807 E. Sycamore St.
TYPE OF PERMIT
Miscellaneous CITY
DATE: 61712005 '
JOB ADDRESS: ,807 E SYCAMORE ST SPRINT CELL SITE
LEGAL DESCRIPTION: ' VINEYARD LOTS LOT B-1 WL Y 100 FT
ElM
BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765, - 4626
CENSUS CODE: 437
QUARTER SECTION: 82
BUILDING PERMIT NO, BLD2004-04031
CONTRACTOR ,INFORMATION:
KS OVERLAND CONTRACTING INC
11401 LAMAR , ,
OVERLAND PARK, KS 662110000
BUSINESS PHONE: 849753-0500
JOB DESCRIPTIONAdd flag pole antenna, bts cabinets, 621f of 6"0' CMU wall (qriginallY issued under 805 E, Sycamore St) ,
VALUATION: 50,000,00 PROCESSED BY: JNJ
APPLICANT: CLARENCE PEARCE
OWNER INFORMATION:
Post # Anaheim
805 E SycaTTjore St
Anaheim, CA 928050000
ARCHITECT/ENGINEER INFORMATION:
ALBERT R TENG ' '
2601 MAIN STREET
IRVINE, CA 92614
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's qcense Law for the fbllow n9 reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to c!=>nstruct, aiter,'<improve,- demolish or repair aoy structure, prior to i~ i~uance. also.
requires the appllcant for such permit to file a signed statement that he is ricensed pursuant to the provisions of the' Contractor's' License Law (Chapter
9)(commencing with Section 7QOO of Division 3 of the Business and ProfesSion~Code) orth~t he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjec~s the applicant to a civil penalty of not more than five- hundred dollars
~OO), \" ,
U I, as owner of property, or my employees with wages as their so.IErcompen~ation, will dothe work, and the structure is notiritend.ed or off.ered for
sate (Sec. 7044 Business and Professions Code: ih~Contractor's License Law does not apply to an owner of property whob~i1ds or improves
thereon, and who does such work hims.elf or,herself or through his or her own employees, 'provide<fthi;l.t such improvements are not intended or
offen3d for sale. If, however, the buHding or,improvemeint is sold with one year 9fcompletion, the owner-builder wiil have the burden of proving that he
~ not bu!ld or improve for the purpose of sale). .' i. ".' '. .
0'1" as tlie owner of the'property,-am exclusively contracting with licensed CQI1tractors to construct the project (Se6. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law). t
G I am exempt under Sec. .' ,-S & P.~C, for'this reason:
Date: Owner:
I ' WORKER'S COMPENSATION DECLARATION
I hereby ~ffirm un'deq:>enalty of perjury on~ of the following declarations:
01 have and will maintain a Gertificate of consent to self-insure for,worker's c,ompensation,
as provided for. by Section 3700 of-the Labor Code, for"the performance ofthe work for which
this permit is issued.. . . :,
~ave and .will main.tain worker's compensation insurance, as. required by Section 3700 of
,th~ Labor Code, for the performance of the ,work. for which this permit is issued.- My worker's
Compensation insurance carrier and policy.are:
Carrier: ZURICH AMERICAN iNSURANCE Policy Number. WC46413S,300
Thissection need not be completed lithe penni! is for one hundred dollars ($100) or less.
o I certify that in the perfonnance of the work for which this permit is issued,'1 shan not
employ any person in any manner so as to become subject to the worker's compensation laws
of CaJifomia, 'and agree that-if I should become blect to the work .s c mpensation
provisions of Section 3700 of the Labor C I an fort with c 'th those provisions.
Daie:617i200S' Applican~ ' U ZBA e.R- "
WARNiNG: FAILURE TO,SECU~EWORKER'S COMPENSATION COVERAGE IS ,
UNLAWFUL, AND SHALL SUBJECT AN EM PLOYER TO CRIM INAL PENALTIES AND Ci ViL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF'COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
,LABOR CODE, INTEREST AND ATTORNEY'S FEES,
CONSTRUCTION LENDING AGENCY
I hereby affirm' under penalty of perjury that there is a construction lending.qgec.-'Jyfor the
performance ofthe work for which this,permit is issued (Sec..3097.Civ.C):
Lender's Information:
LICENSED CONTRACTORS DECLARATION,
I hereby affirm under penalty'of perjury that I am
licensed under provisions of chapter 9 (c encing
with Sectiofl 7000 0 ivsion .3'of the si ss and
Professions C
6f7f200S
Date:
U-'
Contractor
NUMBER
738367
TYPE
,TYPE
EXPIRATION DATE
713112005
A
C10
Construcion Types:
V.N, ,
Fire Sprinklered?
NO
I certify that I have read this application and state thatthe above infqrmation is correct. I
agree to comp"y with all city ordjZ'na , ,s nd statelaw~ r,elating to building construction, and
hereby au .. representives of is 'yto enter upon the above mentioned property for
nspecti R r' sas., '.. '. .
, u. U--- , , Date: 61712005, '
Signature of Applicant or Agent
The permit shall expire by limitation and beco,me null and void if the 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.
Fees paid lor Permit:
Total:
1,394.00
--
INSPECTION RECORD , FINAL INSPECTIONS Date' IrWlector
INSPECTION DATE , INSPECTOR Electrical Final 17.'U. ,6\
Temporary Power Pole " " , Plumbing Final ' . ' "
Plumbing (DlllinlWaste Pipe), A ., ") Mechanical Fi'nal
, Electrical Ground Electrode/Uferl-ill9\ " I\. '"R' 10<"' '"I' ~, -- ' '
SetbacklFormsrrrenches (FootingS) . \;.....' ........ Gas Test , , '
D<l not install sub floor, or pour floor slab u tiTthe Engineering/Grading Final 765-5126 ,
following applicable items have been signed: " ,
.plumbing (Water Pipe.Sprinkler Valves) , , , Fire Dept. Firia\7654040
Mechal)ical (Groundwork) Water Engineering :765-5268
Electrical {Underground Conduit) , ~, , Sub List/Business License 765,-519'
Pre-slab {Compaction/Membrane.Rei m., ~rl--&<
Underpinning (Floor Joist/Girders), , I" ' ~ Zoning 765-5139 " ~
D<l not cover ,or conceal the work belOW ,until the Building' Final ~ast Inspection. Only !f411J.IlYV~
fOllowing applicable items have been signed: ' , , fler Above Complete)
1st Floor Shear " , , ' '. " PARTIAL INSPECTIONS
Firesprh,k1er (Rough) "
2nd Floor Shear , ,Buildina Inspections
Roof (Sheathing/Diaphlllgm'Frame) ,
Masonry (ReinfJBondBeamlPre-Grout) , " ' ,
" .
RClugh Plumbing (Top Out) , ,
Rough Mechanical , ", , , .
Rough ElectrICal (DrY wall) , ' ,
RClugh Electrical ' , '
Framing {Only after Plbg., Elee.', Meqh.. aruj F;re) , , ,,' ,
Insulation (SoundlEnergy)' " , I ' , "
DCl not tape Clr plaster ,until the fClIIClwing applicable MechanicallnSDections
items hav," been sign,"d: ' ','" , , ,
Drywall " " . . " '"
,
Penetrations (Fire Rated) Electrical .' '"
Penetrations (Fin! Rated) Mechanical ,
Penetrations (FIn! Rated) Plumbing " , ,
, ,
InteriClr Lath ' '
Exterior Lath' " Plumbina Inspections
, GENERAL ITEMS , .
Exterior Plaster (BrownCClai) . "
T .Bar Electrical , ' , ,
T-Bar Mechanical', ,
, " '
T .Bar Structural I ,
Sewer , " "
. ' " ' ~Q{~_/
Water Engineering, Backflow ' ElectricallnsDections . .', ,
WliterService ' ' ..I e,,,^- o..~~ U, c:
- ,~
+-0
1"+,'
h'w ,.'
~ Geotechnical Solutions, Inc.
liiiiiI Geotechnical, Structural & Environmental Engineering
CAISSON DRILLING OBSERVATION
FIELD MEMO
Date:
~ I~t I /)5"
Project Number: 5 P - 30 z 8 - 0 '2-
Project Name:
A-NA-ff1n10 p()::,r 3/7 3
( .sf'~/(l/T)
Project Address:
eoS" E. SYc..Apto!<e ST.
A-tJlf-t+67M. C4J q2.- [?o~
,
This is to serve notice that /t..~ ~ ~~ }rv ft.e ...4"Jj,e- Irnf't"J..f-
1...-0 b~ .p~~; ~ #IA'}" r~ C/../d.AMI'V 31 ~
~JfAA"o/' .Lff*t l?' r'".,.-b Sau,,,-<( t-IY\'kr~ ~ >>I~;,..&-
tu r~11'''-' f1/dA<.< (p/~~~ ~*,3/DI{/Orl 5i....:l53).
7J..~ CdISs-ov. ,{LJ (.. ,'l e-k-.- A._ ",f N D,.f..,.j., ~.J(t'" /. ... f&.(
I
~ ~ -i- ~ ~ !;A~/~ d--rJ~/,~'
A written report and certification of this inspection will be submitted upon completion of the
project.
Geotechnical Solutions, Inc.
Remarks:
Signature:
6P~
By: t) SmM fG1::./N, n 1>, f'E. (; e
{ . ,
Title: 'f~{ I./~"A-L (;f:;"OT&..dwJuk bAl6t.
Copies to:
'Phti1'le: (949) 453-0406
27 Mauchly, Suite 210, Irvine, CA 92618
Fax: (949) 453-0409
.......UUgll.. .ua. 1"'-1
39621 Diego Dr
Temecula Ca 92591
PA.g 619979710:2
Fax 909 694 6094
Col 619 379 0735
Bobby MotsinQer
Inspection services
fYPEOF WOflK
~~MUl
SPECro,q
C
o TECHNICAN
AVA!LABLE"; SOIL REPORT {V) IN}
AP?I\OI/EO ~ M N)
fOA WEEK ENDING
ENGINW~ R vce...
CDNT'\ACTOR
(:,.oc
REPORT NO.
PO
SUB.CONTRACTOR
INSPECTION ADDRESS
. REPORTING REQUIREMENTS: ICBO FIELD INSPECTJON MANUAUMTGL SOIL,. MANUAL REvIEW PREVIOUS REPORTS AND LISTS
IF THERE IS NON-CONFORMING WORK AT THE END OF THE WORK DAY. OR MISSING MTRS, AND RAS. ETC" ALL OUT AND ATTACH A DEFICIENCY REP0RT
WHEN A DEFTCIE""CY, YOURS OR A PREVIOUS INSPECTOR'S, IS CORRECTED, SO NOTE ON THE OR1OJNAL DEFICIENCY REPORT AND
SUBMIT A COpy W!TH YOUR WEE.K'S REPORTS,
MATERIALS USfQ BY CO(;Ji P
ERlAl TESTRE?OflTS)'
fM'L
CONTRACTORS EOUIPMENT I MANPOWER USED;
AREA. GRlO LINES, PIECES OflSERYEC
AI> ~o;..)
fZ-rM.
(2d~
5-3
STRUCTURAl NOTES, DtTAIL, OR RflS USEO:
5-~
.
REWO~NT OF All WORK TODAY'
WEA"f}-\E
TEMPERATWlE: 70
PERCENT PROJECT COMPLETION'
SAMPLESTAKEN;~
TESTS REOUlRED~
ThiS is 10 certify that th
Department of General
SITE TIME FINISH:
SlTE TIME START:
LUNCH PERIOD:
TRAVEL TIME:
VERlflEO BY:
reported inspections were made In accordance with the approved plans and specifications and the rules and regulations of the
!y 01 perjury that I know the contents of lhese reports and that all of the above statements are 1rue,
(IZ)IOS-
Oa{e of Report
::i()d'3c( tr
ICaO CertifICation Numhef
.s , j) ~ 72. ~
Ciry I County Certification Number
R..v' 7107