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611 S. Warbler Cir. - B:.J:LD;NG PERMiT NO. GLD2004-02J81 TYPE OF PERMIT Residential Addition ,{fi'i~--~<~li~;~, ANf!, ""',"0' ' //;../fj@ - ,- " <\ ~~~"-. CITY ~~~~:'?,~iHEIM ~~Ir1;~".h'.' . . ,'~""" " o \'\~itC~~f~" /_}' . \~ci~~-" '1 j ~!~~~~f.\~:,~j.'7 BUILDING DIVISION 200 S, ANAHEIM B,LVD, (714) 765.5153 INSPECTION REQUEST LINE: (714) 765,' 4626 , CENSUS CODE: 434 QUARTER SECTION: 210 DATE: 7/6/2004 JOB ADDRESS: 611 S WARBLER CIR LEGAL DESCRIPTION: N TR 8463 LOT 7 y,I'ICl', APPLICANT: DEAN KOUKLADAS OWNER INFORMATION: K KOUKLADAS 611 's Warbler Cir i Anaheim, CA 92807, " JOB.DESCRIPTIONRoom Addition~ 2nd"f1ooraddjtion over existing 3-ca~ gar~!ge.. , , " ' II, , VALUATION:,. 46,000,00" ,,', ' ' , PROCESSED BY: FAN, ' 'I ' ',' 'OWNER~BUILDEi~,DECLARATION'" " I hereby affirm under penalty of perjury that I am exempt from the Ccntr8ctd;'$-License Law for the. following reason (Sec. 7031.5 Business and Profess~ons Code: any dty or county which requires a permit to construct, a~er, improve, demolish, or repair any structure>:priorto its issuance, also requires the. applicant for suCh permit to file a signed statement that he is lic\hsed pursuant to the provisions of the Contractor's License Law (Ch;apter 9)(commericin'g with Section 7000 of Division :3 of the Busil"!ess and profesdpns Code) or tt">at he is ex'empt therefrom and the basis for the alleg,ed [iixe ption. Any violation .of Section 7031.5 by any ap"pli(;an, tfor a permit s L'~,j,$cts tha Ctpplic:ant to 8; dV,~ penalty of n,ot morethan, five hundred d,?lIars ~ ~, ' , ~ ' , ." . I, as owner'Jf property, or my employees with'wages as their COld comi!:QnsBtioi1, y,:P! do the work, .and the structure is not intended or offered for .sale' (Sec. 7044 Business and Professions Code: The Contractor's Licen~eF:aw doe's not apply to an owner of property who,bujlds or improves. thereon, and who does sud'rwork himself or herself.or through Dis or hl3r Ov-f0 employees, provided that such improvements ar~ not if'ltendec! or ' o,ffered for sale. If" hpwever, the bUl,'lding or improvement is, solcfwith one y~r~r of co, m,' pletion, the owner-builder willha ve, the ,burd, en ofpfov:ing that he did not build or improve for the pU'rposeof sale). . i., " " o I, as the owner of the property, am exdusively contracting with iiCense,y0r~r<Jctol's to construct the project (See. 7044 Busin~ss andprofessiolls Code: The Contractor's License Law does not apply to,an.owner.cf pr(;~,r.:rtlfwtlo bwtds or improves therooi1, and wbooontracts for such projects with ~ontractor(s) lic.ensed pursuant to the Contractor's License Law). '_ _ ~t'-" " '__ ." U I am exempt under Sec. ,B p, for this rea.son: __.J' - - Date: ') -:"4. Owner: (' :..--::f 1 WORKER'S COM PEN ION DECLARAT!ON t I hereby affirm under penalty of perjury one of the following declarati'Jns:, . o .' have a~d will maintain a certificate of consent to self-insure for worl;,,::.!s cv,npelisation, 8_S pro~ided'for by Section 3700 of the Labor Code, for the performance of~ew<.:rk for which this permit is issued. . _s' D. I have and wHI maintain worker's compensation insurance, as :-equ:red ~h, Seci.!cr: 3700 of the Labor Code, for the'performance of the work for which this permit Lc; iSSLjxt. M'Iworker's' Compensation insurance carrier'and policy are; . -~ . ~h~'~:~on need notbe completed if the pennit is fo;::~::~~~e:~!!ars 1$1'1~; or l~. l\Zf ' I certify thalln the perfo.nnance of the work for which this permit is iSSU-\d, I shall not employ any person in any manner so as to become subject to thE! workers c')rnpensation laws of Califomia, and agree -that if I should become subject to the WCi"rker's com~nsatio.; . .provisions of Section 3700 of the Labor C e, I s all forthwith comply with t.~o5e provisions. I;' CONTRAC10R INFORWATION: ARCHITECT/ENGINEER INFORMATION: MOHEB D FARAH 1411 S RIMPAU CORONA, CA 91719 I L1CENSfUCONTRACTORS DECLARAtiON ,I, ; I hereby affirm under penalty of perjury that. ; ,am licensed under provisions o'r chapter 9 (commencing with Section 7000) of Divsion 3 of the Busineis~ and Professions Code. 7/6/2004 Date: Contractor NUMBER EXPIRATION DATE TYP~ Date: 7/6/2004 Applicant: . I WARNING: FAiLURE TO SECURE RKER'S COMPENSATION COV['~AGI;' IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER-TO CRIMINAL PEN.'.;_TI~S AND CIVIL . FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADknCN TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN S ECTI 0:, 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES, ' I CONSTRUCTION LENDING AGENCY I hereby affirm under penalty,of perjury that there is a constructionlellding r:~j~ncy f~)r thf:l perform.'3;nce ofthe work for whidl this permitis issued (Sec.3097 ~CiV._~):) r~ ": ,~.....":..:;~':.~.:-;vr;---..:'~-~:' -~.'_.-~-- .~._,,--_. -,' - ,~ ---.., . ,'-. Construcion T'Ipes: V,N, , Fire Sprinklered? LivinQ Area: NO 682 . I certify that I have read this application and state that the above informatior. is correct. I agree to oompty with all city ordinances and state'laws'relating to bu~ding cC'l1struction, and hereby authorize representives of this city to enter upon the above mentionej property for i,n~pecti ses. Fees paid for Permit: Total: 1,739.50 Oat,,, 7/6/2004 Signature of Applicant or Agent The pe mit shall expire by limitation and become null and void if tho building or work has I10t passed final inspection 365 days from the date of permit, issuance. A ,new permit is required to commence or continue work. .~-/-..-. ",~ FINAL INSPECTIONS Date In pector I INSPECTION, DATE INSPECTOR I, Ell!.:trica]Yinal -z.--?-(.J\ //1. ,-....- Temporary Power Pole PiUinbing Final ' , V --t>C ,./1.. A " / 'Plumbing (DrainIWaste Pipe) . ' Mechanical Final .,-~,!!, .., .,..77-0\ " I . Electrical Ground Ele'ctrode/Ufer . SetbacklForrnSlTrenches (Footings) Gas Test , Do hot install subfloor or pour floor slab until the, Engineering/Grading Final 765-5126 following applicable items have been signed: .. ' , Plumbing (Water Plpe.Sprinkler Valves) Fire Depl.Final 7654040 Mechanical (Grouhdwork) Water Engineering 765-5268 ' " . Electrical (Underground Conduit) Sub List/Business License 765-519 - , Pre-slab (Compaction/Membrane.Rei nt. Underpinning (Floor Joist/Girders) Zoning 765-5139 ' , " Donot cover or <;anceal the work below until tne Building Final . ~ast Inspection. Only , following applicable items have been signed: . , Ite, Above Complete) 1 st Floor Shear e, ~b -'" c,t /I ///. .L- e PARTIAL INSPECTIONS Firesprinkler (ROugh) , , '/ 2nd Fioor Shear /tI-: ~ 7 :.pt,. kf. A v Buildina Inspections ROof (SheathinglDiaphragm'Frame) M 17,7~ oM -, ..---.... , . , MasonrY (ReinfJBond BeamlPre-Grout) , , " Rough Plumbing (Top Out) ",,.tv,,.. ~ " Rough Mechanical - "PtJ ~-/'i>..t Rough BectricaJ (Dry wall, ' f . , Rough Electrical Framing (Only ,after Plbg,. Elec.. Mech', and Fire) IU I ~ " , , .. Insulatiori (SoundlEnergy) 11Jt,l.17'f J Mechanical Inspections Do not tape or plaster until the following applicabl ' items have been signed: " . , , Drywall '7.7lf~ II' .L / " , , Penetrations (Fire Rated) Electrical , , Penetrations (Fire Rated) Mechanical Penetratiol)S(Fire Rated) Plumbing . , , , " .Interior, Lath , ' .# " Exterior Lath ' L:. ~..6. -'Plumbina Inspections , GENERAL ITEMS ( Exterior Plaster (Brown Coal) /IU/OS , " r .Bar Electrlcal . f r.Sar Mechanical . , ' , . T .Bar Structural , Sewer , " Water Engineering Backflow " Electrical Inspections Water Service . -- , , INSPECTION RECORD ~~~ ~1~imI~ 1('-) 4 D.EPUiY Special Inspector's Report _Daily _Weekly --.Final TOTAL DAYS ON JOB _ BUILD PERMIT: b 2. ~131 CITY: tel; 'r:fPl JOB ADDRESS: NERAL CONTRACI'OR: (}.L'VA~U- 4)"",b1u e..W TYPE OF WORK: _ REINFORCED CONCRETE _ PRESTRESSED CONCRETE _MASONRY _WELDING _ HI-TINSILE BOLTING +-EPOXY DESClUPllON andl.OCADON ofWORKINSPECIED: OAT"':; ~ ~ ~ ~ L . " . ~IJ::;j~~~~ ~ r: ) -f a'lo 9B~' i-J~1d;5;. . ~r!;;~:i~ ~ pad ~//i ltJer-1: -nil" 'i>t~....r JUD. Droc~.i.l. '.'r" S I / 't!P1 Above mention d approved by No. oB5qS20-~fJ This report has been file and states that the work inspected has been satisfactorily completed. and complies with the a proved plans. and requirements of The Uniform Buildinl1: Code. m-d.t._J~ 'a1.. a~---!$,.,u, 1WlC1f~~iI fj#l ~IB ~'~imllltmmd~ 1(8fl0) 4 DEPUlV ~~1 Dail - y Special Inspector's Report _Weekly F' al _ill TOTAL DAYS ON JOB .L BUILDING PERMIT:' 2004-02381 CITY: Anaheim JOB ADDRESS: 611 Warbler Cr GENERAL CONTRACTOR: Owner Builder TYPE OF WORK: _ REINFORCED CONCRETE _ PRESTRESSED CONCRETE MASONRY _WELDING Hl-T1NSILE BOLTING ...2L EPOXY DESCRIPTION and LOCATION ofWORKINSPF.CI'ED: DATE: 7/20/04 Observed installation of #4 dowels. Into pre-drilled, brushed, and blown clean holes. Simpson ET-22 epoxy used. Locations: 1.) 2- 2' 6"sq pads along south garage foundation * per details on sheet 14, and pad schedule p-2 . 2- L bars each side into existing foundation. * slab dowels aisomstalled (6" embedment) 2.) 1- 2' 6" sq pad, and 1- 3'sq pad along grid line B * per details on sheet 14, and pad schedule p-Z & p-3 * 2- L bars each side into existing foundation. * slab dowels also installed (6" embedment) 3.) 1- 2' sq pad along north garagefoundation. * per details on sheet 14, and pad schedule p-l * 2- L bars each side into existing foundation. .. slab dowels also installed (6" embedment) 4.) 1- 3' fl' sq isolated pad. * per details on sheet 14, and pad schedule p-4 * 2- L bars each side into existing foundation. * slab dowels 6" embedment Remarks: At areas were footing. was only 6" wide and detail called for 12" embedment. Holes were drilled in an angle to achieve at least 8" embedment. Otherwise work was done. per approved plans, and mfg procedures. Above menti ned w rk has ee in e d, and approved by Deputylnspe No.!) 95152.0-88 This report has been filed and states that the work inspected has been satisfactorily completed, and complies with the ap oved plans, and requirements of The Uniform Building Code. TYPE OF PERMIT. Reroof CITY BUILDING DIVISION 200 S.ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUESTLINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 210 BUILDING PERMIT NO. BLD2005-00695 . DATE: 3/14/2005 . JOB ADDRESS: 611 S WARBLER CIR LEGAL DESCRIPTION: N TR 8463 LOT 7 CONTRACTOR INFORMATION: SHARP ROOFING 10782 S MEADS AVE , . ORANGE, CA 928690000 BUSINESS PHONE: 714771'0118 JOB DESCRIPTION:Tear off existing roof, "'-sheet with 1/2" CDX, install 24 ",Gares of Eagielite tile .7.1 IbslCBO #4660 over 30lbs fell. VALUATION: '12,000.00 PROCESSED BY: ENO I. OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the-Contract.or' License Law for the following reason (Sec. 7031.5 Business ~nd Professions' Code: .a."y city or countywhich-requir'e"s a perm~ to construct, altw. improve, demolish or repair anY-structure, prior to its issuance, also requires the applica nt for such permit to file a signed statement that he is l:ce~)sed pursuant to the provisions of the Contractor's License Law (Chapter 9)(coJnrnencing with Se9tion 7000 of Division 3.of the Business a nd Profes.sien5 COlle) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant fora permit subjects the applicant to a dvU penalty of not more than five hundred dollars ~~ . . .! .. 01, as owner of property, or my employees with wages as their-sote conip~-nsation, will do the work, and the structure isnot intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractor's Li~ense lilW 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 owr:.employees, provided that such improvements are not intended or offered for Sate. 'If, however, the building or improvement is sold with one ye=.',: of compietion, the owner-budder will have the burden of proving th,at he '. did not build or improve for the purpose of sale)"., . . :1" . ~ D I, as the owner of the property, amexdusively contracti~g with licensed ;~i1tractors to construcfthe project (See, 7044 Bu'siness and Profe~ions Code: The Contractor's License :law does not apply to an owner. of property'.rho builds or improves thereon, and who contracts for such projects Witfl ~ontractor(s) licensed pursuant to the Contractor's UcenseLaw). '~\ - , l-.J I am exempt under Sec. " B & P.C. for this reason: . Date: Owner: I WORKER'S COMPENSATION DECLARATION I'hereby affirm under penalty of perjury one of the following declarations: o I have and will maintain a certificate 'of consent to setf~inSure for worker'~ .::;ompe~sation, as provided for by Section 3700 of the labor-Code; for the'performance or thc......ork forwhich ~thiS rmit is issued. . . -, . . _ I.have and wiU rnainiai~ worker's compensation insuran~e, ,as required b~: ~ection 3700 of - e"labor Cqde, for the performance, of the work for which this permit is issup.-:t Myworker's ompensation insurance carrier and policy are: '. j -,' Carrier: STATE,FUND Policy Number. 285-0002320 APPLICANT: JOHN SKIRZYNSKI OWNER INFORMATION: Clayton A1biston 611 S Warbler Cir Anaheim, CA 92807 ARCHITECT/ENGINEER INFORMATION: . - . - I . .~h. see,lion need n'at. be cOmpleted if the pennit isfor one hundred doll~ ($10C;'fJi~~s" . I'certify that in the perfonnance of the work for wt:lich this per I is issuc(),Jshal' not m . y any person in any manner so as to beco e subjec to the ,orker's cc'npensation laws of California, and' agree that if I should become bject to e ompe:l$ation provisions of Section 3700 ofth Labor C e. all ~ I w th tt";:':::e provisions. Date: 3/14/2005 Applicant: WARNING: FAILURE TO SECURE ER'S COMPENSATION COVERAGE is UNLAWFUL. AND SHALL SUBJECT/AN EMPLOYER TO CRIMINAL PENAl_TIES AND CiVIL FINES UP TO ONE HUNDRED TH U'SAND DOLLARS ($100,000), IN ADCI'i10NTO THE COST OF COMPENSATION, DAM GES AS PROVIDED FOR IN SECTION .3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES... . I CONSTRUCTION LENDING AGENCY , ! hf>r~by C'ffirm IIrv:fer !)em~~1 of pt"ril.!ry th:=lt th~rp. is::::. t:orist!"l..!ctj')r) :eI:1in~::>':';:~:1cyfo!'" thF... performance of the work for whid1 this permit is issued (Se0.3097 .Civ.C): ~. Lender's Information: NUMBE 571575 TYPE TYPE C39 HIC EXPIRATION DATE ~/30/2005 Construcion Types: VN,. . Fire Sprinklered? NO te that the above information is correct. I ate ws relating to building construction, and ter n the above mentioned property for Date: 3/14/2005 Fees paid for Permit: Total: 482.64 Si nature of Applicant or Agent he permit shall expire by limitation and become null and void if the building or (k has not passed final inspection 365 days from the date of permit issuance. A new permit is required to com~ence or continue work. INSPECTION RECORD , FINAL INSPECTIONS I Dale' ;. L~specoOr "INSPECTION , ' , ' DATE, INSPECTOR' Electrical Final , ' .. Temporary Power Pole Plumbing Final' .'. Plumbing (DrainlWaste Pipe) Mechanical Fil1al , Electrical Ground ElecirodelUfer " SelbacklFormslTrenches.(Footings} , Gas Test ' , Do not install sUbfl()or or pour floor slab unlillhe Engineering/Grading Final 765-5126 following applicable items have been signed: Plumbing (Water Pipe.Sprinkler Valves) Fire Dept. Final 765-4040 Mechanical (Groundwork) , .' Water E,ngineering 765-5268 .. , , ' Electrical (Underground Conduit) Sub i.,ist/Business License,7ii5-519 , Pre-slab (CompactionlMembrane..Rei nt. " Underpinning (FI.oor Joist/Girders) , Zoning 765-5139 , b /',' i " " Do not cover or conceallhe work below until the , Building Final ~ast Inspection. Only; .~S't<" ~ following appl!,catl1e items have been signed:.. , 1-- ~ fter Above Complele) - 1 st Floor Shear ' , PARTIAL INSPECTIO FireSprinkler, (Rough) , ,. 2nd Floor Shear ' , , , 1 Buildina Inspections! RQof (Sheathing/Diaphragrn'FrlW11e) ~'" ./ ~_uf::" ' f-J. ~ ~. , . Masonry (ReinfJBond BeamlPre-GlO\It} , , " Rough Plumbing (Top Out} Rough Mechanical, , Rough Electrical (Dry wall) , , " , Rough Elecirical , .' Framing '(Only after Plbg.. Elec.. Mech and Fire) , , , Insulation (SoundlEnergy) , Mechanical Inspections po not tape or pla~ter until the following applicable' - It~ms have been signed: " '_ - " . , DryWall ' " . , ' , . ,', Penetrations (Fire Rated) Electrical .. Penetrations (Fire Rated) Mechanical , , Penetrations (Fire Ratel;l) PlUmbing .. , Interior Lath , , ' ,', , ExteriOr Lath Plumbina Inspections GENERAL ITEMS . . ", ExteriOr Plaster (Brown Coat) " , T .Bar Elel:tril:al " , T -Bar Mechanical, , ' , , , , T -Bar Structural ' - Sewer ' , " , , Water Engineering Backflow , Electrical Inspections , " Water Service , , "