2080 S. Margie Ln.
CONTRACTOR INFORM/nON: . ARCHITECT/ENGINEER INFORMATION:
MAVERICK REMODEUNG AND CONSTRUCTIO
. I. ,
291 S LA CIENEGA BLVD #V33
BEVERLY HILLS, CA 9021' 0000
BUSINESS PHONE: 8005ot-006?
. JOB DESCRIPTIONAdc!ition to SFD, Extenc! living room, laundry room, and di2ing room, 202 sq, ft. (HIH)
VALUATION: 13,595,00 ,. PROCESSED BY:CAL
.1 . OWNER-BUILDER)JECLARATiON
. I hereby affirm under penalty of perjury that I am. exempt from "!he Gontractoii~ License. Law for the. following~re.asori (Sec. 7031.5 Busine~s and' . '_. '
Professions Code: any dty or county which requires a permit ,to construct,. a.I~~r, improve, demolish or Jepa!r ~riy structure, prior,to"its issuance, a[~o'..
reCluifest\':le ~pplica':ltfor such permlt.tofile a signed statement that. he is HC11?sed p. ursuant to the provisions 0~the con~ractor's. Licer)se Law (Chapter
. 9)(commeI1cing with Section 7000 of Division 3~of the .Business and Professij;:ns .code) o~ that .he is exempt therefrom and the basis for the aileged
exemption. .Any Violation of Section 7031.5 by any applicant for a perri1i~ -Si.l~~.~t.,.s the a pplicant to a dviI pe. .nalty of.not_ more th~n five hundred dO. liars
($500). , . .. . . .' L" . .... . .
D- I, as owner C?fpro.perty, or my ~mployees with wages as their sole .com~~nsa~ionJ w.ill do_the work, and the structLlre}snot intended Or offered for
sale ($ec. 7044 Business and Professions Code: The Contractor's Licensej,pw doesnofapp!yto.an o~neJ of p:"o,pf!'rty who builds or improves . .
thereon, an9 who d:oes such work ,himself or herself or through his.or her pW."iemployees., provided.that such improvements are. not iritendedOl
offered for sale._ -If, however, the building or improvement is erold with one:~*"~ t.of completion, the owner-builder'wlll have the burden of proving that he
'dictnotbuildorimproveforthepurposeofsa~e).. '.. ,.,.l- . ~ . '.
DI,as t~e ownerofthe property, 'am exdusiveiy"contracting With'licensed-t;{l~,trad.cr", t~ construct the project (Sec., 7044-Busina')s'.arid'Pr~fesSjons
Code:, ThegohtractOl"'s- License Law does not apply~' anowroer of propertYiWho blJiJd~orimproves thereon,. 6.fld who. contracts for.such projects Vltith
'l:jontractrn:'S}I\Cense~ purs~~nt-totheC~.ntractor'S"Ucense Law); . 'f . .. .
. lam e?Cempt.ur'lder.Sec.... .., ~ & P.C. for this reason:" .~-l
Date: .' ;.' Owner;..' . .- t~ .
I ... . ...... .. .'. WORKER'SCOMPENSATIONDECLARATION "'t-'" ~----3
I herebyaffi.rm un~er'p'enalty of perjury one ,of the farrowing declarations: . .... .
. 0_, I have ard will :mail')tain a certificate ofGQnse:nt to self-insure fo~w~rker.~compel1satian,
as provided for by Section .~7qO of .the Labor Code; for the -petforman~ of ~!'~l..Vork forwhich
this permit is issued. ..' . it .
o I have and wilt maintain worker'~ compensation inSl:Irance, as required~V Section 37do of .5/3/2004
. the Labor Code, for the performance of the work for which this permit is i::;s~:~d. My worker's . Dat~:.
Comp~nsationinsuraliceca'nierandpoliC}lare: ,.' . --' ;l~'- . .
Carrier: ,EXEMPT - . "Palicy-N!:-lmbcr. EXEt,,1F:!,. NO EMPLOYE
'. . . .. . . . r .'
This section need not be completed if the permit is for one hunc!red c!ollars ($10t'i or lesS.
o I certify tha.tin the_perfol1l'iance oftDe work for which this permit is iSSU~\tj, I shair.not,.
employ any person in any m!3nner so as to ,become subject to the worker's c(;mp~nsation laws
of California, and agree. that iflshould become s qlect to the worker's corr:f:~Jnsa~ion
provision~ of Section '3700 of the Labor C , I s!J.~rr.forthwi~~comply.x~Hh U'fqe ~r,ovisions,
. .-. {',,-,
BufLDING PERMIT NO.. BLD2004-o~433
TYPE OF PERMIT.
Residential Addition
DArE: 5/3/2004
JOB ADDRESS: 2080 S MARGIE LN
. ..
LEGAL DESCRIPTION: N TR 2575 LOT 89
r
\.
(
APPLICANT:.
OWNER INFORMATION:
Victor R Ta bia s
8641 Running G<3it I.,n
Rive",ide, CA .9250~
BUilDiNG DIVISION
200 S. ANAHEIMBL VD,
(714) 765. 5',53
INSPECTION REQUEST LINE: .
(714) 765 - 4626
CENSUS CODE: 434
QUARTER 'SECTION: ,67
UCENSEDCONTRACTORS DECLARATION
I hereby aliirm unde r pe~lalty. of. perjury that I am
licensed under provisinT1so"f Ghapter Q (commenc!ng
with-Section 7000) 0 ',\VS n 3 of the Bu-siness and
Pi'OfessiO ode
NUMBER
800912
TYPE
. Date: 5/3/2004 Applicant: ., .
WARNING: FAILURE TO SECURE WORKER'S COMPENsATION COV_~t'j,t;Fis .
UNLAWFUL, A,ND SHALL SUBJECT AN EMpLOYER TO CRIMINAL'PSm-i'~ES AND CIVIL
FINES UP '1"0 ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AQO"nQ,,:! TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO~; ViQ6 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,. .' ,-".., jF::. . .' .
jCONSTRUCTION LENDING AGENCY:, -'.li j
I hereby affirm under penalty of perjUry that there is a construction lending a(>~r.cy'for the
performance of the work for which:this permit"is issued (Sec.3097.Civ,ch;... :.~'~:' .
t .ender's Information: . . ,):}k': ;'(:
_ ______.-_._...,.........._-_'-__ _ _ .~:i.:i.i~\.>~_
Construcion Types:
VN, ,
Fire SprinkJered?
,
/" .
Contractor
EXPIRATION DATE
. 11130/2005.
B
NO
_--...,.i--.__~'-."...._,.-~,,,_.,_--,,,,-,~,,_ ,_
. .
~ -,,,,--'~-'~_.-'--"-",---,-,----
. , .
I certify that I have read this applic~tion and state that the aboveinfotmation'is correct. I
agree to com \th.al ity ordinances and state laws relating to bunding ccnstructi9n, and
hereby-au' orize e sentives of this city to enter upon the above rns'"!tioned property for
insp n purpq s.
Dalo: 513/2004
1,36.
Signature of Applicant or.Agent
The perinit shall expire !ly limitation and become null and void if thll 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.
Fees paid for Permit:
Total:
INSPECTION RECORD
, ,INspeCTION ' '" ,
Temporary.Power Pole "
, Plumbing (DiainlWaste Pipe) , "
, Electrical ,Ground Electrode/lifer, Jill 0 'l'
SetbackfFormslTrenchll!;. (Footings) . tel ( 10&-! ....
.,00 notinstallsubfloor o~p()UrfIQOr slab untiHhe
fOllowing applicable ilenis have been.signed: .'
'. Plumbing (WaterJ'fpe.Sprink/er Valves)
. "'ecruinical (Groundwork):. ' .
I Electrical (Underground conduit).
.. Pre-slab(CompactlonlMembrane.Reinf. '
. Underpinning (Roar Joist/Girders) .
00 not cover or conceal the work below until the
following'applicableitems have bee~ Signe~
1st Floor Shear :.' . ' . 1'J.lU!?!!.
.Firesprinlder (Rough) . '. "c. " ,
2nd Floor Shear
Roof (SheathinglDiaphragrntFrame) I.
Masonry (ReiJ'lfJBOrId Beamlf're-Grout) '. " .
Rough Pluri1.bing(Top Out) . ' .
Rough Mechanical ,',., ". .
I l:IectrlC3I II) : '
Rough Electrical . . . . . ,'.
Framing..' (Oo~ after Plbg..Elec.. Mech,. and Fire) '111"0'1-' "'Ie.-{IM
Insulation (SoundlEnergy) .' 1111t1~
Do not tape or plaster until the following applicable I, '
items have been signed: .... .' .' ., ' .1
Drywall . . ' . . -IJ',..-o<, N"- '^ j
Penetrations (Rre Rated) Electrical . .
Penetrations (Fire Rated) Mechanical
'Pclnetrations (Fire Rated) Plumbing.
Interior Lath. " . " ".
ExteriorLath . /' .' ~
, " GENERAL ITEMS ..'
Exterior Plaster 113rown Coat)
T -Bar Electrical
, T-Bar M&chanlcal
T -Bar Structural .
Sewer .', ' . '
Waier cngineering Backflow .
Water Service'
DATE
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INSPECTl)R 1
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FINAL INSPECTIONS
Electrical.Final
Plumbing Final
Mechanical Final
Gas Test
EngineeringfGradlngFinaI765-5126
Fire.Dept, Final 765-4040
Water Engineering 765-5268
Sub List/Business. License 765-519
Zoning765-5139.
Building Final ILasllnspection'-Only
.. After AboveComplere)
PARTIAL I.NSPECTIO
Buildina Ins/?ections
.. Inspeclor
J
Mechal1icallnspections
.
Plumbina Inspections
ElectricallnSDectioris