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1616 S DISNEYLAND DR (203)SIGN PERMIT NO. SGN2015-00156 TYPE OF PERMIT New Attached to Structure Sign DATE: 11/19/2015 JOB ADDRESS: 1616 S DISNEYLAND DR 504 R LEGAL DESCRIPTION: O'�ANEI AN�4HEIM 1 ETAIL �QeNDEo `ee BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 QUARTER SECTION: 76 PERMIT APPLICANT: STEVE FLENTJE OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: JOB DESCRIPTION: DCA - Paradise Pier - Cover Bar, Marquee & Ops Signage. VALUATION: 18,000.00 PROCESSED BY: CMN I hereby affirm under penalty of perjury that I am exempt from the Contractors 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 Contractors License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Profession: Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, 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 d rofessions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, 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). I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions Code: The Contractors i e Law does not apply to an owner of property who builds or improves thereon, and who co cis for such projects with a contractor(s) licensed pursuant to the Contractors License Law). El am exempt under Sec. B & P.C. for this reason: Date: Owner:10� -:;u WORKER'S COMPENSATION DECLARATION LICENSED CONTRACTORS DECLARATION . I hereby affirm under penalty of perjury one of the following declarations: I hereby affirm under penalty of perjury that I am licensed ❑ 1 have and will maintain a certificate of consent to self -insure for workers compensation, as provided for under provisions of chapter 9 (commencing with Section.7000) by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. of Divsion 3 of the Business and Professions Code. I have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, or the performance of the work for which this permit is issued. My workers Compensation insurance carrier and policy are: Carrier: Policy Number: This section need not be completed if t he permit is for one hundred dollars ($100) or less. ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers compensation laws of California, and agree that if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 11/19/2015 Applicant: WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND E SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATIoN, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEYS FEES. I CONSTRUCTION LENDING AGENCY 1 I 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): Lenders 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 for inspection purposes. Date: 11/19/2015 SigwAurd of Applicant or Agent The permit shall expire by limitation and become null and void if the building or work has not passed final inspectoin 365 days from the date of permit issunace. A new permit is required to commence or continue work. Date: 11/19/2015 NUMBER: TYPE: Contractor: EXPIRATION DATE: Quanity: 1 Electric f-TCCRMI`tXPIRED INSPECTION NOT COMPLETED DATE: t l lot 2©16 Fees paid for Permit: Total: 504.60 gyp. ii/��/�6 r 'r i,t" :S� 'Y gyp. ii/��/�6 r