857 N. Lemon
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BUjlD~NG P~KMIT NO. 'BlD2003-(~2ga3
TYPE OFF'ERMIT
Mi~cellaneous
. .. . ('~it,~~'>~?~.:
CITYQ~,)~.NiAHEIM
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BUILDING DIVISION
20C' S. 4NAHEiM fJ'_VD.
(7H} 755- 5152
INSPECTION.REQUEST UI'iE:
(714) 765 - 4626
DATE: 7130/200.3
JOB ADDRESS: 857 N. LEMONST
LEGAL DESCRIPTION: N TR 249 LOT 2
CENSUS CODE: 434
QUARTER SECTION: 71
E"xp 1~3o-o,-!
. APPLICANT: ANGELA CORTEZ
OWNER INFORMATION:
Leslie Stiles
857 N Lemon St
Anaheiin, CA 92805
JOB DESCRIPTION:Remove wood siding and sluccohollse.
VALUATiON: 1,100.00j PROCESSfD BY:ODC.
I oWNER-ilulLos1'li~.:\TlQN_ ___J
J hereby affirm under penaltyof perjury that I am exempt Trom th~,C()ntr;:)ctQ;;~.:.L;censeCaw forthc following reason, (See 7C:,,:I,1.5 B~s;ness and ,
Professions Code: any dty or county which requffes a f,Jerm:t to co;~:;trud. a;leK,jmprpV~,:'demo;ish or repair any ~tructule. prior to it'S issua~ce, ai130
reqlJ iras the applicant fOT such permit-to file t:l signed stmemG-nt th3t h,?;s licJirStxi,pt'lr!:il!<:mt ,;:o.the pr'Wisiolis ,of U",e Contractor's lj"ens~ Law (Chapter
9)(commencing with Section 7000 of Di'Jisicn3 of tlie Business ar;ci Profess:Q::'!s C()cie.J or that he if) exempUherefrom and tfle basis fer the al!eged
exemption. W violation of Section 703,"1.5 by 8PY appiic2r!t for a permit 8i1GA~C':3 the <:AppHC:;i!it to a dvi; pel'l::o'tyof r,lot mNp than five hUndn~d'dollars
50~>' a'S. (J'N'n~r of property, or my employees with wages 2S !he}, sole .ccrn~t~sati,~jn,-""iH do the work, and HOOle ~tructtJr~ 'is r.Qt intended or. offered fO;'
salA {Sec'. ;-044 Cusiness_and Professione Cr,de: The GOiltra:::fur's L:cens6 !..;il.W d~€l_F.i (\018p).:,ly'i.0 an OWl"'er of pro'\-}ert"1,who !Ju\i!js ')l"']lflprQVeS
~herecn. and who doe;:> sudl work hfmself or her.:>H!f or through his or hs:: oWli emplnyee3, orovided ti'\at such jmp:TJ'''E'rr.&ni~ are not intE'!n.:'ed:,r
c~,ered fo~ ezlr:>,. If, however, the building Crin\?roven<;ei\t is sokl wit:-l onE: Y:~r of cornpidiofl, ~hc oWnf:r-builrler will heve ~he .burd~n'of pr;w;ng thai: h,) .
chrlnot bUIld or I~prove for the purpose of saleJ.' r ..
o _ t, 'as_the bwr,~r 0f ~lie property, am exclt.:slV~J)r .;or:tr~ctjny ......!th lir:ens~(: r.m tra~~; cors to co;'\::;!r:r:::t the r.>roject (Sec. 7044 Business and Profe'ssicilS
. . COde: T~e C~:mt,~,ctor's U.'?8nse L~w doe::; not app fy to <:;nowner.Of p."~~;J.e~ ,.".,."C' :",;io" pc i"'>.;o~ ..tllere' ,aodwno co:riracts for such Pf01ec.w w rtr.
~' ontractoris) ilcense<.: pursuant tc the '-:ontractor's LiC€nee :..aw).. : '/ ,
'. I 1']Jf~~~ersec. . ,8&P.G'fO~.""""1' _ /" ,~-'_~ __ . v_._._
D ~ 0 ner'.' - . " . ~ -, . ", .
. 3.,,,- - , WORK~R'S COM~NSA:;:;ON Dl:C.0R"3if~N . ~!L . - 'cJ - (BCENSED C!.ON!R:AfTOR~tARATio~Cl
! nemby affirm under p(lnalty of perjury one- cf !.he. fGilo~tr.g rj,'!c!o.r?>ticr,s: )' '. !. I h;;;rebY'2ff:rm 'J:'1{jer. Pt:Nl_!ty of perjury 'tha'tl/'fn
o I h:Jye and wW maintain a certIficate of consent to .::;~If-i,,3uie for W0/ke"~{c::)f"r;per:;:;a~!:irr, I ::cer:sed ur~dar !)((!VislOn: of chaptGr 9 (ccrmTi.>C:;;'1cin'g
a3.pfo:"iCt-}I;i for bV Sadiorl 3700 of the Labor CoJe. for the ~~.r;crll1anre of f.t"'4~''-/:JrK for wnrc.h I ......!th Section 7GOO) of Di~ion 7) (lrthe Busin~5 a0~'
this pc:rnlt is issued,. t .,' Professions Cude.
O' I have ar,d ~.rJIl maintain worker's cornpensatrOfI ;rlsurc::nce, <:lS i'eCiIo;red b.J:S€l~t~''''113700 Of I 7/30/2003
tho? Label Code. for the performance of t~ WQfI( for whICh thIs ;>6~rillt i~ iSSU'~[~. My,.yofy,er"S: Date:
Compensat!o(l 'nsur3nce carner and polic.y are: . . J
Carrie!" Policy Numc.e.. I I NuMBER
, ,
This section need not be completed if the permit!s: iOf OM hundred ac.!t<::.ro;. {$1:\C;' (;'! !$S, TYPE
o I certify that in the performance of the ....Jork.fo~ which th!s P6rit~.t is is.s~~'.Ji-_f#-~~H:;f~Gf, ,.
emp~y any perscnin any manner so as to become $ubject to the y~ory.cr's ct:lh~.~,~tt~~ti61\ laws '
of California. and.agree that jf I-should bt::come ubject rotheworke.('s com~:r(S3.{rO;":;,"1",..
" . . . . :'~". . . :".~" ,I'."::,:,......~._~.:,-'" '.'" '.: '
provisions of Section 3700 of the Labor. o~ to .11; it ...omR~ wiH....:l?;~;~?~?:~~?lls.. .- Construcion TYP8S:
. , .\,'_K~~)~,:\;y~t;'.:,~ Y_ _N, ,
Date: -7/30/2003' Applicant .}-"<:'2-:'>';fX" ptn~ SprinkJeie-d?
WARNING: FAilURE TO SECURE WORK 'S CO PENSATION CO E ,'G~ IS'" ,
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAc1 :ES ANLJ CIVIL I
FINES UPTO ONE HUNDRED TIiOUSAND DOLLARS ($100,OOO):IN AGDI,,10N .1'0 rH~'
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR ,,,(SECTiON 1~7G6 GI. THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. " I i,:..
C CONSTRUCTION LENDING AGENCY ~.; ~ : ~. -
I hereby affirm under penaity of perjury that th~r'e is a constru..:.tiol"\ !e..d!f;g <:;:..l,;:r:~YLor:-::~~ I
per.f?r~ln~ 0~:h~ work tor whidl this permit IS issue:d (Sec.3097 .C;v C): / ~ i: < Ji' I
Lel,C~,s.,n.{"~.tc;'\. __" ...:,-< '--4- '1_.. ~. '''_''-_'.''
CONTRACTOR INFORM',T!Oi'"
ARCHITECT/ENGINEE'R INFORMATION:
!
Co;"\tracto(
cXPIR..;tlON DATE
NO
I certify that I have read this application and state that the above information i~. correct. I
agree to, oomply with all city ordinances and-state' laws' relating to building construction, and
hereby a thorize represeptives of this ci to enter upon the above mentioned property for
inspedi n pur
\
Fees paid for Permit:
Total:
57,34
Dat,,: 7/30/2003
Slg ure of Applicant or Agent
T permit shall expire by limitation and b null and void if the. building or
wor.k has not passed final inspection '365 days from the date of permit issuance, A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION. ; '. DATE INSPECTOR
,
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Eledrical Ground Electrode/uter .
. SetbacJtlFormslTrenchils (Footings)
Do not installsubfloor or pour floor slab until the
following applicable items have bMn signed:
Plumbing (Water Pipe.Sprinkler Valves) I
Mechanical (Groundwork) . .
'. Eledrical (Ul)dElrground Conduit) . . .
Pre-slab (t;ompactIonlMembrane.Relnt. .' .
Underpinning (Floor JOiSt/Girders)
Donot cover or conceal the workbelowunt!l the .
following applicable .items have been signed:
1 sl Floor Shear
Firesprinkler (Rough) ,
'. 2nd Floor Shear
Roof (Sheathlna/DiaohragrnlFrame\ . .
Masonry (RelnfJBond Bean1/Pre-Grout) . .
Rough Plumbing (Top Out) .
Rough Mechanical, .
I KOugh l:leotric 'wah, . ,
Rough Eledrical. .
Framing '. (Only after Plbg,. Elec;. Mech.. and Fire) . .
Insulation (SoundlEnergy) .
Do not tape or plaster until the following applicable
items have been signed: . '. .' .
Drywall.' , . '.
.Penetrations (Fire, Rated) Electrical, . . .
: Penetrar:ions (Fire Rated) Mechanical. . .
PeJ'!etratioriS (Fire Rated) PluMbing
Interior Lath . . ~.A
.Exterlor Lath . fC/ll>''3
GENERAL ITEMS /) /1
Exterior Plaster (BlOWn Coat) rr..p,~ 1~71
T -Bar Electrical . . , I~
T-Bar Mechanical . . .
T -Bar Structural . . . I
Sewer . '. . .
Water Engineering Backflow
Waler Service , .
FINAL INSPECTIONS: Date ' Inspector'
Electrical Final , ". '.
Plumbing Final . '.' ,
Mechanical Final . .
. I
Gas Test .
. .
Engineering/Grading Final 765-5126 .
Fire Dept. Final 765-4040 .
Water Engineering 765.5268' . .' .
Sub List/Buslness'Llcense 765-519 . . .
Zoning .765-5139 .
Building Final .~ast inspection. Only
. ". Iter Above Completel '.
. PARTIAL INSPECTIONS,
Buildina Insoections
, '.
Mechanicallnsoections'
Plumbina Insoections
Electricallnsoections .
PERMIT EXPIRED
INSPECTION
NOT COMPLETEfY
.' DAT ~:J\- \ 1-0 ~