500 E. Wilken Way
~:~:O?F PERMIT CITY
DATE: 7/15/2004
JOEl ADDRESS: 500EWILKENWiw
LEGAL DESCRIPTION: . N TR 3945 LOT 9
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.BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765.5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 99
BUILDING PERMIT NO. BLD2004-02792
. .
APPLICANT: GLORIA MUNOZ
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
Hoine L Federal
500 E Wilken Way
Anaheim, CA 92802 ;
JOB DESCRIPTION,ea, off and install 28sQ of "Eglelite pe' ICBO # 4660," (5:~!bs)
VALUATION: 4',200.00 PROCESSED BY: HRO
I OWNER-BUILDERDECLARATION' I
I hereby affirm under penalty of perjury that I am exemptfrom theCon:tractor~; license Law fpr tl1e'following reason (Sec. 7031,,5 l3usiness and
Professions Cod~; any city or county which requires a permit to construct alt~l"; impr-Ove. demolish or repair any structure. prior to its issuance, also
n~qu ires the applk:a nt for suCh permit to file a si9fled statementthathe is n~'?/'sed pursuant to the provisians af the Cantractar's License Law (Ctiapter-
. 9)(cammencing with Section 700DofDivision 3 of ,the "Business a-nd Prafess:~lS Code) 'or'th~t he is exempt therefrom and the basis far the alleged
exemption. Ariy-violationaf Section 7031.5 .by any applicant for a permit siJbr<'!';;t~ ~!""::e applicant to a clvil perialty of not more than five hundred dollars
($500), . , . . .'; . '.
l1l. I, as owner 0, f property, army employees with w. ages as jheir sole COrh.'P~-1'1'3Cl.ti'on, will do ,the work, and the str, ucture:is not intended or offered for'
$8je"\Sec. 7044 Business and Professions Code: The Contractor's License L:;vV does n.ot applytoan owner of property who builds or improves
thereon,_ and who does such work himself or herself or,through his or her-ow.. employees, provided that such improvements are not intend'ad ar
offered for sa!c. If, however, the' buitding or improvement is sold with one ye;J of completion, the owner-builderwili have the burden of proving that he'
. did not bu~d or Improve for the pu rpose of sale). . \ _ _ .
o . I, as the owner of the property, am exclusively contra ding with licensed ;X,ntractars to construct the project (Sec. 7044 Business and Professior.s
. Cod 13: The Contractor's License Law does not apply to an owner of prcp6-;t~:whO builds ar Improves thereon; and ,who contra9ts for sudl projects with
~on. actor(s)licenseO pursuanttatheCohtractor'sL~ce. e L ). '\
, I am em t under Sec. '& . I Ifor:- i
Oate, '7 Owner: . ~.
WORKER'S CO SA ION ECLARATI -.J
I hereby affirm under p'enaltyof perjury One Of the following- declarations: .
o ,'have and will maintain a certificate of oonsent to setf-insure fer worKers cumpensation,
as provided for by Section 3700 of the Labor Code, for the performance of!l":~' ,//0(.-< for which , .
this permit is issued. '
01 have C1i':'dwinmaintainwofk,er's compensation insurance, as requi~.;:! ht.Section 37DOof
.th.e Labor Code, for the'performance of the work for Which this permit is iSSlJ9J. Myworker's
Compensation insurance carrier .and polir:y are:
Carrier; Polir:y Number:.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
lic~nse<i underpro\lisions of chapter 9 (commencing
with Section 7000) of Divsion 3 afthe Business and
Professions Code. . .
7/16/2004
Date:
Contractor
NUMBER
EXPIRATIONOATE
This section neec:l not be completed if the pennit is fOr one hundred dollars '($10l~~- ?If 'i.eSs. '
o J certify that in the performance of the wark for which-this permit is issuc~. i ~'D" not .
employ any person in any mann'er so as to. bec.ome subject to the worker's G~:!I1~nsatian laws
. of Califomi_a. and agree'that if I should become su . ct[2e wo ,er's camp:;:1Satlon
proviSjon~ ~f,Se~tion 3700 oft.h~ Lab,?r C . ,IJ ? /~ .PI~ wit~ ttY.:se ~~~,ViSiO~S.
Date: 7/16/2004 Applicant. , "
WARNING: FAILURE TO SECU'RE E ENSATION COVZ'^ E IS
UNLAWFUL, AND SHALL SUBJECT EMPLOYER TO CRIMINAL P _rlEB AND CIVIL
FINES UP TO ONE:: HUNDRED 1HOUSAND DOLLARS ($100,000), IN ADDP10N 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. _
J hereby affirm .under. penalty of perjury that there is a- canstructiq,n l~.no ing'z.~7'''CY for t~e
penormance of the work for 'llhich.,thispermit !~ i~sued (Sec.~09_7-"Ciy~r.j:--,. .
L~nd~rs_ iIITo(matlon:. . ' -. -.--.
TYPE
Construcion Types:
VN, "
Fire Sprinklered? .
NO
.s~
'"
- ----:"",.--.
I certify that I have read this application and state that the above information is correct. 1
agree to comply with.all city ordinances and state laws relating_to bUffd.ing canstructian, and
-hereby authorize r . se ,es of this ,to enter upon th~ above mentianed property for
. inspection pur '.
Date: 7/16/2004 .
Fees paid for Permit:
Total:
138.93
19n e 0 App cant
The p it shall expire by Iimitatio orne null and void if the building or
, work has not paSsed final inspection 365 days from the date of permit issuance. A
. M.w permit is required to commence or continue work.
INSPECTION RECORD
, , INSPECTOR
INSPECTION DATE
TemporaQ' Power Pole ,
Plumbing'(DrainlWaste Pipe)
Electrical Ground Electrode/uter ,
SetbacklFormsrrrenches (Footings) ,
Do not install.subfloor or pour floor slab until the,
following applicable items haye been signed:
Plumbillg (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 heen signed: . .. .
1 st ,Floor' Shear
Firesprinkler (Rough) , '
,
~nd Floor Shear ,,/
Roof (Sheathir1g/Diaphragm/Frame) is ;Z~&-,}t AI,' A,
Ma,sonry (Reinf JBond BeamlPre-Grout) , ,
Rough Piumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry WaU)
Rough Electrical' , ,
Framing (Only after Plbg.. Bee.. "Mech:. and Fire!
Insulation (SoundlEnergy) , "
po not tape or pla~ter untirthe fClllowingapplicable
Items have been slg-ned:". . .
DQ'WaU'
,Penetrations (Fire Rated) Electrical '
Penetrations (Fire Rated) MechaniCal
Penetrations (Fire Rated) Plumbillg, "
Interior Lath ,
Exterior Lath ' ,
, , " GENERAL ITEMS, ,
Exterior Plaster (Brown Coat) ,
T -Bar Electrical' , -
T -Bar Mechanical
T -Bar Structural , , ,
Sewer ,
Water Engineerlilg Backflow
Water Service '
FINAL INSPECTIONS ,Date Inspector
Electricai Final
Plunibing Final ,
MeC:_hanic~1 Final ,
Gas Test ,
,Engineering/Grading Final 765-5,126 < "
Fire Dept. Final 765-4040 ,
, .
Water Engineering 765-5268 -
Sub List/Business License 765-519
Zoning 765-5139 ,
Building Final ~asi Inspection.,Only 1~/(J-o"5. @L~
fter Above Complete) ,
PARTIAL INSPECTIONS
BuildinQ Inspections
Mechanical Inspections _,
Plumbina Inspections
Electrical Inspections