2065 E KATELLA AVEPermit Number: SGN2022.00036
Issued: 03/24/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 117
Site Address: 2065 E KATELLA AVE, ANAHEIM, CA 92806
-'Legal Description: P BK 301 PG 15 PAR 7
APN:'25353118
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Installation of (3) illuminated wall signs read "Dave's Hot Chicken"
People Associated with Project:
Contractor SRD SIGNAGE 10601G TEIRRASANTA BLVD #258 SAN DIEGO, CA 92124
Permit Applicant Miriam Guzman
Owner ANAHEIMCA 2035-2085 EK LLC 23 VISTA LN
OWNER - BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reason(s) 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, 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 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
13 1, 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 oursuant to the Contractor's 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 self4nsure 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.
❑ 1 have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this
permit is issued. My workers Compensation insurance carrier and policy are:
Carrier: Policy No.: Expiration Date:
This section need not be completed If the permit is for one hundred dollars ($100) or less.
6XI 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 IA?VldJbecome subject to the workers compensation provisions of Section 3700 of the
Labor
with those
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 ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance I hereby affirm under penalty of perjury that I am
Lenders Information: licensed under provisions of chapter 9 (commencing with
Section 7000) of Division 3 of the Business and
I hereby certify that i have read this application and state that the Information above is correct. I agree Professions Code.
to comply with all city ordinances and state laws relating building construction, and hereby authorize
representives of this city to enter upon the ned property for inspection purposes. Date: 03/24/2022
q Contractor:
Number: SGN2022-00036 Expiration Date
Date Signat f Applicant or Agen TYPE: C45
The premit shall expire by limitation and bd6ome 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.
Fees paid for Permit: $788.00
City of Anaheim
BUILDING DIVISION
INSPECTION RECORD
DESCRIPTION: Installation of (3) illuminated wall signs read'Dave's
Hot Chicken'
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE .
Inspection
SIGN PERMIT
ADDRESS:
2065 E KATELLA AVE, ANAHEIM, CA 92806
OWNER:
ANAHEIMCA 2035-2085 EK LLC
PERMIT #:
SGN2022-00036
DATEISSUED:
03/24/2022
DESCRIPTION: Installation of (3) illuminated wall signs read'Dave's
Hot Chicken'
POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE .
Inspection
Code
Date
Inspector
SET BACK, FORMS,
602
TRENCHES
UNDERGROUND
604
CONDUIT
MASONRY:
REINFORCEMENT,
606
PRE -GROUT
FINAL
699
y1�22
C/ee- �4e &-i.�%4z Cie--- e,
PARTIAL APPROVAL NOTES
INSPECTION DATE INSPECTOR
Inspectors can normally be reached between
7:30 - 8:00 A.M.
(714) 765-5153 + 0
signeard
L/ Cq
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/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.