2000 E. Winston Rd.
BUILDING PERMIT NO.
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BLD2005.0137,O
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TYPE OF PERMIT
Tenant Improvement (Limited)
DA TE: 6116/200'5
JOB ADDRESS: 2000 E WINSTON RD
LEGAL DE:SCRIPTION: ,N TR 14701' LOT t
CITY
APPLICANT: ROGER KIM
OWNER INFORMATION:
Mart Really HOlding COf!1pany
1350 S State College Blvd
Anaheim, CA 928060000
CONTRACTOR INFORMATION:
CHONGSUKHAN
442 MONROE ST
IRVINE, CA 92620 0000
BUSINESS PHONE: 714290-1858
JOB DESCRIPTION:renantlmprovement
VALUATION: 70,000.00
ElM
BUILDING'DiVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714),765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 116
ARCHITECT/E:NGINE:E:R INFORMATION:
HAROLD P WU
1168 N. ROSEMEADBL. #N
ROSEMEAD, CA 91770
. PROCESSED BY: CDL
, OWNER.BUILDERDECLARATION
I hereby aft rm under penalty perjury that I am exempt from the Contractor's License law-for the following rea.son (Sec. 7031.5' Business and
Professions-Code: any city or countywhieh requires a 'permit to construct, alter~ improve, demolish or repair any structure-, prior"to its)ssuance, 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
exem~ian. Any violation of' Section 7931.5 by any applicant for a permit subjects' the applicant to a civil penalty of not more than fiye hundred dollars
~~ '
o .I, as owner of property, or my employees with wages as their sale compensation, will do the work,-and the structure is not intendSd or offered for
sale: (Sec. 7044 Bu.sinessand Professions yode: The Contractor's License Law does, not apply to an owner of property who builds or improves
thereon, and who does such work hims_elf or herselfor through his or her own employees, provided that sl!chimplOvements are not intendecf.,or
offered for sale. :If, however,the building orimproven:tent is sold with one year.of completion; the owner-builder will have the burden of provipg that he
did not build o~.improve for the purpose of sale). 1 . ..
o /, as the Q\Vner .of the property; am exclusively ~ontracting with licensed contractors to construct the project (Sec. 7044 Business and Profe_ssions
Code: 'The Contractor's License Law does not apply to an owner of'property who builds or improveS thereon,.and who contracts for such. projects with
~ol'ltractor(s) ~i6ensed pursuant to the Contractor's Li?6nse Law). ',.
U lamexemptunder.Sec.' ,B&P.C.for.this.reason: '
Date: Owner: - -
I WORKER'S COMPENSATION DECLARATION I
~' eby affirm under penalty of perjury one of the following declarations; , :
"-,-I ~ave and will maintain a certificateOt conSent to self-insure forworker's d_ompensation,
s 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 compensatic;>n insurance, as required by Section3700 of
lhe Labor Code, for the performance of the'work for which this permit is issued. Myworker's'
Compensation insurance carrier and policy are:
Carrier: '
Policy Number. EXEMPT
This section need not be completed if !he pennit is lor one hundred dollars ($1 00) or less.
~ertify that in tl~e 'per;tom1~nce?f the work for Which this permit Is issued,'1 shall not
employ any person in any manner so as to become subject to the workers compensation laws
of CaHtomia, and agree tha~ if I ~hould become subject to the worker's compensation
provisions of ~tion 3700 of the L or Cod hall- orthwith ~lY with those provisions.
Date: 6/16/2005 Applicant: ~ ~ ~ "
WARNING: FAiLURE TO SECURE OR R' ,c-bMP NSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CI VIL
FiNES UP TO QNE HUNDRED SAND DOLLARS ($100,000), IN ADDITlON TO THE
COST OF COMPENSATiON, D" AGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I herebyaffirm unde-r penalty of perjury that there is a construction lending aoer.i.cyfor the
performance of the, work for which this permit is issued '(Sec. 3097 .Civ.C):
Lender's Infonnation: '
I certify that I have read this application and state that the above information.is correct. .I
agree to compty with all city ordinances and sfate laws relating to building construction, and
ereby orize representives D:f this city to enter I,Jpon.the above mentioned property for
iron purposes.
Date: 6/16/2005
, S' -atur Applicant or Agent
e permit shall expire by limitation and become null and void' e building or '
work has not passed final inSpection 3(>5 days from the date of permit issuance. A
new permit is required to CCimmence or continue work.
LICENSED CONTRACTORS DECLARATION
, I he,rel::w affirm under penalty of perjury that.1 am
'/icensed'underprovisions of chapter'g (commencing
with Sectio 7000) of Divsion 3 of the Business and '
Profession's e ~
't?;
6116/2005
Date:
B
Construcion lvpes:
VN, , '
Occupancy Gr.OUDS:
B, . , I
Fire $prinklered? YES
Fees paid for Permit:
Total: 5.669.20
INSPECTION ~ECORD
" . INSPECTO~
INSPECTION DATE
Temporary Power Pole . ,
Plumbing (OralntWastePlpe)
Electrical Ground Electrode/Ufer . ,
SelbacklFormslTrenches (Footings) , .', "
Do noUnstall subfloor or pour floor slab until the ..
following applicable items. have been signed:
Plumbing (Water Pipe.Sprinkler Valves}
Mechanical (GroundwOrk) . ,
Electrical (Underground Conduit)
Pre-slab (CompactiOfl/Membrane.Reinf.
Underpinning (Floor JoistlGirders)
.Do.not cover or conceal the work beww until the . -<
'followmg apphcable ,tems have been signed:.' .
1st Floor Shear . . , . ,
F1resprinkJer(Rough} , ,
2nd Floor Shear "
Roof (SheathiIl!llDiaphragmlFrame)
Masonry (ReinfJBond BeamlPre-Grout) .
Rouah Plumbing (TpJi Out) " , .( ~11 - .
Rough Mechanical r /J( t>I'/1JOS~.r ....1" I ;bH>, l ..I
I Rougn t:IectrlCaI'.... y ..all) .r ~''lL'O) "'-.--c /. i'
Rouah Electrical ' . ~/. (
Framing (Only afte~., Elec.., Mech.. andWe) ~.u.""'5.
.'nsul.lon (SoundlEnergy) . . . . . /
Do not tape or plaster until the 'following applicable' . i.'
items have been signed: . . . . "" _
Drywall . ' , , r..-i.<{.aI "= . w~,.,
Penelr.ions (Fire Rated) Electrical " /
Penetratlons.(F/,re Rated) MeChanical . .
P811elrations (Fire Rated) Plumbing .
Interior Lath " . ,
Exterior Lath . .
GENERAL ITEMS
Exlerior Plaster (Bl'QlNn Coat) .
T .Bar Electrical -. . 7.<;.0'" ~
T.Bar Mechanical ' . 7.,.0) r.
T.BarStructural 7-{' .0 ~ ~vI!..
Sewer / "
Water Engineering Backflow .
Water Service .
,
FINAL INSPECTIONS .
Electrical Final
Plumbing Final.
Mechanical Final
Gas Test
Engineering/Grading Final.765-5126
. Inspector
o
I
Fire Dept. Final 7li5-4040
Water Engineering 765.52li8
Sub.LisilBusiness License 765.519 -7'I'5'{) 13<i'~
Zoning 7li5.5139
Building Final (Last Inspection- Only 7-/2,
. . After. Above Complete). "
PARTIAl INSPECTIONS .
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections