1530 Minerva
JOB DESCRIPTION: Build 6' high by 30 ft. long block wall per city specifications.
VALUATION: 1,900.00
I OWNER-BUILDER CECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter. 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 licem.ed 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 subj~;ts the applicant to a civil penalty of not more than five hundred dollars
($500).
[S I, as owner of property, or my employees with wages as their sole compersation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Lal" does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year:)f completion, the owner~buitder will have the burden of proving that he
did not build or improve for the purpose of sale).
D 1, 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 propertyw!l,O builds or improves thereon, and who contracts for such projects with
e:ntractor(s) licensed pursuant to the Contractor's License Law).
I m exempt unper Sec. , B & P.C. r this ,reason:
te: . .....OS Owner: . ~ ,\....'-l:::l ~;~
WORKER' OMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to oolfMinsure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the ",ork for which
this permit is issued.
[] I have and will maintain worker's compensation insurance, as required by Hection 3700 of
the Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: Policy Number.
BUILDING PERMIT NO. BLD2005-02848
TYPE OF PERMIT C
Blockwall/ Columns ITY
DATE: 9/9/2005
JOB ADDRESS: 1530W MINERVA AVE
~~'
LEGAL DESCRIPTION: N :fR1812 LOT 21
APPLICANT: JOSE CORTEZ
OWNER INFORMATION:
JOSE CORTES
CONTRACTOR INFORMATION:
This section need not be completed if the pennit is for one hundred dollars ($100) or less.
&1 certify that in the pertonnance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the bor Co ,I shal hwith comply with those provisions.
_ C~ L:: s,)
Date: 9/9/2005 Applicant:
WARNING: FAILURE TO SECURE ORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED USAND DOLLARS ($100,000), IN ADDITlON TO THE
COST OF COMPENSATION, D AGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty 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 Infonnation:
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
h by aut . e representlves of this city to enter upon the above mentioned property for
inspe 'on ur ooos.
Date: 9/9/2005
Signature of Applicant or Agent
The perm t shall expire by limitation and become null and void if the building or
work has . at passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 55
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
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.
9/9/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
Fire Sprinklered? NO
Fees paid for Permit:
Total: 133.28
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches (Footings) I.. r ~r 1-1' /7
Do not install subfloor or pour floor ~Iab unlilth~
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves) ,
Mechanical (Groundwork)
Electrical (Underground Conduit)
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:
1 st Floor Shear
Flresprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) -
Masonry (Reinf./Bond Beam/Pre-Grout) 114I/7/;OJ J.' ~7
Rough Plumbing (Top Out) ,/
Rough Mechanical v
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (SoundlEnergy)
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 .I'~.
Engineering/Grading Final 765:51:1'6 1:~j
Fire Dept. Final 765-4040
Water Engineering 765-5268 ,
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (LaB1lnspectlon - Only J.'LI ,},) '7;'
Alter Above Complete) h
-4.;:i;~' '))l./~c, / It?
,<;..-....., .
PARTIAL.: Ii4SPECTIONS
Building Inspections
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MechanicallnSDections
'\
Plumbing Inspections
Electrical InsDections
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TYPE OF PERMIT
Blockwall/ Columns CITY
DATE: 7/13/2005
JOB ADDRESS: 1530 W MINERVA AVE
LEGAL DESCRIPTION: N TR 1812 LOT 21
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 55
BUILDING PERMIT NO. BLD2005-02177
APPLICANT: JOSE CORTES
OWNER INFORMATION:
JOSE CORTES
1530 W MINERVA AVE
ANAHEIM, CA 92802
JOB DESCRIPTION:lnstaIl28' linear feet of 6' feet high block wall and 21' linear teet of 4' high block wall per city standards
VALUATION: 1,900.00 PROCESSED BY: JNJ
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, 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 Profession~1 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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
D I, as owner of property, or my employees with wages as their sole compen;ation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Lav, does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year ;)1 completion, the owner-builder will have the burden of proving that he
did not build or improve for the pUlpose of sale).
~ as the owner of the property, am exclusively contracting with licensed CO"ltractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertywllo builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Conn-actor's License Law).
U I 'pm exempt un.Q.er Sec. & P. for thO reason:
Date: _ 0 ) Own.",..--.,. )
WORKER'S COMPENSATI N DECLARATION
I herebyaffinn under penalty of perjury one of the following declarations:
~ have and will maintain a certificate of consent to self-insure for worker'scompensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
o I have and will maintain worker's compensation insurance, as required by ~:ection 3700 of
the Labor Code, for the performance of the work for which this permit is issued., Myworker's
Compensation insurance carrier and policy are:
Carrier:
CONTRACTOR INFORMATION:
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 Oivsion 3 of the Business and
Professions Cod e.
7/13/2005
Date:
Contractor
Policy Number.
NUMBER
EXPIRATION DATE
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
~ certify that in the perfonnance of the work for which this permit is issued. I shall not
~ploy 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 compemiation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with thosa provisions.
C-D
TYPE
Date: 7/13/2005 Applican .
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performanC'..s of the work for which this permit is issued (Sec.3097.Civ.C):-
Lender's Information:
Construcion Types:
VN, ,
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspectio~ ~oses. fl.
'--- G\ Q' _' C-D /1.. r IZ. ,) Date 7/) 3/2005
~ Signature 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 aermit is reauired to commence or continue work.
Fees paid for Permit:
Total:
125.79
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer ^'
Setback/FormsfTrenches (Footings) 1"7k>,k~ / ,
Do not install subfloor or pour floor slab until thp
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
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/DiaphragmlFrame) , ~
Masonry (ReinfJBond BeamlPre-Grout) If'Ms- II /-
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 Back/low
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub ListlBusiness License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only 'fj-"-o1 J?p~((
After Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
MechanicallnsDections
Plumbing Inspections
ElectricallnSDections
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PLANNING DEPART NT s.sIf&f-:
APP' lOVED ..""'.... 1<~:-'2-if.
DATE 7 ("J oS- _\
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m;f)(:J'tI1oH IAlSZ"~ (lni".I,'
FLOOD ZONE .. e:nrrJ<K
HISTORIC DISTRICT REVIEW:
oJJ ~ So. stamp this paae
_CIrcle one on above line
SEE BUILDING PERMIT FOR
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