6168 E.Paseo Rio Verde
~,
TYPE OF PERMIT
New Residential Construction
CITY
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gli~j~,(N~H ElM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION. REQUEST LINE:
(714) 765 -4626
CENSUS CODE: 101
QUARTER SECTION: 190
BUILDING PERMIT NO. BLD2004-03214
. DATE: 9110/2004
JOB ADDRESS: 6168 E PASEO RIO VERDE
LEGAL DESCRIPTION:
APPLICANT: CARLA FRAKES
OWNER INFORMATION: CONTRACTOR INFoRMrjT!ON:
Ruitson Ouyang' .ROBERT D FRAKES 11'1 .
8641 Hillcrest Rd 32 DEER FIELD PL
BUen~ Park, CA 90621 0000 TRABUCO CANYON,CA:Q2n/9 0060
. . . BUSINESS PHONE: 94~4b'1l'9211
JOB DESCRIPTIONNew 2 storySFD 2805sfllvingl60sf porch & 629sfg.'a9~(Plan 2). . . . .
VALUATiON: ,274,464.00.. . . ., :../"..' .. PROCESSEO BY: KBT' .
". ,.'t. . '. .
I '... ...... OWNER.BUILDE_Rf:f"CLARATION.... . . . _~
I hereb~ affirm unde.r per:a1ty of 'perjury ~hat I am,exempt ~ro~ tf.l,~ ,C(J~~t~actN :i_.\:~Cfins~LawJor~h? foflowjn~_ reas~r. (Si:;c;'79~1:5 ~us.(ness ,and', ' .
ProfeSSIons Code: any CIty-or c:ountywl'uch reqUl~$ a permit to construct. ~..~!o/.,-~lmpiOVC, deli!Qhs~l cr.r~p~rranysuucture. pnodo\ts\ssuaflC~, also .
re~~ires,_~'1e appiicant f~r such p~!Trit tO,file a signed statement that heJs licifS~ pursuant.,to't,he pr6~sfnns'f)fthe Contrsctof.'s License'L.aw (Chapter
9)(comrnencino with Section 7QOO of Division 3 of the Business a ild Prof~$'S'LF3Cor1ef or that he is exeh!~t, therefrom and the basis for the alleged'
exemption. Any viol~tion of .S.ection -'031.5 by ?lny appJ!cant for a pertl11t Sll~:5t$ tile a ppliCa!lt to a ciVil ~nalty of not. more- thary five hundred d01brs
($500). . . . . ,~t. . .' .' ,- .' , .'
0" ,I,:a_~ ~Jr:i:n c:..1 prope:TY.:. ~rmy er0ploy~e~.;~!:ttl \'.'8g~$ as. !ht~irscle CG~J~({ea~iO~I,~WW d(~ tt:l:; ':.:-;:;rk,' an-.-j t~estrtlctu~e i~ not intBnded or cff~rej f6r
sale_:(~_~c~"70~,:~U~lr!!,,,s~::::~d-T(A;!t;.sSions G,X:~:' The Comractof'~ UcenseJ;::!'w does not :-tpplyto an owner of property \'.'i)n,)~ui!d$ or Jr.;'prcves,
t,hefe0n':;,an~ ~ho d"ocs.such \'i6rk l1irr;s~lfpr heiSe!f or,throL.lgh his c(ner r~~~~:m~0yeq'3,P'!ov\ded thff1 !')uc.hirl"!pro..;cmer!~$ a/e_ not intended-or.. "",
offerEid f?<~'e.' If,hc1w<h't1r,: the buildi'lg orimp~ove:l1I~nt if s(;ld with one y{~i:r_~!f <:ompl~1i0n, 1~H~' ~.....;"!(:r.builijer will have the bun:ien of proving i!1.;!t hf!
Gld':lotb,uild~~lmpfovefor_tr:epu:poseof&lie)._ ' .' .':~~r'-. . . '.' . . .. .'
[J J,:~s_,~e:p\"~ner ~f~t.~St:operty, am,exdusiveiy <:cntracllng;with lice'ns;~t~ntr!]c~.ors tt) ccnstruc.:t th~ prr.:jc-ct (S~c. 7044 Bt.jsinE'.$s and.ProfessionG
, Code: Th€_Gphtrac:or't; L!cer.se Law does not'~p~.ty to an o.....m~i of p{c;x~rti~'Jo'.,'~!O b;.;;!ds G( imr""I':J">'cs tnp.reor., ;)n(t.wr,oco!li(ar.tsfor~<:>~'~., pr?jccts wit!"! '
Mon'ti.~qOf(sji.i::;er:sed purscam tothe GQnti':3dor's License Law).. \1 t-~
-I. .l-aljl exempt \~r.;jer See: _~_ ,8'& P.C. 'for !hisi:easGn: --2.l" ______~
Date:' .. ' Owner:" . ,'.11-" , :. ","
c= WORKER'S CQr!pEti~T;ON DECLARATION ~-= ~ [LiCE;i.~f'D CQ;TR;cr;;-S ~~LARAT:ON ].
I her~i='Y affirm under penalty of pE:rjurj one of tr'l~ fOl1cr."'lng de>c1aratlons: ::~~,J'~ j! hereby affirm under penallY of perjUry that I 3m ,
{J I have and w:1I maintz.in 3 cert;ftcate of o.:msetll to seff-insllre? fl..'( WOtk€;('j.::ompens:..::tior: I t:cens8d lmoer cn::r,Jts;;ons of .,:;n3pter Q (comT'1encll,g
-as prOVidec!.f0tb.Y s..ed. 10. n 3700 o. t Ule Labor Coo'e, for the pe rformanr.c' o~~.'..?~. ".' work fQr \:,:~;:c,~ I' With scct:O..~7.0. ('/0). .( DI....s~.~ 3 of the. BU.. S111<;;8:$. a~d"
thispermif;~js$U~d.., .." ,-"J .' P:ufe$~lon:.Co,j l ':' .'J!2~~~
o 'have and wilt ',naintain worker.'s CQmpe~sation in~~-'ranc:. ~s re.'1~i::d '~fse..:.tion 3!O~ of! ~110i:?OO<~ . ,',-"- _ ,(.-. .r.',! <---'- .---:-- ..
the .Laboi Cede,CorIhe performe:nce of t,he w~rk for vV(llch'thiS perrT~lt IS !_!O$d1I.' My worKer s I DJfe: ;', '- Cuntra:ctl'ir '.
C~rnpensation :11~urance .:::arrier and.policyarc: , ' '~ ~'~:::1~' . '. I '
r.arrr~r.: . . . Po!tcy Number: r::XE,~V~i.~'.:~ I. NUMBER EXFIRATION DATE
'. '" ..' ~. ~1901~ 8/31/200.5
.(his-section need not be. completed if the permit is for one hundred doliars {$'fO~_~'r Il~:'. I . ~ypt, ,- A,
o ,'certify that in theperf"cnnanceof the work for which this pcrm!t is iSSl'C~;:j shall j"l')t _ ~ TVPE 8
employ any person in any manner so as :tobecome'subje~t to the worker'~ Cttr;p(~n$8tj()n bW$ I,.
of CEllifomia, and agree that if I should beCO,i~~ubject totheworKet'scom~,Jl~'%ation ',.. - :,:
provisions o. f Secti~~3700 .Ofthe LaZ1. . re(jh311 fOrt ,h .' mhiY".iith. t".".'\'".:t PIOV,.,ivnsl ~'~:'!:CionT:loes:
Date: 911012004..Applicant: .... ...... '-4.---.' ---l Occupant;v GrouQs:
WARNING: F....ILURE TO SECURE WORKER'S COMPENSAT(ON COVl.'R}QE IS. I R0. Ul, " '.
UNLAWFU.L. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENM\IES AfW CIVIL I Firo Soriokle'ed?
FINES UP TO ONE HUNDRED THOU'SAND DOLLARS. ($. .1.00,000), IN'A..DD..\TI.'..9.N TO. 'THEd Dwellin~ Uoits:
COST OFCOMPENSATION, DAMAGES AS PROVIDEDJOR .IN SECTIONVO~ Of THE . Liv;r:Q Area:
LABOR CODE, INTEREST AND ATTORNEY'S FEES:, ' .' . H' . GaraQe Area
I . ".. CONSTRUCTION LENDING AGENCY. '~_2 . ~_ Pat;; Area: '.
I hereby affirm under penalty-of perjury th?lt.there,ls a construction lend,ing ag:i;.;-1qyfor the' I
performance of the work for whj~ thisperm;t is issued (Sec.3097.Civ.C): " ( -,- .1
Lerder's infa:rmation: . . ~ ~< I
ARCHITECT/ENGINEER INFORMA TI0N:
CHARLESD STEICHEN
'1801 E. EDINGER AVE. #225
S'PN'{A I\NA, CA 927050oo0
NO
i
2,805
629
00
I certify that I have read this application and state that the above information is correct..,l
agree to romply with all city ordinances and state laws relating to' bu ~dlng col\strliction, a"d
.hereh. YeJ. orize represent.ives of this city to -en.ter upon the aboV. e mentioned property for
in$pedn~ l~ .' '.
_ '. . '. Date' 9/10/2004 .
Signature of App_icant 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 pern:it issuance. A
new permit is required to commence or continue work. .
Fees paid for Permit:
Tolal:
5;150.12
c... c INSPECTION RECORD FINAL INSPECTIOI'IS .' Date' InspectDr :'
.
. INSPECTION . . . . .' DATE' INSPECTOR " Electrical F.inal ~ '1.....""'" v "-
Temporary Power Pole /1/ A'. : Plumbing Final {,\tMS' ,..""~' <fa
Plumbing (DrairllWaste Pipe) I/_iJ.,o'f Mechanical Fi'nal lttt\\~ T.t"""'-'" "' .
Electrical Ground Electrode/lifer . ,1/ . . ~'U\Or '1-~
SetbacklFormsfTrenches (Footings I. / ~. kLJJ .,,-. Gas Test
DO nDt install subflqDrar paur 11'1 Dr slab until rhe Engineering/Grading Final 765-5126 . .
following applicable items have been signed: . . Fire Dept. Final 7654040
Plumbing (Water Pipe.Sprinkler Valves) . '. .
Mechanical (Groundwork) . .'. Water E.!,ginee.ring 765-5268 .
Electrical (Underground Canduit) . / ~'. ., . . . ...... . .
~ ljub L.istlBusiness. Licerise765-519 V.
Pre-slab (Campactian/Membrane.Reinl. ;lVb ,i),.. ' .
, '.
Underpinning (Floor JoisllGinters) : . . . Zoning 765-5139 ' . , , :'
DO natcover ar conceal the wart< bel,ow ul)lil the Building Final *ast tnspection. Only . \t{l1Il~ "" ..,
following applici!ble items have been signed:" ,,' ner Above Complete) . .. .
1st .Floor Shear .' . , /- Zt> ~LK' ...l' .' J
PARTiAl INSPECTIONS
. Firesprinkler (Rough) A' Bundin~ctjOns .. c'" " .
2nd Flaor S,hear , /- Ul.;a:c ~
Roof (Sheathing/Diaphragm/Frame) J //../15 F, V . &J:t I' '. :.~~~7-0~'
Masanry (ReinfJBond Bean/Pre.GlO\It) ..;. ~
Rough Plumbing (Top Out) " . , ' ,-of-<>T .y___ I . ."
Raugh Mechal)ical , , '1-1"'''--' ~ ~<...-. , . '
. f(Ough E1ectJ:JCalIDryvvalt) '.f. ' (II... ' , . . "
Raugh Electrical ' . .
Framing (Only afterPlbg.. Elec.. r.-lecl'i and Fire) ,. '. . , ,
'"sulation (SoundlEnergy) , . ..
po not tape ar pla~tef until the loflowing'applicabJe Mechanicallnsoections
rtems ' have been signed:. '_ " -;" . .. ..
..
Drywall .'~ .z<;~ /.//. .
,Penetrations (Fire Rated) Elecirt.cal . " '. .
, , .
Penetratial)S (Fire Ratedl Mechanical ' . . , , , .
Penetratiol)S (Fire Rated) Plumbing , 'j . , '..
'.
Interiar Llith c' ~~...,.; I.. ,
" ' " PlumbinQ Inspections
Exterior Lath' ,ff,!' 1'mu, .'
GENERAL ITEMS' ...' . ..' , '.' " " . '
Exterior Plaster (BlOWn Coat) , ~ ~-O3'> ~ "
T -Bar Electrical . . , '
T -Bar Mechallical , . ..'
, ". . , . ,
T-BarStructural . , .', . .
Sewer '. ' ., ' .
Water Engineering Backflaw , Electrical Inspections .
Water Service ..
. . ,
.. " '. .