1040 N. Wanda Dr.
TYPE OF PERMIT
Residential Addition
CITY
. !~""'--
, /;;.~;~~~;~s~~t~\ '
a&'~N~HEIM
'~:~~~f~~;t} ,
BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765; 5153
INSPECTION REQUEST LINE:
(714) 765. 4626
CENSUS CODE: 434 .
QUARTER SECTION: 91
I3U1LDINGPERMIT NO. BLD2003'01887
DATE;; 81712003.
JOB ADDRESS: 1040 N WANDI';DR
. LEGAL DESCRIPiION: N TR 1364 LOT 10
APPliCANT: THOMAS MONTES
OWNER INFORMATION:
. Tholflas A Montes
1040 N Wanda. Dr
Anaheim, CA 92805 , ,
-JOB DESCRIPTION Room Addition. 'f~t floor, family room, laundry and bath t5?n:;t), :~nd flcor ioft {388sfJ. Total 974sf.
IVALUATlOi~: 65,550,00 ._.L___ PROCESSED8Y: JJ.:,
01A'NER.8UiLQE~!P..EfLARJ\ nON _ __1
J herebY.affirm under penalty of perjury that I arnexempt trom ~rle COfltrac:to;~: Lk;erlSFJ La\v fo; the for!owing reason (Sec. T031.5 9!Jsiness and
Professions CodE::: 2r.y city or countywr.ich requires a pe~mit 1.0 c()nstr!JGt,~~:f~'!: irr..prova, df'.i"Jloiish or repair any s.truc~urs, p~ior to itS,iCsuanc,e;abn
roquirss the aop!icant.for sLlch permittofile a cignect ~tatemenl that h:3 13 :k.?bsed pJrS'13_i't to the pll)viSiOI1$ ott~le. Co/1;'a;.:tor's License Law (Cha~ter
9)(commencing with Section 7000 of Division 3 of the ~i.'si:"less and Pr(jf:....s~;(t.i;.5 C(ld~Yor that he is exempt 'therefrom ar,d U:e b3Sis fur t1ie aileged
7;;~~~ior,. _ Any ...iol~ion of S~~ti~n 7031.5 by any applicant for a p:":rm!t '311it~cts_ the apPl!caht ~o a .ciVil peh~Jtycf not more th&n'five hljJ:J_dre~ ~(')n~r~.
[J l, .as.owner of property, or my e~rpl9ye63 ......!~h v/cqes as their so!?c0m!Y'r::5ation. 'Niti do. the work, -~mtj the st~uc~u,e i~n(.\t intended Gr offered fvf
sale {~eG. to<~.Bus!r)es3'anrJ Prpfessiorrs Cod~: TheConl.rac:tor's UG..:ns-e~~w doe::: i:?t ct?ply to an .:;wner of prop~rty 'Nr.O b':'!ifjsori!":~t::i';'>VcS
thereor:.- an': W:-:Od08C ~uctl work himself or 1Ie,(Solf or ~!1roljgi1 r:l!i orhf:r L'W;" 'J';;1P!.::jE.'&S,pf'JVir!ed th~t sLich improv'c:net1t$a're~n6tir:teiided 0r
.offe~edi'0r $dle.";f, hovvever,the building 01 irnprm'ement j~ scld with on~~ yr:l:' of c6r~p!ctjv"" the owner-puild&r wiithc:ve ~r:e, b'.Jrder. of pr';Jv;I;g.that he:_
didr;o~,bujl,dor:mprcve for the plJipost) ctsa!_sl. " ... ,_ t . .' .'. ' ".
~l, a3.'!h;J'oi,..:n~r6f(i~e property. am <;l'XdVS;',/E;t; cCi"\tmctir.g'W~h 1k.~:"'\;:ect-,JOIltr~Gt~"s 10 c;:.p.strUc't trle wOject (Eel';. 7C..14 B~$!ness an':i Profecs;onH
"'Cod~, _ Tbe Cor4ac!dr's license law doe~rnot c:ppiy ~o .:lnowner of pi-q;e-:'t/!'fi;O buik;~ or imprl.~\/es tf1er.eoll, and '.vh,J n.mftacts fcr-sndl rrojccts w:ttr
n...qontr"-lctor-(:;.},!icenseo pursuant to t.he Contractcn; LicensQ l3'N)..' :L, .." , . " .. -' .
Lei I "m ex""wl undee S." ,_~~ ' ,F.C, for Ihis J!!.."!l.iif~ >- ~ ____~___'__..::____~.,_._:+_..,.,.--.
tr\e:~~~OR~;~CON ENSATlor< QECI-AR~-;o~t" .==_ '"~~J, r'-UCE~-i:~l~TW;!ORSDEctt~J
I hereby p.1T!rm ~11j~r p~naJty of peljury Oll~ of Hie fr);Jowinr. deda,:'::ItioJ1i'>:: . ~ " . r. I hereby aii!rm L<~der, pena!:y of pe~iury tt"!a~"r.m~1
[J "I h:3ve an::! 'j;ill ,)'laintain a certificate .of ccnsellt ~o ~e~f:-in::;iirc f-.,.y.:orkt'i'~,(::)fnpen:::ati"n. ! :iceI1sedunde::r provisions of chepter 9 (comm~nci'lg
as phNid<">lJ for.by"Section.-3700 of the 'Labote.ode, fcr,the'p.~{fon!"a;lc~ QfH-:~ WfJ~l< f;Jr '.A!1j~i1 I wIth Section 7000) ofO;v~i~~113 oflheBusiness and,
ti1is pennlti~> issued.. ".. _ " ,', . .;{ . I Professions Code.
. 0 ~ h&ve and.Wmm3jr')tafnworker'~ Gompens'Co.iHun irv;umnce-, c:::, rcC;:':i~d.~:~,SO!"tiC,,__3.70,Q':,f\ 817/2(J03
. :h19 LabGt Cnde, for the pe~fcrmance of th~ work fot which th~s permit ls j"'S'l::fl. My\....o;k~r.s I Date:'
Compe:r"sation insliran09 carrier and poiicy are: .. .~ i
C~(fier: Po!j~y Nu mbe.r. ~ I NUMBER
Thi see-tiO!} need not be ccmpletedif the permit is for one hundred dollr<rr. (.$1~;'.~~-:'!' Jess. TYPE
~ I C€l:ItJfy that lil the performance of the work for 'u'lruch this perr,'llt:s :s~~.~~:...: ~J\9:11;.~t !
emptoy tiny person ip any mi?lnner so as to become slJbJf:ct to tll$ WO(:':HC,"..'.\r:en~a~k'n law::, I
Of CaJrfomia, and agree that if I should beGomr~ stlbj'::ct to the wOrY,l-;r'~ c'.:n;;i::.s21~iOJl _ .
previsIons of Section 3700 of the labor Code I ha~1 Forthwith COliJply..",;~~l~: v;c P;O'J~s;ons. I Construclo'1 T.....pes:
> d -1~", VN"
Date: 8/7 i2003 Applicant: , ~ H~ 1!.~'~,/".:-j Fire Sorlnklered'?
WAf<NING, F,AiLURE TO SECUR W RO<ER'S C,OMPENSA.;:;;;;r, ,~.Rr' CV;;,';i.~'?" I,Si'i,'C,':" , ," LivJn~ .~rea:
'UNLAWFUL, AND' SHALL SUBJECT AN EMPLOYER TO CRIMINAL, PE;-~..;\:-::4~S:::A,~r):(;,I\:H... . "
, PNES l.lPTOONE I1UNDRED THOUSAND DOLLARS ($100,COOl,IN Ai4":<';:",,"Ji;)'j'HC !
C'-JST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTJC~'\-3t66"6,3''tHE '
LASOR CODE, INTEREST AND ATTORNEY'S FEES., ' " .}t~,:", J"
! ' CONS:rRUCTION LENDING AGENCY >;~ '-,':.;:21"'<-\
I hereby- affiqn uilderpenalty of, perj~rythat ~h~r~ is <:1 c-~nstruction,t~nd}"lt~~~~;fiCY/~!lI~~':-'_,:,: I
f~:~!~~a,i~~~:~~~^:~~~, for which thIS pF;:r_~~~:~~~'::,:~~~~~~~,SjV~;~~I' ~i_'~,--_'3 ~--'~~~~~:::i:_L ___~_ _~ _ _____-"_n_ ______~_______
(
CONTRACTOR INFORM/TiON:
,I
ARCHITECTlENGINEEF<.INFORMAiION:
CO-:'ltract("l(.
EXPIRA ncr..J DATE
NO
974
I certify that I have r,ead-this application and state that the above informationj~;-correct:.J
agree to comply with all city ordinances and state laws relating to building cor.structicm, and
herebY authorize r presentives of this 'city toe.nter upon th a bove mentioned property for
,jn~p'ection ur s.
Dale' 8/7/2003
Fees paid for Permit:
Total:
"
1,361.51
Signature of A Iicant 'or ge t
The permits hall expire by limitation and become null and void if the lluilding 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.
. ,
INSPECTION RECORD
INSPECTION ' '
,
INSPECTOR
DATE,
Temporary Power Pole
Plumbing (DrainlWaste Pipe) ,
Eledrical Ground Electrode/uter ,', ~ ' I
SetbacklFormsfTrenches (Footings) , '-7'
Do not install subfloor or pour floor sl,ab until the
following applicable items have been signed: '
Plumbing (Water Pipe.Sprinkler Valves)
,Mechanical (Groundwork) ,
Eledrical (underg, round COnduit,) , '~_ ,I
Pre-slab (compaction/Membrane.Reinr.) ~ .c..
Underpinning (Roar Joist/Girders) " .
Do nOlcover or conceal the work below until tne .
following applicable items have been signed: , "
1 st Floor Shear ' '2l..
Aresprinkler (Rough) ,','
2nd Floor Shear' 17l1'1.l./6"l. F-,I '><...'
'Roof (SheathinglDiaphragiB'Frane) 10 ',1.101
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out)
ROugh Mechanical "
ROugh BectncallDrY walll ','
Rough' ,Electrical ' , "
Framing {OnlyafterF:lbg., Efec.. MeCh., and Fire} '~'),
Insulation (SoundiEnergy) U'''>,.....
Do not tape or plaster. until the following applicable
items have-.been.sign.ed: . . r. .
Drywall' ",., 0::
Penetrations (Fire Rated) Electrical
Penetrations (Finl'Raledl Mechanical'
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
,
,
,
:
..--....
, ~SlrPr
", GENERALlTEMS,
Exterior Plaster (Brown Coat)
T -Bar Electrical
T -Bar Mechanical '
,T -Bar Structural '
Sewer, , " '.
Water EngineetlngB'lckflow "
Water Service
,
"
,:,
,
,
,
FINAL INSPECTIONS
Electrical Final
Piumbing Final
MechilOical.Final
Gas Test
Date 'Inspector,
E!1gineeringlGrading Final 765-6126
Fire Oept. Final .165-4040
Water Engineeri,ng .165.5268,
Sub List/Bus,iness License .165-519
Zoning !65-5139
Building Final ILast Inspection. Only :J. '/4 ' '"
, Afte! Above Complele) I', =
PARTIAL INSPECTIONS "
Buildinq Inspections
Mechanical Ins'Dections
Plumbina Inspections
Electricallnspectioris ,