614 N. Lemon St.
~~~INGPERMIT NO.
BLD2004-03825
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CITY Qrlif~rll~HEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153
iNSJ:'ECTiON REQUESTLINE:
(714) 765 ~ 4626
CENSUS CODE: 434
QUARTER SECTION: 71
.
. TYPE OF PERMIT
Residenlial Addilion
DATE: 1/13/2005
JOB ADDRESS: 614 N LEMON ST
LEGAL DESCRIPTION:. ZEYN TR ANNEX BLK CLOT 13'
CONTRACTOR INFORM;:nON:
MACIAS CONSTRUCTIO;.I SO
355 N SHERIDAN #110
CORONA, CA 92880000,r;
BUSINESS PHONE: 7-14 ?7~18~1
.JOB DESCRiPTIONAdd 493sfto exist. SFD New kit.chen and ext. exist. beJ\:\~m
VALUATION: 30,000.00 ---11 PROCESSED BY: ENO
~ ..' OWNER-BUILOEF.:9ECLARATION'" . . .
\ h~rebyaf,irl'!i under penalty otperjU~ that 1 am exempt frorn the C('lntt~.o<2~~' Licens~ i..aw for the foilo\lving reBscn iSec. 7031.5 Busilie::>s ~11_d
Prnf~s;5ions Code: any dty or countywhi.::h requires, a pen'"lii! to c')i"1$tnIGt. ?!~'~r, ~mprove, dtlrnolish or re~'air any structure, prior to its is-'3u~r~ce,~iso
r~uires the apP'UG:1nt fo'r ::ouch permit to file.a ::;:~I~t?j statement that he is liCf:llSed pursuant to the provis.ions of tile ConliactC'r's License. Law (Chapter'
9}(c~mmencir:g with Sect;on 7000 cf D\\~sion .:; .::of t'le [~:i~inE:~3 and Prnfess~_:~sJ>xle). cr tnat he is eXOffiQj there~l'om ?!1dU~ebasi$for thezll.eged
exempti,on, ,Ar,y '1iol~tion of Section 70:31.5 by any arpifc,~t~t lor Fl perrr:lt .su;:t.';>c~s tr.e ;::pplicant to a dV:\-P!'Jt12:ty of r'lot mor'!"-than five hundred dcH51f'c
(5200); . . ". .' ,n '.,. " , .... .".' "
LI I, as oWn~r ofp~operty,or n,lY 3mp;oye€)s IN;th \dages. a::rtne;;o ;3,:J11'l comqt,',n:;;aticri'-W!i\ d.) tr.ework, c:nd the. 5~n..l(;tur6 i-::;not:r.tefldeci or.offe!ed for
sale (Sec.-:,044 8U51ness and ProfeSf;!ons Cod~: Th: Cun~rc1ctor's ':...i..::en.$e'~F\V :k;es not appiy-to an owner oj property who !:>uilds or improves
tr.er~on, and who dcessuch ~0rk hnnse!f or he~etf -:.rthrcugh his or he", (.vct: ~'mpfoy€'es, pri")\;jd_~-d that ~uch im;:novcm€'nts br~ not ir.t~nded or _ ~
(\ftered for sale :f, however, ~hc bui;d!ng or improvE;-,nent ~ ::;0!d ,~ith one Yc.~trC'f r:ompiet;'JIl. the own~r-tJ:.Jildi:"r "vii: h::'!.\Je.'~he bur.den of proving .th~t he:
didnotbuildorimprovefudhepurpl);;eof~3IR). ." _. f: " _ . '. ' .
o I, 38 the owr.~r, of thB prcpcrty. elm ~Xdu3i'-:'e!j' CGl1trE'cHr.g ',::U; lic,~mst'";d j ?i~tractQrs t:-;CO;lS!;uct the pro!E':~t (3,ac 7044 i3u~~ir.ess .;.:nd Pr0~ri.sSf(,(:.:;
Code: "ihe C9:ltmctor's. Ucer.se ~aw doe'3 not apply to'arl'qwl1c;f Of ~rorf:.."tY;.Hho builds or-improves theiccr., arlJj wt>.) ('(..!ltracts for such rrojectB witr,
i-1fonh~Ltor(~.} \:'~ensed ,pursuant to th~ G<..'ntrZldor'., !...icenis tU'lJ). '~I
.-J j <3nl~~;<empt under f.GC. ..~:..__ .6 & P.C. fo! th1s recbor:: __.3~__::..._u_~. _~ ;-:---.:..~_,_, .
t)8!e;~ . (Ni,ler:_. --,-_.~~________.____k~~:...~~__~-':'____...--;~_.__ '_~"':-'~.....:....~___
r-' . iJ,~ORKER~S'Ct5ii.PE;;;S~JiON Oi~LAR.i;}j()N . :r.'--..' _' I r LlCfJJ<:~D C()j:ir?W:T~r:CLA~:flOiL]
,I t:Qrd!.;y:::;ff:~in linder.p~natty of peijulY-C?~I_e of Hi;,: iolICW;,lg fjc;;;:afat[0r~~: ,'i._. . r . ..' I z.reby affirm d~lI.ier pencdty ct., iJerjt.;~ thatl ~rn.
[J ! h<J'.:'e, and wiil;',IOlir.tairt e certific3te of GOr:scnt tu self-insllre fiJr WQi~~:'!"-~)comp':}r:~<-'!tjnn" I .n~er1s~'d ~i,id!)i pr~"" ~f.c~~act~ _ _ rnendng
as prov:ded for by St;,c!:i011'3700ofthe Labor Code. for the performml(.o:"! of :J:<S wOlk fcnllilid-;",!.:.wlth S C,lon 70 {) of D1 . /oil' th:: 8u
this oerni!t is_ :ssued; .,.. , _ ' . Y . ..j' Pro'fes$ :S C. ~e,'~-,,-
.~ I have a~d wUJ fTl8in,tO, inW.Ork~,r'S 0crnpsr.~ation I,1GUrar,Cf), as fequire.j b~ ,secticr. 2,,~.fOO,d. 1/13/2005
/i.'he't'abor Cc.d~,'forlne perforrr.:l0ce qf the work f")~ whl:::~ this permit f:; i5~t!(J. M;/wor:_!<Gr's Date:
Gomponsation insurarlce c-..artier ~ndpcJl:cy are:r . I
CarriE'r:'- STATE FUND .... Pdit.y Numher:' /'c. . . "1
i t
This se:-ction need notl>€, completed jf the pelmit is for one. hundred doll~rs ($iC~':;:-".It.'5:~,' I
~. . ,certity th:"lt in the penollT!C:lnr.:e of the work for which this permit is iRSUG')..lnhaii nct - I
m loy_ arlY-person in any manner so ae t, come subJect to the work-ai's .cl!r.)r,~l1sation laws
or Ca omi8, 311d agree ~hat if J OL!ld eeon-,e subject t.:> the -""or'r..erri'~orr.p~_,.,::;~tion
provisions of Section 3700 ofth La. r Code, ! 51' ! f~nPIY with thf~e pro',-;slm"..
. D~te:, 1/13t200S . Applicant _ / ~ ...;...-_ -,_: ,. . I Fire Sprinklered?
WARNING:. FAILURE TO SEC~REV' , KER'S COMPENSATiONCO'oJER.'GE.lS ,Dweliino Units;
UNLAWFUL. AND SHALL SUB,dECT AN EMPLOYER TO CRtMINAL PENM.f1E5 ,AND CIVIL . .
FINES UPTO ONE HUNDRED THOUSAND QOLLARf, ($100,OOO),INAD0'nCN TO THE
COST OF COMPENSATION.! DAMAGES AS PROVIDED FOR IN SECTIO,j' 370.6, OF THE
L.\flGR CODE, INTEREST)\No ATTORN!;Y'S FEES. . "'., ~~. .
[' ..... ,-- CONSTRUCTIQN LE:NOI~jGAGENCY i -;-
.1 !i;:eh';""'"m ',r~p;;;h, O'.JBGwv 'bal (i:>ore '!WLCon""WEC!l 'c.-J;:;:::-':;:>:;:"v'" "",' '.
_c-;s:-f~r~-;r.h~ \.vo~~o"-;~~hiCh t~;s.-;~m~t.;,~:;;.~:;;d'f..~~}.; ~G9? :Ci;;Z},+- .=-~"'.-' - ~-'. <. ,- ...~~ - .-- -
Lenc!er'~ ir:formatbn.: -
APPLICANT: VINCENTE MAC IAS
. OWNER INFORMATION:
Gennro 9abrera
614 N Lemon St
Anaheim, CA 92805
ARCHITECT/ENGINEER INFORMATI.ON:
NAZEM SKAF
10441.HOLIO AVIO
RIVERSIDE, GA 92505
-.J.
B
E,o(PlRATION DATe
5/31/2QQ5
Construcicn Tynes:
V N, ,
NO
1.
'_~-.L'~_______'.'_~
Fees paid for Permit:
Total:
1.083.54
Dale: 1/13/2005
_ 19nature of. pplicant or Agent
permit shall expire by limitalionand become null and void if Ihe building or
w k has not passed fi nal inspection 365. days from the date of permil issuance. A
new permit is required to commence or continue work. .
INSPECTION RECORD
INSPECTION
INSPECTOR 1
I
,
.j
l
DATE
Temporary POWer,Pole
, Plumbing (D/3inlWaste Pipe) m~
Electrical GrQUnd ElectrodelUfer ,-'l<>~ 1'- I'J?<....
,
SelbacklForms/Trenches (Footings) ~'k?~fl. 'Tt 'f4\.7
Do not install sub floor or pour floor slab until the ,./
following applicable ilems have been signed: ' -..-
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (Underground Conduit)
Pre..slab (compactionlMembrane.Relnf. ' ' , "
Underpinning (Floor Joist/Girders) , ' ,
Do not cover or conceal the .work below until the j
following applicable items have bean signed: !
1 st Floor She,ar "
Firesprinkler (Roughl ' !
2nd Floor Shear l
Roof (Sheathlng/Diaphraam'Frame) " ~
. Masonry (RelnfJBond BeamlPre-GlOUt) 'j
Rough Plumbing, (Top Out) ", 1(0') ';,
Rough Mechanical ',' , ~ ..-~ ~' I
Rougn l:IectrlC II) , 1
Rough Electrli;al ',_ A ' j
Framing' (Only after Plbg" Elec" Mech" and'Ff,e) . _ 0-'; /"IP f r '::;IJIJ.,..)
Insulation (SoundlEnergy) , ''116 "...v, '~I
po not tape or pla~tilr until the following applicable ,'l.7 '
Items have been sIgned: '
Drywall., '" ..:r'/<i=-~"I.V;'~
Penetrations (Fire Rat~) Electrical " ,/1
Penetrations (Fire Rated) Mechanical
i>enetratlOns (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 Backflow '
Water Service
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,
" "
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FINAL INSPECTIONS' Date
Electrical Finat
Plumbing Final
Mechanical Final
Gas Test '
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business License 765..1;19
Zoning 765-5139'
Building Final (La,tln'pection. Dilly
, lifter Above Complete)
PARTIAL INSPECTIONS
BuildinQ Inspections
Mechsnicallnspections
Plumbina Inspections
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