2265 W. Lincoln Ave.
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aiJ:WiiliG PERMIT N . 'ElLD2004-01200 ' " '
-".,.,
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aU1LPU\;S DIVISION
200 S, ANAHEIM BLVD,
'(714) 765 - 5153
INSPECTION REQUEST LINE: "
(714)765-4626
CENSUS CODE: , 437
QUARTER SECTION: ,32 '
TYPE OF PERMIT
Light! Flag P91e
DATE: 411412Q04
JOB.ADDRESS: 2265W LINCOLN AVE,
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CITY ~J'~~;~~HEIM
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LEGAL DESCRIPJrON: 'SEC? T 4 R10 POR SE114
APPLICANT: DANNY SZETO'
OWNER INFORMATION: CONTRACTOR INFORMA:'ION:
'Hani E Haj' J P CONSTRUCTION CO
2265 W lincOln Ave 2714 STINGLE AVE
Anaheim. CA 92801 ROSEMEAD. CA 91770000)'
, ' .' BUSINESS PHONE: 626572.9181 .
JOB DESCRIPTION Footings for (3) light poles. 24' high maxi",um. per engineeling and zoning approvals.
VALUATION: 6.000.00 PROCESSED BY: PMK "
L OWNER-BUILDER [JECLARATION,
I hereby affirm under penalty of perjury'that I am exempt from the Gontractor's,Ucense law for the following reason (Sec~ 7031.5- Business and .
P.rofes~ons 'Code:anydty or countyw.hictJrequires ~ permit to co~~truct, altt~}: imp'rov~, demolish or repair any structure,p'rior to its ~s:suance, also
r~ulres the applicant for such permit to fil~ a signed statement tha~,he is licenped pursuant t<? 'the p'~vi'sions of the Contractor's 'Ucen~~-Law (Chapter
9)(commencingwith Section 700Qof Division 3 of the Businessandpr()fessiop,s Cod~J or that he is exempt therefromand-the basis for the alleged
exemption:.Any xiolatkm of Section 7031.5 by any applicant for a p'€rmit subjects the applicant to a civil penalty of not more than five hundred'dollars
~~, '. .'", "
o I,.as 'owner"ofproperty~ or my employees with. wages astheir ,sqle compe:1Sation, wilt do the work, and the structure is not intended 9r offei"edfor .
sale (Sec. 7044 Business and P'rofessions Code:' ,The Contractor's license l&.wdoes not applyt6 an owner of property who builds or improves' .
thereon, and who does sudl work himself orherself or through his or,her O'lh' .mplcy~es, providect that such improve,ments are not intended or
offeredfor.sate.-' If, however, the building or improvement iS'sold with QI1E! ,/ea,~' f completion, the owner~buUder will have the burden of proving tha't he'
did' not build or improve for the purpose of sale). ' i' . , .'
D I;, Cjs 'the owner of t.he property" -am ~Xdusively contracting with Ii ~ns ~Sn ractors to construct the proje~t (See. 1044 'Business and.Prof~sSi6ns'
Code: The Contractor's License Law does flat apply to an owner of ope "tno uilds or impr9ves thereon, and who contracts for such projects with'.
~ontract.br(s) Hcense~ pur.suant to the ~ontractor's License LaW)., ' ~ '
U'lamexemptunderSec... . _ ,B&P.C.forthis,feasoh: \
Date:' Owner:'
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of ihe foJJowing declarations;
o I h:ave and will inaintain a certificate of co'nsentto self~inS:Lire 'for worker's;compensati'on,
'. as provided for by Section 37.0.0 .of the Labor Code', for the perf-or~ance of the(work fdr whidi'
this permit is issued, '. . .' : -, ,
01 havea,nd will maintain worker's compensation insurance, as ~ciuired by.jSectio~ 37.o.o.cjf ,5/11/2.0.04
the LaQor Code. for the performance of the work for which this permit is issuer;. .Myworker's Date:
Compensation insurance:carrier,and.polioj-are: .)
Carrie,: STATE COMPENSATION FUND Policy Number. 04600130?9
ARCHITECTIENGINEER INFORMATION:
I
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L1CENSED,CON RACT S DECLARATION
I.herebyaffirm. nder pen Ityof perjury that I am
lioensed under prav iO sof ch pt g.(commencing
with Section 70.0.0) ,0 i io 3 BusineSs' and
Professions Code.
"
, ,
, . , .
This section. need not be completed if the pennit is for one hundred dollars ($100) ~r less.
[] t 'ce'1ify th~t in the '~_rfOrrnance ofthe work for which this permit is_ issue~LI shall not .'" '
employ any.person in any manner ~~ as to come ubject to the worker's cOI.':1pensation laws
of Califomia, and ,agree that if I should me bj to the worker's'compel:sation .'. ,.'
provl<;ions of Section 3700 of the Labo Co ,'s "fo hwith comp'y~ith these provisions,:
. _ ,~ .1-
NUMBER
, 642751
TYPE
TYPE
TYPE
EXPIRATI
413012006
B
C10
C16 FIRS
Date: 511112004, Applicant:
WARNING: FAILURE TO SECUREW R'S C TlONCOVERI>.GEI$
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYE TO CRIMINAL. PENALTIES AND CIVIL
FINES UPT() ONE HUNDRED THOUSAND DOLL!>; 9J~100.000):JN!\DDi1l0N TOlJH(
COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTION ~'706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' ,../'j' .
" CONSTRUCTION LENDING AGENCY . "
, I hereby' affirm Linder penalty of perjury 'that there is a construction len~ing~~gency for the
performance ofthework for whJch' tl?is permit is iSSued {See.3097 .Civ.C): ~,~
Lender's,lnformatio.n: '
,;"'"
Construcion Types:
V N. " '
Fire Spr;nkle~ed?
NO'
,
I certify that I have
agreeto comply iN
hereby <;iuthorize r p .
inspectiqn purpose .
:i
.
dinances and, state laws relating to building construction. anc~
o ttris city to enter Upon the a bove' 'mentio~e(rproPerty for
Date: 5111/2004
Fees paid for Permit:
Total:
, 252.05
Slg tu
The permit shall expire by Iiniit I n a ecome null and void if the bUilding or '
work has not passed final inspectio '365 days from the date of permit issuance. A
new permit is required to commence or continue work. '
.-
. , . INSPECTION RECORD ' . FINAL INSPECTIONS ' ' . Date . Inspedor
,
INSPECTION , DATE. ..INSPECTOft EI.ectrical Fi.nal " .'. , '.'
" '.
Temporary Power Pole ' ' Plumbing Final ,
, . , .
Plumbing (DrainlWaste Pipe) , , .' , Mechanical Final ,
. Eledrical Ground EI!!ctrodelUfer / " .
, Gas ~t- ,
SetbacklFormsfTrenches lFciotings),~ '7.-a.P " . , .
00 not ,install subfloor pr pour floor slab until the EngineeringlGradingFinaI765-6126 .-',,"
following apJ>licable items have been signed::' '. " '
, Pllimbing (Water Pipe.Sprinkler Valves) " Fire Dept: Final 765-4040 , .
MechaniCal (Groundwork) , .' Water En9.ine~n97i;5-5268 ',' . : .
Electrical (Underground Conduit) . , ,
"
, Pre-slab (Compac;tion/Membrane.Reinf. , ' ' Sub LisflBusiness License 765-519' '.
Underpinning (Floor JoisflGirders) .' , , " Zoning '765-5139 , ' .'. ,
, ,
00 not COlier or conceal the worK below until the , Building Finlll \kast Inspection- Only .
folloWing ,applicable items have been signed: , fter Above CQmpletel
1.st Floor Shellr ' '"
. , . PARTiAl INSPECTIONS
, Fi19sprinkler (Rough) Buildina Inspections
2nd Floor Shear . , . .',' , ,
,
Roof'(Shelllhing/Dillphragm'Frllme) , , , , .' , ' . "
Masonry (ReinfJBond eellmlPre-Grout) , , . .
, Rough Plumbing, (Top Out) " , . ,
Rough Mechanical. " , , . . , .
KOugn 8ectrIC1II (ury wall) ,
. ,
Rough Electrical . ' , ,', - ,
Framin'g . (Only after Plbg., EJec.. Mech. and Fire) '.
Insul.lItlon (SoundlEnergy) . . .
" Mechanical Inspections
Do not tape or plaster' until the following app.\icable "
items have been signed: ".: ' . , . ,
Drywall .'. " '. . "
. " .'
Peltetr;llions (File Rated) Electrical' ,
, '. "
Peltetrlltlons (Fire RlIted)Mechanical. ' . " . ' ,
Penetrlltions (Fire Rated) Plumbing' ..' , . .
Interior Lath. ' " I , , , "
.' ". '
Exterior Lath .:' , Plumbina'lnspections
,.. GENERAL ITEMS , . " " " " " . ','
. "
Exterior Plaster (Brawn ColIt) , .' "
T ,Bar Electrical , " . ,
T -Bar. Mechanical ' .' ' .
. ,
T'BlIr Structural . . ,
Sewer , , , . '
Water En!lirleering Backfl()w . " . ,
, .' ElectricallnsDectioilS.
Water Service .... . , " " ,
, .
. ,
. .
PERMIT EXPIRED
INSPECTION
. ,... .
. NOT COMPLETED'
DATE: G-~~\D'/~
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,HE: HOLDE:R OF' THIS PERMIT
R CEEDS AT HIS OWN RISK,
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SPECIFICATIONS
- m. ...._________ __... _.. ___...._.. ___..mm__" ....__ m._ ...__..___...m..____j____
I
HOUSING
Heavy gauge extruded aluminum, Internally sealed for
weather proofing. Closed cell neoprene foam gasket is
applied between lens frame and housing.
LENS ------.-..--.
.188 thick clear tempered glass, sealed into mill finish
extruded aluminum frame with silicone. Lens frame is
hinged and secured with two stainless steel quarter turn
fasteners.
REFLECTOR ..------
Specular aluminum, available on type I, II, III, FT, Vand
VS light distribution.
BALLAST ASSEMBL Y ---------
Ballast is high power factor mounted on aluminum tray.
The assembly is removable as unit for easy maintenance.
LAMP SOCKET ______m__...._____
Spring loaded center contact.
Pulse rated for hps lamps.
ARM
Mounting arm is supplied with two rods and nuts for easy
assembly ot luminaire to pole.
FINISH -. -- .......---..
Polyester powder fuse coating is standard, other finishes
availabte, contact factory.
UL LISTED FOR WET LOCATION
MOUNTING STYLES
I-O ..0
W M WALL MOUNT IA. SINGLE ARM
*D-D VO
2A. TWIN 180'
28. TWIN 900
000&
3A. TRIPLE 90l
38. TRIPLE 120'
40 . OUAD
*
DIMENSIONAL DATA
ORDERING INFORMATION
tJ'
1 Series
2 Mounting Style
3 Wattage
4 Lamps Type
V - Mercury Vapor
H - Melal Halide
S- High Pressure Sodium
5 Voltage
120,208.240,277,480
MT - Multi-tap (120, 208. 240, 277)
6 Light Distribution: I, II, III, FT, V and VS
7 Finish
BZ - Bronze
BK - Black
GN - Green
WT - While
(for any other color consult laclory)
Options:
RCP - Heceptacle and Photo Control
RC - Photo Cell Receptacte only
PC - Photo Cell Only
FS - Fuse
HS - House Shietd
PS - Polycarbonate Shield
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8
8
WATTAGE A 8 C EPA
50 THRU 175 16" 6" 16" ,97
. .....--.--..-.
250 THRU 400 19" 6" 19" 1.1
toOO 26" 10" 26" 2.1
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EXAMPLE ",'v~'v" ~o",," .".f;;-,f, ~o,:;,,?-(j <$-<j-~'IJ ~~,,-<- <1"",0,,"
SB - 3A - 250 -- H - 480 -- FT - GN -- FS
PACIFIC LIGHTING & STANDARDS CO '12831 LOS FLORES BLVD l LYNWOOD, CA 90262 I (310)60J..9344 'I FAX(310)60J..9421
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Square Straight Steel
CATALOG, WALL
NUM8ER A
SHAFT SIZE HT.
8 H
BASE PLATE BOLT ANCHOR
o E CIRCLe BOLTS
EPA
\00
MPH
SHIP
WT.
SSS.".308 .120"
8' 8" W'
SSS.".310 .120"
588.11-312 .120"
588.11-314 .120"
588-11.408 .120"
$85-11-410 ,120"
SSS.".412 .120"
$88-11-414 .120"
588-11-415 .120"
SSS.".416 .120"
588.11-418 .120"
588.11.420 .120"
558.11.422 .120"
$58-11.424 .120"
SSS.".425 .120"
5S$.7-420 .180"
SSS.7.422 .180"
$8$.7.424 .180"
48'
3"SO
3"SO
3"SO
3"SO
4"SO
4"SO
4"SO
4"SO
4"SO
4"50
4"50
4"SO
4"50
4"50
4"50
4'50
4"50
4"50
10' 8" W'
12' 8" h"
14' 8" Yz"
8' 9\12" Y2"
a" %x16x3
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8" 3/4)(16x3
8" %x16x3
9W' %x16x3
%x16x3
10' 9j/2" Yz" 9\7"
12' 91-2" Y2" 9W
14' 9\12" Yz" 9W
15' 9~'2" \12" 9W
\.6' 91;2" V2" 9V2"
18' 9W' %"
9W
5'SO
5'SO
5'SO
5"SO
5"SO
5"SO
5"SO
5"SO
5"SO
6"SO
6"SO
20' 9W' %"
9\12"
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%x16x3
%x16x3
314;<\6x3
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%x24x3
3/4X24x3
%x24x3
3/4x24x3
3/~x24x3
3/4X24x3
3/4X24x3
9W
3/4x24x3
80
68
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68'
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--B
CONSTRUCTION
Square straight steel poles are
fabricated Irom hot rolled carbon
steel with a minimum yield
strength 01 55,000 psi. The
anchor base shall be fabricated
from hot rolled carbon sleel with a
minimum yield strength 01 36,000
psi. The base telescopes tho pole
shaft and is circumferer:tially
welded top and bottom. Anchor
bolts are labricated Irom hot
rolled steel bar with a minimum
yield strength 01 50,000 psi.
Anchor bolts are hot dip
galvanized in accordance to
ASTM-.lI-153.
OPTIONS
AT - 2.3/8" a.D. X 5" long lenon
BT - 2.7/8" a.D. X 5" long tenon
CT - 3" a.D. X 5" long tenon
BC - Two piece square base
cover
OR - Duplex receplacle
PR - Provisions lor receptacle
FINISH
BZ - Bronze Paint
BK - Black Paint
GN - Green Paint
WT - White Paint
GA - Hot dip gatvanized
(Custom colors a'1ailable. Please
provide color chip.)
22' 9\12" %"
91f.."
24' 9W' %..
9\12"
12"
3;~;24x3
50_~
28.8 64#
26,0 78#
23,0 92#
21
106#1
I
113#:
"
120nl
13.)
148#:
162#
I
176#1
190#
I
208#1
227n
I
246#1
256#
;
. . ===!
190#
I
206#,
18
\6
14
10,0
8
7
6
15
\1
10
8
SSS-7-425 ,180" 4~SO 25' 9W' 3/4"
r,,:,::::::===::~====--'_::::====--=---=-=:::,:::=,,-=--
$$5.11.520 .120" 5"SO 20' 113;~" 3/~"
18
n___ ."
25' 9\-2" :%" 9Y.."
20' 9W' 3/." 9W
22' 91/:2" %" 91/.."
24' 9W Jf4"
9\12"
H
/._--u"
S55.".522 .120"
5$5,11.524 .120~
555.11-525 .120~
SSS.11.527 .120"
555.11 .530 ,120~
S55.7.520 .180"
555.7'522 ,180"
555.7.524 .180"
555.7.525 .180"
E
- ~ ANCHOR eOl TS
(JTYP.) 55$.7-640 .180~
555-7-635 .180"
22' 1 H." 3/4"
24' 11h" ~.-
25' I 13f.1" 3:."
27' 113/.- "3;,t
30' 113/.\" ~"4"
20' 113/~" 3/."
22' 113;." :h~
24' 1 H~" ~'."
25' 113;." 31J"
35' 1 P/J" 1"
40' 1B/J" 1"
12"
3/.x24x3
16
13
222#
I
23011'
BOl T CIRCLE
@o
o [J
o '"
'J'XS'
REINFORCED
HAND HOLE
HAND
HOLE
COVER
I e..
,J
. 3-S'GROUND eOlT 555.7-527 .180" 5~SO 27' 1H'''' 3'4" 12"
.~Sy~~~: ~~~~~_~~~:-~.~B~.~~_ 5"SO =_,.~~~_:~1W'. ~~.~'~___~~'___
'.lEVELlNGNUT SS57625 " 6"50 25' 113J~ 3." 12"
A. GROUT OR WINO ' . .180 74 7~
,.,_._"' Y"I\RRANTY IS VQIQ
~ . CONC. FOOTING S5$.7.630 ,180" 6"50 30' 1 t3/J~ 3/.( 12~
2 PC eASE
COVER
(OPTIONAL)
12"
~:~x24x3
10
6 246#
,
5 272#
I
,
23 266#
!
20 290#,
18 314#
16 326#
13 350#
I
1 \ ,8 386#'
,
=
28 389# I
,
I
21 461#'
15 533#.
i
606f{
__J
'!-o
00 <-p'!-? 0
ORDERING Co","" O~' ~~9
'Hand hole on 3" and poles below 16' may not be ,,'nlo,eed. EXAMPLE SSS-11 - 420 - BC- PR-GA
r P~CIFI6 LIGHTING & STANDARDSOO-'~i831-LOS FLo~is~~L_V~i~;N._V;()C;D~-C~~~2~2_~j?;?)~0393..i~!!~i(3.~Olio~~421]
12"
%x24x3
12"
1x36x4
12"
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12"
1x36x4
12"-
1x36,,4
12"
1x36x4
12"
1x36x4
1x36x4
1x36x4
1x36x4
1x36x4
12"
1x36x4
12"
1x36x4 9