2321 E. Puritan Ln.
"
"
I
IDING PERMIT NO" BLD2004-00671
'''~.~<t._
TYPE OF PERMIT
Patio Cover
CITY
ElM
BUILDING DIVISION
200 S, ANAHEIM B.LVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 113
DATE: 3/11/2004
JOB ADDRESS: 2321 E PURITAN LN
LEGAL DESCRIPTION: N TR 1987 LOT 11
.APPLlCANT:
OWNER INFORMATION:
Connell M Me
2321 E plIritan Ln
Anaheim, CA 92806
,--\~
JOB DESCRIPTION:Build 320 sf lattice3200 patio per approved plans, . .,
VALUATION: . 3,200.00
I . OWNER-BUILDER DECLARATION
I hereby,affirm under penalty of perjury that I am exempt from the Contractor'.3 License Law for the, fol!owing reason (Sec. 7031.5 Business and
Professions Cod e: a ny city or county which req uires a perm it to construct, a lt~':r,- imorove; d emoli,sh or repa ir any structure, prior to' its issuance, also
requires the 'ap IicanUbr such permit to file a signed statement that h~Js lice.,"sed pursuantto the provisions of the Contractor~s Lice~se Law (Chapter
9)(commenc' 9 with Sectio.n 7000 of Division 30f the Business and Prof~sif'n~,Coderor that he is exempt therefrom and the basisfqr the aUe,ged .
ex~mptio Any violation of Section 7031.5 by any applicanUor a permjis:ubjer;t~ the applicant to a dvil penalty of not more than,fivehu!1dred dollars
UW. .'. .
, .as owne'r of property: or my employees with wages' as their sole comp.';i~at;on, will do the work, and the structure, is not intended or offered for .
sale (Sec~ 7044 Businessand Professions C.ode: 'The Contractor's,License,:t:-aw l:Ioes not apply to an owner of property whc. builds or improves'
thereon, and who does such work himselforherself or through.his or.'he~ 0...::: employees, provided that such improvements'are not intended or
oftered for sale. If;_ however, the building or improvement is sold with ohe y;i1r of. completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale). ' , ',:", . " .
o I, ,as the owner of th,e property, am exdusively contracting with lice/lsed ,~ntr9ct.o!'s to construct the project (Sec. 7044 Busin~s and Professions
Code: The Contractor's Li~nse Law does not apply to an owner of propeltv1'I.Yho'bunds or improves thereon,. and who rontractsJor such projects with.
. ontract:or(s)'1igensed' pursuant to the Gontractor's License Law).' -, '.. . ' .
~ m'"exel1.1pt under Sec.. ,B P.C. fo is rea n: .'
t,:l.at .3 - 11- 0 <;' Owner: .'
. . WORKER'S COMP SATION DECLARATiON
I :'lereby affirm under penalty of perjury one of the following declarations: ,~
o I have and will maintain a cer:tifrcate of consent to self-insure for worker'.:. compensation,
as provided for by' Sedion 3700 of the Labor Code, for the performance of t'1;'~ \'./ork for which
this permit is issued. . ~ .
o _I have,andwill maintain worker's compensation insurance, as required b: Section 3700 of
the Labor Code, for the performance of the work for wh ich this. permit is iS$l!~. My wo rker's
Compen~tion in,suralice carrier and poliO{ are:
Carrier: PoliO{ Number.
CONTRACTOR INFORMATION:.
ARCHITECT/ENGINEER INI'ORMATION:
PROCESSED BY: PMK
. LICENSED CONTRACTORS DECLARATION
. I hereby affirm under penalty of perjury that I am
licensed under provisiohs of chapter 9 (commencing
with Section7000) of Divsion 3'ofthe Business and'
Professions Code.' .
3/~ 1/2004
Date:
Contractor
NUMBER
EXPIRATION DATE
Tliis section need not be completed if the pannit is for one hundred dollars {$100i cr ICSSj.
D I certify .that in the perfonnance of the work for whiclithis permit is-I~s:~~:i,_~l:-Shall not
employ any person in any manner so as to become subject to theworker's~p::mpensation laws
of Califomia.. and agree' that-if 1 should become subject to the worker's coiT~p':O'sation
provisions of Section 3700 of the Labor Code, I shall fo with comPIy'WitR'hlos~provisioris.
Date: 3/1112004 APPlicant:;J"./,,1:JOIlo
WARN ING: FAILURE TO SECURE WORKER'S COMPENSATION COVER~GE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENALTii;s AND CIVIL
FINES UPTO ONE HUNDRED TI-tOUSAND DOLLARS ($100,OO~).'IN..:odTibN TO TI'tE
COST 9F COMPENSATION, DAMAGES AS PROVIDED FOR INSEC'r(9N'37.06 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ""Xd;' !;c.., . '., .
I' .. . CONSTRUCTION LENDING AGENCY, ''':.J' ..
I hereby affirm ,under penalty of perjury that there is a construction lei1:~.Iij,~_:;f:J:;O:~cy fo~.::ihe-
perfo~!J1ance ()f_t~e ~ork for which this p~rmit !s issued <S~c. 30;97.Civ,qt~ J:J {:. '
--Jp.ndlf!~s.Jilf('l,rm.,.t'n':l, ,.. _ ,,__~_~.--,_> "-'_'
TYPE
Construcion Tvpes:
VN, "
Fire Sprinklered?
NO
J certify that J have read this application' and state that,the above inforrT'!8'tion is correct' I'
agre~. tooomply with - II city ordinanpes abd state raws relating to bu~ding construCtion, and .
hereby uthor" present~' of this city to enter upon the above mentioned property for
Insp IOn poses.
, , Date: 3/11/2004
Signature of Applicant or Age~t
The permit shall expire by Iimitati!)n and become null and void if th& building 0';
work has not passed final inspectloil 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
Fees paid for Permit: ..
Total:
0,00
,/
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power. Pole . .
Plumbi ng (DrainlWaste Pipe) . .
. Electrical Ground Electrode/uter .. .
SetbacklFormslTrenches (Footings) . I./g.& f7l). , {In.
Oonol.iristall sul:ifloor or pourfloor slab until the. Iff
followiflg applicable Items have been signed:
Plumbing (Water Pipe.Sprinkler Valves) . . . . "
Mechanical (Groundwork) .
Electrical (Underground 'conduit)
Pre-slab (CompactionlMembrane.Reir1f. .
Underpinning (Floor JoistlGirders)' .'
00 not cover or conceal the wdrk bel.OW until the ,
following applicable ilems have been signed: "
1st Floor Shear . . '.'
Firesprinkler (Rough) . .' .
2nd Floor Shear . .'
Roof (Sheathingllliaphragm'Frame)
Masonry (ReinfJBond BeamlPre-Grout) . .
Rough Plumbing (TC!POut) . . .
Rough Mechanical
Rough Seetrical (Dry Wall) . . . .. .
Rough Electrical , . '.
Framing- :-, (Only after Plbg.. Elec., f,/iech.. and Fire)
Insolation (SoundlEqergy)"
Do riot tape or plaster _until the following applicable
items have been signed: . .' '.
Drywall ' .' .
Penetrat.ions (Fire Rated) Eleetriajl .
Penetrations (Fire Rated) Mechanical. . .
Penetrations (Fire Rated) Plumbing
Irlterior Lath . . .
Exterior Lath
I ' GENERAL ITEMS . .
Exle.rior Plaster (BlOWn Coat) , . .
T .Bar Electrical .
T -Bar Mec.hanical . .
T'Bar Structural
. 'Sewer . . . . .
Water Engineering Backflow ' . . ' .
Water Service . . . . .'
.FINAL INSPECTIONS Date Inspector
Electrical Final' , . . . . .
.
Plumbing Finai ..... '..
Mechanical Final
Gas Test , . ....
. . .
Eng,neeringlGr3ding Final 765,,5126 . .
Fire Dep!. Final 765-4040 . . .
Water Engineering 765-5268 . . .'
Sub ListlBusiness License 765;519 . '. "
ZClhing 765-5139 . .
Building Final \tast Inspection- Only ?/z5,h~ r;; Ill.
fter Above Complete)
PARTIAL INSPECTIONS !,
. . .
BUlldma Inspections
. ,
Methanicallnspections
Ph.iinbina Inspections
ElectricallrisDections
~,_...
.....-'Y
RMIT DOES
OF THIS PE F ANY OF
THIt ISSUAt,J; VIOL.ATIOtF OTHE Cl~~
~~~ ~~~DINEGRcg~E~Hl~~E~r~K.
THE HOL..e; AT HIS 0
PROOEED
MAR 1 1 2004
OF ANAH~IM
BUllDING,DIVISION t ~
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