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1620 W KATELLA AVE (4)p�— I, City of Anaheim BUILDING DIVISION INSPECTION RECORD SIGN PERMIT ADDRESS: 1620 W KATELLA AVE OWNER: Inspector PERMIT #: SGN2020-00011 DATE ISSUED: 1/24/2020 DESCRIPTION: Install (1) illuminated wall sign for "Planet Fitness". 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 CONDUIT 604 MASONRY:, REINFORCEMENT, BOND BEAM, 606 PRE -GROUT FINAL 699 MISCELLANEOUS INSPECTIONS Inspectors can normally be reached between 7:30 - 8:00 A.M. and 3:30 - 4:30 P.M. (714) 765-5153 + 0 signoard INSPECTION REQUIREMENTS Contractor shall verify with the City Inspector prior to final inspection if a representative is required to be on the site to expose any concealed wiring for final inspection. INSPECTION REQUESTS Inspection requests made before 5:00 pm will be scheduled on the following workday. To schedule your building inspection online, please go to http://www.anaheim.neVinspectionReguest. You may also request your inspection by calling (714) 765-4626 and continue with the following steps: • Press 1 for inspection function. • Press 1 to schedule inspection. • Press 6 for Sign inspection. • Enter your permit # 202000011. • Enter the Code number for the inspection requested (indicated in blue.) • Press 1 for next business day, or enter date preferred. • Select time preference (Request is subject to inspector's schedule.) • At the end of your request you will receive a confirmation number. To access your inspection timeframe, please go to www.anaheim.net/building 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. SIGN PERMIT NO. SGN2020-00011 TYPE OF PERMIT CITY Attached to Structure Sign DATE: 1/24/2020 JOB ADDRESS: LEGAL DESCRIPTION: 1620 W KATELLA AVE PERMIT APPLICANT: FREDY MARTINEZ OWNER INFORMATION: JOB DESCRIPTION: VALUATION: CONTRACTOR INFORMATION: SIGN CONCEPTS 18281 GOTHARD ST #107 HUNTINGTON BEACH, 92648 0000 CA Install (1) illuminated wall sign for "Planet Fitness". BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 E I M INSPECTION REQUEST LINE: (714) 765 - 4626 QUARTER SECTION: 58 OWNER -BUILDER DECLARATION ARCHITECT/ENGINEER INFORMATION: PROCESSED BY: EGA 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 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 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 and Professions Code: The Contractor's 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 Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law). ❑ 1 am exempt under Sec. B & P.C. for this reason: Date: Owner: 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 ❑ I have and will maintain a certificate of consent to self -insure for worker's compensation, 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, performance of the work for which this permit is issued. My worker's Compensation insurance carrier and po icy are: Carrier: TRAVELERS PROPERTY CASUALTY CO ' Policy Number. UB8L595334 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 it any manner so as to become subject to the worker's compensation laws of California, and agree that 91 should become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: 1/24/2020 WARNING: FAILURE TO SECURE)NORKER'S COMPENSATION COVENCt;`E IS UNLAWFUL, AND! 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 ATTORNEY'S FEES. I CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of pequry that there is a construction lending agency for the performance of the work for which this permit is issued (Sec.3097.Civ.C): Lender's 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: 1/24/2020 Signature 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. under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 1/24/2020 Contractor: NUMBER: EXPIRATION DATE: BUS2010-02558 912812020 TYPE: C45 TYPE: BUS Quanity: Electric Sign (WN): Fees paid forPermit: Total: 420.75