6297 Paseo Canoa
CONTRACTOR INFORMATION:
E& R CUSTOM BUILDEllS
17401 IRVINE BLVD #B
TUSTlN,. CA 927800000 .
BUSINESS Pf.lONE: 714 6Y'9665
JOB DESCRIPTION'!"ear off existing wood shake and intall20 squares of tile. :plbsIBCO# 4660
" . t . ,
VALUATION: 10;880.00. . (.' . . PROCESSED BY:ODC
I . . . . . OWNER-BUllDe:f~i!)ECLARATION" ..... .
I hereby affirm under-penalty of perjury that I am exempt from the Contrcc:tc;.r~s License Law for the following reason (Sec. 7031,5 Business and .
.'Professions'Code: any oty or county which requires-s permit to construct, ;;:,J~r, ,improve, demolish or repair anystrucfure, prior to itS issuance. also .
requires the applicant for such perml~ to file a signed sta"tement that he is lic..hood pursuant to the provisions of the ContraC;t,or'stice:nse Law (Chapter
9)(commencing with Section 7000 of Division :3 of the BU$rnessand Profess).ns Code) or that he is exempt the'refrom and the basis for the alleged
exemption.' Any violation of Section 7031.5 by any applicant for a permit sut.;ects the applicant to a civWpenaltyof nofmore than five hundred dollars
~O~)~s o~nerof prop~rty,o~my e~PIOyees Wit~ wag~s as their sole ccm~tnsation, will dothe work. and the structure, is notinte;,~~ or'o~ered.for " .
sale (Sec. 7044 Businessand Professions Code: 'The Contractor's UCerl.:.io;;' _;;la\.~does not a'pply to an owner of property who builds or improves
thereon, and who does suCh_work raimself,br herself or through his or her 0\"0:1 'employees, provided that such improvements are not intended or' " .
off.ered for sale. If, however, the building or improvement,is sold with one ye:.~r,('If completion, the owner-builderwil! have the burden of prOVing that he
. did not bu~d or improve for the purpose of sale); . ,_,' IJ ' .,', .' .
O' i, as 'the 'owner. of the property, am 'exdusively contracting .with licensed bon tractors-to construct the projec~ (Sec., 7044 Business and Pr6fessiolis
Code: The Contractor's License Lawdoes,not apply to an owner of-proper.:y'_~vhO builds or improves thereon, and who oontra_cts for sw;::h projects with
fU(ontractor(s) ,licensed purs~antto t~e Contractor's-Ucense Law).' .
.U I am exempt under Sec. . ,B & P.C. fo~ this. reason: -J
Date: Owner: -!'"
I WORKER'S COMPENSATION DECLARATION. 'i
I hereby affirm under penalty of 'peoury cn'e of the, following declarations: , ;,
. D'" J haye and, will ~intain a certificate ofoonse.ht to self-i~ure f~r. worker~'lcompensation,
as provided for by Section 3700 of the Labor Code, for the performance v~ ~:-.,{' work for which
this permit is issued. . t
.0 I have'and will "1aintain worker'~compensation. insurance, as required ~~; Section 3700 of
the Labor Code, for the' performance of the work for which this-permit is l:;::u;'~. My worker's
Compensation insurance carrier and policy are: , "
Carrier: NO. EMPLOYEES Policy Number. EXEM,'-'
This s~ti~e(rnot be completed if the peiinitis for one ndred dOllaf$($',:~~") ~_'Jass. "
~ify thatin theperformanc:e of the ,wor 'r ,ich his pe{mit:l~'J~t~~:d,lj~haill not '.
'employ any person .in any mannerso as to ecorn subje to the work~(i~ti:'n~n~at!on laws
of Califomia, ancJ agree that if I should b9com~ 1ect to he w,omer's 9or,Sd;j;~sation
provisions,of SeGUon 3700 of the Labor..-code, I hall fo 'with comply, WjJ~_t'a:;~"$e~:provisions.
...ol':'
BU.llDING PERMIT, ',0. <' 'SUl:on03-04450
~f~iJl~~~;~O:::!~:~. '. .
l~iIs~b'. \'~~.'~.> i'~~~ ElM
~ l~>A~/:lh
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~~O~?F PERMIT CITY
DATE: 11/14/2003
. JOB ADDRESS: 6297 E PASEO GANOA
LEGAL DESCRIPTION: N TR 8082 LOT 22
APPLICANT: ENRIQUE APPENZELLER
OWNER INFORMATION:
Jeremy C Hsu
7149 E Mockingbird Way
Anaheim, CA 92807
. BUILDING D!VISION
200 S..ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
. (714) 765.4626
CENSUS CODE: 434 .
QUARTER SECTION: 196
ARCHITECT/ENGINEER INFORMATiON:
I.
11/18/2003 .
Date:
NUMBER .
815191'
TYPE
TYPE'
Contractor
B
HIC
EXPIRATION DATE
11/30/2004
Construcion Types:
VN, , .
Fire Sprinklered?
NO
Date: 11/1812003 Applicant: _ .
,~::
WARNING: FAILORE TO SECURE KER'S COMPENSATION COVEP\GE,IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR!MIN!\LJ"~~:,TIE~;ANDCIVIL
FINESUPTOONE HUNDRED THOUSAND DOLLARS ($100,OOO),)!'I'Il,CDTlO1iEro THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSEGTIG,~' 37Q5'bf THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . .i)~'.. ~i
I . CONSTRUCTION lENDING AGENCYi0r=:-:~:
':'__he_r_eby ;;lffirrn ,_~~de r p.e~~ l,tY~f, p'er.iu.~.~llat:..th~rp. ~a c~Dstr~:W~~. !~r.~ it~~,?~..~~n:?:~o'flbe~- ,
-- ;..-.:.. ;..;,----;-,..:;;',.:..C--0,,,;.; 1-:;....v.~"iO,.- .-., "-'..11 ;.II;~ l)",jtl',;ii. .;j ;~:::.uerJ \~e'"",;",v;:;( .'-'IV .v,;
Lender's Information: - ,
Date: 11/18/2003
gnat re of Applicant or Agent
The permit shall expi e 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 or continue work.
.",-
Fees paid for Permit:
Total:
224.00
INSPECTION RECORD
, , INSPECTOR I
INSPECTION DATE ~"
Temporary PQwer Pole , I r
Plumbing (DrainlWastePipe)
Electrical, Ground Electrode/uter , : -I
, SetbacklFormslTrenches (Footings)
DO Qot install subflooror pourtloor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.SprinklerValves)
Mechanical (Groundwork) ,
Electrical (Underground Conduit) , , "
,Pre-slab (CompactlonlMembrane.Reinf.
Underpinning (Floor Joist/Girders) ,
DO not cover or conceal the work below ,until the
following applicable items, have been Signed: .
1st Floor Shear : ',' '
Firesprinkler (Rough) , " ,
2nd, Floor Shear . I
Roof (Sheathing/Diaphragm/Frame) 1/ :U,::g 1) , ,
Masonry (ReinfJBond BeamlPre-Grout) , ,
RoLlgh Plumbing (Top Out) , ,
Rough Mechanical ','
Rough6ectrICaI .II} ~
Rough Electrical "
Framing {OnJyaher Plbg.., ~Jec.. t..1ech.. ,and Fire}
Insul,ation (SoundlEnergy)
Do not tape or plaster until the following applicable ,
Items have been signed: " ,
Drywall , " I
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing ,
Interior Lath , ,
Exterior lath
, GENERAL ITEMS' ' ,
Exterior Plaster (Brown Coat) ,
T -Bar Electrical , , , ,
T-Bar Mechanical " ' ,
T .Bar Structural
Sewer
Water Engineering Backflow , ,,'
Water Service
.~
J$.i:
~'
FINAL INSPECTIONS . - 'ba!e, ,lnspeClor '
Electrical Final ,
Plumbing Final , ' " "
Mechanical Final
Gas Test , "
Engineering/Grading Final 765-5126
F.ire Dept. Final 765:4040 "
"
Water Engineering 765-5268 "
Sub List/Business License 765-519
Zoning 765-5139 ' '," , ,
, '
Building Final ~ast Inspection. Only liltrhy H0!5/~
. ' 'fter Above Complete),
PARTIAL INSPECTIONS
", Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electricallnspectioris
TYPE OF PERMIT .
Residential Remodel CITY
DATE: 11/17/2003
JOB ADDRESS: 6297 E PASEO CANOA
l-EGAL DESCRIPTION: N TR 8082 LOT 22
ElM
BUILDINC?.DIVI5iON
200 S. ANAHE;M t!i..VD. .
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 434
QUARTER SECTION: ,196
, BUILDING PERMIT NO. BLD2003.{)4468 .
APPLICANT: EBRIQUE APPENZELLER
OWNER INFORMATION: CONTRACTOR INFORM./lflON:
JeremyC Hsu E& RCUSTOM BUILDER~
7149 E Mockingbird Way 17401.1RVINE BLVD #B
Anaheim. CA 92807 TUSTIN. CA 927800000
. . . I-l BUSINESS PHONE: 7146(1..:'665
JOB DESCRIPTION:Cange roof pitch at rear of house per approved plans. '.
VALUATION: 4.800.00
I OWNER-BUILUER ;)ECLARATION
I hereby,affirm under pemalty of perjury that I am exempt-from the c.ontractc(':i Licens.e Law for the fol1ewing reason {Sec. 7031.5 Business and
Professions Code: any city orcountywhich r~uires a permit t.o construct.a~..~;. improve. demolish or repair anystructure,'prior to its issuance; also
requires the applicant for suCh permit to' file a signed statement that he is '!ce:'~sed purSUi;mtto the provisions of the. Contractor's License law (Chapter
9)(commencing with Section 7000 of Divisicn 3 of the Business and Profess~i".$ Code) or that he is exempt therefrom arid. the basi_s.for the alleged
exemption, Any violation. of Section 7031.5 by any applicant for a permit sucI~ts the a ppJicant to a .dvn penalty of not more than five hundred do1!ars
($500).. . .. I. ....
D- - I,.as owner of property, or my employees with wages as their sole comp 1 '1$3ticn; will do the work, and the structure is not intended, or offered for
sale (Sec. 7044 Business and Profes:;iofl5 Coo!'): The Contractor's License lJ'w does n"at apply to an owner of property who builds or improves
thereon, and whc doe.~ such \'Jor~ himss.if cr h~rsE:lf ..;or through his or her.owqemployees, provided that suet! imp,l'Ovements are not intended or
offered for sale.' If, ht:'lwever, the building ~)r in-;pr~Neir:e!,t is sold with one Yt.'n of completion, .the owner-bu-ilderwill have the burden of prOVing .that he
.did not bund or improve for the pUrp~se l..'7 ~Ic)., ; "
D I, as the owner of the property, om eXdusively ,contracting with I.iq!ns~d.}ontr?lct.ors to construct the project (Sec.' 7044 _ Business'and Professions
Code: The Contractor's license LaW does not apply to an owner of p~opertY:'I~Jho b~iJds Qr improves ,thereon.. and who contrac.its for ~uch projects with
~ontrad:or(s) licensed pursuant to t~e Contractor's License ~w). . j .' ' .
U. I am exempt under Sec. __-.:... . B- & P.C. for this reason: _' - i. ,-'
Date: Owner: '.
I WORKER'S COMPENSATION DECLARATION .=;.. LICENSED CONTRACTOR ECLARATION
I hereby affirm. under penalty of 'perjury one of the following declarations: . . -" ,: ',' I hereby, affirm under alty_~ perjury that I am
o .'-have'and will maintain a certificate of consent to self-insure for worker"j"co~pensationJ licensed under~~-'. . ,chapt~T9 (commencing
as provided'f9t-by ~ction 3700 of the Labor Code, for t~e performance ofth:.,.\ work for which with se~~ion..7~~' 'V." IOn 3 0 f.1.!' e . BUsin~. san.. d.
~s per;:D-~ issued, . . . ,_j . Professl Crn . ., .. . . : .
Q...Vilave and will maintain worker's compensatio:n insurance,as required 0: ~ Section 3700 of 1.1/17/2003 .. .
the-labor Code, for the performance of the work for which this permit 'is.i~ul'j. Mywcrker's. Date: Contractor
Compensation insuraneecarrier and poliO/ are:
Carrier: NO EMPLOYEES . Pqlicy Number. EXEMPl NUMBER EXPIRATiON DATE
815191 11/30/2004
TYPE B
TYPE HIC
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ODC
This seCtion need r:'ot be completed if the pennit !s tor one hundred. dollars ($1 OC~ cr less.
0' I certify that in the performance of t~e. ,:",o"'t;!~ or w 'ct:l t. er it is issuf.'cj. I ~hall not
employ any person in ?ny maonerso as to become 5 j to th.e ork~r's, CfI:':"lpensatlon laws
. of California, 'and ,agree that if I should bec6me subj ct,Aothew ar's cOl1i~,!~satioii
pro~isions of Secti~n 3700 oftheLabor c6de, I sh I ~rthwith amply WithJI":'.:se provisions.
Date: 11/17/2003 Applicant
WARNING: FAILURE TO SECUREWOR R' COMPENSATION COVER\GE IS
UNLAWFUL. AND SHALL SUBJECT AN. EMPLOYER TO CRIM INAL PEN."L r1ES AND. CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN A[)O:i10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTIO/< 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY i-~: c ..
I hereby affirm under penalty of perjury .that there is a construction le,ndi~lQ~',tiGY for the
t---CliG..'1"';.'~ oi UI~ i/'.tVt"- .o;-wirici1 (rhS pe! i (lit .5 I~~..lt~d \S~3W( ,C:;~L~;:. ~--";'-;"-.:-
Lenders lniorrnation: .
Construcion Types:. ,
VN. .
Fire Sprinklered?
NO
f thi~ city toenterupon the above menUoneq property for
Fees paid for Permit:
Total:
213.66
Date: 11117/2003
Signature of Appliyant or Agent
The per it hall expire. by li!l1itation and become n,,1I 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 or continue .work.
INSf>'ECTION RECORD
. ,
INSPECTION . DATE INSPECTOR
Temp9rary Power Pole . .
Plumbing (Drain/Waste Pipe) .. . .
. Electrical Ground Electrode/uter I
. Setback/FormslTrenches (Footings) . .. ..
. Do n<>t install subflooror pour floor .slab until the
fol!owing applicable- items have been signed: _ ,
. Plumbing (Water Pipe.Sprinkler Valves) .
Mecnanic31 (GrOUndwork).. . .
Electrical (Underground Conduit) .
Pre-slab (Compaction/Membrane.Reim. . .
.'. Un~pinning (Floor Joist/Girders) . .
. Do not cover or conceal the wo~ below untH the
following applicable items have been signed: ..
1 st Floor Shear . . .,
FiresprinJder (RQugh)
2nd Floor Shear ..
RQof (SheathinglOiaphraaIl1lFrame)
MaSonry (ReinfJBond BeamlPre.Grout) . .
Rough Plumbing (Top Out) .
Rough Mechanical.
ROugh Electrical I)
Rough Electrical
Framing (Only afte:r Pl_bg" Elee.. Mech.. and Fire) 111.U,p {IIA'
InsulatiOn (SoundlEnergy) . ... .
Do not tape or plaster until the. following applicable
items have been signed: . - .:
Drywall . ..
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical
Penetrations.(Fire Rated) Plumbing . . I
Interior. Lath. o . .
Exterior LlIth . .
. . GENERAL ITEMS .
Exterior Plaster (BRl\Nn Coat) . . . .
T ,Bar Electrical
T -Bar Mechanical . . . . . . . ,
T-Bar Structural ..
Sewer .
Water Engineering Backflow .' ,
Water Service .
FINAL INSPECT!ONS '" Dale l!1speClor .
Electr.ical Final .. . . . . .. .
Plumbing Final .... . . ..
Mechanical Final . . . .
Gas Test . .
Engineering/Grading Final 765-5126 .
Fire Dept, Final 165-4040 .
.
Water Engineering 765-5268. . . .
Sub List/BUSIness License.765-519 .
.
Zoning 765.5139 .. .. . .
Building Final~ast Inspection. Only .
.. . fter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections .
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
PERMIT EXPIRED
INSPECTION
NOT COMPLETED
DATE:~hsloq