360 S. Mohler Dr.
APPLICANT: BRENDA PiZZINO
OWNER INFORMATION:
Victor PiZzino,
PO Box 871
Bellflower,CA 90707
JOB PESCRIPTIONNew one"story raised floor detached garage and workshd\;.
. VALUATION: 26,730.00
I OWNER-BUILDER DECLARATION
I hereby affirm uildE;l:r penalty of perjury that I am .~xempt from the Cohtractqi:s License Law for the following reason (Sec. 70'31.5 Business and
Professions Code: any dty orcOlmtywhich requiresa permit to construct. al:er,' improve, demolish or rePajr any structure', prior to its issuance, also
requires the applicant for such permit,to file a signed statement that he is licf\nsed pursuant to ,the provisions of the Contractor's License Law (Chapter
9)(commencing with Sectkm7000 ofDivision.3 of the Business a nd Profess:!.ms Code) or that he is exempt the_refrom and the basis far the alleged
exemption. -, Ariy violation of SeCtioR'7031.5 by any -applicant for? permit sytjects the applicant to a dvil p~nalty af not more than five hundred dallars~
:~,owl1er of praperty. 9r my e~PIOy~eS with wa~es as their sole. com~:Oi1Sation, will do th~ wor~.' a.:m the structure.isnotj~te.nded or offered for.
~ is;~''7044 B'usine::;sand Professions Code: The. Contractor's-License-~,a",-! does not 8_ppryt.o an .owner .of praperty who. builds or improve~.
thereon. and wha does sum work himself or,hefSelf or through his or herawfl employees, provided that sucl:l improvements are nat intended or
offered for ~ale.lf, however,' the 'buildjng or improvement is sold with one ye!3r.of oompletion._the owner-builder will have the bur~en of proving that he
did,tiot build-or improve forth~pulpOse of sale). - . _' .
0.. I, as. the owner of the property., am exdusively contracting with Iicenseo ,:,xlOtractors to construct {he' project (See. 7044 Business and "Professions
Code:' The Contractor's'LieenseLaw does not apply to an owner of propejtywho builds (:mimproVes thereon, and who contracts for such projects.wit!:l'
~ontrador(s) licensed pursuant (0 the Contra r's icense Law). \'
U I am exempt under Sec. . B , or this reason~
Date: 'Owner:
BUILDING PERMIT NO, 'BLD2004-01715
TYPE OF,PERMIT ell
AccessoryBiJilding (Shed, ,Garage...) "y
, DATE: 6/3/2004 ' .
JOB ADDRESS: 360 S MOHLiOR DR
LEGAL DESCRIPTION: PM 118-5 PAR 1 POR OF PAR
CONTRACTOR INFORMATION:
WORKER'S COMPENSATION DECLARATION . I
.' h~reby~rm under pe,nafty of perjury. ~m~of the fallowing .decla~ations: . \ .
o I hav.e.and will maintain a certificate, of eonsentto self-insure for worke:-'.:" compensation,
as, provided for by Sedio.!1 ~700 of the Labor Code'" for the performance ofU"'; work for which
this- permit is issued. . , , . . ,.
. D. I have and Wm maintain ~orker's compensationin~urance. as'required b:, Section 3700 of
the Labor Cod~, for the performance of the work for Which-this permit is iS3;J~ld, Myworker's
CompensatiOn insurance carrier and Policy are: '
Carder: . Policy NU,mber.
~i~need not be ~mpletedifthe pEmnit is for one hundred dollars ($10C,i or I~s, .
~. _Icert,ify tli~tin th-e perfo',rmance of the work far which this permit is 'is.SlIEd!.(shaU not
emploY any'person,inany manner so as to become subjectoto the worker's c,::m"Rensatlon laws
ofCalifomia, -and agree th?lt if J should beeo subject to the worker's comp.1nsation
provisions of Sec,tion 3700 of the Labor C hall forthwith comply with those provisions,
" .
, Date: 6/3/2004 Appli<;ant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVEf'AGE IS'
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENA';_TIES AND CIVIL
FINES UPTOONEHUNDRED,1HOUSAND DOLLARS ($100.000), IN ADDrTlON TO THE
COST. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE'
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I he~eby affirl1li.uider penal~ of perj"urythat'there is a ponstructjonlendi(ig,3~encY.for the
:-per.f()rrncir),Ce of the workfo~_wl:1tch this oer~it is issued (S.ec,3097~Civ.LC):'::..1_ . ~ ;~
Lender's 'Information: .
I certify that J have read this appiication and. state that the abov~ information is correct. I
agree 'to ply witt! all. city ordinances and state laws relating to building CO!\Structioo. and
hereby u ?rize rep~sentives of this city to enter upon the a bove, mentioned property fo~
inspe 0 u~ses,
------
Dat": 613/2004
Signature of Applicant"or Agent "
The pe,rmit shall expire by limitation and become null and void if the building or
work has not passed final inspection ,365 days from the date of permit issuance; A
new permit is required to Commence orcontiou'e work.
:.sUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUESTLINE:
. (714) 765 - 4626
CENSUS CODE; 434
QUARTER SECTION: 208
ARcHrrECTIENGINEER INFORMATION:
THOMAS DRUMMOND' '
1142 ELM ST
FULLERTON, CA 92836
PROCESSED BY: ODe
I
LICENSED CONTRACTORS DgCLARATION ]
I hereby affirm under penalty of perjury ffiat I am
licensed under provisions of chapter 9 (commencing
with Sectiori 7000) of Divsion 3 o"fthe Business and
Professians' Code. .
6/3/2004
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE.
Construcion Types:
VN, ,
Occupancy Groups:
U1. . .. .
. Fire Sorinklered?
GataQ'e Area
NO
1,160
{
Fees paid for Permit:
Total:
2.67 '
'INSPECTION RECORD
. .... INS'PECTiON '. . . '.DATE . INSPECTOR
I. .
Temporary Power }>ole .' ..... '. ......,.
Pluritbing(DrainlWaste Pipe) '. . . . . '.
Electrical GrOtindElectrodelUfer . .
Setb""k1FOI'01StrrenChes (Footings) . . ..
DO not install subfloor or pour floor slab until. the I.
following applicable items' hav$ been signed' . "
Plumbi ng (Water Prpe.Sprinkler Valves) . . ..... .
Mechanical (Grounqwork). .' ..' ;' ',. .. .... I.
!:lecti'k;al (Undergro'lnd Conduit) .
. .I're-slab (t;ompac:tionlMembr_.Reinf. .' , i
I,
Underpinning (Floor Joist/Girders) .
.DOnat cover Or conceal the. work below until the . ."
following applicable items.have. been signed:' .';. .' .
1st Floor, Shear. . '. . . .
Flresprinkler(Rough) ,
2ndFloor.Shilar , .
ROof (Sbealhiog/Diaohragm'Frarnel . .' ,
Masol1r)' (RliiitfJBoitd Beam/Pre,GlOIIt) . .
Rough Plumbing. (Top Out) . .... .'. .
~oughMechanlcal '. . . . . . . .
, HOugh t:IectrlCal (LJI'Y wall' . .' .:.
Rough Electrical' . . .
Framing (Only.after Plbg.. Elec.. r...1ecn.. and.Fire\
In.sulation(SoundlEnergy) . . . .
00 not tape.or plaster' until the following applicable ....
i,tem~have been signed:'.' . ' '-" . .
DrYwall '. . .
Penetratloils (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical'
Penetrations (fire Rated) Plumbing
In_riorLath . . .- . '. ,
Exterior lath . . . '.
.' :.' . GENERAL ITEMS .'
Exterior Plaster (Brown Coat) .'.
.T-Bar Electrical . '.
T -Bar Mechanical , . .
T .Bar Structural .' . "
Sewer. ' .' '. .
Water Engineering Backfl",w . .' ..
Water Service
FIN~L1NSPECTlONS .' .- . Date . 'Inspector
'E.lectrical Final '.' '.' . . .
'.. '.' '.
plumbing .Final .' . . .' . . . '.
. . . . .
MechimicalFinal . . , .
. .' . , '. -
Gas Test . . ,.
. . . .
Engineering/Grading Final 765-61,26 '.. '"
, . . '.
. ". ". u" . . .
Fire Dept. Final 7654040 .
Water Engineering 765.52t!8 . " . .
. .
Sub List/Business licen.se 765-5.19 .' '.
Zoning 765-5139'
Building Final ~ast inspection. Only . '" .', .' .
.' .. .' Iter Abov.eCompfetel., .... . "
. PARTIAL.lNSPECTIONS
BuildinQlnsDections
.' Mechanical Inspections
Plumbinq Inspections
ElectricallnsDections
PERM/T...EXP1REQ
INSPECTION .....
.NOT COMPLETED
DATE:g~J(J~
..,/.