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50 1/2 S ANAHEIM BLVDBUILDING. PERMIT NO:" BLD2001 -02690 TYPE OF PERMIT Tenant Improvement (Limited) DATE: 09/21/2001 JOB ADDRESS: 50 1/2 S ANAHEIM BLVD NEXTEL CA7612 1 LEGAL DESCRIPTION: P BK 178 PG 22 PAR 1 APPLICANT: MI KE BUTLER OWNER INFORMATION: Holualoa Anaheim 100 SAnaheim Blvd Anaheim, CA 92805 CITY CONTRACTOR INFORM/ TION:. ARCHITECT /ENGINEER INFORMATION: PROCESS COMMUNICA'!ON DEVELOPE CECIL R CARNEY C11980 3020 HARVARD STREET 12841 NEWPT (714) 665 -9500 TUSTIN, CA 92780 SANTA ANA, 92704 CA BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 -:5153 INSPECTION REQUEST L INE:- (714)765 -4626 CENSUS CODE: 437 QUARTER SECTION: 83 JOB DESCRIPTION: Tenant improvement in an existing attic space for aounn aimed wireless communications facility. VALUATION: 95,000.00 - - PROCESSED BY DUC • f - OWNER - BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031 5. Business and Professions Code: any aty Or county which requires a permlt to construct aitir,. 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 Iice ised pursuant to the provisions of the Contractor's License Lava (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Prof ssifns 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 subjoc "c the applicant to a dvil penalty of not more than five hundred dollars ❑ I, as owner of property, or my employees with wages as their sole comjisation, will do the work, and the structure is not intended or offered for sale (Sea 7044 Business and Professions Code: The Contractor's License t 3w 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 ow.' employees, provided that such improvements are not intended or offered for sale. tf, however, the building or improvement is sold with one yer:r of completion, the owne = builderoill•have the burden of proving that he' did not build. or improve for the purpose of sate). E I, as the owner of the property, am exclusively contra ding wit n licensed tentradc-s to construct the project (Sec: 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property vho or improves thereon, and who contracts for sunlit prcjeUts with acontrador(s) licensed pursuant to the Contractor's License Law). r I lam exempt under Sec. 13'8, R.C. for this reason`: Date: Owner - - WORKER'S COMPENSATION DECLARATION l. hereby affirm under penalty of perjury one of the following declarations: 6 - 1 hereby affirm under pena Ity of perjury that l am • ❑ I. have and will maintain acetificate of consent to self - insure for ,'orker'i uomoensarion, licensed under provision; of chanter 9 (commencing . as provided for by Section 3700' of the Labor Coda, for the performance of tit mod; for which. with Section 7000) of Divsion3 of the Buu and unit rs issued. Professions Code 11, I have and will maintain workers compensation insurance, as required h • •ecton 3700 of 09/21/2001,4 _ t� the Labor Code, for the performance of the work for which th s permit is ion::. My worker's Date: Con rector Compensation insurance :carrier and policy. are: - - • Carrier: STATE COMP FUND Policy Number..'0440019163-99 NUMBER EXPIRATION DATE This section need not Je completed if the permit is for one hundred dollars ($ 0' or less. 696064 09!30/ 2002 TYPE B .1 certify that in the performance of the work for which this permit is issue 4, I shall not TYPE. C10 • empty any person in any manner so as to becorne subject to the worker's c: moensation laws TYPE C20 HTAC of California, and agree that if Ishould becorne su bjed to the worker's comp 7 nation provisions of Section 3700 of the Labor Code, l shall forthwith ly with tWise provisions. - Construcion Types: V N, Data 09 /21/2001 Applicant: -- Fire - Sprinklered? WARNING: FAILURE TO SECURE WORKERS COMP EN SATIeN COVER:'GE•IS Number of Stones UNLAWFUL; AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAaTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000); IN ADO:TION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE, LABOR CODE, INTEREST AND ATTORNEY'S. 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): I certify that l 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 a 'or u po f 'onee property for in ection purposes. �/ /S ' � fr Date: 09 /21/2001 Sig natur Appltca -'or gent The permit shall expire by limitation and become null and void if 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 Fees paid for Permit: Total: LICENSED CONTRACTORS DECLARATION j INSPECTION DATE INSPECTOR Temporary Power Pole WIl�� / , Plumbing (Drain/Waste Pipe) Mechanical Final WA/ Electrical Ground Electrode/Ufer / Gas Test Setback/Forms/Trenches (Footings) 66d Engineering/Grading Final 765 Do not install subfloor or pour floor slab until the following applicable items have been signed: Plumbing (Water F Valves) Fire Dept. Final 765 -4040 t14 /A2 Mechanical (Groundwork) Water Engineering 765 -5268 Electrical. (Underground Condu d) IIIo2 $s& Iran Pre-slab (CompactionlMerhbrane- Reinf.) 7 114 ot V / 0 6, > Underpinning (Floor Joist/Girders) 7- I A-- F Do not cover or conceal the work below until the _. following applicable items have been signed: 1st Floor Shear YZT frt Firesprinkier. (Rough) 2nd Floor Shear 11114 oi Roof(SheathingIDiaphragnyFrame) n ly(a `A-- - -- Masonry (ReinfiBond Beam/Pre- Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Pbg.. ciee t, ech_. and Firei 7/k'aZ 52.-- insulation (Sound Energy) Do not tape or plaster until the following applicable items have been signed: - Drywall 714 ea Penetrations (Fire Rated) Electrical' Penetrations (File Rated). Mechanical Penetrations (Fire Rated) Plumbing . Interior Lath Exterior Lath • 7J44w Lyg. 4 tw.- GENERALITEMS Exterior Plaster (Brown Coat) T -Bar Electrical T -Bar Mechanical T -Bar Structural Sewer . Water Engineering Backflow Water Service FINAL INSPECTIONS jOle f s or Electrical Final WIl�� / Plumbing Final Mechanical Final WA/ / Gas Test 66d Engineering/Grading Final 765 Fire Dept. Final 765 -4040 t14 /A2 AA /01- Water Engineering 765 -5268 Sub List/Business License 765- 519gg IIIo2 $s& Iran Zoning 765 -5139 7 114 ot V / 0 6, > Building Final (t Last Inspection- Only fter Above Complete) 7- I A-- F INSPECTION RECORD PARTIAL INSPECTIONS( Lang Buildin inspections d h nr I( ?�sl StIcA t ,, (s E A ow_ lil2Yrol ( vAret pet e4J'ame''roar^ r' (I*IOI OV.'S Sh eE- Z C ,.I r rHst Mechanical inspections Plumbing Inspections Electrical Inspections ELECTRICAL PERMIT NO. ELE2001 -01669 TYPE OF PERMIT Alteration or Addition to Existing DATE: 09/21 /2001 JOB ADDRESS: 50 1/2 S ANAHEIM BLVD NEXTEL CA7612 I LEGAL DESCRIPTION: P BK 178 PG 22 PAR 1 APPLICANT: OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT /ENGINEER INFORMATION: PROCESS COMMUNICATION DEVELOPE 3020 HARVARD STREET SANTA ANA, 92704 CA Electrical for Tenant Improvement at Communications Facility. Ref # BLD2001 -02690 PROCESSED BY: MJF OWNER - BUILDER DECLARATION j I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason (Sec. 7031.5 Business and Professions Code: any dty or 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 Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. My 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. If, 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). 7 1, 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 propert y who builds or improves thereon, and who contracts for such projects with a_oontractor(s) licensed pursuant to the Contractor's License Law). I I am exempt under Sec. , B & P.C. for this reason: Date: Owner: WORKER'S COMPENSATION DECLARATION 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 pr ided for by Section 3700 of the Labor Code, for the performance of the work for which thimit 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 carrier and policy are: Carrier: STATE COMP FUND Policy Number 0440019068 -99 JOB DESCRIPTION: Lender's Information: `7/ `/ - 41Z -36(6 This section need not be completed if the 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 worker's compensation laws of Califom ia, and agree that if l should become subject to the worker's c•. pensatio provisions of Section 3700 of the Labor Code, 1 shy( forswith comp Date: 09/21/2001 Applicant: , WARNING: FAILURE TO SECURE WOR COMPE • T16N 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 ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY CITY OF ANAHEIM e provisions. I hereby affirm under penalty of perjury that there is a construction lending agency for the -issQ_z(Seo - C' C» - - I certify that I have read this application and state that the above information is correct 1 agree to comply with all city ordinances and st- - .ws relating to building construction, and hereby authorize representives of this dty to > upon the above mentioned property for insp6ction purposes _ / nature o • ppl ent Date: 09/21/2001 The permit shall expire by limitation and become null and void if 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. Date: NUM 696069 TYPE: TYPE: TYPE: BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 QUARTER SECTION: 83 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of penury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Busi s . and Professions Code. B C10 C20 HTAC Co actor EXPIRATION DATE: 09/30/2002 Subpanels: Under 600 V, up to 200 amps Meters: Under 600 V, up to 200 amps ees paid or Permit: Total: 112.90 2 1 INSPECTION .. DATE . INSPECTOR Temporary Power Pole. - Plumbing Final I ( t ti [ � Plumbing (Drain/Waste Pipe) Mechanical Final Electrical Ground Electrode/Ufer Gas Test . Setback /Forms/Trenches (Footings) - . Engineering/Grading Final 7655126 Do not install subfloor or - pour floor slab until the following applicable items have been signed: Plumbing (Water Piipe.Sprinkler Valves) Mechanical (Groundwork) . Electrical (Underground Conduit) . Pre - slab (Compaction /Membrane.Reinf.) Underpi (Floor Joist/Girders) ' Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear Firesprinkler (Rough) • 2nd Floor Shear - Roof (Sheathing/DiaphragnJFrarne) Masonry (ReinfiBond Beam /Pre - Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plba . Elec ";ech . ane ;re) , Insulation (Sound/Energy) . Do not tape or plaster until the following applicable items have been.signed: Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath '. Exterior Lath GENERAL ITEMS Exterior Plaster (Brown Coat) ' T -Bar Electrical T -Bar Mechanical T -Bar Structural Sewer - Water Engineering Backflow Water Service FINAL INSPECTIONS i I Date " - In R tC �--- Electrical Final - Plumbing Final I ( t ti [ � Mechanical Final Gas Test . Engineering/Grading Final 7655126 Fire Dept: Final 765 -4040 Water Engineering 765 -5268 Sub List/Business License 765 - 5194 . Zoning 765 -5139 Building Final (Last Inspection -Onl After Above Comple te) INSPECTION RECORD PARTIAL INSPECTIONS Building Inspections Mechanical Inspections Plumbing Inspections Electrical Inspections C. R. CARNEY Architects, Inc. November 2, 2001 Nextel Communications Site #7612A "Plank" 50 South Anaheim Boulevard Anaheim, CA 92805 Reconfiguration of radio equipment due to existing field condition: The reconfiguration of the radio equipment and batteries as required to satisfy an existing framing condition in the field is approved as described herein. All radio equipment frames and structural framing members shown on the approved construction documents have been relocated from the east side of the room to the west side. Upon review by the engineer of record it is determined that the shifting of equipment to the west end of the room does, in no way, impact the existing structural system, providing that the additional specified structural members are relocated along with the equipment. The additional structural framing members, as specified by plans, must be located directly below the equipment as required to support equipment weight and tie down bolts. All attachment and framing details as drawn on the approved set of construction documents are applicable and must be applied to the relocated equipment. This field change has been reviewed by both the architect and the structural engineer of record and is hereby approved. Thank you for your assistance in this matter, if you have additional concerns or questions please contact us at (714) 665 -9500. Sincerely, S. Lazzaro CR Carney Architects, Inc Field CTanficatton 12841 Newport Avenue Tustin, California 92780 -2711 714 665 -9500 Fax 714 665 -9501 www.crcarney.com MECHANICAL PERMIT NO. MEC2001 -01011 TYPE OF PERMIT CITY' Alteration to Existing DATE: 09/21 /2001 \.., JOB ADDRESS: 50 1/2 S ANAHEIM BLVD NEXTEL CA7612 I u _ LEGAL DESCRIPTION: P BK 178 PG 22 PAR 1 APPLICANT:MIKE BUTLER OWNER INFORMATION: JOB DESCRIPTION: 4 '. lrogin_ e - - tee r ► NAHEIM CONTRACTOR INFORMATION: ARCHITECT /ENGINEER INFORMATION: PROCESS COMMUNICATION DEVELOPE 3020 HARVARD STREET SANTA ANA, 92704 CA Mechanical for Tenant Improvement at Communications Facility. Ref # BLD2001 -02690 OWNER BUILDER DECLARATION hereby affirm under penalty of perjury 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, 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 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 or 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. If, 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 rofessions 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 contractor(s) licensed pursuant to the Contractor's License Law). ❑ I am exempt under Sec. , B & P.C. for this reason: Date: Owner: WORKER'S COMPENSATION DECLARATION I I hereby affirm under penalty of perury one of the following declarations: O I have and will maintain a certificate of consent to self- insure for worker's compensation, as propvided for by Section 3700 of the Labor Code, for the performance of the work for which this fSermit is issued. (y' 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 carrier and policy are: Carrier: STATE COMP FUND Policy Number: 0440019068 -99 Thls section need not be completed If the permit Is for one hundred do Bars ($100) or less. 0 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 worker's compensation laws of California, and agree that if I should become subject to the work- 's compensation provisions of Section 3700 of the Labor Code, I sh- o r with comp 0°11h those provisions. Date: 09/21/2001 Applicant: WARNING: FAILURE TO SECURE WORKER'S CO PEN • OVERAGE 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, INTERESTM AND ATTORNEY'S FEES. 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: certify that I have read this application and state that the above information is correct. I agree to comply with all city ordinances and;‘, - laws r- - to. building construction, and hereby authorize representives of this city- • • on the above mentioned property for inspection purposes. CONSTRUCTION LENDING AGENCY ature o • pp'cant • r • gent Date : 09/21 /2001 The permit shall expire by limitation and become null and void If the building or work has not passed final Inspection 365 days from the date of permit issuance. A new penult is required to commence or continue work. PROCESSED BY: MJF Date: 09/21 001 NUMBER: 696069 TYPE: TYPE: TYPE: BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 QUARTER SECTION: 83 LICENSED CONTRACTORS DECLARATION 1 I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Sedion 7000) of Divsion 3 o Business and Professions C••-. B C10 C20 HTAC Items Compressor 3 to 15hp Air Handling Units to 10,000 C.F.M. Contractor EXPIRATION DATE: 09/30/2002 Fees parr) for Permit: Total: 97.20 2 2