4854 E. Maychelle Dr.
.
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CITY QtlL~t,fS~,HEIM
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,
BUiLDING DIViSiON
200 S. ANAHEIM BLVD,
(714) 765, 515?
INSPECTION'REQUEST LINE
(714) 765 - 4626
CENSUS CODE: 434
.,QUARTER SECTION: 167
BUI\..DING PERMlT NO. 8\..02003-03773
1YPE OF PCRMIT
Residential Addition
DATE: 10/8/2003
JOB ADDRESS: 4854 E MA YCHELLE DR
LEGAL DESCRIPTION: N TR 5083 LOT 25
APPLlCANT:ANDREW DURATE
OWNER INFORMATION:
Andrew Duarte
4854 E "-1aychell. D'
-Anaheim, CA 92807
JOB bESCRIPTIONExtend 2 existing bedrooms and add closet . i
,
VALUATiON: 22,612.00 . \
I OWNER-BlJILDE:~gi:Cl.ARA nON
I.hereby affirm under penatty of perjury that I am exempt from the Contrac::('i"sijcer.~~ Law,for th~ folloWI1"g reason (Sec. 7031.5 Business 3fld'
Pro,fes~ioils'Code: any city or county which requiresa p~rmit to construct, c3~~!'". '-i!Tlprovc,'d::::mollshcr repair 3n'/ siructurE:. prbrto itsissuarice~ also
requires the applicant for such permit to. file a signed statement that h~ jS!~C(J'I!sed pursuant.to thepJT)visic~ms of lhe Contrqctt)r's UcenseLaw (C~apter
9)(commE::1cing with Section 7000 of OivisiOl"'. 3 of the Business O::"ld P",ff'.s-:::'i::1S CODe) ():-t~dt he 13 eXe"mpt therefrom and.the ba$is for the alleged '
ex~mption. Any violation' of Section 7031.5 by any 2pplicant for a perl'Y'\.ir st.;:;l'I:,..,te tt';_~~;:;li6:~nt to a Civi: p~na.l(y of not'more tlinn.five hUl!dre. d. dollars
($500), .. .. . . . .. .
o I, as owner 9fproperty, Of my_employees with wages as their,sole COJTIr:li.s""~!0P, wB! uc tho '.ycfk, ar.d ~he.structur(j is nct int~t1ded,or"offerel~ ~.~.r
sa:e (Sec. '701": 8usiness anti Professions Code: The C()ntrcoctor's Uccns~ :.~;\V dCG3,not app~y to an owr,er of propertY who builds oj- jmpr~>ve~
_ thereon, and who does sLlct:. work nimse!f or hej$elfortr,roughhls or :-,~:- c;;:'~,f::mp~')yees, prcv;cled tr.~t to;Jch improvement.> are n0t. il)tenry,ed Of',
otferedror sale. if! howeve;, the bUflding or improvemen(is s'Jld with one.i'z.{.- of completi<;>n, theowfler-ouilder will have the burdeii of moving that
-~_i~t build or improve for ttle'purpose of sale). '~-, . ", "
~ _ If as tt.:~ oWlJer of the property, am exdustvbly c'onfracti~g ,with nCeI13,:..'k-tti.PJ~r)rS to co!";::;trll::;t,theprt'lect (Sec., ~044 2l!sirle:;.;5 al:dP:of6~~:;:(is
Code: Th~ Gpntracici'.S License Law does not apply to an owner of prop-:::r.....--J,'hO ht:,iic!s or i!'",1;:::roves .hera/)o, ar:d who ~r..tra.Cttsfor such proSe~h ......ith
~;jac\cr~') lice~sed p:Jrscant to the Contractor's Licen~-W). t 1
me)(emi:~llnd(7rSE::c. _ . ~J fh1~J as~:~ ~ ~
Data' I'D-DI'l.D..2 Owner. &1 . ~~ __ L
-, -==--=:.:~')R!i~~~~ CO PENSATION Ei:LJl.RATION~::r==- I L LICENSED CONrRACT_O~SDECt.ARATIOt: I
t pp.retly affirm un~er penaitj cf pt::.:iu....; one of the following declaiations: \j ,'-I h6_reby ~':lffirm und~r peha:t:1 of perjl~'Y ihat -j am'
[] I have and will rnalnt8.in a certific:::.te ;:;f ;:::cnsent to seif-m5ui~ for wt:.;:::;....lC("'ftl~E.!1Si::l.t:O..I, 1!:t:f)3e1:.~,tndecp-rovlsiorls 'of c.t'apter P (commencin.g
.as ;Jrovided f')r by .:;E.-.::!.ion 3700 of the Labor Code. for the lJerf!)I"md(,ce 0; ::~1 _vork 1M w'm..il I witt'! Se~tion70~O),.of Divsion 3 cfihe .Business i.nd '
this oermit is issued. . . 'j , Profp.sslons Coae.
~ _ .' . , :: I
o I h~veand_ will maintsin worker's compensation i:1surance. <1S ~'Bq':ire<.! ~'J Sao..:t:O" 37GO('( I -'\0/8/2003
the' Labo~ Code, for tr:e: p~rbrm<.U1ce of the work for'whlch this ;JCr~Tlit ~., !5.,o:.:":'!'(!. r.1Y""('Irl(E'!"s Dat~.
Compensation ing;)rance earlier and poliW are: -; I
Carrier: Poky Number: J.. ' NUMBCR
J.
CONTRACTOR INFO~M.>TION:'
~ .
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: AEM
'I
ContrClCotor.
EXPIRATION DATE
This secticn llE'ed not, be completed if the pennit is for one _hundred dollarf: (?i~':'.~,~;, !:''is.
o I-certify ihCltln the performance of the work for which thi:s periTIH ~~ iS3:;"'+~ l_s!~~;i nt)t
~mp!oy al1Y person in any mallner so as to become subject tv the'wl)rJ.:.~r$ ':.'~:~~i:ens.'atlcn laws
of Califomia, and agree that if I.should become subject, to the worker's co::::;:"~';"'~,~At:on
::I:~i::;8;~Os::tion 370001 ,he Labor C . e, I shall lo~hwi. co7dt.~-Jij~~f?,i3;on~;_
WARNING: FAILURE TO SECU . WORKER'S CO.,PE.'NSATiON COV::'::,.t)1l,:!$
UNLAWFUL. AND SHALL SUBJ CT AN EMPLOYER TO CRIMINAL PE~;A;';'iiESAND CIVIL
FINES UPTO ONE HUNDREoD THOUSAND DOLLARS ($100,000), IN A[>Gi'.10~TO.rHE
COST OFCOMPENSAT,ON; DAMAGES AS PROVIDED FOR INSECT;C'f< ~1;\9'P~T'!'"
LAEJOR CODE; INTEREST AND ATTORNEY'S FEES' _ ; ,.' .'.
I CONSTRUCTION LENDING AGENCY;}.. ..... ... _
I hereby affirm u:1der penalty_of perjury that there is aco:,stiLrc,ionlendinu ri;,;:':r-.cyf?1'"!he
!)enormance of the wOikfor whid'l'thl., permi.t is iss!Jed (~",ec.30:27 ,Clv.C): .-;,.).-: .~-,-" .
_.t;_~_~J_i~L:';'io!~i,-'"O~,'Nn....:.' . .. . .. -.' . ',-- .. -'O'. -'.
-TY?E
Con:->trucion Types:
"N, .
Occup~ncY Groups:
R3, ,', ,
Fira Sprlni<lered.?
OweilinQ Units: .
UJin!:ll\rea:
NO
1
336
;-<;t:...:-~~
I certifY that I have r~ad this application and state that the above infor('~tibn ,is correct: I
agree to comply with all city ordinances and state laws'relating to' building cot:strucUon, and
hereby authorize representivesWthiS dty 0 enter upon the above mentioned property for
inSRed' rpo s.
Date: 10/8/2003
Signatur 01 Applicant or Agent
. The permit shall expir by limitation and become null and void if the ;,uilding or
wOrk has not passed fimil inspection 365 days from the date of permit. issuance, A
new permit is required to commence or continue work.
..
Fees paid for Permit:
Total:
694.63
INSPECTION RECORD
. iNSPECTION .' ..' .
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Uter
SelbacklFormsfTrenclles (Footings) '.
Do not install subfloor or pour floor slab until the
following applicable items' have" been signed:
Plumbing (Water Pipe.Sprinkler Valves) .
Mechanical (GroundWork)
Electrical (Underground Conduit)
Pre-slall (CompactionlMembrane.Rlli nt.
Unclilrpinning (Roor Joist/Girders)
.Do not cover or conceal the work below until the
followi~g applicable items have been signed:
1 st Floor Shear .' . I
Firesprlnkler (Rough)
2nd Floor Shear
RoOf (Sheathing/Diaphragm/Frane)
Masonry (RelnfJBond Beam/Pre-Grout)
Rough Plumbing (Top OLit) .
Rough Mechanical . .
Rougn l;Iectrlcal \ury Wall) .
Rough Electrical '. . "
Framing (Only afte, Plbg.. Elec.. Mech and Fire) ~_I~...,4~.
Insulation (SoundlEnergy) . V_\.7. NA I . L-
po no.t tape or pla~ter until. the following applicable ...
. Items have been sIgned:.. . . . mil
Drywall . . ~'Il'
Penelr;llions (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire RatedlPlumbing
Interior Lath ..... .
Exterior Lath "-fl - 0
. GENERAL ITEMS
Exterior Plaster (Brown Coat) I. "'/1.&'1 .
T-Bar.Electrical
T -B.ar Mechanical
T.Bar Structural
Sewer
Water Engineering Backflow .
Water Service' .
DATE
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INSPECTOR ..~
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FINAL INSPECTIONS
Electrical Final
plumbing Fim,l
Mechanica.1 Final
Gas Test
Engineering/Gr3(ling Final 765-5126
Fire Dept. Final 765-4040'
Water Engineering 765-5268
Sub List/Business License 765-519.
Zoning 765-5139
Building Final Ilastlnspection. Only . /1 AI t ,( !
. After Above Complete) f VI I .
PARTIAL INSPECTIONS
. Buildina Inspections
Inspector
Mechanical Inspections
Plumbina Inspections
Electricallnsoections
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