5301 Westridge Rd.
BUE_u;NG'PERMIT NO,' BLD2004-01502'
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BUILDING DiVISION
200S, ANAHEIM BLVD,
(714) 765.. 5153
INSPECTION, REQUEST LINE:.
(714) 765 -.4626
. CENSUS CODE: .. 43,4
QUARTER SECTION: .180
TYPE OF PERMIT
Blockwall/ C.olumns C ITV
. DATE: 5/3/2004
.JOB ADDRESS: 5301 EWESTRIDGE RD
LEGAL DESCRIPTION: ,N TR 7566 LOT 5
, APPLICANT: VICTOR CABALLERO
OWNER INFORMATION:
VICTOR CABALLERO
5301 E Westridge Rd .
Anaheim, CA 92807 .
JO.BDESCRIPTION:lnstaIl40 If block wall 6' high to city specs,
VALUATION: 960,OO
I . OWNER-BUILDER DECLARATION
I hereby affirm }Jnde.r penalty of perjury !hatl am exempt from the Contra,ctar':; License Law fQr the following, reason (Sec. 7031.5.Busin~ss and
PrOfessfor.s Code: any dty orcountywhich require$a permft to construct, after, .improve; demolish or repair'any structure,' prior toits issuance; alSo
requires'tl:le applicant for such permit to 'fit,ea'signed statementtl:1at he is'lice~sed_pUrsuant to the provisions of th~ Contractor'sUcense law (Ch'apter
. 9}(comme:ncing with Section ?OOO of Division 30f the Business and Professl')~1z Code) or that he is exempt therefrom and the basis for the alJ~_ged
'exemption. ,Any violation of Section 7031.5" by, any ~pplicant for a permit subj~cts the applicant to a civil penalty of not more than. five hundred-doltars
'($500). ',' " '., '. ,'- " ~ " . '_..... .', ~.:
'0 It' elsown"er of property, ormy employees with wages' as their'sole CO\Tl~~;r-.sai.ion, wiU do the work, and the structure' is' riotintended oroffered for
sale (Sec. 7Q44 Business a'ncJ Professions Code: The Contractor's License lc;IW does r:lot apply to anowner of property who builds'or ilTl'proves , ',' '
thereon, and who d.oes'suq, work t1imself or herself or' through his or her oWI':l:"m'ployees, provided'th;:lt such 'imprOvementsaie not intended o'r-~
, bffered for: sale. If, how-eve:rt the b.uitding or improvement is sold with one ye's'r-j"'Of ~mpletiori, '~he owner"b~ n~ter will'haye the burden of proving that he
~id, b~ildor~mproveforthepul\)oseofsa'e)._ . _, ,.', , '_ _ ',:, _ _' , ; '~'- .
-, -_1,_8. s the owner oft~e properiy,am.exclusively contracting.,with licensed ,~n. tractors to con~truct-the project(se. c. 7044 Business and Profe,ss!ons
, e:, T~e Contractor's License Lawdoes not apply to an own 'r of property \V110 builds or improves thereon, ari~ who contracts for such projects with
,aj(c;mtract?r(l?) licensed pursuant to the Cont~- tor' Lice, ,.- w)', .: ,,: '. ...'.. '. _.' '" " '
, -LJ I am exemptunderSeq. ,', , . r I eason: .~_ ' _ " _ _ - . . '_
Date:' Owner:' .
.....
WORKER'S 0 PENSATION DECLARATION
'1 hereby affirmunder penalty-of perjufy,one ofthe following declarations: . i"
, ,,0, .',1 have,arid_,wiU ~intair; a certi,fic~teof consent to ,self-insl:lre f<;>r worker'i~:~ompensation,
.. _-as -prov,ided for by sedion '3700 qf the labor Code, for the performance ofth:;. work ~or which
this permit is issued. '.
..0 J haveand'will "!1_aintainworker's compensation" in~urance,-as'requj~d ~).iSection 3700 of
the Labor Codet-for the performance of the work for which this permit is 'issll~':'l. Myworker's
, Compensatibn; insUrance' carrier and policy are: .'
Carrier: Policy- Number.
. ~'S s 'cm ne~ not be Q)ITIpleted if the pennit i~ far ane'hundr~ dallars{$100j or less;
I certify' that-in the'perfo~ance of the work for which 'this permit is issueJ, I shall n~t
. ploy'any person ill any mann.er so as to become subject to th~ worker'S;CCrl1pensation laws
. ,'of California, and agree that if "should, beco"':le su ~~ct to . eworker'scompensation
provisions of Section 37.0q of the ,Labor ,I at ith cpmply.with those provisions.
CONTRACTOR INPORMA-r:ON:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: CAL
.~
LICENSED CONTRACTORS DECLARATION
l,hereby. affirm under penalW of perjury that I.am
licensed under provisions of.chapter 9 (commenCing
with' Section 7000) of Divsion 3-oftheBusiness and
Prafes'sions Code: . , .
5/3/2004
Date:
Contr:actor
NUMBER
EXPIRATION DATE
TYPE
'Date: 5/3/2004:. Applicant: .. .~,
. WARNING; FAILURE TO SECU . ORKER'S OENsATION COVERAGE IS, .'
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL PI'NAL TiES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OOQ1)il\lc0PD~noN TO THE;
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR I.N~,l'C!ION 3,796 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,' :,.:,"!..... .
CONSTRUCTION LENDING AGENCY,'..',
l hereby affirm under penalty of per1ury that.there is a conStructic.n}eridi_n.l:rat:-;a~y'fo9hE;l
performance: of the wo~k f,?r which .this permit is issued (Sec.309.!.Ciy:q):.;, ._~, ~'!f-:'- '>-:~~"".
L€-rl<.ier's ;n;onnation:.'
CQlistrucion Types:
VN, .,
-','- ,~" ,.-,'
.""-":'-
I certify thatl h~ve read thisapPlication.and state that the above information is correct. I
~gree to" cOm Iywith -all city'ordinances and state laws relating to building cOl'Istructiont and .
hereby h ize r resen e is city to enter upon the above mentioned proPerty for
inspe on r s.,'
Date: 5/3/200.4
Fees paid for Permit:
Total:
0.50
Signat r 0 ppHcantor Agent
The permit shall expire by limitation and become null and void if the building or
'workhasnot passed final inspeciion 365 days from the date of permit issuance. A
new I?ern:-it is required to ~mmenc~ o~ cc;mtinue work.
IN$PECTIONRECORD .
,. . 'INliPECnON . " DATE . 'INSPECTOR
.- Temporary Power. Pole '. .
P.lumbing (OrainlWaste Pipe) .. .
Eledrical Ground Electrode/I . .
SetbacklFormsfTrench4lB'\FOOtings V UI1/Ql .
Do n<;>t i~tall"subfloor . . "oor slab until the,
fol/owmg applIcable 'tems have been Signed' . /
Plu!l1bing (Water Pipjl.Sprinkler Valves) . . . '.
.' Ml\Ch3nical (Groundwork) .
.' . .
Eledrical.(Underground'COIlduit) . . . I
Pre-slab (Compaction/Membrane.Reinf. .. '. .
Underpinning (Floor Joist/Girders) .
. Do not cover orconcealthe.-work below. until rhe
'. fol/owing applicable items have been signed: . . .
'. 1st Floor Shear . . . . . . .
. Fitespriillder (ROugh) . .
.
2nd Floor Shear. : . ., . ,. . .' . .
Roof (Shealhing/Diaphragm/Fram!!l' '. . . .
. MasonrY (ReinfJBond Bealll1Pr t) 111'~lo'" 741'
RoughPlumbing (Top Out) , (...... .
..
Rough Mlichanical .. .
Roughl:lectrlcal(Dry. walll . ". .
" Rough Electrical , .
Frami.ng.' '. (Only aher Plbg" .EJec.~. Mech.. -and' Fire) -
Insulation (SoundlEnergy) " .'. " . .
Oo.not tape or plastllr' until the following applicable. .
items have belln signed' .' . . '. . . '.: .
, Drywall .' . . .
Penetrations (Fire Rated) Electric;al ..
Penetrations (Fiie Rated) Mechanical . .
Penetrations (Fire Rated) Plumbing . , .'
.
Interior Lath.' . . . ..:...... . .... . .
Exterior Lath . ,
.' . . . GENERAL ITEMS. .'
Exterior Plaster (BlOiNn Coat). - .
. T 'Bin electrical
T-Bar Mechanical." . . .
-T -Bar'Structural' '.' .. .' 0 .
. .sewer .' . . . . . ,
Water Engineeril19 Backfl.ow
Water Service .
.
FINAL INSPECTIONS 'Daia Inspector
Electric'll.Final . .
Plumbing Final' . .
. ., . ,"
Mechanical Final .
, . ,. .
Gas Test . . .
EngineeringfGniding Final 765-5126 .
I'ire Dept.Final 765-404.0 .' .
Water Engineering 765-5268. . . ..'
,.
Sub ListlBU!;in~ss License 765-519 . . ' .' .
.. Zoning 765'5139 . . .
Building Finai . \l-ast Insp.eetlon-.Only lIrjof .A':. ~.
fter Above Complete)
: . PARTIAL INSPECTIONS f!?--
. Buildinj:J Inspections
/Jf.
. Mechanical Inspections
. Plumbina Inspections
Electrical Inspections .