3371 E. La Palma Ave. (2)
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BUILDING PERMIT NO. BLD2004-02479
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TYPE OF PERMIT.- ' ~~v I (f-
Tenant Improvement (Limited)
DATE: 7/14/2004
JOB ADDRESS: 3371 E LA PALM
lEGAL DESCRIPTION: KRA
R TRACT BlK K lOT 17 POR OF
APPLICANT: JOHN OME
OWNER INFORMATIO .
Rock.welllntemation orp
2201 Seal Beach Blv
Seal Beach, CA 9 40
JOB DESCRI
VAlUATIO :
CONTRACTOR INFORMATION:
KERRY CONTRACTORS:INC
5862 BOLSA AVE #1081
HUNTINGTON BEACH, Cpj 926490000
BUSINESS PHONE: 714891,.0554
IONg-snant Improvement Bldg 271. '
300,000.00
ElM
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BUILDiNG DIVISiON
200 S. ANAHEIM BLVD.
(714)765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 145
ARCHITECT/ENGiNEER INFORMATION:
JON ZIMMERMAN
18002 COWAN
IRVINE, CA 92614
PROCESSED BY: CAl
NUMBER
690876
TYPE
TYPE
OWNER-BUILDER DECLARATION
I hereby irm under penalty of perjury that' am exempt from the Contractor/s License Law for the following reason (Sec. 7031.5 Business and
Profes ns Code: any dty or county which requires a permit to construct, alt~r, improve, demolish or repair any structure, prior to its issuance, also
requir the applicant for such permit to file a signed statement that he islicd"used pursuant to the proVisions of the Contractor's License Law (Chapter
9){commencing with Section 7000 of Division 3 of the Business and Profess~)ns Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031,5 by any applicant for a permit suti(ects the applicant to a civU penalty of not more than five hundred dollars
($500). . . " .:(
o .',as owner of property, or my employees with wages as their solE~ Comf.~nsation, will do the work, and the structure is not intended or offered for
sale {Sec. 7044 Business and Professions Code: The Contractor's License!.!aw does not apply to an owner of property who puildsor improves
thereon, and who does such work himself or herself or through his or her owtl'~mployees,provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one ye;3~af completion, the owner-bu ilder will have the burden of proving that he.
did not buUd or improve for the purpose of sale). . f: ','.'.
o I, as the owner of the property, am exdusively contracting with licensed'.:::ontractors to construct the project (See. 7044 Business and Professions
Code: The Contractor's license Law does not apply to an owner of property'who builds or improves thereon, and who contracts for such projects with
tjontractor(s) licensed pursuant to the Contractor's License LaW).,;
I am exempt onder Sec. , B & P.C. for this reason: ---4'
Date: Owner: \:
I WORKER'S COMPENSATION DECLARATION!
, hereby affirm under penalty of perjury one of the following declarations: i -
o I have and will maintain a certificate of consent to self~insure for worke~'1 compensation,
as provided for by Section 3100 of the labor Code. for the performance ofth;e work for which
this permit is issued. (
o I have and will maintain worker's compensation insurance, as requiredlYj Section 3700 of
the Labor Code, for the performance of the work for which this permit is issubd. My worker's
Compensation insurance carner and po,licy are: ~
Carrier: STATE COMP INSUR Policy Nu mber. 0006962t2004
Thissootion need not be compJetedlfthe permit is for one hundred dollars ($10q or less.
o I certify thatin the performance of the work for which thi,s permit~_i~U~d,1 shan not
employ any person in any manner so as to become subject to the worker's,cpmpensation laws
of Califomia, and agr~e that if' should become subjeGt to the worker's compfmsation
provisions of Section 3700 of the labor Code, I shall forthwith comply with t~::>se provisions.
I
Date: 81512004 Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERI\GE IS'
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO 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. !
I CONSTRUCTION lENDING AGENCY i
I hereby affirm under penalty of perjury that there is a construction lencling',arencyfor the
'~~~~~~:~;~~~~~c~~';..~_~,.fO~~,~i,~ !.h~s_~_~~mit i~~~S~~d (Sec._~!.._~iv.C~:.,:.A ._ __
I certify that I 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 bu iJding construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspection purposes.
Date: 815/2004
Signature of Applicant or Agent
The permit shall expire 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.
UCENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 1000) of Oivsion 3 of the Business and
Professions Code.
8/5/2004
Date:
Contractor
EXPIRATiON DATE
6/30/2006
B
HiC
Construcion Types:
VN, .
Fire Sprinklered?
YES
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Toal:
3.976,41
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BUILDING PERMIT NO. BLD2004-04125
,-
eUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714} 765-4526.
CENSUS CODE: 437
QUARTER SECTION: '145
TYPE OF PERMIT
Tenant Improvement (Limited) C ITV
DATE:.12/23/2004
JOB ADDRESS: 3371 E LA PALMA AVE
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LEGAL DESCRIPTION: KRAEMER TRACT BLK K LOT 17 POR OF ;
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APPLICANT: jOSEPH GULLEY
OWNER INFORMATION: . CONTRACTOR INFORiv:J\T10N:
ROckwel.llntemational Corp BOB PARRETTCONSTll..GTiON INC
2201 Seal Beach Blvd. . '. 1230 W BARKLEY !IVE'
Seal Beach, CA 90740' . . ORANGE, CA 928680000.., .
. , , .'1_
JOB DESCRIPTION,!. Caddin9 new AlC unit & condensin9"ni! on roof. :1.
-. I
VALUATION: 70,000.00 . A . PROCESSED8Y: DUC
I . " ' " OWNER-BUILDE \JECLARATION .. ""'"'I
I hereby affirm underpeflalty of perjury that J am exempt from the,Cantract~ i~_ License Law for the: follOWing reason {Sec. 7031..5 Business and .
Professions Code: any city or ccuntywhich requires e permit to construct, el\&~;: improve, demOlishpr ~€:'p3ir,any structura, ,prior to its' issuance,alSa
r~q'uires th.e. 'a. PPlica. n.t for such .per.mit to file. a signed statement tt.:ath.e iSljc..~;..,".....,..e..d.P ."..rs"anpat,he, 'p .rqVl.~.ionsOft}le Gontracto,r's. Llcehse Law (ChaP.ter '
9)(carnmencing with Section 7000 of Di.vision 3 of the Busin'=,:>3 and, Profess' \l"3 Code) or that he is' exelJ1pttherefrom.Gind thebas!s,for theal!egt.>d
exemption. '~y violation of Section 7031.5. by any acpticarit for a permit ~tf:eGts the a {?pficant to a dvilpenaltyof not more ii1an five hund:-ed "ioliars
($500).. o. . ...,. . .
o I; a. s owner-?f property, or my employees w.. 'ith wa.ges as their SOli. (;c!"r...~t~:::sat;on. will ode- the. work., and the ~tr:.lctllre .i~ not in.telide~for offer~d for ,
safe. (Sec. 7044 Business and Professions Code: The Conti'actcr'!:iLicense ~3W obeS ntlt appJyto an owr.er of prop~:rty who builds or improves .
thereon, and who does such work himself orherselfor thr.ough,his 9rh(~i cw.. ampioyees, provided that 3uch imlJrOveme:-.tsare not intended or . -
offered for sale. If,however, the building or improvemep't;ssold with-one y~~t. of c:ompletion; the owner-builJer will have the bu;den of proving that he
did notbu!!d or improve for the pU/'P'ose a. fsale). :, . "~;:".,. . . . .' . ',' . _ ' '"
[] ,1-" as the owner of the property,' am exdusively' cont~~ctfng. w~t~,llc\Z'n$ed~.o:--'tra.~ars 19 ~onetr-u(.t the proje~t (Sac. 7044 BUsi~e.c:;s .and Prcfesslof1s .
.COd~:.The CantraGtor's Lice.nse-Law does not apply ~o 2n.o\-vri~rof ompelt~;:];:~0 t:..!j1ds or imprave~ thercoi1, ::lnd whooo~tr.acts forsllch P~(;jec~ witl, .
a_cc~tractor(s) licen$ed pursuant to the Contracton~ Ucei1SEo-L~_W/}, lC'
0, .!arn, exempt under Sec., - ' ,B&P.C,.fcrthis.rf:;;3Scn: .-- t----- -
Dote. Owner: '
r . WORKER'S COMPENSATION DECLARATl9.l'i-=.~ '=--- I I-
i nElreby affhm under penalty of perj~ry one cf the tollo'll\ing dcclaiatiol1s'
LJ I hS!ve and win maintain a certificate of consent tc self-insure for wnr~~"" ~0rr.ce!lSa~lon.
a,s ProV:d. e. d for by Sectlcn 3700 of the Labor Code, for the pertmmance of ~hr,\}:';rk f('rwhl.ch
this perrn!tisissued. " > . '1
~have and will maintain'worker's compensation insur~mce, a,s..requirea h:~iiSed!0!'13'joo of
'(f~e ~aborCod e, fo rthe performance of the work for wr_, ir-hth is permit ~~ issu~b: My wo rker's .
Com'pensationinsOrance carrier and policy are: . .. ,~;c ,
Carrier: AMERICAN GUARANTEE & L1AB. . Policy Number: WC437('..'l;j100
. .' ~
This section need not be completed if the pennit is f9r one hundred do.H~~($10G~~\ ~es~. .
o I certify thatin the perfa~ance of the Yiork for which ~hispermftis 'i&.1~1~f( s~a" not
_employ any person in any manner so.aslo become: subject to .the w9rke;'sc.Ahpensaticn laws_,
of Qalifomia, and agree that if l'should becomesubjed: to the worker's COmtx:.0s:::iion
, provisions of Section 3700 ofihe labor Code, I sna fort with comply with t~]se'p.ruvisions.
ARCHITECT/ENGINEER INFORMATION:
WAYNE TWEDELL .
11 G'OLDEN SHORE DR
LONG BEACH, CA 90802
LICENSED CONTRACTORSpECLARATION'=:J
, herety r.:ffinn under penalty of perjury tI1at I am .
licensed u!~der prov1s:ons of cnapter 9 (commencing
With Section 7(00) of Di~n 3 of the Blisiness and
ProfessioflSCode. .
B
Hie
EXPIRATIO '
'2128li005
Daie: 12/2312.004 Applicant:
WARNING: FAILURE TO SECUR
UNLAWFUL, AND SHALL SUBJE
FINES UP TO ONE HUNDRED. OUSAND DOLLARS ($100.000), IN ADD,'1!9N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION ',706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' .
. r CONSTRUCTION LENDING AGENCY __,_
I hereby affirm under penalty of perjury that ther~ is a construction l"3nding ag~:""\(;y for IIi'=!
pe'rtormance of the' Work for whidl this permit is issued (See. 3097;Civ .C): :' _.
. -t~!11;;ers-ioriv!iri:t7.i:,.~- ~'-;-O--_--O---"'---'-" -------- - ,- -----.~-._--------
Construcior. ,vpes:
VN., .
Occupanc\' Groups:
B,. . .
Fire Sprinklered?
YES
__~__t___
I
,." <-
I certify that I have read this application and state- thatthe above information is correct. I
agree to comply with alle;:;ity ordinances and state laws relating to building construction, and
. hereby authorize repreSenti s'of this city to enter upon the above mentioned property for
inspectio.n pur1-~s. .
Date:!2/23/2004
Fees. paid for Permit:
Total:
965:13
Si atu e of plican
The pet' . shall. expire by Iimitat 0 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. .
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Water Engineering 765.5268
Sub List/Business License 765-51911-U-a:[; (f"6/YUf.
..
Zoning 765-5139 . . . . .. ..
Building Final fLast Inspection. Only ? _,'/ J ~
After Above Complete) "- ~tl -v.;l r711.. .
PARTIAL INSPECTIONS ~-/,
_ f~:~~~f In~n: A~J L-/A
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~ 1~1J4.n., 'bkf:J;""'A~1. dJ_fiiA-T;J.
JjL.. .fl... . t 1Yl_ OA~ Ci '
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. ' , Electricallnsoections
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INSPECTION RECORD
. ,
INS,"ECTION,
DATE r, INSPECTOR
. ,. ,.'
Temporary Power Pole'
Plumbing (OrainlWaste Pipe) , '
Electrical Ground Electrode/Ufer
setb,aeklFormsmenches (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.Reint.
Underpinning (Floor Joist/Girders)
Do ,not cover or conceal the work below lintll the .
following applicable items have been signed:
1 sf Floor Shear " . " .
Firesprinkler (Rough) , ' , ' ,
2nd Floor S!1ear .
Roof (Sheathing/Diaphragm/Frame)' ,
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top~ utI ,
Rough Mechanical l> 1/"-" ) ,
Rough E1ectrll:a1IDry Wall) ,
Rough Electrical .
Framing '(Only after Plbg,. Elec" Mech, and Fire) t l_1.e.
Insulallon (SoundlEnergy) , , . t . ,
, Do not tape or plaster until the following applicable n' .
items have been signed: " . -, ,
Drywall . A
Penetrations (Fire Rated) Electrical " ..
Penetrallons (Fire Rated) Mechanical
Penetralions (Fire Rated) Plumbing
Interior Lath '
Exterior Lath
. , . , ' GENERAL ITEMS
Exterior Plaster (Brown Coal)
T .Bar Electrical
T.Bar Mechanical
% T.Bar Structural.,
Sewer
Water Engineering Backfiow
Water Service
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FINAL INSPECTIONS
Electrical Final
, Plumbing Final
Mechanical Final
Gas Test'
'Date
1/-llI.G,r;
In sf) ctor
- ;frh::;,
7
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/7 '//~.
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-/1I..iP6
Engineering/Grading Final 765-5126
Firll Dept. Finai 765-4040 , '
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, Mechanicallnsnections
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Plumbina Insoections
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