5980 E. Marsha Cir.
TYPE OF PERMIT
Residential Addition CITY,.
DATE: 6/17/2004
JOB ADDRESS: 5980 E MARSHAGIR
LEGAL DESCRIPTION: N TR 8679 LOT 36
ElM
BUILDING DivISION
200 S. ANAHEIM.BLVD.
(714) 765 -'5153
INSPECTION REQUEST LINE:
(714) 765 - 4626 .
CENSUS CODE: 434
QUARTER SECTION: 192
. ...
BUILDING PERMIT NO. BLD2004-02170
APPLICANT: MARK SERRIS
OWNERINFORMATIQN:
. Ma-rk Serres
.5980 E Marsha Cir
Anaheim, CA 92807
JOB DESC.RIPTIONAdd 42~sf bedroom, bath on 2nd floor (HIH)
VALUATION: 28,871.00 '<.
I 'OWNER-BUILDERDECLARATION
I h'ereby affirm under penalty of perjury that I am exemptfrolpth.e. Gontrac.1o~:'?: Li.cense Law for the following reason (Sec. 7031.5 Busine~s and. '.
P,rofessionsCode:: any city or co'untywhich requires apermittdconstruct, "alth,'improve. demolish or rew"jr any structure., prior to.i.ts issuance, also
requires the applicantforsuch permit to file a signed statement that he is licensed pursuant to "the p'rovisi~nsofthe:Contractor's-Ucense: Law (Chapter:
9)(commencing withSectio"n 7000 of Divis,ion 3 of-the Business and P!ofesS:i"lns Code), o,r: that he is exempt, therefrom arid the basis for the alleged'.'
exemption. Anyvio'lation of Section 7031..5 by any applicant for a permit sui?\~.cts t~aapplica,nno a'civil'penalty of not mOre than five' hundred ~ollafs
. OO_~?~s.. own~r ~fProper:!Y-~ ~r .my employees ~it~' wag~s PS: their sole cOrn'pj~nsation!, will ct~ the .work,and the stru~turei~ ~o.t intended or ~ffen3dior"
.sale (Sec, 7044 Bus'~aJ.1d Profession~ Code:' The Contractor-'s Lict:ns~;.:$J.w does not apply to an own.er of property w~o'buifds or impf()ves .
thereon, and w(joessuch work htmself or herself or through his or her,ow,~ employees, prov~ded that such improvements'are not intended o_r'
. offered fo e.:.lf. hO~Ewer, the building or:improvemerit 'is sold with one y{;,:~r of c:ompletion. the owner-builderwH have the.burdenpf proving that.he
did uild,orimprove for th<;l purpose of sale). '. .
" ,J., _ _' '.
I, as theowher cfthe p:'o~erty"arn' exclusively con1 racting w,ith, ilcensed ;~ntractors to const! uct the project(Sec. 7044,_ Business and Professions,
Code: The Contractor's License law does not ~Pply:to'anow-ner 'of ptopertY?l!ic ?uildsor'improves the~eon, and who oontracts for sud; projects with
. _' ontract~~(s) Ii~en'sed purs~anLto ~he Cqritractor's ice~se' _l w). I
'a exemptJl.nder.Sec. '. or t s fe on: ,"_
Date: ' ";f-/v<-( Owner: "
WORKER'S COMFENSATION DECLARATiON T
lhe'~~byaffirm:under penalty of perjury'tme, of the following _declarations: . .,
o <.I havea[ld will majfl:tai~"~certificate of oonsent to SP._lf-insure for"V'JrkE:ir'} compensation,
as provided fo~ by Section 3700. of the Labo~ Code, for the performance of,th!,: \~.:oiK for whidl-
this permit fsissued. . '. ~
',0 .) J).sveantl Will maintain wqrker's com!?e~sation insur9-nce. as requiJedbj Sectio!l ??"qo I)f
the labor Code.:fortheperformance of the work for which this permit is iSS!l:J? j\.1'1worker's
. .CompenSation i.nsu~~nce.,~rrierand policy are: .:. " f,' ,
Carrier:.. PohC:{ Number. '_ -\
. This section'need not ~ OOmpleted if the pem:-.i't is for one hund~ed dollars ($101';. ,or 1($5.
o I.certify thatin the pertorrnance of.the.w.ork for:whic~.t~l~ p~fmit is issui:.kl shall-~ot
employ'any person in.any manner so as to become subjectto-jhe\'Vorker's,~lrripensatlon laws
.of Qalif9rnia. and agree that ifTshou'ld become, su'bje to tt1~-w6rk~er's:colTl~ic1n~ation
,pr.Olil~IO~S of Section 3.700 of the Labo~C~! I rthlii h c ply With:I~f'ie provisions,
Dale: 6/17/2004 Applicant. ~.
WARNING: FAILURE TO SECURE WORK R'S COMPENSATION COVEF'"GE'IS
UNLAWFUL, AND SHALl.SUBJECT AN EMPLOYER TO CRIMINAl PEN,{!;TIES AND CIVIL
FINES UPTO ONE,HUNDRED THOUSAND DOLLARS ($100,000): iN !\O~'i-nDN TO. THE
COST OF COMPENSATION; DAMAGES AS PROVIDED FOR IN SECTlo."J'37JJ6 OF THE
LABOR CODE, iNTEREST AND ATTORNEY'S FEES. ;' .
I CONSTRUCTION LENDING AGENCY ,?_,
J hereby affirm-under pena.lty of perjury that there is a construction lendr.1 C!~~~nc:y for. the
_:l?etforman_c:.of~~~:",~rk.!Or~hicti.~~ pe~~it is _isSU~d (~,e~.~p~.!:c:;~~~,,::y ..... ' : .
L~llder~ IniOffr'idiiOll;' : .; '" - ,,' ,', " ~
CONTRACTOR INFORMP.TION:
ARCHITECT/ENGINEER INFORMATION:
CRAIG F STANGER
2014 E, WESTPOR, DR. #A
ANAHEIM, CA 92806
PROCESSED BY: ODC
I
--=:I
IJCENSED CONTRACTORS DECLARATION
J hereby aff,irm llnder penalty of perjury that I am
'licensed unde~provisionsof chapter. 9 (comm.~ncing
with Section 7.000)- of Divsion3 of the Business and
Professions C9de: '
6/17/2004
Date:
Contractor
'. NUMBER
EXPIRATION DATI<:
TYPE
Construcion Types:
VN, ; .
Occupan'cy Groups:
R3. .. .
Fire Sprinkl'ered?
Dwellin\1 Units:,
UvinQ Ar~a:
NO
1
429
,,_.~~,,-,.:--
j certify that I have read this application and state that the above informatlon!s correct. I
agree to..comply'wt(:h all city ordinances and state laws relating to building COf:smJcticin, and
hereby'authortz epreSenf es of this city to enter upon the above mentioned property for
insp .
Fees paid for Permit:
Tolal:
552.89
Date: 6/1712004
. . Slgria.ture of 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.
INSPECTION RECORD'
. INSI'ECTION'. . . .'. . DATE . INSPECTOR
'. Temporary p'ower Pole. . . '. ....
.
Plumbing (I)nlinlWaste . Pipe) .;'
.' Elecirical GrQund ElectrodefUfer . ( ~7tfI'..
!\atbacklFormslTrenCheS (Footings) . .
. DO not install subfl.oor or pour floor slab until tne .
following applicable items have been. signed: .
.' Plumbing (Water Plpe.SprinklerValves)
r.1echanical (GrOundWork) .. '. . . .. '. . .
.
!:lectrical(UndergroundConduit) . .'
. Pre-stab (CORlpactioniMembrane.Reinf. . .
Underpinning (Floor Joist/Girders) .' . ,
1-'0 nbt cover or conceal the.work b!'low untIl the
'.following applicable items have been signed:. ..' .
; 1 siFloor Shear .' .' ":1S" -s -P7 rrz: A.- ,
. FinlSprinkler . (Rough) . , . .., . . .' AA ..'
2nd Floor Shear' . .' .... 't-z,:~
ROof (Shealhing/DiaohnlgmlFrane) . h31'-/l.... l^.l .
. Masonry (RllilnfJBOnd BeanlPre-Grout) . . ,.
.
.' Rough Plumbing '(TopOUI) .'.
Rough Mechanical.' . .'
. KOugh t:IectrlC 'wall) .' .'. I. . ".
. Rough !:1&Ctrical ." '. liJf '.
. Framing . (Onlr.fter Plbg.. EI~.. Mech.ndFlrel '2'1'~ . ,I-:-
In$Ulation(SOUndlEnergy)
Donat tape or plaster until the follOWIng applicablE; . "I '.
.' items have been signed:" .... . . ......
Drywall . . . , '. .' 'ilLI
-
Penetrations (Fire Rated) Electrical . I
'., Penetrations (Fire Ratl!d) Mechanical'.
PenetratiOns (Fire Ratl!d) Plumbing . .
, Interior Lath .., '. I'A .
Exterior Lath .'. ,. 1If. ~
. . GENERALnTEMS .
. Exterior Plaster (Brawn COal) "
. T-Bar Electrical , . .
T.BarMechanical ,; . "
. T.BarStructural , . '.
. .
Silwer r
. Water Engineering Backflow .
. .'.
Water Service'. ..... .
F:INAL INSPECTIONS
Electrical Final .
plumbing Fi,nal
Mechanical Final
Gas Test
Engi neeririg/Gratli rig Fina.1 765-5126'
Fire Dept. Final 7654040
Water Engineering 765-5268 .
SilbListlBusiness License 765.5.19
Zoning 765-5.139
Blli/dlng Final . ILast inspection. Only
. . ''''fter Abov,e Complete).
OI"ARTIAL INSPECTIONS
BUildinalncons ..... _ ..' . '. .
.;1J~.L._-to ~~. Ot-fr;~p
< .' ...... ..... .... ' ". '.' ......4~;
1'?~7:-P</-:P~~if(5~~~
..I'.!'f__..:_.--_--.,'..,..-,..--'_'.--_---.;.:'-.:~
q~?:3-M(Ilr2--~o~--,*-; .
. " Mechanical Inspections
. Date . Inspector '
,,/.
Plumbinalnspections
Electrical Inspections