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1199 N EUCLID ST (6)Permit Number: SONM240112 Issued: 09/12/2022 www.anaheim.neUbuilding (714)765-4626 Quarter Section: 44 Site Address:=1199 N.EUCLID ST D, ANAHEIM, CA 92801 Le al Descrijitlon P 113; K"369 FG 16 PAR 1 APN:.07214075 CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (7141765-5153 Project Description: Installation of (1) illuminated wall sign for" Poke & Tea Factory". People Associated with Project: Permit Applicant Lavender Fung Owner V E M STAR LLC 1199 N EUCLID ST OWNER - BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following reason(s) indicated below by the cheekmark(s) I have placed next to the applicable Item(s) (See. 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 the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she Is exempt from Ileensure 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). 0 I, as owner of property, or my employees with wages as their sole compensation, will do (__) all or"portions of the work, and the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal efforts, builds or Improves the property, provided that the Improvements are not Intended or offered for sale. If, however, the building or 0 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' State License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractoes State License Law). 1 am exempt from licensure under the Contractors, State License Law for the following reason: Date Signature of Property Owner or Authorized Agent WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for worker's compensation, Issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. `� I have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this it is issued. My worker's Compensation Insurance carder and policy are: Cerner. STATE COMPENSATION INSURANCE FUND Policy No.:01 85132 Expiration Date: This section need not be completed If the permit is for one hundred dollars ($100) or less. ❑ I car* that in the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become subject to the worker's compensation laws of California, and agree that, If I should become sub to the workers compensation provisions of Section 3700 of the Labor.Code. I shall forthwith comDty with those provision; _ _ Date (1 ' ` v Signature of Applica,, jr WARNING: FAILURE TO SECURE WORKERS' COMPEN ION C VE GE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($ 00 0). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE. INTEREST. AND ATTORNEY'S FEES. I CONSTRUCTION LENDING AGENCY 11 LICENSED CONTRACTORS DECLARATION I I hereby affirm under penalty of perjury that there Is a construction lending agency for the performance Lender's Information: I hereby certHy that i have read this application and state that the information above Is correct. I agree to comply with all city ordinances and state laws relating building construction, and hereby authorize representives of this city to enter upon the above mentioned property for Inspection purposes. The premit shall expire by limitation and become null nd vild If the building or work has not passed final Inspection 365 days from the date of permit IssuadbeA new permit is required to commence or continue work. 1 hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professions Code. Date: 09/12/2022 Contractor. SIGNS EXPRESS MANUFACTURI Number: SGN2022-00112 Expiration Date 11/11/2022 TYPE: C45 Fees paid for Permit: $586.00 City of Anaheim BUILDING DIVISION Inspection INSPECTION RECORD Date SIGN PERMIT ADDRESS: 1199 N EUCLID ST D, ANAHEIM, CA 92801 OWNER: V E M STAR LLC PERMITM SGN2022-00112 DATE ISSUED: 09/12/2022 DESCRIPTION: Installation of (1) illuminated wall sign for' Poke & Tea Factory'. POST THIS CARD WITH THE APPROVED PLANS IN A CONSPICUOUS PLACE ON THE JOB SITE Inspection Code Date Inspector SET BACK, FORMS, TRENCHES 602 UNDERGROUND 604 CONDUIT MASONRY: REINFORCEMENT, 606 PRE -GROUT FINAL 699 PARTIAL APPROVAL NOTES INSPECTION DATE INSPECTOR Inspectors can normally be reached between 7:30.8:00 A.M. (714) 765-5153 + 0 signcard INSPECTION REQUIREMENTS A representative is required to be on the site to expose any concealed wiring for final inspection. INSPECTION REQUESTS Inspection requests made prior to 5:00 pm Monday - Friday will be scheduled on the following workday. To schedule your building inspection online, please go to https://aca.anaheim.net/CitizenAccess To access your Inspection timeframe, please go to www.anaheim.net/buildincl after 7:30 am on the day of your inspection. Under Online Services, click on the "Inspection Timeframes" link or call (714) 765-5153 + 0.