820 N. Pauline St.
SUIL!:liNG PliRMIT NO.
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TYPE OF PERMIT.
Residential Addition
DATE: 4/6/2004
. JOB AQDRESS: 820N PAULINE ST
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CITY ~:~<<.).. 'M'
'. UfT.,-'iJ' .HEI
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BUiLDING DIVISION
200S. ANAHEIM BIND.
(714) 765 -5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUART!=R SECTION: 82'
6).,[)30lt'rP4789
LEGAL DESCRIPTION:' N TR 592 BLI, D LOT 6
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APPLICANT: MARIA GUTIERREZ
OWNER INFORMATION: .
Martin Gutierrez
820 N Pauline St'"
ANAHEIM, CA 92805'0000.
JOB. DESCRIPTION:Add 2nd story (:f bedrooms; bath), .1st story 1"l;odry,h8li'!..nd 9ar,,90
VALUATION: 59,400.00 . ; t. .
L . '. . OWNER-BU!LDJ;.F{PECtARATION
. I hereby ~ffirm under penalty of perjury that.' am exempt from the Contract.l:j,-LicenseLaw fot. the following reasol) (Sec. 7031,5 8uS:ine~s and
Professions' Code: any dty or county w,hich requires a 'permit to con~(ruct,_,a.:~)(, [mprove, demOlish',or repai- any structure, pricJr to its, issuance, 3,lso
requires the appli~f.1t for such"permil b file.<;!si~ned st<'ltement.th~t he' is nc.~~~~~tpursual1t to the provision~ Of the, Contrador's'_Ucense L?w (~h~pter
9)(cominencing with Section 7000 cf-DivisiQn'3 of the Busir,essan9PrQfesi;~J,s(';ode) or that he Is exempt Jherefrom aDd the basis for the,alieg~' '.
.exemption" Any~viofatjon, of-Section 7931.S by .any applic8.nt for ;:;I parmit S(l!~~blli th.e applicant to a' dvil' penalty Clnot more tha'r,"five hundr.ed dollars
($500). . .'. . '.' '. .... ;;;,,"< .' .... ..... . .........
~. I; as owner of p~operty, or.~y employees WltI, W:3Q:s ~st~eir'sc~~ co-r:n~fr'l~~t~_~n.,-:W.iH.doJhe ,^,~rk~. a~d.~~e; str~ctlire i~,,~ot i.ntend~,or"off~re~ fC;f
s3le-<~cc. 7044 BU~,\Oess"nd Profe~s;ons Code: The L.::fitraCIOr's LrCen3&L:Gl~""dcesDot applyt.o all OW/.ler of pwperty wl)o builds or Improves," .
therecn, ~nd whcdoessuch v.J:orkhilT'st~l( or herself or thr~;llgh hi~ ,or her: ('1\;:_,tarnpioy~e~';p;"bVid~ that such imptOvements'ar~ :1()t intended 9r' . .
offered Tor sate. I!, hO'"Y~.vHr, .the. building cr impro.vemeI1~ i3,$o!.:: ..'''!~!,~ (il<;: 'J;~~t,,?! ~rnpletion, th~ owner~builder wi!] have the burden of proving that of?'
'did not buildor.improve for thepLirpose'of sale).. '. _ ):. .'.' ..,:..". _ .' .. ......
o I, as the' o~ner of thl3 prop€rty,_,.am e~dusjve!y cOlltractir.g with !!cen3ed,oomr3dors tOCbi)~truct the project (Sec '7044 Business anclProfessiorls
Code: TheContractor'sUcense L:3w does:n:Jt t"lpply t('. <3n owner of propert~tj~o -:Jui!ds(?r lrnpr9yes ~hereon.and'wno oontracts for 3uch projects with
~onttador(s);licensed' purs.uan! to the Contr~ctor'~ U.::ense LaW): . ,.,{~. . . .
U I am exempt :.;nde~ S,ec;, ,_~~ _.-. B& P.C. fo~s reason:_ .._ ~.. '-.~;-"..;
Date:,. . .., -.,.. Ow?er:.7 ~Ad ~ '1 . ~~-==~r' ".-' _J
r 'WORKER'S COMPsNSATION'DI:CLARA~LO:'; -.'1'. .. _
'll1eieby a~rm ~rider p_enaltyof perju,yone of the-f~l!oWing:dE'claratior.s.: . f>>:" "'. .
o . '-have and will. maint.aijlS: ,_:artiflc3te of consent to se'lf-insl,lrE:! for wo..t:c~1p:::'mpens_a~ion,
_as provided for by Section 3700 of the Labor COOl::!. for the perfprman:-,e ofti:.: wOlk fOIWhiCh
. \his, permit is issUed; .. . '. . '~'.'. "
o ,-I have and win maintainworKer's.compensatiollinslJrance, as reCj~::i'U(: h~JS~ct;on 3700 of '4/6/2004'
the, I.,abor Code, forthe'pertormance of the' work ~orwhich th!5 pE;rir:it i..; j::.s:1Nt Mywork(;tr's Date:
.Compensation insurance carrier and 'policy are: ' ..i
, Carrier: . policy Nu mber.
: This section neE!d not be~pletedifthe pemlit is for one hundred dojia.~ ~$-:\J(;};:'; !ess~
,rg[ I certify that in the ~:~rfo:rm'ance~f.the work tor whiqh this p~rrnit"i$'-I~!.if.-d, t s~::::jll hot " .
employ any person in any manner so as to become subject to the ~or~e,(~~.$.'?:npe~s~Uonlaws
of California. and agree that if I should become subject to the wOI~t..er~"c,b~,;,hsation
provisions of Section 3700 of the La bor Code, I shall forthwith comply with J;;.:::-e PI OVISlvns.
Date: 4/6/2004 Applicant: 'j.(>:J-.A"""h, Ct4'/~'~"":-: '.
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION' fi~.:,G= IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRiMINALPEN:",/ioS ~ND CIVIL
FINES UP TO ONE HUNDRED .TrlOUSAND DOLLARS ($100,OdO,),Jj..(;~iii;';i\:jr~ TO THE
. .COST OF COMPENSATIQN,DAM,<>;GES,AS PROVIDED FOR IN SEQTlt#i doe OF THE
LABOR CODE, INTEREST AND A'tTl1RNEY'S FEE~. . . ';:1:'<,: . ,
I CPNSTRUCTION LENDING AGENCY~j . .
I hereby affirin-u_:nder penalty of perjury that.there" is a const.rlJC!ionje:jldiri9~~~,nCYfor the
perforrD<3"n~ofthe,work for which this perm!! is,iS&led (See. 309r:Cw:C): <q 1.-'._-. .. .,',
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CONTRACTOR INFORMi,ifION:
ARCHITECT/ENGINEER INFORMATION:
. IGNACIO G OCHOA .
7692 QUEBEC DRIVE
. HUNTINGTON BEACH, CA 00000 0000
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PROCESSED BY: FAN
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'.LICENSED CONTRACTORS DECLARATION I
thereby aTfirm ~nqer P?l!alty of perjury that 18m,
'licenS~d.unde;~ provisions of chapter 9 (complt:ncing
wittl Sec.tiol~ 7600) of Qivsion 3 Of the Business anc
P;ufessions Code.. .
Contrac~0r
NUMBER
EXPIRATION DATE
TYPE
ConstriiCion Tvpes:
VN, ,
Occupancy Groups:
R3, U1, . ,
Fire Sprinklered?
'DwellinQ Units: .
l,.ivinQ Area:
Garaqe Ar.e'a
NO
1
459
410
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I certify that I h~ve read this application and state that the above information i!: correct. I
agree to comply with all city ordinances and. state laws relating to buUding comtrllction, and
h.~r~byauthorize rep'resentives-of this'dty to enter upon the above mentioned property for:'
inspect-ion purposes"
'l&'~J ~ . CifA~ -iir. . ." Date 4/9/2004
'. . ignature _pplicant or Agent
The permit shall expire by limitation and become ilull 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: .
1.284,84
INSPECTION RECORD
. '. DAn; '. INSPECTOR
Temporary Power .Pole '. .
Plumbi ng (DrainlWaste Pipe)
Electrical Ground Electrode/lifer
SelpacklFarmslTrenc:hes (Footin9ll) -, 11,r/l4 ~
Do not install subfloor or pour floor slab until the
following applicable' items have been signed: '" .
. Plumbing (Water Plpe.SprinklerValves)
Mechanical (Groundwork) . .
Electrical (Underground Conduit) .
Pre-slab (Compac:tioniMembrane;Reinf.
Underpinning (Floor Joist/Girders) .. .
Do not .cover or conceal the work below until the.
.' following applicable items have been signe.d:. '. .
1 st Floor .Shear . ' . .' "'l/ rz
Firespri nkIer (Roug h) . ,
2nd Floor Shear //7 '-'0.'-1
Roof(SheathingfDiaphragmlFrame)./I). /~ .l.1~..r././?
>. Masonry (ReinfJBoncfBeamlPre-Grout) , .
Rough Plumbing (Top Out) j 1/7, 711
Rough Mechanical,. '217M '7>H1AJ( _.
Rough electrICal \....y naU, . , .
RoughElectrlcal '. . .'. . .' II ~AlI'1 .
F. raming' IOnlyafterPIb\j.. Elec., Mech..and Fire) . ,liIJ~' .'
Insulation (SoundlEnergy) . .gi;tt:1f:...
Do not (ape or plaster .untilthe followin ap )lIcable .
. iteOl.shave been signe~1: '., .:~..., .
Drywall'.' ...... ..... .~ V
Penetrations (Fire Rated) Electrical / . . . '.'
Penetrations (Fire Rated) Mec:hanic;al I . '. .
Penetraticins(Fire Rated)Plurilbing .
Interior Lath .' .. ..... . . . '.
Exterior Lath . . , 1"J17M J/ WIll 1I . .
. . . .' GENERALlTE'-'iS"/
Exterior Plaster (Brown Coat)
T.Bar Electrical
T-Bar Mechanical. .
T -Bar StruCtural .
Sewer .
Water Engineering Backflow
WaterService '. .' .
INSP~CTI6N
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FINAL INSPECTIONS
Date. 'Ins"ectof-'
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Fire D~pt. Final 765-4040. .' .
Water Engineering 765.5268 .' . '. . . .
Sub List/Business .License 765.519 .(j)-dJ:f . hill 0
Zoning 765.5139. '.
. Bu,uding Final\M:: ~~g:i'i:~%~~l~) "7 fuJ:15 ~.'.
. PARTIAL1NSPECTIOtlS ~e.
~~~I~;; ~~~;~ti~n$11 ~ o/?-k ni...t;;d-
v . ~7~~~~
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Electric:al F.inal
Plumbing Final. .
Mec:hanical Final
Gas Test. . .
Engineering1Grading Final 765-5126
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Mechanical Inspections
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Plumbina Inspections -'. .
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Electrical Inspections .
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