2660 Stockton Ave.
DATE: 5/26/2004
JOB ADDRESS: 2660 W STOCKTON AVE
LEGAL DESCRIPTION: N TR 2303 LOT 39
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BUILDING DIVISION
200 S.ANA)jW~D.
(714) 760- 0153
INSPECTION REQUEST LINE:
(714)765-4626'
. CENSUS CODE: 434
QUARTER SECTION: 19 f(
BUILDING PERM I; NO. .J;lLD2004-02102
, "--' .
, TYPE Of PERMIT CITY
Patio .Cover '
APPLICANT:',
OWNER INFORMATIOI\i:
Paul R Clark
. 2660 W stockton Ave
Anaheim, CA92801 ,
JOB DESCRfP~f10NPatio Cover: Remove 'Unpermitted patio ~n'd install new 69gsfpatio per engineered plans. .(HIH)
VALUATION: 12,000.00' . J PROCESSED BY: JJJ
I. .. ' '. OWNER-BUILDEF!pECLARATION' .',. " .
I hereby affirm under penalty of perjury that lam exempt from the Contract~r~s, ljc~nse Law for the fOllowing reason (Sec. 703.1~5 -Business and
Profession::; Code: any dty orcountywhi/?h re.quires a 'permit to construd, ~-'t.\-'-improve. demolish.or repair any struqtur~, prior to'its issua~ce"also
requires the applicant for such permit to file a signed statement that he islj,<::,":l')sed pursuant to the provisions of the Contractor's .Licens~ Law(Chapter
9)(commencing with Section 7000 of Division 3,of the. Business and Profess,.:~:n3 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 slJ~'.;eGts the appl!cant to. a civil penaltyofnot-more than five hundred dolla~s
($500).' . . . . ' ,', j . . '.
IJO.. ,I, asown~r of pro perty"or my empJ:cyees with wages as their sol~ comp;;lisatibn,_ will do the work, and_ the structurei~ not intended or ~ffered for.
'sa~ ($ec',,7044 Busine~s and P'rofessions Code: The Contractor's License r..~\tl does-not a.pply,toanownerof property who builds or-imp~o\ies .
thereon, and'who does sudi work. hi mself _or herself or through his or her 0.'1>;': employees, provided that such iropmvementsate not intended on
offered fo~ sale. .If"howevs-r, the bUilding or improvement is sold witl1 olie Y-6:,;;- af tompl:etion, the owner-builc:lerwill have;the burden of proving'that he
did not build or improve for the purpose of sale) ; , ' , ; <. . ",: ~
. 0-'1. a5 the owner of tl)e property, am e~dusiv~ly contracting with licensod ~:1:tractors to construct the project (See. 7041 Business ~nd Professions
Cod,e:The Contractor's License_ Law does not apply to an 'owner of properry~"ho builds 0" improves therebT1; and Who. r.:ontrads far sum projects with
" Ma~i'~'dcr(s) licensed pur.~~ant to the'Contra~ 5 u~~se La'N).... , '
~~ 2l!:lJ..t mp underSec,' . . :
Date: J /".2-' 0 r ' . Owner:
WORKER'SCOM ENS. TION DECLARATION __L
I her~by affirm- under penalty of perjury one of the follOwing declaratior.3:
[J I have, and-wili-,maintain. a certificate of -_oonsent to. self-insure for WOl'ke-rj~-COr.1pensation,
as providedf6r by Sectio.n '3700 of the Labor,Code, for the performance ofti;,~ work for which'
this. perrnit is issued. . .
,0 I have and will maintain'worker's G:<?mpensatlon insurance, asreqvi~:""; !J:~' S9ct!cn 370'0 of
the Labor 90d e: fa r the performanceof tr,e wark fo..r whi~h th is permit IS iS3lif. it. My wo rker's
Conipen~tion' insuranCe carrier an-d pOlicy are: ".
Carrier: ' Policy Numb~r.
I
CONTRACTOR INFORMI'.T1QN:
ARCHITECT/ENGINEER INFORMATION:
I
. LICENSED CONTRACTORS DECLARATION I.
1 her~by'affirm und~rpenalty of perjury that. 1 am'
licensed ur.der'pr?vis,km-s qr chapter 9 (cammencing
with Section 7000) of Divsi6:n-3 ofthe BUsiness -and
Professions Code. ' . .
5/26/2004 .
Date:
. Contractor
NUMBER
EXPIRATioN DATE
. . .
This section need not be :cOmpleted if the p'ermit is for one hundred d~lIars ,($1 CO;.y less.
01 certify thatinth~ performance oTthe wark far which this permit is fS$'':~~, I shail nOt ,
employ any perso.hin any manner sa'as to become subject to the warkei's,~ctJ:'l-pensation laws
of Califo.mia, and"ag~e'e that if I should becomesu . ct to. the worker's COrnPf.':"tsaticn
'provisions of Sectian 3700afthe Labor C e.l forthwith. comply' i ,th:.s~ pravisio"ns,
TYPE
Date: 5J2~/2004 . . Applicant:
WARNING: FAILURE TO SECURE E S COMPENSATION COVER.,GE IS . .
UNLAWFUL, AND SHALL SUBJECTANEMPLOYER TO CRIMINALPI;NA! TII;S AND CIVIL
FINES UpTO ONE'HUNDRED lHOUSAND DOLLARS ($100,000), INADDnlQNTOTHE
. COST OF COMPENSATION,DAMAGES ASPROVIDED FOR INSECTIOt, 3'f06.0F THE
LABORCODE, INTEREST AND ATTORNEY'S FEES. .' . . ::<' .
I : CONSTRUCTION LENDING AGENCY_ " .
t h,el'ehy _affjrrn,_~:"'d_::!!: ,op.na!ty oaf perj~ry t!1at the!"e 'is'aco:1~tr~-=~idr:' fepd!-i~ ""'(_~'f>cy-f-d_?tn~~___"':,_.
penormance of the wark tor whidl this permit is i~Slled (S.e6:'3097.Civ.C): ....
Lender's Infarmation:
Construcian Types:
VN"
Fire $prinklered?
Patio.Area:
NO
692
,\",.'
:"
tcertifyJhat I ,have read this application and state that the abave infarmation'i.'i'carrect. I
agree,ta oomply-_ ith.all city ordinances and state I~ws relating.ta buAding car:str,uction, and
I"!ereby uthar:" .r p~sentives of this dty to enter u'pon the above mentianed prC?perty for
inspecli ur se.' - '/;/7. - /_" "
: . . .' . ~ , Date: 5/2612004
. Signature af Applicant or Agent
The permi sh<!ll.expire by limitation a,nd become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new per~tis 'required to commence Or conti~ue work. .
Fees paid for Pe.rmit: ,
Total:
1.20
INSPECTION RECORD
,..~....~
. INSP.ECTION. '. . DATE INSPECTOR
Temporary Power. Pole' . .
'. Plumbing (DrainlWastePipe)
ElectdcalGroun.dElectl'C)de/Ufer / /I /J~I .//.
.. SelbacklFornislTrenches (Footin ]YIL'\ I\';"""~ ';';UO
Do not install Sutlfloor or. pour floor sla until the ..
followingapplicableit~ms have been signed: .. . '.
Plumtling (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork)' . '.
Electrical (Underground Conduit)
. Pre-slatl (CompactionfMemtlrane.Reinf.
, Underpinning (Floor Joist/Girders)'
Do not.cover or conceal the work below until the
. following applicable items have bei'in'signed: .'
1 st Floor Shear
Firesprinkler (Rough) . .'.
2nd Floor Shear '.. , . ~
. Rpof (Sheathing/Diaphragm/Frame) fA (,,/0:> .
Masonry (ReinfJBond BeamlPr9'Grout) J
Rough Plumbing (Top Out)
Rough Mechanical
R9"9h ElectrIcal. \ U<)" ""all)' .' .
. Rough Electrical . . . ~
Framing (Only:after P'lbg.. Elec.: Mech.. and Fire) .
Insulation (Sound/Energy)' .
Do not tape or plaster. u.ntil the following applicable
items have been ,signed:.' . .
Drywall '. .... . . . '.'
Penetrations (Fire Rated) Electrical I
Penetrations (Fire Rated) Mechanical
penetrations (Fire Rated) Plumbing
Intenor Lath '.
. Extenor Lath '. .
.'GENERAl ITEMS
Exterior Plaster (Brown Coat) . .
T ,Bar Electncal '. . . .
.
T-Bar Mechanical .. . . .'
T -Bar Structural .' '.
Sewer .
Water' EngineenngBackflow . .
Water Service . . . . .
FINAL INSPECTIONS' : Date '.Inspector
Electrical Final . ~ .. . ~~~.
. '. . .....
Plumbing Final
Mechanical Final .
.' . . .'. .
Gas Test .' .
.'. ..
Engineerin9lGrading .Final 765-5126 ... . .
Fire D"pt. Final.765-4040 . . . .'
, '., ".
Water Engineering 765-52.68 .
Sub List/Business lic"nsl!765-519 . .
'.'
Zoning 765~5139 . .' .
.
Building Fina" ll:ast Inspection. Only'. . dv.iitS r ;- ,.
. .... fter Abov.. Complete)
PARTIAL INSPECTIONS . (.,;~. .
Buildina hisP9ctions '. '.' . .' '. . ~ l~
M~~ S.~.~ 1rr-\l."a,.l1"~'
t.Jb"'~~,.r~~., .... .
MechanicallnSDections. .
Plumbina Inspections
ElectricallnsDections