115 N. Lindsay St.
~.
...':>._-~~..
TYPE OF PERMIT
Re:.3identiarAddition .
.. . . .,. (itt);~,5:i~~~: . .
CITY ~%,~~.j,ti~fI ElM
. \::1.~:;?~~<~~.~.-~;;/
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BUILDING DIVISiON
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLiNE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: .39
5U:l,DING PEi<,.!IT NO. BLD2G04-01848
DATE: 5/19i2004
JOe ADDRESS: .115 N LINDSAY ST
LEG,^.L DESCRIPTION: N TR 1851 LOT 34
APPLICANT: GAHY MAl
OWNER INFORMATION:
GARY MN
115 N prldsay S'l .
Anaheim, CA 92a01
. -J<?B,DE9CR!PT!ONA,ddi.tion of(2)-bedrooms,.(2) balhro'oms, a"d-a kitcr.en to\; SFD. (HIH)
,VALUATION: - 69,:,52.00 I_
I . . OWNER-BUILDE";9.l;CLARATION
I. hereby affirm-under pei''lalty of perjury' that j'arn exempt from the C0i1tracto:-'~1 tic,ense Law'for the following reason {Sec. 7031.5,Business and
Professions Cede: any City or.,ccufltY,w~lichrequires a permit to constru~t;,'::h.;'l,i', i;nprove, demoHsh or repair any structure/prior to ,its issuance, ,also
requires the app'licant for such permit to file, a signed ~tat,emetlt that-he;~ Ir("~;~::.;e9 pursuant to,the provisions of the Contractor's License Law (Chapter
9)(comrr.encing with Section7QOO of Division 3ui the 8usille.c:;~ and ,.Pr::l_'1ss:.:'\:;s',Co~e) or,thaU'16 IS exempt therefrom and the basis for the al:eged '
[e;;~):;()n. A:1Y Yio"lation of Sectio~ 7031.5 by an~ applicant for a p~frnitslj;:.t~0.:$' tlif:: G;p~11ic,ant to a dvil p~nalty of not _more th~ n ~ve hund,red dollars
"I, as o'J,'!1er of property, or my employees with wages as theirscit~ c.or!lpids~tion, will do the work, and thestruct~re is not intended or offered for
ie {S~~c:. 70_44 au~iness and Professions Code: The Ccntrack,r's UC€:T:~~,~)!~.; 'jries not applytoan owner of. property who builds or irnproyes '
thcreon,and-who'dces ,such Work-i1imse!f or herself or through his O~ hG~ ':....;.f~r.lp:0yees,provided th;at such, improvements are nof ,intended or
offered for sale. If, r1owever, toe buildingor ,improvement :s solCl with 0:ll= yc;y-ofcompfetioll, the owner~builder will have theburdeo of.proving that he.
did not buiid or improve fOI th~ purpose of sale). '. i! , _ ',' . ..'. . .'
. 0 I, as th~C!wner oit~IS pfoJpert'j. am excit..:;1'.1:-:-!Y COr';'fcl(.~:ng wlth ncer.se~f}i":!.f<;:q-ors'to constf.llct the project (Sec: 7044 8usinessand Professions
~od_e: The ~ontracto.r'sUC€!nse' Law.does not apP~i t6 an-ow,~'.~:' orp..op~:t,y, tt:" b:.HIC:::3' 'Jr,i-;nprcves thereon. and who,cont,racts for such projects with
~ontrac!:or(s)llcensed,pur$'..'::lnt to the Contractor's License 'Law), ~'
~l~ am exemptunde, se~wne~- Jr'~ this. ,,,.',r: ~-*
[, ... "WCRKER'SCO~EN~E~LARATON~__._L. 1
I. h~reby ~ffjr~un~er,pe~ai~ of perj~ry t)n'~C)f ~he following de~larations:. _ i ;
[J I have_end Will malntalna ce~ilficate of mnsent to ~elf-JOsure fer ......or!<cr'f;COm?~riSatlon.
as provided for by 8.ection 3700- of the LaborCode, forthe performanoo oft;~ ......orl< for which
this permit is'i5sued." .' _ ';-
0,' havB:_and will maintain worker's,co'!lpensation ir.r,uranco.'as j'c.quircd t):~ Section 3700. of
the ,Labor COdEl' ff)_r the performance of the.work tor which ihis p.en:u!t is iSSt,E-~. Mywerker's
<::XllpenSl3tion ;r13~,ralice carrier and poHcyar,e:. .1
,-,arner: Policy Nu mber., I
This section need not.be ..:Omp'leted if the pennit i$ for one .hundroo dollars (~1CO;;vr less.
[] r certify that in H.le perforrnane;e of the work for which this, pennil;f, i.s::.,:ue.), ': snail ~ot
employ any person in any manner so as ',0 become subject to the #orkers t:(;npensation laws
of Calitom'ia-"and, agree thatii ! shoul:~ become subject 'tr:l th.e worker's co,n:~e:'133tion-'-
j)rovisiofls of Section 3700. Of the Labor Co e,l shaH fort with comply With ~~~~:,e provisions.
, .
Date: 5f19/2004 Applican ._,,~;...
. WARNING: FAILURE TO SECURE WORKER' COMPENSA ON C(iVE;.l:,~E.'S
UNLAWFUL; AND. SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAi'qf;S AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000); IN AiX;,,,ON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FO" IN SEC~iON3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,. .
I CONSTRUCTION LENDING AGENCY: .
I ' '
CONTRACTOR INFORM?',TlOI'I:
ARCHITECTiENGINEER INFORMATION:
PROCESSED BY: CAL
LICENSED CONTRACTORS DECLARATION I
I h~reby affirm uriderpenalty of PEilrjury that I a~
licetlsed under provisions 'Jf chapter 9 (commencing
wlth'Sectlon-70DD) of Divsicn ~'fc.ithe Bus;n&~sand
Professil;ms Code.
5/19/2004
Date':
Contractor
NUMBER
EXPIRATION DATE
TYpE
Construcion Types:
VN; ,
Fire Sprink]e~ed?
NO
i hereby affirm under penalty-of perjury that there is a constructionle,iiding ac'''ncyfor the
performanq3 cf the work for which this permit is issued (See. 309T.Ci-: .C).
Lender's InforfTlalion: .'
"'-4
I.c_ertify that I have rea_d-this a'pplicatiqn and stateth.at the above information i.) correct. I
a'gree to-mmply with all city ordinances and state laws relatfng, to building copstruction,-and
. hareby'authorize representives of this dty to-enter uponthe above mention~ propertY_ for
\n,.,ection :ur s.
^ Date: 5/19/2004
Signa e of Applicantor Ag nt
The permit shall e ire by limitation and become null and void if the building or
work has not passed final inspection 365 days fr.QIll the date of pernlit issuanCe. A
, new permit is ,required to commence or continue work.
Fees paid for p:errnit:
.Total:
1.106.93
: .' IJIISPECTION RECORD .' . FINAL INSPECTlO~$ . " Date . Inspector I.
.' INSPECTION . . .' " . ElectriCal Final , .' , . "tiMOr'
DATE . . INSPECTOR " ,eu. ,- ~.
Temporary Power Pole '. 1 Plumbing .Final . . , rl\{~\of A., ,.
. Plumbing (DrainlWaste Pipe) . . . . 'tfz,1l0( "1
Elecltical GrOund Electrode/ur~ . . Mechanical Final .
,:,. . 1.'tt~1\qJ
Selbackli'ormslJ"renChes (Footi '. Gas Test .. . , . 1hu.""
Do not install subflOor or pour floor slab until the '.' ~ -. Engi.......ringlGrading Final 765-5126 '.
fOllowing applicable' items have been signed' '. '/ .. .
Plumbing (Water Pipe.Sprinkler Valves) Fire Dept. Final 76!l-4040 . .
;( '. '.
r.lechanical (Groundwork) .' . . Water Engin....ring 765,5268 ", ., . .
I !:Jectric;aJ (Undergr.ound Conduit) .'
PI'e-slab (Compaction/Mflll1br3l)ll.Reinf. '.. Sub i.istlBusine~sLicense 765.5,19' ,l)1r ~'lPWf V
Underpinning (l'IixlrJoiStlGinlers) , . , , ' . Zoning765-5,t39 ' , , . " . , ~4/Z710 ... "I
"
,DollOt cover or conceal,thework.below until the .' , " Building Final . ~ast Inspection. b~!~~ ~'.'..
'followingapplicable items. have been signed: .,' . '. .' fter Above Complete). ~ r-v-.....
1st Floor Shear '.'. " . . :l'1\1Ii'V' 41L1/I '. PARTIAL INSPECTIONS." ,,'
Riespri nJiI"" (Rough) . " . .
. 'Buildinalnspectibns ',' " " '
2nd Floor Shear' " , " , .
ROOf ISheathina/DiaohragmlFram!li' ""IIN11' ",.fl. , , . '7>/J.I-tlit FOtff'lJiRtJ-.5 "Ii StAJ5.tiL ~fl--.
Ml!!$oor)' (RIIlinfJBond BeamlPre,Grout)' . . .'" , . . 40D/T1Pf'I. "'"Nt.Y: :I/'-'.?,;i < 'Ii ':, . '. ",
R!lughPlumbing (Top Out) . ',' , , ' , .. . . .;.b' ..},~
' Rough MeChanical ',. ~'Zl~~J:"~" '. .
lU)\19h t:Iectnc31 II)'... .' " . ..' , ".' ,,' , '. . ..,.,.'C.
. . .
RoughElectrical' ." . IJ' , . "', . ,
Framing (Gn~afterPlbg..EleC::f,jeCh.andFire).~"" . '. . .' .' . . . . .. .'.
In$Ulation (SoundlEnergy) .' .' . . . '., . .'. .
. Mechanical Inspections' .' ,
Do not tape or.plasteruntiltl1e followiAg applicable ',.
Uem.s have been signed:: . . '- .- .', . ,_." .. ." . .'.
"
.DrYwalf . . '. .. .. '0 . , . . .
Pl!rietrations (Fire Ratedi Electrical . .
.' . ~ .'
Penetratioi)S (Fire Rated).Mechanlcal . . . '. . . . .
. P!lRetrations IFire Rated) Plumbing ~ . . . . '.
Interior.t.ath ' ..... . '()-/3-u'f . .. Inspections '.' .
Eliterior Lath ". .'. n...i-o PlumbinG .,
'" .: . GENERAL ITEMS . . . .
exterior Ptaster (Brown Coat) '. '. .'
T.Bar Electrical . '. '.' '.
. . . ..
T.Bar Mechanical' ' ' ..... .~ . .. ':
. .' '.
T.Bar Structural . , . .' . . .
Silwer ,.," . '.' . .. .'. . . . . .' " . .
Water .Engineering .Backflow .. '. '7 Electrical Inspections
Water Service . . ..
.
--
TYPEOF PERMIT
. Blockwall/ Columns
DATE: 5/20/2004
. JOB ADDRESS: 115 N LINDSAY ST
LEGAL DESCRIPTION: N TR 1851 LOT 34 .
CITY
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//:-.'/$'4 _ .~ ,.;:- ~..;<>\
~C';i,"KA'(~^"\H" EI M
a~~Rt!fM:
\\~'~<""'W'l' 'I .
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BUILDING DIVISION
. 200 S. ANAHEIM BLVD.
(714) 765-5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 434
QUARTER SECTION' 39
)
BUILDING PERMIT NO, BLD2004-01874
APPLICANT: GARY MAl
OWNER INFORMATION:
GARY MAl
115 N Lindsay SI
. Anaheim, CA 9280,1 ,: . . .
JOB DESCRIPTIONSlockwaU -1581In. It of 6'mhlgh blockwalls, per city stand,,,d spec's. (HIH)
VALUATION:' 3,792,00' " ~,
I OWNER-BUILDER'PECLARATION
I hereby affirm under penalty of perjury that I am "exempt from the C~>ntractor'}. License Lawfqr the following r~ason (Sec.- 70315 Bu's.jnes~ and
Professi~:ms Code: any city or oountywhich requil13s a permit to construct, a!tr-r, improve, demolish or repair'any structure, prior to its iss.uance, also
req.uires ttte CiPplicant for.~uch p~rmit to fife a signed s.~atement th~t he.is licerj,sed pursuant to the provi.sions of the 'Contractor's:Licens'e Le.w (Chapter <
9)(commencing with Section 7000 'of Division' 3 of the Business and ProfessiopsCooe} or that he is exempt therefrom and the basis for the alleged
. exempti9n. Any viOlation of Section7031.5 by any applicant fora permit subJ-ctsthe applicant to a civil pen'altyef not more than five hu'ndred doHars
~~l~s ~wner ofp~operty, or myemployeeswlth wages as their sole c~mp,l1Satlon, will do the work, and the structure Is not Intended or offer~d tor
~e {Sec, 7044 Busmess and ProfeSSIons Code: The Contractor's L1cense-L~w ooes not apply to an owner of property wh() bUIldS or Improves
thereon, and whodoes -such work himself or herself or through hisof:t-ero'"vrtemployees,. provided that such improvements.are not intended or' '.
offer~d.for Sflle.' If, however, the building or imprdvem~nt is sold with one yciJ'1 of completion, the owner-builder will have the burden of proving that. he
did not build or improve -for the purpose of .sale).:, ' ' . " ,:;', ' . . '
o .1, ,as the owner of the ptoperty" am exdusively contracting with licensed lontractors to construcfthe project (Sec. 7044 Business and ProfessiOns'
C'ode: The Contractor's,Licens!=: Law does not apply to an owner of propeity.;.:'t.ho builds or improves thereon, and who ccintracts for such projects with
. '.' .- ~ . . . ..
>E' ontra~or(s) licensed pursuant to the Contractor's License Law) J. t. . . ' .' ..... .' :, .
. lam._ex mp under Sec. ,B & P.C. for t is reaso' _~,' '. . '. -. ,
'. ate: '. Owner: --=l . "
CONTRACTOR INFQRM<\;-ION:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: HRO
WORKER'S COMPENSA ON D LARAT/ON
J ber~by affirm under: penalw of pe~ur'y one 9fthe follpwing i:fecJarat;ons: :
o I have .and' will maintain a certificate of consent to self-insu~e for'worker.~t::ompensation,
as provided for by Section 3700 of the Labor Code! for'the performance of thJ'work for which
this permit is issued. . ". .' , i
o I Qaveand will maintain worker's compensatiOn insurance, as requtred bY.'Section 3700 of
the .Labor Code; for the performance of ,the work for. whiCh this permit is iSSll~'? My worker's
Cot:npensation insurance carrier and policy are: _ :
Carrier: . Polley Number. I
. j
Thi,s section,need not be completed if the pennit is for one hundred dollars ($100:. br ies.s.
o I certify that irithe ,perf0/Tl18nce'ofthe work for wh'ict) this permit is issuec, J ~hall n?t
employ any person in any man'ner soas to become subject to theworker'sco\n;:ensation laws
of CaJ,ifomia, andagree.that if.1 sho'utd' b~come ;>ubject fo the worker's.compehsat[90 -
provisions of Section 3700 of the La!x>r. Code, , shaU forthWith mptywith thc~e provisions, .
? ..' . ,. .
. Date: 5/20/2004 Applicant'
WARNING: fAILURE TO SECURE WaR ER'S COMPENSATION COVER',SEls .... .
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL'c;cS' AND CIVIL
FINES UP TO ONE. HUNDRE;D THOUSAND DOLLARS ($100,000), IN ADDn1o.N TO THE .
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECT/ON 3t06'OF THE
LAB0.R Co.DE, INTEREST AND ATTORNEY'S FEES. . ;.:
COr<lSTRUCTION LENDING AGENCY . ':
f hereby affirm under penalty of perjury that .there.is a construction-Iend,ing agr~ncy fo,: the
performance6f the-work for which this permit is iSsUed'(Sec.3097 .Civ.C): -
'l.ender's Information:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjory that I am.
licensed under provisions of chapter 9 (commencing'
with Section 7000) of Divsion.3 of the Busines's and
P ro~ssions. Cod e.
5/20/2004
Date:
Contractor
. NUMBER
EXPIRATlo.N DATE
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
NO.
. ,'--- -~, - -' , , - --------.........
I certify that I have read this application and ,state that the above information iscorre-.;t; I
agree to oomply with all city ordinaJ)Ces,and state laws relating to bunding construction, and
hereby-authorize repreSentives of this city to enter upon the abovementioned property for
iris e:ctiOn rposes.' .
;
~ {
'"l
Date: 5/20/2004
Fees paid for Permit:
Totat:.
0,50'
Slg ture of pllcant 0 Agent .'
l11epermitshalJe pire by limitation. become null and void iftheoui/dingor
work has not passed finallnspei:tion 365 days from the date of permit issuarice. A
new permit is required to Commence or continue work. .
INSPECTION RECORD
iNSPECTOR .
. '. .INSPECTION 'DATE '
,
temporary Pow,er Pole
Plumbing (Drain/Waste Pipe) .
Electrical Ground Electrode/lifer ; ~
SetbacklFormsrrrench"ll"Cl"ooti~ ~/1 'It""'l ~
Do not install subfloor or,pour, ,Ioor slab until the
following applicable Items have been Signed:
. Plumbing (Water Plpe.Sprinkler ValVes) , . .
Mechani.cal (Groundwork) " . . . .
ElectriCal (Underground Conduit) .
pnHllab (Compaction/Membrane.Reinf.
Underpi nning (AoorJoist/Gi rders) ", "
Do, not cover or conceal the work below until the '. .
following applicable items have been signed: '
. 1st Floor Shear '. ".
Firesprinkler(Rough) . , .
2nd Floor Shear "
',' Roof (Sheathjn!llDlaph~~ illl1E! ' -
,Masonry(Reinf./Bond Be e-G 1M.!....
, Rough Plumbing' (Top Out) I ' .
Rough Mechanical .
,.Rough l:IectrlCaI (Dry Wall),
Rough Electrical . . .
Framing (Only.after Plbg:,t:lec.. M~Gh-.. and Fire)
Insulation (SoundlEnergy)
Do not tape or pla~ter' until th,e. following applicable
Items have been SIgned: ',.. , .
Drywall .
Penelfatiorl$ (Fire Rated) Electrical
Penelfations(Flre Rated) Mechanical. ,
Penelfal;ions (Fire Rated) Pluinbing , . .
Interior Lath . " .., . ',' . ' .
Exterior Lath
, ' " GENERAL,ITEMS
Exterior Plaster (Brown Coat) .
,T -Bar Electrical . .
T -Bar Mechanical . ' .
T-BarStructural . I
Sewer . . , . ,
Water Engineering Backflow .
Water Service .
FINAL INSPECTIONS. '
Electrical Final
Plumbing,Final
Mechanical Final
Gas Test
,Date
Inspector
Engineering/Grading Fina,765..s126
Fire olip!. Final.765,4040
Water Engineering 765;5268
Sub List/Business License 765-519
Zoning ,765'5139
Building Final {Last Inspection. Only , tL",,,,,,",,'
'", . . After Above Complete, 1/I'II"J
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections.
Electrical Inspections ,
! \ r; _ N L 1 N D SA'1 ' S c-
A TV 1'\ tft \ tv'\. 6A q 2- ~ 0 l
r'V=,:..s.""1 'r
~ 801-00
'Rs --1a1)O
LANNING DEPARTMENT
Af:t?ROVED
~ ~~CT10N~
~ ~ \1 ("",,\a,,, )
FOOD ZONE .h
IS IC DISTRICT REVIEW:
N/ A See sta~ilP thiS .pa~e
. cle (1ne 0(1 - above Hne
EE BUILDING PERMIT FOR
ANY CONDl-;\Of~S..__.
'C\
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~~ 1Allvf-
W~\\ Ii\> .s,^(.\M-
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~I'T Gr-e)(?
~r_oo~
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+1:\1;; 1:!:!~4\ll,,", 8f 'l'HIS "e;aMI': COES
rllCJ't ~~. VtOLATION OF' ANY OF ~
THE BUILDING CODES OF THE CITY.
THE HOL-DER OF THIS PEf'lMIT
PROOEEDS AT HIS OWN RISK.
. ~
MAY 2 0 2004
BUILDING DIVISION OF ANAH 1M
Lf....OI~~PPB~OV
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ADDReSS: .5392 I1/. DOVE ST-
LOT 4/ TRA CT I/. 13697