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5642 E. La Palma Ave. .BUILDING P~RM,! NQ".. 13LWOQ3-ll0183 .' ? .. WPEOF PERMIT' ; Tenant Improve/Tlent (li/Tlited) . DA -rE: '5/6/2003 JOB ADDRESS, ~,-----"';"'~}"""" -i-. .'-~ BUILDING bWI$<CIN 200 $. ANAHE!MBLVP. (714)765-6153 . . INsPECTION RE('lUESrLlNE.' (714) 765' 4626 . CENSUS CODe: 437 QUARTeR SECTION: 184' LEGALOESCRIPTION: PM 100-17 PAR 3 POR OF PAR ,p,- ,-- '.-". . . lji{.t~,.j:~'kb; . CITY Q..~!~~~~HEIM" \~!:.~~{~;~} .' '.1 l 5642 E LA PALMA AVE . . . ~, CONTRACTOR INFORiMji!ON: ARCHiTECT/ENGINEER INFORMATION> T M M CONSTRUCTION \~C PETER r ERDELY; . . 17941 BROOKSHIRE # a 9581 W. PICO BLVB. . . '.' HUNTINGTON BEACH: 52. '~7 aoo\) CA LOS ANr,ELES, CA 90035 . .JOB 'DE$CRIPTION:Tenant improvement"renovate e::<isting facade, ,in-sta!l tiI~ ,?oJ.'ren~ware/upgrade stairs- APPLICANT: CHRIS CHAISSON OWNER INFORMATION: VALUATION: 80.000.00 I. ". . .OV\lNER-BUlLDE'.( DECL"\W10N . .... ..... ..__...l'. ll\~r~by:affirmlir.der penalty Qt rerjl1rythzt 'am exempt fiom t/1e,Ccntractor \ti'-:;:nse L3':Nfor thefollOwir:g rea50n{See.70,2.:1.~'5_Busin~5?,'-ClI)(j.;" _ . : Pro'fess~or._s-,Cod e: any dJy.or co't)nty ~v f"",;ch req uir~s q perm it to const(uct,a F .(, im;::i',o_":F,:demolis~ or rep<:l ir a'nystrur;tl'lre,: prio r-to :rt<:;'.~.ssu~riGe',~lso . '. n:~qulres 111:~ Hpplieantfor:sucn ,perm;,t to,ti!e' a signC(i .'3tat~rnE'nt that h~iu lic~ .$-.~d put:ouant to the,pro"Yi_sions ofthe.Cor:trClct'''r's:,Ljcen:s~:L:J~ ((;~,~p~e! .: 9)(cornl11er,dng.with Se~tjon 7.0.00 of Division 3 cf the Businees and ~rof~s$; ..I}~:G0d~) or t'r2?l,the-,Js 9xeft:l'pithare~romal_idt~e b3sjS,'.rC!rth~'7l1,1,~G'~d',: '. exe'rnption. ',At1Y'v;qlat:cil nf.Secti0ll r03i.$ by ,a~y afjpli~~al1t f(~r c::,c'::f[l'~t;~I.l;~Ct~ t!":e ~tpp!ica,...t to ;;!'dvn';:>Ana:t.yOf'rio"t,rf)qf.etha_~,~\fehurl,d~edd:c,ll,~rs ($50.0.),.".. ..:.... . ,,' . . .i...... . ........ ........,.....>,..:.,:::,..'.. o I. as ownfir ofprcperty, or fl',/ ~m?:cYl?f:S '~vilh wage:; as their :~;Ole c6f!-;'p :'.1~~tll)n; _will ~o _:floe wor:<, and Jht3:::~_tr"':_iurP:,Is_no~ 1(;te~1~~..~:tr,.)~ereo for '.3al~ (Sec, 7044 ,Business anJ_pn<;ie-ssions Code;, Tt:e Contfactc,r's ucense~ .W cces,iiot:appl'jto 3n.oy.;,ierpr:p~op~,i1y,wt()':bUi~S'?Y lifloroyes", , thereOI\"arnf \'-Iho dc~s"scc.h '~\'v;k hir(ls~;lf ,Ci her.:.elfor .through hi;:;'orh~r f)V~J";~:nplt.yees: provided ihat5_u9h-J~~:lp_iP,"~~tqef\~s.ara'n\Ajtlt.jriij,edr;.r'-,::" o~(~edt.'")r'Gai~: ithO'w~\'er, the' tuil,::!l~1r.; or ilnpfcvement i:i sold with'c;:;..) y"i-:::' -:-'::,'{ 'rJ)(11ole\;_on,: the'owt"1e~:t:~~.i,i~e~ *'ill'-~3:i~,,,tt~~',_bi.ltd~?:~f.p~oVj~9,th-,3't:hG did.~t tlliild or,irrpTC>ve /c:"_ the pt;rpGs~,Of w1p,). ':, . . a :~.. _.'. . 'c... .:'- . _ ,:. :::;;:-.::S;: ~:,:-:::~;<\~;:'_\L:'-,;'.'_:':',",-::>~.,,;,;-:-:,-:/:':'c_.. ..-::..>,~':" :;.;".~::..' 0:-' I,as~the.owr;~r of L"::e pr.opel:ly, ar.:-, N~C1~s;veiy co;;troct;ng'wjlhl;';:<:,ns."j~0;11rlJc.tcr$.to c~nstrl.lct th~:;S;Oj'e'y~l?~<:::';2():'.14'8~,s!Deg;'~:oll)d"rrOf~s;;id'rl~~ - ^. Gode':~_'rt1eContr.nctor's Licp.nse ta\y d~.es not f)pp:y-toan o.....ner of pl"o::erty. ~;h('~ huild,s o{improv,*, 'ther'~6rii-'c::nd.:.yhccg:,hf\a(":f:.;for.$'iJd(p,'ojf!8tS\;:~ifn . Mo,ntr3ctor(~).ti6ensed pu(slJant.toth~Golltr?ctor's Lj,;ens<? Law)." { '. " .' , :-~: '::" ~' . . ~te:,:~~nder se~w~~. ,8,& P.C. for this !"ea$~:~___ '~~~~<~'~"'~~#i$~b~~:*~~ .__, L' WORKER;S ~OMPENSATION !)ECl;.R.t,TIQ~~-=. ___= C'~J rucENSEr..J~ONTRA0TO::lS DEC~~JO!!..] ~~Ier..y affirm under penalty of pt">rjury' 01e of tha foiIOl.....il1g dedarst,or:s.. 1'.- I herct~ affirm ~l~dcr p:,nalty of perj...ry '[hEll J am LJ I nav~ ard will maintain a certIficate ,.~f consent to self-ln::iUie tclf wClrl<G:' ;()mJ.lei':~.,<;'"1I!r)n l"cens~d :.J1)"u:,'prOVlSlons or' ter 9 (co(!~mef'lGln'j as provld for by Section 3700 of the Labor Code, for the perforr:1a"r.€! 0; '''''t work fer w:,idl with Sect:o;""l7~C'O).of Divs' ofthp. R'J neSS a\'d thts _It G .is.sued.,. , . . . . .. . -J~~,' ,_.,,0. . PfO!),~~\9nS..~8. {;,;~~ .~ c.~; ., hcweC:,r")d VliU'mai':ltain worker's c0n1pen$atiCr1 inSllJance, aSI">'JQuHbd :!_~Se(:tk)r;,3?OOof. 5/6!~op~;7i,:~~:',,,,:Y'> 1he LaborCQde.. for the_performance of the, w:.Jrk for-~!hich. this :;ermit ;8 kS.~i~~. ,~y'-iJorker'.s 03te;;/.o:"\ '~!~';.ij\;..:',j~':::; ,Compensotkln' insurancecanteranq poHcy ;3re: .'-~ 1:," ;,' -, Carrier: S;AT,E CO~PENSATIONINSFUND ' . PoJjcy~1!Jmb'(!I: '~,6D?-3.~3Z).' NUM8ER B0070S This section,need ~ot be' completed if ~e permit il? jor onf! .hurldr":!d doll~~ (~199~' IP.5S,._~,., I TYPE . [J I certify tha~jn th,e perfonnance of the wOr'~for which t~ls per.lf~itiS i5S~l~2:J:sha1r r.:~t TY,p~ empfoy any person in'any manner so as ~o.become ~ubject to the v.,'NkerS-!J(,J-ppe,nsatlor. :'aw.s o.f <?~!~om'ia, and~gr7e that if I shoUI~ ~come subject t~ew-Ofker'~oi'!:l~l~~ti,?n. ._' , '. p~~vlsrt?ns.'C'~~.ec.tlOn 3.7;OO~f.t~e.L~bon;Ode,-l. a~.: rthWJt~.c -~:t~':~tl~troV'!-S.'.~I1S' Date: 5/&/2003 .' Appll1;anl: . . . . . . -- .' .,: . >'. 'WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVER;..'!:;EiS UNLAWFUL, AND SHALLSUBJECl AN EMPLOYER TO CRIMINf\l: PiONk;l'Jl"SAN{) OIVIL FINES UP TO ONE HUNDRED1HOUSAND DOLLARS ($100,OOQj. INADD,'}{)N TO THE' COST OF COMPENSATION. DAMAGESAS PROVIDED FOR IN SECTIC~::i7U6 OF'THE LAaOR CODE, INTEREST AND ATTORNEY'S FEES. ..' .. . I .' . . .... . ..' .... .... . CONSTRUCTION LENDING....G\=f:li;V '.~:;j . '. '.' . "I,hereby affirm !-Jrlde:r pe,nglty of.',perju,ry that:h~~?~:~,:,~0:!~S{!On ~1,~ilig:3~!JDCY ~or i_~~- perform:Jnce of.!he work forwhlch thIS permlt IS IS"'~Jed (~,;at97' /":l\~:G); :?':._\~; ~'::''::';::';''~!':;;7.-:j:.;:';:i:-'':- -., - --':-~- . .~- - ~- -- __d ,.>'-"':/~--:2"f",:..v___ '"---'-___. PROCESSFD BY: AJA Contractor 8 .HIC eXPfRAHON'OATE. 10/31/2003' Con"struciqn T'/pes:' IIIN. '. , Fire ,Sprinki~ted? YES I I . ~ ,. .:". . . . ,-~- ,""--~,..~ <------.,-'--,'.,.---->...:..........:-', --"..,','--'---'- . I c.ertffy thatJ have.re<:jdthis application and state that the, above infon'nation is' correct. I agree to ooJ11ply with allci ordinances ndstate laws relaUng .to building construction,-and. hereby"authoi"iz. ep.re iveso i' ty to"enter,upon-the above mentioned propert~ for inspectioh' po' . . . .' Dat", 516/2003 . 'Fees paid for Permit': Total: 1.560.86 "-1 . ....' _ ,'_' Signa-tu,re, of Applicant-or Ag,ent. ", . .TIle permit shall expire by limitation and become null and void if the building .or . . work. has not passed final inspection 365 days from the date of permit issuance. A new permit is required to commen".. or continue work. IIIISP'ECTION RECORD ....., .". .' . .' .' INSPECTION ' .. DATE. INSPECTOR- , ." . ." . ..'Teinp!>rary Power Pole. .' ,. ... .' .' .' " Plumbing (DrainlWaste Pipll): . .... '.. EIe.:lriCalGroUlld Electrode/Uter . , . . . . SetbacklFormslTfenCheS (Footill!l$l . . '. .' . Do noU~tall subflOor or pour floor slab until the. . ..' following appiicable items have been signed: . , .' Plumbing (WatllrPipll.Sprinklllf Valves) . . '., J .. MlIchanical'(GroundWOrk) '. ., . '. . . :' EIe.:lrical (Undllrground Conduit} " . Pre-slab (Compaction/Membrane.Rllint. . '. ..' 'I . Underpinning (RoorJoistIGirdef's) '. . ~m)t cover Or concea.1 the work billow . until the . .' .following applicable items ha~.e been signed: '. . A'~~. ',. 1st~looj-Shllar ..' . 'f..o', . 'r;-/~I./ I . FiresprinJiJer (ROugh) .' , ~ .' 2nd Floor Shear . . . . '. ",,:. ' I Roof (ShilathinglOiao/lralln:VFrlmll) .. ' -Jf-r:P, 'YI ~~ . .' Masonry (ReinfJaOndBeain/Pre.:GltlI!t) . ., /~.! :' Rough Plumbing (Top Out) : .' . . ....- '. Rough Mechanical . '. , I ROugnaectt,clll rDrv waill '. . . .....' . .. Rough Eleclrlcal' . .: , . . -l . Framing, (On~ afferPIbg., Erec.. M"h.. and Fire) '/. '.a.-, Iff . Insulation (SoundlEneravl' ,. . '. . , 00 not tape .or plaster "ntil the following applicable . : .items havll been'signed:. . . ..., ..... . , 'Drywall; .... ....: .'. . .' ' . '2- -3.4 (M . I Penetrations (Fire Rated) Electrical ..' . . I : Penetrations (Fire Ratedl MeQlanical . ,:. . " PenetrationS (Fire Rated) Plumbing .' . oj Interior L.ath. '.' '. . '. . . I Exterior Lath ' . . .' . .. . ' GENERAL. ITEMS " '. I Exterior Plaster (Brown Coat} . , .' T _Bar Electrical.' . . . . :r'Bar Mechanical '. ". ,', '.' . . . T -Bar Structural . ' '. . . " . Sewer ." Waler Engineering .Backflow ' , . . . . WalerServlce . , . , , . FINAL INSPECTIONS ", 'Oale,,' Inspector Electrical Final PlulTlbing Final Mechanical Final Gas Test Erigil1e!!ringlGradirigFinaI165-5126' . '.. . .Fire. D!lpt;Fi.nal 71;5-4.04.0 Water Engineering7l;S-521;8 .'. Sub L.ist/Business .license 71;5-519. Zoning 11;5,-5139 "'-- ..' Plumbina InSDections . .' . ElectricallnSDections