2730 W. Monroe Ave.
TYPE OF PERMIT
Residential Addition
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CITY ~,~~!,iR!~HEIM,
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BUILDING DIVISION
200 S, ANAHEIM BLVD,
.{.714} 765 ~ 5"j53
'INSPECTION HEQUESTLINE:
(714) 765 - 4626
CENSUSCCbE:: '434
QUARTER SECTION: 19
BUilDING FERMIT NO. 'Blli2003-026Z0
DATE: 7/2212003
JOB ADDRESS: 2730 W MONROE AVE
LEGAL DESCRIPTION: ,NfR'2775 LOT 79
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APPLICANT: DAVID VOLPE
OWNER INFORMATION:
. David J Volpe
2730 W Monroe'Ave
Anoheim, CA 92801
, JOB DESCRIPTIONAdd 336sf family room to rear of SFD
VALUATION: 22,613,00 j, PROCESSED BY: iVoJL
I " , " ' ,OWNER-BUILDi::R ilECLARATION _.~ ' .
I hereby affirm under penalty of perjury that. I ~m exempt froll1 the ContrarAC(i License Law for the foHowing re2S0n (8e<.:. 7031.0 Business and
Professions Code: Bny dty or county which requires a permit to COnstn;ct"G"r~~.'r. !r.'lp~')V~, demolish or re~ir~ny structr.irc,'priOr to its !ssu~nce, 'abc
requires the oppliC3nt for such pe:"mit to fiI~.a sfgned s.latt::ment that he is jiC~f~Scd, pU;S,uarit to. (he provisions ofth~ Cont"mclor's License Law (Chapter
9Hcomrr.en~jilgwjtn Section 7000 of Oi....is!Cln3 of the Business and Prcfe:,:;:G{lS ecde) cr th~t he is exerr.pt therefrom ana the basis fOr'thealieged .
exempti011. A..,y violation of Ser.tion 7031/&;fjy;~y-~!:!:,ljca(lt fe. a perfTl:l sU!;.!{'9t:dhe a;Jplicc:1nt to a dV11 penalty of net'mere thc:(n five hundred doll:;:lrs .
(~?90). ' ,'f,", , '
7[:yf" I, as owner OT property, or my employees w[th we:go=.:s as their sole compr.r~ativn; wHl rlo thowcrki and the structure IS not intended or offered for .
sale (Sec. 7044 Business and Professions Code: .The Contractor's License L1w'~:oe:s not ar.ply to al)_uwne.. of pfOpertl who bLl1lds or imprOVE::3
thereon: and who does such work himself or h-e.melf or t~\rO\.l9hhiscr'he-rowr',:;m"PIOyeOS, provided tl1atsuch improvements c:rfenct intended or. .
offererj for:!?ale. ,if, bow ever, the bl!i1ding or imp'"Ovememt is sold with one YB<'~~I;Of Cl:hi\pletion, the OI.vner:.bLJi!der wifl h~ve the bL.;r.d~n ('If proving tllat he
did not build or Jmprove for the purpose of sale). . ',,- . '. ;. .' '.
o I. as the owner of the property, am ex.dusively i;.ontl"actir,g witf\ lic(~nse.-: &)11~r~_ct'Jrs t.oconstruci the projp.ct (Sec. 7044 Bl~siness and Profe~;sions
Cude; TheCyn~r~ctor's Licen~ lawdoes not.<=pp:y to <::111 ownei' of property~tr,o builds or i....,p:-01les ~hereon,c:.,1d .,,,tio contra'Cts for s.lch !Jroj6C~s witn
~ontractor(s) lice.nSed pursuant tothe c.~n~racto' Uta 'I~ La~v). .."
U'/amext1mptunderSec. . - ~8& c. i) t... .: --s;- _____._
D'Je:X,7.~-63. Owner: >Q.L.1 ,'t, _____
r - WORKER'S COMPENSATION OEG ARA~,_~" L1CENSEO cONTRACTORS OECLARATION J
I herehy.affirm,under penalty ofperjurj-f)oe of_the following declat?-ltions~ .,~ . ~ hereby affirm'unjer pAna!ty of r;:erjurythat I ar:n
0, I have and will '!l8intain a certificate bfsonsent to seif-insl.ud !or wo;-~er'~',CO,l1iJ'ensation, II licensed undsr provisions of chaptdr_9 (corilmencin!;
as provided for by Sedion 3700 of the labor Code, for tile perforr'P.ance of th~'y""o'n< for wh!c";h \"lith Section 7000) of Di\>$lon3 of the, BusJ~less and
th:s permit l~issUed. . .' .\., j Professions' Cod e.
. [] J ,heve alld will maintain work7r'S compensa.tion insurancE', a$,~qL!i:e0 ~Y;8cctiCn'370a of I. 7i22!20o.3
,the Lobar Code, for the performance of the work for which this perr:-1it is i~t!e't. My worker's D~te:
Corhpensation in"SL!rance carrier. and policy are: . t .
Carrier:' 'Pol!cy f\Jul!lber. r NUIV1BER
~~$ }ection need not be completed jf the pennit is for one hundred do:lars ($10::\_.... 11:55.
.=:slSJl'l certify that In the performance of tt"Je work for Wnlcn thiS p~rml~ ~ ISS~l~'(:;_i shaH r:ot
employ any person in any manner so as to become subject to the worker't~<,:":;'")el1sat;on laws
of California, and agree that if I should become subJed to the worker's ccmDe 'S~tIQ~ I
. provisions of SectIOn 3700 ofthe Labor I shaH ti Ith c ,n with l~r:E:-':proViclons Construcion Types'
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Date: 7/2212003 Applicant:, ,.""_:. . _. ~. I Occupancy Groups: .
WARNING: FAILURE TO SECUREW RKER'SCOMPENSATIO COVE,!$.P,O"J8, :,' R3"",
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMi Al piCF,A1,T1r-S',i\ND,CIVIL Fire Spnnl<lered?
FINESUPTO ONE HUNDRED THOUSAND DOLLARS. ($100,OOO),IN".D~r~~iNTO Ti;JE Dwellinq Units:
COST OF COMPENSATION; DAMAGES AS PROVIDED FOR iNf\EcnqJ::7CGo!' THE' Livinq Area:
LABOR CODE, INTEREST AND ATTORNEY'S FEES,"; ,,,';~':.,' I
L_ 'CONSTRUCTION lENOING AGENCY ,~--, '
1 herebY, a ffirm,l,Jnde,' pe,'nalty of perjury that .there is acon::;~n.:ctio. n !ci1ding a:;.jn~~Eo.r th~:'" ,.'1'
'::>p.rfo~l(:~.~~_of-t~e work for which this permit is issued (See.30g? ;Giv:C.): ,_ ;~}~-S:'; /' <' .
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. CONTRACTOR INFORMA;,:CN:
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ARC.HITECT/ENGINEER INFORMATION:
WILTOLD HRYNIEWICKI
7706 BOTANY
DOWNEY,
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':;G!1t~actor
EXPIRATION DATE
TYPE
NO
1
336
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I certify that I have read this application an~ state that the above informa.t:on i!: correct. I
agree to comply with all city ordinances 'and state laws relating to building cor.struction; and
herebx authorize. represen' s.of t 's city to enter upon the aboy'e mentioned property for
insgect:i r s. .
Dale: 7/2212003 '
Fees paid for Permit:
Total:,
667.56
Signature of Applican r Agent
. The permit shall expire by limitati n and become null and void if the huildingor
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
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. .. INSPECTION RECORD
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INSPECTION.
.. Temporary Power Pole
Plumbi ilg (Drain /Waste Pipe) .
.' Electrical Gtound Electrode/Ufer --:-
SetbacklFormsfTrenches(Footings) .' ~~~
. Do notinstallsubflcor or pour floor slab untilthe 7'
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
. Mechanical. (Groundwork) .
Electrical (Underground Conduit)
P.e-slab "lCompac.tlonlMembrane.Reinf. "?T?-<";1 z s:-
.' Underpinning (Floor'JolstlGirdeo-s) . . 7 .
. Do not cover or CClnceal the. work below until tl1.e
. fOliO. wing app. iica. ble .items have been signed: ';W"2
1st Floor Shear. . "3-~~~ ffqJ. -;....-.
Fi.esprinkler (Rough)' .... y-
'. 2nd Floor Shear .' . ....
RootISheathingfDiaDhragmlFrame)' V~ Z,C -::;:?
. Masonry (ReinfJBond 8eamlPre-Grout) Y
RoughPlumbinac (Top Out) .
R()ugh MechaniCal -,---:-
ROugh 8ectrICar ( III
Rough Electrical. ..--. .' .'. .
Framing . (Only a~er Plbg., Elec.. Mech.. and F;rej ~-1'.?A ~../
InsUlation (SolindlEnergy) .!,/ .
po not tape orpla~ter until the followingapplicab,i7 .
Items .have been sIgned: .
Drywall, :"
Penetrations {Fire ~ated) Eleclric;al .
I"enelrations {Fire. Rated) Mechanic;al
Penetrations (Fire Rated) Plumbing
Interior Lath... .
Exterior Lath-'- '. . .
. .' GENERAL ITEMS
ExteriOr Plaster .(BrownCoal)
. T-Bat' Electrical
T-Bar Mechanical
T.Bar Structural
Sewer ..
Water Engineering Backflow
Water Service
DATE
INSPECTOR.
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FINAL INSPECTIONS. .
Electrical. Final
Date
In'?!lector'
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Plumbing Final
Mechanical Final
Gas Test
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EngineeringfGrading FinarT65.o126
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Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub ListlBuslnessLicense 765-519 '. '.
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Zoning 765'5139
Building Final . I~st Inspection- Only
. After Above Complete)
PARTIAL INSPECTIONS
,..Buildinalnspections ..... '. .'.
{~~~U "Jr.- gA/,P/J55
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MechanicallnsP8ctioiis
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Plumbina Inspections
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Electrical Inspections
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PERMIT EXPIRED.
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INSPECTION
NOT COMPLETED
DATE:G ,fiv{ oS- '_