8180 E. Somerset Ln.
BUILDING PERMIT NO. BLD2005.00207
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 565
QUARTER SECTION: 220
CONTRACTOR INFORMATION:
. MASTERPIECE POOLS & SPAS. INC
22343 E LA PALMA AVE #104
YORBA LINDA, CA 92887 0000
BUSINESS PHONE: 714602,1132
JOB DESCRIPTION: Install 17' linear teet ot 5' toot high stucco blockwail .
VALUATION: 750.00 PROCESSED BY: . SAM
I OWNER.BUILDER'DECLARATION I
I hereby affirm under p~naJty of perjury that I.am exemptfrom the Contractc.:'~- License Law for the following reason (Sec.. 7031.5 Business and .
Professions Code: any dty or county which requires a permit to construct, altdr, .improve, demolish or repair any structure, prior to its issuallce, also .
requires the-"applicant for such permit to file '8 signed statement that he is lic€'rl.sed pursuant to the provisions of the Contractor's License Law_(Chapter
9)(commencing with Se.ction 7000 of Division 3 of the Business and P~ofe$s:.::i,s Code) o'rthat he is exempt therefrom and the basis fur the alfeged
exemption. 'Any violat'ionof Section 7031.5 by any applicant for a permit SUbj:1t::ts. the applicant to a civil penalty of not more then five hundred. dollars
($500). . .'.i' . .' '.
o I, as owner of property. or_my employees with wages as their: sole com~r;sation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Profes.sians Code: The Contractor's License L~w does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her oWr:,,!~mployees, provided that such-improvements are not iriteOded or
offered for sale. If, however, the building or improvement is sold with one ye",+of-cor:r:pletion, the owner-builder wui have the burden of proving that he
did not build or improve for the purpose o1.sale). '
o I, as the owner of the property, a'm exdUSively contracting with licel".sed:~ntractors toconstructthe project (See. 7044 Business and Professions
Code: The Contractor's liCense Law does not apply to an ow~er of propertyifrho bJJiids or improves thereon, and who rontracts for sud1' projects with
~ontract..or(s) licensed pursuant to iheContractor's' License Layv). \
U I am exempt under Sec. , B & P.C.'for this reason: I
Date: Owner: ." i
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty'.of perjury one of the following declarations: I .
o I have ,and will ma lnfain a certificate of consent to self-insure for worker's compensation,
. as' proVided for by Sed ion 3700 of the Labor Code, for the performance of th~work tor wJ:lid1
~'thiS ermit is issued. .- . ','
~, 'ave and Will maintain worker's compensation insurance, as required b>:Section 3700 of
the' Labor Code, for the performance of the work for which this permit is iSS.lj~~;t Myworker's
. Compensation jn~lfrance carrier and policy are:' .
Carrier: STATE COMPENSATION FUND Policy Number. 1663216:1.003
This section need not be completed if the'pennit is for one, hundred dollars {$1 r:,ci dr less.
o J certify that 'in the, performance of the work for which this permit is is.';IJ~:~i,__:1 shall not
employ any person in any manner so as to become subject to the worker's, Qi~llIpensation laws
of Califomia, and agree that if I should beco e subject to the wo r's compi:hcation
p~ovisions of Sec~ion 3700 of the Labor Cod hc:1I1 forthwith 0 ~~se provisi?ns.
Date: 1/24/2005 Applicant: ?I 7.~
WARNING: FAILURE TO SECUREW KER'SCOMPENSATION COVERAGE IS .
UNLAWFUL, l\ND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FiNES UP Tb'ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADD!l10N 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 ~ereby a!firm under pe~_a ~y QfJ~_elj!JI:.'iJh:~tJ~.~~~.-is~,?, fo.0~U:l_I,c:'!jo.l"!_lerld ir.0~~;;j:1cy-fnUhq___._
performance of the work for whid1 this permit is issued' (5ee.3097 .Cjv .C): ' _
Lender's lnformation:.
. TYPE OF PERMIT
Blockwall/ Columns
DATE: 1/24/2005
JOB ADDRESS: 8180 E SOMERSET LN
LEGAL DESCRIPTION: N TR 13458 LOT 14
APPLICANT: DANIELLE FARRIS
QWNER INFORMATION:
Ramon eollel!
.8180 E Somerset Ln
Anaheim, CA 92.808
ARCHITECT/ENGINEER INFORMATION:
I certify,that I have,read this application and state that the above information is correct. I
agree to romply with all city ordinances and state laws relating to buUding construction, and
hereby aut .- e representiv this city to enter upon the above mentioned prQperty for
i nspe ion pu
Date: 1/24/2005
Signature pf Applicant or Agent
permit shall expire by limitation and become null and void if the building or
ark has not passed final Inspection 365 days from the date of permit issuance. A
new permit is required. to Commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of pet jury that I am
licensed under'provisions of chapt r-9 (conimencb;g
wfthSectio '}ofDivsiona, tl.~, sinessan
Professions'Cod "
1/24/2005
Date: Contractor
NUMBER
804110
TYPE
. EXPIRATION DATE
2/28/2006
C53
Construcion Types:
VN} ,
Fees paid for Permit:
Total:
125.79
INSPECTION RECORD
INSPECTION . PATE INSPECTOR
Temporary Power Pole . . '-C---c. .
Plumbing (DrainNVaste Pipe) .
Eledrical Ground Electrod!!lUfer
SelbacklFormslTrenches (Footings) Z..;(j'6 '"'/-'&.""
00 not install subfloor or pour floor slab until the 1
following applicable items have. been signed: '.'
Plumbing (Water Pipe.Sprinkler Valves) -c-
Mechanical (Grou ndwork) ".
Eledrical (Underground Conduit)
Pre.-,;Iab (Compaction/Membrane.Reinf.
Underpinning (Floor Joist/Girders) .
00 not cover or conceal the work below until tne
.following applicabll! items have been signeo:'
1st Floor Shear '.
Firesprinlder (Rough). .
2nd Floor Shear . .
Roof ISheathing/Diaphragm'Fi ./} )
Masonry (ReinfJBond Beam/Pre-Grouft 2- '(7 .6) e')r
Rough .Plumbing(Top Out}'- /
Rough Mechanical ' ..'
Rough BectrlC all} .
Rough Electrical .
Framing '(O~lyafter Plbg" Elec.. Mech.. and Fire) . .
Insulation (SoundlEnergy)
Do not tape or plaster. until the following applicable
items have been signed: . .
DryWall .
Penetrations (FiAl Rated) Electrical . .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing .
Interior Lath
Exterior Lath
, . GENERAL ITEMS
exterior Plaster (Brown Coal) .
T -Bar Electrical . .
T -Bar Mechanical
. T .Bar Structural
Sewer . '
Water Engineering Backflow
Water Service'
FINAL INSPECTIONS Date . Inspector'
Electrical Final
Plumbing Final
Mechanical Final .
Gas Test . .
.
Engineering/Grading Final 765-S126
Fire Dep!. Final 765-4040 "
Water Engineering 765-5268.,
Sub List/Business Llcense765-519 .
Zoning765-5139 .' . /~
Building Final ~ast Inspection. Only ~,''l^ Or ~L..Jo
. fter Above Complete)
/
PARTIAL INSPECTIONS
Buildinq Inspections
~:. ,.~...^;
Mechanical Inspections
. Plumbinq Inspections
Electrical Inspections