510 N BROOKHURST ST 104 (3)City of Anaheim
0
BUILDING DIVISION
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
510 N BROOKHURST ST 104
OWNER:
FIRST ANAHEIM LLC
PERMIT#:
SGN2021-00125
DATE ISSUED:
10/20/2021
DESCRIPTION
Install 91) Illuminated wall sign for 'Cricket -
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
I Date
Inspector
SET BACK, FORMS,
TRENCHES
602
UNDERGROUND
CONDUIT
604
NSP
CTION
MASONRY:
N
f „IVII'
—
REINFORCEMENT,
606
PRE -GROUT
y� l
AT
--:
FINAL TRENCHES
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PARTIAL APPROVAL NOTES
INSPECTION DATE I INSPECTOR
LE
Inspectors can normally be reached between
7:30 - 8:00 A.M.
(714) 765-5153 + 0
slgncam
I-L
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://aGa.anaheim.neVCitizenAccess
To access your inspection timeframe, please go to
www.anaheim.netlbuiidina 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: SGN2021-00125
issued:'10/20/2021
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
www.anaheim.net/building
(714)7654626
Quarter Section: 39
Site Address: 510 N BROOKHURST ST 104
Legal Description: P BK 85 PG 4 PAR 3 PM 85-4 PAR 3 - EX STIR -
APN: 07207206
Project Description: install 91) illuminated wall sign for "Cricket"
People Associated with Project:
Contractor BLUE SIGNS & MFG 8721 CHAPMAN AVE GARDEN GROVE, CA 92841
Owner FIRST ANAHEIM LLC PO BOX 1205
IF OWNER - BUILDER DECLARATION 1
I hereby affirm under penalty of perjury that I am exempt from the Contractors License Stale 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, after, 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' Stale 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 Ilcensure 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' Stale 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' 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 oursuant to the Contractors State License Law).
I am exempt from licensure under the Contractors, State License Law for the following reason:
Date Signature of Property Owner or Authorized Agent
I hereby effiml under penalty of perjury one of the following declarations:
I have and will maintain a cerbficate 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.
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:
Cartier. Policy No.: Expiration Date:
This section need not be completed N the permit Is for ons hundred dollar ($100) or leas.
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, lf I should become subject to the workers compensation provisions of Section 3700 of the
Labor Code. I shall fort(ttvitlgcromoN with thine orcl Aions.
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION-B�GE 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 ATTORNEY'S FEES.
I hereby all 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 coned. 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 mentioned property for Inspection purposes.
or Aged
The premit shall expire by limitation and become null and void 9 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 provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the Business and
I'mWIMMA r:dde
Date: 10120/2021
Contractor:
Number: SGN2021-00125 Expiraton Date
TYPE: C45
Fees paid for Permit:
$584.75