3151,3155 W. Lincoln Ave.
~UiLDING PERMIT NO. BLD2004 03944 "
- CITY G~;:Ji'HEIM
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CONTRACTO'R INFORtvVt'ION: ARCHITECT/ENGINEER INFORMATION:
BROOKFIELD SOUTHLAI~DHUILDERS IN03EORGE RICHARDS '
3090 BRISTOL ST #200 - '\,':" 555 ANTON BLVD. SUITE 850
COSTA MESA, CA 92626 C(ibc." COSTA MESA, CA
BUSINESS PHONE: 7144f''!.68?8
. JOB DESCRIPTION New Triplex .Bldg,Type II - BLDG 7 " . (",
VALUATION: 329,800.00 " ,', :1.."" PROCESSED BY: FAN
I. . OWNER-~UILDER1~ECLArMTION '-
I hereby affirm underpenaltyof perjury that I-am exempt from the Cb!ltractCrifst:!cense Law for the following reason (Sec. '1'031.5 Business and_.'
'. Professions Code: any city-or yountywhich~_~equi~sa permit to:cons'iruct,'.ii'l~:fK;:i~pr,c>-...e:d€mClish orrepalr any structure, prior to its issuance, al~p
'requiresJh~ appliCant f~r suc*l permit to fUe a signe9.statemenft~'a~hi3 :~{':t!.~e\l.:~f-:d _pur.~unnt.:to the.p~\fiSi,lt'nS of the Ccntra~or's ~icer:se law {C~ap_~c:r
. 9)(co.mmencing .~ith Sectipn 7.oPO o.f Division 3 of the. Business:and Rrof~':S.~~h:~'~b~ef6r that h~is~?<~'mpt therefrom andtt"16 basis. for the alleg~c::!,::/'"
7;;;:J~,i:?n'.:AnY.Violat!On af Sec~iO~_70~,1.5 b~ any ap_piicant,far.8 p~~.mit:i_:~j~yt~_:~he.a.p.Puc~nt ta,_a.a~il penalty ornot mor.e tha.n,five h;~,~':~~_~L91.I~r~,<
[1 .1: a# owner ofprpperty,_~ ar ,my emplo.yees witt"> '."~'eges ~s tl'}eir SQ!_~ CO~I;_fqYi;l~~t(o.q/Wii~ d<:>the wo.rk, and the stn.!9tl!,re_ is nct intended c~ offered f~C ,:;
sale_ (Sec. 7044Buslness and P,rafessionsCade: _Trle Contractar's Lic~.ns';:f~~iv:~d.6t3s:not applyto.an-pwr,er-of property who buildsor)rnp.n:iVes ' ,.'"''
,!hereon, ,a~g_whp_daessuch warkhimself.9rt1erseltort~~ough his (It ~er.o'<1';itemploii;!t;)$. p;"avided thatsl!ch irnprove!'D.e:i)~sa.re_nofh't.ended or -c.:,_"".': '
Of',.F.red,~p~.sa!e: "It: howeve,r. th~ b~ilding OrimP,rO"Ve,men! :s sold 'N.itn t.m,?.~Yi,::lr"O",f-.'-C6,mpi:",....tjon. the Ol!", ~~r-bl!ilder:,VI!II'tiave- the' burden af provir.g t,~a,"! be, _:,--..
didribt'bt!i!d or improve for the purpose of sale).' .. .'. "... .;~ ..... ...... . ' . ..,'
[J..: I~_,OS t~~ owperafthe property.; am' exdusivcly (.ontm'~ing with !ic'.:mse';;h-r;r:itr<:id9~s.toccnstrucUhe project ($ec., 7044 Busir1ess anq. Profeti.~lon~ ,
C0ij~:,~r.he Cqntrflctor's.Ucense Law does n,or.apply to' an awner ot propf,"rt0}iiJSl !:)lIllds or~improves ~herM;I: aop whq_!Xlntracts for such projectS Wit!l
~_t;oniractoi"(s) liGerised _pursuant to the'Cantra-Ctof's Lirense Law). -,..,- .it .::-- ." "',.'. -,~.'
LJ ~ '::1111 exemptunderSec.': ~__...> .8 &'P.C. farthis reason: __.J~~______ --~
Date:.~>" ~ O.....Jner: ;. , ,
. L-.: , WORKER'S COMPENSATION DEClARAT!CJN 4t-:-f. "l
! :iereby: affirrnunder penalty' of perjury ,one uf the f.olicwing'declarations:' - 1; .
LJ. I t;ave and ~iILrrIa'inta'in:a certificate of consent to self-insure f(Jr worker:kcSlmp€'nS~tion, ~
as provided for by Section 3700 of the La~Qr Code, for the performance ottt-:it: warf.' f()rv..h~d1
~Y'0rmitisissued. .', " "-.' ;:,. ,
M' .I. have and will, maintain worker's compen:mtton insurance; as requiied ~:L~ Section 3700 of
the Labor Code, for.the.p~rformance of the work for which this permit.i$ i~')':...!.. Mywarker's
.Compp.n:sation insu'ranceca'rrierand Policy are: "
. Carrier: OLD REPUBLIC INS. CO. ,Po[j<:..Y Numbe-r; M\^/CiJ'~;J1400
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This section need not be completed if the pelTT1it is fof*one hilndred.dollars {~1031!?~;jsS'S.
, 0 ,I certify that in th~ performan<::e of.the work for which this penn'lt l~ .ls;.~~~tl:-Shall nat
employ any person in any' manner sa as to become subject tot,he v.i6r.Ke?~'1:;{;m.DCr1sati0J1 Jaws
. of Califo~:a, and agree that if I should. become subject to. ~he VlO~'<:~f:~' 6q1~r;?~~~~'tion'~.
prOvisi?nS of Section3700 of the Labor Code, I shall fo;thwith co.n:PtV\':ft~'I;~~~;i~-:~prCViSlpns.
Date: 11110/2004 Applicant: ~ .... " _..if F"
WARNING: FAILURE TO SEC.UREWORKER' OMPENSATIO~~;G~&E IS
UNLAWFUL, AND SHALL SUBJECT AN EMPL ER TO CRIMiNALPEN,t.."/!'iES:'AND CIViL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,600}:,li~.},.Dr,fn()N- TO THE
COST OF COMPENSAT.ION, DAMAGES 'AS PROVIDED FOR IN ::'E,jric", 070eOF THE
LABOR CODE, INTEREST AND 'ATTORNEY'S FEES. " i '
r- CONSTRUCTION LENDING AGENC'{ -=,
! ~~:=~e:":~ .1ff'rm :.!n..;p~ p'7na~'~__p:~r~lJrvfu.at t~re_~~~ ~on-:::!;:'J~tioI11eQ.c!J~q \!._:J.riCY for th~ .
performance of the work for which thJspenl1lt IS Issued (Sec.3097.Civ C). -: - --', -- . -~ ----~- .~__~C_.-=. ~.---- . ~ ~. -- -'__.
Leode('s Information:
TYPE OF PERMIT
Tract Housing
DATE: 1111012004
JOB ADDRESS: 31513155 W LINCOLN AVE
LEGAL DESCRIPTION:
, APPLICANT: CHERYL .STUMP
OWNER INFORMATION:
Robert C Timms
, .PO Box 727
Cypress, CA 90630
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I certify tha't I have read this applicatibnand state that the'above infarmation is correqt. I
agree to. romply ~ith' all city.ardinances and state t~ws relating to. building cO;'lstruction. and
heteby authariz,e representives bf t~is, city to ent~r u~n the abave mentianed property for
Inspe ion purposes.
Date: 11/10/2004
ignature 0 Applica or Agent
all expire by limitation and become null and void if thn building or
work has n passed final Inspection 365 days from the date of permit Issuance. A
new permit is required to commence .or continue work.
.BUILDINGDIVISION
200 S.ANAHEIM BLVD.
(714) 765 - 5'153
INSPECTION REQUEST LINE:
(714) 765' 4626' .
CENSUS CODE: 104
QUARTER SECTION: 8
LICENSED CONTRACTORS DECLARATION J
I hereby aff,lrrn' under penalty of perjurythatl?\01
licensed u nder provisions-afchapter_ 9 (commencing
with Section 7000) of Divsion 3 of the Busir~ess and
~~:6;;~~:S C~I j ^'I- . ~_
Date:.. . . ", - (), Ca~tractor ','
NUMBER EXPIRATION DATE
823768 9/3012005
TYPE B .
Construcion TYP'6S:
VN, .'
Occupancy Groups:
R3, U1, , ,
Fire Sprinklered?
Livin'Q Area:
Garage' Area
Balco'~v / Deck Area:
NO
4,347
1,352
23
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Fee~ paid for Permit:
Total:
11.243.34
INSPECTION RECORD
FINAL INSPECTIONS
Date
s' ector
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Water Engineering 765-5268 . II. i.,.,'~ j)a-->~
Sub L.ist/Business Licens.e 765-519 t. "l b:ts: >5~ ,~
Zoning 765-5139. l'-fH Ie fc])$/c.:T'L
Building Fin~1 fLast Inspection- OnlY. c../~.I,,~ ':" ~
. After Above Complete) .,">(...;....0:= -' .
PARTIAL INSPECTIONS _"'~ ..
Buildina Inspections . ~ ['""1.
.--- '.
Plumbing Final .
Mechanical Final .
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INSPECTION
, DATE
INSPECTOR
Electrical Final
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Temporary Power Pole , .
Plumbing (OrainNVaste Pipe) IZ-c -O't Ad U
Electrical GroundElectrocle/Ufer. . /2. 1,,/4-
. SelbacklFormsrrrenches'(Footings) P-I,,,,.4_
Do not install subfloor or pour floor slab until the .'
. following applicable items'havebeen.signed:'. , 1
Plumbing (Water Pipe.Sprinkler Valves) ;
MechaniCal (Groundwork) .
Electr.icaJ (Underground Condu it)
Pre-slab (CompactionlMembrane.Reinf, 'tl/Jb14
Underpinlling (Floor Joist/Girders) ,,.
Do not cover or conceal the work below until the
following applicabie items have been signed:
. 1stFloorShear ...._X~~-~
Firesprinkler (Rough)
2nd Floor Shear . . J ':/, .
Roof(Sheathing/DiaphragrnlFrame) .~/""" '.:;I' )/11
Masonry (ReinfJBond BeamlPre-<3rout) , .. ( ". ".
Rough PIU. mbing .(Top Out). . . ~ ~." VY6' '-"
Rough Mechanical .' ~ ~~ l.&J--
Rough 6ectrICaI (DryWall) . . .' ~ tr .... . .
Rough Electrical .', . .,..~. . . '. "
Framing (Only after PIb9... Elec.. Mech.. and Fire) ''''l'''~ J.... .... .' .
Insulation (SoundlEnergy) . . . '. i<:l-'l,4'Zis .'. .
Do not tape or plaster untilthe'foilowing applicable ..' .' Mechamcallnspectlons
items have been. signed: '... _.' '. . .'
Drywall . '. ". NIIIIIIY'
. Penetrations (Fire Rated) Electrical
Penetrations' (Fire Rated) Mechanical
Penetrations (Fire Rated). Plumbing . .-
Interior Lath . ~ ...r
Exterior Lath - . /. . ,<< ./ II'" __
. GENERAL ITEM . ., ~
Exterior Plaster (Brown Coat) '1t611Af f-/;"I
T .Bar Electrical . t 1/
T.Bar Mechanical . ..' .
T .Bar Structural.' .
Sewer, . . '-J'it-t:Jt;' 14..4, -
Water Engineering Backflow
Water Service'
~
Gas Test
Engineerln9tGrading Final 76505126
Fire .0ept.Fillal 765-4040
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Certificate of Insulation.
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Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety stmdards and tomorrow's energy requirements.
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Fiberglass is inorganic and therefore permanently noncombustible, so it does nc>t have to be treated
with fIre-retardant chemicals that will likely lose their effectiveness over Inne. [t has not been treated.
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisrure nor will it
settle over time as may other insula1ion materials..
This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed In Ihis home
to provide the following thenna1 performance:
Job Name, Cantada Lane Tract: 16683 Pbase: 1
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Lot #: _____~___
Plan: }P.~ Bldg. #: .__'
Addreso: ~~~L~Y..:1-in~!!!!!.____________--_---_-__-_-__-
Attic Area: !5-~.l?_ Bl_~~~_________-_----_-__ Ioterior Walls:
Knee Walls:
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Between Floors:
Exterior Walls: R-J3 Unraced Batts
Cantilevered: R-D Unfuced Batts
Garage Ceiling: R-O Unraced Baits
Party Walls: 3 1/2 Sonnds Batts
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Title 24 Canlking Ineluded (Ederior Doors, Windows and sill plates)
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Conchita Ortiz, SecreJary/Treasurer --or-- R. Scott Jenkins, President-or--
LOll Merola, Director of Operations Officer
. OJ Ins~llatiofl Co., Inc.
17112 (626) 812,(;070 U".sd146S709
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R- means resistance to heat flow_The nigher the R- value, the greater the insulating power.
Ask your builder for the fact sheet on R. values. Kee.p this certificate with your other
valued papers. If you ever sell this home, this certificate should be passed on to the. buyer.
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Certificate of Insulation
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Your Home has been insulated with Certllin Teed Fibergl:lss Insulation products, which are desiglled
for today's safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be trea\ed
with fire-retardant chemicals l:liat wiJllikely lose their effectiveness over tlme. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisrure nor-will it
..\tie over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally inslaHed in this home
to provide the following thermal performance:
Job Name: Cantada Lane
Tract:
16683
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Lot#:.___..!Q..____
Plan:_1A._ Btdg.#:_____
Address: 31~_W. Li~!:Q!!!..___________________d.._______..
Attic Are.: 1!:::!.'!.!lJ?wn d.
Interior W alh: Knee Walh:
Between Floo.s:
Exterior Walls: R-13 Unfaced Batts
Cantilevered: R-lJ Unfaced Batts
Garage Ceiling: R-B Unfaced Batts
Party Wath: 3 112 Sounds Batts
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Title 24 Caulking Included (Exterior Doors, Windows and sill plates)
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Conchita Ortiz, Secret ffreasurer --or-- R. Scott Jenkins, President-or-.
Lou Merola, Director of Operations Officer
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170: (626) 8 2-6070 L1ce_" 04657D?
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R- means resistance to heat flow. The higher the R- value, the greater the insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate will) your other
valued papers. If you ever sell this borne, this certificate .bould be passed on to the buyer..
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Certificate of Insulation
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Your Home bas been insulated with Certain Teed Fiberglass Insulation products, which are desigtted
for todays safety standards and tomorrow's energy requirements.
fiberglass is inorganic and therefore pennanently noncombustible, so it does not have to be treated
with fIre-retardant chemicals thaI will likely Jose their effectiveness o\'er time. It has not been treated
with chemicals that can corrode wiring or metaL fiherglass will not absorb moisture nor wiD i!
settle over time as may other insulation materials.
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This also certifies that CertainTeed Fiber Glass Insulation has been professionally installed in Ihis home
to provide the following thermal perfonnance:
Job Name: Canblda Lane
Tract:
16683
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Lot #: ____~!.___
Plan: ..2-JL Bldg. #: __.__.
Address: 3155 .~~,-Lincol,!_____________________,_______.
Attic Area: ~:!2..I?.l'?!l~____---_.____-_---______lnterior Walls:
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Knee WaUs:
Between Fll}l)rs:
Exterior Walls: R-13 Unfaced Batts
Cantilevered: R-13 Unfaced Batts
Garage Ceiliug: R-n Unfaced Batts
Party Walls: 3 1.12 Sounds Batts
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Title 24 Caulking Included (Exterior Doors, Windows and sill plaWS)
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t702 (626) 8 6 70 License #4657119
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Conchita Ortiz, SecretarylTreasurer -or- R. Scott le/lkins, Presidenp.~or--
Lou Merola, Director of Operations Officer
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R- means resistance to heat flow. The higher the R- value, the greater the insulating power.
Ask your builder for the fact sheet on R- values. Keep this certificate with ,"our other
valued papers. [f you eversell this home, this certificate should be passed: on to 'the buyer,