527 N. Sabina St.
,CONTRACTOR INFORMATION:
BELFOR USA GROUP INC ;
440 WCROWTHER AVE
PLACENTIA, CA 928700000,.
BUSINESS PHONE: 714854-;12:30
JOB DESCRIPTIONFire damage repair, I
VALUATION: 20,000,00 [.
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the ,Contractor's jJcense ~~w for.t~e following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a.permit to construct, a:t~r.-!mprove.'demolish or repair any structure, prior to its issuance. also
requires the applicant for such permit to file a signed statement that he is Ijcen~:ed 'pursuar.t to the proVisions of the Contractor's License Law (Chapter"
9)(commencing with Section 7000 of Divi.sion 3 of the Business and Professiop:;; COdel or that he is exempt therefrom and the basis for the alleged
exemption.. Any violation of Section 703.1.5 by any applicant for a permit subjd-.:ls the appEcant to a civil penalty of not more than five hundred dollars
($500), ' , , i' ,
D I, as owner of property, or my employees with wages as their sote compejlSatlon, 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 buiids ciimproves .
thereon,. and who does such work himself or helSelfor through his or her own~mployees. provided that such improvements are not intended o"r
offered for sale:. If,' however, the building or imprcvement is:sold with oneye9t~"'f completion, the O\."ner-builder will have the burden of proving that he
'didnotbuildor-improveforthepurposeofsale)... . r . ' _
o 'I, as the owner of the property, am exdusively contracting with Iicensedli:lntractorsto construct the project (See. 7044 Business and Professiol1s
Code: ,The.Contractor's Licen"se Law does not apply to an_owner of property.j-}l1o'bUilds or improves thereon" and who contracts for"such projects with,
~on.trador(s) licensed" pursuant to the Contractor's UcenseLaw).. r ...
U I am exempt under Sec. __ ,B & P.C. for this reason: __L. ' '
Date: Owner: ", L .
I 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
o I have and will maintain a certificate of consent to self-insure for worker\coll1pensation, licensed Linder provisions of chapter 9 (c.ommencing
as provi;ied for by Section 3700' of the labor Code, for the performance of thfl'; v;:ork forwhidl with Section 7000) of Oi n 3 of the Business and
this permit is issued.- Professions Code. -..:::-
~ave and will maintain worker's compensation insurance, as required b!' Section 3700 of 3/31/2005 / ----- ~
'- the Labor Code,Jor the .performance of the'work for which this permit is iSS_U€S. Myworker's Date,: Contractor
Compensation insurance carner and policy are: ' . I
Carrier: AMER!CAN HOME ASSUR. Policy Number. WG715:3V20.
This section need not be completed ifthepennit is for one hundred dollars ($10tlj or less.
o _ 1_ certify that in the perfonnance of the work for which this per,mit is iSSll~1d. I shall not
employ any person in.any manner so as to become subject to the worker's C'jmpensation laws
of California, and agree that if I should become subj ct to the worker's comp~nsation
provisions of Section 3700 of the labor Code,,1 sh fort~ C~I~I wit~roV,isions.
Daie:3/31/2005 Applicant:
WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVEFc,GE IS
, UNLAWFUL, AND SHALL SUBJECT AN EMPLOy'ER TO CRIMINAL PENA!,TIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDIT!ON TO THE
COST OF COMPENSATION: DAMAGES As PROVIDED FOR IN SECTIO"J3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,
I' CONSTRUCTION LENDING AGENCY _
. .1 h:::-:"::~~y.a:t:1(~,~ '.lr:der i::';'1..:dtj;" 'of p.~";~ry~~'*t.t~lsre.is--a~iJc!:c'~ l~:-':::'"!:':~ ":-:;~n:::If:j,f'4i=-:c:;:~ ~1::"'1;'-'-"
BUILDING PERMIT NO. BLD2005-00865
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TYPE OF PERMIT'
Repair
CITY
DATE: 3/31/2005
JOB ADDRESS: ' 527 N SABINA ST 2
LEGAL DESCRIPTION: VINEYARD LOTS LOT B-2 ELY 142,22 FT
APPLICANT: ALLISON PRIDY,
'OWNER INFORMATION:
Mu H Sung
3502 BelleRiver Dr
Hacienda Heights, CA 91745
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUESTL!NE:
(714) 765- 4626
CENSUS,CODE: 434
QUARTER SECTION: 82
9-?-
ARCHITECT/ENGINEER INFORMATION:'
PROCESSED BY: DUC
NUMBER
810553
TYPE
TYPE
Construcion Types:
VN, ,
-Fire Sprinklered?
performance of the work for which this permitisissued'(See.3097 .eiV.C):
Lender's Information:
I certify that i have read this application and state that the above information is correct. I
agre~ to -romp! with all city ordinances and state laws relating to building construction, and
. hereby author. e representives of this city to enter upon the abov~ mentioned property for
inspection p ses.
~
---....
Oate: 3/31/2005
Signature of Applicant or Agent
The permit shall expireby limitation and become null and void ifthe building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
I
B
HIC
EXPIRATION DATE
7/31/~005.
NO
Fees paid for Perm!t:
Total:
995,64
INSPECTION RECORD
I
.
DATE
INSPECTOR
INSPECTION
Temparafy.PawerPale
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodelUfer
SetbacklF9I"msfTrench8$ (Footings)
Do nat install subfloor .or paur floor slab until the
following applicable ilems have been signed: .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Canduit) .
Pre-slab (Campaction/Membrane.Rei nt.
Underpinning (!'Ioor Jaist/Girders) .
Do nat cover .or conceal the work below until too
.following applicableitems.have been signed:.
.
.
....a...:::.::;..
1stFlaarShear . -2'1-"? 't/'.;;p:-..,
Firesprinkler' (Rough) I /
2nd Flaar Shear ~-L
Roof (SheathinglDiaphragrnlFrame) . ~2'1'<i5 - r /'/-17 .
Masanry(ReinfJBand Be3lllIPre-Grout) I /.
Raugh Plumbing (Tap Out) f;;- n,,~ ~
Raug~~' :ll~~"""'~ t:;..t;j,.~
ROI.Ig~wall)
Raugh Electrlcat (j- 2/7-bt
Ffaming (Only after Rlbg., Elec.. Mech.. and Fir'!!: "~7.ll Mr.:
Insul;Jllan (SoundlEnergy) "k l?>ll ?ff. ~.
pa nat.tape a. r plaster until the fallawing appJicabll!' 1 .j
Items have been signed: - . - l..
Drywall. .'. IIt.(Jr~I'
Penetratians (Fire Rated) Electrical .
Penetratians (Fire Rated) Mechanical ,I. j(~ ", X f -r Vl-vt
Penetratians (Fi", Rated) Plumbing' /
Interlar Lath .
ExteriarLath .
I . .GENERAL ITE
Exterior Plaster (BraNn Coat)
.T-Bar Electrical .'
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflaw .
Water Service
/>/'1
s; ~. ,/
:\\.-L ~'il'/
\V 'iJf'" .
FINAL INSPECTIONS ..Date. Inspector .,'
Ele~trical Final '1 I 'fl) 2.
Plumbing Final . '(ltlS ,'-
Mechanical Final '1 ,10:>- .
.
Gas Test . .,
EngineeringlGrading. Final 765-5126 .
Fire Dep!. Final 765-4040 .
Water Engineering 765-5268 '. . .' .
Sub List/Busil1ess License 765-519 t.)~ ACV5.
Zaning 765-5139 .
Building Final ~ast Inspection- Only 1/ ,J-oS --
Iter Above Complele) ,
PARTIAL INSPECTIONS
Buildina InsDections
C:><ZDYje
.~14
MechanicallnsDections
Plumbinq InsDections
I
ElectricallnsDections