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826 S. Maywood St. BUILDING PERMIT NO. BLD2005-03572 TYPE OF PERMIT Blockwall / Columns CITY DATE: 11/9/2005 JOB ADDRESS: 826 S MAYWOOD ST LEGAL DESCRIPTION: N TR 3371 LOT 10 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 104 APPLICANT: LUZ HEREDIA OWNER INFORMATION: CONTRACTOR INFORMATION: LUZ HER EDIA 826 S MAYWOOD ST ANAHEIM, CA 92805 JOB DESCRIPTION:Build 39 lineal feet of 6 foot high block wall per city specifications. VALUATION: 1,000.00 PROCESSED BY: MSM I OWNER-BUILDER [)ECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's.:Ucense Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjepts the applicant to a civil penalty of not more than five hundred dollars ~O). , I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sa Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves there n, and who does such work himself or herself or through his or her own I3mployees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one year of completion, the owner~builder will have the burden of proving that he did not build or improve for the purpose of sale). D I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: 'The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with ,a..Qontractor(s) licensed pursuant to the Contractor's License Law). U I , exempt under Sec. ,B ..,p.C. f his r ason: Date:" r- Owner: WORKER'S CO ENSA ION DECLARATION I hereby affirm und~r penalty of perjury one of the following declarations: o I have and will maintain a certificate of consent to self-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. D I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's Compensation insurance carrier and policy are: Carrier: Policy Number: io section need not be completed if the pennit is for one hundred dollars ($100) or less. I certify that in the perfonnance of the work for which this permit is issued, I shall not loy any person in any manner so as to become subject to the worker's compensation laws of California, and agree that if I should become subject to the worker's compensation provisions of Section 3700 of the Lair Code, I shall forthwith comply wit~ those provisions. Date: 11/9/2005 Applicant: WARNING: FAILURE TO SECUR RKER'~OMPENSATION COVERAGE is UNLAWFUL, AND SHALLSUBJE T'AN EMPLOYER TO CRiMINAL PENALTIES AND CIVIL FINES U P TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDIllON TO THE COST OF COMPENSATION, DAMAGES AS PROVI DED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under pena~y of perjury that there Is a construction lending agency for the performance of the work for which this permit is issued (Sec.3097 .Civ.C): Lender's Information: I certify that I have read this application and state that the above information is correct. I ;e to com~ly with all_clty..d?-b9.!Q~~a~d sta!~_!~W~ relating to buildi~g consJruction, and h r by authorIZe representlves--oT-thi~to enter upon the above mentioned property for . ect~oses.) ~- ~ 4- .=,(L" ~...;. Date: 11/9/2005 o Signatur~ ~r Applicant or Agent 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 work. ARCHITECT/ENGINEER INFORMATION: LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 11/9/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Construcion Types: V N, , Fire Sprinklered? NO \':;,"!'.:' . """... .:~~.;~ Fees paid for Permit: Total: 133.28 City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground Electrode/Ufer t;'~ SetbacklFormslTrenches (Footings) I '16.~ Do not install subfloor or pour floor slab until the C following applicable items have been signed: Plumbina/Water Pipe/Sprinkler Valvesl Mechanical (Groundworkl Electrical/Underaround Conduitl Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) 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 (Sheathing/Diaphragm/Frame) ~ . Masonry (Reinf./Bond Beam/Pre-Groutl 'fI-(8-q;, IY./P<-,/ Rough Plumbing (Top Out) / ') Rough Mechanical <--- Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele., Mec. And Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath GENERAL ITEMS Exterior Plaster (Brown Coat) T -Bar Electrical T-Bar Mechanical --' "'..,." T-Bar Structural -~-~~. .- Sewer Water Engineering Backflow Water Service FINAL INSPECTIONS DATE INSPECTOR Electrical Final Plumbing Final Mechanical Final Gas Test Cross Connection Control (714)765-4280 Engineering/Grading Final 765-5126 Fire Dept. Final 765-4040 Water Engineering 765-5268 Sub List/Business License 765-5194 Zoning 765-5139 Building Final (Last Inspection - Only I{)(~ V~ After Above Complete) PARTIAL INSPECTIONS Buildina Insoections Mechanicallnsoections Plumbina Insoections Electricallnsoections ...'- .~ ~.......-...'.............''''''' ;111 (ll Y VV 07J cL 4v e- ty2.-- S \0+ i PLANNING DEPARTMENT I~PP'p.OVED i..nH~ H)~'LIJ)r:~- C))/ .~,/0:~,,' ACTION I~ .. lk~ .-.- ~ ( ) {l11;ti~I~~ :~t COG ZONE HISTORIC Dt'5-;TR\CT r:{'~ ,/" 'i" N/A S~!;. ~;;i:c.[n;J th:s (j<::':;--,~ I -ef'rol$ or.~~"~n--;b'ovg~ll'r~~--- SEE BUILDING PEFMIT FOR I ANY CONDITIONS J V'-UiJ tAl (J'fC- C0 ~ r----., \\i ------' J' 'x.. CJ ?:. ~ ~ ~ ---- ~ ~ ~ (j;r :s-- i- q2-0 ~. 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