1713 E. Sycamore St.
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TYPE OF PERMIT
Residential Addition'
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CIT---r ~~i~.l:fN~)-I EI M
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BUILDING PIVISION
200 S. ANAHE!M BLVD.
(714) 765 - 51.53
INSPECTION REQUEST LINE:
(714) 765- 4626
CENSUS COPE: 434
QUARTER SECTION: 102
BUIl.DING PERMIT NO. !!l.D2003-02515
DATE: 8f712003
JOB ADDRESS: 1713 E SYCAMQRE ST
LEGAL DESCRIPTION: ANAHEIM EXT LOT 3 S175 i-T E 240FT
APPLICANT: RUBEN L PENA ,
OWNER INFORMATION: CONTRACTOR INFORMifrION:'
)
~o se _Ayon ~
1713 E Sycamore SI , .
Anaheim. CA 92805 . . ,. '. .'
JOB DESCRIPTIONAdd 1190~f living and 245sf garage to existing ~FD ciso r~PJf1c? windows same for same and add.stuccq to rerr.ainderofhorilo,
I .
VALUATION: 86,041.00 . J. PROCESSED BY: ODC
!. OWNER-BU1LOERbECLARAT10N .
1 hereby affirm underrienalty ofperjurf that I am exemptfrorn.the-(;Qntracto~i3_Uc;.nse-Law for t~e fdl-iOV'Jng rcason (Se'~~:7031.5:Bll~!.r.~t.s'and.
.Prof~sslons_9ode: any citY or-county which requires a permrt lQ_COD~truCI,-5:I}r.__imPlcive. d ernolish or r-=pa ir ,~ir:y.:'ltr~d,ur_e, prior to ItS.:',iS&~ar1Ce,~iso:..
r~c;ujres.the'applicant for 8ucr,-permit to file a signeQ $tetem~.ryt~r~Ht he_is liC!'41se<1 p'u~$.uant.to toe pr0vi~io'iS cf the.C()n~:I:actp_r'sU_~~n~~.Lavy{Chapter
9){commencing "with Section 70UO of Division 3 of tl1e Business;Ji:d prOf(;$:5j:jO~ Code) ~r that, he is f;:Xi;:rr.::lt .tharefrom ~l1dtl:1ebasisfofthe alleged .
~;;n~~~i.on. Ar,y violatk)n ~f Section .7031.5 by any_ap'j)lic.a:~t !:)~-.6._:.per~~'it ..~!.iC~:GtSU.:e._.~~~~;c~;nt to::l civ:l _~cnalty cf n~t'II1~.~.e_~Cl:_~fi:{_e,.?lIndred dona~~:: .
~, as owner 01 proper:y, or my employees with wages as their SdB c.om8~"s~tio~. will doir,e worK; afld 'JlOsto't;c\ure;3 "~t ifltend~d .Of oneced for
sale (See. 7044 8usiness~nd ProfessJofls CO;:le: The CCl1tractor'$l~c';f)~e.;l":'''.i.d.oe~,!"'!ot:aprlyt~ an o'imercfprO;Jsrty If/ho buiids or :mproves
~her~ori, and whodOcssl.!cr. 'Nark himself Of herself or throughh!$ Of ,her o':~ff.'~Jnr:-10yeeS; pn::"/ld::-d ~;y~t such imj:.rovev-.cnf::> ar~<no~;~tendE::d .or.. .
offcre.a for sale, .if., however, thf; buHding or improvement ~s soid,..."ah C'le Y.:~i(,cf co:1,n;:-.let1on, tb-am....ne.i-bllild<:::r Will ha'..'e, the burden eJproving that iie
.didnct.bui:dor;mproveforth-s>puJ"'"t-'oseofsale).. , . t. .:. - . : . . .,., ". . ..
[] (as the owner Qf !he property, :Jm cXCJLlsNely contracting \vith ,iic€:n;;.&(;F).)'~!la'};'Qr:'::'.b :;'l)('_s!ruc\ '..he pfoje~::t (Sec. ."/0-14 8usjn~$s'?nd. Profe~bns
Code: TheCont~actor's liu-nse L<:::w does not ~DPly to a-n Qvmer or ~rOik!;~':: l;~;o. ~:"-I;i:h:, or Ilr.;.:-rC'..e:; i..il~rzcn, .an,:i ~"h'J' cor.trar.ls fOr.Situ" proj~cts with
~ontractor{s) licensc;d pur~w~i)t to theConttzc~pr's.License.'L::fw).' . . or; '-,.::-... .. "... .' .... . ,.' - .
..L.J:_jam&xe~PtLlnderSeG. _~;__ ..'~P.C'~ff11J~i,e~~or.:_.>~_,~ ,.,'....,.~. . '.' .' ,_... ________
f-gato:R-O".1,;,(/)'<,Ownor: ::1::.-,- "ft;.....c.X~=4~kr.4.A~=--,>..._--------:::. "
~ .' WORKSR'S COMPENSATION DECLARf<Tim!.,.....l_._'-~~ L!..!Cf~O~TRACTORS DECLARATiO"N j
I h.;rebyaffirmunder penalty of perjucy one of th~fo!lcwing dEl;;iar3~:'.)",~~: .,~:__.,.. i. IliBrecy "afu;1 u~der iJen~lty at perjul y thet.,lHrn
LJ i.have and will ma!ntaip a cE'lrt!fjca{e of-collsentto SEl!i.i.nsu:'"efo; 'l::)rkC<..i'.r:':'m~.anS1:)tiO:1' I n~enst'd ~nt!er (Jrovi:io~s ~f r;. ~~~pter 9 (co~lr:nericin.g.
as prcviCled for by ~ectiar: 3-100 l')f the Labor Cede-, forrhe :::';~;:f0JiTlen.ce. ot t,;,: i.',fr:.r'r< rc.- v~h:r.h I Wl:~ 8ect!on 700D) c-r D;w~..)r...'( c..;fthe Busme:...-s and
. this permit is is&ued... .. .. _:_.' .. . _ft.~:.,' . ...- - II 'Professions COO~.
_D .1 ha.ve and.will rr18in~ain worker's. COIY1pc~ssticn in~l';(~;:"!GP.'-<3.~ I€ctii~d (ts~~ti~n~100 of 3/7/2003 ...
the Laber Code, f-0r the performance oi ,h'::l.wor~ fur whichfhis pelnl!tl-:; :~:..:~'t-: Myworkc:~'s Date: Contr<:'lctor
Compensation insure.flre ca.-rier and polit:.y are: . ,. .., '.. ,\~ . I
GarriH: '. .. '. .POI.lcyNul1loel: t . -J NLJt\.13EF< EXPIRAT!ON OAT!;
~sctiQn need not be COMpleted if the pemllt is f~r on~ hundred cioi!ars ~$'ji}~;~:- !(55. . I TYPE
~~ I certi~that in the perfom13.pce. of.the WO(;-; for ..VhiC.h.ttll$- p.ennit ii"-I'.:.Sti";:,)..:J.t.a.,undt .' I.
empJoy.'any persoll In allY manner so as ~o b:-:come1:>ubject. to th.o'vV9rk?:'s t+::~p~:lsat:r.m 1~IWS
of .California; and agree that if I should become subjept to the wbrl-i.er'~'.~oirT.:1~<~jl#9,n_,
. prO~'isio.n. s olsec. tio" 3700 oflhe Laborfo<le, ; she!! t.-jl"'.:C ceemrr.. 'PPi'yY....;i"i!!;,,\r(3~i.~.riS.:.',.r.,::._s.:,..:..:.( ~~~~tr~GiOn TYDP.S.:
Date: 8/7/2003 . Applicant: J~_~_;jf.j\\::-I.."-:. ^-_.-",~". OCClliJanCyGroups:
WARNING: FAILURE TO SEcLiR~RKER'S GOMPENSATlON C6'!E"N.~~;ls,''''''.C R3, U1., " .
UNLAWFUL; AND SHALL SUBJECT.A1'J EMPLOYER-TO CRIMlN_J>.L .PENAi:f:1$;;6J~9.(;iV!L Fire Sodnkiflred?
FiNES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,OOO\,iN''''Dr.~tiQN'TO THE Dweilina Unit.:
COST OF COMPENSATION, DAMAGES AS PROVIDED FORI'! SECTiQt.';$il",OFTHE Livlnq Area:
LABOR CODE, INTEREST AND ATTORNEY'S FEES . .:' ,,', "..:" :Gaca~e Area
II hereby affirm under pena~yOo~:~r~~Ct~~~~e~;~~I~:':r~~~~~n~;~;J ~~~~~;J~;t~~9
';P~~(~o(maf1ce oft~e work for whlGh t~IS permlt,Islssuea (~er;.3097.,CIV.C): "1",., ,.~ .'-,. "\, I
. ..:t..?.n~~r'2Inf9\m;:~.t!on: ,_ -. _";:..,-,--'--".:1-=--~.. _'-- .--c,-.::.i.-__::'...~_~.~.'._._.~..:::;o
ARCHITECT/ENGINEER INFORMATION:'
NO
1
'1,190
245
. I certify that I have read this application and state that the above infofJTlation :s correct. I
. agree to ,oomply with all city ordinances and state laws rela~ing to building construction, and
hereby authorize represeQtjves of this city to enter upo'n the above mentionec property for.
. jnsPj:;:pose~ ' .
+' ... . . fA- '" ~ Date: 817/2003
. ' .' Signature of Applicant or Agent . ..
The permit shall expire by limitation and become 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 for Permit:
Total: .
1.992.72
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,
urnbing Final
echanlcal Final
as Test .
nglneeringlGradlrig Final 765-5126
re Dept. Final 765-4040
ater Engineering 765-5268
ub List/Business License 765-519
oning 765'5139 .
Uilding Fi~~1 (Last Inspection- Only"
. After Above Complete)
PARTIAlINSPECTI S
uildinQ InspeC~ions . . .... '. ...LJ....' '
~, ~4r1-~'-~~c:r~~~
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~ -<,' .,
1
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FINAL INSPECTIONS
ectrical Final
INSPECTION RECORD
, INSPECTION . , " ' .'DATE INSPECTOR El
Temporary Power Pole . . PI
Plumbing (Drain/Waste Pipe) . - ' ' M
Electricat Ground Electrode/Ufer ' . ':--J('~
SetbaeklFormsrri"enches (Footings) 71Z-'Zlr? "<..iL :7 G
Do not install subfloor or pour floor slab until the E
following applicable items have been signed: . "
Plumbing (Water Pipe.Sprlnkler Valves : Fi
Mechanical (Groundwork) ", .' '.
W
Electrical (Underground Conduit) .
Pre-s"'b (Compaction/Membrane.Reinf. . S
Underpinning (Roar Joist/Girders) I Z
Do not cover or conceal the work below until the ~, B
following applicable items have been signed: .
1st Floor Shear' " .' . , . ICln ,,;7,
Firesprinkler, (Rough) . .
2nd Floor Shear .. " ~, . B
Roof (SheathIIig!DiaphragrnlFnm&) IOJrt01 P
Masonry (RainfJBond BeanlPre-Grout) ", c:-- .
Rough Plumbing (Top Out) .' , \ IIf1Jn Y'
Rough ,Mechanical , \~\;..,- '1-"
, Rough aectrical (Ory Wall) .' n V --,
Rough Electrical _ ~
Framing (OnlyafterPlbg,Elec Mech,andF<<e\ ~ '.
Insulation (SoundlEnergy)" I ; J.J 'M
Do not tape or plaster until the follOWing applicable
items have been signed: '
Drvwall .' .'. ' '. .
Penetrations (Fire Rated) Electrical . " '
Penetrations (Fire Rated) Mechanical. ,
penetrations (Fire Rated) Plumbing . .'
Interior Lath, . .
Exterior Lath . PI
,'. ".0'.", GENERAL ITEMS 'A II
Exterior PJaster(Brown Coal) 7'-J;;Bf/:"7L/ r '
T -Bar Electrical , ' , I
T-Bar "'echanical " .
T -Bar Structural , "
Sewer " ' ,
Water Engineering Backflow . , I ! EI
Water Servi"" .:' , , .
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echanicallnspections
umbin!:l Inspections
ectricallnspections
insp ctor