1270 N. Woodglen Dr.
.___ -4>-
TYPE OF PERMIT
Blod(walll Columns
DATE: 8131/2004'
JOB ADDRESS: 1270 N WOOD GLEN DR
'c~~'~~ \; ~
CITY 6~~AfJ~~HEIM
~:::,);~~~ ."
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQI1ESTLiNE:
(714) 765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 200
BlJILOING PERMIT NO, BLD2004-03330
LEGAL DESCRIPTION:. N TR 9171 LOT 10
CONTRACTOR INFORM'\TION:
CURCIE POOLS
1311 N JEFFERSON 51
ANAHEIM, GA 92807000(;
BUSINESS PHONE: 714523-5571
JOB DESCRIPTION!nstall. new 5 feet high block wall for pool equip 1
VALUATioN: . 1,800.00 'i
I OWNER.aUILDERDECLARATION
I hereby ~ffirm under penalty of perjury that I am exempt from the Contract(;i~Ucense law for tl1e following reason (Sec. 7031.5 Business and
Profe$slor~ Code: any dty or countywhich'requires a pennit toccn::;truct. o~,J'r, improve, den1otishor repair any structure, prior to its issuance, also
r~qu'ires :h8appllcantfor such permit to file;:: signed statement that he is nc.;r.sed pursu.?nt to theprovisionsofthe Contractor's License Law (Chapter
9}(co:TImenclng with S.ection 7000 of Divisien 3 of the 8usil1~s$ and'Pr'..)ress"';Jns Code) or that he is exempt therefromanci the basis for the alleged
exemptll,)(l. Any violation of Section 7031:,5 by any appticant for a perm'it 5!.I~ects the app-licorrt to a civil penalty of nDt more than five hundred doHc-rs
($50m. .
o I: as owner of property, or'my employees wittl wages Bs'i'helr $o:e C.Of.,j'i:-::n.Sation, wiil dQ the work, and the". structure IS r"~{ intended Nottered for
Saie,(Sec:. 7044 Bus:nessand Professions Code: The Contractor's Uccnse'}aw dOW3 nct apply to an owner of property who bwilds or improves
there6ri;'Ql1d who does ~uch work t1imself or t'\.1iSE::f (".r through his or r.er ov;;~:"t einpioyee..">, pr::;vided thzt such lmp,'Ove;r:ents; a.re not intended or
offered fo'r saie. if, hc.wever, thF' building or improvement is sold with one y?,~r of ccmpietlc;n, the owne.r~buj!d€r will h<;;.ve the burden of provIng that he
did not build OJ if))prove for the purpose of sa!er. ...:,' .
. 0 ~,as tbe DWfl€:r (Jf the property, am ey.dus:v~:y con~rClctjng >/Jlth !(cel";;'Po:,l,'::,:-nfrndcrs to constru<:t fhe project. (S~('~ "/044- Buslr,p.S$ and Prufessions
Code:' The COI1traC'(or':;::.license Law does not apply a 'lineI' Ofpff.:;f::ert.y\vho builds Qrimproves ~~:ereon, ~nd who ())n1racts for .sP~i1 pr~iects with
~LC'..ontract(',r(s) lir.ensed ~?ursuanUo th n 1se Law). :i.
[J i 2m exempt untier Sec._~. . . : th' ~ .$RSon:
Date: - Owner:
--- '._~-
c: WORKER'S C PE, SATIOI'! DECLARATiON ,_____J r LICENSED CONTRACT9RS DECL~RATiON j
i nerehy affirm under penalty of perjury one of the f:::;,lIowing declarations: . I I hereby affirm under pe:1aity 0 erjur.y tha~ i a;-"
o i"llo':"'e,a, lid Will maintain a certiflcatec,f cc>nsent 'tc 3elf..insure for v.jcrk~r~;3 c'Jmpensstio:1" I' l~e~sc-d l.!nder pr~o ; 9 (C6~ltn~I)Cll.1g
as nrovidc-d for by Section 3700 of the Labor Code, fer thG performance of ~hS;. 'Nor" fm which _ With Se::::tron 700 I () the !3us!ness ;J~d
thi~ permit is :ssued. ' '. . , . -.{ . I ?rofet;sior;s <':. e
, 0 ,I have and wiH msJntain worker's CGn~pensatlo~ InsuranGB, as requimd d;J Section 3700 of, 8/31/2004' IS:.
thl;'< l<:lbpr C?d~, for the perfo~m_anc~ of ~he \....crk fer which this perml\ ~ is::;u~;d. Mywor!<"er's 1 Date: I
Compensabon InSurance carner andpohcy are: . 1 I .
Carriar: STATE FUND PC'tk.:i j\!umb-ar. 046~02 I. 'r~.:T C{)11480-Z0Cj NUMBER EXPIRATION DATE
This section need not be t'r"'"""leted if the nqnnlt is for one hundred dOfl:trsl.$1C;;,. or ltiS~" 3T1',r2p9Ei3 1/3112005
-'''~ ~.- C12 PA'I
o I certify tl,at In the performance of the work for'vihich 1hi~ per it:s i~'.'~)d, Ishal! not TYPE C27
employ arw person in any manner so as to. becDme subJ~ct to work€'IJs cpmpe'lsalion laws TYPE C29 MAS
of Califomla; and agree that if I should bee je. t wor'r<er's CO;flp:eI:S3tion .-IE ('5')
provisions of Sl?dion 3700 of the Labor sh it.'1 compljwithtt.,~s~ ptovisions. Conslrlicion Type~:
V N, ,
Fire Sprinklered?
APPLICANT:
OWNER INFORMATION:
.John J HeUer
, 1270 N Woodglen Or
Anahejm, CA .92807 ,
.ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: DOR
,
COr'! tractOf .
Date: 8131/2004 Applicant.
WAR'lING: FAiLURE TO SECURE W
UNLAWFUL, AND SHALL SUBJECT EMPLOYER TO CRIMIN.~L PENAcTIES AND CIVIL
FINESUPTO ONE HUNDRED 1J-fOUSAND OOLLAHS ($100.000), IN AOC!!"!CN TO THE
COST OF COMPENSATION, DAMAGES A.S PROVIDED cOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I . CONSTRUCTION LENDING AGENCY _
I hereby ?ffirlT) under penalty of perjury that there is a construction lendIng CJ[,~r;cy for the
})~!i.or!:!'.?J10_J)Jtl)e v.:crk 1or_wnlch thLo:: {H:~rr;1it ;;-.; i~2.:,?(f !S".<:!-(:.-30~7 .r.iv.!:\' -~
Lender's Information;
NO
..."
I certify tha t i
agree to co I
hereby aut or;
inspection
r
tion and state that the above information is correct. I
ances and state laws relating to bu~ding construction, and
s of this.city to enter upon the above mer:tione~j property for
Fees paid for PerrrUt:
Total:
125.04
Date: 813112004
Signature of Applicant or Agent
The perm sliall expire by limitation and become null and void if the building or
work has not passed final i.nspection 365 days from the date,of I*rmit issuance. A
new permit is required to commence or.continuework.
^
, ,INSPECTION RECORD , FINAL INSPECTIONS Date Inspector
, INSPECTION - 'DATE INSPECTOR , Electrical F,inal ,
Temporary Power Pole, Plumbing Final , .
Plumbi ng (DrainM'aste Pipe) . . Mechanical Final. ,
Electrical Ground Electrode/Ufer ; .
SelbacklFormsfTrenche!i(Footings) /- - Gas Test ,
. .
Do not install sUbflqor or pour floo( slab until the Engineering/Grading Final 765-5t26
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves) Fire Dept. Final 7654040
Mechanical (Groundwork) . .
Water E.ngineering 765-5268
Electrical' (Unclerground Condu it)
Sub list/Business License 765-519
Pre-slab (Compaction/Membrane.Reinf. , ' .
Underpinning (Floor Joist/Girders) toning 765-5.139
Do not cover or conceal the work below ulJli, the Building Final j(-ast Inspection- Oniy ~ 't1/0( rr..:1\1 f . .
following applicable items have been signed:' " ' , fter Above Complete) .... """""'-\.
1 st Floor Shear . , PARTIAL INSPECTIONS
,Firesprinkler (Rough) . '
, Buildina Inspections ''J. , .' J '. . V
. 2nd Floor Shear '. ,
Roof (Sheathing/Diaphragm/Frame) . c!,Ht;:.Ir-ea/ 1 rndtt '" fo f1a ,
Masonry (ReinfJBOnd BearnlPre-Gr<i\lt) g-h:>a / OP.\ /~/_ '"Z~-6\
Rough Plumbing (Top Out) . . . ,
Rough Mechanical , " . ,
: RDugnl:lectrlcallLlrY Wall}
Rough Electrical
Framing (Only afterPlbg.. EleC:. Mech and Fire) ,
Insulation (SoundlEnergy) Mechanical.lnspections
00 not tape or plaster until the following applicable
items have 'been signi;d: .' , .
Drywall .
Penetrations (Fire Rated) Electrical . . .
Penetrations (FIno Rated) Mechanical . . . .
Penetrations (Fire Rated) Plumbil1Q .
Interior Lath . . . . .
.
Exterior Lath . '. Plumbinq Inspections
. GENERAL.1TEMS .
.E1lterior Plaster (Brown Coat) . .
T -Bar. Electrical .
T -BarM.echanical . .
. . .'
T ,Bar 'Structural' . . -
Sewer . . . . .
Water Engineering Backflow Electrical Inspections .
Water Service "
. . .