2103 E. Ward Ter.
TYPE OF PERMIT
Patio Cover
CITY
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BUILDING; DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 112
BUILDING PERMIT NO. BLD2005-00138
DATE: 1/1812005
JOB ADDRESS: 2103 E WARD TER
LEGAL DESCRIPTION: N TR 1843 LOT 49
. CONTRACTOR INFORMAflON:
SOUTHERN CALIFORNIA ROOMS INC
14104 E FIRESTONE BLVD
SANTA FE SPRINGS. CA 206070000
BUSINESS PHONE: 800607-5223
JOB DE$CRIPTION:Palio'enclosure .ICBO #1968P.
VALUATION: 6,800.00
I OWNER-BUILDERPECLAAATION
I hereby affirm under penalty of perjury that I am exempt from the. Contractor":! UceiiseLa,w for the following reason (Sec. 7031.5 Business and
Professions Code: any city or-couQtywhich requires a permit to cbnstru.ct. nl~~:r. improY!?{..gemolish or repair any structure. prior to its issuance, also
requires the appJicantforsU"chpermitto,file a signed statement that he is Iice:13e:::l p:..:rsu'ant to the provisions of the Contractor's License lavv (Chapter
9)(co'mmencing with Section 7000 of Division 3 of the Business and Professi(qs._Cqde)Qr\hathe is exempt therefrom and the, basis for ~he &Heged
exemption. Any violation of Section 70~1.5 by any applicant for a permit slJbJ.~ct:; the a ppli~ant to'a dvR penalty of-not more than five hundrel;i dolla:-.s
($500). .' . ..' '. ..... . ..' . ."
D I" a~ owner of property, or my employees with 'wages as their sole comp.;;1s"3lion, will'Jo the work, and the structure is not -intended or offere'd for
sale (Sec. 7044~lIsinessand Professions Code: TheContractor's License L_hw r.lo~s notapplyioai, owner.of property who builds or improves
thereon, an~l/fho'does such work himself dr herself orthrough his or her owr~('mPloy~e~,pr~v,i~',~~,th~t such improvem~nts are not intended or '.
offered fOI'::5:8le,. If, however, the building or improvement is sold wittJ_one yeC'~ of compieV~n,'the;_'9Wraer.builderwill. have the burden of proving that he
did not buiid or improve for the pmpose cf sale). ;, ;," '" ' , '
'0 I, as. the oWn~r of the property; am exclusively contlactin'g with licensed .~_')n~;actor$' toe-onstrilci the project (See. 7044 Business and Profe:?S;iorls
C'Jde: The, Contractor's License law does not apply .to an owne~ of propert\-'?ho builds OJ improve_s thereon, and who rontrdcts for sum projects~with
a contrador(s) licensed pursuant to the Contractor's Licehse Law). ' } "
o ,I ameX6lTIpt under Sec,. , S' & P.C. for this ~eason: ,__i___~~
Date: Owner: ! -. .
C.. WORKER'S COMPENSATION DECLARATION _.> I RLlCENSED CONTRACTORS DECLARATiONCl
I herebya_ffirry: under penalty of perjury one oHhefollowing declarations: [ I hereby affirm under penalty'ofperjury that. I am .
01 ~~ve'and wW JTlaintain a certificate of consent to self,.insure for wo;-ker"~"compcr.sation, . 'ii~en$ed ~nd~r pro"is!o~l'S ?fchapter 9{~o?imel"!c..[ig,--.
as provided for by Section 3700 of the Labor Cede, for t:'e p-elformance ct tll(: WOrK for which with SectiOn ,.000) pf DI'~lQn3 of the B~slnessand
this permit is issued. . 'Profeasiop.;3 Code. .',-
[J i have and wil.! ma!l\teinwotker's compensation insurance. as required by Section 370Q,cf 1/18/2005
the labor CQde.,for the performance of th'e work for which this permit is issu'e.:L Myworker's Date:
. Compen'sation inSurance carrier' and policy are;-
Carrier: PoliCY' Number: EXEMP-:-
APPLICANT: EVONNE NORTON
OWNER INFORMATION:
leon Frerchis
2103 E Ward Ter
Anaheim, CA 92806
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MSM
~.
Contractor
Ttlis secti.on need not be completed.if the pennit is for one hundred dollars ($10(,) ,or JF;SS. .
o I certify that in the perfo'"rmance,ofthe work for. which 'this permit is issl..'cd, ! shall net
.~mploy any person in any manner so as to become subject to the worker's cOfnpensation.laws
of.C.alifomia, ana agree that if I should become subject tothewo~_er:'s compe~'sation ,
t?rovisions of Section 3700 of the Labor. Code, 1 shan forthwit~ comp,ly with those provisions.
Date: 1/1812005 Applicant:.
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION.COVER~.Gf; IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL PENALTIES AND CIVIL
. FINES UPTO ON", 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. ...
I CONSTRUCTION LENDING AGENCY
I herepy.2t!if!Il.UD9~r per:alh"gLpj~rjury that thE:!:re_!:?iI.~QDstructiOI1 !enc!;r;p a~~~nc:' fer the
perfoJrmunce of the worK for whtch this permit is issued (860.3097 ,Crv,C):
Lender's Information: .
...N"Yi<1BER
:827'937
'TYPE
B
ExpiRATION DAl'E
12/31/2005
Construcion Types:
VN, ,
Fire Sprinklered?
NO
I certify that I have read this application and state that the ~bove information is correct. I
agree to oomply with all city ordinancesand state laws relating to building c'Qr~struction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspection 'purposes.
.. Date: 1/18/2005
Fees paid for Permit:
Total:
558.96
Signature of Applicant or Agent
The permit shall ~xpire by limitation and b,,<:ome null and void if the building or
work has not passed final ihspection 365 days from the date of permit issuance, A
new p'~mit is required to commence or continue work. .
INSPECTION RECORD
, ,INSPECTION' , DATE INSPECTOR
,
Tempor;lry Power Pole' , ,
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodelUfer ,
SetbacklFarmslJrenches, (Footings)
Do not install subfloor or pour floor slab untillhe '
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) ,
Mechanical (GrOUndwork) .
Electrical (Underground Conduit)
,Pre-slab (CompactionlMembrane.Reinf.J
Underpinning (FlOor Joist/Girders)
Do not cover or conceal the work below untlllne
following applicable items have been signed:
1st, Floor Shear , ,
Firesprinkler (Rough) ,
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Out) ,
Rough, Mechanical , ' "
Rough l:IectrlCaI (Dry,Wall)
Rough Electrical
Framing {Only after Plbg.. EJe.c.. Mech.. and Fire)
Insulation'(Sou,ndlEnergy) , , '
Do not tape Or plasler untillhe following applicable ,
items have"been signed: .', - . ,
Drywall, ' " ,', ,
Penetrations (Fire Rated) ElectriCal ' I
Penetrations (Fire Rated) Mechani,cal ,
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
, " " GENERAL ITEMS
Exterior Plaster (BlOWn Coal) , "
T -Bar Electrical' "
T -Bar Mechanical ' ' ,
T -Bar Structural ' , , ' , ",
Sewer
Water Engineering Backflow ' "
Water Service
FINAL INSPECTIONS Date I ' Insp~tor
Electrical Final I~-II-Oj '~L
Plumbing Final , " /
Mechanical Final
Gas Test ,
Engineering/Grading Final 765-5126 ' ,
"
Fire Dep!. Fina(765-4040 '
Water Engineering 765-526lr
Sub List/Business License 765-,519 I
Zoning 765-5,139 ' ' ;"/ '
' ,
Building Fil)al ~ast Inspeelion- Only VI! .Of '0( I'~ S0-
fter Above Complete)
PARTIAL INSPECTIONS I
Buildina Inspections
, Mechanical Inspections
Plumbina Inspections
. . . .
, Electrical Inspections