607 N. West St.
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TYPE OF PERMIT
B.lockwafr 1 Columns
DATE: .8/19/2004
JOB AODRESS: 607 N WEST ST.
- ~<~~~r-~~<-';:P~:~?~>:~.
CITya~(~~tii~HEIM.
.\~~~;.*\~;~;0;/
BUILDING DIVISION .
200 S. ANAHEIM. BLVD.
(714) 765- 5153
. INSPECTION REQUEST LINE: .
(714) 765,4626 . .
CENSUS CODE: . 565.
QUARTE;R SECTION: 62
B1JILDING PERMITNO. BLD2004-03189
. LEGAL DESCRIPTION: ANAHEIM HOMESTEAD TR LOT 15 LOT IN..
APPLICANT:
OWNER INFORMATION:
Daniel Shaddock
607 N We~t St
. Anaheim, CA 92801 . ..
.JOB DESCRIPTIONMdition 01262 lineal le~tol 6 feet high block wall lene..
VALUATION: 6,000.00
I OWNER-BUILD!;RlJECLARATION c..J
f here~y affirm under penalty .of perjury that J am exemptfrcm the Contractc(:i License !,;e::w for the following" reason (Sec. l031.58usiness and.
Professions Code:, any city. or county which reauires a permit to ,construct, <,!ltlr, im.prove, demoHsh .or repafr anystruc~ure, :prior.toi~ _issuance, 815,.0"
requires the applicantfor such permit ta file a sig_f'Jed' statement th?t h.e IS l!c..::~t.ed pursuant to the provisionsof the Contractor's License Law (Chapter
9)(commencingwith.Section 7000 of Division 3of~th~ Business and ProfessfC:n~ Code) _orthat heis exempftherefrom and tne b-aslG for the aHeged
I3xemption; ',Any violation. of Sectiqn 7031.5 by'any.applfcantfo~ a permit $llbj'cc~ the applicant to a' qv:l penAlty oJ ,not more th~n five hund.red dollars
($500). . ... .. . ... .
o I, as' owner,of property, or my employees With wages as their_ sole ccmp.msation, will do the work, and the. structure. is net intended or'offer.edfor.
sale (Sec. 7044 Business and Professions Code: The'Contractor'sUcenGc Lr:J'II does.not apply to an owner:of property who' builds Llr.improve$ .
thereon. and wl,Q doe~ such 'work himself or !1elSef.f or through h(s or, her cwd employees, providedth.<li-such :mprovemer,ts are' flqt intende9 or.
offered for sale. If,however, the building or improvement is sotd '"v:thonp, ye;~r.Gf compteticln, ,the owner.l:-uHder will havetbe' burden of proving' that ne
'did,hot bu,ild or improve for the purpose of sale)., ,I" " . '.
o .!, as the 'owner ofthe property, -am exdusive:ly contractingw!th Ij(;;3;;oSC;'; ,;;c"tractors to construct the proiect (Sec. 7044 BU$inesS and Professions.
Gode: T~e Contractor's L1cen~ L.aw does not a'ppiy toar; owner of propp.rtY:~/j,Q- builds'or improves thereon,. and whooontraclsforslicilpr.cje.ct8 VJifh
Ljohtmctor(s) Ucens$d pursuant to theCo~tractor's ~J'7r,ls~, ~w). "1 . f ,.
I am exempt unqer Sec, . ,'., _ '..! ~ P ..;. lor .-/1I1JreasoP:I. _ :-..
Date: Owner:. ~.~ ,&..Ao.rJrLOtX_...
~.. ,WORKER'S COMPENSATION DECLARATION.. .;
, I h~rcby affir.m underpenaltyof perjqry one of the following .declar;;ttions':
,D' I have and wili maintaili a certificate of oonSEmt.t~,self.inS;Jn~for worker':~ compens.qtion;
as. provided for by Section 3700 of the Labor Code, for the performance Of th:: WOr'J{ jar which,
.this permit is issued.-'.. . . .
[J' '.have and'will rnai"ilt?linwork.er's.compensatiora i~sura~ce, as required -h:' SeCtion. 370{) of
.the Labor Codo, tor the performariceof the work fo~ which thi:; permit-is iss.urd. i\.~y worker's
Compensation. insurance. carrier ancl policy are. ' .
Carrier:': Policy Number:
, This section need not be completedifthe_pennit is for one~undrad: ~?Ilars ($10!J~ 0:" I~s..
O' I certify that ir1:the perfolTl1ance of-the wor~ f~r which this per/ill! is jsSue~, l--sh_all-ilot
'employ.any person In any manner so S$ to become subject to t.he WQ:'"ker'~ ccmpl;:ns.ation laws
of Califomia,.arld' agree that if I should become subject to the worker's comp~:nS'ati6i]. '_.
. . provisions of Section'3700' of the Labor Cod I shall fo with comply with tr:i~se prcy'isi:ms.
CONTRACTOR INFORMATiON:
ARCHITECTiENGINEERINFORMAT/ON:
PROCESSED BY: DOR
:=J
LICENSED CONTRACTORS DECLARATION I.
. I~by af1irrr;\jnd~r pena~ty of perjury that i am
licensed,L!ndsr provisl.:ms of phapter9 (comme_ticil,g ;
with Secticn 7000),oj Diw,ion~' of the Business and
, ProJessions Code. .
8/19/2004_~____
Date~
Contractor
NI)MBER
EXPIRATION DATE.
TYPE
Date: 8/19/2004 Applic;ant: .
WARNING: FAILURE TO SECUR ORKER'S COMPENSATION. CQYsr'AGE/9
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMI~~AL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED lH.OUSAND DOLLARS ($'iOO,OOO), IN ,l\00i110N TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTI.o." 3;;:06 OF THE
LABOR CODE, INTEREST-AND ATTORNEY'S FE.ES. .
ICONS1RUCTIONLENDING AGENCY.;
I !1ereby affirm un.der penalty of perjury; that there .is a constn,jction le(ld ing ~f:~i1cy ror the'
: perfor,manceofthe wor~'for which this permit is issued (Sec.30g-, .Civ.C):' .._ '
r U;:~I-llJ?r S If!TCriHdUO,-t.
R
.'.'...,:
ConstruciOfl Tvpes:
VN, ,
Fire Sprinkiered?
NO
. , , . - ,. .
J certify that f have read this application and state that,the above information is correct. I
. agr,ee to.oomply with. all.cityordinances and State laws relating to building CO;l,,<;truction, and
."hereby authorlie represenUves of this'city to enter lJpon the above,men~ioned property for
insp:ct~.n' ppres./.
. ~-GJ/,ar/,Jo~ Dato:8/1912004
. . Signature of Applicalltor Agent "
The permit shall expire bY.limitation and become null and void if the building or
wQrkhas not passed final inspection 365 days from the date of permit issuance. A
new permit is required to Commence or cor:llinue work.
Fees paid lor Permit:
Total:
242.52
INSPECTION RECORD
: INSPECTION: . . . ..' DATE I. '. . INSPECToR.
. .
Temporary Power Pole' . .... .
Pltlmbing(DrainiWaste Pipe) .' . .'
. ElectriCal Graund Electrodelurer ..' . .'
.' SetbacklFOI'fll$/TrenChes(FootirigS) . "If-' Ifi,P.mst/l'
oj-OS
Donat install supflooror pour floor slab until the
following applicable items>havebeen signed! . . . .'
Plumbing (Water Pipe.Sprinkler Valves) .' . .
Mechank:al (GrOUndwork) . .'.
",feetrical (Underground Conduit) . .
Pre.slab (~ompaction/Membr_.Reim. .
Underpinlling (Floor JoistlGitders) . . '.
.Donot coverorcollC!lalthe work below until the ..
'folliiwin(Japplicable items hav$ been signe.d: 0 '.
15tFloor Shear 0" .... .
F1l1lspiinld.. (Rough) . ..
2nd Floor Shear'. . . .
ROof ISheatlling/Diaphragm'Frame) . '.'
MasOnry (R8infJBond BeamIPr~n:lUt) rt:./{-oS- '/{.
Rough Plumbing' (Top Out) . .
ROugh Mechanical. .' .' '.
ectricallDr-v Walll . .
. Rough Electrical 0 . .' '.. -
Framing (Only after P.l.bg.. Ele~:, r,-,lech. and Fire) . .
In.su.lalirin(SQlIncllEnergy)' , . . .
Do not tape or:plaster until the following. applicable
items have been signed:.. '.' ....... ".
Drywall . . .' . J .'
Penetrations (Fire Rated) Electrical ' '.' .'
Penetralions(filll Rated) Mechanical
Penetrations (Fire Rated) Plul11bing .
Interior. lath ..' .. '., -,-
Exterior Lath . . . . '. -c-
'.' . .. O' ,. .GENERAL ITEMS '.
Exterior Plaster (BroWn Coat) ... ' .
.T-Bar Electrical
. T.Bar Mechanical. .' .... .
T -Bar Structural . . . .
Sewer ..' . .
. Water Engineering Backflow .
Water Service .
.'
FINAL INSPEC..TlONS> . Pate . . . Inspector
Electrical Final .. ..... '. .... .
pliimbing .Final .' . . . . . . .'
.'
'Mechanical Final '. ,. . . .'. .
,. '.
Gas T~st ....
" .'
Englneeril)9lGrllding Final 765-512.6 . ..
.... . o.
. Fire Dept. Final 765-4040 . .
.. .
Water EiigineerinI;l765-5268." " ". .
Sub, 'ListlBusin"lls License,76S-S.19 :,
Zoning 765-51.39 , .'
. .
BLi.ilding !"in;.1 ~ast Inspection. Only' '$'0-0S' (2. f~dJ
fter Abov.e Complete).
. : PARTIAL INSPECTIONS.'
Buildinalnspections' .
. .'".
. .'
. .
.:. Mechanicallnsoections
:Plumbinq Inspections
.
ElectricallnsoecticJns'
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