344 S. Mohler Dr.
TYPE OF PERMIT C ITV.
. Repair
DATE: 2117/2004
JOB ADDRESS: 344 S MOHLER i:JR
LEGAL DESCRIPTION: P BK70 PG 43 PAR 1
ElM
BUILDING DI'!!SION
200 S. ANAHEIM BL.'D.
(714) 765.5153
INSPECTION REQUEST UNE:
(714) 765. 4626
CENSUS CODE: 434
. QUARTER SECTION: 208
. BUILDING PERMIT NO. ,BLD2004-00415
APPLICANT: HARRY KEAl.
OWNER INFORMATION:
Ma risa a.eaton
344 S Mohler Dr
. Anaheim, CA 92808
CONTRACTOR INFORMATION:
. R BEST IMPROVEMENT
11861 CARDINAL CIR #E
GARD EN GROVE, CA 9281.30000
BUSINESS PHONE: 714 53(':2755'
JOB DESCRIPTION: Repair 240 sq.lt deck per approved engineered plans. i
ARCHITECT/ENGINEER INFORMATION:
JIN WON KIM
1651 E FOURTH ST
SANTA ANA, CA 92701
VALUATION: 3,000.00
I OWNER-BUILDER"pECLARATION
I-hereby affirm under penalty of perjury that I amexen1pt from the Contractor:3 UcenseLaw for the following reason (Sec. 7031.5 Business and
Professions Code: any dty'or CQ,untywhich requires a permit,to construct, a~,;;~. i,mprove, demoli~h or repair any structure, prior to its issuance, also'
requires the applicant for. such Permitto "file a signed statement that he ,is, licensed pursuant to the provisiohS of the Contractor's License law. (Chapter
9)(commencing with Section-7000 of Division 30t th~ Business andProf~sik,~ Code) .or that he is exempt therefrem and the b~sis, fodhe alleged
exemptien. Any violatien .of Sectian-7031.5 by any applicant far a permit su8;ects the applicant 'to a dvil penalty .of net more than five hundred ,dallars
($500). . . . . .,.,... '. . ... .
D .1, as own7r of pr.operty: .or my _e~p1aye~.vvith wages as their sole camrYWIS;;'ltion, will dotl)e wark, and thesttucture is nat intended-ar,offered fa~ .
sale (Sec. 704:4 Business and Prafessie':'!s Cade: Tl:te Cantractar's License ~<:1W does net apply ta an .owner .of praperty wha buildscr impraves
therean, and whe daes such warkhimself .or hemelf .or through his .or her aVliij-amplayees, pravided, that such improvements are nat intended .or
.offered far,sale'. If, how!9ver,the building p:r impravement is sold with .one ye:~r'of comple.tien~ the owner-bunderwill have the burden afpraving that he
did not buDd or imprave far the purpase .of sale). '
D I,as the .oWner .of the praperty, am exdusively cantracting with licensed :~:::nt~actars.ta cans'truct the project (Sec. 7044 Busines's and' Prafessians
, C~e:' The9antractar's License Law'does nat apply ta an .owner of property:;'.; ho builds .or im-pr.oVes thereon, andwha contractS for such projects with
;l..lfdntractor(s) licensed pursuant to the Contractor's License Law). \ .. ..
U I am ex~mpt under Sec. .. B & P.C. for this reason: '.
Date: . OWner: ,.
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the follawing declarations:_
o I have. and will' maln'tai~ a certificate of consent tb self-insur~ferwark~r"i' compensatian,
as pr Ided far ,by Section 3700 .of the_ Labor Code, far th~ perfarmanceaf,tt"!;.. work farwhich
'. thi rmit is issued. . . I
I hc~ve and will maintain wOrker's campensatian insurance, as requirdd b\" SectiOn 3700 of 2/17/2004
. the Labar Code,- far the performance .of the wark far wh ich th is permit'is iSsu.JU. My wa rker's Date:
. Compensation insurance <:a'rlier and policy are: .' .
Carrier: NO EMPLOYEES . Policy Number. EXEMPli
PROCESSED BY: MJF
";.
'.
Date: 2/1712004 Applicant:
WARNING: .FAILURE TO.SECUREW
UNLAWFUL, AND SHALL SUBJECT EM . Y R 0 RIM INAl. PENAlTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADD''OION TO THE
COST OF COMPENSATION, DAMAGESAS PROVIDED FOR IN SECTION 3706 OF THE
. LABOR CODE: INTEREST AND ATTORNEY'S FEES.
I . "ON~'TRI'''T'^N.LE''D'''(' 'f"\E..~v."..?i'., ...,>.
_.:.~ ___"_~~ ,_~"" .,.'>...... ~J.,..,_ l_'.~. _ ." d,3.~.~~I:-.l~_.....__..~....!_..
I hereby affirm under' penalty of perjury that there is aooAstructiOriiend ing ay~ncy for the
perfarmance .at"the work for which thispei"mit is issued (Sec.3097.Civ.C):
Lender's Informa,tion:
NUMBER
585033
TYPE
B
Construcion Types:'
VN, ,
.;:;.~
te that the abave infarmation-Is carrect. I
ate laWs relating t.o building COristructian; and
enter upon the_abovementioneti p~aperty fbr
Date: 2/17/2004
Fees paid for Permit:
Total:
181.30
tu of pplica Agent
The permit aJlexpir by limitation and become null and void if the building or
WOrk has not passed fl. al inspeCtion 365 days from .the date of permit issuance. A
new permit is required to commence or continue work. .
INSP.ECTION RECORD
,
, INSPECTION
, DATE INSP,ECTOR
Temporary Power Pole ,
Plumbing (DrainlWaste PiPe)
, Electrical Ground Electrode/Ufer J
SetbacklFormsrrrenches (Footings) 6. 24d t'A..L ,
Do nol"install subfloor or pour floor slab until the c,
fQllowing applicable items have been signed: " ,
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) , ,
Eledrical (Underground Conduit) , ,
P",-slab (Compaction/Membrane,Rei nt,
Underpinning (Floor Joist/Ginlers)
Do not cover or conceal the work b.elow until the
following applicable items have been s.igned: ,
1 st Floor Shear , , , , "
Firesprinkler (Ro\lgh)
2nd Floor Shear '
Roof (Sheathing/Diaphragm/Frame)
Masonry (RelnfJBond BeamlPre-Grout)
Rough Plumbing (Top Out) "
RO\lgh Mechanical' , c
ROugn Electrical (Dry Wall),
Rough Electrical ' '
Framing (Only afterPI!J9'., Elec.-. ~.-1Bch. and Fire)
Insulation (SoundlEnergy) , ,
Do not tape or plaster until the following applicable ,
~ems have- been signed:.,. . . .
Drywall
Penetrations (Fire Rated) Electrical , , ,
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing , "
Interior Lath , ,
Exterior Lath' I
, , GENERAL ITEMS
exterior Plaster (Brown Coat)
T .Bar !:Iectrical
T .Bar: Mechanical ,
T-Bar Structural , ,
Sewer'
Water Engineering Backflow ,
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 List/Business L,icense765-519 , ,
Zoning 765.5139 , " , "
Building Final ~ast Inspection- Only .
fter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
"
Plumbina Inspections
, Electrical Inspections
PERMIT EXp '.
N INSPE9T1d:ED
OT COMPL ,",
. . ~ [TED
DA TE:. 't,,~.
, ~
-