503 S. Paseo Ganado
" '..
BUILDING PERMITNQi:\BLD2003"0420!!
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTlINE
(714) 765 - 4626
CENSUS CODE: 434 .
QUARTER SE:CTION: 204
~~~~FPERMIT CITY
DATE: 10123/2003
~OB ADDRESS: 503S PASEO GANADO
-LEGAL DESCRIPTION: . N TR 8215 LOT 73
APPLICANT: CODY HULL .' \
OWNER INFORMATION: CONTRACTOR INFOR!I'ATION: .
.carl T Grosso . HULL AND SONS ROOAI,Gee
503 S Paseo Ganado 6040 RIVERSIDE DR #0
Anaheim, CA 92807 CHINO, CA 917100000
. BUSINESS PHONE: 90962(:'8410
JOB DESCRIPTION:Repalce exlsijng shake with.Eaglelite tile ICOO# 4660. 7.:\,bs.'
VALUATION: 8,000.00 ,i PROCESSED BY: CAL
,1,' ." . - ...... OWNER-BUILDERi!JECLARATION '.' .' .
I hereby affirm under penalty of. perjury that I ani exempt from the Contractor'qL!cense Law for the folloWing reason (Sec. 7031.5 Bus,iness and
Professi~ Code: any city or, county Which requires a per!1!it to 9onStruct: ~lt~;r,' improve, demolish or repair any str.ucture, ,prior to 'its issuance.- also .
. 'req~ites.the applicant for such permitto file_ a signed statement that heis Ii~~l'!$('>..d p~rsuantto the provisions of the Contractor's License Law (Chapter
9)(oommencing with Section 7000 of DIvision 3 of the Business and Profess,)?sCode) or that he is exempt therefrom and the basis for the.allaged
exemption., J;l1y violation of Sec~on 70,31.5 by any applicant for a permit~ub~.:~c!S the applicantto a dvU penalty of not more than five hundred dollars
tjO?)~s 6v;ner of property, or my empfOy~~with,Wages a~ their sole co~~jl':~iO~, 'will.do the'work, and the~tructure'ls not j~lte~dedoroffered ~or
sale (Sec. 7044 ~$il1ess and Professions Cocte: The Contractor's .License d~wdoes not apply to an ownerof property who builds'or improves
thereQt1. and who:does suchwerk-himself or herself or through his or her o...vll':emplovees, provided.that sUch improvements are not intended or
offeredfor sale. ' If, however, ~e bUilding or improvement is !>9ld with one i.~f;/i?f completion, the owner-buijder will have the burden of proving that he
did not bu ild or improve for the purpOSe of sale). ' ' . . ,<:~,:;;~~:., , . .
. 0 1,- as the owner of the property, am exdusiv'etY ,contmcting with IjCens,e?~"ontraCtors to construct the project (Sec: 7044 Business and Professions
-Code: 'The Contractor's License Law' does not apply to an Qwn,er of prope,tty \',-ho bu~ds 9r improves thereon, and who oontracls for such projects with
[jon:trador~S) lice~ed pursuant to t~~ Contr,ac~or's lice~, Law). ':"-: j . .. '
I am exempt under Sec. _ " B & P.C. for this rea$on: -::~i
Date: Owner: _'-
I, WORKER'S COMPENSATION DECLARATION \
I hereb~affirm under. penally Of pe~ury one oflhe. following declarations:
0- . ,I h~veand will rYlai~ain 'a certificate of con~nt to~ff.insure for:-worker;~:,-x.mpensation,
provided lor. by Section 3700 of the Labor Code, for the performance ofth". 'N~ik for whiCh
per ,is ~sued. ...._
have and wiil maintain worker's compensation insurance. as' required o~' $e!:'tion 3700 of
Labor Code, for the performance ofthe work for which this" permit is iSSUEd. ,My wo'r'ker's
ornpenSation insurance carlier and policy' are: '.
Carrier: .STATE FUND - '.- Policy Number. 162030C-.\12
This section need not be completed if the permltis for one hunllr$d dollars ($1.9.lr or[,,"5- .
o {certify that in, the perfotmance ,of the work for which this' ~rr~it,~_"i~~~:{:,{~ha" not' . :
. employ any person in any ~nn.erso as to become sUbj!Jct to UlEfworl5-~t~'e:~:r:~nsatlo~ laws
ofCalifomia,_ and agree that if I should beeo ,subject to the,worker~$b6rop~nsation " '
, prOVisions ~f section ,3700 <;>fthe La bor Cod ,'I " forthwi~p~mPly.w4~J-hr~~~~rOVi$iOns. .
.~ ' , ,',,'~
,C"/-
ARCHITECTIENGINEER INFORMATION:
I
LICENSED .CONTRACTORS DECLARATION
I hereby affirm under penally of perjury that I am
licensed under provis'k:msof chapter 9 (commEmclng ,
with Section 7QOO)of Divsion 3 of the Business and
Professions Code.
10/2312oo}, u,PYmll
. Date; ./ \ Contractor
NUMBER
554747
TYPE
TYPE
CJ9
HIC
EXPlRA110N DATE
7/31/2005
Date: 10/23/2003 . Applicant:
WARNING: FAILURE TO SECU E WO ER'S COMPENSATIONCQ;''{ER\Gg;IS-
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRlMINALPWiAtTIE:SAND CIVIL
FINES UPTO ONE HUNDRED THOUSAND Do'LLARS {$100,OOOl:l!:ti.ilbp:'iioNTO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR INSEC;)'10I:':m)6 OF THE
LABOR COD E, INTEREST AND ATTORNEY'S F'EES. - , - : ,X:!';':
I CONSTRUCTION LENDING AGENCY-",,;;': .. ",e;
thereby affirm under penalty of perjurytha1 the(e is a c~nstrUctl~nJe~jtlg ~'enq~ for th~
'>::-id'.)-ir-~:.:,::?'~ft'-::~ '.'!C'r!-:. fc:;- \'!~:ch!~;~'p,::~;;,::';6!~cX;~-d(Bj'c,'-:%~~~}':'-, L:.:._ '",",-:~ ""-.
Lender's Information; .'.
Construcion Types:
VN, ,
Fire Sprin~lered?
NO
...:~,;"
,. , . -', , '
I certify-'that I have read this 'application and state that the -above information is correct I
agree, to cOmply wtUl all city ordinances and state laws relating, to building corlStruction, and
hereby authoriZe repre ives of this ci to enter upon the above mentioned property for
I~ect~se~"
Date: 10/2312003
Fees paid for Permit:
Tolal:
282.66
- . . Sig e of Applicant or Agent '.'. .
. Thepennit shall expire by limitation and become null and void If the building or
work has not passed final inspection 365 days from the da~ of permit issuance. A
new permit Is required to commence or continue work. -
. INSP,ECtION . DATE INSPECTOR Electrical Final c'. .
.
TempQraryPower'Pole . . . . . Plumbing Final ..' '.'
Plumbing (Dll!inlWaste Pipe) . Mechanical Final
EleCtrical 'Ground Electrode/uter '.'
SetbacklFormsfTrenches (Footings) Gas Tilst '. ..' ..'
.
Do not install subf.loor or pour floor slab until the Engineering/Grading Final 765-6126 . I. .....
following' applic<lble items have been signed:' . 1 ..
Plumbing (Water Plpe.Sprinkler Valves) . . Fire Dept. Final 765-4040 .
.: . .. .
Mechanical (Groundwork) . . Water Engin~ering 765.5268 .
EleCtrical (Underground Condu it) . '.
. Sub list/Business license 765:519 .
Pre-slab (Compaction/Membrane.Reinf. .
\..Inderpinning (Floor Joist/Girders) .' . . Zoning 765-5139
.Do not cover:or conceal the work below unllltne Building Final *as(lnspection. Only 1'Bf'/63 . ~5,.;p51t</,
followlng'apphc<lble Items h<lve been signed: . .' . ". fterAbo~e Complete) ,
1 st Floor Shear . . '. PARTIAL .INSPECTIONS '. f V
Firesprinkler (RoUgh) '. .
. 2nd Floor Shear' .'. . I . . ~dina Inspections
RoOf (Sheathing/Diaphragm/Frane) . \114-'1'3 I t:.n+- S/\.(y""", . ' . ....
Masonry (ReinfJaond 'Beam/Pr&oGrout) . . . ' r . . ' .
Rough Plumbing (Top Out) .'. '.' . '. . .
Rough Mechanical . . .
I HOugh Electrical (Dry wall) . .' '.
Rough EleCtrical . .' . '. ,
.' Framing :(Only after Plbg., EleG:. t/rech.. and Fire) .
InSIJlation (SolsndlEnergy) .' .
PO not tape or pla\'ter until the following applicable .. Mechanical Inspections
,terns have been signed: . ' ," ..' . c . '.
Drywall . .. . .
Penetrations (FiR! Rated} Electrieal . .
PenetratiollS (FiR! Rated) Mechanical , '. . . . . " ....
Penetrations (FiR! Rated) Plumbing . .
Interior Lath . '. . . ". 1 .
Exterior Lath' . Plumbina Inspections
, . '. GENERAl,lTEMS .
Exterior Plaster (Brown Coat) .
T -Bar Electrical' . ' . . .. '.' .
T-Bar Mechanical .... . '. . ,
'. '.
'T -Bar Structural . .
Sewer .
.
Waier Engineering. Backflow. . Electrical Inspections ' '.
Water Service . , .
INSPECTION RECORD
FINAL INSPECTIONS
Date
Inspector