2439 E. Lizbeth Ave.
..'"'" '-'-.
TYPE.: \)f:::~RMIT
Residential Addition
CITY
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765- 5153
INSPECTiO:;,=:EQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 114
BUILDING PERM!T NO.
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2LD2004-o0376
DATE: 311/2004 ....
JOB ADDRESS: 2439 E L1ZBETH AVE
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APPLICANT: SlEVEN POZNOSKI . '
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OWNER INFORMATION: CONTRACTOR INFORM,\TION:
_ . S~even P Poznoski ,!l
2439 E Lizbeth Ave
Anaheim, CA 92806 f
JOB DESCRIPTION Room Addition. Add 79251 family room. !.
VALUATION: 53.301.00 1
.1 .OWNER.BUILDER'OECLARATION
I hereby affirm under penalty of perjury that lam exempt from the Contractol;$ .License LaW for the following re{!5on {See.. 7031 ~5 Business and
Professions Code: any ci~ or county which requires a. permit to c6nstruct,'a~r, !mprove, demolish or rep:Jir any structure, prior to its issuance, also. '
reql:Jires the applicant for.Sl!ch permit.to file a signed ;;tatement thath~ IS lic.-Jpeed pursuant to the proVisions of-the Contractor's License Law (Chapter
9)(commencing with Section 70.00. of Division 3 of the Business and Professi~riS Cod.e) ",r tha.t he is e~empt therefrom a(ld the.basis for the alle:ged
. exemption.. Any violation of Section7o.3t.5 by,any applicant for a permit subfects.the applicantto a civil penaltyof not rno.r,ethan five hundred dolh1rs
. ~O?)~s_ow~er of property, or my,'employees' with wages as their $OrecorTlt:~~:~1:'lti~n, will ~I? the worK, ~nd t~e s~ructure i~ ~ot inten~ed or offere~for .
sale (Sec.,7044 Business and Professions Code: The Contractor's Ucensl}-S~W does not apply to an owner of property who builds pr,improves
there ,and :who dOBS,sum work himself or herself or throughhis cr her o,^,~em~loyees.providedthat such ImplovelT!entsare not intend6d or
.offe d for sale. . If, howe, ver, the building or improvement is sold with or.e y.,.~r cl completion, the owner-bui,lderwm !t~~-_the burden Of, proving that 'he
di not. build or imp~ove for the pUlpose of sale).- . . I . . . .' .' ',- ., ,
. I, .as the owner of the property, am exdusively contradi~o,~.ith l~enst:dPJ!ltractors to construct the project (See. 7044 Business and Professions:
Code: The Contractor's License Law does not apply to an own'er.cf propertY\N-OO buDds or improves thereon, and '.vho oontrscts fer such projects'with
Montractor(~) I~censed pursuant to the Contractor's License Law).. 1 - .... - , ..
'-' I '\.m'yxqrnpt under S, ec. . " ~~ & P.Cdorllhis re~sOi1: --+
l....Date: ~/fl Q 4 'Owner:' ';';\.\..1l'-'l'\. C ~ . J '__'_
I " " WORKER'1:! COMPENSATION DECLARATi'ON.r-"--'~
I her~by affirm under penalty of pe~ury ohe of the following declarations: \,. , .
[] ..1 have and will maintain a certificate. of oonsent to self-insure for worker} com~.~lisation,
as provided for by Section 3700 of the Labor Code, for tJ'le performanCe of U-:i=? work for whiGh
this permit is'issued. '.. ,{.' . .
o I, have and will maintain worker's compensationinsu.rance, as required b~' $ectnn 370.0 ,of.
the_ Labor COde. for the performance of the work for which this permit.i::; iseu{<t "!\1yworker's
Compensation in,surance carrier and policy are:, . l'
Carrier: . POlicy Number: ~
rhi~sectionneed nctlle completedjfthe permit isfi:)r.one hundred dollars (~.1tdor less.
.~ I certify that in the ~6nnance of the work for which this permit is)ssu~h;''-.~h~11 not
employ any person in any manner so as to become subject to the worker's o::;mp'~nsation laws
of Califomia, and agree that ,if I should become subject to the worker'sconlC;~1"$3ti_on-, _ ' ,
proyisions of Section 3700 of the Labor Code, 1 shall forthwith.comply With.tt~"i~~~~?~i.~ions.
~~~N~~:O~~ILURE T~~~~~~E~a~t~~~N covErH~I:
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENACT)l:S'AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADo:TiC*tl'OTHE
COST OF CPMPENSATION, DAMAGES AS PROVIDED ,FOR IN SECTION 3706 OFTHE:
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ;.,:' .
I CONSTRUCTION LENDING AGENCY .'
I hereby affirm unde.F penalty. of perjury that there is a cOnstruction lending _~fenfY fqrthE;t
performance of.thewprk for which this permit is issued (Sec.3097.Civ.C):. ., ..,'
Lenaer's.lnformat=on: ~__ l-;";._~;i..~"~:~::
LEGAL DESCRIPTION: N TR 4443 l.OT 29.
ARCHITECT/ENGINEER INFORMATION:
MARKIBRAHM
PO BOX 16994
IRVINE, CA 92623
PROCESSED BY: JJJ
LICENSEc' CONTRACTORS DECLARATION j
, I hereby affirm ur,der ?enalty~of perjury that! am
licensed under provisio,ns cfchapterP,.(-cDinmencirig
wi~h Secfion 7000) of Pivsion3 of the BUH:ljesS and
Professions Godz;
3/1/2004
Date: .
CdntractQr.
, NUMBER
EXPIRATION DATE
TYPE
Construcion Tvpes:
VN,',
Fire Sprinklered?
LivinQ-Area:
NO
792
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;:,:.-,..-....-.. , ,
~- -'-- ":0" .~;--____..:_>
.( certify that I have read this application and state that the above information is correct. I
agree to" comply with aU city ordinances. and state laws' relating to budding c01lStruction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspection pur/X)ses.' ,
~~ V'< sjfnal;t~ or Agent Date: 3/11200.4
The permit shall expIre by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of pern:it issuance. A
newpermit is required to coml1)ence or continue work.
. Fees paid fOf Permit:
Total:
543.64
.' INSPECTION RECORD. .' .... . FINAL INSPECTIONS' 'Oate . ~nspector
Electrical Final. J. Ls. . .Pi.5-
INSPECTION . DATE .INSPECTOR I 1,.:,:;,,, .
Temporary'power Pole Plumbing Final ' )/1 . . "C-
. . ...,: .
.Plumbing (DrainlWaste Pipe) . I . M~nical Final . ~"'d<J~ ~.C
Eledrical Ground Electrode/.uter ~ f,/ -.:> Y. ~ . .' ,NI- . ./.
SetbacklFormsfTrenches (Footings) .,. f-i'~tIY Gas Test
Do not install'subfloor or pourfloorslab until the .' . Eogi neering/Gradi ng Final. 765-5126 '. . .
following applicable ilems have been signed: . . .. . '. .' .
Plumbing (Water Pipe.Sprinkler Valves) . Fire Dept, Final 765-4040 .' .
. .
Mechanical (Groundwork) Water Engineering 765-5268 . , ,
Eledrical (Underground Conduit) . Sub List/Business' License 765'519 ~/'"l>kS'
Pre-slab(CompactionlMembr~,Re!nf, . SS/L'
Underpinning (Floor Joist/Girders) Zoning 765.51;39 '. . ., .... ^
Do not cover. or coneea.1 the work belOW until the A/ Building Final !kast Inspection. Only rz/Z-9-/oS /" Q 1IIi/e; .
following applicable ilems have been signed: '. . fter Above Complete)
'lst Floor Shear . . Cf:-- ~..o PARTIAL INSPECtiONS IT
Firesprinkler (Rough) {
2nd Floor Shear . L /' ,. A f Buildina Inspections
Roof (SheathinlllOiaphraarnlFrame) "1 -ZL.-.b '.iV.G. . .
Masonry (ReinfJBond BeamlPre-Grout .' . .
. .
Rough Plumbing (Top Out) .
Rough Mechanical . . . '. .' , . .
Rough Electrical (Dry Wall) .' . . .. . .
Rough Electrical . ~ , I .
Framing (Only after Plbg., Elee" Mech and Fi .. .
Insulation (Sou ndlEnergy) .<;. rJ,,6<R UI. .". '-0
po.not tape orpla~ter ontil.the foU!)wing appli.~able '/ . Mechanical Inspections
Items have been SIgned: . '. .., . . .
DrYwall . > -w-(Jf JC . . .. . .
Penetrations (Fire Rated) Electrical ,. . .'.
Penetrations (Fire Rated) ~chanical . .
Penetrations (Fire Rated) Plumbing . ':
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Interior Lath . . . . '.
Exterior Lath ' .' L ::;<> Plumbina Inspections .
.' GENERAL ITEMS. . . A' ./ . .
Exterior Plaster (Bl!JWn Coat) . '. :
T .Bar Electrical . . .
T.Bar Mechanical. I . i . . ,
T-Bar Structural . . .
Sewer . . . .
Water Engineering Backflow . . . Electricallrispectioils
Water Service . .
.