931 N. Maple St.
TYPE OFB."ERMIT
Blockwall (Columns
DATE: 10/18/2004
JOB ADDRESS: 931 N MAPLE ST
~ ~ -.,
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CITY g.~i4,N~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: 38
BUILDING PERMIT NO. BLD2004-03854
LEGAL DESCRIPTION: N TR 1721 LOT 44
APPLICANT:
OWNER. INFORMATION:
ANTONIO AQUINO
931 N Maple S1
- Anaheim, CA 92801
. JOB DESCRIPTIONlluild 75 Linear feet of 6 foot high block wall per city spcificatlons.
VALUATION: 1,800.00
I . . OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracto?g Ur;ense LC;:lw for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit tor:onstruct, a>hr,- improve, demolish or repair anY"5tructllre, prior to its issuance, also
requires the applicant for sU,ch permino file a signed statement that he is tk;~nsed purSu8flt to ,the provisions of the Contractor's License Law '(Chapter
9}(commencrng with Section 7000 of Division 3 of the Business and Profe~s;".;;s Code) or that he is exempt 'therefrom 'and the basis for the alleged"
exemption. Any v.iolation of Section 7031.5 by any applicant for a permit suHi3cts the applicant to a civil penalty of not more than five hundred dollars
($500). . .;;. . . .;.
o I, as owner of pro perty. ,cr my emplOYees with wages as their sole com[.;..msation, will do 'the work, and the'structure-.is not intended or offered for
sale .(Sec. 7044 Business and Professions Code:" The Contractor's Licensl?lhw'does not apply to an owner of property'who builds or improves
thereon, and who does such work himself or herself or through his or her ovJ;;'employees, 'provided that such improvements are not intended or
offered for sale'. If, .however, the building or improvement is sold with one ye:~;r of completion; the owner-builder will have the' burden of pro~lng that he
did not bUIld or improve for the pu !pose of sale).. 1"" .
o I, as t~e Owner of the-property, am exdusively-contrac:ting with I,icensed;:.-or.tractors 'to construct the project (See. 7044 Business and Professions
Code: The Contractor's l.:icense law does ,not apply to an ownerof property\:y:f1o builds or ir:'"iproves thereon, and who contracts for such projects with
~ontract.or(s) licerised pursu~nt.to the Contrac~o(s License law). ' ::,'.
U I am exem und r Sec. ., Il & P.C. for. Is reason:. ,.~- (
Date: () I P Owner: 14 ~./_~_~_~/
WORKER'S COMPE SATION DECLARAT!ON ~. ~
I hereby affirm under penalty of perjury one of the following declarations: ";
o I have' and will ma,intain a certificate of consent to self-insure for worke(d compensat,i,on,
as provided for by Section 3700 of the labor Code, for the performance of th'c wo-rk for which
this permit,is iSsued.' , i
o J have and will maintain worker's compensation insurance. as required by Sect~')n 3700 of
the Labor Code, for the performance of the work for which this permit. is issu;.d. Mvworker's
Compensation insurance carrier and policy are: . :.
Carrier:' Policy Numb~r,
CONTRACTOR INFORMPT!ON:
ROSARIO AQUINO
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: CDL
LICENSED CONTRACTORS DECLARATION
.! hereby affirm under penc:lty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3.oHhe Business and
Profes.sions Code.
10/18/2004 _
Date:
Contractor
NUMBER
=XPIRATION DATE
This section need not be completed"ifthe pennit is for one hundred, dollars ($10q or less.
o I cer:tify that in the perfonnance ofthe-wor~ for which this: permit is iSSUE:..~, I shall not
employ any person in any manner so as to become subject to the worker's c\)~Tlpehsation laws
of California, and .agree that.if I shoUld. become subject to the worker's comp2nsCltion
provisions of Section 3700 of the la.bor qode~ I shall forthwith comply wit t1~se proyisions.
Da.te: ,10/18/2004 Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION VER\GE IS
.UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAiTIES AND CIVIL
. FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION.3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.'.
I CONSTRUCTION .LENDlNG AGENCY t
I hereby affirm under. penalty of perj ury, that the're is a construction lending ng,Ancyfor,the
performance of the work for. which this permlt is issued (See.3097 .CIV.C): .', . .~,
'- ~. .. -,-' --""""",,_. -----< --.-.
Lt:ll\:l\:;;:f-S '1fFIOfll'rduon:
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
NO
'{,
I certify that I have read this application and state that the aboveinfor.rnation is correct. I
agree to oomply with all city Qrdinances and.Slate laws relating to building construction, and
hereby ,authorize representives of this.oty to enter upon the. above mentioned property for
lnsp~ction purpq ... /J' '.' "
.. GI''C Date: .10/18/2004
Signature of Applicant' r gent
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 permit issuance. A
new permit is required to commence or continue w?rk.
Fees paid for Permi~:
Total:
125.04
, INSPECTION RECORD
,INSPECTION ' DATE, INSPECTOR 1
Temporary Power Pole ,
Plumbing (DrainlWaste Pipe)
Electrical Ground Elecirode/Ufer . ~ /
'SetbacklFormslTrenches (Footings), IcI("I/~
Do not install subflqoror pour .f1oor-slab until the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
N1echanical (Groundwork) ,
Electrical (Underground Conduit) " ' ' ,
Pre-slab (Compaction/Membrane.Rei nf. ,
underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
,following appliccible items have been signed:"
1 st Floor Shear . " '
FireSprinkler (Rough) , '
2nd Floor Shear , "
RQof (Sheathing/Diaphragm/Frame) , i ' A ' "
Masonry (ReinfJBond Beam/Pre-G~t~ijlr -1I/JA.I..
Rough Plumbing (Top Out) , -, .
Rough Mechanical I
I ROugh Bectrical lOry Wall)
Rough Elecirical
F'raming . (Only after Plbg.. Elec.. Mech and Fire:~
Insulation (SoundlEnergy)
Do not tape or plaster until the following applicable " '
items have been signed: .' . ' , . .
Drywall . , , ,
Penl!!rations (Fire Rated) Electrical , .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated)Plumbil1Q , '.
Interior Lath ,
Exterior Lath
. , ,GENERAL ITEMS
E>rterior Plaster (Brown Coat)
T -Bar Electiical
T -Bar Mechanical ' , ,
T -Bar Structural '
Sewer
Water Engineering Backflow
Water Service
/ \
FINAL INSPECTIONS Pate Inspector
Electrical F,inal " " , '
Plumbing Final " , I, ,
,
Mechanical Final ,
Gas Test , ,
Engineering/Grading Final 765-5126
Fire Dept. Final 765-41>41> ,
Water E,nginee,ring 765-5268 "
Sub List/Business License 765-519 "
Zoning 765-5139 , ,
"
Building Final ~ast Inspection- Only' , 9/,:'Ud"$' lSr4cAs "
fter Above Complete)
PARTIAL INSPECTIONS,
Buildina InsDections
, , MechanicallnsDections
,Plumbina InsDections'
Electricallnsi;)ections'
"
(3~
THE ISSUANCE OF THIS PERMIT DOES
NOT APPROVE VIOLATION OF ANY OF
THe: BUILDING COD!::S OF THE OITY.
THE HOLDE" OF' THIS PERMIT
PROCEEDS AT HIS OWN RISK.
OCT 1 8 2004
BUILDING DIVISION OF ANAHEIM
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BUILDING PERMIT NO. BlD2004-00250
TYpE OF PERMIT
Resid"ntial Addition
CITY
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BUILDING DIVISION
'200 S. ANAHEIM. BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714)765-4626
CENSUS CODE: 434
QUARTER SECTION: 38
DATE: 3/2/2004
JOB ADDRESS: 931 N MAPLE 8T
LEGAL DESCRIPTION: N TR 1721 LOT 44
APPLICANT: ANTON 10 AQUINO ,
OWNER INFORMATION: CONTRACTOR INfORrvo{\TION:
ANTONIO AQUINO . f
. 931N Maple St ,
AN.^.HEIM, CA 92801 0000 l
JOB DESCRIPTION2-story room addition. (HIH) ',I
VALUATION: 69,520.00 ."
L OWNER-aUIUJE~~;ECL:~R.t\TICN'
I hereby affirm under penalty of perjury that i am exemp1 from 1he Coptract;:::jR'Ucei1.::;~ If<W fOi the following reason (Sec. 70-31.5 Business ar,d
1-")lOfessions COde: any _city or cou~tywhich requires a permit to CG:1strllct, C:I;~i3r, !mprov(;::. demolish or repair any structure. 'pric.r to Its issuance, aiGo
fequ ires the arplicant for sum permit to file a sighed statement tnat he is p.~_~,;i~e,j -PU~suc:U;lt.to:the pmvisions of the Conb3'::tor's, L.icense LaW: (Chapter
'9)(commer:"lcing with Section 7000 of Division 3 of the,Businf:.ssar',d Prc~~-::-,:;')ns'C~de) n;- tiizt he is exempt themirom <:inn ~he basis for. the al,leged
exemption. Ar,y violst:9n of SectiOI' 7031.5 bvany npplicant for apc:-lT'-it $U~.:.cts,itp.~'Cp\ica~"\ to;,,;. dv'i.p,:,n'altyof no~ more than five hundred ddl~r'3
($500). ..... it - . . .
D . j, 'as ~\o'mer of ::>roperty, or my' employeds V-Jith wages as IIi:i:". ::'Ol~ ~~;i.:;I.t1~.:ns'aticn, wi!1 dotho 'Nork, ':md. the $t~ucture:is not intended.or ,.6ff~rE:d for.
sale (Sec. 7044 Bu:siness andProfessio.ns Code: The Cont:-actcr's lic-:ns,,; .i::.w t:oe3 not s;:>ply toanownerof property who ,~'i1ds or impf'o\tes. '
thereon, ,and who-coes such workhimsf3lf or her.:;el.f 0..' +hrcugh his or :~.:..r.::,:.).i~mp;oyees, provided. that such improvemer:ts-ar~' not intendeC::_or
offered fer !3alc. If, h~wever, the building or irrproVf~n;ent ;g scld with one y:.tf .~f completion. the owner-bu!lder will have the t:irden of oraving that lot:
~did noj..b111fd cr irr.proV'3 for ~he p,urpose of ~Ie). . 11 .
~ 0: as th~) O".vner of the properf'J' am exdusively cc~trar.ting With 1ic.~I":::c:";\C:.Jntr3C::ors to constr~ct the project.(Sec. 704': !:!c<;irles3 and Professiol}s
ode; The Ccn!ra.:;tc-'s Ucense LE,w does not apply t~ an owner c-f ;~r~.:::."i.:~~':ho bu.:C:s or improves :hert.'On, ar,d wNJ..mntrac.ts for SUd\ })rojects v..th
~ontractcr(m !icerlSeJ pursu<Jnt to th'3 Contractor's L:cense :":l;if")~ "~ //.:j' ./ .1-)
U l.JmextJ/Tlotur:derSec. _ ,S&P.C.forthJsreasol' _ ._rfL~ ~~l.__.
Date: OvVner:
c=.---- WORKER'S COMPEr~SATiON DEC"-ARATIO;;---t.' ~ LICENSED CONT~.\CTORS OECLARATION i
I herepy 21flnn Ul1d~r ~enalty'of perjuryone'cf tha foiiowing del:laratior:s: ,,;,,~, . I' hereby affirm cnlier-penalty of.perjur'ltt'1am:ri"""
0' I have ~nd Wi.lI,maintain a certificate of consent to setf.;.insure fOrWQrJ.:~f.!~> '~I). rr:~~n<;.:ticn, . licensed.under provis:Olls of chapter9 (commehc!r:g'
.ao!? pro\lided for.by Section 3700 of the Labol" Code, fer the perlorrnan:~ offr.... ',....ork for which with Section 7:JOO)oi Divsion 3 of the' Business "nd
this perm;t-is: issued. .. _ . , ,1; :'_ . ." P;'Ofessions Code.
D : hove and will majnt~il") worker's'compensC:ttion' insurance, ~s''"9quj~d ~;.k::;ect!on 31':JO of 3/7J2004
tt1e labor ;Ccd~, for tt!e performance pf the w..)rk for which th:s perm;t is 'i$S;..~r~.a-" Myworkcr's Date:
CompensatiOn insurance carrier and Policy 3.re: . J. .
"-carrier: PoJiCj Number. '.'.1 .
. '. ';I.'~
~is secti6n Nfed ~ot be completed if the pemlitis for one hundred dOi1afs {S~. }t:~r :ess. " TYPE
I certj~.t1":at in the perforrnanc~ of the w?rk ~orwhich this per,:"lt::::;ji{;)_~t~~J ~:-,~i1not I.
play an. y person in a.ny m~nher so. as to be.come..SUbject to ~he WCrke(~'-r~.,.!\..~~pe~sat!on laws
of Califorr!?, and 'agree that If" should become subJect to, thework~r'$ COi'i1~'FI$.<Jtlon
provisions of Section 3700 Of.the Labo.r r C COO~d shall !.O. rth",:ith compiy v.m" ::,f.i~ ~rCVl.sion3,. i eON'~t~cion Types:
Date: 3/2/2004 . APPlicant~d'2~. a~~ Occupancy Groups:.
WARNING: FAILURE TO SECURE WORKER'S CCMPENSATION ~\';;~';\G= IS R3" , . .
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMiNAi;P;:NA':;r!ES AND CIVIL Fire 5prinklered?
FINES UPTO ONE'HUNDRED THOUSAND DOLLARS ($100,0001;iN,..:i':~::ON TO THE LivinQ Area:
COS1'()F ,COMPENSATION. DAMAGES AS PROVIDED FOR IN SEc'i10i'st06 OF THE .
LABORCODE.INTEREST AND ATTORNEY'S FEES. ,::~,.;.. \.:,
r CONSTRUCTIQN lENDING AGENCY'<,. .-.
I hereby affirm uhder penalty,of perjury that there, is a construction I~ndinf!r&l~cy'f~:r'~!ie_
_Lc:l"fcrman~. of~~.lew"rkfor whi~.!~i~p~_r~it i$~~~I~d (Se~~~~7.C!"..GK:;5-'~,. .', 0,:'_ -_' , ,j _______~__~ ,~_ __
i..c""";~::a S l'IIVIj'lldlo.tj:l: .
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: CAL.
C0ritractor
NUM9~R
EXPIRATION DATE
NO
499
1
I certify that I have read this application and 'state that the above' informatiOi1:s CC';"fCCt. J
agre,e to comply with all city ordin.ances and ,state laws retating to building_ClJ.lS'truction. and,
here by authorize reprege,ntives of this dty to ,enter upon the above mention(!(; property for .
'inspect~. n pur ses. " " " '-~ .
, ifIP?, ~ . ..'1 Doh: 3/2/2004
. '-""" "Signature of Applicant or AIJ ,t .' ,
Jhe permit shall expire by limitation and become n\lll andvoid if the buildin$! or
. work has not passed final Inspection 365 daY'! from the date ofpemdt issuance. A
new permit is required to commence or continue work.
Fees paid for Perrrut:
Total:
1,344.14
. INSPECTION RECORD
INSPECTION. DATE. INSPECTOR
Temporary.Power Pole . . .
Plumbing (DrainlWaste Pipe) .'
Electrical.Ground Electrode/Ufer 2 .
SetbacklFormsrrrenches (Footin~)
Do.not install subfloOr 9r pour.floor slab until the
following applicabl€{items have. been signed:
Plumbing (Water Pipe.Sprinkler \fl!lves) .
Mechanical (Groundwork) . '.
Electrical (Underground Conduit) ----. ,
Pre-slab (Comp.actionlMembrane,Reinf. ~I
Underpinning (AoorJoistlGirders).
Do nolcover or conceal the woll< below until the
.following applicable items have been signed: .' .
1stFloorShea.r .' '. ~'r:f,ILt(I
Firesprinkler. (Rough) .
2nd Floor Shear . .' ~..
Roof (Sheathing/D1aphragm'Frame) . '-4 --D1
Masonry (Reinf./Bond BeamlPr.Grout) '. . '.
Rough Plumbing (Top Out)
Rough Mechanical ". . . .
Rought:Jectrlcal {Dry wall'
Rough Electrical '. .
Framing (Only after Plbg" Elec..r,,1ec!r.. and Fire) '/<(10<4 :ow .
InsUlation (SoundlEnergy) '/110</ :zA../ . .
00 not tape or plaster until the. following applicable .' '.
.items have been signed:' . : ' '-
Drywall . . . . '111f~ .,- tlAIU.II
Penetrations (Fire Rated) Electrical . . .-.J
Penetrations (Fire Rated) Mechanical
Penetrations.(Fire Rated) Plumbing '.
Intflrior Lath . . ~?..ot.t .-'1/..1~ .
Exterior Lath . ~ _ 9' .0'-/ ...,. ~
. . '. GENERAL ITEMS ")
Exterior Plastflr (Brown Coat) . . "r7 ' ~^
T -Bar Electrical . . '. .
T -Bar Mechanical . .
T -Bar Structural' ". . .
Sewer .
Water Engineering Backflow' .
Water Service . .
FINAL INSPECTIONS
Electrical Final'
Plumbing Final
Mechanical Final
Gas. Test
Engineering/Grading Final 765-5126
Fire Dept. Fina1765-4040
Water Engineering 765-5268
Sub ListJBusiness.License 765-519
Zoning 765-5139 .
Building Final (Last Inspection. Only
)\.fter Above Complete)
Date '.
'"
Mechanical Inspections
Plumbina Inspections
Electrical Inspections
DEPARTMENT OF BUILDING AND SAFETY
STRUCTURAL OBSERVATION REPORT FORM
ir.S R~PORT INCLUDES All CONSTRUCTION WORK THROUGH 1-17 DAY OF
I
I
.../ t/ iJ .,t7.--
REPORT NO.
, iH:U> 4-
PAGE NO. + Of --/..-__
PROJECT ADDms
STRUCTURAl OBSERVER
)WNER
DAlf
CP'V 1Y1- 0
LOCATION AND PORTIONS Of BllXi.
J-fflUHOATlOH a-WAll a.FlooR
0- fOOTINGS, SUB I: SHM WAllS O..cONCftffe- O..$TEEL MOMEHr ..sPECIN. O..cOHCftfTf
L1...ftl,fSlflnSfO COttCf'n'f SlAB$ O.:JIWONRT O..sTEEl MOMfHT-ORDltwn' O-STEElDfCK
U-Q.lSSOHS, f1lfS. (jAAOE BEAMS -WOOD a..sUfl6flACED a-WOOD
O-HIUSIDE SlOGs.. SPfcw. O. O""OHCitfH: -DUCTILE O.
fOUNDATION ANCHORS
0- o. O..cOHCRfTE-HDH-DUCTILf 0-
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'!VfDDEfIClENClEIo
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C--f7~ ~-F ,v/'0
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r OHWf rn.U THE fOUOWIIIG STATfMEIlU AK[ nUf TO TilE 8m Of KY lltOWLEOO{ ANO BfUEf;
o DEfICIENCIES CONI/NUED ON ATTACHED fOR" 8&S161 A)
I All Tl/f IEGISmED fll'GlltfEl Ok UCEHSfD AACHITEa WHO IW mfOHSI8LE OlAJ.Gf fOl THE muaUUl OBSHVATlON
I, Ol.lllOTHfllEGlmlfD UGIIl'EU OJ. UCEK1EO AlCHmu WI\G I HAVE I)ESMiltAlID ABOVE AHD IS UIIDU MY
USPOIISJ8lt (IWGE, HAS PflfOltlED THE k[QUlltD Sm: YISlfi AT EACH SrGNIflCAIlT COHSllllCTlOH STAGE TO VHlFY If
/HE mUC1JJ!E /SIN GENUAl CONf<lIIWlCfWI1H lIIE APIIOVEO llANl AND IlmEICATlONI;
ill DfIKI!lJCIB WKIlH IIiOCU"E/lJfO HAVE BEEN commo UNliS OlllUWllE INDICATED ABOVE,
I ulOnrrAMO TJfA.TfIIW.ACCErTAHCfDfTHEmUCTUWnmrlS 8YTHf OfPAWIEHTDf BUilDING ANI:! WHY CANNOT
Dew. WfllIOllTTlIECOUfmON Of ALl08m.VEO DEflCIENClES;
l.ol mroHSJBlI WI THfSUBl1lSSrOH Df llIf DlrG11W. Of 11m mOlTTO mE OEPAkTHEHTOf BUILOIHGANO SAFETY,
ClTYOfl01AMGfW.
\ \{,lifE n.o~\l:lm SllIlOUUl. OBSUYATIOH IH A((OIDAHC[ WITH TIff UQUllfl1EHn Of THE CITY Of lOS AHGflH.
,CA
ST,\MI' UF EN(jJNEER OR.-\RCllrru..T
STltUClURAL OBSERVAnON DOES NOT WAIVE AHY Of THE REQUIREMENTS fOR BUILDING INSrECnON BY AUTHORIZED EMPLOYEES Of THIS DErARTMENT
>JS1IIBII11OI, mUOUlAl 08lE!YE11O IflDO!lG11W.1O l1IE BUllOlJIG IISI{(JO!~OffK~ AlTAtHTHE f1111CO,.,1O lIIE AIIIDVED 11.1II1, AND IHt IECONO CO,., f<l! mUC1JJlAl OBIE!VEA'IIHO!O AND ~llilBII11OII.
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