931 S. Sylvan St.
TYPE OF PERMIT
Residentio::Jj Adaition
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CITYQ~
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BUILDiNG DIVISiON'
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTE.R SECTION: 21
BUILDING PERMIT NO. BLD2005.00105
DATE: 3/812005
JOB ADDRESS: 931 S SYLVAN ST
. LEGAL DESCRIPTION: N TR 1951 LOT 172
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APPLICANT: SUSAN BANGS
OWNER INFORMATION:
SUSAN BANGS
931 S Sylvan 81
Anaheim,CA 92804 L
ii.
JOe DESCRIPTION;Extend kilchen and remodel eXiSling.]. .
VALUATION: 10,400.00 ':f:' PROCESSED BY: FAN
r '.' . OWNER.BlJiLDEPibECLARATION' _ ..' . :=J . .
I hereby affirm under penalty of perjury that I am exempt frolll the COfjtractc~$ License Law tor the following-reason (Sec. 7.031.5 Business and" .
Profe~sions Code: any city or county which requires a perm'it to construct; ~i,*r, jmprov~, demolish 9f repairanystrllcture; prior to lts'jssuance, also,.' .
requires the applicantforsuch permit ~o file a signG:d statement that he i~ C$}-~,.sed pur_suant tn the provLsions of the Contractor'sUcense Law (Chapter
9)(cornmencing withSection 7000 of Divisicn 3 of ,the Busi:1eSs~nd Profes$;h'1$ Cede) orthat he is exempt t~erefrom and the basis fo~the al!eg~~
exemption. Any violation of. Section 7031.5 by any ;;:ppli::c:nt for a p~rmit sul"1~9ts the applicant to a ciV;~ penalty ofJ'lot more than fjv~ hundred do!Ja(s
($500).. . i:- .... '. . . ..
D. I. <?,:1 owner of property, or my emplC'yeeswlth wa.ges 8$ their ~c:e C~fT\!i~nsaijon, will do the Work. and t~p. structuicis not inter\d~ or offeredtor .
sale (Sec. 1044 Business anr.! Professkms Code: The Contractor's Lirel'ls€\ i1aw does not apply to an vw.r.ei' d,roperty,who builds or improves'
thereon, and who does such work himself (jr herself or through'his or hl;r ovA~mp!oy~es, provided that such irr:pro.\ferYIer;ts.ar~ r.otIntei1.ded Q( .
offered for ~le. If, however, the buildine or ift~prOvementis sold with one Y~"IrOf'compl~tjon, the <?wn.t3:r-bl:'ilcI~r wiil have the tureen c.f pr-:Wing'.tnnt he
'$' not build or imptove for~he pU:j)ose of SO:3le), '. ".l'ii,.' '..' . ..". '
'. ". .1,- .~S.' :h$'-.'_ ~ner Ofth.. e.. .prope.riy,am exdu~ively contracting with t:cens.~~.:".,.;~..~., '.' trz~ors to .cons-truct th~ pro]cc..t (?ec. 7044 BUJ:;iness af_l<f P~feSsio~s .
. _.ode: !hc'Co:1tractor's.Llcense, Law does not apply to an. owner of pWjJen:.r.tn~ bUIlds Of Im~roves th?teon; ~nfJ who C(\fltracts for such pr.:>Jec.ts w~h
~ Jfollt.-adOf(s) Iicensoo'pl,lr~uant tothcComract?r's Lice(l~,e L<lw). '. "i~";:> .'- '...
_l.:ameXdmptunderSec, , &P.C.fortt)j~~asor.: -~._..,~t:: - .' _......,~_. _ . _' _' -'
DCite:, '~~ ...... . Owner:. . I"- U'J42-' ~L~--,-____..,~_.;...., _ _ _.' .
r -- - . . WORKER'S CO. PENSATION DECI.ARATIOt~. . f . i r i.,ICENSED CONTRAC=rORSDeCi:ARATl~1
I he!~~y ~ffirm u~d.etPe~al~6f pe~~_ry one Of the fO!lo:,jn~ d;~;ar~tio.ns;_ ,." :l" ,': r! ~er~bya~'lf~~~ie;..pe~:,iry~O~ i)e~~ury l"1at t, Sin,"
0'. .' nave. an.d WIll maIntaIn. a cert~fic-ate..Of.ccnsen. t toself-lnsure.fo,r w.(.'rk{''!r~~..(;'omr.f;:!l~iJt.\O.;:1, I !J~~nsed ~nderl?I;Nts!O~...?f."'laP.ter 9 (co!"1mancrn?
as provided for by Section 3700 of the Labor Code. for th~ pe;formaN;e of lh.'~.work fo{w.bich wl\h Se~tlOn 70~C) ot D,vsron 3 of the BlJ3!nE'$.S ana
ti'l!S permit is.issued... . f. ".' Professlo.lS Cooe,
D J have and viill maintain'Worker's 'compcnoatior. insurance, SG retlt!imd b?;S.flcticn 3700 of I 318/2005
.the l.abor Code; for the periormance of the work forwhlcn till,; permit ~ issu.J:d; .My worker's. ,D;:Jte:'.
C6moel1satic:--=--'<<Urance carrier and pollOi <'I~e: : ,'"'2',
Carrier: ' .,. , Policy Number. 'J
I
This section need not be. completed if the pp,rmn: is for one hundred dollc:rs ($t!J'~or less.:
~.I' .'1 certify. thatil"! the.pe.' rfonn'ance. of the work for whic,h this permit lsi::;Sl;.-~~.:,h,l,Z h~!I !ie. t
. . loy any person!n any manner &0 as to become SUbject to the wcrker'::;-cofl1pl~msation laws
Califomia, and agree that.if I should become subject te the worRer'S corr,~tnsQticn
provisions of SectIon 3700 of the Labor Code, I S!1SU forthwith comply With t?-:!Jseprovisions,
ila;e: 31812005 AppliCant '-..f" ~ 6~~ .U>
WARNING: FAILURE TO SECURE W~ER'SCOMi"ENSATIOI'I CQ'iEf:AGEIS.
UNLAWF~L, AND SHALL SUBJECT AN EMPLOYER TO CRIMiNAl PENALTIES AND CIVIL
FINESUPTO ONE HUNDRED 1HOUSAND'DOLLARS ($100,000), IN ."DD,TlqNTO THi:
COST OF COMPENSATION, DAMAGES AS PROVIDED POR IN SECTION. <icoa OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. " . .
I j::ONSTRUCTION LENDING AGENCY _.....;.':;-," ". .,
I'hereby affirrr. under pena)ty of perjury that there is a cor:s1ruct!on'l~ncHrnrf'~-';n.~_VfPt the .'
,p~.!to!fP.an~ ofth;e work for which this pe~it is i_$sued {Sec.3097X;jl/.Q.t,:;::j__,,,j.~~i;~~~,,,,,,~~~~:i.d~~,~,G,,-" ,,~;.'-'
--'\.~(;,::':-..:;'f''''~:;;''-i6f;nalitJ:):----'---'~-'' '.,- ~ ~,.
/;.
CONTRACTOR INFORM.i':JION:
t\:,-,
ARCHITECTIENGINEER INFORMATI.oN:
Contr:3cter
NUMBER
EXPiRATION DATE
TYPE
Construcion Types:
VN, , .
Occupancv Groups:
R3,', . ,
Livinq Area:
156
,'.<'
'"'''''''..............-
I certify that I bave read thisappllcation and state that the above information IS correct"'1
agreeto comply with at! city ordinances and.sta~ laws relating to building construction. and
hereby authorizerepresentives of this city to enter.upon the above mentionee property for
ins ect: n purposes. . .
. b
" Signature of A plicant or Agent . ..
The permit shall ej(pire 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.
Dale: 3/812005
Fees paid for pe..mit:
Total:
840.63
INSPECTION RECORD
.. . INSPECTiON DATE . INSPECTOR
Temporary Power Pole.. '.
Plumbing (DralnlWaste Pipe) .
Electrical Ground ElectrodelUfer A
SetbacklFormsfTrenches (Footings) , )./1-45 , I/'/'kl..
Do notiostall subf/oor or,pour floor slab until the V
'following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler valves) ..
Mechanical (Grourldwork) , .'
Electrical tUndergrouna conduit) ,.
Pre-slab (CompactionlMembrane.Reint. 0-11-<0 j
Underpinning (Floor Joist/Girdlll"s) , . /)
Do not coveror conceal the work below. until the.
following applicable items have been signed: ,
1 st Flo.or Shear
Firesprinkler (Rough) , , ,
2nd Floor Shear
Roof (Sheathina/lliaohraamlFrane) fL...
Mascmry (RelnfJBond B!lanlPre-Grout) "om .
Rough Plumbing (Top Out) , J-}t"" .~Gv'.....
. Rough Mechanical, ~ /'
Rougn l:IectrlC.. lury ....II} .
Rouoh Electrical, , ' . . . ,
Framing '(Oniy'afterPlbg.. Elec.., Mecn,.and F;re) '7//~/p, ~./~
Insulation (SoundlEnergy) 7'/Z/kF A:/). .,
po not tape or pla~ter until the following applicable
.tems have been Signed: " . ..
Drywall , ..
Penetrations (Fire Rated) Electrical ' . .., '
Penetrations (Fire Rated) Mechanical ..
Penetrations (Fire Rated) Plumbing
. Interior Lath : . '
Exterior Lath .
GENERAL ITEMS
Exterior, Plaster (Brown Coal) , , ,
T-Bar Electrical
t-Bat.Mechanlcal '
T -Bar S~ructural
Sewer ,
Water Engineering Backflow
.. Water Senile" .
FINAL INSPECTIONS Date 'Inspector
Electrical Final . " d <::b' '-.~/-
Plumbing Final . . /I I ".. c....L.w.:....1
Mech.anlcal Final . II f lofi (,.LA~<;(.
Gas T&st " '
. ..
EngillMringlGracling Final 765-6126 . . .,
Fire Dept. Final 765-4040 . "
.
Water Engin.eering765-5268
Sub ListlBuslness License 765.519 /om/r;< ' joAJl-O I (,on..
ZonilJg 765.5139 '. ' . .. ,
Building Final kust Inspection- Only , I", !o:) "'--1.' ~
fter Above Complete),
0 PARTIAL lIilSPECTIONS ' #$A .
BuildinalnSDections 0 '
7,hstA.$' ~&//&/-Kt~c.k B~
Mechanical Inspections
k~
Plumbing Inspections
q~1ft3~ /YW i/' q,k/ ,
~
Electrical Inspections