1903 S. West St.
TYPE OF PERMIT C
Residential Remodel ITY
DATE: 7/25/2005
JOB ADDRESS: 1903 S WEST ST
LEGAL DESCRIPTION: N TR 3204 LOT 98
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 67
BUILDING PERMIT NO. BLD2005-02330
APPLICANT: MARY SANDOVAL
OWNER INFORMATION: CONTRACTOR INFORMATION:
TONY M SANDOVAL
1903 S WEST ST #0
ANAHEIM, CA 92802
JOB DESCRIPTION:JnstalJ french door in place of existing window leading to the rear yard
VALUATION: 2,500.00 PROCESSED BY: JNJ
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that r am exempt from the Contractor'S Ucense law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, :mprove, demolish or repair any structure, prior to its issuance, also
requires the appKcant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis tor the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
~as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Law does not appryto an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year cf completion, the owner~builder will have the burden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property wh) builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law}.
U i r am exempt under Sec. B. f r this re o'
Da . Owne .
ARCHITECT/ENGINEER INFORMATION:
WORKER'S COMPENS CLARATI N
r hereby affirm under penalty of perjury one of the fol ng declarations:
a=?have and will maintain a certificate of consent to self-insure for worker'scc\mpensation,
as provided for by section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
o I have and will maintain worker's compensation insurance, as required by S~ction 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: Policy Number:
~tion need not be completed if the pennit is for one hundred dollars ($100) 0'; less.
o I certify that in the perfonnance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if t should become subject to the worker's compensation
provisions of Section 3700 of the Labor Code, I shall forthwith comply h those ovisiens.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that' am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
ProfessIons Code.
7/25/2005
Date:
Contractor
NUMBER
EXPIRATiON DATE
TYPE
Date: 7/25/2005 Applicant:
WARNING: FAILURE TO SECURE WORKER'S CO N COVERAGE is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOY 0 CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE 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.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency tor the
performance of the work for which this permit is issued (Sec.3097.Civ.C): .
Lender's Information:
Construcion Types:
VN, ,
I certify that' have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representive this city to nter upon the above mentioned property for
in ectio ses.
Date: 7/25/2005
Fees paid for Permit:
Total:
53.87
19 atur Applicant or Agent
The permi s I expire by limitation and become null and void if the building or
work has passed fi nal inspection 365 days from the date of permit issuance. A
new permit is reQuired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been sIgned:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical /J / J. I
Rough Electrical (Dry Wall) IfY,/&,- -;", 'f.
Rough Electrical I /J ~. J A
Framing (Only after Plbg., Ele., Mec. And Fire) l7JjPijDf" r._
insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior lath
Exterior lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub listlBusiness license 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only
After Above Complete)
C-. ~ .
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections