become null and void if the building or work has
not passed final Inspectoin 365 days from the date of permit issunace. A new permit Is
required to commence or continue work.
City of Anaheim
BUILDING DIVISION
IN1SPECTION RECORD
SIGN PERMIT
ADDRESS:
110 W BALL RD
OWNER:
PERMIT#:
SGN2021-00062
DATE ISSUED:
7/7/2021
DESCRIPTION:
(EPR) Installation of (1) digital preview board, (1) staggered
menu board and (1) order point with attached ladder canopy. "El
Pollo Loco"
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
PERT717
CONDUIT
604
)(45p'
MASONRY:
OT
,'..'I
BOND BEAMMENT,
606
PRE -GROUT
D
TE:
FINAL
699
MISCELLANEOUS INSPECTIONS
INSPECTION DATE INSPECTOR
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.
To schedule your building inspection online,
please go to
http://www.anaheim.net/inspectionRequest.
72—'ou 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 # 202100062.
• Enter the Code number for the inspection
requested (indicated in blue.)
• Press '-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