2632 W. Stonybrook
BUILDING PERMIT NO. BLD2004-01383
ElM
BUILDING DIVISION'
200S. ANAHEIM BLVD.
. (714) 766 - 5153
INSPECTION REQUESTLlNE:
(714) 765 - 4626
CENSUS cODE: 434
QUARTER SECTION: 21
TYPE OF PERMIT
. BIOckwall/ Columns CITY
DATE: 4/26/2004
JOB ADDRESS:. 2632 W STONYBROOK DR
LEGALQESCRIPTION: N TR 2874 LOT 7
APPLICANT: ALFREDO MENDES'
OWNER INFORMATION: . CONTRACTOR INFORMi\TION: ARCHITECT/ENGINEER INFORMATION:
ALFREDO'M Robles
2632 iN Stonybrook Dr
. Anaheirn,CA 92804
JOB DESCRIPTION:lnstaIl40)f block wall 4" 6' high with 1 6' high pilaster to city specs.
VALUATION: 1,160.00 ,PROCESSED BY: CAL
I OWNER-BUILDER DECLARATION I
I hereby affirm under penalty of perjury that I am exempt from theC6~~ractQlj's License law for the.follo~ing reason (Sec. 7031.5 Business and
P"rofessions: COde,: any dty or countywhich,requires a p~rmit to construct, a:!Ci, improve, demolish or.repairanystructure. prior tolts issuance, also
requires the applican~for such permit to file a'signed ~tatement that he is IiC~I1Sed pursuant to the P"?visions of the COl'Jtrad?r'~ license Law (Chapter'
9)(comrnencing with Section 7000 of Division 3 of the Business and Professbns Code) or that he _is exempt therefrom and the basis for the alleged
.exemption. Any violation of Section-7031.5,.by any applica!1t for a permit sut-jdcts. the a p'plicant to a,dvil penalty of not more than five hundred dollars
$50 . c' . '.. . .' .
'1"as6wn~r of property, or my employees with wages as their sole corilr1ensation, will.do the',work, and t~e struQture is not intendedor offered for
a ,,(sec. '7044l;3usiness and Professions Code~ The Contra.ctor~s Licens.e Law dO'es not apply to an ownet of property who- builds' or improves
eon, and who does suph work himse,lf or helSelf_or through his orher ov~.'"!'employees, provided that such impro....ements are not'intended'or
offered for sale.,. If, however, the 'building or improvement is sold wjth one year of rompletion, the owner~builder will have ,the burden of. proving that he
did not bUild'or improve for 'the purpose of sale). . .' ,
o I, :as the owner of the property,' am exdusiveJy contracting with-licenseJ c..ontractors -to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's license LaWd'oes not apply--to an 'owner of property who bunds or improves thereon, and who' rontracts for sudl 'projects with
~ootractor(s~licensed pursuant to the Contractor's ,Li~nse Law). . . -
W I am exempt under Sec." , B & P C. f . eason:
Date: . Owner:. - 1
WORKER'S 0 PENSA: ON DECLARATION
I-hereby' affirm under penalty of perjury oneofthe following declarations:-'
D. I have and will maintain,a certl.ficate of ro~sent to self-insure forworktirs compensation,
. as provided for by sed ion '3~OO of the' Labor Code, for the Performance ofth'e work for-which'
this ,permit is issiJed; . ...., .' "
. d I have an9 Will maintain worker's c'ompensation insurance, as ~quired t;{ Section 3700. of
the labor"Code, for the performance ofthe work for whichthis' permit is issu-~d. My w9rker.'s
Compensation insurance ca'rrier and policy are:
Carrier:' 'Policy Number.
. LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty,of'perjurythat I am.
. licensed under provisions of chapter ~ (co.mmenc_ing.
with Section 70(0) of Divsion 3 oflhe Business and
"PIO"fessions Code:
4/26/2004
. Date:
Contractqr
NUMBER
EXPIRATION DATE
his secti , ~ot be.Cf?Rlpl~tedifthe pe.nnit i~ for one hundred doU~rs ($10q or,le5:s.
, certify that _in theperfonnanceof the work for which this permit is issued, '-shaU not
m y.any person in any manner so'as~to, become subject to theworkers'CtlrYlpensation laws
. 0 California, and agree that if I should become subject to theworker's comp_m$-ation
provisions of Section 3700 of the labor_ Code, I Shall Oth com'ply with U-ose provisions.
. ' .., ~ '
. TYPE
Date: 4/26/2Q04 Applicant:
WARNING: FAILURE TO SECU ORK. ENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUB ECT AN EMPLOYERTO CRIMINAL PEfJAi.T.I.ES AND CIVIL
FINES UP TO.ONE HUNDRED THOUSAND DOLLARS ($10Q,QOO); IN AorXfJ:ON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO~, 370$ OFTHE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. : t.
CONSTRUCTION LENDING AGENCY'
I hereby affirm:under 'penalty, of perjury that there -is a const(uction lending ag:ancy~or the
performance of the work for whim this permit is issued (Sec.3OS7.Civ.C): ....:..
LenOers lniorm<'ltlon: .-. .
Construcion Types:
VN" .
I certify ~hat I have read this application and state that the above _in-fo"rmation is Gorrect. I
agree to cOmply with all city ordinances and state laws relating to building cOllStruction, and
hereby authorize representives of this' dty ,to e_nter upon the a bove mentioned property for
inspection purposes.' - Wi' " .
v' ... c. . \ (!,-/J- Date: 4126/2004
/\ · .... .... s1gnawW'~r ntor Agent
The permit shall expire by limitation and become null and void if the building or
work has riot passed final inspection 365 days from the date of permit issuance. A
'. new permit is required to commence or continue work.
Fees.paid ~or Permit:
Total:'
0.50'
. INSPECTION RECORD
. '. " INSPECn"N: . . , . DATE INSPEC.TOR
Temporary Power Pole' . .
Plumbing (DralntWaste Pipe) '.' . , .
EledrlcalGround Electrod.elUfer .
Selbackll'ormsrrrenches (Footings) .,
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe,Spririkler Valves) , .'
Mechanical (~rOOndwOrk) '.' .
Eledrical (Underground Conduit)
Pre-slab (C.ompactionlMembrane.Reinf, .
Underpinning (FIQi:)r Joist/Girders) '. . .... ,
Do !lO1 coYer or conceal the work below. . until the
f.ollowing applicable items have been signed: .
.1stFloor.Shear .
FiresprinkJer (ROugh) , '.. .
. 2nd F'por Shear '. . ,
ROof (Sheathing/Diaphragm/Frame) .
Masonry (ReinfJBondBeanlPre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical ". '. , . .
Rough BectrlCaI (Dry Wall) . . .'
Rough Eledrical . . . .
Framing {Only after Plbg.: EJec.. Mech.'. and Fire) ,
Insulation (SOIlndlEnergy) ." ,
Do noHape or plaster until the following applicable
itemshavebeen,signed: ,:_' . ."'_. . .,' .
Drywall .. .'.' .....
Penetrations,(Fire Rated) EleCtrical ".
Penetrations (Fire Rated) .Mechanical
Penetrations (Fire Rated) Plumbi"g . "
InteriOr Lath . . ". ". . .
Exterior. Lath . .
GENERAL ITEMS .
Exterior Plaster (Bl'O'Nn Coal) ,.' . .'.
T-Bar Eledrlcal :' .
.T-Bar Mechanical . . . , '
T -Bar Structural '" '
Sewer .' . ".' . ',' .
'Water Engineering Backflow . . . .
Water Service . ., .' . , .'. .
FINAL INSPECTIONS. ..Dat!! . . Inspector . .
Electrical Final . . I '. . .
Plumbing Final I " .." .
MechanicalFinal I . .'
. .
Gas Test 1 , .
.
EnQineering/Gradin\l Final 765-5126 . .'
. Fire Dept. Final 7654040 I . .
. - '. ~
, ~aterEngineering 765-526,8 . . .
Sub List/Business License1765-519 .
. .
. Zoning 765-5139 I . .
'. ., . .
. c. _I . . "
Building Final . ~aSllnspection- Only. .
. fter Above Complelel
. . PARTIAL INSPECTIONS . '.
'. Buildina Inspections -
:', . .
I
1
I
I
, Mechanicai InSDectiJ~s'
!
1
I
I,
Plumbina InsDection~
. I
1
I
I
Electricallnspection~
I
I
I
PERMIT. EXPIRED
INSPECTION'
NOT GOMPLETED
'DATE:~ 0<-('
-
~
t
si,
-------
D IivGk- \ O-f d
0'1"-
~a,{\'\~
\ cM->-n ,) "'i
Kt,O(V\
-=
~"'~ OV\fV
Jv\ \J ""^"O (Luo YV\
r
c1v63::V
~tnt O",J
w.
i\i~ 'f/~Yf!l~i~~~~~i:~1~~
i"ROCEEDS AT HIS OWN RISK.
APR 2 6 2004
BUILDING DIVISION OF ANAHEIM
APPROX'J1~ D
yf, l-f'J"Wbtf-{J1 3~ BY ( j' If:O.--
rro Cf-;' 5~
KoYV\
~~
~,I'
a
1:2/
'I..
\
\
~
1;
~
!xifll'ro 0 ""
f0; fP rV\, ,
,','\
;.l!
~
~
':s
1':11
'1,
.. . ,
;
Pc Iv$J:,- (; . -> 6j/ ~r~ ,
O~ba Lf(~/6Y U\
c:l
-.-L
,
\2s la.co'
cS?S ; t2-\
PLANNHIG DEPARTMENT
,POVED
o
.'."'J,~,\6~
l\niti..l~l
sy
i
\' FI-OOD ZONE
HIS~/A ~e~~T,:~o~t~i~.~~:~:
Cire C\\C -Q\\ <';.bove line
UILDING PERMIT FOR
ANY COi'!DI,:C"~,i3..J
Ot-~ VI V\;~ lo\oL ~
VJ6\\\ 0'\-;::;' -5h~ .