5675 E LA PALMA AVE (8)POST THIS CARD WITH THE APPROVED PLANS
IN A CONSPICUOUS PLACE
ON THE JOB SITE
Inspection
City of Anaheim
40
BUILDING DIVISION
SET BACK, FORMS,
INSPECTION RECORD
SIGN PERMIT
ADDRESS:
5675 E LA PALMA AVE 198, ANAHEIM, CA 92807
OWNER:
BAYPORT IMPERIAL PROMENADE ASSOC
PERMITM
SGN2022-00078
DATE ISSUED:
06/2212022
DESCRIPTION:
Installation of (2) Illuminated wall signs for • Asurlon'.
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 I DATE I '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:Haca.anaheim.neVCitizenAccess
To access your inspection timeframe, please go to
www.anaheim.net/buildinq 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.
Permit Number: SGN2022-00078
Issued: 06/22/2022
www.anaheim.net/building
(714)765-4626
Quarter Section: 184
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
Site Address: 5675 E LA PALMA AVE 198, ANAHEIM, CA 92807
Legal Description: P BK 84 PG 5 PAR 2 PM.84-5 PAR 2 - EXCEPT POR. IN
APN:34628106
Project Description: Installation of (2) illuminated wall signs for" Asurion".
People Associated with Project:
Contractor CS SIGNS LLC 4 TERRASTAR LANE201910291625208010 LADERA RANCH, CA 92694
Permit Applicant ADRIAN CASTANEDA
Owner BAYPORT IMPERIAL'PROMENADE ASSOC 3090 PULLMAN ST
OWNER - BUILDER DECLARATION
I hereby affirm under penally 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).
13 I, as owner of property, or my employees with wages as their sole compensation, will do U 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 properly 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 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 oursuent to the Contractor's State License Law).
I 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
permit Is Issued. My worker's Compensation Insurance carder and policy are:
Carrier. OAK RIVER INSURANCE COMPANY Policy 5 5 xpiration Date: 5/21
This section need not be completed if the permit Is for hu oilers ( 00) or less.
❑ I certify that In the performance of the wo r w ' is pe it Issued, I shall not employ any person In any manner so as to become subject to the
workers compensation laws of California, a gr that if I s ecome subject to the worker's compensation provisions of Section 3700 of the
Labor CodeA shall f6rthwith comply wi rovision
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.
I . CONSTRUCTION LENDING AGENCY LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that t*construcUon envy 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 applicatin ove is correct. I agree Professions Code.
to comply with all city ordinances and state lan, and hereby authorize
representives of this city to enter upon the abinspection purposes. Date: 06122/2022
Contractor. CS SIGNS LLC
0 Number: SGN2022-00078 Expiration Date 5/2/2023
Date Signature of Applicant or Agen TYPE: C45, C10
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.
Fees paid for Permit: $689.00