2788 E. Verde Ave.
....."-
...~\~
,
ElM
BUILDING DIVISION
200 S. ANAHEI.M BLVD.
(714) 765: 5153
INSPECTION REQUEST LINE:
(714) 765- 4626 .
CENSUS CODE: . '434
QUARTER SI'iCTION: 124
BUILDING PERMIT NO.' BI.'l2004-00686
TYPE OF PERMIT C
Residential Addition ITV
DATE: 6/3/2004
JOB ADDRESS: 2788 E VERDE AVE
. .
. LEGAL DESCRIPTION:N TR 3439 LOT 37
APPLICANT: STEVEM ILLER
OWNER INFORMATION: CONTRACTOR INFORWTION:
Cecile D Leavell STEVEN M MILLeR
2788 E Veroe Ave. 33782 VIOLET LANTERN.
Anaheim, CA. 9:2806. , '. DANA POINt, CA 92629o,ba
JOB DESCRIPTIONMd 206m living room extension (HIH)
f
VALUATION:' . . 13,864.00 . ' ...;' . PROCESSED BY:' HRO . '.,
I ..' . ". .... . 'OWNER'BUlLDERbE.CLARATION '. .'. . ..". .... I
.,1 h~re~:'Y~ffirm under penalty of perjl,lry that I am exempt from the contract():'~" licenSe Law for the fo_llowing r-=ason ($ec;703:1_1"5, Business an.d. .'
Professions Code: any dty or county which requires a permit to construct, alt. r,_ improve, demolish or repair any structure, prio.r- to its issuance, also'
, requires the applicant fo.( such permit to file a signed statement that he is lice:.: .sed i:)(.!rsljant)o the provisions Of the Contractor's license Law (Cha'pte-( "
9)(commencing-with Section,70CO of Division 3 of the Business'snd P(ofessk~,}s C606},or t~:.lt he is eX~lTIPtJheiefrom_and_the basi's fot" the alleged
exemption. Any yiolation of SeGtion?031.5 by any applicant for a pefmitsut:.fds,the applicant to a dvn' penattyo~ r'!ot more.than'five h.undred dollars' .
($500). . . .' , .,..... .' .' '.
o . I, sS,9wner of p-roperty, or my employee$ witn wages as their: sole comp~nsation. will do'_-the yvork, and the struc~ure is not in,tended .'or off~red for
sale (Sec. 7044 Business and P~ofessions Code.: Th:e Contractor:s License Lp'.l does n~t apply to an owner of prop~rty .wtlO .b!:ii1~s Qr improves
thereon, and who,does such work himself or herself or through his or her o~,i>~~ployees,provided that such irnprovementsarenot intendeci.or" .
offered for sale. If, however, the bl!ild ing. or 'improvement .is sold with one yeP of completion, "the.owr:er-blJilder wnl have_the, burden 6fprov'ing tha.t h.s
didnqtbunctorimprove.forthepl,JrPoS80f-sale);.. .. .t.::::;. . i ' _,-". '. ,',- :.:_....','- :.-
'.01, as th?, o~ner-R:f.thE:!_ prop~r1'/.ain exdusively contracting with:lice!1se,~ i~?ritrc1ctors to'const~.uctthe:project (S~c. 7044 ~sin~s.and)~foressions_
Code: The C0rltr&C~c;rS license Law does not apply to an owner of prop~rtr~':vh') bUi!ds_ or improlles thereon, and- who oontracts, for such projects with
a contfactor(~}licefi..~ed pUrsuant to the COl1tra::::tor'sLlcense 13w). 1,\ '. ..
01 am exe'mpturide/Sec."., . . ,,,- ' ,:8 & P.C. forthi~ reaSon: ._....:.~.r.' '.'
Date: . - Owner: . .. . - '.'
j WORKER'S COMPENSATION DECLARATION .~f~'
."1 he~~by affirm under penalty of p~rjury ope of the ,following declarations": . (t.
0' ".:Lhave an~ .will maintain a certifidate of !:Cns_ent to ,self-insure fpr worker;~:bompensation;'.
a~ .proVid~~ f~r by Sect1cn,3700 of the Labor Coae, for the performan,C?- of thr :-'/orldor which
thIS permit :,.,',scued. '. _ ' '-r, ' " .
.00 . '.have' a."~(; wili rnail1tain worker's compensation insurance. as reqUiredb~l::,SectiOn 370,0 O;f
~ Code, for,the performance-of the work for which this permit is issu;}j. iV1yworker's
Compensation' inSurance ~'rrler' and pqliey are: - . . _ . ..:l .
Carrier: .EXE~PT . . . . Policy Number. EXE~p';'ri .
. This section.ne~ not be eompl,etedif the pennit"is for-one hUQdred' dollarS ($19~!,'~ less.
o ' cer:tifythat in theperfonnanceofthe work forwhic!1this permjtlS)sS-~.>~itshall not
employ any person inany mannerso.as to become s '. ctto.thework~r' .c,;V~pensation laws
of Califomla, and agree that if I should became. toihe"worker's c mpert$ation ",
provisi.ons .of .Section 3700 of the Labor-Cod I: forthwith comply' .1h< ~~ ptovision,s.
, . :~~. l .
Dale:. 6/312004 Applicant'[~ .:'
WARNING: FAILURE TO SECURE. 'S COMPI;NSATION cOVijt',@E IS ..
UNLAWFUL, AND SHALL SUBJECT AN eMPLOYER TO CRIM INAL PEi'c!f\PIES .AND CIVIL
.FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,090), INAOp"~Of':J TO THE .
COST OF COMPENSATION, DAMAGES ASPROViDED FOR IN SEC,IOl>l :l{06.,OF THE
LABOR CODE; INTEREST AND ATTORNEY'S FEES, <<,;t' ","
I CONSTRUCTION. LENDING AGENCY,. \. ." :,:l }'" ,
__ _ll:lere:by_ AffirQi under !)ena!ty of p'Jrjurv tnat there ls a construction lendr.~Yi";~i.~V fnLthe..;.,,-;~..'
performance of the work for which this permit is issued (Sec.3097.Civ .C):
lender's Information: . . .
ARCHITECT/ENGINEER INFORMATION:
/'
I
6/3/2004
Date:
NUMBER
526709
TYPI;,'
B
EXP1RATION DATE
. 3/31/2006
-'M~""
ConstruCion Tvpes,
VN, ,
Occupancy' Groups:
R3; " ,
Fire Sprinklered?
OwelliOQ Units:
LivinQ Atea:
.NO
1
206
I certify that I have read this application and stat at the aboVe in-fC?rmatil?n.isc.orrect I
agree'to comply with 1 ordinances and state I ws relating to bu'Uding construction, and
hereby authorize p ives of t\1i.s citY to enter, upbn the above mentioned property for
!nspection purpo
Date: 6/312004
Fees pa.id for Permit:
'Total:'
. 1.39
. Signature of Applicant or Agent .
The. permitshall expire by Iimiti\tion and become null,andvoid if the building or
. work has nol' passed final inspection 365 days from the date of permit issuance. A
'new permit is requirj!d to commence or continue work.
. INSPECTION RECORD'
I~SPE(:T1oN . .... . 'DATE' . INSPECTOR,
. .
Temporary Power Pole. ....
". Plumbing (DrainiWaSle PiPe) '. ". .
. Electrical GrOund EkH:trQCJelUfer "'" ,r
.
SetbacklForr!'\SlTrenChes (Footings) . .;t;(j~",., g- -,.",-... .!
. ,
00 not install subfloor or pour (Ioor slab until!he .6->
.' followingapplicabJe items .havebeen signed." . . .
Plumbing (Water f'ipe.$prinkler Valves) . . . 1
Mechanical (GroundWol'k)' .' .... . . :'
..
!:!ectr<<;al (Underground Conduit) . . .' .'.J'\ ,. .
'. pre-slab'(C~actionlMembrane.Reinr" "{, c . (j;'''''{,''-'7 '. .
. Underpin!ling (Roo. Joist/Glrders) , j\
. .!J<> not <;bver or~nceal tne""ork pelow until the. ...-
. fallowing applicable items h~ve been signed;': .' . '., .1
1 st. Floor. Shear' . . . . '. " '. 0 1f/ii1;}';
.
:.. ArespriokJer(Rough) . ' , .
. 2nc:! Floor Shear' .... . " .....-; j;'
.. .ROof (SIle.hlng/Diaphragnv'Frame)'. ;. >-U-c.;r 'jp. 'r-l
MasonrY (ReinfJBond Beam/Pre-Grout) . . ~ . II
R!llighPlumbing (Top Out) . . '. ." 1./.' "
.
. Rough Mechanical . .' '. . -
. - .
--..''''''.... 1& I
Rough Electrical... V j
. Framing. (Only aner Plbg ,Elee r.:eeh and FJre~ ....
Insul.ion (SoundlEnergy) . . . D4
. Do not tape or .plaster !Antil tne followil'g afmhcable ..'
items have been signed:' '. '. - -. . '. . ...;. '.
'. DrYwall . . . . . ~'4/.""; r~rA. .
Penetrall~ (Fire Rated) Electrical .. 1/
.Penetr.ionS (Fire R.ed).Mechanical.... .'-""
. . Penetr.ions (Fife R.ed) Plumbing . .'. . '. .
Interior Lath . -.. . I, C7 . ..'
Exterior Lath'. . .' . . I'I'-</DY '.-,.- .
'. -. '.' . . GENERAL ITEMS . . - -n
.' !ElCterfoj Plaster (Bl'QIWn Coat) . IJ~./J.fJt. ,.
.' .T -Bar Electrical -. .- (JIJ
T-l3ar Mechanical' . ." .:. . I.
. T-8ar Structural :. .'
1
Sewer - '. '. . '. . ' . .
Water Engineering Backflow . .'. . .. .' . .'
.
Water Service'. . . .,< .
\
FINAUN$PECnONS .
.. ..
Dale
lnspei: r
.'-...".^
Electrical. Final .
Plumbil)gFinal '
Mechanical Final .
Gas Test
Engineering/Grading FjnaI765-6126.
Fir. Dept.. Final 765-4040
Wate, Engineering 76$-;;268 .
Sub List/Business' License 765-5,19
Zoning 765.5139 .:
Bu. i1dirig Final :ILasi Inspection: Only . . ~ ~A ""'.
. ,,- -.' AflerAbov,eComplete) 1"'","V'f
. . PARTIA1.INSPECTIONS
Buildinlilnspectlons
. .
., Mechanical Inspections
Plumbina InsDections
. '.
Electrical Inspections'
";)