3157-3161 W. Lincoln Ave.
TYPE OF PERMIT
Light! Flag Pole CITY
DATE: 6/8/2005
JOB ADDRESS: 3157 3161 W LINCOLN AVE
LEGAL DESCRIPTION:
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REOUESTLINE:
(714) 765 - 4626
CENSUS CODE: 570
QUARTER SECTION: 8
BUILDING PERMIT NO. BLD2005-01734
CONTRACTOR INFORMATION:
BROOKFIELD HOMES SOUTHLAND INC
3090 BRISTOL ST #200
COSTA MESA, CA 926260000
BUSINESS PHONE: 714427-6868
JOB DESCRIPTION: Install (1) private lighting pole per city standard- Public Works design # 742.
VALUATION: 2,500.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, atter, 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 licenSed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and 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 a permit sUbjedts,the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La\v-does not apply to an owner of property who buildsor improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving thafhe-
did not build or improve for the purpose of sale). ,
D I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. , B & P .C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
this R rmit is issued.
h ve and will maintain worker's compensation insurance, as required by Section 3700 of
or Code, for the performance of the work for which this permit is issued. Myworker's
Co pensation insurance carrier and policy are:
Carrier: OLD REPUBLIC INSURANCE COMPAN'iPolicy Number. MWC11101400
APPLICANT: CHERYL STUMP
OWNER INFORMATION:
Anaheim Redevelopment Agency
201 S Anaheim Blvd
Anaheim, CA 92805
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
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LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Oivsion 3 of the Business and
profeSSion~COde I (' A_r-.
6/6/2005 /'- ~
Date: ontractor
NUMBER EXPIRATION DATE
736657 6/30/2005
TYPE B
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o I certify that in the perfonnance of the work for which this permit is issued, 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 compensation
provisions of Section 3700 of the Labor Code, I shail forthwith comply with those provisions.
Date: 6/8/2005 Applicant:
WARNING: FAILURE TO SECUREWO R' COMP SATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITiON 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 which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
Construcion Tvpes:
V N, ,
Fire Sprinklered?
NO
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 laws relating to building construction, and
hereby authorize representives of this city to eQter upon the above mentioned property for
inspecti urpo
Date: 6/8/2005
Fees paid for Permit:
Total:
114.59
Signature f Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed fi nal inspection 365 days from the date of permit issuance. A
new Dermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches (Foolings)
Do not install subtloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Reinf.)
Underpinning (Floor Joist/Girders)
Do nof cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/DiaphragmlFrame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., EIe., Mec. And Fire)
Insulation (Sound/Energy)
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
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical
T -Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backtlow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only
After Above Complete)
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PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections
TYPE OF PERMIT C TV
Tract Housing' . I ."
DATE: 11/10/2004
JOB ADDRESS: 31573161 W LINCOLN AVE
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:'
(714) 765 - 4626
CENSUS CODE: 104
QUARTER SECTION: 8
BUILDING PERMIT NO; BLD2004-03945
LEGAL DESCRIPTION:
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CONTRACTOR INFORrJl~TION: .' ARCHITECT/ENGINEER INFORMATION:
BRO OKFIELD SOU.TH. L...~...;N.'D B.UILDERS IN03EORGE RI.CHARDS .' . .
3090 BRISTOL ST #200,,'. .."" 555 ANTON BLVD, SUITE 850 .
COSTA MESA, CA 926:?Q-r.OO COSTA MESA, CA . . .
BUSiNESS PHONE: 714'427-6868 . . . . .
JOB DESCRIPTIONNew Triplex -Bld9 Type II - BLDG 8 . ') ,
VALUATION: 329',800.00 .,...1. PROCESSED BY: FAN
1 . .' '.' '. . '. OWNER-BUIL~DECLARATION .... ." . . .
I h~reby affirr:n under penalty of perjury that I al11 exempt from the _C.ontradC,,::>'; License Law_ for the fQIJowing reason (Seo. 7031.5 Business and
Professions Code: _any city or county which requires 3__ permit toconstruct_~;a_j;:;f;)rnprOVe, demalishorrepairanystructure.prior to its issuance, 'als9' .
requ,ire~ the applicant forsuch-,permit to-file a signed stateme.nt that he isJid\ll.1sed pursua'ilt to the PIO,visions of the' Contractor's License Law (Chapt~r
. 9)(coinT1)encing with Section 70:PO of Divi'sion 3 onb~' Businessand'~robS~~;jS Code)orthat he is ,ex~rrpt therefrom andJhe basisfor'the alleged
~;;(;b}~iC~. _~~ ~,iolation of $e~tion 7031,5 by any applicant fo'r a.perTit.",l!!Jicts ~he aP:lica~t to a d~n 'per"lalty o~ not ~~re_t~an five hun'dred dOIl~!S
D - ~,a~, owner of p:operty', or my em?loyees ,with ;vages 2S their ~!~ C?I~~~r~~U()~~ will do the work. and. the str~ctllrels not i~ter\d~ or offl1re? ~,~r
sale,(Sec. 7044 Busll1essanc;l ProfesSions Code: The Contrac14r's LIC'ensehil)N (io.esnot apply to an owner of property who bUlldsorlrTlpro~es
thereon, and.~ho does such wOI~,himselr~>r herself or through his O! h~r.,O\r~1Lem:plo~'c~s. provided that slIch impro~".1ents are,noljntendeo 9('-' ,,~,.,'
offered fot sa !e.. ' If., however, the building or improvement Is sold with one Y~€l!" of 'completion. the owner-builder will i1a~ tne.burden of proving-that he '
.did n9t ,b~Ud ~rilT'prove for th~ purp'os~.of-sale). . ,~,___<- ,":i_;_;;ll, '_' , ,'"" ' ,
o "I,_as theow~er of the prcperty'fmex~usivelr con.tracting wit,h ~icen$(01:~~I'tract6j"~ to construct the piojec~.{Se~ 7044: Bus!~,ess and Profassions
COd. e.::.-'.T. h.e...co..ntr~9,t9(S Licer:ce La. '.;~.'doe~~nOl apPlY. to .an oWl"\erof.pi9pertxi~'YhO ~ullds or improves thereon,'a\ld WhO.. roo ~1racts for sl!ch proj'3cts with
Ljon:n~stpr(~~JicenSed pursuant to'~~e Contri::!:ctor's L!s:enr-e 4'....i); .' r . ." ~,', . ~~~. " ,
I am.exempt l,l~der-Sec..:. ,,_y,'~f~':-'''i'' '> .,_8 & P.C,for this reason: _ 'l,.;;
Date: -' -' -',' '" -,', . Owner:,-,:-- ,,:,' , ". . ': ,J.~
L..... . <'.' . WORKER'S COMPENSATION DECLARATIOt'L ~
I hereby atfirA) -undel p~l1aity of pe~ury one of the following declaratlons::) .
_ [:'J I haVe ~rid wili maintain a certificate of consent toself-insure.fc~ ..."or~;~/f;:(;orn-~en~ation,
~:s ,ovided for by Section 3700 of the Labor Code. for the performanca-of W;e work for which
thO permit is !s!5ued. . . . '. . . l. .
-' I have arid will m.aintain worker's comper.Jsation insurance, as ;equifu(l b; Section 3700 of
the Labor Code, for the performance of the work for which this permit is issu!1c. Myworker's
Compensation -insurance carrier and: policy are: .1"
Carri-er-: QLD REPUBLIC INS. ~O;' . PolicyNumoer. MVY~1.:!'.;r~~,~9-C'
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This'section need flot be CCHllPlete.q if the pennit is fer one hun'dred dollars (~~,<f:C?r.less..
o '_cerMy that in the perfonnance of the work fer which this permit is is.<iild-;~r$hali not '
employ any person_in al1Y manner so as to become subject to th~ worke,':(.t,'-;lI'npensation laws
of Califom!a, and' agree ''that if I should beconie su bject to the worker's' CO~F';~ation
'provisions of Section 3700 ,of the Lab()r Code, I ,shall forthwith comply \\'it.~.:}~ose provision~,;.
APPLICANT: CHERYL STUMP
OWNER INFORMATION: .
Robert C Timms
PO Box 727 . '
Cypress, CA' 90630
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LICENSED CONTRACTORS .DECLARA TioN
Lherebyaffirm under penalty of perjury that i,am
licensed under provisions of ctiapt~er 9 (commencing
.with Section 7000) of Oi\lSion 3 oftne Business and
~~1f6;;~~:sc~. ~
D.at~: ~--.V- Contraotor,,'
NUMBEREXPII~A T IQNDA TE
823768 9/30/2005
TYPE B
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Date: 1111012004 Applicant:.
WARNING: FAILURE TO SECURE WORKER'S ..
, UNLAWFUL,AND SHALL SUBJECT .'\N EMPLO R TO CRIMINAL PENA'.TiES AND 'CIVIL
FINES UPTO ONE HUNDRED TH.OU$At'JDOOLLARS ($100,000), IN',ADG'110N TO THE
. COST OF COMPENSATION, DAMAGES AS'PROVIDED FOR IN SECTiOtJ 3106 OF THE'
LABOR CODE, INTEREST AND ATTORNEY'S FEES, ~: I .
I CONSTRUCTION LENDINGAGENCY -C
_I hereby_{!ffirm un.<;t.!9-~pella_tty:cQf.RerJUrY~t!:;~_l th~r~$:~,~Q~~tu_~tLvnIe_f:.~(tjf'l.q ::'-:'.~r!fY!0r t"-?~_L
perfoi mance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's 'Information:
Construcion Types:
VN,. ,
occUBancy GrouDS: .
R3, 1", .
Fire Sprinklered?
U~inQ Area.
Garage Area
Balconv I Deck Area:
NO
4,347
1,352
23.
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I certify that I have 'read, this applil?ation" and state that the above information is corfect. I
agree to oomply with all, city ordinances and ,state laws relating to bjJ ilding construction, and
'hereby authorize fepresentives of. this city to enter upon the a bove mentioned property for
i.nspeCtion purposes.
Fees paid for Permit:
Total:
11,243.34
Date. 11/10/2004
19nature of AppliCant 0 Agent
The permit s 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.
" , DATE INSPECTOR' Electrical Final ~; ..1\1
INSPECTION - ',....
, Plumbing Final A. />
Temporary Power Pole ,
Plumbing (DraiR/Waste Pipe) 11""'-1- M..chanical Final' ~_I ./ ~,
Electrical Ground Electrpde/Ufer ' , Tz 7;." #Ii; Gas Test I( (AV{
SetbacklFormslTrenches(Footings) 1/::.T11 i!li:.,
Do not install subfloor or pour floor slab unti rthe '.1 , Engineering/Grading Final 765-5126 ' I ~ ,)'), .~
following applicable items have been signed: . '''lIb>" ,~'
Plumbing (Water Plpe.Sprinkler Valves) 12A~ . Fire Dept. Final 765'"t040
Mechanical (Groundwork) , Water Engineering 765-5268 , I-zDb~ -JJc,.Je-.
Electrical(Underground Conduit) , , ~ Sub List/Business License 765-519 , Mos 5sfJ ,,-!L
Pre-slab (Compae:tion/Membrane.Reinf. /2.= ,
Underpinning (Floor Joist/Girders)' , '7 , Zoning 765-5139 , 't.-'3/oi D$ -6-rt...
Do not cover or conceal the work below untIl the Building Final'!}ast Inspection- Only b/~/'tSiJ .;.'
following applicable items have been signed: fter Above Complete)
1 sf Floor Shear .../ /h 7i " PARTIAL INSPECTIONS ~
Firesprinkler (Rough) Buildina Inspections' ~I-,
2nd Floor Shear ' 3.-( Y-t?1 A"
, Roof (Sl1eathing/DiaphragmlFrame) - ./
Masonry (ReinfJBond BearnlPre-Grout) ,--- ~ ,
Rough Plumbing (Top Out) --- . ~llE'- "
Rough Mechanical ' '
Roughl:fectrlCalTDry "Wallf (j/,- ,
,
Rough Electrical : ' ~ ,
Framing (Only after Plbg.. EJec., Mech. and Fire) ILl" IAlf , ' ,
InsUlation (SoundlEnergy) ,../ , ",
-Do not tape or plaster until the fotlowing'll!lPiicable 'n Mechanical Inspections '
items have be~n signed: . - . , - i. : . , , , '
Drywall '-J.. , , , ' , ,
, ,
Penetrations (Fire Rated) Electrical I,
Penetrations (Fire Rated) Mech~ical
Penetrations (Fire Raled) Plumbing , "
,
Interior Lath .~ ( " -
Exterior Lath GENERAL ITEM ' ~ .AJIJ\ PlumbinalnsPElctions
,
Exterior Plastllr (BraNn Coat) 5"-'!-<6 ~. ...,
T -Bar Electrical, ' ' -'
,T -Bar Mech;,"ical '~
T -Bar Structural '~ I
Sewer " " -/~,A'" 'A.nil . " , ,
Water Engineering Backflow ~ Electrical Inspections
Water Service '-21'() "
, INSPECTION RECORD
FINAL INSPECTIONS
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Your Home has b""u insulated with CertainTeed Fi1:>erglass Insulation products, which are designed
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with fife-retardant chemicals that will likely lose their effectiveness over time. It has not been treated
with chemicals that can corrode wiring or metaL Fiberglass will nol absorb moisture nor will it
settle over time as may other insulation malerials.
This also certifies that CertllinTeed Fiber Glass Insulation has been professionally lustaUed in this home
to provide the following thermal perfolUlIDtce:,
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Lot #: __.Ji____.
Plan: 2A-Rc_ llldg. #: _,
Address: 3161 W. Lincoln '
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Knee Walls:
Between Floo rs:
Exterior Walls: R-13 Unfaced Batts
Cgntilevered: R-13 Unfaced B.tts
GgrggeCeiling: R-n Uufaced Batts
pgrty Walls: 3 1/2 Sounds Batts
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Lou Merola, Director of Operations Officer
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Mk your builder for the fact sheet on R- values_ Keep 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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Fiberglass is inorganic and therefore permanently noncombustible, '0 it does not have to be treated
with rJre-retardant chemicals that will likely lo.e their effectiveness over time. It has not been treated
with chemicals that can corrode wiring or metaL fiberglass win Dot absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass In.nlation has been professionally installed in this home
to provide the following thermal performance:
Job Name: Cantado Lone
Tract:
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Lot#: 7
Plan, lA Bldg. #: ____
Address: 315~ W. Lin~olo_________;______._______,.
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Attic Area: ~~},?_l?}own __.__.______________ Interior Walls: _________________. Knee Walls: ._,___________..m _____________n_____
Betweeo Floors:
Exterior Walls: R-13 Unfaced Batts
Cantilevered: R-13 Unfaced Batts
Garage Ceiling; R-13 Unfaced Balt.
Part).- Walls: 3 1/2 Souods Batts
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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- yalues. Keep this certificate with your other
valued papers. If you eyer seU this home, this certificate shonld be passed on to the buyer.
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with chemicals that can corrode wiring or metaL Fiberglass will not absorb mo isture oar vd,ll it
settle over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally instaUed in this home
to provide the followingtherrnal perfonnance:
Job Name: Cantad. Lane Tract: 16683 Phase: 1
Lot #: .__.!____
Plan: __~!L Bldg. #: __.--
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Attic Area: ~:!?_I?l?~__________________ Interior Wans: ____________. Knee Walls: --------------------------.----------
Between Floors:
Exterior Walls: R-13 Unfaced !lolts
Cantilevered: R-l3 Unfaced Batts
Garage Ceiling: R-B Unfaced Barts
Pa rty Walls: 3 112 Sounds Batts
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Ask your builder for lbe fact sheet on R. values. Keep 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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