1155 N. Lotus St.
BUILDING PERMIT NO:
CITY
4"\~~~:;~{~\ .
,..}I., . ."'''1'~'~'J I
O,IiJ~~~nEIM
\\~~~l;:~~/
BUILDING DIVISION
200 S. A~AHEIM BLVD.
. (714) 765: 5153
INSPECTION REQUEST LINE.
(714) 765- 4626.
CENSUS CODE: 434
QUARTER SECTION: 37 I '1
BLD2004-03682
''''''''' .
TYPE OF PERMIT
Residential Addition
.
DATE' 11/24/2004 ,
JOB ADDRESS: t155:N LOTUS ST
LEGAL DESCRIPTION: N TR 2093 LOT 127
APPLICANT: RALDI ADRAYAN
OWNER INFORMATION:
Joel Castaneda
1155 N Lotus St
Anaheim, CA 92801
JOB DESCRIPTION:Family room additlor.
VALUATION: 17,600.00
I OWNER.BUILDERPECLARA TION
Ihereby affirm under pel}alty of PElrjury'that I am exempt from the Contractor'pUcense Law tor the followinG reason (Sec. 7031.5 Busine8s and
Professions Cqde: "any dty or: county which requires a permit to construct, all.i)r. improve. demolish or repair any structure, prior to its issuance, also
reqlJires the applicant for such permit to file.a signed statement that he is Jicd1~ed pursuant to the provisltms of the" Contradcr's License La\v (Chaptp.r
9)(commencing with &ection 7000 of Division 3 of the_ Business and Professj~\1sCodi'l) or that he i~ exempt tnerefrom and T,he'basis for thl3 alleged
exemption. -Any violation of Section 7031.5 by any app.licant for a permit Sl.;/').I!.,p~s the applicant to a' dvU penalty of'not mo're than five hundred dollars
J!tf~)~s owner of property,crmy employees with wages a; 1heir sole con'~(~"t;on, Wili do the "(ork, and th~ st;uct"re.ls co; I.ntended or offer.d for'
sale (Sec., 7.044 Busmess ~nd ProfesSions Code: The Contra,clor's LicencE': L;nv dQ6S nnt apply to an owner of pru-perty who bUlld~ or mproves'
'lhereon"and who does sUdl,work himself or herself Of thrOl,jgh his or her oW(,'employees, plovidep that such improvements arenot intende4 or
offered for satE!. If, however, the building or improvement is sold witn o;;e yet of completion, the owner-bu.ilder wi!] have the ~urden of pr<:>v!ng that r.e
did not build or improve for the purpose of sale). _ Ii .' . _ " _"
C1. -', as. the owner of the -property, am exdusively contract!ng witl11ice!'"\sed ~'1:1tractors to con')truct the proj.E"ct (St::c. 7044 Busil!ess and ProfessiC'ns
Code: The Contractor's License Law does notappty to an OWAer of P\'c,~)ertJ'- \yh-,) buUds, or improves thereon, a.nd who COt;tracts'fcr Sl!C1" proiec::ts with
,p.J(or:atractor(s) licensed purs~ant to t~e,Oontractor's Lice~se Law). . 'J~:::, . '
U,lame em. under.Sec. _' .&.p . fortl)i$r17aJ}on. -.A-. ....~,i.:
Dat 'I If Owner: ~~. :,b~_.
I . WORKER'S CO PENSATION DECLARATION ~_~~_
. hereby affirm under penalty of perjury one of the fottowing declarations: r
o I have and will ~intain a certificate of consent to setf-insure fo'r WOrkef'.y~ompensation,
as provided for by Section 3700 of the Labor Code, for the performal1ce of fr.n."lbik. lor whIch
this permitis issued. ::~,
o I have and will maintainwo~er's comp~nsation insurance, as requirud'tj,'$ection 3700 of. 11/24/2004_
the l<."Ibor Code, for the perfor:m,ance ot-the work for which this permit is issu{~~t My workl';:r's D<3_te:
Ccmpehsation.insurance carrier and potioy are:
Carrier: PolicY Number.
CONTRACTOR INFORMl'fiON:
ARCHITECT/ENGINEER INFORMATION:
PROCESSEDsY: FAN
I
I
LICENSED COtHRACTORS DECLARATION .-,
j hereby affirm under penaltv of perjury that I am
I_icensed under provisicr.s'of ch:lpter 9 (Gommencing
with Section 7000) of Divsioii 3 oftne Busine-ss and'
Professions Code.
Con tractor
: ~
NUMBER
EXPlRATtON DATE
. This, section need not ,be Completed if the,permit is for one, hundred doUars($10~:\~r ie$~.
tll certify that in the performance of the work for which this permit i~ iSSlJ:,':"d,'I. $hafl not
emptoy any person in any manner so-as to become subject to the worker's c~.nl~ensatLon laws
of California, and agree- that if I should.beco\me subject to the worker's COl11P.e;-r.;;ation
P~ovisions of Section 370,0 ?fthe Labor Co ,! ~hatl forthwitt;,com!2' ~Vilh tr.::o~s pr~viSions.
Date: 11/24/2004 Applicant. ~ ~
WARNING: FAILURE TO SECURE ORKER'!l COMPENSATION COVEf'AGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIViL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AD[HION 'to THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIOI' 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .
I CONSTRUCTION LENDING AGENCY
I nereby affirm under penatty.of perjury thzt there is a constru(:tion lending ~g,~ncyfoF t~e
__ oerfor(nance oft~e work for whir..."': this Dermil is issu?d (Sec.3C97 Civ.C)' . . L .
ler;der"s-I."fom,atio,);' '- -
TYPE
COllstrucion Types:
VN, ,
Occupancy Groups:
R3" "
LivinQ Area: . 253 .
,
.
I certify that I have read this application and state that the above informat,ion ~s correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
.herebY authorize represeritives oqhi~ city to enter upon the ab<;>ve mentioned property for
in ection rpose. /J ../J .
~~ Date: 11/24/2004-
Signature of Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed final irlSpection 365 days from the date of permit issuance. A
. new permit is required to commence or, continue work.
Fees paid for Permit:
Total: 856.20
.
.. INSPECTION RECORD
INSPECTION
DATE
.
INSPECTOR
Temporary Power Pole
Plumbi ng (DrainIWaste Pipe) /"'<
Electrical Ground Electrode/uter n/zlo'l (/ /. ,
SetbacklFormsrrrenches(Footings) 1?/lJ,,'1 #'l<.,L...-/ /'
Do not install subfloor or pour .floor slab unti Ithe
fol.lowing applicable-items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GrounclWork) _' _ '.'
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf.
Underpinning (Floor Joist/Girders)
I ~ not cover or conceal the work.below--until the
fOllowing applicable items have been signed:
1 st Floor Shear. .
Firesprinkler (Rough) .
2nd Floor. Shear . .
Roof (Sheathing/Diaphrag""Frane)
Masonry (Rein.fJBond BeanlPre'Grout)
Rough Plumbing (Top Out)
Rough Mechanical .
Rough l:IectTlc.a1 (Dry wall)
Rough Electrical' I .
Framing (On~ after Plbg. Elec.. Mech. and Fire) 1-J,.-A'I47, ~Pl
Insulation (SoundlEnergy) . - III "<..110.........
Do not tape Or plaster until the following applicable
items have been signed: - . - . -,.
Drywall .' '. . . ~'J1',(I( P /<. A I.
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing .
Interior Lath .
Exterior Lath -' '4tiffd7
. .... .. .' '. GENERALITE~." _ t',
Exterior Plaster (Brown Coat) . . ~.
T -Bar Electrical . . - !-
T -Bar Mechanical
T -Bar Structural
Sewer . . '.
Water Engineering Backflow .
Water Service'
/
.
.
.
.
.
.
/7. ,1//1
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126 .
.' FireOepl. Final 765-4040.
. Water Engineering 765;5268
Sub List/Business License 765-519
'-Date Inspector
6-z.o("' ~
.
b.- 2-0<::' ;:s;rulK>t-
.
.... .
Zoning 765-5139 ,=:r,.-of .&t2JzJ~~
Building Final (last Inspection- Only /" 0 (' C . ~ -
-.' After Above Complete). <0";>'
. . PARTIAL INSPECTIONS.
Buildina InSDections
o. .
-
. .
71
.
MechanicallnSDections
.
'.
.'
.
PlumbinCl InsDeCtions
.
.
.
ElectricallnSDections
.
.
.
.
.'\'
.
~'. - .
.
.