700 S. Walnut St.
APPLICANT: EVERARDO CORDOVA
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECTIENGINEER INFORMATION:
EVERARDO CORDOVA
700 S WALNUT ST
ANAHEIM, CA 928020000
JOB DESCRIPTION:lnstaIl18' linear feet of 6' feet high blockwall and (1) 6' feet high pilaster per city standards
VALUATION: 1,500.00 PROCESSED BY: JNJ
I OWNER.BUILDER DECLARATION
J hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation at Section 7031.5 by any applicant for a permit subje:ts the applicant to a civil penalty of not more than five hundred dollars
($500).
~ as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La'N does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own nmployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner~builder will have the burden of proving that he
did not build or improve for the purpose of sale).
D I, as the owner of the property, am exclusively contracting with licensed ccntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and whO contracts'lor such projects with
,a.Q"ontractor(s) licensed pursuant to the Contractor's License Law). .
U I am exempt under Sec. I? e , a.&..p .G. for thjs Jeason: /
Date' - ..- - Owner: 'fz!i..6 fl t4-[{@ /2 ........~ )......-'-.
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
m I have and will maintain a certificate 01 consent to self-insure for worker's compensation,
~~ provided for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued. .
o I have and will maintain worker's compensation insurance, as required by Hecticn 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: Policy Number:
BUILDING PERMIT NO. BLD2005.03775
TYPE OF PERMIT
Blockwall 1 Columns CITY
DATE: 1113012005
JOB ADDRESS: 700 S WALNUT ST
LEGAL DESCRIPTION: N TR 1247 LOT 6
This section need not be completed if the pennit is for one hundred dollars ($lOO) or less.
'&] I certify that in the performance of the work for which this permit is issued, I shan not
employ any person in any manner so as to become subject to the worker's compensation laws
of California, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with thos? provisions.
Date: 11/30/2005 Applicant: ~
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED "!HOUSAND DOLLARS ($100,000), IN ADDlllON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
r hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec.3097 .Civ.C):
lender's Information:
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property ~or
Inspection purposes.
Date: 11/3012005
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 issualce. A
new permit is required to commence or continue work.
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: 565
QUARTER SECTION: 64
LICENSED CONTRACTORS DECLARATION
I hereby affirm un er penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Dlvsion 3 of the Business and
Professions Code.
11/30/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
Fees paid for Permit:
Tolal:
133.28
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodeJUfer
Setback/FormsfTrenches (Footings) 1/2. /,/~ < '~ -
Do not install subfloor or pour floor slab until the /'
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkier Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Fioor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout) ~/~ ,.. /' /
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) 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 DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control (n4} 765-42110
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only Il~1r If/ /':
After Above Complete)
lJL/,v~ /
PARTIAL INSPECTIONS
BuildinQ Inspections
MechanicallnSDections
PlumbinQ InsDections
ElectricallnsDections
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