1337 W. Lynne Ave.
TYPE OF PE.RMIT
Blockwall 1 Columns
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l::;'''''' '. .. " 'irtJ\,
CITY 0~i~~lN~HEIM
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BUILDING DIVISION
200 .S: ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 -4626
CENSUS CODE: 434
QUARTER SECTION: 66
BUILDING PERMIT NO. BLD2004-04058
DATE: 11/8/2004
JOB ADDRESS: 1337W LYNNE AVE
LEGAL DESCRIPTION: N TR 3278 LOT 55
APPLICANT: ERIK SAUVEY
OWNER INFORMATION:
Allan L Lewis'
12935 Villa Rose Dr
Santa Ana, CA 92705
CONTRACTOR iNFORMJ\rION:
PORTRAIT HOMES INC.' .
265 N JOY ST #200
CORONA, CA 928791323.
BUSiNESS PHONE: 95125.:'7611
ARCHITECT/ENGINEER INFORMATION:
JOB DESCRIPTION:lnstallation 018 pilasters.
,
VALUATION: 1.600.00 :\
I O~NER-BlIILDER~DECLARATION
. I hereby ,affirm under penalty of perjury that I am exempt from the Contractcr~~~' L icer~s€: Lav~ fOi" the followhg reason (See, 7031.5 Business and'
Professions Code: any dty or county which requires a permit to construct, ;:d~f,iniprove, deroolish or repair. any structure. prior to its issuance, also
requires the applicant forsuch permit to file a signed statemeilt that he is iic~;'\r-.ed plJrsuant to the provisions of the Contractor's License Law (Chapter
9)(commencing.with Section 700Dot Division 3 of the'Buslness and Profes:;:[;.t~5 Gocie)or that he is exempt therefrom and the besis for the alleged
exemption. Any violation of Section 7031.5 by ar:1Y applicant fQI" a'pernutsuc~~cts the appiicant to a civn penalty af not more th~ 11 five hundred do/latE
~~ . .1. .
D.' t, l'lS owner of property, or my employees with wages as their,soie com~~~!1.<;atir~i1, will do the,work, and the structure is not intended or offered for
. sale (Sec. 7044 BusJnass and Professions Code: The.Contr8ctor'::; License ~\1W tioesnctarplyto anclJIJr\er ofprvperty who bmlds or improves '
i!:"le-reon, aJid who does such wor~ himself or h~lSE'M or"throug.h his"b{her DV.{~ employeBs, provIded lhatS~ICh improvement.s are not intended or
offered for sale. If, however, ,the building orimpro'/ement is sold with one yc~";;::.i .::omDletion: theoVlner-buiider wIll hove the burden of proving ~i1at he
did not build Of improve for the pUrP:pse of sale). :~, ~ . " .
. 0 I, a1'; the o#ner of the property.: am exdusively contracting '~it:{'f.iccr:$c.j~;ont'.L:Ci:ors to construct the pr,oject (Sec. 7044 Business a:-,d Protes~ions
Code: The Contractor's Ucense LaW does not apply to an ownei of prope1ty,t\,flO builds or improves thereon, and w!"o GO-ntracts ~or such projcr.:w wit~
~ont(ad.pr($) licensed pursuant to the COrlfi:aclo,r's License laW). '! .
U I am exempt under Sec. ,8 & P.C. for this reason: _._:
Date' ' Owner:
L . WORKER'S COMPENSATION DECLARATK'N' ~~=='-:=J I
f he.reby affirm under penalty of perjury one of the fOll,""lwing decl3Iat:on~: '.;-
o I have and w!il maintain a certifICate of ccn$ent to self-insure tor worl<e~'l>' ~orn{h)i1s'atjon.
as provided totby Section 37QO of the Labor Code, for ~.h.e oe:formnnce of \i',;'.: "oJ'JGr1< fer which I.
tlli;rpermit is issued. . . 1 . I
~.I'"have and will maintaIn worker's compensatioil insurance, as required:'f Sect),?,", 37'1)0 0f '11/8/200
Xhi,.e Q; l.l?or Code, for the performance Of. the work tor which this permit is issu:r'~' :\1y......oiker's I Date:
Compensation insurance carrier and policy are: i
Carrier: 'STATE'FUND' , Policy Number. 160292~~I\1~, . NUMSER
T~iS seetl~ need not be completed if the pennit is for one" hundreel' dollars ($1 o.~ ~O!' :ess. l' ~;~~7.
~cerl:ify that in the perfonnance of the work for which this permit IS iSSr.J1;:, 1 shail not
.~mPii>y.any,person in any manner $0 as to become subject to the worker's c,:~mpel1sation laws
of Callfomia, and agree that if I should become subject to the "Norker's comp;}f;sation .
provisions of Section 3700 ofthe Labor Code, J ~ forth ,camp- with t~,:~'se 'provisions, Construcion Tvpee:
" J. VN, ,
Fire SDrlnklered?
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARA,lONl
I !'Iereby affirm tinder penl;l:!ty of perjury that i .:;m
licensed under p-rovisionsof chapter 9 {commenc!ng ,
with Section 7000) of Divs' ;i'3,ot the Business <:,nd
Professio s
EXPI~TION DATE
3/31/2005
B
Date: 111812004 Applican'
WARNING: FAILURE TOSE JREWOR R'S COMPENSA "GE IS
UNLAWFUL; AND SHALL SUBJECT AN EMPLOYER T . .IMINAL PENALTIES AND CIV!L
FINES UP TO ONE HUNDREo' THOUSAND DOLLARS ($100,000), IN ADDiTION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECT!ONh106 OF THf'.
LABOR CODE, INTEREST AND ATTORNEY'S FEES. i
L . CONSTRUCTION LENDING A~~NCY . . ':~::.._..c__
,Jb,ereoyaffirm I lt1d?f"o':!'naJty 9f.I')PI-!11.~_th;:jt fh~!'A j" ;:!("(l:;strU<.;.ti0f1I~r~i;YI~~:':'~;,~01:__~.'?_ :"-___1 .~_
performance of the work for which this permit is issued (Sec.3097 ,Civ .C):
Lender's Information: .
NO
I certify that I have read this application and state that the above information is corFect. I.
agree to comply with all city ordinances and state laws relating to'building construction, and
hereby authoriie representives .of thO city to enter upon the above mentioned property for
'I)S ion ~rPose~"..,
Fees paid for Permit:
Total:
194.45
Sig ure o:f Applica ent
The permit shall expire by Iimilationand b null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to =minence or continue work.
Date: 111812004
. .INSPECTION ReCORD
. INSPECTION . DATE' iNSPECTOR I.
Tempora/y Power Pole .
Plumbing (DrainlWaste Pipe) . .
Electrical GrQund Electrode/Uter ~
SelbacklFormsfTrenches(FootingS) . I?//L/^" /J .
Do 'not install sub floor or pour floor slab until the /
fOllowing applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GrOUndwork)
Electrical (Underground Conduit) .' '.
Pre-slab (Compaction/Membrane.Rein!.
Underpinning (Floor Joi$t1Gil'ders)
Do not cover or conceal the work below until the'
fOllowing apP'li.c,~bje items have been signed: ". . .
15t FloOr Shear .
Fireliprinkler(Rough) '. . . . .
2nd Floor Shear' " . .
Roof (SheathiIllJ/DiaphragmlFrame) . //
Masonry (ReinfJBond BeanlPre-GlO\It) ...7....~ ""Ai' . 'J
Rough Plumbing (Top Out) '.
Rough Mechanical . '. .
I ROugh l:IectriCaI (Dry wall) .
Rough Elecirical .' .
Framing (Only aner.Plbg.. Elec. Mei:h and Fife) .
Insulation (Sou ndlEnergy)
po not tape or plaster until the followirig applicable .
Items have been signed:.. . '. '.' .
DryWall
.Penetrations(Fire Rated) Electrical . . .
Penetrations (Fiie Rated) Mechanical .
Penetrations (Fire Rated) PIIJl)1bil1g.
Interior Lath . . I ..'
Exterior Lath ,.
GENERAL ITEMS
. Exterior Plaster (Brown Coat) . . .
T -Bar Eiectrical
T -Bar Mechanical .'. . . .' .
T -Bar Structural ..'
Sewer .
Water Engineering Backflow .. .
Water Service . . .
FINAL INSPECTIONS
Electrical F.inal
Plumbiitg Final
Mechanical Final
Gas Test
Engitleerin9fGrading Final 165.0126
Fire Dept. Final 7654040
Water E.nginee.ring 165-5268 .
Sub List/Business License 765-519
Zoning 765-5139
Building Final ILastinspection:Only,~/, ../
, . After Above Complete) Tf, J .
PARTIAL INSPECTiONS.
BuildinalhSDections
MechanicallnSDections
Plumbina In'SDections
Electrical insoections