124 S EUCLID STSIGN PERMIT NO. SGN2021-00072 BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
TYPE OF PERMIT New Attached to Structure Sign CITY OF A N A H E I M4626 REQUEST LINE:
(714) 7INSPEINSPE CTI�_ ON N
DATE: 6/29/2021 QUARTER SECTION: 54
JOB ADDRESS: 124 S EUCLID ST
LEGAL DESCRIPTION:
PERMIT APPLICANT: ALAN NUDEL
OWNER INFORMATION:
CONTRACTOR INFORMATION: ARCHITECTIENGINEER INFORMATION:
EDWARD I HALPERN TR
MY SIGN DESIGN INC
15054TH ST#219
4821 LANKERSHIM BLVD F145
SANTA MONICA, CA 90401-2381
NORTH HOLLYWOOD, 91601 CA
JOB DESCRIPTION:
Installation of (1) Illuminated wall sign for "!Home Furniture'.
VALUATION: 2,895.00
PROCESSED BY: AEG
no.eoy annul unue. canary or p ,Ju'y emr . am eacnryr imn. aro VUlMaGl01 s ucense Law Tor me rouowmg reason laec. rwr.o cosiness ano eroressions cone: any cay or
county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed
statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professions
Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil
penalty of not more than five hundred dollars ($500).
❑ I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044 Business
and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or
through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one year of
completion, the owner -builder will have the burden of proving that he did not build or improve for the purpose of sale).
I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 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).
❑ I am exempt under Sec. , B & P.C. for this reason:
Date: Owner.
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to sett -insure for workers compensation, as provided for
by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
tI have and will maintain workers compensation insurance, as required by Section 3700 of the Labor Code,
or the performance of the work for which this pennit is issued. My workers Compensation insurance carder
and policy are:
Carder: STATE COMP FUND Policy Number: 9265538
This section need not be completed If t he permit is for one hundred dollars ($100) or less.
❑ I certify that in the performance of the work for which this peril is issued. I shall not employ any person in
any manner so as to become subject to the workers compensation laws of California, and agree that if I should
become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with those provisions.
Date: 6/29/2021
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND 1
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO 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 ATTORNEYS FEES.
LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec.3097.Civ.C):
Lenders Information:
I certify that I have read this application and state that the above information is correct. I agree to comply with
all city ordinances and state laws relating to building construction, and hereby authorize representives of this
city to enter upon the above mentioned property for inspection purposes.
Date: 6/29/2021
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 inspectoin 365 days from the date of permit issunace. A new permit is
required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
under provisions of chapter 9 (commencing with Section 7000)
of Divsion 3 of the Business and Professions Code.
Date: 6/29/2021 Contractor.
NUMBER: EXPIRATION DATE:
BUS2021-01634 6/29/2022
TYPE: C45
TYPE: BUS
PEWN11T EXPIRED
INS) LU i ION
NOT 00`1VAPLE T ED
DAiE:
ees pal or emit:
Total:
594.75