3167-71-73 W. Lincoln Ave.
-,_.----.
BUiLDING PERMIT NO.
BLD2004'03947
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CITY ~~~~~l}!~H ElM
. . ''.,~~R~j~g0j.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714} 765 - 4626 '
CENSUS CODE: 104
QUARTER SECTION: 8
lYPE OF PERMIT
Tract Housing'
DATE: 11/10/2004
JOB ADDRESS: 3167.71.73 W LINCOLN AVE
LEGAL DESCRIPTION:
./;.
CONTRACTOR IN~':MA'~ION: . ARCHITECT/ENGINEER INFORMATION:
BROO. KFiELDSOUTHLAliiUBUILDERS IN03EORGE RI.CHARDS
3090 BRISTOL ST #200 . .'. . 555 ANTON BLVD. SUITE 850
COSTA MESA, CA. 92626 0"00 . COSYA MESA, CA .
BUSINESS PHONE:' 71,442i[\Je88
JOBDESCR~PTIONNe>'(TfipleX-BldgTypell-BLDG 10 .:. .' .....'..f...:,.. . .'.
VALUATION, ,329,800.00 . "... "::'~ PROCESSED BY. FAN .
J. . .: . '~. -:-,'. .' . _-, ' . . - OWNER~BUILDER::~~'ECt;\~J<\TiO'N, . C,'.' '. , . .. '. -, _' .',
. I herp.by affirm under penalty of perjury that I am exempt frol\l th~_ Contrac:t~yc~nt::e_,law for thefclloY"irig reason (Sec. 7031.5 Business a;~d
Professions Code:.any city or county~hich requires aper!'nit ,to COi,lStrUct; 3Iftr:in1Rrove:,:de~(l01i~,[1.Prrepair any f'tructure, prior to !ts, f::.s,uance.'alsc""'
.requires:Jhe applicant for'such permit to ,file a signed statement that he_ rs Ik:~~t~~; P.lf!SU~dft9 th~ provisions ofth~, Co.ntrador's"Ucense Law (Ctlapter
9)(comm.~ncing with Sectio!17000~Of Division 3 of the Susiness a ~9)?rOfess~j~:s Code) or ,ttiat h0 ise>:empttherefro~ and t~G ~asisfor the ,alleged .
:"emptiCp...f'OY violation of Section 70315 by any applicant far" P",,"it su'r:{cts,t~~~'PPlicanl to a dVllpenalty of not morethan five hurdred doH",,,,
[j. 50?!.'.~s. .DW. fler of p'rope.1ty. ,0; my employe~s with wages..o.::r.,th.eir-,.SO.liCo"';;fl~atiO,.,.w...'i!ia:{;;,ewbi~".ind me slruc~;re is not '".tend~. or oirerad. fl)..'
sale (Se~. ?044,SLlshiess and Professions Code: The CQnt(actor'sU,~.er'se-t;,',-v'cOssnotaptiyto an owner of pmperty who bwkJsor improves':-', ,
there::ln, ;;j'nd, who does such vv9tk ~lims'9if or herseif.,.or through h'is 'or h~r (;~v~mp!oyee.s. provided that such implovements are not:ntend3d OJ,'~>':_'
cff~red frx sale; If, however,' the building or improve::mer..t is sold with;cne Y';l' of CCI:loi~tion. the owner-blJiidet will have the burden'of proving that hr;
dId not build or improve for the purpose of sa!e}, . > J .
[J I as the owner of the property, am eXduslVe!y contractIng wltn licensed' '{,ent:-<S:1cr:? to construct the project (See. 7044 Busll1~s and Prcf€;ssic~,s
Cede: The Con~ractor's License....Law.doe's not apply to an O'Nn~r of rr(;oe,tY'l~hv builds or improves thereon. -ehd who rontr"-\cts fer suc.., proj"eo'i.s, WIth
'MOl1tractor(S)~IICe!1Sed pursuant to the Co"nlri3.ctor's Ll('..ense Law). '1 . .,,' _ - -
'-. I am eXE;mpt under Sec. I B & P C. for thrs reaSl1ii: ~ ~ .--
Date:'.,.-.." - Own.,: ',.. --;:f-:---;-'_u
I .... :'~\i, .c:\NORKER'S COMPENSA"i9N(;ECLAR-;OO;~-.3- '_ ~ _' -j ;_ICENSEO<:ONTAACTORS DEClARATION -I
I hBmb~':_~fflml 'Jnder_I)~~aity'of pe~ury Oi'_e of the folio....,!ng d8C1aratjon~:. ',';:'rr" ' . I l.hE:reby-alfirm under pe:-;alty of.perjury'""that i am
0,1 h~ve and .Wjii rha~ntain} certi,fic;atB ~f .oonsen-t to seif~ins~fefor ";vcrk~t'si::p:~t-',?riS:'jti?n, ! licensed unde:" provisioi"!sof <;haptcr 9 (comrt.er,Cing'
ta.~ rov:j~~f?r ;.lY SectiOJl 3/00 oftha Lo?9rCode, for t!'1e pertornl~nce.0:..' t~_~.:;\.'\i(HK ror "f!hlm I w:th Section: 7000) of Divsion' 3 of the Rusines::> and
t permit ISlSeued. ' '. . .'~. ,l. ....' ' Professicns Cooe. . . '" -'. . '
I hav., e a.,:j will r(lairltain.WOrke.r's -compensation insu,r.an. ee, as (e'q~lire(!~>f,-::~',~.i.iOn 3700 of I' 11i10/2004 ~_. .~~. ". :
the Labo,r Code, for the performance of the work for which,this pern~;t,is is=;'J~~.~, -Myw?rkt,:,r's Date:. .... - '-~.:_: ...:: .-"_ c. ;;:;;~.--- '.
Compensation insura nc:e ca rrier and policy are:'. .. 'I .'. '.' . ..' .
Carr:ier:, OLD R.EP~BLIC INS: CO," ,- . ' poaty Nu:,:ber., -i\W-r~~_1;~-;V 4?O -,', NI,JMBER ' EXPIRATION DATE
This.seetio'l .n~~ not be completed ifu,e pennit is for' onehun.dred dull2rs I~~'?,?JH:~:-iq3~' :,;. I 8.i~~~'d B 9t30i20G5
o _I certify that in the performance ofttle work for which this perm!tis is=.,u:2_<{') shaJ: n.o~ r
employ anyperson.in any manner so as tooecome subject to the worlffi,r's, c6,h;Jens;:Hlori i:aws ,':'-',
of Califomia, andagre;e that if I.should become subjeCt to the worx.er's'cn'rr.c~:~sat:on ".', I .
,provisi.on~ of Section 3700'oftbe Labor Co~e,,1 ,shall forthwith comply iiiith thst~C pr'Jvisiqns. :,,-," Const,(~don TYDe~:'.
, , _ -. '"' VN, '.,. .
Date:. 11/~0/2004 App~ican,t:', ,-' ~<\A~,;. -_ ~'~L...__ IOccupancv_Groups:
WARNING:' FAILURE TO SECURE WORKER' COMPENSATIONC..YERV,!"IS,. '., IH3, U1", .
UNLAWFUL, AND SHALL SUBJECT AN EMP YER TO CRIMINAL PE;NA;,'I'iES _\NqGlVI,L Fire Sprinklered'>
FINE..SVPT.. 0. O. NE HUNDR. ED. THOUSAND DOLLARS ($. 100,00. 0.>. '..I~. J .ADDI./ON '. TO.TH E../;'IVInQ Area:
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTiO,'1.1705 OF. THE '.. . Gara",e Area. . .
. LABOR CODE, INTEREST AND.ATTORNEY'S F!"ES. . . i Balconv; Deck Areo:
/.' . , . . CONSTRUCTION L~NDING AGENCY' '.'1~--.::::_._ '. ". .
_.I heoiliy.affj;:m.JJ(1d€'q:::E'c..~~Ld~~r:ury3b~~ tI:<9r.'!:1"'....,_';Dr'l.<..tr;ll~ti!l,n.._!t"~!i1C_!!;;:~h,.,~..r" ;;.....==1 <-,
. perfo.rmar:ce _of the work for which this pe(mit is issued (Sec. 3097 ,Civ .C):
Lender's'lnforrnation:
APPLICANT: CHERYL STUMP'
OWNER INFORMATION:
. Robert C Timms
PO Box i'?,7
Cypress,CA 80530
hiO
4,347
1,352
23
,-,-"-,-",-,:,,,
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I,certify that! have read this application and state that the above jnformationj~ correct. 1
agree to comply with all city ordinances and state laws relating to building'com,truction, and
hereby .authoriZe representives of this city to enter upon the above mentioned property for
inspection-'pU(pose5,
Date: ';1/10/2004
Fees paid for Permit:
Total:
11.243,34
ignature of Applicant 0' Agent
The permit s I 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. .
5
"
INSPECTION RECORD '.
FINAL INSPECTIONS
INSPECTION' DATE INSPECTOR Electrical Final.'
Temporary Power Pole '. Plumbing. Final
Plurnbing (Dl3inIWaste Pipe) t-H4 Mechanical Final
Eledrical Ground Electrode/Ufer: '. .'
SetbacklFormSlTrencheS (Footings) . . .. Gas Test
.
Do not install sub floor or pour floor slab unti I the , Engineering/Grading Fi[llll 7
following applicable, items have been signed: - . I
. Plumbing (Water Pipe.Sprinkler Valves) 2.4 -Nt- Fire Dept. Final 765-4040
.' Mechanical (GrOUnclwork) I. I Water Engineering 765-.5268
Eledrical (Underground Conduit) , .
. preo.slab (Compaction/Membrane.Rei nt. 12fNJ-t4. Sub List/Business License
Underpinning (Floor Joist,lGirders) , . Zoning 765-5139 '
Do not cover or co.neeal the work below until the Building Final ~astlnspectio~
following applicable Items have been signed: fter Above Co
1st Floor Shear ,( : 11)..---W'o/1 1::>,'
PARTIAL I
Firesprinlder (Rough) . ..
, 2nd Floor Shear 3!'t.o&.< .-,.,; Building InsDections
.
Rpof (Sheathing/Diaphrallm'FrarJle) V." ,
Masonry (ReinfJBond BearnlPre-Grout) -// . ,.
Rough Plumbing (Top Out)','
Rough Mechanical, ' . /" .
Rough E1ectrlC.a1IDry wall) . ,
Rough Electrical ." e ~/7.n , '.
,Framing (Only after Plbg.,E:Jec.. r...1ech.. and Fire) 1'1
Insulation.(SouncllEnergy) Mechanicallnspectio
po not tape orpla~ter until the following ~pplicabl~ (" .
,terns have been sIgned: ' .' . W ·
Drywall., " :'. ' . . ,
. ,
Penetrations (Fire Rated/Electrical \ , . ,
Penetrl!tlons (Fire Rated) Mechanical . . ,
Penetrations (Fire Rated) Plumbing '""
Interior Lath' . . ( . t . n. '
Exterior Lath' . ,'- ~ '^' AlII ' . Plumbina Insnections
.... " . GENERAL ITEM 'ilJY:[' V . .
, Exterior Plaster (Bl'C7Nn Coal) . ' ~ X .J-: .
, T .Bar Electrical. ' .' , '
T-Bar Mechanical ' ,
T -Bar. Structural . , ~ .
Sewer I-Idr-M:- . .
Water Engineering Backflow Electrical Inspections
Wat"r Service . . . -71_11< A-.LJ.
.
ate
6506126 .
765-519
-Only " _J
mplete)' .... 'Cj{ l)
NSPECTIONS(".~<-'. .
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Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are de~jgned
for today's safety standards and tomorrow's energy requirements.
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Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with fire-retardant chemicals thaI will likely lose their effectiveness over time. It has not been treated
'with chemicals dlat can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulation materials.
This also certifies that Certain Teed Fiber Glass Insulation has been professionally in~talled in this home
to provide the following thermal performance:
Job Name: Cantada Lane
Tract;
16683
Phase:
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l<>t #: 1
Plan, 2D_~_ Bldg. II: _____.
Address: ~16? ~. Linc~!!__________.._.__....-_.-
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Attic Area: J.l,:!~.?!9~_..._________-__.._loterior Walls:
Koee Walls:
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Bet",<<n Floors:
Exterior Walls: R-13 Unfaced Batts
Cantilevered: R-13 Unfaced Batts
Garage Ceiling: R.B Unfaced Batts
Party Walls: 3 112 Sounds Batts'
Title 24 Caulkiog Indnded (Exterior Doors, Windows and sill plates)
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Subco ir dor.. OJ Insulation Co., ltlC.
~oo S. Vinet t) u. Ca 91702 (626) 812-6070 LiceD.St #4ti5709
Signed
Conchita Ortiz, Secretarynreasurer --or-- R. Scott Jenkins, President--or-
Lou Merola, Director of Operations Officer
R- means resistance to heat flow. The higlier the R- value, the greater the insulatin~ power.
Ask your builder for the fact sheet on R- values. Keep this certificate \\ith your other
valued papers. If you ever sell this home, this certificate should be pa!;sed on to the buyer.
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Your Home has been insulated with Certain Teed Fiberglass Insulation products. which are designed
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Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
",th fIre-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 not absorb moisture nor wm it
settle over time as may other insulation materials.
This also certifies that CertainTeed Fiber Glass Insulation has been professionally in>talled in this home
to provide the following thermal performance:
Job Name: Canlada Lane
Tract:
16683
Phase:
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Lot #: __1._._
Plan: _~_A _ Bldg. #: ._____.
Address: 3171. W.!-J.,,-~~_I!!...._________________________
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Attic Area: ~-19 BI?~____________-_-.___-_-Interior Walls:
Knee' Walls:
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Between Floo rs:
Exwrior WaU,: R-l3 Unfaced Batts
Cantile,'ered: R-J3 Unface<l Batts
Garage Ceiling: R-B Unfaced Batts
Party Walls: 3 1/2 Sound' Batts
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R. means resistance to heat flow. The higher the R. value, tbe greater tho insulating power.
Ask yom builder for the fact sheet on R. ,'lIlue,. Keep tbis certificate with your other
valued papers. If you ever sell this home, this certificate should be passed ou to the buyer.
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Your Home has been insulated with CertainTeed Fiberglass Insulation products, which are designed
for today's safety standards and tomorrow's energy requirements.
Fiberglass is inorganic and therefore permanently noncombustible, so it does not have to be treated
with file-retardant chemicals thaI will likely lose their effectiveness oyer time. It has not been treated
with chemicals that can corrode wiring or metal. Fiberglass will not absorb moisture nor will it
settle over time as may other insulatio1l materials.
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This also certifies that CertainTeed Fiber Glass Insulation has been professionally installe.d in this home
to provide the following thennal performance:
Job Name: Cantada Lane Tract: 16683 Phase: I
Lot #: ..__1.__...
Plan: _~.~_. Bldg. #: ___
Address:~.173. W:_~!!t.~!>.!J..1__n_..________"'____'______'_'___
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Attic Area: ~::.l_?_.B..lown_____.__..___________Jnterior WaUs:
Knee Walls:
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Between Floors:
Exterior Walls: R-13 Unfaoed Batts
Cantilevered: R-l3 Unfaced Batts
Garage Ceiling: R-B Unfaced Batts
Party WaDs: 3 1/2 Sounds Batts
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Title 24 Caulking Ineluded (Exterior Doors, Windows and sill plates)
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Subcontractor.. OJ Insulation Co., fne.
600 S. Vinceat. AzuSIl Ca 91102 (626) 812-6070 LiCE:DS.f' #4l1iSi09
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R- means resistance to heat flow. The higher lhe R- value, the greater rhe insulating power.
Ask your builder for rhe fact sheet on R- values. Keep this certificate wim your other
valued papers, If you ever sell this home, this certificate should be passed on to the buyer.
TYPE OF PERMIT
Light! Flag Pole CITY
DATE: 6/8/2005
JOB ADDRESS: 3167, 71, 73 W LINCOLN AVE
LEGAL DESCRIPTION:
ElM
BUILDING DIVISION
200 S, ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 570
QUARTER SECTION: 8
BUILDING PERMIT NO. BLD200S-01736
APPLICANT: CHERYL STUMP
OWNER INFORMATION:
Anaheim Redevelopment Agency
201 S Anaheim Blvd
Anaheim, CA 92805
CONTRACTOR INFORMATION:
BROOKFIELD HOMES SOUTHLAND INC
3090 BRISTOL ST #200
COSTA MESA, CA 926260000
BUSINESS PHONE: 714427-6868
Install (1) private lighting pole per city standard- Public Works design # 742.
ARCHITECT/ENGINEER INFORMATION:
JOB DESCRIPTION:
VALUATION:
2,500.00
PROCESSED BY: SAM
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that am exempt from t e on tractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permn 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 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 subjeCts 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 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 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 yearbf completion, the owner-builder will have the burden of proving thal'he
did not build or improve for the pUlpose of sale).
o 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:
o 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 permit is issued.
o-t. have and will maintain worker's compensation insurance, as required by Section 3700 of
~bor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: OLD REPUBLIC INSURANCE COMPAN'lPolicy Number. MWC111014Q0
This section need not be completed if !he pennit is for one hundred dollars ($1 00) or Jess.
o I certify that in the pertonnance of the work for which this permit is Issued, I shan not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia., and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor e I shall forthwith comply with those provisions.
LICENSED CONTRACTORS DECLARATION
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
profeSSiO)2lCod " Q J._ "
6/8/2005 N)... 4- ~
Date: 0 Contractor
NUMBER EXPiRATION DATE
736657 6/3012005
TYPE B
Date: 6/8/2005 Applicant:
WARNING: FAILURE TO SECURE WO
UNLAWFUL, AND SHALL SUBJECT A OY TO CRIMINAL PENALTIES AND CiViL
FINES UP TO ONE HUNDRED THO AND 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 Types:
VN, ,
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 enter upon the above mentioned property for
inspecti n rposes.
Date: 6/8/2005
Fees paid for Permit:
Total:
114.59
Si ature 0 Applicant 0 Agent
The p mit 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 issull1ce, A
new Dermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Foolings)
Do not install subfloor or pour floor slab until the
follOWing applicable items have been signed:
Plumbing /Waler PIDeJSDrinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joisl/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprlnkler (Rough)
2nd Floor Shear
Roof (SheathingJDiaphragmlFrame)
Masonry (Reinf JBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (OnIV after Plbg., EIe., Alec. 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
Eleclrieal Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Depl. Final 765-4040
Water Engineering 765-5268
Sub Usl/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection . Only (p
After Above Complete)
PARTIAL INSPECTIONS
Buildina Insoections
Mechanicallnsoections
Plumbina Insoections
Electricallnsoections