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1025 E BALL RD (66)Permit Types BLn ELE I MEC I PLM X Permit Number: BLD2009-04159 Issur a:'03/04/2010 INSPECTION REQUEST LINE: (714) 765 - 4626 Quarter Section: 105 Site Address: 1025 E BALL RD Legal Description: CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 Project Description: Plumbing to install water main and sewer for new 6 story building. Valuation: Construcion Types: N/A, , Fire Sprinklered? No Cool Roof No Total Fees paid for Permit: 358.79 People Associated with Project Owner ANDREW C EDWARDS TR 1230 S LEWIS ST ANAHEIM CA 92805 6428 Engineer RYAN J BITTNER 18 TECHNOLOGY, SUITE 154 IRVINE CA 92618 Contractor C W DRIVER CONTRACTORS 468 N. ROSEMEAD BLVD PASADENA CA 91107 0000 Permit Applicant DINO MACASERO Type Electrical Fixtures Qty Type Plumbing Fixtures Qty Type Mechanical Fixtures Qty Water Main per 100 ft. Sewer per 100 ft. 1 6 The permit shall expire by limitation and become null and void if the building or work has not passedfinal inspection 365 days from the date of permit issuance. A new permit is required to commence or continue work. City of Anaheim Building Division Do not occupy this building until the final inspections have been made. BUILDING PERMIT DOES NOT AUTHORIZE ELECTRICAL, PLUMBING, OR MECHANICAL INSTALLATIONS - SEPARATE PERMITS ARE REQUIRED. INSPECTION I DATE I INSPECTOR Do not pour concrete until the following applicable items have been signed: Plumbing (Ground/Underfloor Drain Waste) Electrical Ground Electrode/Ufer Setback/FormslTrenches (Footings) Do not install subfloor or pour floor slab until the follwing applicable items have been signed: Plumbing (Ground/Underfloor Water) Underfloor Rough Gas Mechanical (Groundwork) Electrical (Underground Conduit) Pre�lab (Compaction/Membrane Reinf.) Floor (Jolst/Girdem) Underfloor Insulation (Raised Foundation Only) 2nd Floor (Floor Nailing) Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear Firesprinkler (Rough) (Fire Dept.) 2nd Floor Shear Roof (Sheathing/DiaphragmlFrame) Masonry (Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Duct (Mechanical) Rough Mechanical 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 Drywall Penetrations (Ele., Mec. & Plbg.) Interior Lath Exterior Lath GENERAL ITEMS Electrical Service Meter Exterior Plaster (Brown Coat) T-Bar (Struct., Ele., or Mec.) Sewer Water Engineering Backflow (Testable Only) Water Service All applicable items below must be signed before utilities will be released. FINAL INSPECTIONS DATE INSPECTOR Final Gas Test Electrical Final Plumbing Final Mechanical Final Cross Connection Control p1417554220 Engineering/Grading Final (714) 70sm2e Fire Dept. Final (714) 765-5041 Fire Sprinkler Final (714) 7655041 Water Engineering (714) 765.4591 Sub List/Business License (714) 765-5194 Zoning (714) 7655139 Building Final (Last Inspection - Only After Above Complete) FINAL INSPECTION must be approved by the Building Division. PARTIAL INSPECTIONS Building Inspections Mechanical Inspections Plumbing Inspections Electrical Inspections Permit Backs Master-2008.xis Permit Types BLD ELE MEC I PLM X Permit Number: BLD2009-04159 Issud`d: 03/04/2010 INSPECTION REQUEST LINE: (714) 765 - 4626 Quarter Section: 105 Site Address: 1025 E BALL RD Legal Description: CITY OF ANAHEIM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 OWNER - BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Contractor's License State Law for the following reason(s) indicated below by the check mark(s) I have placed next tothe applicable item(s) (Sea 7031.5 Business and Professions Code: any cRy or county which requires a permit to construct, after, improve, demolish or repair any structure, priorto its issuance, also requires the applicant for the 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 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 [__) 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 to an owner of property who, through employees' or personal efforts, builds or improves the property, provided that the improvements are not intended or offered for sale. 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). — 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 Contractors 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 4 it has not been constructed in its entirety by licensed contractors. 1 understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: htto://www.leginfo.ca.ciov/caletw.htmi. 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 with all applicable city and county ordinances and state laws relating to building construction I authorize representatives of this city or county to enter the above -identified property for inspection purposes. Signature of Property Owner or Authorized Agent WORKER'S COMPENSATION DECLARATION: Date 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 TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OR THE LABOR CODE, INTEREST, AND ATTORN EY'S FEES. I hereby affirm under penally of perjury one of the following declarations: 1 have and will maintain a certificate of consent to sell -insure for worker's compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this peril 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: ARCH INSURANCE COMPANY NAIC Name of Agent: Phone No.: Policy 0 WC12270706 Expiration M112010 I certify that in thl performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workAscpmpensation laws of California, and agree that, if I should become subject to the worker's compensation provisions of Section 3700 of th,h LoIr Code, I shall forthwith comply with those provisions. ti I (o ature of Applic of Date Permit Number: BLD2009-04159 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 CTORS DECLARATION: I hereby affi m dUrthe penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the Business and Pr fions Code, and my license is in full force and effect. tractor Sign NUMBER EXPIRATION DATE LICENSE TYPE (S) 102 1/31/2011 B siq o Date 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. fbld permit combo declare