275 S. Peralta Hills Dr.
'-.
TYPE OF PERMIT
Miscellaneous CITY
DATE: 11/9/2004
JOB ADDRESS: 275 S PERALTA HILLS DR
LEGAL DESCRIPTION: .
A;;;r-:~:'2'~~
/,\,,~;':">l;.J. ;~
/~;Jtj \~-'f, ~o~
!,J,.,l!:.Zf ...~ J 'P
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IV "$'"
~^' ~~:~. ,p.<'
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ElM.
BUILDING DIVISION
200 S. ANAHEIM BLVD:
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765- 4626.
CENSUS CODE: 565
QUARTER SECTION: 163
BUILDING PERMIT NO. BLD2004-04090
CONTRACTOR INFORMATION:
TAYLOR TENNIS COyi{T3INC
1250 N LA LOMA CIR \': S
ANAHEIM. CA 92806 OGi;O~
BUSINESS PHONE: 714 !'3f;'3883
JOB DESCRIPTION:lnstaIl223Iinear .feet of tennis court fence, and 8 !ights\~t.indards
. \j
VALUATION: . 15.000.00 . .' . ;;[. . PROCESSED BY: JNJ
I '. . .. . OWNER-BUILDER:~ECLARATION .
I hereby ~ffirm under pena Ity of perjury that I am exempt from the Contract:~n~-L.icen.se Law for the following reason (Sec. 7031.5 Bu~iness and.
Professions Code: any dty or county which requires a permit. to construct, i;.6r, improve. demolish or repair any structure, prior to its issuance, also
requires the applicantfor such permit to file a signet\~tatement that he is Ib"~~sed pursuant to the provisions of the Contractor's License Law (Chapter
9){commencing with Section 7000 of Division 3 of the Businessand Profcs~'ii~nsCode) or that he is e~empt therefrom and the basis foi"the alleged ,
exemption. An'y violation of Section 7031.5by any applicantfor a permit s~bhcts the applicant to a civil penalty of not more than five hundred dollars,
($500). . . {:i. ' " . . .
o I, as owner of propertY, ~r my employees with Wag~s as their sole comp~nsalion, will do the work, and the s-tructure is-not intended or offere:d for
sale (Sec. 7044 Business and Professions Code: The Contractor's Licenst;_:l:~w does I"lotapplyto an owner of property ~ho builds or improves '
thereon, and who does such work himself or herself or through his or her"ov'/i\ ':employees, providect'that such.improvements are not intended or ;
.offered for sale., If, however, the building or improvement is si)ld with_one Y~'fr of completion, .the owner-builder will have'the burden of proving' that he
did nct build or improve for the.purpose of sale). :/:1. '
.0, I, as the owner of the property, am exdusively contractir,9 witi1lJCense1'}:ontradors to construct the project (Sec. 7044 Business and p'rofe$sions
Code: The Contractor's License Law does nqt apply to an owner of prope~tvwho builds or improves thereon. and who contracts for sudl projects with
oontracl.or(sj licensed pursuant to the Go:ntractor's License Law). ,;~~!
I am exempt under Sec. ' ,B & P.C. for this rea::.on: ,-'''j-i~p,
Date: ' Owner: u'.~,U.
I WORKER'S COMPENSATION DECLARATION -{I-
I hereby affirm under p,enalty of pe~ury one of the fOllowit:lg declarations: .} r'"'
o I have and ~ill ma intain a' certificate of consent to self.insure for' workee.~. compensation,
as provided for by Section 3700 of the Labor Code, for the performanCe 0ftt,!:\Nor!< forwhidl
~:;: =~~S;i~ld~aintain worker's comp~nsation insurance, a's ~qUlred~:\section 3700 of
mt:bor Code, for the performance of the work for .which this permit is iSGu\;,c., Myworker's
Compensation insurance carrier and policy are: ' \; .
Carrier: CLARENDON INSURANCE Policy Number. 02KROO,,7632
APPLICANT: DAVE TAYLOR
OWNER INFORMATION:
ANTON 10 SUAREZ
, 10448 SALINAS RIVER CR
FOUNTAIN VALLEY. CA 92708
l
"
ARCHITECT/ENGINEER INFORMATION:
. , ,
This section need not be completed if the pennit is for one hundred dO,lIars {$'H'!~,rl..?r ~ess.
o I certify that in the performance of the -work for which this 'permit is isst~~~_,.! shall not
employ any' person in any.mahner so as to become subjec_t to the workef's_tr~ir.~ensation laws
of Califoinia, and agree, that if f ,shou Id become su bjed to the worker's comp:;osation
provisions of Section ~700 of the ,Labor Code, I shalrfort ith comply witt: ~,t;l)Se provisions.
Date: 11/9/2004. Applicant:
WARNING: FAILURE TOSECURE ORKER' C MPENSATION COV~R..~GE IS
UNLAWFUL. AND SHALL SUBJECT,AN EM R TO CRIMINALP;E~li\LTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND LLARS ($100.000). IN AJ";!)1TlON TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTIGN 3706 OF THE
LABOR CODE. INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY ___I
I. hereby affirm under penalty ot'perjurythat there -is a construction lending 2{;encyfor the
-:,pe!'for.m~~_~.of!h..~,v.'!-..f.k..!ot-_1.'\.'~~_t~ig...::H';..:o-,~:t :::;.-i.s~..d (S ;';;:-~f"Giv;-('..-;:-"-
I..ender's Information: . .
LICENSED CONTRACTORS DECLARATION _J
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of DivsiOn 3 of the Business and
p",feSSion~cod
11/9/2004 /"-
Date:, Contractor
NUMBER XPIRATIONDATE
373423 5/31/2005
TYPE Hie .
TYPE D47
Construcion Types;
VN. .
I certify that I have 'read this ~pplication and state that the above information is correct. I
agree to comply with all city ordinances and 'state laws relating_to building construction, and
hereby i3uthorize representives o,f this city to enter upon the'above mentioned property_for
insQ ion purposes.
Date: 11/9/2004
Fees paid for Permit:
Total:
382,26
Si atur of Applicant or Agent.
T e.permitshall xpir by limitation and become null and void if the building or
. work has not p final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
'. . .... INSPECTOR
. INSPECTION DATE.
Temporary Power Pole '. .
Plumbing (DrainIWasle Pipe) .
Electrical Ground.Electrode/uter . I~
SetbacklFormsfTrenchll$ (Footings) .
Do not install subflQoror paur flaorslab untllthe
following applicable. items have-been signed:
Plumbing (Water Pipe.Sprinkler Valves) I
Mechanic.alIGroundwOrk) ~. ;:
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Rei nf. I
Underpinning (Fioor Jaist/Girders) .
Do nat cover Or conceal the work below until the . .
fOllowingapRlic(3ble items have been signed: ". - .
1st floor Shear . . '0
FireSprinkler (Rough) .< J-
2nd Floor Shear' if
Roof (SheathinglDiai:>hragm'FrlWlle) ii,
. Masonry (ReinfJBOnd Beam/pre-GlO\It) T
Rough Plumbing (Top Out)., . .' ~ . .
Rough Mechanical '0 . . , .
. I R!lugh E1ec.trlcalIDrywall) " UI/~
Rough Electrical . .IH\~JO') I-'"
Framing 10nly afte, Plbg. Elee.. Mech. aMFi,e}' ,
Insulation ISoundlEnergy) .
Danot tape ar plaster until the fallowing applicable
items have been signed-:, -', " .
Drywall '. .'
PenetrationslFire Rated) Electrical
PenetrationslFire Rated) MeJ:/lanical
Penetrations (Fire Rated) Plumbing
Interior I.;jth . : .. . . .
Exterior Lath
'. '. '. '. GENERAL ITEMS
Exterior Plaster (Brown Coat) .'
T ;Bat Electrical .
T -Bar Mechanical. .' .
T-Bar'Structural.
Se...r . . '.
Water Engineering Backflow .
Water Service .
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final.
Gas Test
Engineering/Grading Final 765-51.26
Fire Dep!. Final. 765-4040
Water Engineeting 765-5268
Sub list/Business License 765-519
Zoning 765.5139 .
Building Final (last Inspection. Only.. '7i
. . lifter Above Complete) 17
.PARTIAL INSPECTIONS
Buildina Inspections
InspeCtor
Dale
}
Mechanical Inspections
Plumbinalnspections
.:(
ElectricallnsDections
BUILDING PERMIT NO. .SLD2001;02970
.~.
~~T""_~_ .
'TYPEOF PERMIT
RetainingWaUs (Major)
DATE: 0812112001
JOB ADDRESS: 275 S PERALTA HILLS DR
.LEGAL DESCRIPTION:
. '. . A~~:'~"';rl~:\ .... .' .
CITY ~~fj~~.~~HEIM
. \~lI~Y'/Si? .
BUILDING DIVISION
206 S.ANAHEIM BLVD
(714) 765.5153' .
.INSPECTION REOtJESTUNE:
(714) 765.4626' ,
. CENS,US C;ODE: . 565
QUARTER SECT,ION:163
APPLICANT: LANE C:UR.TIS 71 J...f &'6'1 ~ 2..?b()
OWNER INFORMATION: CONTRACTOR INFORMNION:
B",;'HWu CURTIS COWUIS L .
560 S Avenldp'Faro 777 S PERALTA HILLS DR .'
.Anaheim, CA .92807 ANAHEIM. 92807,0000 CA
. JOB DESCRIPTIONlnslall retaining walls: 128 linear ft. of 7'.6" high & 461inea;' ft. of 10'.0" high:
VALUATION: .. '.18.420.00 . . .': . . ' PROCESSE'DBY; MJF
J .... . .:.. .. . . ':." .' . OWNER-BUlLD!i~ DECLARATION ' .' '. ". '. .'
. l. hereby affirm under penalty of perjury that I am.ex.empt frqm the ,Contractor',s License Law for the followinbJ reasolll (~e~. 7Q3'1..5 Busin~!3s and
. Professions. cod e; any 9tyQr'countywhich requires a.perm~.bconstruct; a'Mr, improv_e, ?eiTlC)list:tor rep8tranystrucWre, prior to)ts" is..i;ui:mce',aIs9 .
requkesthe _applicant for such permit to Jile a signed statem~'ntt.tiat he is.lice'ised pup:;Oant to the proviSions of the Contrado~'s,LiceJlseLaw (Chapter,
9){commencing'with.8ection 7000 of Division 3 of the, Bl.,lii.nessandProfessicihs Codel.or.that he'js exemp~ tlWrefro11l' and the,hasis fortfie_-alleged
'exemption.' Any violation' of Section 7031..5 by any applicant for~"ermjt sUbj9ctS thE:!' applicant to a dvil penalty of not.fllorettfan five hUAdfed dolla~s
($500)." ", ,'. " ',' " '" ", " .' ': . " .'.. ' ,.,' "',
[J .!, as owner of property, or my:employe~s with wages 95 \helr sole,c6nl,F~!lSQtion, will do ~lie work"and 'the stru'ctureis "(lot--in:t6flded_ oroffered fer
sale {Sec. 7044. Busihessand,Professions Code:", TheCqntlactor's Uce:nse,L~w,rjces no(applytoan ownerofprvperty-who,.builds ,orimprov~5'
thereon; and who does such_work himself ?r:h'elSelfar thraugh'.his.".or hero\\,n~mPlbye6S,;proVidedthat s'uchimproyements'are n()t intendector ','
offered for sale. It however, the ,bUilding :or:improvementis sold _with one yr,;~lr of coriipletio'n, the'owner~huilder_ 'Hill have the,bu'rden,o( pro'vi!1g'tll~fh~'
. did notbuUdor improve for the'pUlposeof saler, ' . _ " .,' ,:~..'. . _:_.. .' _ ,'. . ~:".' ,'" ..'
O. I,'asthe ~wrier i:?fthe property, ,a~ exdus.ivelycontract;ng'Witti,Ude0sed.,i,00lf~ctoi"$.to c(}l'!~trllci the ~roject(q~~G. T044: B!J~~ne~$'a'r1d:'f)cofessions_.
Cod'e:. The..<:;ontra.ctor's lIcense.Law. does' not.l;lppty to an-oWner 0(propertj::r/ho buildsorfmproyes thereon, and wh\)_'lX'"(1ttact.sJ~r ~tJ.ch:projects\'Y'itn'
a 6b11t~acto~(s) H~enSed :pursuant to the ContraGtor'~License~)";. \' '.' . . .
).J- . la!1J.'exemp,t uriderS.ec.." '. ' '. "', '8& P.C. for ;fhis,reason:" .~._J.-,-~ i....:._-,....._-..::~:...:;;..;...._~.:...-..._~
.'Date: 'Owner:"' . .:L".~";:"'__, ":', " .
I '. WORKER'S COMPENSATION DECLARATION J.-::':~"' ....j~l. lICE~SWCONT~~TORSDEPLAAA1'ION:J"
. - t ,h~rebyaffirm under penalty 6f.perjury'one'of the foilowing d_eclarations: ,'. , f' _.' _ ' '_ ",., J ';-' _J;her~byaff.in}1.u~:.[J:~en, itY,of'periwy t~atl,an;t
-.'0: 'lhaveand':Wil!mainta~' a certifiCate.'ofOO!1sent"to self-insure for worke(~{GOrrlpen5aU'on: )lce~sed:u.i:1~er prvvisiQil: . . e~ 9)~omm:nc;ng
.~. i p vide<1 for by section ;?10Q.of the Labor COde, for the'performance of 1h,;,\.vor.< for.whidl -'witl1 ~e.c~jc~nlOOO)Gr ' the'Business' anc
th'pel'mitis.issued... ',-' '.... ".. " . ....,1"',... PIP.fessionsCode.-'
. .'1 tiave'a,nd Wi.ll".maintain worl<er's compensation insur~nee. as reqUjred"b:lS~ct;o~, ~700'of 68121!:~oo1.'
th~ Labor.Code" fo~.th~'peiiormanc~.of the work for \/ihichthis permit is issu~~:L MY'Norker!s; '. Date:-'
Compensation insurance,carrier andpdlicyare:_'. . -.
Carrier: STATE FUND . Policy Number. '1486593-~
. " ~
This section need not be ~pleted if the pennitis for one hundred dol1~rs ($100:' ur less. .
. O' I c:ertify tha(in" fhe-~rfo'~ance of the work for whieht:his 'perlTlit Is lssue,i.. t 's~a_ll'-n~t
employ' any person inany manner so as tobecome'subject to the worker's cc.,r.pensation/aws
of Califo.mia, arid agree that, if ., shoo Ii:! beqoJ:l:le subject to the worner'sc:orPp€;DSc:ition, :
prQvisions of Section 370?. ofthe.LaborQod~, I snail forthwith comply ~itht~~~~.ep~ovisions.
Date'.08/21/2001 ' Applicant:.. .' ...,'.' .... .
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVER",GE IS
. UNLAWFUL,.ANDSHAt,L SUBJECT AN EMPLOYER TO CRIMINAL PENA:'TIES AND CIVil
FINES UPTO ONE HUNDRED THOU.SAND DOLLARS ($100,000);11'1 ADDinONTO THE
COST OFGOMPENSAT'ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE,
. LABOR CODE, iNTEREST AND ATTORNEY'S FEES. .., .
CONSTRUCTION lENDINc;oAGENCY
. Iher:eb~_ affirm under penalty.ofperjury,.that there is-a construotion lending ar':~'lcy'fot the
. performance'of the work for which this. permit is !ssued (See, 3097 .Civ.C):
. .1 ,?,nrl.:.r's Jnfnrr<'l2li~r:.:
, '
;.. -_.','-.;..,.".......~.....',...
I certify/hat I ha
. agree toOOffiP
h~re by."auth
insp .
read this ~ppJ;cationafldstate, that the above information is corree,t. I.
aU city otdinances.and.sfate l~ws .relating tobundii1gco~~stru'c~ion,an~
p,rese' es of this city to enter upon the: ab?vementlonecl property for
Date: 08/2112001'
'.. ,... IQnatureofApplicantorAgent.. .., . ... _'
The permit shall ElxpirEl by limitation andbecorne null and void if the building of
". work has not passed final inspeCtion =165 days from the date of.pe/'lJlit issuance. A .
new permit is. required to commElnce of continue Work. .
, , ,
ARC)-lITECTIENGINEER .INFORMATION:
,I
. 'NUMBER
341095 B
TYPE
TYPE'
EX~iRATlqN DATE'
'.. 07/31/2002
'.. HiC
.L1C:
ConstrucionTypes:.
VN, VN,
Fire '$pr!nkleredZ. .
'.NO
.. '
'---:-.~;_-"..
. " ,,"
'~~-'~~-""-'~'_'-"--'----'---"-7-_
'. Fees,paid for Permit:
Total:,'
497.50
. INSPECTION RECORD
. ....iNS~EC'!"lqN ...,' . DATE' '. INSPECTOR
. '. . .
, Temporary. Power Pole'.' .
Plumbing(DrainiWa$tePipe) . . , .,. ." .cc
Electri.cal Groun.c1Electrodell.lfer . :
. " '.'
5etbacl<lFormslTreili:hes (Footings) . ." .
. Do not install subfloor or pour floor slabuhtil the
following appfieable, it,mis haYe 6~en signed,'. . .
. Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (!>(ouf!Clwork) .' . '. .'
. E~ctri.cal (Underground Conduit) . , .
'. .Pre-sl"b ((;OIllPactlonlMembrane"Rei nt. . .
. Underpi nning (Floor Joist/Gi rders) ... . ........... '..
Do not Cover or conceal the work bel.ow unt" tile . .' -c-
," following applie.able items have been signed, . ..., .' I
. .HI/Floor Shear . . ... . . . .
firesprinkler (Rough) . " . '.
.' 2nd Floor Shear' , .' . . .
RoC)t(ShelllhiilgllJi;jphragn\lFrame) . . ,. . -
" MaSonry (Reinf~of1d Beam/Pre-Grout) '. . .'
." Rough plumbing (Top Out) . .... .
. Rough lIIIectianical . . . ' . . '.
Ro1l9h Electrical (Dry Wall). . '. '.. . .
Rouah . Electrical . , .'.~
Frami,ng.:"' (On!y'aft~rP!b9:; Elec:. Mech.. arid Fire) .... .
.
Insulation (SoundlE;nergy) '.... .'
. po.not tapear pla~.ter u,nlil the following applicabl., ,.
'I.tems.have been slgn.,d: .' . ...... '.' : .'
'. DryWall..... ". ... ,. . .
. Peiletralions(Firli Raled) ElectriC'!1 . ..... " .
. Penelralipns(Fire Rated) Mechanical". .. .
'.' Penetrations (Fire Rated) Plumbing . .'
'. Interlor Lath '. ' .... .
Exterior Lath .' . . ..' .. .... .
'. .... . . GENE:RAL ITEMS .. ,
Exterior Plaster(Brown Coal) ..' .
:t,BarEiectrical .' .' , . . .' ."
T -Bar Mechanical" - " . .
-T 'Bar Structural ..' . '.
Sewer . , . .. . . "
, Wale.r Engineerlng :Backflow .... ' ., ... .
. Water Service' " .' . .' . . .
-
.~ '
. . .' .'
. .'
. . .'
. .
.' .
. .
',PERMIT. EXPRIED'
. INSPECTION .
NOT COMPLETED
'. .Ltf. '
" .",~b~
DATE:
-
. . FINAL INSPECTIONS
Electrical .Final
PliJmbing Final..
Mechanical Final
Gas Test
Engi~tingiGradingFinal.165-5126
Fire Depl; Final 765-4040
Water Engin<lering .765-5268 '.
Date'
Inspector. .
. .
SubL,iWBiJsiness Licens~ 765-51'9
Z'lni,,~ 765.-5139
Building Final'. (Last Inspectiori. Only.
". . . . '. .. After Above Contplete)..
'. .' PARTIAL INSPECTIONS.
~ ... . -.. . .
BuiidinCllnspections
. , .." , '- . . - "'.' '. .
.' .......... '. "T/"';#?P?Q,9:r. ~4<<C.p.~.
Y-:V"'/-:?N1?s;~, . -' .'
~.
. .,~,,/- .
'~.
~
.
. .
.M98t:'-a.iie.ai 1"'5B8Jt:~..8'
""
PlumbinCllnsDections.
.',"
Electrical'lnSDections.
PERMIT EXRI RED
,INSPECTION' .'. .....
NOrCOMPLcT")
DAT~:,$l6l-1 -:'
"...,..
JOB DESCRIPTION:Construct (2) :'iI,""ers.
VALUATION: 2,000.00
I OWNER-BUILDER DECLARATION
I hereby ~ffirm under penalty of pc' ..;:,t I am exempt from the Contractor's License Law for the following reason { eo. 7031.5 Business and
Professions Code: any city or cow" \A I;;~h requiresa permit to construct, aller, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such penl;! to file a signed statement that he is lic~:nsed pursuant to the provisions of the Contractor's License Law (Chapter
9)(cGmmencin~1 with Section 7000 cf [);vision 3 of the Business and Professi.)ns Code) or that he is exempt therefrom and the basis for the alleged
exeli:ption. AI:Y viol;"ltion of Section 7031.5 by any applicant for a permit sub~!9cts the applicant to a dvU penalty of not more than five hundred dollars
($50,,).
o I, as owner of property, or my '~n'nioyees with wages as their sole compensation, will do the work, and the structure is not intenped or offered for
sale (Sec. 7044 8usiness and Prr"C' ,," '''i Code: The Contractor's License i,aw does not apply to an owner of property who builds or improves
thereon, and vvho does such won-; or herself or through his or her OW;1 employees, provided that such improvements are not intended or
offered for $.9 Ie. If, however, the' :d-"' or improvement is sold with one yearaf completion, the owner-builder w"' have the burden of proving that he
did not build or improve for the pu r; os' r sale).
o l, as the ('Wner or the prope,-" "elusiVely contracting with licensed contractors to construct the project (See. 7044 Business and Professions
Co(~ ff The Cc'r-',(,acior's License L. c; not apj:J::.' ~o an owner of prapertywho builds or improves'.ilereon, and who oontracts for sud'! projects with
,a.i{ontractar(s) !icens(~d pursuant 1: 'I,,, C0ntractor's License Law).
U I am eXe/l':~t under Sec. , B & P .C. for this reason:
Oat-:-;. Owner:
I~- WORKER'S c:9~!:rENSATION DECLARATION
! hereby affirm un;~er penalty of per "V r of the following declarations:
o 1 have a:'d v,,..dl rT1~1intain a c< )f consent to self-insure for workers compensation,
as provided for by Sectian 3700 < ',or Code, for the performance of the wofk for which
this ;)r;rm)t is ;'.~lied"
o I have81';(:! ',;i:1 n~i:linlainwo':
the L;~bor Co,jc:' f,l, P perfo':ne,
Com::;:nsation i",':J,? "jrB carrier
Carriu: STA ~T; C::)!,iPENSATlC)'\; "
BUILDING PERMIT NO.
TYPE OF PERMIT
B/ockwall/ Columns
""~ITY
DATE: 2/14/2003
JOB ADDRESS: 275 S PERALTA rl'LLS DR
LEGAL DESCRIPTION:
APPLICANT: LANE CURTIS
OWNER INFORMATION:
ANTONIO SUAREZ
10448 SAliNAS RIVER CR
FOUNTAIN VALLEY, CA 927080000
CONTRACTOR INFORMPTION:
CURTIS INC LOUIS L
777 S PERALTA HILLS DR
ANAHEIM, CA 928070000
BUSINESS PHONE: 714/631-2560
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 163
ARCHITECT/ENGINEER INFORMATION:
LANE CURTIS
4214 SPINDRIFT WAY
NEWPORT BEACH, CA 00000 0000
PROCESSED BY: AJA
)ensation insurance, as required by Section 3700 of
work for which this permit is iSSU'3d. Myworker's
"I are:
l"', )
Policy Number. 1486593-00
Thi~, sxtion ne',,;! 1101 be complete'
D : certIfy tld ii~ (~Jo perfanllC:
emp'I' y any P' "' '1 ii, 2ny mann
of C, 'fomia, 0" that if I '
prOY'I' 'ons of :) /00 of lilt
if j"'" "
",mit i. for one hundred dollars ($10:;1 or less.
work far whicn this permit is issuE'd, I shaH not
, become subject to the worker's c')mpensation laws
orne su bject to the worker's compensati"on
.de, I shall forthwith comply with those provisions.
Dati:
31191::,
AppJic;;' "
. '11'- r~ Si-::~
'.:_L S\J;),;
.;";DR,-c)
<:ATION, D
~'?:ST N:O
C:
"ally c
,ER'S COMPENSATION COVErAGE IS
MPLOYER TO CRIMINAl PEN",LTIES AND CIVIL
,0 DOLLARS ($100,000), IN ADDI1l0N TO THE
,"S PROVIDED FOR IN SECTION 3706 OF THE
cY'S FEES.
N LENDING AGENCY
, there is a construction lending agency for the
'lit is Issued (Sec.3097.Civ.C):
Wt~r:'~J iNG: j
ur~~
rr~,":'
.'vVFUL,
Ui::JTC (
OF CC
'::: r;or~'
CO:,:
L/','-'-
C
I,;
~I ,1 it ir
p',,;
, ;C0'
L<-',. ..> ",..oJ'
I C8r\i'J that \ ',:0,';" read this Cl ppl:
agi"\; to C01n (1 ali city ordi:'
her\.. / a\Jthc" '(-i~:re~";untives c
ins'f.-:' .\'(jl) pc: '";~"
,j state that the above information is correct. I
; state laws relating to building co.nstructian, and
:0 enter upon the above menti?ne~ property for
d~lo: 3/19/2004
TIE
WO~
new
,-e 01 A.
~,rmj t ~ ~ by i ,
,;::; no scu,lnai ;;,
:;::;-rmlt :s j ,:'quired to COJ11"";~'
enl
ld become null and void if tho building or
365 days from the date of permit issuance. A
or continue work.
LICENSED CONTRACTORS DECLARATION
t hereby affirm under penalty of perjury that lam
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
3/1 9/2004
Dale:
Contractor
NUMBER
341095
TYPE
TYPE
EXPIRATION DATE
7/31/2004
B
HIC
Canstrucion Types:
VN, ,
Fire Sprinklered?
NO
166.47
tI ~ 1.,9-'2> ~<j
- ;:
'I erN J+
.~
~~ ~ft-avJ pU-bJ-s-
..-- ;-
Customer
Account No.
Contact
Name/Title
AddresslPhone
Type of Project
Project Owner or
Management
Capacity (kW)
Estimated Average Annual
Energy Output (kWh)
Proposed Hours of Operation
Project/Site Location
Project Description
RECEIVED
CITY OF ANAHEIM
PUBLIC UTILITIES DEPARTMENT
APPLICATION
FOR COGENERATION FACILITIES AND
INTERCONNECTION TO CITY'S SYSTEM
FEB 2 0 2G04
UTILITIES
-:LECTRfCAL ENG!NEERING DIVISWH
T onv Suarez
275 Peralta Hills Drive
Anaheim. California 92807
CID: 5587\5
HD Boesch
REVCO Solar Engineering Inc.
LID; 259595
26631 Cabot Road. Suite B. Laguna Hills. CA 92653
Photovoltaic Enenlv Generation System
Tonv Suarez
4.758 kW AC
Please provide proof of ownership of development site or a notarized statement signed by site owner
granting you exclusive land or development rights, or proof of exclusive rights to develop the project.
120/
Voltage; 10 240V
NOTE:
7.427 kWh
Davlight Hours
South Roof (new home construction)
Type Photovolatic
Generator Type
Interconnection Voltage
Fuel Source
kW of Generator
Inverter
120/240
Sunlight
4.8kW
Nameplate
Total Decreased Load (kW) 3.9 kW
Start Construction 6/7102
On-Line Date 7/1/02
. (see original aoolication aooroved 7/9/02)
Signature
303W
304W
Main Panel Size:
(AMPS) 10 (O~tl
30
Finn/Organization
Is Customer increasing voltage and/or changing panel size?
Yes NO-L
Address
Telephone
Date
Release necls~pLbefore meter is set:
Electrical;t k"ftluilding _ Metering _
If) ItofeJ.
None
c: Customer Services New Business Supervisor
.'
("r~y
~.um7am
N8! P,OOl/002 F-I4S
,~PR-?NOO! or, 1111I FROII-R~VCO SOLAR
CulIOIlWf
crrv OF A.NAlIEIM
PtlBLIC unums PU'A.KTMl:Nt
APPLICATION
Foa COGtNZ....TlON "A.CruTIES 4ND
INTERCONNECTION TO ctn"S SVS'X'EM
~N,'j $~
2.-; <; p~ H-'/U. ?:>te.
A;r;iO\U\t'No.
o;;llt I~
J ""'.. n.Ri-
g(~ TH
7<;0'
CCllII&ct
NamoII'illt
~
'Jpeof1'tqject SoOt.. ~ P~\loL77VT( ",AI" "['!.AJ7I'?~ ',.
p=ar ("'..;:),N}
~(kW) At
,t-~~::>l 1'-l:"t i
l'rOlloud Roan; of Operation ~ I it hI' h "" ...~
.,1- p",j-SiteLocallou. -::,.........\-. ~
~j~~OlI ~e
Otllmlor Type / N V...."'-n..f ~
IiIIItr<:Gnllcclion Vollue /1i'JJ 1,'.\0
. ' (
F\lelllouxoe <;;; U I.i
kW of OonClIjar V, r
C:;,Av ~ ItS '7
f'~yo......,.,a...,.<-
Namoplatt
Total ~creuCd:E1d W) ? i~
:iran Cooatrw:ti"" ..... 1 ,0 '(. _
O....lim n.", \ '0 1-
N011l: 'P\&Ue JlfOYIde proe! 01 ~ of cInoIl_1 oiIe Of Illo_ltItamml,ilUCl !Iy sjfe_
pqliJll Vll1l exellllive I.wI or develoJmcllt ,;p.... or proof of c",bniv. rigla II) lIt\>tlllp ~ Jll'O.Im.
~:~~~nn~~ :::~1~::-(~:3:= *'4~_
FinllIOl:pIlizalic.n '::>
1....1.-;' c...ob,}\- ~ ~\"<.b
"e.'t"",) op ~~ \ '>> l.1:I-
c..,"1..1. S;..,
T.~",,) ";\.0;-0,'\..\ 'V
nile 1..,,\) '7- '? I o--z..
e: C\ISIm'O<f _ N.... l'I...iMII s"pcm.or
Is ~ ~1lIi"l! YO~ UIiJIDl cballalDa: paealllct?
Ycs_ No_
Rele...""::&l11lY bei'<Ite _ i. ..t:
El.ctriea1~BQl1dine_ Melt.ltag_ Nll1lC_
'1 f1I02-
Notes'
1. Key Manufacturers are:
-Inverter, SMA-America, Inc.
20830 Red Dog Road
Grass Valley, CA 95495
www.sma-amerlca.com
- Panels, BP Solar
630 Solarex Court
Frederick, MD 21703
www.bpsolar.com
- Racks, Professional Solar Products, Inc. __
4630 Calle Quetzal A "<,,, I eut
Camarillo, CA 93012 1),U.lP7>
www.prosolar.com
2. All components are UL listed and CEe certified,
where warranted.
3. System will be commissioned by owner per
utility inter-tie agreement.
4. California Contractor's License C-46 #387219
5. Two (2) 30A Utility Visible LOCkable Disconnect,
and (1) existing 60DA Service Entrance will be
used for Inverter. La.be./ M 11.+;/1>'1 diownned>;,
6. All AC circuit breakers will be mechanically
secured to the panelboard as per NEC 384-16(g)
for backfed devices,
7. A grounding electrode system in accordance
with NEC 690-47 and 250-50 through 60 and 250-
166 shall be provided. Per NEe, grounding
electrode system of existing dwelling may be used
and bonded to at the service entrance. If existing
system is inaccessible or inadequate, a
supplemental grounding electrode will be used at
the inverter location consisting of an UL listed 8 ft
ground rod with acorn clamp. Grounding
conductors shall be no less than #8AWG and no
greater than #6AWG copper and bonded to the
existing grounding electrode to provide for a
complete system.
8. Reveo Solar Engineering, Inc. acknowledges
that no electrical wiring will be aluminum per NEC
article 100 & 110 section 110-5.
9. RevcD Solar Engineering, Inc. acknowledges
this system shall comply with all applicable codes,
including the NEC, IEEE standard 929 and UL
standard 1741.
10. Installation shall be performed by individuals
familiar with the codes.
Project Address:
275 Peralta Way
Anaheim Hills, CA 92807
600
VDC 0
Roof of Home
Photovo/taic Arrav
Qty40.BP SX150modules;.Four 10 module panels wired in series
UL 9L09 Class C
Pmodule= 150W STC/140W PTC
Ppanel= 1500W STCI1400W PTC
parray= 6000W STC/5600W PTC
Vmodule= 24VDC nomlnal/43.5VDC open circuit
Vpanel= 240VDC nominal/435.0VDC open circuit
Varray= 240VDC.nominaI/435.0VDC open circuit
Isc =4.75A
Ideslgn =5.94A ..
Intennodule wiring = DuraSheath If:. Low-Voltage Power, Unshielded, EPR, HYP, Volts:
600V, UL Type RHH/RHW-21USE-2, Conductor Size (AWG/kcmil): 12, Conductor
Strands: 7/.0612, Rated at9000C wet or dry with Multi-contact connectors
-
All conductors & ground are #12 or
#10 AWG THWN in 1/2" conduit. 40ft
run Or Liquid Tight under 6ft.
SquareD HU361R Heavy Duty
Disconnect (or equal) UL E2875
AIC Rating 10,000
All conductors & ground are
#12 or #10 AWG THWN in 1/2"
conduit. 40ft run
Or Liquid Tight under 6ft.
It' '-..
o
30A
Qty 2 SMA Sunny Boy
SWR25 OU Inverter
2500W
Input: 250-600VDC
Output: 240V AC @ 60Hz
Imax =10.4A
Inec =13A (@125%)
Internal GDFI (ldif>1000mA
NEMA 4X Enclosure
UL 1741
No PV fusing required per NEC
690-9, Exceptions A&B
REVCO-Solar
Outback PSSB (or equal)
with 15A PV string circuit
breakers sized per mfg's.
instructions for PV fusing
ETL Listed. Up to 4 strings
per disconnect. 2 per
inverter
Side of Home at
Service Entrance
All grounds and
neutrals bonded here
to existing grounding
conductor
~
OOA
This Service Fed From
Multiple Sources:
Photovoltaic and Grid
/
Saurez
Electrical One-Line
3jZE FOCM !M'GI'.,Q REV
A 0
SCAlE 1:1 SOS SHEET 10F1
. I
'.
Electrical Characteristics'
Maximum power {Pmax>'
Voltage at Pmax (Vmp)
Current at P max (Imp)
Warranted minimum Pmax
Short -circuit current (lsc)
Open-circuit voltage (V oel
Temperature coefficient of Isc
Temperature coefficient of voltage
Temperature coefficient of power
NOCP
Maximum series fuse rating
Maximum system voltage
SX 1608
160W
35.0V
4.57A
150W
4.85A
44.0V
Notes
1. These data represent the performance of typical modules as
measured at their output connectors. The data are based on
measurements made in accordance with ASTM El036 corrected
to SRC (Standard Reporting Conditions, also known as STC or
Standard Test Conditions), which are:
. illumination of 1 kW/ml (1 sun) at spectral distribution of
AM 1.5 (ASTM E892 global spectral irradiance);
. cell temperature of 25 ~C.
The power of solar cells varies in the normal course of production;
specifications of these products reffect that variation.
2. During the stabilization process which occurs during the first
few months of deployment module power may decrease up to
3% from typical Pmax.
3. The cells in an illuminated module operate hotter Ulan the
ambient temperature. NOCT (Nominal Operating Cell
Temperature) is an indicator of this temperature differential. 8nd
is the cell temperature under St8ndard Operating Conditions:
ambient temperature of 20'C, solar irradiation of 0,8 kW/m',
and wind speed of 1 m/s.
SX 1508
150W
34.5V
4.35A
140W
4.75A
43.5V
(O.065z0.015)%/"C
-(160z20)mV/OC
-(O.5&05)%rC
4h20C
15A
600V (U.S. NEC rating)
1000V (TOV Rheinland rating)
SX 1508 I-V Curves
6.0
5.0
4.0
g T=OOC
- 3.0 T=25OC
l: T=500C
~
::I T=75OC
(J
20
1.0
SX 140B
140W
34.0V
4.11A
BOW
4.5A
42.8V
0.0
o 5 W . ~ ~ ~ ~ ~ ~ 00
Voltage (V)
Mechanical Characteristics
Weight
BP SX 150B
15.4 kg (34 pounds)
Dimensions
Dimensions in brackets are in inches.
Unbracketed dimensions are in millimeters
Overall tolerances ,,3mm (118")
Output Cable
AWG #12 (3.3mm'), RHW-2
11.1 [0.44]
2.4 [0.09]
!
27 [1.06]
SECTION A-A
1593 [62.7]
INCLUDES
SCREW HEAD
PROJECTIONS
GROUND
HOLE
2 PLACES
12.7 [0.50] X
9.5 [0.37]
MTG. SLOTS
8 PLACES
20 [0.8]
4 PLACES
2.8 [0.11] MAX
SCREW HEAD
PROJECTION
8 PLACES
A A
790 [31.1]
BACK VIEW
1250mm
CABLE
800mm
CABLE
754 [29.7]
BP SX 150B
'" ..(<~. "
950 [37.4]
2 PLACES
321 [12.7)
INCLUDING
SCREW HEAD
4 PLACES
200 S. ANAHEIM BLVD.
(714) 765- 5153
CITY OF ANAHEIM
PLAN CHECK RECEIPT
BUILDING PERMIT NO.: BLD2001-04510
DATE:
TYPE OF PERMIT:
JOB ADDRESS:
LEGAL DESCRIPTION:
APPLICANT:
3/14/2003
RESIDENTIAL REMODEL
275 S PERALTA HILLS DR
CENSUS CODE: 434
QUARTER SECTION: 163
ERIC RAY
OWNER INFORMATION:
ANTONIO SUAREZ
10448 SALINAS RIVER CR
FOUNTAIN VALLEY, CA 92708
CONTRACTOR INFORMATION:
CALKINS CONSTRUCH)N
6263 E TRAIL DR ,
ANAHEIM, 928074039' CA
ARCHITECTIENGINEER INFORMATION:
JOB DESCRIPTION:
VALUATION:
Artificial rock landscape.
12,000.00
Construction Tvpes:
VN
Fire Sprinklered?
NO
Fees paid for Permit:
BuildinQ Permit Fee
Microfilm (Der DaQe)
Issuance Fee (New)
Plan Check Fee
SMIP
199.50
1.00
25.00
129.68
1.20
Total:
356.38
To obtain Plan Check Review results through our Automated Response System, please call the following number and select
the following options:
(714) 7654626
Press (2) Permit Functions
Press (1) Permit Plan Review
Press (1) for BLD, Enter the 9-digit Permit/Plan Rev!ew number
Your plan check should be completed by the City Development Team by 11312002. The Plans Examiner assigned 10 your
project will contact you if plans are ready before the noted date.
_ ~_ l,.
FDunded In 1857, the City Df Anaheim is one Df the nation's premier municipaNties and California's 10th most populous cUy. As the oldest and largest
cUy in Orange County, Anaheim covers 50 square miles, with nearly 330,000 residents and 2, fOO GUyemplDyees. The municipal corporatiDn's
annual budget is $960 milliDn and bDasts world-c/ass companies such as Boeing, Carl Ka",her Enterprises, Disney, L-3 CommunicatiDns, MTI
TechnDlogy and Pac/fic Sunwear. Annually, the City Df Anaheim aisD welcomes millions ofvisUDrs, truly making it a place where the world comes to
live, work and play,
TYPi;OFPERMIT' .
New Resident;'al Construction'
OilY
(~f~~ ...
OI,,~N.HEIM .
\;~~i!~~D:f
. BUILDING DiVislqN .'
200 S. ANAHE!M BLVD,
(714) 765 ,!;jq~ " .
. INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE. 101
QUARTER SECTION: 163
BUIl.DING PERMIT NO.. BlD2000-02177
DATE. 1/10/2003 .'. . . .
. JOBADDRESS: 27& S PERAL TAHllLS DR
LEGAL DESCRIPTION:
. '. .r
CONTRACTOR INFORM4boN..ARCHITECT/ENGINEER INFORMATION:
CURTIS INC L.oUIS L): . . . LANE CURTIS
771 s. PERALTAHI.LLS.DR ".1.:' . 42148. P....I.NDRIF. T.WAY . .
ANAHEIM, 92807 0000 CA'I . .'. NEWP.oRT BEACH, CA ,
. J~B DESqRIPTION. New S.F,D. COR #140629,N.oTE. Gar~geis on 53 DC~'JpancY"ReneW perIT1its for 6-IT10nth 10 ",pi,e 7/1.0/2003) .
VALUATION:'. " 1,055,000.00 '. . '..' . '.. ,';,. .t. . .." .... PROCESSED BY: AJA . '. ..:..' .
! ....... ,'.' ..,.........' ..... ,'" 'OW.NER-BUILDi~.& ECLARATION. . .....,... ". .: ..~
. .1,'~erebY"<lffjrfTl under, penalty of perjLfry that..! 'am exempt .traIn the"C{)ntreGto~; : UqenS~ ,Law.forthe, following, n~ason (Sec; .7031.5_B~siness .,and
PrqfeS$i'Jns Code:,'~ny dty'or~countywl1ichreQUi_re~ a,perry}ltJoc,O,rlSlruct,' ;ii;' r:it'rlOfove, detDOlish or re~ir, i\nystructure,"priOr:o i\s.i$.Sllance,.. al&'O
'r.'eq~"ir~'..t._t)e. ~PPlica. '~.uor.sUch.p..e _~mit to file a.s. !Qried s,tate.;m. en.l th.,a.,..th... ~.I.?,fi~~ I~ed.pursu.an.tto. the'pro. vi~jO. n',.~ Of~h. e. CO. nt.rador's L. iC._~f1S~ taW'{Ch,C3.r;tte...r,:. .
'. 9)(commencingwithS.ection 700Q,ofDiYisiol1 ,3 ofthe.Busjnessand?n.'f~s~;;~.,s.Code) or that- he is exempt.therefrom and the basis for tile alleged'~.'. '
'. exemptivi1.'p;ny'violation'of .Se<?tion 70,31:S.b'y arl'i applipallt for .~. pf3rrryit su6jj}ctS, the aPPJicant to'a.dvil penalty.of-not more ~nfive,.hundred dollaJ~5'
($500). C" ...... > "'..Y;'. .< .,' ..' '. '. . ,.~.'
[] I,a~ 9V/ner 6fp~operty..:or'm.y'employe~ y:ith wage~ ,,?-s-their<,~~!9 ?Or.l~'~n:S'C'til?n..",,!ur.,dO :the vVork, andthe-strllctur~ ,is,net inte:ndeci6r o~~red'.fQ(
; sak: (~ec. 7044.E~usine~s ?lnd,f=:rpfessicns Cod~:. TJ'la:Co~~~~~to~'t;~~jcer:~~~f,~V_dr:lesnot~PPly,tc an.ow/"ler of proper~x who' builds ot imrroves '.
..thE}reol1,_..and Who'~f)es Sudt\\iork_hirnself or- r.erSel f or t1 irot},9h his::?;' hcr::O"'J'~' ".1mp!~)yees:,providedthat-such impro~'-eii1ent.& ilre not. intended or," .
'~.' ~enr,~ .~...bou~,;'..{ol~iIT1 1~,r.'~C.::' ~6~;.'t,!~h~.~brp.U..:~~..~gcr'j~~.f (.ovem~ ni.is' S.O!d.;~.:;.:..'.:.:..1"ne. ,...:.~.,~'..Of'" om,.,.,.,.&ticn., the.'c. .w. net bUil.~. e. r W.....ill. .hi3VO t,h..,:" [i.'.~urden...O...fPrc.. v'n9'lh,oi::~.,...h'.:,.
o ".I.'::i,~ t'rebvJr:lt~r ofthe property",aM eXdll$ive.ly f,i.-:)~tr..:l~ii'g.V.;fthjice('se,j ..ntract'yr$ tc)-constrlJct the project(Sec' "1044;'Bu,sinessand- Profe~joiJs,._'"
Gode: ,The Ccntractor's,Ueense Law does'not aopiy to. an owner.:ot:.property ;Jr,o blJi'd.~- or i.mproyes_ thereon,.and'who-c6n.tracts for such pmjecw; \~Ah'
:-~rc6ntra:~or{s)liGensed,pur$uar'lttotheContl'"act6i'$Ucanb~LCiw)"_ " ",I'i:" . '.' .'. .., ":'. ~-' '. '~<:,:-,I:.
O":I~n~':~x~rnPt._!:j~dar Sec.:-: -', " -_' ,"6:& P .(;:..10,' 'tt1is rea~o;i;~:' ~. -:_,-.t.:...;..' '~~'~~'.' . " . '.. ' _~_,--,-._~,,~:,:~:
. D.=;te:-- . ',.' Owner::,' :',: ::. ":. -, . .-":'::" '-:, .~~::l':':. -. .-.... . _" .;;:~_"
I ........ .'. ., WORKER'SCOMPENSAflON DECLARAIIQi'iCjl: .'"J 'L UCENSED CONTRACTORS DECLARATION!
~el:eby'a~rm.-un,d~~-p~?ar.t.y_,'pfperju,'ry ?~e."or;:he fOllO\~Jngi!,n:c.ra~z.~~~.~:.' ' . ..~':'., .:"_ .._' "I hereby affirm IJnder penalty of per:Llry t~Gt I ::m
'W ,lh3".....e:~n.d. . will ma.. i.~t.O. in:a. c.ert.ificate of-cor.sent to serf~im'L!~~.. j(jr..;."c..r~L."f'.~-l,:,?mp.e.n. s.ation,. 'Iieensed under'provisions .cn3pte(9 (ccr'nr11-enb;~g"
a~r::'rovideu for !:?y-Section'":3700of the labor Code, for the pelforn~anGe cfhy~Yor:CfO( wt'i.C!'1 wittlSectbri 7000), Qf.. {s' n 3 .e ":e$~ anri
this per .IS i,ssued,_,. ....". ,',' ,,'..:__:. .-"~__:,_,,,",' .P,rofessions Cd.€:.
:i~.:. ha. v~andW. il.'. m.ai~ta.in.WOr.k.e.r'SG..om~ensation .:.ns~Jranc.e,a~._ re...q~:',:jd?<';liOq3700 of .1/10/2003.
the. Labor-.Code;fo,rthe performance of the we.r!.. for ....yh:qh ihiS per!njt :::>:3SI.j~: t'~lyworkers O'at~;
COnlpe'1sation insurance carrier and policy<are: . '.. .' ....',-"-,:1....... ,
C.rrier:STATE COMPENsATiON FUND. policy NUlT'b9r..~4865D3 "0 . NUMBER
. :rhis'S~~?n,need' noib~ com~leted i~~~' permiti~.for ,~ne:hu~dr~.d:JI:~~~:~ ~~{i~,:~r(~s::,_: . 314.:g~5 , 8 '
D-' I c,ertify that_in ~h~ perf~rmanc.e of!~e wo"rk for w.hicli,tt.,.iSPfl,r(ni.~'is _1:~SY'~~:.J\~hali. !1bt,. :: TYPE ". .Hie '.
employ .any 'person in any manner so as to become subject to th~Vv'C'rKE:iI~ss~1ipensation laws
of C~I~oinia;,arldagr.ee. that if I shook:! 'becomesubj , to th'e_wO!};_er~s_:ccm'pU,,;atjO~,. :. '
proviSions;pf Section ;3700 of the Labor Code, I':~,..) orthwith ..~t~,~se. rovisions.
. '.- ~~
DaIK.1110/2003 Applicant:. ..' --..,.
WARNING: ,fAILURE TO SECURE . ER'SCOMPEN8ATiCN CO'JERi:.Gt .is, .'
. UNLAWFUL, ANDSH...LL SUBJECT AN EMPLOYERTO.CRIMiNAL PENAfTli;OSAND CIVIL
FIN,,~ UP T.o .oNE HUt-jDRED!itOUSAND DOLLARS (S100,COOl.IN AODI)1(\'1)o.TtlE
. C.oSTOFCOMPENSATI.oN; DAMAGES AS P R.o\il OED FOR IN SECTIOft3700...oF THE
'.LABORC.oDE, INTERESTAND ATTORNEY'S FEES. . ... . .
I.. .' . CONSTRUCTION LENDING AGE~CY .'. r
I hereby.affirm'Ulider penalty_'of perjury-that. there is a:coristructiOr1le'ndiog.a~')l1cVfo'r-the.
. :'JerforrrK?n.ce cf1he.,:^,ork for \Nhidl ,this-p-ermit jsj~sued '(See. 309,. :Civ'.C):' /.,.c:i:_-~'
- 't2.<3i;yc:';"'-5'iii;,)I'(,\g;;;;;~:"~
APPLICANT. LANE CURTIS
OWNER INFORMATION:
EXPIR)>,TION DATE
7/31/2004.
Construciori Types:
VN, ,
DwelliflQ Units:
UvinQ Area:
GaraQe Area
. Patio Area:
.'
1
12.891
,5,122'
796
___--' .1 __.____________~_
.,---'-.-~'
-"-'~'-~-'-,'. ."'-.~~-~
Fees ,paid'for Permit:
Total:
14,469.48
0/
Dale. 1/1 0/2003
. .'_ , _p. . Sig~atu. ofAppU98ntrJrAgent . '. " ..','
. The permit shall expire by limitation and b""oJne null and void if the building or
wor~ has not passed final ;nsp""t1on 365 days from the date of permit issuance: A
. newpermi! is required to cOmmence or continue work.
O'
j
I
,
INSPEC110NRECORD :
"'IN.SPECT10N ;;.
temporary'PowerPo'e. .
Plumbilig (Di'ainlWaste Pipe). . ".
: Elec;lrlcal GroundElectrodelUfer .' '.' ". .. .
....
... SetbackiFormsfTrenches (Footings) .'. '. . . .'
00 nol.inStallsubfloo. or pour floor slabunti I the.. .
fO!1oWing'applicableitems have' /;leen signed: . .' .
'. Plumbing (Water P1pe.Sprink~r Valves)
Mechanical (GroUndwork) '.
Eledrical (l!ndergrOllndConduit)
Pre-slab(CompactionlMembrane.Reinr. I.
.' Underpinning (Floor'JoistlGirders) ... ". .
. 00 n9tCO\lerpr concealtnewOl1<bel.ow u.nt.1 the
.{ollowlngapphcable Items have been signed: .......
'1stFloQ" Shear .' . '. ".
Firespnnkier. (Rough)' . . '.'
..2nd.Floor Shear. . .' ....
Ropt' (Sheathing/Diaphragm/Frame)'" ....
MaSonry (RelnfJBorld BeamlPre-Qrout) ....
RCll.lghPlumbing (Top Out) .,. I..
f{oilgh Mechanical . .... . . .
RoUlJhElectrical (Dry Wall) . ....
.' Rough Electrical. .' '.' , .
.Framing. '(Onlyafterplbg.. Elee.. Mech.. aod Fire) . ."
Instilation(SOIlndlEnergy) .'.
.' .00 not tape or plaster until, the following applicable
Items havebeen.signeC/: .' ,c .' ..
. . ......
Drywall. , '. .... .. o'
PenetratlOl'lS (Fire Rated) Electrical
.Penetratlons .(Fire Rated)~chanical .
Perietrations(Fire Rated) Pluinbing'. '.' .
. Interior Lath ....... , ".
Exterior Lath .. .. : ". :
.... '. ." GENERAL ITEMS '.'
, Exteriot Plaster (Brown Coat)... . .... .
T -Bar Electrical .... .
. T-Bar Mechanical..' .
T,Bar Structural .'. '. .'
Sewer' ". .... . .' .
WaterEnglneerlngBackflow .'.: .
Water.Service . ". . . .'. .
'..
DATE.
INSPECTOR
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FINAL INSPECTIONS
ElectlicalFlnal'.
Plumbing FhiaJ
Mechanical Final
... Date. '. Inspector
Gas Test
EnglneeringlGraditl~ Final 765-5126
Fire .Dept Fin,,1 76,5-4040
)/\IalerEngineering 765-5268
Zoning 765-5139
Building Final ILast inspection. Only'
'. .' . !:>.Iter Above Complete)
PARTIAL INSPECTIONS
. Buildina Inspections. .......M.....~........ .........._....... ~:.......:..................._.......
>;:;~t:?j .~~'1..1/-7 ~
. .
. Mechanical Inspections. . .
,
. ,.Plumbinalnspections
. . .
. .
ElectricallnsDections
FROM ROCK OF AGES
~
FAX NO.
9093320693
Apr. 12 2002 07:02AM P2
-......-..--.
Inland Engineering & Consulting, Inc.
Structural & Civil Engineering
121 N, St. COllege Blvd., Ste. 10-B
Anaheim, CA 92606
Tel: (714) 966.1790
FAX: (714) 956.0667
Job #01366
March 26, 2002
RE: GROTTO COVER FOR SUAREZ RESIDENCE
275 S. PERALTA HILLS DRIVE, ANAHEIM HILLS, CA
To Whom It May Concern:
The undersigned from Inland Engineering inspected the
reinforcement for the concrete slab and columns at the above
address, and they do comply with the structural plans. Please note
that the concrete slabs and columns lll:e supposed to be pouTed in
place (2500 PSI) rather than using shaterete. Therefore, no
inspection or test panel shall be required.
Please feel free to call our office with any questions or comments.
Respectfully Submitted,
S:E
- r<UIYI r<ULK WI- RueS
~
FAX NO.
9093520693
Rpr. 12 2002 06:32RM P2
Inland Engineering & Consulting, Inc.
Structural &. Civil Engineering
121 N. St. College Blvd.. Ste. 10-8
Anaheim, CA 92806
Tel; (714) 9W-1790
FAX: (714) 956-0667
Job #01366
March 26,2002
RE: GROTTO COVER FOR SUAREZ RESIDENCE
275 S. PERALTA HILLS DRIVE, ANAHEIM H1LLS, CA
To Whom It May Concern:
The undersigned from Inland Engineering inspected the
reinforcement for the concrete slab and. columns at the above
address, and they do comply with the structural plans. Please note
that the concrete slabs and columns are supposed to be poured in
place (2500 PSI) rallier than using shoterete. Therefore, no
inspeqion or test panel shall be required.
Please feel free to caJl our office with any questions or corrunents.
Respectfully Submitted,
L~~:-E
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Inland Engineering & Consulting, Inc.
Structural & Civil Engineering
121 N. 51. College Blvd., Ste. 10-B
Anaheim, CA 92806
Tel: (714) 956-1790
FAX: (714) 956-0667
January 8, 2002
City of Anaheim
Building Department
Anaheim, CA
Re: Suarez Residence
To Whom It May Concern:
In our professional opinion, the grotto column reinforcement need not be attached to the
swimming pool wall. Footings for the column are to be placed over the existing footers
of the existing retaining wall footing, if necessary, but they do not have to be doweled
into the footing. Also see attached addendum drawing.
Please feel free to call our office with any questions.
Respectfully submitted,
Shawn Nikjoo, P. .
.. aUILOING PERMIT NO., 6LD2001 ;04510'
............-
TYPE OF PERMIT
Residential Remodel
CITY
,~r;;'~' ..: ;.''".'; .
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1:.'" ~'t.t;W"" ,~Q$;<i"'.
f,.~Ii. '~~~"N' "~~Y;?HEIM
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. BUILDING DIVISION
200S,.ANAHEIM ElLVD.'.
(714)765-5153 . ...
INSPECTION REQUEST LINE:
(714) 765-4626'
DI>.TE: 1~27120Ql. .. .. ... .
JOB ADDRESS: 275S PERALTA HILLS DR
."', . .
LEGAL DESCRIPTION:
CENSUS CODE:. '434
QUARTER SECTION:. 163
APPLICANT: ERIC RAY.
'OWNER INFORrYtATION:' CONTRACTOR INFORM\TIOk
ANTON 10 SUAREZ . CALKINS 'CON~TRUCTI )N .
. 1'0448 SALlNASRIVIi'R cre . 6263 ETRAIL.DR
.. FOUNTAIN VALLEY, CA.92708 ANAHEIM,928074639 CI: .
. JOEl DESCRIPTION: ArtificiaLrock landscape. . . .: . . ... ...
VALUATION; .. ,12,000.00 . .. , . .. PROCESSED BY: .MAR . .. ..
I . , .. ........ ..... .'< ., OWNER-BUILDElrJ~EC(AP.ATION.... .... ., ... . ....; ....... ...... ..-::1
I_hereby .affirIT.1 \.i.ndeJ:pe.~.alty 'of perjury" th~t I"am exemp~ frorrdh:~::,C?on~r<;!ctc\'s Lic~ns'e.Low for the follo~ing r~ason(Sec. 7031,5 ~llsiness~ a.nd: _ .(_ ,_,
Profes'sions Code:: any dty"or coun.tywh!chreq uires a permit, !9,C?gr'l~tn~ct,~_",er, illip'rov~, qemolishut',repair any stru.c.tu~e. ,prior ,to'its:, issuance;, a15'0"',
requjres the applicant f~)'r, such..perrrut. to:OI_e',a signed _stat~m~,nqh?th_eis li')_ASe(i.pUrs.u.ant'tothe prbViSiOI1S of the .contractoJ:'s,License La~ (Chapter.
. >9)(comni,en~ing with 8-ection7009 9f Oiylsioh 3 of the-- Businessand_Prpfes5'jns Cod€"f~or'-that, he ,is- exem'pt ~t1e,refr9,m 'a~ 'th,e basis for the aUeged. . .
eKemption._ .A~~ v~lation of Secti,p,n 7031.5 by.any ap'plicant for a pe~miJ sujac1s' the C:\p:JUcanHo apvil penalty'ofoot more,tt,a,n 'fjye"hu~9red dollar~ '
($500). ., .,.,.. ... .... ...' ... ... '. . .... .. .. ..... .
,'. D _' I,as, Qwner of propertY" or .my' employees with wages ,as their ,sole :coni\,:msation, v/ill qO the'.lfJork~,'ar)d the_,stru'ctu,re-is 'rio-t;flt~nded oroffeied for'
'sale (Sec~ 7044 Busfne:ss,;3nd Pro~essi9ns Gode:~ The. Contractor's bice'n~~: ,;;'=1~ ~Q(is p.Qt'apply to an :owne.'r o{propedy wh~'buildS Or'lmprqve~' '
, ther~on, and '~ho ddes such_wo~k himse~ or herselfQr through his o(tler ovtl'einploye~s,.providedttiat sUyhimp.rovements are'not iqte'ooedo( '.
p1lered f9r sale. .If, _l1oweve(,-t~e"-,buildirig or _improyem~nt is sold withone'y'~ar of Comt'leti'o'l1~-:the~owne~-PUilder wHl'ha~~: the' burde'n of proving-that,he:
'didnotbuildorimpro~e'for~hepu.rposeofsale)'-:.,," _.' _ "'" _ '. . _ "', . ,'" . '_' ._' .
'D ,.t '?s.thEloWl1er 6(thepr()perty~:am exdusively 'contra"ctin!";J:with licens:e~';'~'ltractors 'to cO'1stn.lct_theproject (Sec. ,7044 Busin.Ei,,'sand Professions
'.' Code: The. Contra'ctor,'s License Law does. riot-apply to an owner cfpr.opert' \1'/\10' b.uilds Q"r iniproves, thereon,: andwho.contract.<:;:for such.projectS'with
a.contr",:ctor(s) 'Iicen~ed purst.!cfnt" tathe Contraetor'sL.lcense'Law), ,. . ~ - ,-. . .' -'.- ,', - '. ' . .
D '1. am ~xempn.inderSec~ :'~'':''''''-'''' B &. Re. for t~is' reason: _~_.:.,._.:-...__.,.._~....:___ .
Date,:; . , Owner:. '. .' . '.' ";..; ._ _'
p . . WORKER'SCOMPENSATIONDECLARATION~::~--~---"l
I, he'r.eby affirmunder,penalty,Of perjury one of-the _folloWing declarations:' , -__~'., " '
o >ihave and' wil.l~intaina ~ertificateof oonsen'f tose'lf-ihSure for woi-i{!"'.i'~ compens'ation,-.
as provided f_orby:,Section'3100'-of the. Labor COde,' forthe performance of(e_"'~io*.fo'r which
. ~'S permit is issued.. " . .' ' ':"",
,'.1 ha~e.a'nd wBI,'mainti:l(n \o\to'rkeris,'compensation insurance,.as 'require(.1'l::y'_S'3c~ion3'700,()f
, ,t . Labpr Code,forthe performance of the work,forwhich this permit ~ is;:,L,:r3.d.. rv':y worker's
.: Compensation'llisurance~'carrier and, pOlicy are:
. Carrier: STATE FUND .
ARCHITECTIENGIN~ER INFORMATION;
L1CENSEDCONTRACTORSOECLARATION J
I, h~~eby affirl;il und<::-r penc;lty'of perjury ,th?t .If!m
"1i6~nsed under prcvr$iori~ of c'tiapter,g,(commenc]nQ
wr~h ,SeG:tio:n7o.00) o(Divsion,3 6fthe BUsjnE!s~ ai1d
"Prof€l.Ssio~~O;de',';" ". ..;", '
12/27/2001. . . ....,...... ~ ~-
,-Oafe: ., .: ... :_...... Contra'dor
. ".- ,',
Ni,lMBER EXPIRATION,DATE .
308288 08/3112002
TYPE B
Policy Number:' 1589311..01
, " , '.
This se.ctio,{.neEid not be. completed,i,fthe penn!~ isfQrc>ne-"undred dQlta'rs ($10';)0;" less.
,_' ," ."- .,' _, ... C'.' "I'. '
o :I,certifyth.atin.,th~, perforrryaflc-e o~t,he wo~k:,for w,h[ch this permit is. i~L';:'tj, _I shalf no~
,emp,fqy any'pe~onin any f'!1anners~as'to become subject to' theworke\~:<:~mpe:lsationl.aWs
of Calif6mi~.. a11~ agree,tl)at if I.should _beCome ,subject to thewor:ker'scornrt;:nsaticn
.PFOVisiOn..SOf.. secI..ion 370. 0 6fl. he L.abo.. r CO'.. '.1 shall fO.,rt.~Wit.h.,?,~~,.PIY with t\oie prO:i~....ons'so,~~t~cion TYP~s:
. Date:'-.12/27/2001. Applicant:. . V. ~ 'v2 ~_~:"';":li-'-I Fire Sprinkl~red'? .
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVEi;A<.';EIS ,'. . ...
UNLAWFUL, AND SHALL SUBJECT-AN EMPLOYER T() CRIMINAL PENf.LTJE~ AND CIVIL
. .FIN.ESU-PTO ON. E. H. I:JNDRED lH.O..USAND DOLLARS ($10Q,000),IN Am(i.nON.T0.. ..1HE
COST OFC;OMPENSATION, DAMAGESAS PROVIDED FOR INSECTIO!i 3706.oF THE
.. LABOR CODE, INTEREST AND ATTORN'EY'S FEES, .
I . . .... CON$TRUpJON LE~DIN(> AGENCY. ., .
..I_hereby_a~irm uhder penalty,of.perjurythat there_is a, 'constr.uctl,{:m leli~.ing c:.ler:tcyfor the
. :-p,erforma.nce o~ theworl< fo,r whiphthis'permit is isSued (8ec.-3097.Civ,C),: '
, LeAde~s J:lform'ali(;m:, ' , .
. NO.
, .
..,_._,._-=-----~'-
'-, '.
---~_.-'--~'-
I tertlfY that-,Ihave' re_ad"thiS application and state that theab,oveinfol'mation is.correct.. I
agree'to 'romply wit~-all;_ bityord,!nanceS and_ state laws relating to_building' construction; and
.here'by ?lJthorize repre~ntilJes dfthis city, to enter u.pon. the' a bov,e men~iqned,' proPs rty Jor
in~ctiQV1:4j~ .. ... Date: 12127/2001 .
.. ,: .':.,-, ,-_- . . .'Signature of'Applieapt o:r Agent: .,:
The. permit shall expire by limitation and become nun and void if the building or
work.hal; not passed final inspec:t{on 365 days ftomthe date of Permit issuance.. A
. new permit is .required to coml11ence or coiltinue work. .. . .
" Fees p_aid for Permit:
Total:'
356.38 ,.
. 'INSPECTION RECORD
bate" ". Ins'p.ectar.
..' . INSPE610N~' '., ..... . I. DATE
, Temporary power'Plile" ,.... ,. '.' . . :
Plumbing (Ol'llin,IWastePipe) .' '. .
E\e.Ctrical Gr.ouIidElllCtrode/u(er -c:- .' . ~
SettiacklForrrlSrrrenr;heS(Footings) ','
00 not install subflodr.pr pour flOOr sial). unti.1 tile
..,. 'follpwingapplicable items have' been signed.: '" ' . ..
Plumbing (Water Pipe.Spririkler WIVes) . c-. '.
.'. Mi!challical (GroulldWOtk) .: . -;-
. E\eclfical (Undl!rground Conduit) " I:
. .':pre;slab(ColllpactionlMembrl!l18.Rei nf. \
Underp/. 'nning (Floor JoistlGirders)
."
00 not cover or, conceal the work below ,until,the
fpllowing applicable ilems ,h~'Ji, been signed: ' '.,'
1st FlllOr Shear, ',' ' ", .,' .'.
Fjresprinkler (Rough) '.,' ',,'
2nd Floor Shear " , . ' "
Roof (Shfiathingil)iliphl'llgmlFr;me), ,', " rc-,
Masonry (ReinfJBond Bean)/Pre-GroLit) ..
RoughP.luIlIbllJg (TopOlit)
Rough Mechanical c:c ~"
Rough Electrical (Dry Wall) ',' .
Rough Eleclrical.' .:, : . '
Framing, ,(Only after Plbg" Elec" Mecil.. and Firei .
InSlilation.(Sound/j:nergy) " , c:c .. : " I,
Do hO,t tape or plaster until the followingappJicable
". items havebeef:isign.ed:," . .: .'. ." .'
'. Dr}l\Yall .' .. c:c
Penetrations.(Fini Rated) Electrica'-'"
P!!Iletrations (Fire Rated) MeChaniCal
.':. . Penetrations (Fire Rated) Philllbing
, Inte.rior Lath . '. . .
Exterior Lath. . '.' ..' ."
.'. . GENERALlTEMS
Exterior Plaster (Brown.COat) '.
.' T-Bar...E1ectricaf '.~ '. . .
T-Bar.Mechanical . . -c:-.. ..'
T-Bar Structural .. ...... '.
Sewer , . .. '.
Water Engineering.Backflow c-. . '.
Waler Service
:
"PE:JiMI T {XPRI ED
.,'jNSP-ECTION
',NOTCOMPLETE(>>,' '.
-vl &\\ o~
DATE:' \"
INSPECTOR
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FINALIf<j$PECTIONS .
Electrical FiI,al
plumbing Final
Mechanical Final'
Gas Test. .
Engiri~ringl.Grading finai 765-612$,
Fire. Dept. Final .765-4040 . .
Waler Engineering 7'65.5268..
. ,Sub List/Business,License 765-519
Zoning 765.5139
I . 'Building FinaL ILast.lnspectlon. Oniy
. ., l\fterAbove Complete)
PARTIAL INSF'I:CTIONS
BuildiilQ Inspections
:,";
:,-
. .
Mechanicallilsilections .
. " - . ,. .
Plumbinalnspections
.
.
. I. . Electrical jnspectio~s
'.'
PERMIT EXPIRED
, .
'. .INSPECTION .'
.' NO T 'C OMPLETC [}
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. . .' .. I" .
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INLAND ENGINEERING. & CONSULTING. INC.
SlrUtturll De. . PIMnlng
121 N. Slate 'Collego Blvd.. Ste. 10-8
Anahe/ln, CA.2IOC
Tet: (714,'''-1710
FAX: (714'.....otI17
Job No. ~Vt8""
Date 1 Cl.- '^ - 0 "2-
Sheet No--1- of l.t
".
.~
STRUCTURAL CALCULATIONS
PROJECT: . SUARe.s FBlDetlcE
f+rI,tHt=IM HIU-5
CLIENT'
R 0 eM, CJ F A-tYE <,
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INLAND ENGINEERING
DATE '0/02,/,,<-
SUBJECT ~tJP.fl ""1:- REO!;,
AI'I~",^ \-lills leA
SHEET NO. ' '7-.:::.
JOB NO. DV1g-r
BY CHKD.
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GENERAL NOTES
1. lAP AU. sruL 12" m.
2. ARl'IPlCIAL J/llCI BY NO!' IIIfAIfi IlOIL.
a. ~~=:g. fOO'1'JKC ",~,l/IlIUIRBD I'OllIACll ADD1Tlmw.
4. ARl'IPlcw. IIOCI JORIIID om DIIIIlIlI OR llANJI 1WlS. IlOCIII Dr ALSO BE
1IllILOY. IIIW'I II cmmGtIIllTlOll BY TARY.
6. comw:roB IIIWJ. YIIlIFY AU. DDIBNSIOIIII AM\) CONDmOllB.
e. STIlUC'1'llIlAL PIPB SIWl. CONfOlll( TO AmU601. ASTII A63 G1W)I B TYPE
lOR S Py = 36 IS!. ION.; ,
7. llTllUI;l uJIIL TllBE SIWl. CONfOllII TO .ASTII JIiOO. GlWlI B FY = 4ftlII.
8. llrllWIUJIIL lIl'IIL IIIWJ. CONJQJlII TO JSTII ....
8. AU. BOLTS IIIWJ. CONI'ORI TO .ASTII AJrfI '''ASIIIIl U.H.O.
10. 1IWIIlG IIIWJ. COItJ'OllJI 'JO .osc 8PICS OIl LOCAL COD!S AM\) rswullllED
BY lDllFWI QUID 1JBIlfG ARC PIlOCBIlS I'1OlL 1UCTll0DBS. BBOP 1ILDS
BY .APPJlORll PA8IIICA'fOlI. COMTlN1IOUS DlSPICrION IlBCIUIRBD JOR AU.
PIIUl QUlING. "
11. PAIlIlICA'l'ION.' 1lIIC'l'I0N AM\) PAINTING or S'l'RUCTUIlAL ll'1'BIL IIIWJ.
CONI'ORI TO use SICl'. lltOli. '
12. AU. lIl'IIL LBSS i1WI lf4- TBICI SB.W. DB GALTAJQZBD OR UBI DOUBLI
COAT or PRIIIIR. '
13. sou. TYPE JSSUIIID s:Mt.SILTY ~,~m ~IItI"TY GJI(~ ,_
AM\) CL&m GllAYIL, lBLI IlJWIING . 100 LBS. . n,u.
14. COlIC. 'ro BAg 1!lIl. 1!LTlIIA'1'I 00"_'11 SI'1lIIfG'.lll or 2IiOO. l
. 28 DAYS AM\) SB.W. DB POIlIlID AGAIIlS'l' 1lMb!lrrUJIIWI sou.. 1"0 romrs.
15. AU. IlOIJII DIIILLID OR P1lNCIlID.
le. AU. '0IlIll 8BAU. COIlPORI TO 11187 1DlTI0N OP use.
17. RIIIlfORClNG ll'1'BIL SB.W. COIIPLY 1lTII .ASTII 1-e16. GRD. 80, DIPORIIID.
retXK5 Of 1a5
CLIENT
IOf I
SBBI!:T NO.
02-tB1
lOB NO.
IO/I!1/02
,10
DATIl.
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, 121 No It. CCIlIIlle IIYd. ste. 101. Aulllllll11. CA 9:BI6
Tel: (7104)9116-1190 FAll: 17141956G667
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. fiUILDING' PERMIT NO.BLD2000-112177
~~.'~
TYPE 'OF PEKMIT
New ~e!entiaICi?nstruction
. CITY.'.
.,
. ~ATE:07/3;/2001,.' .'.. .... .
JOElADQRESS: 275 S P,ERALTA HILLS DR .
LEGALDESCRIP,TION:
ApPLlc;ANT:l.ANE CURTI~
OWNER INFORMATION: CONTRACTOR INFORM: ION:
CURTIS CO LOU!".L .
777 S PERALTA HILLS DR
.' . .... .' . . ...,. .ANAHEIM.948070000 CA.
JOB DESCRIPTION: NewS.F.D. COR#14Q629' '. .'
VALUATION: '750.000.00'
I certify that Ihave read this
agree ~o \nmply ',\Iith',all 0
herebY'au.thqriz~ repre"
.. iilSpection pur'pose ..
nandstate'th~t the above information -lscor~ect., 1., ,
c I ,and State laws relatIng 'to 9uildi~g cor,$lructio,"!;.a~d'
,i city to:'~l'lter 9ponthe above mentioned ,property f~r ,"
Date: 07/31/2001, .
-" 19na ~o App nt or Agent " '., > : " .
. . The permits hall expil'e by limita.tion and bec;ome null ane! void ifthebuildiilg or
. work lias not passed final inspectIoil365 days from the d",te of Il'lrinit issuance. .A
new permit is requj~ed to commence or continue work.
Bu1q:iING DIVISION
.2OOS.A,NAHEIMBLVD.
(714)765-5163 . ,,"
INSPECTiON REQUESTLINE:..
(],14) 765,- 4626
CENSUS CODE.: 101
'QUARTERSEc.1:ION:16$
ARCHITECT/ENGINEER INFORMATION, .
. LANE CURTIS . .
4214 SPiNDRiFt WAY'
NEWPORT.BEACH, CA
',.
PROCESSED BY:. FAN :
, .L:lCJ:NsED~oNrAA~ToRib-~Ci.AflATION-' 1 ~.....
. - '~,.1 her~ yaffirm~un~er ps_ ~_, . pE>rrjury th~t I ~n:i :.;.....
'; Ilcens'ed tJndet.prp:vlsipns. -/1 t ~COr,n~~I)G.\ng
with Section 70Ob). 9f Pi Hu&iness and'
PltifesSi9l)$ ,COde.
NUMBER
"341095B
TYPE
TYPE.
Cdnstn.lcidn.Tvoes:
,.:VN;"
'Living p.,rea:'.
_<?ai-aQ~ Ate_a
~'Co~tra<?to(-
HIC
L1C
EXPiRATION DATE
07/31/2002 , .
. . . .., OWNER.BUILDER ECLARATION
.. I 'herebY,affirm under penalty 0 perjury that}.a'nt exempt,romthe"......ontr3ctOr ,~icens.eLaw for.the.: oflowiligreason(Sec,.-703J ~5 tJsinessand, ,,' " .: '
Pro'feSSions Gtxfe: 'any"City'or county which, requires a-perr1Jij-to,cons-truct,_ alt. f; :improve,; .de~lishotrepa.irany structure;prior:to'!ts)S$.uanc~, "a~s6 :',~'
" requ/reS,t~_apPlicantfor.suGh permit to file a signed statementthathei,$ Ijce sed pur::?uanpo the provisions.ofthe Cpntractot'~,LicenseLaw'{Chapter<'
"'9)(c6m\l1encingwith 5e,ction 7000.ofDivision 3 oftheBusfness9,nd.Profes~j( sCode) or that he_!s.exemptthe,refrom- a'nd the',ba!?i$',~or,the aflEiged,,'.'",
.'exelJ1ption. '.Any violation, of See.tion 7031,~ ~y alW ~pplicani for ci'.r,ermit~ub_.ts-the applic8()t toa,civi! pena!tyof not more than five hl)l1dred dol!~t.$ :':;
($500).,' _,.', ."." ", . ,,'_" ,', . _ ",,' ,__,'.: ,.' __' ,_,'_ .... ,:' " "
" 0,1, asowne'r Qfprop(;!rty,,or mY'E?mph:iy~:e$ with w'agesBS their_s6le"comJ; _,sation'"willdo':,the wprk, and,tf1e.str9dureis.'noUntelided:orOffere_~ fo(;; ';. '..'
" s,ale' {~c,. !044, Business and ProfessiQns Code: The Contractor's, l,lcen..'"\e' _ '~idQes n'ol~ppIY t<?'.ari-o_wDe,r 9fvpropert.f who';~UBds,ot impro"es:.',:," : ,"
': :tl'~rebl.1,:'aruj'who.does such work, himself or herseif crthroug.hhj~' ,o'rher 6Wf emplt?~e~S'i:R.r.9YJd~d'ihat'S-.U.9i:l tmp)~Yements-are.-:not.jrjtende~or' ;-,>,:', :,':
. 'o~ere~ fo~,sale.:)~"how:ever,. thebUi.I<:1ing ordn:l;)rovemeht' ~ sold \yith.~de _y,e<; %-~r~.~plet~on'".~~ _Ql,yrie.r~bL!jl,d~r,~.iII, ~a:~,trye,:61;J.n!en_~f:i:>roytn~:t.ha~-,he
:dld,not bullq ~r!mprov~ for the' pUrpose of sale}, ,.'_ ' ._ .... , ':_; "'. ' .
'...C) .:I~_ ,a~ the. owne.r ()Hh~ pfe;>p,ertY, .am ~Xdus,v~'Y,,'6o~mcti';9..~lth'l~ensed tiaq,ors 'te;> corw.tructih~'-p~oj~i (se~~,f644BU~'j;;~ss"'~n.J"prc.fe~Jon,$ .',
9ode:'.The Contractor's ,License Law does net apply \0 an owneco(property,; t~_~uijdso.r-.improv,es.ihereoil<a.ndwhO'cQn.tractS:fQ(sl)dl: pt()i~,cts _w:it\1' .
\'P4_01~~~~~~1r(~~__'1li::~n~~ pursua~t~o.th.e-c?nt~ac.t61-'~..Liccn~.~a~)::'" -, '. ;.. -.' "- .... . .,'-, ' ,", " ';j..",: -./,. ,-, . '.~
:~~-;!-amexemp.tl1nderSl?c. ,- '.' . ',B&P,C:forthis,reasdn:,. .~_--:- .....::........~___~.:.:.:~-~.,~__.,..
"Date: -. Owner: . .' .' :.,t' ; ,
j , WORKER'S COMPENSATION DECLARAtiON- "~" ....-.:J
- -_--:
_l:hei'eb.i'~ffi1Jn under penalty of perjufyone-.of the fOI1Owing-declarattOi)S: ';' ., _; . ::'<.
\Cl~,'l n~ve'~nd will'maint~b1'a ,certiftc~e'of co~seht~toseW-;nsurE;:far'V\:';rka.r'~ i;Om~l3~.~t.i9n',
.as pro.videdforb'y section 3790 of the labor ccxie, for. the perfor01ance'_crthV'i6iXfo'r-whidi '::
:' this permit is)ssued.-' , '. _ .
:;::'O:~Jhav~a~d will' maintain wo,rk~(~ cOn:lpensation-iflsuf'ance. ~~. (eqUired'~J -sectio'ry aloa of' 97/31/2001.
the .labor Code,for,the~performanGe of the work for which this permit is ,!SSU . ,_. My,wo'(ker's Date>.' .
COl.~pen'sation inst.iranceearrierand'pqliq,are: . .'
.C...ti.~'. STATE FUND . . . . .POliCY. Number. 1480593,)0. ,
Thi~sec"tioilneed. not' be: cOm~.letedif the pennit is for <me. hundred dollars ($1 ao,l..'lr 'l~s..
:'~:d,. i-,:~~rtifYthatinthe:pe'rl~llTriince'of.theworkJ wh;cht~is pen'nit.is.f$SlJ~~::~'~~!rlJOt'. .
employ'any person,in anY.marinerso as tobec. ttc the':~iorke(sccl':1pensation ,laws
_ot?a.lif?ry1ia,a[1d_agree,tli.at ifl,shOu~..beco' ~ew<?rk~r_'~ c~~s:atj6n'" _ .
.; provisions of Section}70I? ofthe Lat)orCo ' ~~_IZ,~it~~~;1;1'1~;'prov~s;ons~
Date: 07/31/2901. Applicant: .'.,... .. 'j,
WARN ING':FAILURE'TO SECURE V RK 'S CaMPEN SA TIONCOj.i~Fi;"GEIS' .
. uNLAWFUL. AND SHALLSLiBJECT AN EMPLOYER TO CRIMINALPENAbTlESAND G.IVIL
FINES UPTO ONE tiUNDRED THOUSAND DOLLARS ($100.0Qcl).INl\bbino!'-lTOT-HE"
.COST OF COMP"NSATION, DAMAGES'AS P'ROVIDED. FORINSECf!ONl3i06 OF THE
LABORCODE..JNTERESTAND ATTORN.EY'S FEES. .,: '. . '-1.}1':' .'. "." .
1, .. ..' ....'.:.. .... '. c;ONSTRtJ~TIONLENDING AGENCY, <;":! J .'
I,_he!eby.~t:fkm,under penalty of.perjury tt'}3nhere.is? co'nstrU9:ti9~,Jej)d)~~_~;3:9'fntY fpr. ttt~
'performance :of-thework for which .thi'& permit-is Issued {Sec:3097.,Ci.""Q):,'{._. -:; :' .
:o~,~~?er5 ln~~rr.nati~~~""",;_::_~:__~~;,,:. __ -'_:~~~"7;.,_-"_,..r~,,..~.'!.:.:::--:,:.:~Lj~C':~'~":' ,:. _-:- -: -",Wa <- .~. '-.--
10.08.1
S.12~
. .
......
. ,"~
,,: ",-
t,~:
Fees:p$lidfor Permit;'
Total:
9.939,30 .
,-J
. ",'
1',',"1
.
".-,.
-,-:-.
INSPEc'nON RECORD'
.'
. '.
!NSPECTpR .
".. .' :,'.1
...f
,.. . ,;
~I .
'I
I
. . .'INSPI;CTION; . . .., '
TemporaryPowerPole ,.:.-c
Plumbing (DrainM'aSte Pip~)T
, EIe<:lrical'Gro\Jnd'Electrodel\:Jfer" ". ....
'Setbaek'lFormslTrenchl!5 (Footings ),t /1, "f, I OLl,
.', Do not, install subfloor or pour floor slab unt, I the . . , "
. follOWing applicable items have been signed: . '.
""."Umbing(WaterPlPe.SpriDkleryalveS) , , I .'
"r&!cl'lanical(QrOllndwork) ,',. ".."". ..' ,
" r=.lectrical (Unootgroulld<;ondu~)' '. '''' .
pl'I!-slatl (Compac;tionil'itembraile.Reillf. /fa J '{I A... .'
,U/tderpinnlrig (ROar JoistlGirl:iel's) .' , ' .
.. Do not cover or,concealthe'workbe1oW .untdtne: . . .."
.following applicable items hav~beensigned: . '. .' ..,. "
, 1stFloorS.h!1ar. ..... "".,." " ..',
Fil'l!sprinkler(RQugh) '.' '. .'. '.
, '2.nd'Floor Shear " .'. . ,'. '." -/j~~1-4~' I
,'. ~ofIShealhiI1gfDiaphragmlFrame) -zg;",'7/;I~ I
: Masonty(ReinfJBond BeatnlPfe.,Grotit) ., . . ,/,y
Rough Plumbing (Top Out). .' .'......, .... .f'! ,',
Rough Mechanical,' -. . .' . . '.
. . Rough Electrical (Drv:Walll, . '.
ROllllh. Elel1tricaV . '. . .
.' Framing. (OnlyaftefPlbg.;Elec.. Mech':. arid Fire).' .' :. '.
IlIsulation (SoundlEnerllV)lj~flT<a:", .' . . '. .
'. .DolI"t tape or plaster Ilnt.i.lthefoUowing applicable -, .... . ..'
, itefnshav<;beensigned: " ,. .,.... ..... .',",:'
D~U ':'.. .......,. .17 'A.'", .\ I.~I - . .
Penetr'!llol1S (Fil'l! ~ated)Electrical ' I, JV .
, Penetrations (Fil'l! Raled) I\IIechanical: . .... '.'
... 'Penetr'!lions (Ftl'l! Rated) Plumbing .. ..'
lilterior Lath :>, " "':' '. .
!:l(terior Lath '. .' . . , ..
:..' GENERAL ITEMS'
, exterior Plaster (Brown Coat~ .' ~~6...o'
. T-8arElet.trical.' ....... . . '.
T.Bar Mechanical. .
T,Bar Strlll1tural', '.. . ' '.' .
. Sewllr'.:.' ".,'., T
< Water Erigl"eerlngBackflow
Water Service ':. '..
I DATE'
'. '.
..' '.
:'
.
.... ,1
,
,~. ~7 .j
T! I.""'"
......:.,D ~
.' :
. .
>
.'
.' ~-~',
'.,
t
flNALlNSPECTIONS
Date
.' Inspector. .
Electrical Final
PIUmtling l"illa.1 .' .
Mechanical,l"ina.1
Gas Test. .
Engineeringf~adil1gF.inai 765-l;126.'
Fire. O~pt.l"iDal-?65-4040 ......
. Wa.ter Englnl,ering 765-5268,
Sub l.istfBusir\llSsi.i~en"'l165-519 i ~
l<>ning765'S1,39 .' .' . . . '
BUildillg. Final ILast Inspection-Only."
.. .' .... " After A.bove,eomplete)-17-:o..
.' . .' .' ". ;. PARTIALlN$PECTIONS
BuildinCl fnspections~ . ',:'.' ... .',; L: ... ".
..WJt-G~:1t i/JJl4!ti,6.g;:~8-11-01
. - - -. - ,- - '. - -. - . - - -,
- . . - , , . . .. -' .
'.3-~~;-Qf/UGe~/?~~L"".~~..~.~ff-'
~~~c'.~."'#f.
, ~
'1'.c/J'.:.rt/-'A' -
. 9'--9i17/-~
l
. 9,... ?t1'-i:?,tt
?~;t;;r~/- ..
A ~;O"? ~
13" ~ '-Z"
'IZ-rJ'6~F/<~II1IN5.t!l/~.Xlo/~t~ .'.
Electricallnspections. . . .
"
","
t.
'. ~."""'-'- . '-"~".~," '."':""~'
CITY OF ANAHEIM
--,.'. """. """';'.'-~"~'<'~:-"'-:"'.,
. ..FINA;NCEDEPA.RTl\1ENT. ...'
COLLECTIONS OFFICIALRECEIPT/I>EPOSIT
OA~E:7'::"( 20Qt
~c~F~*~t~71'~...JbU.s
s' 'F 1::>; .'. 2. 7 S- 5t":>. PI8i? Ai- 7A ~t.H J).2. .
'1 : ,-
I '..
-r-RA f':r=; C. F-4> k:;' (r'J ~'" pA, "ItS
~~~rV'Li Sl~t:
:----rl;\:,A! l<;..eo~~\ ~()~
?AQ,"'...f- 'kf'C<' "F"ECE
(
;, )\ .........:
. "",':.;.,;
....~~'K"....
. i
I
. I
~ 1
-'I
'."':
,
I
&4700 .
. 7~~:~: ,
I
'2...)80/ 7. oe 1/'
4}~n- W. .
I
I
...,.......,. ..-"...
. .'. .
'F,rJSL'>; /-J
". PREPARER'SNAl\1E
.....~~~~XT.A~D/OUfAILSTOP)
-- ...-..."...'.. "'-":',":'--.
. EFFECTIVEDATE:
.-' ,.', .'.' ,.'.,
S .;\-C\
,....',-.....--'....,-" .:-.........--.'..-,.,-.,..
DOCUMENT TOTAL~
302/
E.
. TOTAL
DISTRIBUTION: WHITE-AC.COUNTING YELLOW-CUSTOMER . PINK-RECONCILE COPY .
GOLDENROD - ORIGINATIN'G DEPT. .
t-:.. --
I'.....
'-.
"....
COR71OO
1'"
,
~
'-i
I'
i:
i;
!~
I::
\."
N!140629
. .
O.~_.. '.'A1J~/k.,v1tJ .....~...~P9Jo:r
. (STATE):. - ._' ," '. -_ (
. DEPOSIT BREAKDOWN
. CHECK(S)..... ___ ....
QTy-------L-- AMOUNT:B7D'? 7(;J
CURRENCY:
100's x
= \';
)
!
50'sX'
20's X
lO'sx
=
=
. S'sx'
.)
l'sx.'--
COIN:.
CASH AMOill!T:
. TOTAL DEPOSIT: $
. ", ._-.. ".... '''.'
fin - 'l'.n
. . Co. \p. .
.:.";-?',;".;,',
2i~I/Bl 5.' Receipt: 0075S3&}
$M7.1lll1lI .
j313 8163
$93.1lll hI
3m . .
.<._..,..~ .$778.00 HI.
.8@1. srIC
$2M7.1JB "I
6794.
$4340.76 "I
216<134789 :ill.1 E
. COl.-IS Rev.7/00
(
CERTIFICATE OF COMPLIANCE
P A Y1I1ENT OF SCHOOL FACILITY FEES
ORANGE UNIFIED SCHOOL DISTRICT
1401 N. 1IA1\'DY STREET, ORANGE, CA 92867
997--6141 ext. 218
Developer! Applicant Name:
Address:
Suarez, Antonio & Pauline
275 Peralta Hills Dr.
Anaheim Phone:
Owner Name:
Address:
same
Phone:
PROJECT:
AddresslLocation:
Type of Project
same
addition
APN#:
Tentative Tract #:
No. of Dwelling Units:
o Single Family
o Multi Family/Condos/Apt.
RESIDENTIAL:
Total Square Footage:
2,810
Applicable Fee:
o Level I
o Level 3
o Level 2
'" Other
Multiplied by Applicable Fee: $2.05
Total School Facility Fees: $5,760.50
Other.
Total School Facility Fees:
COMMERCIAL:
Total Square Footage:
Multiplied by Applicable Fee: $0.33
Total School Facility Fees:
FEES WAIVED:
18I NO
DYES
REASON:
1bc above l"l'.~tations as to square footage arc lnJc and ~ DcvclopcdApplicant agrees that if it is Iatcr dctcnuined that....ch
''''''''''''''(>.6ons arcnottroe, then this Certific::tc Of=Z<h"lI~~ and the appropriatc CityfCounty sbaIl be notified.
Developer! Applicant Signature: . . '/ /
.
This ccI1ifics that the abcvc named Dcvclopedapplicant has paid schoolliicili fees in colI!Pllancc with Education Code Section 17620 ct. soq.
And Govcmmcn(Codc Section 65995 cL soq. . ~-
August 29, 2002 -/
~L- Interim Director Facilities PIannin
Date Name Title
NOTICE: The 90-day period in which you may protest the fee described herein will begin on the date this fee is paid.
However, if the fee was imposed by the City or County as a condition of approval for your project, and you have
received the requisite notice, the 90-day protest period began at the time your project was approved by the City or
:::ounty.
ELECTRICAL PERMIT NO.
ElE2001-01374
t~P;']S;10\
CITY Q~:J.~N~HEIM
~,."."
\:: -:-~~-, -. I
\\ "" '~I - I
" " I '<C.l -'(:, ~
,<,'{ "'-'~ - - ~,~\ j
":',.:.-:/7
TYPE OF PERMIT
New Residential
DATE: 07/31/2001
JOB ADDRESS: 275 S PERALTA HILLS DR
LEGAL DESCRIPTION:
APPLICANT:
OWNER INFORMATION: CONTRACTOR INFORMATION:
CURTIS co LOUIS L
777 S PERALTA HILLS DR
ANAHEI M, 928070000 CA
JOB DESCRI PTION: . New SFD #BLD2000-02177
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(1,14) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
QUARTER SECTION: 163
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: FAN
~
OWNER-BUILDER DECLARATION
ere ya Irm un er pena 0 perjury that am exempt om the ontracl()rs Ucense a# or t e allowing reason ec.7 .5 uSlness a
Professions Code: any city or county which requires a permit to construct, ~ Iter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is lk;'ensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profes!;ions Code) or that he is exempt therefrom and the basis for the alleged
exemption. MY violation of Section 7031.5 by any applicant for a permit slbjects the applicant to a dvil penalty of not more than .five hundred dollars
($500). i
0" I, as owner of property, or my employees with wages as their solecorr.'pensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License"Law does not apply to an owner of property who buildsor improves
thereon, and who does sud'l work himself or herself or through his or her OW" employees, provided that such improvements are not intended or offered
for sale. If, however, the building or improvement is sold with one year of c.')mpletion, the owner-builder will have the b'urden of proving that he did not
build or improve for the purpose of sale).' ,
D I, as the owner of the property, am exdusively contracting withlicenseft contractors to construct the project (See. 7044 Business and Professions
Code: . The Contractor's Lirense Law does not apply to an owner of propert;y who builds or improves thereon, and who contracts for sud'l projects with
FLGontractor(s) licensed pursuant to the Contractor's lirense Law). j
U I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of pe~ury one of the following declarations:
o I have and will maintain a certificate of consent to self-insure for worke<r's compensation,
as provided for by Section 3700 of the Labor Code, for the performance oftl1ework for whid'l
this perm it is issued.
o I have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is iss'Jed. Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 1486593-00
This section need not be completed Ifthe permit is for one hundred dollars ($1 (IO) or less.
o I certify that in the perfonnance of the work for which this permit is issled, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of California, and agree that if I should become subject to the worker's conmensation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: 07/31/2001 Applicant:
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for whid'l this permit is issued (Sec.30g7 .Civ.C):
Lende~s Infonnation:
I certify that I have read this application and state that the above information is correct )
" agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this dty to enter upon the above mentioned property for
inspection purposes.
Date: 07/3112001
Signature of Applicant or 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 to commence or continue work.
LICENSED CONTRACTORS DECLARATION
ere y a Irm un er pena 0 perjury at am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
Date:
~GU(tga!
341095B
TYPE:
TYPE:
Contractor
EXPIRATION DATE:
07/3112002
HIC
lIC
Garage/Carport per Sq.. Feet
1 - 2 Family Per Sq. Ft.
Subpanels: Under 600 V, up to 200 amps
Under 600 V, over 100 to 1000 amps
Meters: Under 600 V, over 200 amps to 1000 amps
Motors Up to 1 hp
Motors 1 to 10 hp
5,122
10,081
2
3
1
3
5
...ees palo Tor t'ermlt:
Total:
1,003.29
: _.~- "
INSPECTION RECORD FINAL INSPECTIONS Date Inspector
INSPECTION DATE INSPECTOR Electrical Final
Temporary Power Pole . lJ>iumbing Final
Plumbing (Draln/Waste Pipe) / / Mechanical Final
Electrical Ground Electrode/uter ""/l/N I/7A_~ /./1
SetbacklFormsfTrenches (Footings) I I // Gas Test
Do not install subfloor or pour floor slab until the I' Engineering/Grading Final 765-5126
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) Fire Dept. Final 765-4040
Mechanical (Groundwork) Water Engineering 765-5268
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf. Sub LisUBusiness License 765-519
Underpinning (Floor JoisUGinders) Zoning 765-5139
Do not cover or conceal the wor\<. below until the ~ast Inspection- Only
following applicable items have been signed: Building Final fter Above Complete)
1st Floor Shear .
PARTIAL INSPECTIONS
Firesprinkler (Rough) Buildinq Inspections
2nd Floor Shear . ,
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out) .
Rough Mechanical. \
Rough Electrical (Dry WaHl . .
Rough Electrical
Framing (Only afier Plbg . Elec.. rJe~h _ a~c F:re) . ,
Insulation (SoundlEnergy) , Mechanical Inspections
Do not tape or pla~ter until the following applicable
jtems have been signed: ~
Drywall
Penetrations (Fire Rated) Electrical ..
Penetrations (Fire Rated) Mechanical . . .
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath Plumbinqlnspections
GI;NERAL ITEMS
Exterior Plaster (Brown COal)-'
T-Bar Electrical
T-Bar Mechanical .
T.Bar Structural .
Sewer
Water Engineering. Backflow . . Electrical Inspections
Water Service .. '/. ~ if, . .
" 1. 1;
-
,,f,r/b/ U!G@,sL4f30l:rD&,Jurz)l (,)/ 'f.+ ~,A)I(. "".w,
PERMIT E)(PRIED
INSPECTION
NOT COMPLETED
.
DATE: 10 3( 0:2-
, '--
,. ., __". l
.
.,
A~;r; ~~
f\~,"'.J~<,;:i ~...(;"
..../1.""" c ~.~'\
f,;if/t'\J \"""0,
.l,. ~ '( \1 \
CIn1s~me';;;J~NAHEIM
\ . k" '.' --'-'-~'i'! J
' \1;;'\~{i!lf..\'~~-~.~";.'fi.'.>; .'
"' '\\'S"!.;".~'.\'.'.(.'?p"''f !
~k'.~,P';~'lt"':~i L-
:--P(jf___dJ.~,,~;/~);7
;;:":.-.~,1_1?: ,U'/ ~
tjUILUINl:i UIVI:::iIUN
200 S. ANAHEIM BLVD.
(714) 765 - 5153
SWIMMING POOL PERMIT NO. SW12001-00049
.
TYPE OF PERMIT
New Pool and / or Spa
...
DATE: 4/1 0/01
JOB ADDRESS:
INSPECTION REQUEST UNE:
(714) 765 - 4626
QUARTER SECTION: 163
275 S PERALTA HILLS DR
...
LEGAL DESCRIPTION:
APPLlCANT:JOHN RIDDLE
OWNER INFORMATION: CONTRACTOR INFORIIATION:
GARY & ELA CALKINS
6263 E TRAIL DR
ANAHEI M, CA 92807
JOB DESCRIPTION: New Gunite Pool and Spa.
ARCHITECT/ENGINEER INFORMATION:
VALUATIOII(:20,000.00 . PROCESSED BY: MJF
I . . , . OWNER-BUIL?f."li'ECLARATION
I he[~y affirm under penalty of perjury that I am exempt from the Cpntrador-3 License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is'icensed pursuant to the provisions of the Contractor's License Law
(Chapter 9)(commencing with Section 7000 of Division 3 ofthe Business;lnd Professions Code) or that he is exempt therefrom and the basis for the
alleged exemption. Any violation of Section 7031.5 by any applicant for < permit subjects the applicant to a civil penalty of not more than five
hundred dollars ($500). '
n I, as owner of property, or my employees with wages as their Sc,le cO:'npsnsation, will do the work, and the structure is not intended or offered
ffir' sale (Sec. 7044 Business and Professions Code: The Contractor's lk:anse law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his qr he'r-'wn employees, provided that such improvements are not intended or
offered for sale. :If, however, the building or improvement is sold withoneT'YE?at of completion, the owner-builder will have the burden of proving that
he did not build or improve for the purpose of sale).
n I, as the owner of the property, am exclusively contracting with licens:KJcontractors to construct the project (Sec. 7044 Business and
Professions Code: The Contractor's license Law does not apply to an O1^,ner of property who builds or improves thereon, and who contracts for
such projects with a contractor(s) licensed pursuant to the Contractor's li(-ense Law).
o ,I a, exempt u'}der Sec. B & P. ~ __,...._
DatE'!:"'" I Owner:
WORKER'S C MPENS DE TlON
I hereby affirm ~nder penalty of perjury one of the 0 owing declarations: .....
o I have and will maintain a certificate of consent to self-insure forwork'~r's coniPensation,
as provided forby Section 3700 of the labor Code, for the performance O' the work for which
this permit is issued.
n I have andwill maintain worker's compensation insurance, as require.; by Section 3700
orthe Labor Code. for the performance of the work for which this permit is issued. My Date: 4/10/01
worker's Compensation insurance carrier and policy are:
Carrier: Policy Number:
LICENSED CONTRACTORS DECLARATION
I hereby a irm under penalty 0 perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
Contractor
NUMBER:
EXPIRATION DATE:
This section need not be completed If t he permit Is for one .hundred dol,lars ($1, )0) or less.
o I certify that in the performance of the work for which thisper,mit is is~ued, I shall not
employ any person in any manner so as to become subject to the worker'.t. compensation
laws of California, and agree that if I should become subject to the worker:s compensation
prOvisions of Section 3700 of the labor Code, I shall forthwith comply wit~ those provisions.
TYPE:
Date: 4/10/01 Applicant:
WARNING: FAILURE TO SECURE \M:JRKER'S COMPENSATlON;COVERAGE IS
UNLAWFUL. AND SHALL SUBJECT AN EMPLOYER TO CRI MINAL PENALTIES AND
CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($1 OQ,OQO).IN ADDITION TO
THE COST OF COMPENSATioN, DAMAGES AS PROVIDED FOR IN S8~TION 3706 OF
THE LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction tending agency for the
performance of the work for which th is permit is issued (Sec.3097~~lv. C):_.
--'-l..etider~rjiit6rmatloli:-- --.-----"--.----- ,-- - --~-------~.-~-.~""_. . -.
Swimming Pool Size
Valuation
Census Code
570.00
l
20,000.00
329
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state 1a'NS relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspe n purposes.
r-ees palo Tor t"ermn:
Total:
615.61
f,-'
Date: 4/10101
" ieant or Agent
Thl permit shall expire II Ion and become null and void if the building or
rk has not passed finallnspectoin 365 days from the date of permit Issunace. A
new oennit is r9rJulred tn e:nmmAnt"A nr r..nntlnllA \Alnrk
,
I
.,
'-' 1 ..........^.............~,-, '.
..
.,
-
.. INSPECTION RECORD . \ FINAL INSPECTIONS Date ",--
. Inspector
. . INSPECTION DATE INSPECTOR I Electrical Final
\
Temporary Power Pole Plumbing Final
Plumbing (DrainIWaste Pipe) Mechanical Final
Electrical Ground Electrode/Ufer
.
SelbacklFormslTrenches (Footings) Gas Test
";.;,,.
Do not install subfloor or pour floor slab until the Engineering/Grading Final 765.0126 .'
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) " Fire Dept. Final 765-4040
Mechanical (Groundwork) . Water Engineering 765-5268
Electrical (Underground Conduit) .
Pre-slab (CompactionlMembrane.Reinf. Sub List/Business License 765-519
Underpinning (Floor Joist/Girders) I. Zoning 765-5139
Do not cover or conceal the work below until the ~ Building Final !l:ast Inspection- Only
fallowing applicable items have been signed: : . fter Above Complete)
1 st Floor Shear .... PARTIAL INSPECTIONS
Firesprinkler (Rough) Buildina Insoections
2nd Floor Shear ,
Roof (Sheathing/Diaphragm/Frame) .
.
Masonry (ReinfJBond Beam/Pre-Grout) ,
Rough Plumbing (Top Out) .
Rough Mechanical :
Rough Bectrical lOry Walll - -.- " ,
Rough Electrical
Framing (On~ after Plbg., Elec., Mach., and Fire)
Insulation (SoundlEnergy) Mechanicallnsoections
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
Interior Lath
Exterior Lath Plumbina Insoections
GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow Electricallnsoections
Water Service
~w..'
PERMIT EXPRIED
INSPECTION
NOT COMPLETED
DATE:
t.-z... {t\ I 0"""2.