619 S HILDA ST (2)r Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-02058
Issued:06/29/2009
INSPECTION REQUEST LINE:
(714)765 -4626
Quarter Section:123
Site Address:619 S HILDA ST
Legal Description:N TR 3438 LOT 44
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Project Description:Mechanical for furnace changeout and add air conditioning.
Valuation:
Construcion Types:
Total FeespaidforPermit:
N/A.
68.40
People Associated with Project:
Owner
Contractor
Permit Applicant
FRANK H EMSER TR
SERVICE CHAMPIONS HEATING AND AIR C
CARLOS ZAMORA
619 S HILDA ST ANAHEIM CA 92806-4306
22911 SAVI RANCH PKWY YORBA LINDA CA 92887 0000
Electrical Fixtures Qty TypeType Plumbing Fixtures Qty Type Mechanical Fixtures Qty
Heating Appliances,including vent
Compressor/Boiler-up to 15 hp
Heating/Cooiing Coil
Residential Registers
1
1
1
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,fbU psrrr,it combo
All applicable items below must be signed before ufililies will be released.
FINAL INSPECTIONS DATE INSPECTORCityofAnaheim
Building Division
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (7i4)765-4280
Engineering/Grading Final (7i4)765-5126
Fire Dept.Final (714)765-5041
Fire Sprinkler Final (714)765-5041
Water Engineering (714)765-4591
Do not occupy Ihis building until the final inspections have been made.
BUILDING PERMIT DOES NOT AUTHORIZE ELECTRICAL,PLUMBING,OR
MECHANICAL INSTALLATIONS -SEPARATE PERMITS ARE REQUIRED.
Sub List/Business License (714)765-5194
Zoning (714)765-5139
Building Final (Last Inspection -
Only After Above Complete)
INSPECTION DATE INSPECTOR
Do not pour concrete until the following applicable items have been signed:
Plumbing (Ground/Underfloor Drain Waste)FINAL INSPECTION must be approved by the Building Division.
Electrical Ground Electrode/Ufer PARTIAL INSPECTIONSSetback/Forms/Trenches (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have
been signed;Building Inspections
Plumbing (Ground/Underfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
2nd Floor (Floor Nailing)
Mechanical InspectionsDonotcoverorconcealtheworkbelowuntilthefollowingapplicableitemshave
been signed:
1st Floor Shear
Firesprinkler (Rough)(Fire Dept.)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Plumbing InspectionsRoughMechanical
Rough Electrical
Framing (Only after Plbg.,Ele.,Mec.&Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed;
Drywall
Drywail Penetrations (Ele.,Mec.&Plbg.)
Interior Lath
Exterior Lath
Electrical InspectionsGENERALITEMS
Electrical Service Meter
Exterior Plaster (Brown Coat)
T-Bar (Struct.,Ele.,or Mec.)
Sewer
Water Engineering Backflow (Testable Only)
Water Service
Permit Backs Master-2008.xls
Permit Types
BLD ELE MEC PLM
X
Permit Number:BLD2009-02058
Issued:06/29/2009
INSPECTION REQUEST LI NE:
(714)765 -4626
Quarter Section:123
CITY OF ANAHEIM
BUILDING DIVISION
200 S.ANAHEIM BLVD.
(714)765 -5153
Site Address:619 S HILDA ST
Legal Description:N TR 3438 LOT 44
OWNER -BUILDER DECLARATION:
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Lawforthe following reason(s)indicated below by thecheckmark(s)I have placed next tothe applicable item(s)(Sec.7031.5 Business and Professions Code:any city or county whic*requires a permit to construct,
alter,improve,demolish or repair any structure,prior to its issuance,also requires the applicant forthe permit to file a signed statement that he or she is
licensed pursuant tothe provisions of the Contractors’State License Law Chapter 9 (commencing with Section 7000)of Division 3 of the Business and
Professions Code)or that he or she is exempt from licensure andthe 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 (S500).
-I,as owner of properly,or my employees with wages as their sole compensation,will do C )all or ( )portions of the work,and the
structure is not intended or offered for sale (Sec.7044 Business and Professions Code:The Contractors'State License Law does not apply toownerofpropertywho,through employees'or personal efforts,builds or improves the property,provided that the improvements are not intendedorofferedforsale.If,however,the building or improvement is sold within one year of completion,the Owner-Builder will have the burden of
proving that it was not built or improved for the purpose of sale).
an
—I,as the owner of the property,am exclusively contracting with licensed Contractors to construct the project (Sec.7044 Business and Professions
Code;The Contractors'State License Law does not apply to an owner of property who builds or improves thereon,and who contracts for the
projects with a licensed Contractor pursuant to the Contractor's State License Law),
—I am exempt from licensure under the Contractors'State License Law for the following reason:
By my signature below I ackonowledge that,except for my personal residence in which I must have resided for at least one year prior to completion of
the improvements covered by this permit,I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety
by licensed contractors.I understand that a copy of the applicable law.Section 7044 of the Business and Professions Code,is available upon requestwhenthisapplicationissubmittedoratthefollowingWebsite:htto://www,leQinfo.ca.Qov/calaw.html.
By my signature below,I certify to each of the following:
I am the property owner or authorized to act on the property owner's behalf,
I have read this application and the information I have provided is correct,I agree to comply ^Ifall^'pliMrble ciw and county ordinances and state laws relating to building constructionIauthorizerepre^ntativesof tnis city or county to enter the above-identified property for inspection purposes.Co -o 9
Signature of^fOBertv^WfeTor Authorized Agent Date
WORKER'S COMPENSATION DECLARATION:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000),IN ADDITION TOTHE COST OF
COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self-insure for worker's compensation,issued by the Director of Industrial Relations as providedforbySection3700oftheLaborCode,for the performance of the work for which this permit is issued.
I have and will maintain worker's compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for
which this permit is issued.My worker's Compensation insurance carrier and policy are:
Carrier:MAJESTIC INSURANCE COMPANY Policy Ng20080497502 Expiration
Name of Agent:Phone No.:
I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subjecttotheworksr'sco
3700 of the La
ensation laws of California,and agree that,if I should become subject to the worker’s compensation provisions of Section
r Code Jshall forthwith comply with those provisions.
Signature of Applicant Date
Permit Number;BLD2009-02058
DECLARATION REGARDING CONSTRUCTION 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):
Lender's Name;
Lender's Address:
LICENSED CONTRACTORS DECLARATION:
I hereby affirm under the penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000)of Division 3 of theBusinessandProfessionsCoderan^d my license is in full force and effect.
Q-Contraclor Signature Date
NUMBER
799170
EXPIRATION DATE
9/30/2009
LICENSE TYPE /St
C20 HTAC C36
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 orconthue work.
fbid permit combo declare