120 S GRAND AVE (10)CITY OF ANAHEIM
BUILDING DIVISION
Permit Number: 61N2022-0008,11 - h • ' -" "' ' " 200 S. ANAHEIM BLVD:'
Issued: 03/16/2023 (714)765.5153
www.anaheim.net/building
(714)765-4626
Quarter Section: 9
Site Address: 120 S GRAND AVE, ANAHEIM, CA 92804
Legat Descriptlon: S TWP 4 RGE 11 SEC 14 SEC 14 T 4 R 11 POR NE1/4 (P
APN:13527138
Project Description: Install (1) illuminated monument sign for "The Lincoln on Grand".
People Associated with Project:
Contractor BRAVO SIGN & DESIGN INC 520 S CENTRAL PARK AVE E200509291604445120 ANAHEIM, CA 92802
Permit Applicant Ted Howard
Owner THE LINCOLN ON GRAND LLC 15320 BARRANCA PKWY 100
OWNER - BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License State Law for the following reasons) indicated below by the
checkmark(s) I have placed next to the applicable Item(s) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to
construct, after, 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 licensure 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 ( ) all or U 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
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 Dursuard to the Contractor's State License Law).
1 am exempt from licensure under the Contractors, State License Law for the followinn 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:
❑ 1 have and will maintain a certificate of consent to selfinsure 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.
bI 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
permit Is issued. My worker's Compensation insurance carder and policy are:
Cartier:
Policy No.: C69964886 Expiration Date: 7
This section need not be completed if the 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 o become subject to the workers compensation provisions of Section 3700 of the
Labor Codb.I shall forthwith comely with th a orotdSion
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL 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 OR THE LABOR CODE. INTEREST. AND ATTORNEYS FEES.
I CONSTRUCTION LENDING AGENCY 11 LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance
Lenders Information:
I hereby certify 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.
Date Signature of Applicant or Agen
The premit 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 issuance. A new permit is required to commence or
continue work.
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing with
Section 7 0) of Div}'aro the Business and
Prof f nsAhdeJ
Date: 10`03/16/2023
Contractor: BRAVO SIGN & DESIGN INC
Number: SGN2022-00086 Expiration Date 7/1/2022
TYPE: A, D42
�� • Fees paid for Permit: $1,169.00
Inspection
City of Anaheim
Date
�,. BUILDING DIVISION -
i
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
120 S GRAND AVE, ANAHEIM, CA 92804
OWNER:
THE LINCOLN ON GRAND LLC
PERMIT #:
SGN2022-00086
DATE ISSUED:
03/16/2023
DESCRIPTION:
Install (1) illuminated monument sign for -The Lincoln
?�)
on Grand*.
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
Code
Date
. Inspector
SET BACK, FORMS,
TRENCHES
602
�/
y �
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.netICitizenAccess
To access your Inspection timeframe, please go to
www.anaheim.net/buildiMalter 7:30 am on the day of
your inspection. Under Online Services, click on the
"Inspection Timeframes" link or call (714) 765-5153 + 0.