1230 N. Miller St. B231-34
I.
CONTRACTOR INFORM/ITION:
MORROW MEADOWS'.CORP
231 BENTON CRT"
CITY OF INDUSTRY, CA ,1.7890000
. BUSINESS PHONE: 90959.07700
JOB DESCRIPTION Modify containment dikes / New duct supports (Express Plan Check)
VALUATION: 15,000.00 ,<
I . OWNER-BUILDEiUJECLARATION
I hereby aff!rm under penalty of perjury that I am exempt frornthe Contracto~'~.!jcense L~wfor the following reason (Sec. 703:1.5 Business a~
Professions Code: any. city or countywhich:requiresa permit to construct, a!:ei, .improve. demolish or repair any structure, prior to its issuance, also
requ ires the applicant for ~ch permit"to ~Ie' a signed statement that he' is Ik;:c.lised pursuant to the provisio,ns of the Contractor's license Law (Chapter
.9)(commencing with Section tooo of Division 3qf the Business-and Profess;')ns 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 dvn. penalty of not more than five hundred dollars
($500). . . , y
D I, as owner of propertY, or my. employees with wages as_their sole com~.insation, will do the work. and the strucbJre is notintended or offered for
sale ,(Sec. 7044 Business and Professions Code: The Contractor:s Licel1SB ~:3W does not applytq an'owner of property:~vho builds or improves,
thereon, and who does such work himself _or herself or through his or her O\~h emplovees; provided ,that such improvements are not intended or
o,ffered for sale. (f;however,.the building or improvement is sold with one y~}-jr of oompletion, the owner-builder willllave the burden of proving that he
. did not build or improve for,th-e purpose of sale). , '
o I, as the owner of the property, am exduSivelY contracting with licensec:'qontractors to construct the project (Se.c. 7044 B~siness and Profes,sions
Code: The Contractor's license Lawdoes not apply 10- an owner-of propeltywho builds or improve::? thereon, and who oontracts for sudl projects with
~ontracto~(s) licensed pursuant to th~-Contractor's License Law). . '.
U I. am exemptunder Sec. , B & P.C. for this reason:
Date: Owner:
,.:
I . WORKER'S COMPENSATION DECLARATIONt
I hereby affirm under penalty of perjury one of the following declarations: ~\
o I have and wilt ma intain a certificate of co~se!"!t to self-insure for lA-orkN.';>'comper:sation,
,as provided for by' sedion 3700 of the' Labor Code, for the performance of tt,~ .work for which
this' it is issued.. I
I have and will maintain worker's comperisation insurance. as .required b~i Section 3700 of
tti labor Code, for the, performance-_of the work for which this permit is iSSl1{':t Myworker's
o pensation insurance carrier and policy are: .
Carrier: ST. PAULFIRE&MARINE Policy Number. WVK610:J100
BUILDING P;;RMlf NO.
BLD20(l3:J4138 .
." .
TYPE OF PI;:RMIT
.Tenantlmprovement (Limited)
,"', ,<
CITY
DATE: 12/2212003
JOB ADDRESS: 1230. N MILLER ST B231-34
LI;:GAL DESCRIPTION: KRAEMER TR LOT 17 BLK K POR OF LOTI
APPLICANT: JAY SUTHERLAND
OWNER INFORMATION:
Ro~welllntemational Corp
2201 Seai Beach Bivd .
Seal BeaCh, CA 90740
..
BU,LDING DIVISION
200S.ANAHEiM BLVD.
(714) 765 -5153
.INSPECTIO~J REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 437
QUARTER SECTION: 144
ElM
ARCHITECT/ENGINEER INFORMATION:
GAGAN P BAINS
7 MORLAN PLACE
ARCADIA, CA 91007
PROCESSED BY: KBT
. .
This section ~ed not be cornple~d if the, pennit is for one hundred dollars ($1 Ofi) ~.;Iess.
o I certify that in the perfonn,ance of the work forwhichthis permit is issu.:d~,I:shall not
employ any pe.rson in any manner so as. to become subject to the worker's c.znpensation laws
of California; and agree that _if I should become subject the worker's comp:!!,,!si:ition
provisions. of Section 3700 of the La~r e', I shall ~ ith comply with tt-',;)'ie: ptbvisions.
Date: 12/2212003 . Applicant:
WARN ING: FAILURE TO SEC E
. UNLAWFUL, AND SHALL SU JEC. EMPLOYER TO CRIM INAL PENALTIES. AND CIVIL
FINES UP.TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADC.;:(lON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION (i706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .' t
I CONSTRUCTION LENDING AGENCY .' f
. I here~y affirm under penalty of pe~jurythat there is_a CO"str.Jction .h:mdj"'n~.;i;~.;cvfor the..
--partormance.ot the, work for which this permit is issued ($ec.3097-.Civ.C):
L!=nder's Information:
I cert:ify that I have read this application and state-that the above information is correct. I
agree to oomply with all city ordinances and state laws relating to bu nding construction. and
l1erebya rize repre~, . esofthis dty.to enter upo,n the above mentione:..odproperty for .
i spedi utposes. -
Date: 12/2212003
19nature of Applicant or Agent
The ermit 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 commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that j am
licensed under proVisions of chapter 9 (commenc'ing
with Section 7000) of Divsio,n the Business and
P rofess.~'ons C. ..' , .r
12/22/2003. ..
Date: Contractor
NUMB. . EXPIRATION DATE
. 230813 6130/2004
TYPE B
. TYPE C10
Construcion Types:
III N, ,
Fire Sprinklered?
YES
I 'c,-..- ".' I"~::
Fees paid ,for, Permit:
Total:
535.26
INSPECTION RECORO
I INSPECTION DATE INSPECTOR
Temporary Power Pole .
Plumbing (DrainlWaste Pipe) ...
Eledrical Ground Electrode/lifer
SetbacklFormsfTrenches (Footinils)
Do not instal.1 subflooror pOUr floor slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Rei nf. . .
Underpinning (Floor Joist/Girders) . .
Do not cover or conceal the work below until the ..
following applicable items have been signed:
1st Floor Shear . . .
Firesprinkler (Rough) .
2nd .Floor Shear .
Roof (Sheathing/Diaphragm/Frame) .
Masonry (RelnfJBondBeamlPre-Grout)
Rough Plumbing. (Top Out} .
Rough Mechanical. . .
KOugh t:Iectrical \.... J nail)
Rough Electrical
Framing -(Only after Plbg.. Elec.. Mech.. find Fire)
Insulation (SoundlEnergy) ..
O() not tape or plaster until the following applicable .
items have been signed: ' .
.Drywall .
Penetrations (Fire Raled} 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 Backflow
Water Service .
;
FINAL INSPECTIONS 11' Date. Inspector
J:lectrical Final. . ..
Plumbing Final . . '..
Mechanical Final . .
I Gas Test. I ... .
Engineering/Grading Final 765.0126 .' .
..
.Fire Dept. Fina1.765-4040 . .
Water Engineering 765.5268 . ..
Sub List/Business License 765.519
Zoning 765-5139 - .
Building Final ~ast InspeCtion- Only .
. . fler Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
MechanicallhSDections .
Plumbina Inspections
ElectricallnSDectiohS
PERMIT. EXPIRED
.INSPECTION ..
NOT COMPLETED
DATE: \(00[95.
.-