1825-1829 W. Lincoln Ave.
TYPE OF PERMIT
Tenant Improvement (Limited)
DATE: 6/14/2004
JOB ADDRESS: 182$W LINCOLN AVE
CITY.
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BUILDING DIVISION
200 S. ANAHEIM.BLVD.
(714) 765,5153 .
INSPECTION REQUEST LINE:
(714) 765 -4626
CENSUS CODE: . 437
QUARTER SECTION: 46
BUILDING PERMIT NO. BLD2004-01367
LEGAL DESCRIPTION: SE:C 8 T 4 R 10 S 295 FT E 400 FT
APPLICANT: SANG. NGUYEN
OWNER INFORMATION: CONTRACTORINFORMtTION: .
Trust Zorayan GOLD EN lAND CONST~:U CTION
.314ViaLidoNord 11121 PALMWOODDR
Anaheim, CA 92801 GARD EN GROVE, CA 928.100000
.. BUSINESS PHONE: 714400.2816
JOB DESCRIPTION,enant Improvement, denial office I .
VALUATION: 38,000.00
I OWNER-BUIUJFR:DECLARA nON
I, hereby affH-~ under,penalty of perjury that-I am exempt from the Contractor? Lic.ense,t.aw for the follqwir~g -reason{Sec. 7031.5 Business ~nd .
Professions Code: any city or county which requires a permit to. 'construct, al!ar, improve, demo'lish pr repair any structure, prior to. its iSSUance, ,also
. requires the applicant for such permit to file a signed ~tate'ment that he is licr:,j,sed pursuant ,to the pl'pvisions of the Contractor's License Law (Chapter
9)(commencingwitt) Section 7000 of Division 3 of the Business and'Profes$~1ns Code) or that he is 'exempt therefrom and the basis for the alleged
exemption.. Any violatio'n of Section 70315 by any applic'antfor a'permit sl.!t~ects the applicant to a dvil penalty of not more than five hundred dollars
.($500). . ',. . .. .. .
.0 I, as owner of property, or my employees with wages as their sole comp~nsation, 'will do the work., and the struc:ure is not intended or pffered for
sale (Sec. 7044 Susines$ and Professions'Code: The Contractor's license :.:aw-doe!,>,nqt apply to an owner of property who builds or impr:)Ves
there,on, and who does suCh work himself or herself or through his or her 0wi, employees, provided that such improvements are not intended or .
offered for sale. -If, however, the building or improvement-is sold with one yc~r of completion, the owner-builder will have the burden of proving that he.
did notbu'ild or improve: for the purpose-of sale). .: ' <'. ' ' ' .
o _ I,as the owner-?fthe prop'erty', am_exdusively cont~cting with licensed ;:On tractors to construct the project (Sec~-7044 Business and Professions'
Code:_ Th.e Contractor~s License law does not apply to all owner of prope1t}'Who builas or improves thereon, and whq contracts for such ,projects,with
aJ(.on~ractor(s) licensed pursuan~ to t~e Contractor's license law). I::. .
LJ I am exempt under Sec., -,8'& P.C. for this reason:
Date: Owner: '.
I WORKER'S COMPENSATION DECLARATION .1
I ,h~reby affirm under penafty d 1J€~ury one of th~ following declarations: ' '} . .
:: 0 ,I have and will ma intain a certificate of conserit tc? self-insure for worker'j cof!ipsnsation,
. as provided for by Section 3700, of the labor Code, for the performance of (hi) work for which
this perm.it is issued. . . . . 1,
o I havea'nd win maintain worker's,~ompensation insurance, as required t..:) Section 3700 'of
the Labor Code, for the performance of the work for which this -permit is isSu,:d, -My worker's'
Comp.ensation insurance car.lier .and policy are: '. _ ,
Carrier: EXEMP 'Potic.y Number. NO EMP',_OYEJ:,S
-This sec . need not' be completed. i! the pennit is for one hundred d~lIars ($1 O? or.'ess.
certify that in the perforrnance'ofthe work for which this permit is:issi'!':"::r,.fshali-hot
employ. any person in any manner so as to' become subject to the worker's .-..;~pensationlaws
. of Califomia, and agree that if I should become subject. t~rthe,worker's cOr11~~ri'saHon
provisions of Section 3700 of the Labor Code, I, shall fort with'comply, with.;t;-'.""I .provisions.
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ODC
LICE;NSED CONTRACTORS .DECLARATION
, hereby affirm under penalty of perjury that I am
licensed.' under provisions of chapte.r 9 (comm~ncing
with s.ection 7. OOO) of DiVS.~. 3 ofthe.Business and. . .
: :/~:~sos~~n57:-- _.....~
Date: . Contractor
NUMBER
596833
TYPE
B
EXPIRATION DATE
6/30/2004
Date: 6/14/2004 Applicant:
WARNING: FAILURE TO SECURE WORKER'S CO PENSATlON COVEflAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
. FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADC'mON TOTH;;:
. COST OF .COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT/0I" 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ..
I CONSTRUCTION LENDING AGENCY , c'
I hereby affirm u-nder penalty ofperju,y th::lt there ~ a c;onstruct.Lonl~.Ddil1g_5~~encrf.Qt;1be_._.:
-~~orinance Of me worK. lor wnicn tr:l$ permit !S Issu-ea (~ec. 3OY7 .eiv.C):
lenders Information:, '
Construcion.Tvpes:
VN, , . - .
Occupancy Groups:
B, , , ,
Fire, Sprinklered7
NO
l-certify that I have re this-application and state that the above informatiOn is correct. I
agree to comply w' all city ordinances and state 'laws relating to building construCtion. and
~ereBy ..authO. ..r.iz epresentiV,h:. f this_ city to..enterupon. the above mentioned p.roperty for
Inspectlo pu ses. '. ... . -". .
.. .... .. .~. .. Dale: 6/14/2004
Signature of Appli,cant or .Agent '_ .'
The permitshallllxpire 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-
Fees paid for Permit:
Total:
983.88
INSPECTION RECORD
.. . . INSpECTION. . DATE . INSPECTOR.
. . .
T etrlporary Power Pole . ..... ..
. Plumbing (DrainlWaste. Pipe)
. Electrical GrOund Electrode/urer .. . . .,
,.
SetbacklForl1'l$lTrendles (Footings) . . .. . '. H
00 not. instal I Subfloor or pour flooq;lab until the
... following ~pplic~ble items have been signed'
Plumbing (Water Plpe.Sprinkler Valves) .' '. .
Mechanical (Grauildwork) :,. " .' ..
. Electrical(UndergroundConduit) . . ,
.
I're,slllb (ColnpactionlMemlJrane.Reinr'l '. .
Underpinning (RoorJOIstlGinlers) . .. H
.D<l not cover'oroonceal the Violl< below until the
'followlng. ~pplic~ble items h~ve been signed:. .
. 1.stFloorShear . . .'
FiresprinkJer (RQugh) . '. . . . , .
. 2nd Floor Shear' .... .
. .ROof (5heathiilafDillDhragnv'Fraine)
Masonry (RlliinfJBond BeanlPre-,GJout) . . . .
.... RoullhPlumbing (Top Out) . .
Rough Mec,hanical . .
... Rj)ugh BllCtric '~111 . . . " ' .
Rough Electrical. . . . / . '
Framing (9nty Ilfter Plbg.: Elec.: t,;lec.11 and Fire, ~"ov. .
InSlJlalion(~ndlEnergy)' . ~ ,.
Oo'not tape or.plaster until tne follOwing applicable ..'
items have been signed:' '. ,.' ... .~. .
Drywall '. . .'. , , .....' -1.0-1 -~ ./
.Pen!!tral;ons (Fire fUted) Electrical '.. ..
. Penetrations (Fhe Rated).Mechanic:al,
Penetrations (Fire, Rated) Plumbing . . ,
. .Interior-'Lath .. ,. ...
Exterior Lath, . . ..
. . .' " GENERAL ITEMS
ExIeriorPlaste, (Brown Coat), . ,
. T .Bar Electrical .. . . . .
'.. T .Bar Mechanical .'
T.Bar Structural ' . .
Sliwer
Watlir Engineering Backflow .
. Water Seriice '. .' . . I,
FINA~ INSPECTIONS '.
Electrical Final
Plumbing final.
II/Iechanical Final .
Gas Test
Engineering/Grading F.inaI76S-S126
Fire Dept. Fina1J654ci40
Water Engineerinl1 765.52li8 .
Sub List/Business License 765.519 .I
. Oaie
Inspector.
Zoning 765.5139
Building Final (Last Inspection. Only
. .... -After Above Complete)
" PARTIAL INSPECTIONS
BUildinq'lnspections
~....
l..---r r -:t
. Mectlanicallnspections
Plumbina Inspections
. ElectricallnsP8ctions
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'.'CEAtt'FICATEOF OCCUPANCY
. . ". . . .,
. "CitYPfAha~eim. ,..
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'. :Thisstruc;turehS$ beeninspectedpUrSlJantto
amended by The City bfAnaheim.' .. .....
. '.' . .... .... ". . . 4,
Any chaoge in the Charactero! occupanc'
. or groupqf oc.cupaoCies requires a new
:' .' .... ....... >-.
. DESCRIPTlONOi='OCCUPANCY:. 118
.' -. -, - ." " 'n '
lace the bijiidingina different division
.. O~CUPAN?Y CLflSSIFICATION:' B
NO. OF STORIES: 1
CON$TRLJCT'I~NTYPE: ..'V N '.' . h
.6UiLDINGOWN~R: "Trust Zorayan '. 'O(j '.
~UILDIN.G ADDR7S$: H325..W LINCOLN A . AI Di 0
. DATE OF. ISSUANCE: 4/8/2005. .'
- . " L.'_ .,.. ._" .
PROCESSED BY: '.Jose Jirnenez ' :
.' .
'. .
IT: '. BLD2004-01367 .
EA; t,746"
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OFF'JC:E COPY'
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