321 S. Yorkshire Ln.
BUILDING PERMIT ~n.,^<..D2005.o0250
TYPE OF PERMIT
Residential Addition
CITY
-~~.,", .
fs;;~'tjt~-~i~~\ " '
'."~.lHEIM
"\Z~~2f}.~;t/ '
BUILDING DIVISION
.,
200 S. ,t.NAHEIM BLVD,
(714) 765 - 5153
INSPEl:T10N RSQUE'ST LINE:
(714) 765.4626
CENSUS CODE: 434
QUARTER SECTiON: 202 3''1
, DATE: 2/8/2005
JOB ADDRESS: 321 S YORKSHIRE CIR
LEGAL DESCRIPTION: N TR 9333 LOTS
,
CONTRACTOR INFORMATiON:
, ' MLW CONSTRUCTION
231 N CIRCULO ROBEL
ANAHEIM, CA 92807 0000
BlJSINESS PHONE: 160802,1743
JOB DESC~IPTION: Add 59sf to exist Kitchen SFD
VALUATION: "1,800.00
I ' OWNER-BUILOER,;~ECi..ARATION
I hereby affirm under penalty,of perjury that I am exempt from the ContiQc!.c."';, license Law fOT the following reason (Sec: _7031.5 Business and
ProfessIons Code: any dty or county whIch requires a perrr:it to GOf"stfuct, ~:t<::r, :mprGVe, demolich or repair any structure, prier to its issuance, also
requires the applicant for such-permit to file a signed statement that h",,;g E;f2\s-ed pllrsuant to the provisions of the ,Cbntractor's'LiGense .law (Chapter
9)(commencing with Section 7000 of Division 3 of thE:' Buslness.;.nd PWfcsskirs Codel or"tha'"he is exempt th~refrom and. the basis for the ailege(! .
exemption.- Any violatioli of Section 7031.5 by any applicant fclr a pE.rrrkGub}~c~ :the applicant to acivU pen~Jtyofnot more than five hundred do/iars
($500). " _ -('. '. ',. ' , ".
o I, '8& owner of property, or my empl.oyees with wages as their so!e (..\'):n~~1ns:;:;~ion; will do the work, and the structure is not intended or-offered for
sale (Sec. 1044 Business and Professions Code: The Contractor's' Uce;\~& i,'~)w does not apply to an owner-of property who bllilds o(improves
thereon, and Who does such work himself or herself or through his Ol her oWl;' ernj.:h.JYaes, pn)V!ded that such :rr.pmvements are not intend~ or
offereafor sale.. If, however, the building or improvement is ~ck! wit!': on€: yet:r d completIon, the owner~bLJilder will have the m.rden of,p((N!(I!;rthat he
did not build or improve forthe purpose' of Sale). .. ;, .'.' . :
D'!, as the owner of the property, am eXdllsively contr.2l(~.ii;g wilh jjcer;$~d':':O:lt:acto;-~to r.onstwct the project (See. 7044 BlJs1nes~ ic1nd Pfote&.:on3'
Code; The Contractor'sUcense law does not apply to 311 owner of piOpelt)'1'~'~.j builClS or improve~ thereon, and who oontracts fOf Sllch projects with
~ontrad.~r(s) Iic.e~ed, pursuant tothe'~pntractoi:s Licsr.se Law}. ) .
LJ - I am exempt under S~c.' , B& P.C. for i:hi$- re$son: _._{
Date: Owner:
L
APPLICANT; MICHAEL WALTER
OWNER INFORMATION:
Stanley l Shaw
321 S Yorkshire Cir
Anaheim, CA 92808
ARCHITECT/ENGINEER INFORMATJON:
'LARRYW GIBSON C9103 '
3573 ENTERPRISE 714-632,1238
ANAHEIM. CA 92807
PROCESSED BY; JNJ
WORKER'S COMPENSATION DEClARt'.TlpN___:.____ :
LlCENSELl CC~TRACTORS DECLARATION J
I hereby. i3ffirm ur.de~ ';tnalty. of perjury ,that I am
licensed under prc.vjsi .." f:chapfer r'nrnencing
with Section 7000 . .," slbrf.... ~s and
Professions C .
I hereby affirm under penalty of perjury one of the following declaration::-: ;
O' J have and wlU maintain a certificate of consent 10 self-instJre for wo'rker-;; c.0mpei\.~atlori,
,as provided for by ~d.ion 3700 of,1he Labor Code, for.the perfcrmancs cf~h~ ','!!.)TK for which
..,this permit is issued. .
~ have and, will maintain worker's compen.sation insurance, a,:> required !),j 3e-clbn 3700 of
, e Labor CodeAor the performan'ce of th~ work for Wh,iCh this permit is j~u..'d. MY WOiker'S
Compensation insurance carrier and policy are: .
Carrier: STATE FUND . Policy Number. 1732801:0<1-
This section need not be compleled iftlie permit Is for one hundred dollarsIS10(~ or l!J5s.
o t certify that in the perfonnance of the work for which thj~ permit isiss.;jQ':i, I shall not
employ any person in'any manner so as to become subjectto the worker's ('{Inpensation '.aws
of California, and agree that.if I should become subject t the worker's c tp2!'"iSat;or.
provisions of Section 3700 of the-Labor Code, I sha with co t ,tr:~x>~ pruvisions.
B
Date: 2/8/2005 Applicant:
WARNING: FAILURE TO SECUR . COVERAGE!S
UNLAWFUl, AND SHALL SUBJ T AN EMPLOYER CRIM!NAL PENACTI",S ,\ND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTIOj'; ~706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .
l . CONSTRUCTIONLENOING AGENCY ::,_._,_
! hl',:reby -aff;;,"!i uru:~r pef'~It'J-of oer!iI~1 t~~ ~hp.l'"e -~ ~ C~!~!;t'":.:::t.:-!"! :f:.~":'-:~:--~-'~::; f~;:, .-&:~-
per:formance ofthe work for which this p~rrnit is issued (Sec.3097.Civ.C):
Lender's Information:
Conztrucion Types:
VN,,. , .
Fire Sprinklered?
Living Area:
NO
59
Date: 2/8/2005
Fees paid for Permit:
Total:
606.84
19n .of pplicant or Agent
Th permit shal pire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
" 'iNSP.ECTION RECORD . FINAL INSPECTIONS .' .Date Jns.
. "'-.---
INSPECTION . DATE INSPECTOR Electrical Final ". ~ .~IU 1
- . "
- . ti U~ r. "
Temporary POINerPole ./"li Plumbing Final .
Plumbing (Drain/Waste Pipe) . ,-J -(7-' '.". , Mechanical Final .. "fA. .
Electrical Ground ElectrodeiUfer " / . TV VF""
SelbaeklFormsfTren\:hes(Footings I . Gas Test '.
. 1-/7.<>, ..... . .
Do not install subfloor or pour floor 3J.'Jb tJnlil the .,.,/ ~. Engineering/Grading Final 7~i26 '.
following applicable items have been s' : Fire Dept: Final 765-4~40 : .
Plumbing (Water Pipe.Sprilllller Valves) J-/7-(> ~ ,
Mechanical (Groundwork)' . /;~ / Water Engineering 765.5268 .
I. Electrical (Underground Conduit) 7>-'''''''' ~: o/~ .'
Pre-sfab.(CompactionlMembrane.Reinf. "]-11-0 ;" Sub List/Business 'License 765;519 V ". ..
Underpinning (Floor-JoistlGirders) . Zoning 765.5139'. . ....
Do not cover or conceallhe wor!< below untlllhe . '. Building'Final *ast Inspection. Only . 4lzr~ <:r:..
following' applicable ilemshave been signed: . . . fter Above Complete)
1st Floor Shear , t( -!J.o r -:?/~ '..",- . . PARTIAL INSPECTIONS .
Firesprinkler (Rough) , t. Buildina Inspections
2nd Floor Shear .
Roof (Sheathing/Diaphragm/Frame) . .
Masonry (ReinfJBond BeamlPr t) .-,j' - .'
RoughPhlmbing (Top Out) loV....., '1-1.3 .0 .l~v_ .. .,
Rough Mechanical \ Y.n.o . . .
. . . .
i Rough f1eetr -.....11) . . . r. . . .
ROUllh Electrical . . '/-/3-0 . ,
Framing '(On~ after P'bg.. EleG.. MeGh.. and F;re) -J.l...r ~ .
Insulation (SoundJEnergy) t/hl.., 'f,;.. Mechanical Inspections .
Do not tape or plaster until the tol/owing applicable a. . ~
items have been signed: . . .' . '_. . . . .
Drywall '1-1-'1-. or ~~y~ . . .
. .
Penetrations'(Fim Rated) Electrical I .
Penetrations (Fire .Rated) Mechanical '. . .' . .
Penetrations (Fire Rated) Plumbi"9 .,
Interior Lath . . ~
Exterior Lath, '. 'f-l-J./ .L .lL PlumbinQ InS'ictions, . y _ DW\J~
. .'. GENERAL ITEMS '^ I . '3 -If.or. f/...", ,;.{, fQlf ."'.r'
Exterior Plaster (Brawn Coat) . -;--'90. ..-< "=t: I;" \. J ,
T -Bar Electrical . . I
'T -Bar Mechanical .'. . .
: .
T -Bar Structural . . . ,
Sewer . ..'. . .' . .
Water Engineering Backflow Electrical Inspections . ,
'aJf-J_~
Water Service . 4~( ~6- ?DC
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