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1211 N. Las Brisas BUILDING PERMrrNO. . BLD2002c03829 TYPE OF PERMIT Tehant Improvement(Limited) DATE: 6!11/2004 JOB ADDRESS: 1211 N LAS BRISAS LEGAL DESCRIPTION: P EK 164 PG 1 PAR 6' f~;~}~~{( .., . ~,E,:;caq!~J.I EI M. ~..~~' "J';;;!" · .\~~;'r.T!~:} /' .O'c-, " . BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTIONREOUEST LINE: (714) 765 - 4626 CENSUS CODE: 437 . QUARTER SECTION: 132 APPLICANT: JAMES LEbNARD OWNER INFORMATION: James'K Leonard 1230 yaldaraiso Dr.' ..... . .' . Placentia, CA 92870.aOOa . '" ,.", ': .' . . JOBDESCRIPTION:Tenant tmproveli1ent.J~.emove interior non.bearing partior[s in manlifactoring eara only. Also t-:bar, ducts, terminate ~Iectrical iri walls' . VALUATiON: andf.!,~8a'Mnd ciarifier.Re-issued permit for 6 months ~Xp:r€S12111/2094. PROCESSED BY; CAL I . ........ . . OWNER.BUILDERPECLARATION.. , . '. . I hereby affirm under penalty of perjury that I am exempt from 'the Contractar\s, ~icense' Law for the following reason (See, 7031.5 Bus,iness and . ,Professions Code: an~city_qr county Which ,requires, a permit to r:o'ls:ruct; a~'f;, _iniprove. demolish orrej,air anystructu're. prior to its iss.uance,. also_ . requires, the appfl~nt .~orsuch_ p. ermit to, file a signed. statement tha. t he is liC~;~I~:d P'Jrsuan. t.tc, the provisions of the. ~ontractor's License Law <.C. hapter 9)(commencing with Section 7000 of Division 3 of the Business'aod ProfessJdr.s Cude) or that he is exempt therefrom ~nd the ba:>is for the ar!eg~d,' ~x~mptio:1, Any violation of Section'7031.S by any applicant for.a. permit SUDJ~cts ,the apppr.ant to a civil penalty of nc;Hmore thanf:ve h.undred dollars ($500)-.'< .'. . '.' ..' '1 . ' ,...., .'. .. ,< ,,'<< ~,as ow~r of property, or my,employe~ WIth wages ,as tt~eir -SoJe comr;?,it;.s<:ltjun,~wm do the work, and the'$tructUle is not btended or_offered-for" ,lal~ (Seco 7044 8usi~ess and Prafessi<?n'~ Code: _ The Contractor,'$ License ~J\.~' d00s !lot.apply to an .owner of pr<)perty wha bui!ds .or improve~ thereen, and who does such work himself or. hersoelf()f through his or her o"4,'~r(lplc'lee:':', provided that such iropruvemants ar~net intended .or : ~~.e~6~ ~~ra'~~.'im 1::~~:~~.~_:~.h~hepub.~~~i~9.oi~~~:ovem.e. nt is sold with 0 n..Y~ll..,....~f_:~rnp.!etion., the. ow. n. er-b'lil.de.( will have.. t~ ~rd..n of proving !hathe. D I, as-the owner of the property, am exd~$ivelyco.ntrading wit!". iicensea '~;ntraCto(s tCGonstru~t the project (See. 70.14 8l;~jn(;lSsahd Profss.<;io;:S Code:. The Centractor's License law does net apply to an owner of proper.:y~ .il'.) builds or'improves ther~en, ~nd whc rontrads for such projeds with ~. 0 .act6~(S)JiC. ensed PUr3ua.nfto.the~ntraCt.orls.L\a:ns~ :aw).: --... !~_ '. ' '_ " : '., ." , . , . I alJ1.:~XPJ11pt~lJder Sec.,. . ~ P.C. f~rtnls ~ClS .' .~.~\.~..._o, '. " , '....'. _ .', Oate:k1C:!?'L Owner: ,. , "_... . .."., .-'.' CITY CONTRACTOR INFORM,(I'nON; I . WORKER'S COMPENSATION DECLARATION '. ,~ rhereby'affirm under pen'a)tyof perjurY one.ofthe follOWing dec!al;ltiolls~ ~r o ,'I_'have 'i::!ir1d,Will maintain 'a cert'ificat~ <?f consent toself-in~ure for worker'J,'::o:'lJPensation. a~,provided for by~ction _3700 .of th~'Lab6r QOde. for the,pyriQrmancecfth{:~'/G:r'I'".'!Or~nich thisperm;t is issued. .' . . , . . _(} . '.' . o I have a nd will maintain worker's compens~tion .insurance. as requ'ired nf\SectkHl 3700,of the lab .or Code, for the perforriiance.o~ the- Work for which this permit :s h:::;.~;(,~.. MY'J;0rker's CompeAsation insurance car~~r and policy are: ' Carrier: . . - Policy Number:, ,. ;' , " ,,', . '" -"-,' '-"';,'.--: ': This section ne~ not be completed iftheperplit 1.$ fur one hundr!KI dollars ($'I.~~' '21" :f$s: o 'certify that.in tne.Perf~rrnaj,ceofthe'werk forwhich this permi~ ~isS'ue:f,I's.~ail r~bt employ any person in any manner so as to become subject to the worker's cC-;:tpensation laws "of California; an~ agree that if1 shQuld become subject.te tt)e workels.compcinS<=ltipn -J provisions of Sectien 37,00 ofthe Labor Co ..1 shall forthwith QomP.ly:with thr.:;;~ provi~ions. ~. .. D~te: 6111/2004 AppliCant WARNING; FAILURE TO SECUREW R R'S COMPENSATION COVERAGE IS .. UNLAWFUL, AND SHALL SUBJECT AN EMPLOYIOR TO CRIMINAt;;PENAl'<"IES AND CIVIL FINES UPTO ONE HuNDRED lHOUSANDDOLLARS ($100,OOO),jN ADDl-10N TO THE COST OF COMPENSATION, DAMAGES AS PHOVIDED FOR INSECTIONl;'36 bF THE"" .' LA60RGODE;INTERESTANDATTORNEY'S.FEES. "<"< " ~.. .... . r '.' '. ..' '..,. . CONSTRUCTION LENDING .AGENCY';J..~> . ", '.. . . ' I her~by affirm under ~erialty of perjury th,at fr.ere is a constructioflJ.?ll{'!!~;g ~gE:.:-:}t :~( t~,~.. __I..' pa,formanCd 01 ille iivorK ior,wtlict1 thIS permi;: isisSlJsd {Sec.3097.Ci'l,G}: - Leric!_er'~ Informatien: '. ' . , " . J certify that I have read this application and state th_at the, above information ir,. correct. t agree to cbrf!plY with all.city ordinances arid state 'c:lws:telating to buildin'g con:.;truction. and hereby author~~represe~t~es of this City to enter. upon the a-bove mentioned property fer' . .in~p ionpurposey..l . . l." ~.~.!..-~ Date: 6/1112004 .. ,.. ,Signature .of Applicant or Agent The permit shall,expire by limitation a.nd become hull and void if the nuilding or work has not passed final inspection $5 days from the date of permit issuance. A new permit is required to Commence or continue work. ARCHITECT/ENGINEER INFORMATION: I LICENSED CONTRACTORS DECLARATION I I hereby <;lffirm updc-r penalty of perjlJrytli3t I.am'. licensed under provtsiOli$ of chapter.g (comrTlencing' with Section 7000) of Divston3 of the Business' and Professions Code. . 6/11/2004 < 'Date" C"C:nuactor EXPIRATlo'N D",TE ~UMBER TYPE Construcion Types: , VN" . Fire Sprinkie.red? -NO . -,-".. ~ .. J'-~:'r,'.. Fees paid for Permit: Total; , 524.42 INSPECTION RECORD . . . '. . . , . INSPECTION.: .' . . . PATE .INSPECTO/l Tempo",ry Power POle . . . . I" . . Plumbing (DrainlWaste Pipe) . El8ctl'icalGrciund ElectrodelUfer . . ..... .' Setback/F~lTrenChes (Footings) .' '. . DO nQtil1Stal/$ubfklor orpoor floor Slab IInW the . '. following applicable items' have been signed' . .... .'. Plunibing (Water Pipe.Sprinkler Valves) .' .' r.techartical (GrQu~k) . . ...... . . !:lectrical (Undergr.ound Conduit) '. - I t'~-sIaD ,Compaction/Membrane.Reinf. . . . . .' .Underpinning (l'IoorJoistlGirders) . . I.I.lO npt cover or conceal the wor1<.belowunt.l.the 'folloll'iing applicable items have been signed' .' . . 1 stFloor She"r .' .. . . Firesprinkler. (Rough) . . 2nd FIQor Shear' ..' . . . '. .' RDofISheathing/DlaphragmlFrame) . . Masonry (ReinfJBond BeamlPre-GlllIlt) .' RoughPlumbing (Top Out) . '. . Rovgh Mechanlc.al . . ..' I ROugh electrical II) .' , Rough Electrical .' . .' .' . . . Framing. '(Only afterPlbg~_Ejec,. Mech,".and Fire) . > '. In$lllation(Sound/Energy) . po not tape or plaster until. the following applicable, .' .' I_tem~ have b~r:1 ;SIgned: . . . . - - - '.', . .' . DrYWall ..' . . ." Pen_alions (Fire Rated) Electrical . f>enelral:iol!S (Fire Rated) Mechanieal. . . . Pen_aliOns (Fire Raled) Plumbing '. '. . .'. Interior Lath . . .... Exterior Lath .' .' '. . .' GENERAL ITEMS . Exterior Plaster (Brown Coat) . T-Bar,Electrical" . '. . .... . T -Bar Mechanical .'. . T -Bar Structural. ' . . Sewer . . '. Wate,. Engineering Ba.cktlow . Water ServIce ..' . .' .' FINAL INSPECTIONS' Electrical Final plumbing .Final Mechanical Final Gas Test E;,gineeriligfGrading Fjnal' 765-6126' 'Fire Dept. Final 765-4040 Wate,. Engineerin!!- 7~5-5268 Sub 'ListJBI!Sines~License 765-5.19 Zoning 765-5.139 Building Fin~1 CLasllnspection- Only' , - . After AboY,eCo"lplete) . . .,PARTIAL I~SPECTJONS ' " BuildinolnsDections Date Inspector '~: :..":' . '" . Mechanicallnspections . " PlumbinQ Inspections, ." " Electrical Inspections