6164 E. Paseo Rio Verde
BUILDING. PERMIT NO..
8LD2004-03215
. . /ql/:.'..~74i~:~,
CITY Qf;iA.~:~l-tEIM
\~t~'~:~~~:l
"..
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUES, LINE:
(714) 765 - 4626
TYPE OF PERMIT
New Residential Construction
DATE: 9/10/2004
JOB ADDRESS: 6164 E PASEORIQ VERDE
CENSUS CQDE: 101
QUARTER SECTtON: 190
LEGAL DESCRIPTION:
CONTRACTOR INFORMP: nON:
Ro.BERT 0 FRAKES il
32 DEERFIELD Pl
TRABUCo. CANyo.N. CA .8"679 0000
BUSINESS PHo.NE: 9"'-945.\.9211
2805sf Hving/ 60sf porch & 6295f garaaJ-fPlan 2)
<\"0
.. j'
I o.WNER.BUILOER~)'EGLARATlo.N
I he'reby affirm und-er penaity of perjury tt-oat i ani exempt from the CO"ltrad'o!'p.License Law for the following resscn (See: 7031.5 Business and
Professions Code: a.nv dty or county which requ:res a 1='ennit to COI,struc(-:iltl(:~improve, rlemo!ish or rel);:lir any sTructure. prior to its isSuance, also
requires th~ apPli~nt-fbr such permit to file a-3,i9r'!.eC statp.men.t that he is ii.s;I:~.~~d pi.l;Slla:r:t'-to.tll~ plo0srons of the Contract. or"s Lice. rise Law-(Chapter
9)(commencing with Sectiol1 lO,CO of Division 3 of the Bus;n~ss and Profess.ti'~S Code) or that he is exempt therefrom and,the basis for the alleged
exempUon. Any violation of Section 7031.5-by 2.r.y' appliCant for a permit su~;e~ts. the 3?p\\cBnt to a ciVIl penalty of net morc;tha!1~lve nundred dollars
($500). . ";1. . '. . .. ... . '.
o ',I, as.-owner of property, Q,- my employees ',../ith w<)ges as their sole CO'!!8~~~s,atio~_! ,""!iil,do the work, ,andclhe structure is~,ot inte~ed cr offe!'p.d for
sa\e (~ec. 7044 Business and Pf')fesslo~ls Code: fhe Contractor's Licens~:~r"'';; rlces nol appiy to, an cwner of property w~2"b'ui.J(1s. t?f, irT!pro'{&s
thereon, and who dl?es su,~~!);",y,'"(lrkh!rrysclf or hc:self 0;' U-iroughhis or h::;r0'.';;V~mp]cyees. proyided that,~uch improvement_$ 31e not intendf\CI or ~ _.'
offeree for sale. If, mwever, the ouilding or imprav~ment .!~ said with onE:-y:,:~:l: '.)f complBtivil,!l1e oWn~r-bLJildei will ha'Je tt~e burden of proving that he
didn\l't bui!d or improve fOf the purrlose Of sale). '. _ '. ,"::r " .-;',.. '", ' ",:-,:,',' .' .,,' ."
[} . !, as the owner r.:fthe prep.arty. am ~xc.irJt\'idj COl1t~ct\ng with licel")s'e~t,~ntmct:')'c to conf;truCii the pmjDC! (Sec. 704-18u~il1essaJ1d Profes.<-;iqrrs .
Cod~:~,!he _Cor.t~ador'~ ~!_ceflse. Law ~oes not apply t? .30 owner-ot prcpe1~+;H10 buiir:!e or !mwoves thereon.. and who coni:racts for. such projects with
~..Jfo'!tractor(:3) llcer.seo purSllant tcdhe C:)ntracto:'s L'~nse Law). -~;jr:.":
U j am e~ernpt under Se.-c. __.-____ ,B & P.C. ~0r this reason' -....._::2~.~-:::----r-. .: ' ____--:________
Oat..",. '_ Owner' .'.--_--t-..,..,', c ,.;,. ~,,','
~. _"'."" ,. _.~_ _' ==.j'J._~_____-..,.,_;;.. '_ ' ,- __
I . WORKER7SCOMPi:::"SATioN f!.ECLARATIQli._.J~-'--li. I.ICEi'!SED G.oNTP.ACTQ~S DSCLARATION l
I hereby affirm' onder pen~HV of perjury one ot the fcllowlng o€clarations: .' >4 _ r ", ! hereby altirm tinder per'81tyotpp.rjury that ,I am
[] Ihav~and\'lit! rnaint':3in a cafUfrcat::;: 0f aHis~n~ to self-i,isure for WOrke-(;~,O)mpens3ti.:>n, I Ij~:I1;.ed :~nde~ r:roV;~[C.'~S?f Chap~ter 9 ~co~n,.r.eflGing., .
a~ provid~. :'. f~r by.secti6n.,3700 of the LGlbo~Code, fer the perfo.rmanCB cf.' r:r..;~~.~ \'/<J.rl$inr ,<"hich. ,. .Vlllr~ .........,~3~:,?n~: of Cl1V$. .lOn 3 o~ the.- 'usme.~5 and.
thiS perm.,t IS ISsued. . >-~ .'; I ProI8S~.~iIS); 01/11, /' . fA ~ ~ ... ".'
o 1- have and wili mdrntaJn IN0*er's compelisEltion in5ura~ce, a$ require-'J:tA?d~t~)n ::l700 ...:::f 9flCf200~{ _~.: - r~
the Labor Code, for the.p~rfGm1anCe' of the wor.k for which this permft !~ iss:i<-0'. My vlerxer's 03te: ' Contractor
Compensation in$llranc"e carrier 2nd ;->olicy are:. . t
Ca-rrier: PoliO/Number: EXEMPli
. . \
This.section need not be compl~ted if the permit is for on;) hundred dcllc;;rs ($10i>~flr less.
o I certify that in th~ perfonnance of the work for which this permit is is3lJ'ei;, I shi'3U not
employ any perSOll i""any manner so as tc. bt:come subject to the worker's cd.npensation ~aws
of Califomia, and agree thZlt if I should become subject to the warke's cwmp{l::;,aiion
provisions of Seelio., 3700 of the .Lebor '!bril/l s~C~forl~~o,:,pIY ",ithth!?".:,~1r~V~Sib~S. ~o~~ti'~CiOP:- fVPBS:
Date: 9/1 0/2004 Applica~ . f~ r ~ Oc:cup"ancv Groups:
WARNING: FAilURE TO SECURE Wo.RKER.S Co.MPENSATlo.N COVER~GEIS R.3. U1: ...
UNLAWFUL. AND SHALl SUBJECT AN EMPLOYER TO CRIMINI'.LPENALTjE~AND CiVIL FIf. Sp""klered?
FINES UPTO o.NE HUNDRED THo.U SAND DOLLARS ($100.000). It-; ADO;'f10N TO. THE 1.D-A,ellinq.uni:S:'
COST OFCOMPENSATION, DAMAGES ASPROVIOED FOR IN SECTiON '3706. OF THE UviflQ Ama;
LABo.R Co.DE, INTEREST AND ATTORNEY.S FEES. . .... Gardqa Area
I . CONSTRUCTION LENDING AGENCY =I ,!,~~io Area:
I hereb~ affirm under pena\ty.of'~rjury that there- is a construction lending a:;:pncy for the',-' '.
performance of the work for which this' permit is issued (Sec.3097..Civ.C): (
Lender's Information: : i .
~~_~~c .~T-
'certify that I have read this application and state that the above information is correct. '1
agree to'comply with all, city brdinances and.state laws relating to building construction, and
hereby 3 rge re:pre.sentiv7' f t s city to enter upon the above mentione.d property for
inspedi ses. .'
. ~ '.. ~~=~
Signature of Applicant or Agent
The permit shall expire bY limitation and become null and void if the building or
work has not passed finalinspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
APPLICANT: CARlA FRAKES
o.WNER INFORMATION:
Ruitson 'Ouya ng
8641 Hillcrest Rd
Buena Park. CA 90621 0000
ARCHITECTiENGINEEB INFORMATION:.
CHARLES 0 STEICHEN
1801 E.ED1NGER AVE. #220
SAN! A ANA: CA 92705 0000
JOB DESCR.IPTIONNew 2 story SFD
VALUATION: 274.464.00
PROCESSED BY: KBT
-.J
NUMBER
6190'!2
TYPE
TYPE
EXPIRATION DATE
8/31/2005
A
8
NO.
1
2.805
629
.60
.,
Fees paid for Permit:
TQtol:
5.150.12
-
, INSPECTION RECORD , FINAL ,INSPECTIONS 'I Dale Itlspeclor ,
, ' , INSPECTION' ' DATE' INSPECTOR , Electrical Final " ~t"c "r.
Temporary Power Pole , /}' " Plumbing Final ~~OS' 11"". L L J\
Plumbing (DrainlWaste Pipe) IJ/-fL-otj <:::::,.-d:7, ~, ,Mechanical Final ClMor' -r, .~ 1_..nII
Electrical GrouhdElectrOde/Ufer , / 1 I :,,--
, ' ~l"r '"\, "'~....~
SetbacklFormsrrrenches (Footings) rr Ek ,^, Gas Test "
D!:> not install sub floor or pour floor slabunfll tM EngineeringlGrading Final 765-5126 ,
following appli.cable- items have been signed: ,
Plumbing (Water Pipe.Sprinkler Valves) , , Fire Dept. Final 7654040
,
Mechan,caJ(Grou ndwork) ,
Water E,ngineering 7,65-5268 .
Electrical (Underground Conduit) , / 4 ,
v,t~~ ~b List/Business License 7il5.519 V ,
Pre'slilb (CQrnpaction/Membrane.Reinf. " " '
Underpinning (Floor Joist/Girders) , F Zoning 765-5139 ,
Do not cover or conceal thewor!< below until the ~ast Inspection- Only : ~~fo.r Pr MJ- "",
folloWing appli,c,aQleitems have been signed: '. - ~~ .. , ' Building F,inal fter Above Complete) , j~, '......
1st Floor Shear ' ' ' f.tI-<>i r-, , PARTIA~ INSPECTIONS
FireSprinkJer' (Rough) , I
2nd Fioor Shear " ' ' 1-)/... l Buildina lrisoections
RQof (SheathinglDiaphragmlFramel L /4>-t:>6 'L ~l,,-O<;-- ~ ~~,~/:
Masonry (ReinfJBond Beam/Pre-Gl'O\It) , A ' ,',
Rough Plumbing (Top Out) , j 7..&1"> ,;<
,
Rough Mechallical 7_,.r . "
RQugh ElectriCal (Dry Wall) , , ',....., , , , , ' , '
Rough Elecirical "ZJ , H./tK" 1" -.L" ~ ,
Framing (Only after Plbg.. Elec._ Mech, andF.irer.; -nC A , ----
Insulation (SoundlEnergy) , ,
Do not tape or plaster until the follOWing applicable' Mechanical Inspections
items t:'ave ,been signed:'. -.' , ,
DryWall , " 'At!:: '#..w~
Penetrations (Fire Rated) Electrical ,
Penetrations (Fire Rated) Mechanical : ' ,
penetrations (Fire Rated) Plumbil1Q , ',' A , , ,
Interior Lath " ~~~~ , , :
Exterior Lath ,f10!( '1~ ,Plumbina Inspections
, GE;NEAAlITEMS " " " , "
Exterior Plaster (BlO\Nn Coal) '., '.J-:1~l)r: - ,
T ,Bar Electrical , , ,
T -Bar Mechanical , ,
T -Bar Structural '" ' ,
Sewer' , ' , , ,
Water Engineering Backflow, .
Electrical Inspections
Water Service " ..
"