6167 E. Paseo Rio Verde
BUILDING PERMIT NO.
BLD2004-03212
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. BUILDING DIVISION _
200 S. ANAHEIM BLVD,
(714)765-5153
INSPECTION REQUEST LINE:
(714) 755 - 4626
CENSUS CODE: . 101
QUARTER SECTION: 190
TYPE OF PERMIT
New Residential- Construction
.,;;....,
/(;~;~i~;i.".: >.'~1[2'~\
CITY If*.~~1iHEIM
, ' {.:ftl!~:;i3~j) ,
DATE;; 9/1 0/2004
JOB ADDRESS: 6167 E PASEO RIO VERDE
LEGAL DESCRIPTION:
APPLICANT:
OWNER INFORMATION:
Ruitson OJyang
, 8641 Hillcrest Rd
Buena Park, CA 90621 0000
!
JOB DESCRIPTION New 2 story SFD
, \
, VALUATION: 2'54,343.00 ' , "lg~PROCESSEDBY: KBT ','
L' , ' , OWNER-BUILDER DECLARATION ", -""
I hereby affirm. under penalty 9f perjury that I am exempt from the Comractw'$Ucense Law for the following reason (Sec. 7031.5 Busines.3 and
. Professions Code: arwoty or county which requires a permit to construct, a~1~t, imprqve,.demolish or,r_epair any structure, priede its issuance, also "._'
requii-es the appllcant for such permit to file a signed statement that he is JicthBed pursuant to the provisions of the CorJractor's Licen'se Law (Chapter
9)(commencing with.Section-7000 of Division 3 of the Business a nd P'rofess!J~$ Code)" or that he is 'exempt therefrom' and the basi's for' the alleg'ed:;'~
exemption. Any violation of ~,ection 7031.5 by any applicant for a permit s7.~;rieci.s the'applicant to a civil penalty of no.t more th~n five hundred. d,q,U~,r~_:__:<,
tjO?)~s owne~ Of.p~o:'perty"Jrmy em'proyees with wages as theIr solef)orr-;~i~~.h~<;ttion, will do'tt:le work, 'and the structure is n9,t :;ntended or Off:;~~;~/~~\~':
sale (Sec.-7_044 Business and Professions. Code: The Contractor:~ License-law does not ~pply to an owner of property who b~,Jilds or_irnproves '
thereon, and who does such work himsf:!1f or herself or through his or her c\.~/;)t~mp)oyee5, provided that such ~mproveme!1ts are::not intended or _ , .
'offered for 's:3le. If, ho~ever, the building or improvement is/sold with one yay;. of roml)J.e:tion, the owner-builderwili have-the-burden ofp.-oving'that,he
. did not bu_i!d or'improve,f<:rthepurposeof.sa!e),. . . '_ J(:'- _" _ _' ,,' _ ,,':,_, _ _'.
o I, as the owner of the property, ,am exclusively ,contracting with licensed'ir..gntraaors ~0 construct the project (See. 7044 Business arrdprofessions
Code: _The ~'ontractor's U~nse Law does nqt i(:lPi'!Y to an o~""ner of prope~~f?hv builds or improves thereon, and whO contractS for suCh projects'with
tLqontractor(s) iicensed pursuant to t~e-Contractor's License Lav/). ',;ir .
U I am exempt under Sec.-,' , B & P .C, for th\s rea$on: ._-.:~~.
Date:- Owner: J,~
I' WORKER'S COMPENSATION DECLARATIOtL-,-r~__.-=--.J
I hereby affirm under penalty of perjury one of the following declarations; {,
o I.hsve and will mi3in~ain a ~ertificat~'of -ronscnt to self-ir~sure for y.;orl<::~_rJ;c'.)mpensati~rr,
'?IS provided forby Section 3100 of the Labor Coc:(e, for the pelfor.mance ofi}l'-; v~()rkfor which
this permit is Issued. . ' . J:' - . ,"
C I hav.e and will maintain worker's compensation insurance, as reqt.:ired r.t' .Secticir. 3700 of
the 'Labor Cod 13'_ for the performance of th~ work fer wh:ch th,;s permit is !SSIJ~d. My worker's
Compensation ,insura nee ca rlier and policy are: ' . T;
C:;trrier: . .' Policy Number. EXEMP1
"
,Thiss~~on need nOt be compl~ted if the pennit is for one hundred doll<:,r~ (~1!}9 ':>rless.
o I <?ertify that in 'the perf~llTIance of t-hewc;rrk for which thiG !)erm\lislss:..!:;;:!, ! sha.1I not
~mplo'1 any person in ;3ny manner so_as to become subject to,~he wprke(s :-:~:'f1~pensaticn laws
of California, and agree that if I.should b pme subject to thewo:1<:er'sco(nr~::;$3tic'n
~roVJSjOnsof se~uor") 3700 of the Labor:p;d, l. srI all, farthw~~a. 'Y:~~~4,-;}J:~e provisions.
'Date: 9/1 0/~004 Applicant:_ . r . <,,' ~':':: ~._
WARN ING: FAILURE TO SECURE WORKER'S COMPENSA TION ;:;d\iEf1;,.GE IS _
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CR1MINAL:P" PN'~,!'.rIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100.000J:H,''p''I)[ : nON TO~THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN. SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES, ", , ;
I CONSTRUCTION LENDING AGENCY, r=-
: heieby affirm under penalty of perjury that there is a constructionlending ;':~.l~,;cyfor the
performance of the. work for wh!ch this oermit \S ls;;ued {Sec. 3097 .(;i.... ~C): ".,l
:-;_~~gn.0~~:~_I~f()~::nat~~_,_.,~.,..____~--,~",,==-----,.c..:.:;.;....~~"':"~:"'___.--;-_._~~'_2:~ -~._
CONTRACTOR INFORMtTION:
ROBERT D FRAKES II "
32 DEER FIELD PL
TRABUCO CANYON, CA 'S.?679 0000
, BUSINESS PHONE: 94945;-9211 "
2593s1 living/ 94si porc~ & 607s,f 9ara~~e t:Plar. 1)
ARCHITECT/ENGINEER INFORMATION: ,
CHARLES D STEICHEN
1801 E. "'DINGER AVE. #225
SANTA ANA. CA 927050000
v
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LICENSED CONTRACTORS DECLARATION
I hereby arrirm undAr penalty of perjury thSlt I ;;'m
licensed under provisions of chapter 9 (commencing
with Sect:on 700 ~}/9f Oivskm 3 ot.the -Busin8$s an,d '
:/7~~;;~:ns CO V, '~. p ~'_'
Date: Contractor
I
NUMBER
619012
TY~E
TYPE
EXPIRATioN DATE
8/31/2005 '
A
B'
Construciori Type's'
V 1HR, ,
Occupancy- Groups:
R3. U1, . ,
Fire Sprinklered?
DwellinQ Units:
UvinQ Area.
GaraQe Area
Patio Area:
NO'
1
2.593
607
94
'-----,-.,~--'-~---- .
.:::::.........._- .-~.
Icertify that I have read this application an.d state that the above information is correc!. I
agree to rom ply with all city ordinances and state laws relating to buiiding construction, and
~ereby .au~ho w1, representives 07th' ~ to enter UP9n the above mentionec! property for
,!nspedron p r se , " , . . '. . .
, , Date: 9/10/2004_ .
Signature of "Applicant or Agent
The 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 commence or continue work.
Fees paid for Permit:
Total:
5.058.53'
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, , INSPECTION RECORD FINAL INSPECTIONS Date' Inspeclor ' '
" ,'" INSPECTION , , 'DATE' INSPECTOR Electrical Final 1-r.lI..d. ~,
. '
Temporary Power Pole ' , ~ I Plumbing Final ~\UIl6~ t"t.~W'J.. "
. Plumbing (PrainlWaste Pipe) , II ll'''''<{' ,r lli\l.I\:>r 'f.~~
Mechanical Final
Electrical Ground,Electrode/Ufer , / Gas Test ~~z40r- T','" ,~; J..
SetbaeklFormsfTrenches (Footings), /1 ~'Pf,.Q" ' ~' ,
, Do not install subfll/Or or pour floor slab urllil tlie ' Engineering/Grading Final 765-5126 "
followlng'appllcable Items have been Signed: , " , ,
Plumlling (Water Pipe.Sprinkler Valves) , Fire Pept. Final.765'-4040 , ' "
, t.lechanical (GrOUndwork) Waler Engine.~ring 765-5268 ' ,
,
" Electrical (Underground Condutt) ,4 Sub list/Business Lice,nse 71;5-519 "
Pre-slab (CO"'P.actionlMembrane.Reinf. 8A/"A' " A /
Underpinning (Floor Joist/Girders) , (, Zoning 765-5139 ' , '
,
,Do not cover or conceallhe wor!< below unlil the Building Final \l:ast Inspection. Only , t\'ll\~ rr,~~
following apR1icable item, have been signed:" A , , ' , , fter Above Complele)
15t Floor Shear . /. ..fl. ~,.I ) , , ' , ,,: PARTIAL!NSPECTIONS tV7';"Oct" "f
FireSprinkler (Rough) "
, , ,.' ' , j B -Id' 'I " f ,'Z?~f'"r"''''<;:' ~ t,
2nd Floor Shear ' " j.... I~-IX ~/. , UI mQ nSDec Ions ',' , , ,,' '".',. . , '
Roof (Sheathing/Diaphragm/Frane) :' ./' 8--1~()~6dt;,~ ,~ I~..~..-
Masonry (ReinfJBOnd Bean~GIO\II) , -> -
Rough Plumbing (Top Out) \D ';..r) 3' 'f~-r "0 ~,
Rough Mechanical , "J- ,"'=I' J. " . " , '
, . ~ugh ElectriCal I Dry Wall) ~I , , . ,
" '.
Rou'gh Electrical ,,', "~ 4' -
. FraminglOnlyafter Plbg, , Eleo.. Meoh. and F"el ~;)<; , , " ---------------
Insulation (SoundlEnergy), , ' I ' ---.
po not tape or pla$ler, un\i1lhe following applicable' Mechanical Inspections
Ite~s have bee." Signed:. . . . J- . , "
Drywall ,,--, '" , .he: Lh
Penetrations (Fire Rated) Electrical ' '
, " ,
Penetrations (Fire Rated) Mechanical :: , ,
Penetrations (Fire Rate!l)'P/umbing , , . ,
Interior, Lath -.y: Jr'K PI", _'A ' '. "
. ~/~9,-,
Exterior' Lath , , , ?()c, . ' PJUmbinQln~ections
GENERAL ITEMS ' I 'S~,-():> ,:t> V _ ok.
Exterior Plaster (Brown Coal) . ' ,4l- "'_1'1'::,' I,a,
T;Bar Electrical .,- , , ' ,
T -Bar Mechanical . ' , , ", ,
, ' , .
T -Bar 'Structural , ,
Sewer , ,
",
Water Engineering Backflow Electricallnsp~ctions
.. "
Water Service .1
" .-' .-.,