3147 W. Monroe Ave.
BUILDING PE[l.MlT NO. BLp2004'02105
TYPE pF PERMIT
Blockwalll Columns
DATE:' 512612004
JOB ADDRESS: 3147W MONROEAVE
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. t'.~~tr""~'iD;\,.
CITY Q~tlf'1~HEIM
\~~t~!r~~#/
BUiLDING DIVISION
200 5. A'JAHEiM .8LVD.
(714) .765: 5153
INSPECTION REQUESTLINE:
(714) 765' 4026
CENSUS CODE: 434
QUARTER SECTION: 8
LEGAL DESCRIPTIO,N: N TR 1820 LOT129
APPLICANT: ROBERT ROSS
OWNER INFORMATION:
Bernard J Ross
3147 vv' IvtonroeAv:e
Anaheim, CA 92801.', . l:
JOB DESCRIPTiON:Build 243 If qf 6 It high block wall per city standards. ,.
VALUATION:. 5,832,00 I PROCESSED BY: PMK
L OWNER-BUILQ~'uECLARA TION
I hereQY affirm under penalty of perjury that J alil exempt from the. Contr~Cfo\,:S License Law fqr the following reason - (Sec.1D31.5 Business and
Professions' Code: any dty_or county which requites a permit,to construct, '2: fer, improve, demolish or repair any structOre, prior to its isSuance, also
requires the ~pp!ic:ant for~u~ p~rmit t~- ~f~ a'signed~tate~ent thai. he l~~~kf~~d',r~;ssuant to' the. provisions nf_the Coritr~~or's U~en~e Law lChapter
9Hcom.me_nt?lng WIth Section 7000 of OrVlSIOr'l ;3 of the BUSIness and Prot~~s.p;""!$Co~e) or that he IS exempt therefrom ana toe b::!st"$ for the ?Il~ged
e;;~Ption., Any ~iQ,lati~n af.S~cYon. ~~~1.5 b~ any ~PPIi.cant for a p~rr:nit Sill'.1?r.:i~ th~ applicant to ~ q~!1 penalty o~-not more than five ~ur:dred ~o~lars
~ownerof property; or my employe~s with wages os their sole oc"y;+,,;sdtion,W,1I do the wOl'k, and the structure is not intend.ed or pffered :or
&ale (Sec. 7044 Business and Professions Code: _ The Canbactor's Ucens'~ ~~<)"'" d0es not a pply to' an. owner of property whO' bl,jlds_O'r imprO'vE:s
thereO'n.. and Who,does such work ,hin'1self or he.rse[{O'~ throug'h hts ,Cf her (\',;i'~; P':,'f,;::loyees, provided that slich improvements arenot int~ncted or
O'ffered far sale; If, hawever. .the building-ar imprevement is sold with an~;Y~fJr pf rompletian. thp. owner-bu!lder witl have the burden of proving that he
did not build or improve fo'r the pUlpose af.sale).. ,,~' ',' ,'_ . .' _ . . , ' _'
o I. as the owr.U3r af theproperty; am exdusively contracting with Iic9nsed~tractcrs to cons1nlt;:t the project {Sec. 704/~ Business and Professiops
Cade: The Can tractor's license law does hat ap;JJy to' an owner af prap6fi.~\....ho_bunG~ or improves thereon, ?nd vvno contracts fot 3t1ch proj~cts with
~<?ntr ctor(S) li~ensed. pursuant 'to' the Ge-ntr~ctor'~ ~-Law). . \
/1'.. I n exempt un r Sec. . .... r ;ea~on: _ -'1--"
(Oat. ,",>-~'-c:J Owner:'. . ... _ ,_..,,':~_,
. ... 'WORKER'S CO ,PENSA 10 DECLARATIOIL=J(,~__J .~
t herebyaffitm under penalty of.perjury one of the following declarations: l' . . '
. 0 I hAve <;I:nd will main~ain a_certificate' olconsen'ttGsel(i~ure .fc.rwc:'"l~t:r\> compensation,
as provid~d for by Section 3700 of t~ LabOr Code. for the penOri"ilanc<::: ef tr.~.,..,Wl)rk fOJ whir:\1
this permit is issued. - . r
D. .1- have and will maintain wo'rker~s compensation .insurance. 3S. reqi..i;,-:e,-1tl. S~Gti'Jn 3700 of
the Labor Code;for the performance of .the work for whIch this permit is issU'l\O. My V\'orker'$
Compensatior1' insurance carrier and poliOf are: ._:,. ,.
Carner: Policy Number. .
This seCtion need not be ~mpleted If the pennit is for one hundred dOllar({~:'!O!I~ or I&$S, .
01 ce~ify that in the perfolTfla.nce ofttle w\1rk for which thisper~iit i~ik.p'J~I{J.I;;.~h:}11 ,nat .
. employ any person in any-manner so S:S to become subject to the wQr-te:~ C1!'l"'J~;!nsa:!.I)n laws.
'of Califomia. and agree that if_I shauldbecQme subject to the warker's~qN)~p~insatian:",:' .
provisions af Se'ctian 3700 of the labor.Co sf'1a!1i with camply\t!th t!'e:~€l..fl:rov]si6ns.
Date: 5/26/2004 Applicant: " ..~: r
WARNING: FAILURE TOSECUREWORKE 'S COMPENSATION CClvEli!\GEIS. ..
UNLAWFUL, AND SHALL SUBJ.E.C T AN EMPLOYER TO CRIMINAL ~.N. PlrTJE.'S AND CIVIL
FINES UP TO ONE HUNDRED 1l-IOUSAND DOLLARS ($100,OOOr.l~t,[)[; TiGN TO THE
COST'OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SE9:!iOtJ U(iQ OF THE
LABOR CODE, INTEREST AND. ATTORNEY'S FEES,'i:jf,! ,;,\.,
I . CONST~UCTION LENDING AGENCY .,{,;-nf. .
I h-'?reby affirm under penalty afperjury that there is a c"n_s;:ruq~ion !end!~,;a:.;c:n~:'y-f?r:.:..~"e:.,.c I, ..
c<,r:~~~~~~!~~r~~~~~:~~~rk f~~_~~i_~~~i_~.pe~:~t is issue~_~Seq. '3097 ,Civ .~:'~ ;'l:'~'-~ ~" .~:~ ;~:~~_:j~~'.-~._
. CONTRACTOR INFORM.t.TiON:
ARCHITECT/ENGINEER INFORMATION:
j
LICENSED CONTRACTORS DECU\RATIO.t!
I hereby effir,"t under ~n3lty of perjury that h:.m
lic"ensed under provisk>r:is ~f ...:hapter,g (commencing
with Section .7000) of Divsion 3 of1he Busin~s_ and
Profes3ic;l$ Co.::e. . .
(;
I
5/26/200~ .
. Date:
Contractor
NUMBER.
EXPIRATION DATE
TYPE
Construcion.T -Ipes;
VN, ,
Fire Sprinklered?
NO
I certify that I hay read this application and. state that 'theabove informatian is correct. I
agr:ee to com with all city ardina!1ces and state laws relatiilg'to bu Uding ccnstructian, and
h.ereb~ aut rize representives af this city to enter upon the above men!iane..i property for
, p~, r-=>
-<..c::::..:-. , ' Date' 5/26/2004
. . ignatureof Applicant ar 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 io commenoe or continue work.
Fees paid for Permit:
Total:
0.58
INSPECTiON RECORD
. INSp.eCTioN. . .' .DATE . INSPECTOR.
.'
Temporaryl'ower Pole.' , ,
Plumbing (DrairilWaSle Pipl1} .' . .
Electrical GroundElectrode/Ufer ',' . ,;
SelbacklFormslTrenches (Footings}. fl.~:;T1 . ,
, Do notinstall subtloor orpourfloor slab untilthe .', '.
following applicable items have been signed: '
Plumbing (Water Pipe.Sprinkler ValVes) .
.
Mechanical (Groundwork)'. . ." ,
Electrical (Undeiground Conduit} , .
Pre-slab (Compaction/Membrane.Remt. . ,
Untlerpinning (FlOOr'Joist/Girders) , : .'
Do not cover or conceal the..workbelowunlll the
fqllowing applicable items have I)een'signed: .
l.st Floor Shear ..' '. .'. . .
Firesprinkler, (Rough): : . . ,
2nd Roor Shear : '.' . .
Roof, (Sheathill!llDiaphlllgnVFramel .' . '.
Masonry (RlilnfJBond BeamlPre-Grout) ,
Rough Plumbing (Top Out) .' ' .
Rough Mechanical .
Rough t:IectrICal\uryWah) ',' ,
Rough Electrical. . " .
Framing {Only after Plbg., Etec..Mech. and. Firel :
Insulation (SOImdlEnergy) " , .
Do not'tape <>r pl"ster:uritil the. following "ppJi""bJe ,
itemsh.ave beensigned:- '. ,," .'
Drywall . '. . . . : ' "
Penetrations (fire RlIled) Electrical .. "
PeOetralions (Fire Rated) Me.chanical '.
.Penetr.ions (Fire Rated) Plumbing .',
.Interior Lath, ,.. '. . '. I."
Exterior Lath' '. . , '. . ,
, , .' '. . GENERAL, ITEMS : ,
Exterior Plaster (BIO\Nn. Coal) I.
i:
T.Bar Electrical '. . "
T.Bar Mechanical .... . ' , "
T~8ar 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 License 765-519< . ,. ,
.
Zoning 765~5139 . . . . '. n
Building Final hLastlnspection. Only '~CI( ~"" .
Iter Above Complete) 1<; , . -;7'Y'
, PARTIAL INSPECT,IONS
BUilding Inspections
Mechanical.lnSDections
. .
Plumbing Inspections
Electrical Inspections