419 E. Sycamore St.
-,
f:lUlt:DING PERMiT NO. BlD2004-021\13
.~
J'
lYPE OF PERMIT "
Tenant.ltnprovement (Limited)
f '.l':;>~
CITY &~-A1N:AHE'M
. t\,~,.';}:-i<7;;;",'f:9:/. ...
,.; (,\ '.
BUILDING DIVISJoN
200...S.AN:".HEIM BLVD,
(714r{65"~'~'it>3
INSPECTION,REQIjEST-LINE:
(714) 765 - 4626
CENSUS CODE: 43)
QUARTERSE=:CTION: 82
, "'-
DATE: 812612004
Jo"B ADDRESS: 419 E SYCAMORE ST
LEGAL DESCRIPTION: VINEYARD LOTS LOT B-2 SLY 113 FT
APPliCANT: Al CO!'>NELlO
. OWNER INFORMATION: CONTRACrOR INFORMt.'?"iON:
JERRICK U CORNE'L10
16307 ALPINE PL.
LA MIRADA, eA 90638 I
JOBDESCRIPTiONJenant Improvement. New laundry room at ex!sting~partm:..mt3.
ARCHITECTIENGINEER INFORMATION:
VALUATION: 6,000.00 PROCESSED8Y: EM"
r-'~ OWNER-fiu:LD~R:rH~ClA.Rr-\TiON ---=--==
I herebYi2lffi,m under penalty of perjury inat ! am eY.'3f'nptfrom H'le Cllnt[;:;d:.:;;(';~ Lj>:::er..:;e LAW for the following reC'lson (Sec. 70315 Busjness and
Profesz!ons Code: any city oi,countywhich requiras'a perr:nit to CCmSif;.i:;,:t, '<:;l~_~';, hnprc.....e, demoli::::h or repair Ci!lY structure. pl'ior tv its issuan-ce,_ also
requires the applicant for such perm.it to: file a slgru'3d stDtemerottllat he is Jice:~se.:! pUlSUc::int to the provi$io!"is of the Contrador'sUcense ,Caw (Chapter
9)(comrnencing wIth Section 7000 of Divis'on 3 of the' 8us;ne'3s Q;)oj Profes::>i7'7s Code) or that he is exe(npt therefrom end lj--le basis for the alleged
exempticr:. Ar:y violation cf Section 70315. by anYZ:P()Jjcant (or 3 ;;erm;~st.:(3;(::Cts the ~pplic?nt. to a dvil pena!fy o'f not rtt.'Jre than five.hll~dred do!le:rs .
~)'. . . "'. " .
.~" 'a$ O"l,'ti..~r Of property, 01 my ernployee$ w;trl, ..'.....o?ges ::;;,So' tl-,ei< ::;o,e ccrr'J:'\~,,~sa:iop, wm do the work, and tha stnJcture is not intended or off.;:r~d f('lf"
581:3: (See: 7044 Business and Professions Code: The Conm:::c:or's UGf'i'1S8 V.J,\f! do-':'3 l:'\')'l apply to an owner of property Wh0'buildB or improve5
. ihereon, cH,d who doe~, soJch wo:-k hims'eif or herself or thru\Jgh his or her f)WH~:e:llPloYc.O.s,P(cvided that 'sue;) improvem<:mt~ are not l!1tended cr
offf:,"ed (or sale. ~f. hQ:....:evei, the building,'or impro\'ernenti,,; ~ol;j with one 1~Ji or-Cu;T1oletion, tha owner.blJi!der will have the burden of prcNiog th~t he
oj:i rout build or 'Improve fOf tn€; purpose of s:3le}. ,_ ,
o i, as the CiWner of the property, ~m eXdllSi~e(y c.ontl<:l'c!lng w;ih nC2nse.11~.n~r;:!ctors tc constn..:ct the project (S~c. 7;)44 Business and- pjofe~ior;s
Code: ThE: Ccnti3ctor'.S License Lawciu~s 1101 applY to, 3n oVme of prop;n~'j'1.ho b' . or improves thereon" ~nd who c:w.tracts for such project.<:.: with
"<
(a..~ontf[Jc::or{$) h-::ensed pursuort to ttla- Contractc,'s Lir. <:.:'~ ,~ Ie
~ exempt ,<no"r1;ec. ___ ,B .C. f ,
!Date_ ~~..R.;:2-t-6~~;':,ic;;;-E'NSf: O~ (;f.ClARAT;O~~~,-~{~=_=:__j I LICENSED CONTRACTORS OECLARATI~
I hereby. affirm under pflnaity of,perjury on~~ of th.. aHowing j~d;)rGtl!nn-3: ;:,:' r : hereby affi~rn ,'_mC::e~ pen.:Jlty d pp.rlur; that I am
[J ! h2ve- aT~d ,,vi';l ~~aji!tain a cer.ific.Gte of Q:!nsent to self-insure fcr'~:ork's/:!.G:~:;ppens2ticlr1, I licensed ur,de~ prol,;s:onsof chapter ,9 (commenci.'1g
." 'f !- ..... . ~70A "h I' C-' f th rf J" 'I ~ . <4' ~. h wHh Seytion 7000) of Djvsio~'3 oithe cusiness ",;0
Q:,<; pr;)Vh...~cl. ,<)r uy :-:;eC\K..>n.;:. .. 0, ,I e .8::Jor \..>\.;f.!, or ,e pe' o.-r;;d;)C-€ o! \':.r"'f~)J"J':. .onVrllC:
, . I Professions C,)(j~. .
this penn:! i$ :sSU0'd. . " , .' .
r:-l lha....e '3!nd 'Nii!rnainta;n worker's G.(impen'S~tior;!llsvrar:~e, a~ re{:liirod b'~Ser.tion 37CO ':JF I 8/2t}/2004 _____________.
f~Labor Code, for n~epe_rforl[lanceof the work f0rWniG,h.l':1is purnit" is i:>'''l)~. ,'r~1y'..vnrker'$ I Date:
Cc,mp.ensation instll":;:zn(;e .;arooir ~nd policy af€:: " j , I
Cafri~r;' '. Pulley N:Jmbe~:, i. I, NUMBER.
This section net-xl hot be completed if ths permit is fer one hundred d6r,~:; :ttQi.J:~ i<!S~. TYPE
11 I c6ftrfy that In {he penonnance cfthe:-.Vvork fer which thIS per.T,.t IS i'S'il:e\j , Sh.,::l not I
emPloy any pe:-son In any manner so as to b;:;come SUb;AC~ ~c the WCikc"s e,;r;}. ., atlOI1 :j.ws
of Califor11!a, and agree: that if I shculd c::;:come subject to t'"Jewoii.;:er's CvrT,n~ f>Z1 (.If: r---
prov:siorJs of ScsctlO'l 3700 of the Labor Code- I '" l. . 'I' Wit:l rt -' ~rn'lisior.s. I Construcion Tvpes.
,. IV 1HR, ,
Date:._ -3i26.'2004 Applicant: _ _ _ _ OCClJpaoey Gro.uo~:
WAR~J1NG: FAILURE TO SECUREWO R'" COMPENSATION COVER;\GEIS -, .R'i, , 1 "
ONLA'NFUL, AND SHALL SUBJECt AN. -MPL YER TO CR.iM!N..~tl FE~~j.,\.I)ES ANDCIV!L Fire, $pr;nklered?
F!NES l...'..PTO ONE~HUNDREDTHOUSAND DOLlA, RS ($1(lO,OOP).",..IN f.\r11._~'i,f!0.N,;TO.THE '-I' New! Add!tionai Area:
COST OF COMPENSATION, DAMAGES AS PROVIDED FO~ IN$EC1"O~":F(l6i.QF THE. .
,LA~CJ";GODE, INTEREST AND ATTORNEY:S .,:EES. . _~:",.?:/ ~__'-I . .
L . ' .' . '. . . CONSTRUCTION l ENDING AGENCY, ]:__~.' _.;00':"'-:.. I
I htreb~',.anirfTI ,LJ~d.~! .pe,nalty cf. perj~ry tha~ ~h:r~ is,~ constriJct:on!~,t:dlri.,g~(~J~~~.Y fo,:,t~ 1
Pi-'nCrIT13nce of me'vvod.; for whIm thiS pe(:'TI;t IS Issued {S€c.-3097.C:,-,.C): -
..:....L8!..::1e0~~0n:n;.:;.!.L0n;~.~ _ .'~ ____.....:-:.,_ . . i
Contr3ctor
EXPiRATION. DATE
NO
B8
i I.::ertffy that I have read this appHcation a.nd state th e above irlfcr:-r!~tior.] is correct t
. .agre,e"to oomply with aU city-ordinances and stat ,aws ~lating to b"ll~dh'\g cOi"!struction, and
hereby authorize r city to ter on tho<:! above Mentioned property for
in;Xion se
. Date: 8/26i2004
Fees paid for Permit:
Tolal:
688,07
nature of Applicant or Agent
The per < sha expire by limitation and become ~ull and void if the building or
work has not passed final inspeCtion 365 days from the date of perrilit issuance. A
new permit is required to commence or continue work.
. . ~
.' '. INSPECTION RECO.RD . . FINAL INSPECTIONS, . Date ~l Inspector
<<. . . DATE. I. Electrical F.inal ?- 2JS- os- ~-.::r7
. INSPECTION INSPECTOR I'
. . .""
Temporary Power Pole . Plumbing Final '1-U'", . "" Ii' -:..~
~ . "-
Plumbing (DrainlWaste Pipe) h',H'r c--.T/ ,\ . .' 7-2,"t o. ~~ ~ ".
Mechanical Final . ''!V_
Electrical GroundElectrodelUfer . ,.
SelbacklFormsfTrenchll51l'Ootings) ) "3"0' ~U\ 0(.,. Gas Te~t/~,;". t""...J . ......J..J 'jfi ~.~)-:o ~~o/'-
Do not install sUbfl""r or pour 1I00r slab until the ,/ Engineerit;grGrading Final 765-5126. . ,
following 'applicable item~lle"nlSign€d: .
Plumbing (Water Plpe.S . ) ,-" oar .\ Fire Dept. Final 765c4040 . .~ J/l
Mechanical (Groundwork) '. .' . /. Water Engineering 76!;,5268 '. . 1ft
Eledri~al (Underground Conduit) ..... . .
Sub List/Business License 71;5.519 7-I9./:i. /lI'>i7'l
Pre-slab (Compaction/Membrane.Rein!. ~'$''''' . c-rGc..:...
. Underpinning (Roor JoistIGirderJl) / Zoning 765-5139 . . Ii 1:t:I
Do.not coverpr conceal the wort< below .Until the Building FiI,,,I' ~.st Inspection. Only . "7'l.2. <:j ,.. .'ff..('
following app.hcable Items have been signed: . . fter Above Complete) , <:-:>I
1 st FlOOr Shear . pARTIAL INSPECTIONS' . ..' ,.
FireSprinkler (Rough) '. . .
2nd Floor Shear . ral~a Il1s!}:ctions . . p .'. .\ L~~
RQof (Sheathing/Diaphragm/Frane) . . . . r': tk-- {<;r~ ~iJ;J.
Masonry (Reil1fJBond BeamlPre-GIO\II) . ' . . .
Rough Plumbing (Top Out) f, "".,..j . . '.
Rough M&Chal)ical . . . , . ; (") . . . .
. Rougn E1ectricallDrY Wall) .1' . .
Rough Elecirical ,.-, . . .' .
. Framing." (OnlyafierPlbg.. Elec.. MeCh.. andflte) , .---' . .
Insulation (SoundlEnergy) . . rv .
00 not lape or plaster until the follow;n p ficabie Mechanical Inspections
items have been signed:. . .' . "
Drywall .' . . ..,., .. vfSI ,
Pei1elrati~ (Fire Rated) Electrical " '.
. .
Penetrations (Fire Rated/Mechanical . . .
Penetrations (Fire Rated)Pltimbil1!l . '. . .
Interior Lath . '.. ( ./ . '.
Exterior Lath . . ',Co-s. \~I..~""" . PIUmb~QlnSzections . ,",.' ....... ..
GENERAL ITEMS '. . : '+os~. 1'.... ::tT'P:"J._tJJ~ t1J---
Exterior Plaster (Brown Coat) . f~.1 (v....i s/j I~J-n; -f,,-<cJtMr ~ .
T ,Bar Electrical
T -Bar Mechanical .. . . + ' ' +') fL:.5:;. . " v
I C""",r_ 11''''> . oV c---.". '
T -Bar Structural , . . . J ~ dJ..lA_ -)-/2<.<>, .1.- j' t{,.,(. ftuitvC .
Sewer '.
Water Engineering Backflow . . . Ele~tricallnSDectlO".s 7 )~67:.-:-
Water Service