704 S. Lemon St.
TYPE OF PERMIT
Residential Remodel
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CITY. ;;.'''~ '~~j~~HEIM'
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPEOCTiON REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 84
BUILDING PERMIT NO, BLD2003-04374
DATE: 312812005
JOB ADDRESS: 704 $ LEMON ST
LEGAL DESCRIPTION: .STUECKLESUB. LOT 17
APPLICANT: ELVIRA BERMUDEZ
OWNER INFORMArION: CONTRACTOR INFORMATION: ARCHITEOCT/ENGINEER INFORMATION:'
ELVIRA BERMuDEZ JIIN TARN L1U
704 S Lemon St. .. 1720 E. GARRY AVE..
ANAHEIM,CA 928050000.. .' . "\ SANTAANA,CA9270S0000 .
JOB DESCRIPTION New foundation, change flat roof to S:12 pitch roof, total in',,"or remodel, add 206sf bedrool)l an&new 9.arage wlo
VALUATION: . (Rel&l,~930J>&-03380). Renew permit for six months to e~Pi'e 912810S PROCESSED sY:'HKl
I . QWNER-BUILDERDECLARATION
I hereby affirm undElr penaltyof perjury that I am exempt from-the Contractor'tUcense Law "for the following reason (Sec. 7031.5 Business and
Professions Code:-any dty or county whIch requires a permit to construct, alh~:'. improve, demolish or repair any'structure, prior to its Issuance. also
requires th~ applicariHor such permit to tile a signed statement that he is Iic€;:.sed pursuant to the provisions of the Contractor'S; License Law (Chapter
9)(comm,'9!1cing with Section 7000 of Division "a ot the Business and Professrc-r:~ Code) orthat he is exempt therefrom and.the basis for the alleged
exemption." Any vio'lation of Se:::tion 7031,5 by any applicant for a permit SLJbib-~ts the applicant to a evil penalty of not more than'five hundred dollars
~. .' .' ~ . .
I;. as owner of pr~perty'j'or ,my employees with wages as their' sola compinsation, will do the worK; and the structure \s not intended or offered for
ale. . c:, 7044 Busines.s aod p'rofessions Code: The Contracto(s Ljc~nse U;w doe.s not apply to an owner of property who builds or ;mproves .
t reon,'and who does'.~udi work himself or herselfor throughnis, or,l1er own'::"mployees, provided that such improvements are noUntended or .
offered tarsale. 'If, however, the. building or improvement is sold with one ye;:.~of completion, the owner-builder will have the burden of proving that. he
did not.buildor improve for the purpose of sale). ' "... [. .' .
D I,.as the owne'r' of the property, am exdusivelY--contracting with licensed i!)!1tractors to construct the project(Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property';Ji:C builds or improves (hereon, and who contracts for sudl projects with
'~ontractor(s) licens'ed pursuant to the Cohtractoes License Law). . ! . " " : .
U. I am exempt under Sec. .' ~, P.C. for this reason: 1 __ . ". "
Date: O..vn . ......
WORKER'S CO PE TION DECLARATION
I hereby affirm, under penalty of .perj!Jry one of the following declaration's:" ".
o I, 'havs" and will Ii'lairita!n a certificate of cOnsent to self-jnsureforworker'~,,"cori1pel1sation,
as provided fqrby Section 3700 of the Labor Code, for the performanoo of th<fYl/ork for whim
this permit is issued. : ' "'\:'.
[] I "have and ~ill maint<;lin Vforker's. comp~nsation insurance, as reqUi'red,b~ S~ction 370Q of
the Labor Code, for the perforrnanc.e of the work forwl:1ich this permit is issuE;~l Myworker's
Compensation insurance carrier and policy are: - :
C~rr:ier: Polic.y Number:
. LICENSED CONTRACTORS DECLARATION
I.hereby affirm under penalty of perjury that lam
.licensed.llJider provisions of chapter 9 (commencing
with Section 7.000) of Divsion 3"ofthe Business and
Professions ~ode.
312812005
Date:
Contractor
NUMBER
EXPIRATION DATE
''--:' "'"",, ',,' " ;',
This section need not be completed if the pennit is for ohe hundred dollDrs ($1 CO! pr less."
~Certify that in the performance of lhe work for which this.permit is,is$uec. I shall not .
"m any -person in any manner so as to become subject to the worker's.compensation laws
-California,. and agree that if I shoUld become subject to theworker's comp'~..satio!1
provisions of Section 3700 otthe La bot Code,' I shall forthwith comply with tncs~ provisions.
TYPE
Date: 31281200S P lcant:
WARN ING: FAILURE TO SEe E
. UNLAWFUL, AND SHALL 5 JECT AN OYER TO CRIMINAL PENAL-rIES AND CIVIL
FINES UPTO ONE HUN ED THOUSAND DOLLARS ($100,OOO);IN ADl'1!I0N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlo.'1 ;;706. OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
i CONSTRUCTION LENDING AGENCY
I hereby affir~ l!nderpei'lalty of perjurl ~hat there is a construction lending :3Qe:1cytor the
. performanc."" of the work fer which this permit is issued (Se~.3097 .Civ:C): ~ .:;,.
L-ende;(air,f0ir"a:-ioii: -'~.."-----'- .
Construcion Types:
VN, "
Fire Sprioklered?
UvinQ Area:
NO
'206
I certify that I.have read this application and stat-ethet the above'information is correct. I
agree to comply with all city ordinances and state laws relating to bu ilding conMruction, and
hereby authorize representives of this city to enter upon the above mentioned, property for
.~ 'os ction purpose
Date: 312812005
Fees paid for Permit:
Total:
3,354.09
ture of Applicaht or Agent
The perml I 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. .
.'
Building Final (Last Inspection- Only
Alter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections.
INSPECTION RECORD
INSPECTION .' DATE INSPECTOR
Temporary Power Pole .' . ,.. . '
Plumbing (Drain/Waste Pipe) . Z- '\j: ".L .,4h7f7:T;7.
Electrical Ground Electrode/uter <1_ .f-. ~
SelbaeklFormsrrrE'nches (Footings)"'~ .J 'HI ...- .
Do nQt install subfloor or pourfloor slab until he '
following applicable items have b.een signed:
Plumbing (Water Pipl1.Sprinkler ValVes) r-ilf.jJl,{
Mechanical (Groundwork) . . f
Electrical (Underground Conduit) _ U
. Pre-slab(CompactionlMembrane.Reinf.; Z,7.L...o<., .4 J<1Jhs:1.
Underpinning (Floor Joist/Girders) . .' . /"
Do not cover or conceal the work below until the .
following applicable' items have been 'signed: .
1st Floor Shear .'
Firespri nlder (Roug h)
2nd Floor Shear '.
Roof(She..hlng/D1aphragmlFramel .
Masonry (ReinfJBond Beam/Pre-Grout) I.
Rough Plumbing (TopOut) . r _tJ4- -I.;{<'6 evt<
Rough Mechanical . '. . . '1_ /llJ...
i ROugh E1ectncallDI'Y wall) _ _~I/ ~:t.L.
Rough Electrical . . , f' "
'. Framing (Only after ?Ibg.. Elec.. Mech..andF;re) ~_ M k./ h". fp~,
Insul..ion(Sound'Energy) . Ii ,,'I" q' .
Do not tape or plaster until the following pplicable, V'
. items have been signed: ". '.: ' . ./
Drywall . . < ? .d. /rJo..
Penetr"ions (Fire.Rated) Electrical .' I
Penetr;llions .(Fire R"ed) Mechanical.
Penetr..ions{Fire R"ed) Plumbing .
Interior Lath . . . . I .~
exterior Lath . -:S-~I "
'GENERAL ITEMS. ..'
Exterior Plaster (Brown Co;Il)
.T -Bar Electrical
T-Bar Mechanical
T-BarStructural
Sewer
Water Engineering Backflow
Water Service .
.
.....
.'
. .
FINALlN$PECTIONS
Electrical Final.
Plumbing Final ·
Mechanical Final
Gas Test
ErigineeringlGrading Final 765-5126
Fire Dep!. Final 765,4040
Water Engilleering 765.5268..
.Sub List/Business License 765-519
Zoning 765-5139
Date
Insp'ector
I
Mechanical Inspections
'/
.'
Plumbina fnspections'
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ElectrlcallnsDections
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PLANNING DEPARTMENT
APPROVED
DATE 'l:.Ll'1/e:f'1_
f'.rf~G ACTION
BY \j:{l1,1 (... !
FLOOD ZONE X okW~__
HIS \~h,wt'R~~:'iLi:
N/ A See stam thi::- . .\ e
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lrcle one on above lill!;
SEE IlDING PERMIT ::OR
ANY CONDITIONS
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