8994 E. Santa Ana Canyon Rd. Verizon
TYPE OF PERMIT
Accessory Building (Shed, Garage.,.) CITY
DATE: 2/4/2005
JOB ADDRESS:
LEGAL DES9RIPTION:
BUILDING DIVISION
200 S, ANAHEIM BLVD.
(714)765-5153
INSPECTION REQUEST LINE:
(7)4) 765,- 4626
CENSUS CODE: 437
QUARTER SECTION: 207
BUILDING PERMIT NO. BLD2004-o3991
APPLICANT: RYAN SHERER
OWNER INFORMATION:
STATE BOARD OF EQUALlzATIOi'l- Asses
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CONTRACTOR Ii'lFORMAiT'ON: ARCHITECT/ENGINEER Ii'lFORMATIOi'l:
WESTERi'l TEL-COM DE'/ELOPMEi'lT INC JAMES H MITSCH
41.115 CHERRY ST I
, MURRIETA, CA 92562000!,:
JOB DESCRIPTIONtelecom facility and emped:for verizon, bts cabinets, 6 an~.t, blockwall per city specs 56',
VALUATION: 70,000,00 PROCESSED BY: CDL
I ' ." .' 'OWNER-BUILDE~PECLARATION ' , , " '. "
I h~eby affirm under: penalty of perjury that I am exempt fr9rt1 th_e.contractO(f~-- License law for the folloWing reC:lso.!1 (Sec. 7031.5 Business and
Professions Gode: a-ny city or county Vv'hich requires"C.I permit K);constwct, aliI r; improve, derr10Iish or repair any structure, p:-ior to. its issuance,-also
requires the appU~nt fo.r. such permit to file a signed,statemer.llhat he is ~i?e, sed- pursuant to the provis!ons of the Contractor's L!ce,"!se ~aw (qhapter
9)(commencing with Section 7000 of Division 3 of the Business al'Jd~tofes~iCr':$ Code) or that he is exempt therefrom and the basis for the allegea.
exemption~ MY violation of Section 7031.5 by any applicant,for a permit SU9i:~cts the applicant to a avil penattyof not more. than five hundred dollars
($500): , ' ' ". ,,' ..f. '
o .I,as owner <;If property, or my empl,byees with wages as their- sql~com.p;}i1sation, wBl do the work. ~ind the ~tructure is not intended or offered for
sale (Sec. 7044 Business and Professions Code:. The Contractor's License_-V~i'N does not apply to ancwner of propeliy who, builds or improves _ -:
thereon, and who does such'work himself or he'rself or through hi~ <;Ir ~~row:'/.~mPIOyeeS, provided that sucb imprpve:l~ents are not In'tend~ or.',
offered for sale.. ft, however, the building or improvement is sold_ with one ye~)~.Gf <Xl rnplet:on, the owr.Gr-t'llJilder wii!,ha'le tI-,e bllrdeil of proving that he
did not build,6r improve for the pUipose of. sale). ' .' -:;- ~ -' ' : _'.-'
0, I, as the owner 6fthe propelty, am _exdusiveiy contracting wjfti'Hc~i)Sl;;:d;Hrtraclors to construct the project (S.€c. .7044:3usinef;s i."nd Professions
Ccde:T~e Contrz,ctor's Li.cense Law dO,es not apply-to an owner of.-~roperty \vhob:.Iilds (J; imp~oves thereon, and who !X>ntracts for SUQ~l project"i' Wi[:'
~ cOI1.tractor(s) licensed- pursuant to the Contractors License Law): '::;-:~ . 1:.0 ". ',. '. .
o I am eXE1.mpt under Sec, __ ,'B & P.C. for this reason: .,__'.____._
Date: . Owher: ' '. . < t
i WORKER'S COMPENSATION DECLARA'TION_..:....r=---- '-.1 I
"lherebyaffirm under penalty,of pe~ury one of .the following deciaration-s: i .'-
L' .Ih.av~ .~nd. will maintain a certificate" of COnsent to ~if-i~sure fo.. work3:-'Ai:;'~:m,pensati()n. I
as p:-oVi~ed for by Sedio.n 3700 of the Labor ~ode, for the perfortnan~ elf tb:i~Yf;rk ft?r which I
t.l--Jis permit1s issued. ,\
~I have and wiUma_intain worker's comp.E:!_rl$ation insurance, as required b:M':;"ection 37Ct) of
, .the ...abor Code, for the perfor,rnane-e of the work for whid1 this permit is i~SLl~+_.. i'v~y.worker's
Compensation.insurance carrier and policy are: : ;;'
Carrfe"-: ACCORD 'Policy' Number: 450J.:.02.1~ .
This section need not be ~Plete~ if the pennit is for one hundred dollars '($1 00; (". i....
~ certify that in th~, performance of the work fC?r which this pe rmit isissue4; '( !>ha n not
emplOY any person in any manner S'O as to become subject to theworke~s co(:pensa,tion la....'s
of. C~lifomia, and E1gree that, if I should become subject ta the warker's com~r'!_~'.ation
provisions of Section 3700 of the L r C shail forthwith complywithtfKj~!~brbviSions~
Date: 2/4/2005 Applicant ' J t
WARN ING: FAILURE TO SEe E WORK MPENSATiON COVERA';3E IS
UNLAWFUL, AND SHALL SU JECT AN EM PLOYER TO .CRIM INAL PENALR!ES AND ,CIVIL Fire Sorinklered?
FINES UPIO ONE HUND D THOUSAND DOLLARS ($100,000), IN ADDI\lON 'TOTHE
COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION i70E;' OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. I
I ,', CONSTRUCTION LENDING AGENCY , :';:c
I h~reby affirm ~nder pena It}'. <:f. perj~ry that !~~r~, is a c, on5l, ruc1ionl,~ndiJ'lg'-~;'l'::ICYf?1" the
?",-""O!"fT!1'!!'!ce nf .ne wor!~ forw!"!~d1 t"l~ rer;iIII1~ 'sJ'::lJerl ($~r~309? ,C;IV,~~: ~ -. '_..__
lende~s lnfonnation:
, L1CENSF.1:J COt.:TRACTORS DECLARATIONl
I hereby zf,inr. under t)enalt)' of pc.rjury that i am
licensed' nd~r provisior.s'of chap-ter 9 (commencing
with Secti 7000; OivSion.3 of the Business a!1d
Prafes'sians
J
E'XPIRATION DATE
8/31/2005
8
Construcioil Types:
VN.' ,
Occupancy Groups:
NO
I certify that I have read. this application and state that the above-information is correct. I
agreeto romply-with all city 'o~dil1ances and state laws reI1::lting to building cOf)$tructian, and
hereb' uthorize "representives of this city ta enter upon th.e abovementioned property for
i?f.ion urpoSe '
Date: 2/4/2005
Fees paid for Permit:
Total:
1.739.73
nature of Applicant or Agent
e permit shall expire by limitation and become null and .void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence, or continue work.
INSPECTION RECORD
INSPECTION , DATE ,INSPECTOR
Temporary Power Pole , ,
Plumbing (DralnlWaste Pipe)
( Electrical Ground Electrode/uter '\At ~ ~
' SelbacklFormsfTrenches (Footin!l$) FA ~Q l.
Do not install subfloor or pour floor st,ab ntil the :,
following applicable items have been signed: '
Plumbi ng (Water Pipe.Sprinkler Valves)
Mechanical (Groundwprk) ,
Electrical (Underground Corl!luit)
Pre-slab (Compaction/Membrane.Reinf;
'Underpinning (Floor Joist/Girders) , ,
Do nolcover or,conceal the wor1<'below until the
fQllowing applicable items have been signed:
1 st Floor Shear ' ,
Firesprinkler (Rough) "
2nd Floor Shear . ,
Roof (Sheathing/Diaphra!lI1l1Frame) , ,
Masonry (ReinfJBondBeamlPre-GlOllt)
Rough Plumbing (Top Out) "
Rough Mechanical
KOilgn l:IectrlCaI jury ,wall}
Rough Electrical " ' ,
Framing (Only after Plpg., Elec.: r",1ecl'i.'. "and Fire)
Insulation (SoundlEnergy)
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 ,
ExteriorLath ,
, GENE'RAL ITEMS "
Exterior Plaster (Brown Coat) " ' '
T ,Bar Electrical
T ,Bar Mechanical ' , ' ':' , ,
T .Bar Structural
Sewer " " " , I
Water Engineering Backflow ,
WaterSer.Vice ,',
FINAL INSPECTIONS ' Date, ',Inspegtp(
Elect-:ieal Final . :3 If-or( -..........;=7,. L
Plumbing Final /
Mechanical Final
Gas Test .
Engineering/Grading Final 765~126
Fire Dept. Final 7654040 ,
,
Water Engineerin'g 765-5268,
Sub List/Business License 765;519 ,
"
Zoning 765-5139 ~-
Building Final ~ast Inspection- Oniy ~-lcf"'J -V- 'ZJoy
fler Above Complete) Ce,
PARTIAL INSPECTIONS, /'
Building Inspections
Mechanical Inspections
Plumbing Inspections
, Elec, tricalln~pections ' n" " , ' , , :"
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mesa inspection
229W. BONITA AVE., SUITE 2E
SAN DIMAS, CA 91773
inc.
OFFICE (909)592-4153
FAX (909) 592-6248
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clt~einforced Concrete
o Post Tensioned Concrete
o Reinforced Masonry
Registered Deputy Inspector's Report
DH.S. Bolts
o Welding
o Shop
o Sprayed Applied Fireproofing
o Quality Control'
o Drilled In Anchors
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CERTIFICATION OF COMPUANCE
I HEREBY CERTIFY THAT I HAVEIN$PECTED TO THE BEST OF MY KNOWLEDGE
ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE
FOUNDTI-lIS WORK TO COMPLY WITH THE APPROVED PLANS"SPECIFICA1l0NS,
AND APPLICABLE S~T10NS OF TH~ GOVERNtN~.~Y~ING LAWS.
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All inspections based. on a minimum of 4 hours and over 4 hours. 8 hours minimum.
In addllwn, an(0wn e~endlng tOOOho~'W", bee, nSho", minim,.
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229 W. BONITA AVE., SUITE 2E
SAN DIMAS, CA 91773
inc.
OFFICE (909) 592-4153
FAX (909) 592-6248
R~gisteredDeputy Inspector's Report
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o Reinforced Concrete
o P~ensioned Concrete
~inforced Masonry
DH.S. Bolts'"
o Welding
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o Sprayed Applied Fireproofing
o Quality Control
o Drilled In Anchors
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CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE
ALL OFTHEABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE
FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS. SPECIFICATIONS.
AND APPLICABLE SECTIONS OF THE GOVERNING BUILDING LAWS.
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All inspections based on a minimum of 4 hours anctb.ver 4hOyrt. 6 hours minimUm.
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mesa inspection
229 W. BONITA AVE.. SUITE 2E
SAN DIMAS, CA 91773
inc.
OFFICE (909) 592-4153
FAX (909) 592-6248
Registered Deputy Inspector's Report
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o Post Tensioned Concrete
IO-~nforced Masonry
OH.S. Bolts
o Welding
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CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE
ALL OF THE ABOVE REPORTED WORK UNLESS OTHERWISE NOTED. I HAVE
FOUND THIS WORK TO COMPLY WITH THE APPROVED PLANS, SPECIFICATIONS,
AND'APPLlCABlE SECTIONS OF THE GOVERNING BUilDING LAWS.
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mesa inspection
229 W. BONITA AVE" SUITE 2E
SAN DIMAS, CA 91773
inc.
OFFICE (909) 592-4153
FAX (909) 592-6248
RegisterediDeputy Inspector's Report
o Reinforced Concrete
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o'YstTensioned Concrete
llJ'Reinforced Masonry
o H.S. Bolts
o Welding
o Shop
o Sprayed Applied Fireproofing
o Quality Control
o Drilled In Anchors
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All inspections based_ olia minimum of 4 hours and over 4 hours ~ 6 hours minimum; ,
In addillon,any inspection extending past noon ~~an 8 hour minimu:.
ApP'OVedby;r2l//:;;;~'''' · ..... '.
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CERTIFICATION OF COMPLIANCE
I HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE
ALL OFTHEABOVEREPORTEO WORK UNLESS OTHERW\SE. NOTED. 'HAVE
j:OUND THIS WORKTO COMPLY WITH THEAPPAOVED PLANS, SPECIFICATIONS,
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