945 N WEIR CANYON RD (2)City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
0 SIGN PERMIT
ADDRESS:
945 N WEIR CANYON RD. ANAHEIM, CA 92807
OWNER:
SHIDLER RONALD MARK TR
PERMIT#:
SGN2022-00040
DATE ISSUED:
04/01/2022
DESCRIPTION_
Installation OW) illuminated wall sign for"Clyde K".
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
Inspector
SET BACK, FORMS,
TRENCHES
UNDERGROUND
04
CONDUIT
v ^
MASONRY:
I
APE
-I IUN
REINFORCEMENT,
PRE -GROUT
COS
PLETED
FINAL
/'$
PARTIAL APPROVAL NOTES
INSPECTION DATE INSPECTOR
Inspectors can normally be reached between
7:30 - 8:00 A.M.
(714) 765-5153 + 0
signcam
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
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: SGN2022-00040
Issued: 04/01/2022
www.anaheim.net/bu ilding
(714)7654626
Quarter Section: 212
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Site Address: 945 N WEIR CANYON RD, ANAHEIM, CA 92807
Legal Description: P BK 242 PG 1 PAR 1 PARCEL MAP 242-1 PAR 1 POR OF
APN: 35222106
Project Description: Installation of (1) illuminated wall sign for "Circle K".
People Associated with Project:
Contractor DONCO & SONS INC 2871 E BLUE STAR STREET ANAHEIM, CA 92806
Permit Applicant Nick Fink
Owner SHIDLER RONALD MARK TR 945 WEIR CANYON RD
I OWNER - BUILDER DECLARATION I
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Slate Law for the following reason(s) Indicated below by the
checkmark(s) I have placed next to the applicable item(s) (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 Iicansure 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 (_I all or U portions of the work, and the sbucture 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 contracting with licensed Contractor; 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 Lew).
I am exempt from licensure under the Contractors, State License Law for the following reason:
Dale 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 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.
la I have and will maintain workers compensation Insurance, as required by Section 3700 of the Labor Cotle, for the performance of the work for which this
permit is issued. My workers Compensation insurance carrier and policy are:
Cartier. STATE COMPENSATION INSURANCE FUND Policy No.: 9113884 Expiration Date:
This section need not be completed O the permit is for am hundred dollars ($100) or Isle.
❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the
workers compensation laws of California, and agree that, 81 should become subject to the workers compensation provisions of Section 3700 of the
Lan Core. I shall flhwith cemoly wlty tyre orovl�'ion� ��/
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES
AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($t00,ODO). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES
AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEYS FEES.
AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lenders Information:
1 hereby certify that i have read this application and state that the Information above is correct. I agree
to comply with all city ordinances and state laws relating building construction, and hereby authorize
represenfives of this city to enter upon the above mentioned property for Inspection purposes.
Date Signature of Applicant or Agen
The premit shall expire by limitation and become null and void if the building or work has not passed
final inspection 366 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 1 am
licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the Business and
Professions Code. O
r
Date: 04/01/2022
Contractor:
Number: SGN2022-00040 Expiration Date 10I1/2022
TYPE: CIO, C45, D40, B
Feu paid for Permit:
$585.00