813 S. Western Ave.
CONTRACTOR INFORM!\TiON: ARCHITECT/ENGINEER INFORMATION:
LODARCY MASSE CONSTRUCTION INC PHILLIP R BENNETT
2700 DAWSON AVE I 5535 E. CERRITOS DR.
.SIGNAL HILL, CA 90755 G~,'O ORANGE, CA 928690000
BUSINESS PHONE: 5629$(...'l406
JOB .DESCRIPTIONNew2$tory SFD Living:2414 Garage:462 I
VALUATION: 173,689.00 PROCESSED BY: MJL
I . . .. . ... . OWNER-BUILDEl3.m:cLAR.~TION .. .....
I hereby affirm. under penalty of perjL!ry that I am exempt from the Contractl:~~~ License .L aIA' for the following reason (Sec,. 7031.5 Busir~~s~,and .
Professions Code: any city or cauntywhich req~ires.a permit to C9hStruct, af'~;',f, irriprove, demolish or repair any'structure, prior to its issLlcin<;e. also
require:; ,the-applica"t for such permit to file a signed statement that he is lit>::ls-:.-d pLrsuant to the provisit?ns of the Contrador's Licel)se Law (Chapter
9)(commencing with.Section7000 of Division 3 Of the 8usin'essand PrQfessi,?~s Gods) or tt-.at heis ,exempt th~refrom and the basis hrthc alleg~
exemption~ Any violat,ion' of Section 7031.5 by ~ny applicant for a-permif.sub.i~Gts theapplic<3nt to a civn'pena~yof.not rm're tha.~ five hundred dollars
($500). . .. ! .. . .. .
o .I, as owner ofpror>erty, or my em!=!oyees with-wages as their sole comf"lnsation, will do.the wqrk, and thE' structure i$l1ot intendea (4'; uttered fur
. sale (8eo:7044 a\Jsir:~s and Profese;;ons C<:de: The Controctor's'Licens.e I.~~N doesnot apply to an owner of property wno builds or imJ;~(ives .
ther~on, and who does such work himself or h6rself or through his or her ow.! '9:ilployees, oroYided that suchimprove.mentsare not intended or
offered for sale. If, however, the building or improvement is sold with one yi';;;r of C(lmpleti~>n, the owner-bu ilder will have the ~tlrder1.of proving 'that he.
did not build or improve for the purpoSe of sale). ,\. . .. ,.' " .
o I. as the '0wnerofthe propeiiy,'im axdusillely contradingwith Ijcerised)~ilt:'~dors f(icoJ1structtheproject (See. 7044 Business and. Professions_
Code: The Contractor's License law does not apply to an owner ofproperty...i.srobu:ld'3 or iii1pfOVe-5 thD;eon, andwho_contracts for such projects with
~ontractor(s) licensed purs'uant to the GOl1tractor's license Law)., \- .
LJ I ,am exemptunl1er Sec.' , ,B&P.C.forthisreas~n: ___-'-___"- ""___
nate: OvVner:
I . WORKER'S COMPENSATION DECLARAtION
! hereby affirm under penalty of perjury one of the followingdeclarat\ons:
o I have ~nd_will maintain a certificate of consent to sclf-!nswe forworkr;r'j"..:;ompen5ation,
as provid by Section 37.00 of the Labor Code, for the-perfonnance offh;: work for \"!hic.h
'a.~" ,Jt is iSsued. . i~ . "
. have aqd will'maintain worker's compensation insurance, as required ti...: S.:"'';):tlOi13/~O ;')f
Labor Code, for the performance of the work for which this permit is issu,-:j. My worker's
ompensa'tion insurance eanier and poliO! are: .
Carrier: STATE FUND Policy.Numb.r. .1704280:
(~
BUILDING PERMIT NO. . BLD2003-02508
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TYPE OF PERMIT
New Residential construc.tionCITY
DATE: 2/13/2004
JOB ADDRESS: 813 S WESTERN AVE
LEGAL DESCRIPTION:
APPLICANT: RICHARD MASSE.
OWNER INFORMATION:
Royal C Marten
POBOX30
Sanla Clara, Vt 847650000
=]". -'-"l
. . .
'This section need' nOt be completed 'if the ~nnit is for one hundred dollars ($1 C~!i t". loso.
D (certify th.at in the pertOnnal.1c.e of the vyork. for which this permit isissue,j: I shall not,_
employ any person in any manner so as to beCOme subject to the worke(s _c:t:n~~nsation laws
of California, and agree,that if I should-become subject t6 the worker's ccrr,p..f1sat:on
provisions of Section 3,700 of the Labor Cod shatt forthwith.compiy with it~~~'provisior.s.
Date: 2/13/2004 Applicant: '}'W 'j!'<.A,..L
WARNING: FAILURE TUSECUREWORKER'S COMPENSATION COVER"GE IS. ..
UNLAWFUL, AND .SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN.!. i,TJioS AND C:VIL
FINES UPTO ONE HUNDRED lHOUSAND pOLLARS ($100,000), INJ\,[iC;'i10N TO THE
COST. OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTlO'c '3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
. ,,---',,"--
I. . CONSTRUCTION LENDING AGEtlCy____i , .
. .~.I.-;,.,.....! '~' ,::>~:.:-: 'Y:"~"<::''' p':"-...~l*~-~~rll.:~1 i~"t th::,"'=~,;:s ...C'!~_~~d;~;:.rt~...~;-"t.;__,.,~~:?,-;di.'-!",fr,p.________..
. pe,formance oftha work for W'hk:h this perml't,i,s issued (See. 3097 .Civ.C):
Lender's Information:
I certify that I have read this application and state that the above inforniation is correct. I.
agreelo comply with all city ordinances and, state laws re1atil.1g to bu i1ding cO:1Strqction, and.
hereby authoriZe rep se.ntives of this city to enter upon the above mentioned property for
insp~ion'purpo' ;.,
. ~ Date: 2/1312004
Signature of Applicant or Agent
The. permit shall expire by limitation arid become null and void if th(' building or
work. has not pll$sed final inspection 365 days frOm the date of pernlit issuance. A
new permit is required to commence or continue work. .
BUILDING DIVISION
. 200 S. ANAHEIM BLVD.
(714)765-5153
INSPECTION REQUESTLINE:
(714) 765-4626
CENSUS CODE: 101
QUARTER SECTION: .6
i
LICENSED CONTRACTO~s OECLARATIO!L.1
I hereby affirm under penalty of perjury that ',am
licensed under provisions ~hapter 9 (commencing
withSection700C) of Oi .10 .0 of the BUSiness and
Professions Ccd~ :8~.. .
'" ~fA'~
21'i3/20:J'i ~~
Date:
Contractor
NUMBER
733437
TYPE
TYPE
EXPIRATION DATE
.3131/2005
B
HIC
Construcion Tvpes':
VN, ,
Occupancy Groups:
R3, U1, , ,
Fire'Sprinklered?
Dwellino Units:
Uvino Area:
GaraQe Area.
NO
1
2,414
462
. .
'_.~-;~~-~--~~~~----;--~-
Fees paid for Permit:
Total:
3.023,34
INSPECTION RECORD
, INSPECnON
,
INSPECTOR .I
DATE
Temporary Power Po'e "
Plumbing (DrainlWaste Pipe) , _
EleCtrical Grou,nd Electr<idelUfer < "
SetbacklFormsrrrenches (Footings) '7-B..c4~~
Do not install subfloor or pour floor slab until the '
fallowing applicable items have been signed: "
Plumbing (Water Pipe.sprinkler Valves)
Mechanical (Grouridwork)
EleCtrical (Underground Conduit)
Pre-Slab (CompactiOlllMembrane.Reinf. 7-fJ'.c<f ,{J/ij;
,Underpinning (RoOr Joist/Girders)
Do not cover or conceal the,work below, until the'
following applicable items ha~e been signed;
1st Floor Shear , " , , ~ u... or ~
Firesprinkler (Rough) ,I t, \\ .
2nd Floor Shear ,', ~"Tl41' f
Roof(sheat~~hragmlFrane) 'Qi l'fIIO J ~.I
Masonry (RelnfJBond ~anlPre-GlOUt) 'I ," " '
Rough Plumbing (Top Qut) I
Rough Mechanical, " , " ,
Rough Electrical ,...}' nail) ,
Rough Electrical' '\
Framing (On'fy-after P.lbg., Elec., r,jfech.. and, Fire.l
Insulation (SoundlEnergy) , '
00 not tape or plaster until the following applicable, ' 'I'
items have been.'signed: - ~_' _ '
Drywall , ""'%.~:Cf~[ 4.,)" ,
Penetrations (Fire Rated) Electrical ' , , ,~ '
Penetrations (Fire Rated) Mechanical " I
Penetrations (Fire Rated) Plurribing , I
Interior Lath " , ,,',' /j ~" n'
Exterior Lath 'fPI-lt<:.f )..k..... ,
" GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical,
T -Bar Mechanical
T -BarStructLlral ,
, Sewer
Water EngilleeringBackflow
Wat"r Service
,
,
,
,
, ,
,
FINAL INSPECTIONS Date
Electrical Final
Plumbing F'inal
Mechanical Final
Gas Test
Engineering/Grading FinaI7~.Q126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Busilless License 765-51
Zoning 765-5139
Building Final (Last Inspection. Qnly
After Abave Camplete)
PARTiAl INSPECTIONS '
Buildii'lQ Inspections
Inspector'
V',
v'
,../
;;; YI j;<'p-6
Mechanical Inspections
Plumbinq'lnspections
ElectricallnsDections