5910 E. Marsha Cr.
BUILDING PERMIT NO. BLD2004-01930'
.~
ElM.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
i~$PEGTION REQUEST LINE:
(714) 765 - 4626
. CENSUS CODE: 434,
qUARTER SECTION: 192
TYPE OF PERMIT
Bloekwall/ Columns C I TV
DATE: 5/24/2004
JOB ADDRESS: 5910 E MARSHA CIR
. LEGAL OESCRIPTION: N TR 8679 LOT 29
APPLICANT:, ROCKS'
OWNER INFORMATION:
Raymond E.Rocks
'5910 E'Marsha Cir
Ahahelm, CA 92807
JOB DESCRIPTION:Add 2 pilaster' 6' high arid add bloek wall. 10 eily specs.
VALUATION:' . 400,00
I . OWNER'BUILDER j)ECLARATION
". I :here~y affirm under penalty of perjury' that.1 am exempt from the Contractot,'~. License Law forthe folJowing reas!)" (Sec. 7031.5 Business and
Professions Code; any city o~countywhjch requires a .permit.to construct, ai!i" improve, demolish orrepair aflY structure, prior to its issuance, also
requires the applicant for such permit to mea signecf,stateme.,t that he iSljc=~sed pursuant to t~e provisions of the Contractor's Licehse Law(Chapter
.9)(commencing with Section 7000 ot Division 30t the Business'and Professi;'~ls Code) or-that he is exempt therefrom and the basisfor the alle_ged
. exemption. AnV violation af'Section 7031.5 by any applicant for a permit suc:~cts the applicant to <:l civil penalty of not, more than fi\re hundre<;tQollars
($500).. ". "i\ . . . . . . . .', '
o .1, as owner of property; ormy employees with wages as their,~le com~'.:insation. will do_the w~rk,-and the structure is not intended or offered for
sale (Sec. 7044 Busin~s ana Professions Code: The 'Contractor'sUcense t:.~w doe,S not- apply to an owner of property who .builds or improves
thereon, and who does such work hinis'elt-or herself or through his or her owl; employees, provided ~hat such improvements are not intended or
. offered for sale. tf, however; the. building or improvement issord with one yeir ot'cornpletion, the owner-builder will have the burdenof proviflg'thafhe
~id build or iinpr,bve fo~thepUfPoseofsale).. ..' i\, ' -_',' _ -
, ~, as the owner of the property, am exdusively c<?ntracting with licensed ~~ontractors to construct the project (See. 7044 Business and ProfeSSIons.
Co e: ,The ConJractor's U<;enseLaw does not_apply t? an.ownerof propertYT,?'r:o ~tJjld~ or improves thereon, and who'_contracts for such proje~ts wit.h.
p....qontractor(s) I~cens~ -pursu,ant, ts> ~he Contractor'sLrcense aWl"~ . .> . : '.
U I am xe pt u d r Sec.' " B.C. for this ' on: _ ; . _ .' . - _ .
Date: ' 'Owner:" .
WORKER'SC PENSAT N D CLARATION
thereby, affinn under penalty of perjury one of the foilowing declarations: "
'0 Ihaye and will maintain ~ certificate ~f cOnsent to self-insure for worker';i}(;ompensation,
as provided 'for by Sedion 3700 of the labor Code, for the performance of tl;;; ~'!ork tor' whiCh
this permit is issued;. . . !
o f have and,will maintain worker's compensation insurance; as reqUired b:\'SeLtion 370Q bf 5/24/2004
,t~e Labor Code, forthe performance 9f the work for which this, permit is is::~~~l Myworker's Date:
c::qmpensatio\1 insurance carrier-and poliCy are:. !
Carrier: Policy Nu mber:
CONTRACTOR INFORM.mON:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: GAL
LICENSED CONTRACTORS DECLARATION
I hereby affirm u.nder penalty of perjury that'l am
Ilc,ensed under proVisions.of chapter 9 (commencing
with 'Sectio n 7000) of. Divsion 3 6fthe Business and
Professions Code.
Contractor
NUMBER
EXPIRATION DATE
\.:
This section lJeed not be completed if the pennit is for one hundred dollars ($100l:~'r' leSs.
o I certifY that in tne'_perfo~ance ofth~ work for which this permit is-issue.~( I'-ShaH not
employ-any person inan"y man,!er so as to-became,subject to, the workers_co:,npensation laws
of Cantomia, and_agree that. if I shouJd become SUbject-to the worker's compe;'satipn
provisions of Section 3700' of the Labor COde, I' sha" forthwith mply wit thd3e visions.
. l"
Date: 5/24/2004 Applicant: . .
WARNING: FAILURE TO SEGU ORKE SCaMPI". SATION COVER~GE IS .,
.UNLAWFUL, AND SHALL SUBJE.CT AN EMPLOYER TO CRIMINAL PENAI.TIES AND. CiVIL
FI.NES UPTO ONE HUNDRED THOUSAND DOLLARS ($lQO,OOQ),IN ADDI;i:10N TO THE :,
COST. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION S'10$01' THE ;,)
LABOR' CODE, INTEREST AND ATTORNEY'S FEES, . . .~, '",r ,
I,CONSTRUCTION LENDING AGENCY j
J hereby affirm under penalty of perjury that there is a construction, lending ag,:lrlcv"for the
__peI}6f~n~ of the work forwhidl this nermitts i$sued (Sec.3097.Civ__Ct_.__,r.-.:.________
lender's Information: .
TYPE
'Construdon Types:
VN" .
. I certify thatl-have read this application and state th'attheabove in'forf1.18tion i; correct. J
agree to Comply with ,all city ordinances and state laws relating to building cOflStruction, and
hereby autho(lZe representiVes of this dty taenter n the a Ove mentioned property for .
i.nspection urpo.ses.. . .
Date: 5/24/2004
Fees.paid fo~ Permit:
Total:,
0.50
g ature of icant or Agen
The permit sh I expire by limitation and beeollll! null and void if the building or
Work has not passed final inspection 365 days from the date of perm'tissuance. A
new permit is required to cOmmence or Continue work.
INSPECTION RECORD
. " .' INSPECTION . 'DATE .INSPECTOR '.
. .'
Temporary Power Pole .' . . .'.
PI\lll'lbing{DrainiWaste Pipe) .
Eklc:trical Grciund Electrode/lifer .C)
. .S6tbacIllFl.lm1SlTrenChes{Footlngs) ;../. (J <
00 no/install subflOor or pour floor 51a un!i1 the
following'applicable items have been signed!. '.
PlUtnblng (Water Plpe.sprinklerValves) -c' . . . . .
Mechanical {GroundWork' . . '.
ElecttU;al (Undelgroilnd Conduit) . ." .
. t'reOSIaD (ClImIIactionlMembrane,Reinf. .
Underpinning (Floor JoisVGinlers) .
.uo not cover or conceal the work below untIl the ' . .'
".fcillowiJig applicable ite:ms- have' been signed: .
151 Floor Shear. ' . . . ....
FireSprinkl.. (Rough) .
2nd Floor Shear.' . . .' '. .
ROof (ShilathinglDlaphraallllFrane) .'. ;, . .
M..oniy(~inf.IBolld Bllam/Pre-GJOUt) . , '
Rougl>Plumbing (Top Out) .
Rough Mechanicaf ..
I<<lugh,~ectrical (DrY wallJ ..' . .'
RoughElectrical . . . -
Framing '(~iy after Ping.. Elec.. r;'ech. and f:ire)-' .' ,
Insulation'(SoundlEnergy) . '.
Do not tape or.plaster unlillhe./ollow;Ag applicable
i.lems have been signed: . . . . . . .
Dniwall . .
. . PilnetratiQns (Fire Rated) Electiical . . .
Pen-"iQn5 (Fire Rated) Milchanlcal '. .'
PenetratiOns (Fire Rated) Plumbing'
IntllriorLath . .
EXlllrior Lalh
. .' GENERAL ITEMS. '
ExIl1rior f'laster (BlWln Coat) I. C .. '.
'T .BarElectrical .
T .Bar Mechanical . ..
T -Bar Slruclur;ll . . .' . .
Sewer -
WalerEngineering Backflow
Water. Service
FINAL INSPECTIONS
Eleclri~1 Final
f'lumbing .Final
Mechanical Finai
Gas Tesl
Engineering/GraClingFina1765-5126
Date
.Inspector '
. .
. Fir~ Dept. Final 765-4040
Waler Engineering 765.,52&'8 .
Sub list/Business license 765.51
Zoning 765-5139 '
Building Final fLast Inspectfan',Onfy
.. '. . Mer Abov.e COl1)plete)
. PARTIAlINSPECTI.ONS
BuildinalnSDections
.. ..
." , '
. Mec\1anicallllspections
. .
.. PlumbinalnSDections. . .
. ElectricallnSDections '.
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MARSHA
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APPROVll VI01.;1~;.;; 0F ANY Or THE
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