525 N PINE WAY (9)Permit Types
BLD
ELE
MEC
PLM
i�
X
Permit Number: BLD2010-00182
Issued: 01/21/2010
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 72
Site Address: 525 N PINE WAY
Legal Description: N TR 2237 LOT 32
Project Description: Plumbing for residential remodel: Install sewer clean out.
People Associated with Project:
Owner CARL J HEINZ TR
Contractor GEORGE BRAZIL PLUMBING HEATING
Permit Applicant BRUCE SMYTHE
Type Electrical Fixtures Qty Type
CI1�Y4, D:F-=AIIA'HEIM
BUILDING, %Y glON
200 S` ANAHEIMBLVD.
(714) 765 - 5153
Valuation:
Construcion Types:
N/A, ,
Fire Sprinklered?
No
Cool Roof
No
Total Fees paid for Permit:
136.73
525 N PINE WAY ANAHEIM CA 92805-2505
1401 N BAXTER ST ANAHEIM CA 928050000
Plumbing Fixtures Qty Type Mechanical M tures Qty
Sewer per 100 ft.
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. fbld permit combo
City of Anaheim
Building Division
Do not occupy this buildinc 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/Forms/Trenches (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 -slab (Compaction/Membrane Relnf.)
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:
let Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Relnf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Framing (Only after Plbg., Ele., Mee. 8 Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele., Mac. & Flag.)
Interior Lath
Exterior Lath
GENERAL ITEMS
Electrical Service Meter
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mac.)
Sewer
Water Engineering Backflow (Testable Only)
Water Service
All applicable items below must be signed before utilities will bRreleas2 .
FINAL INSPECTIONS
DATE
INSPECTOR
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control plsf 75s ao
Engineering/Grading Final p14) 76ss126
Fire Dept. Final (714) 7655041
Fire Sprinkler Final (714) 7655041
Water Engineering (714) 765-4591
Sub List/Business License (714) 7655194
Zoning (714) 765.5139
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.x1s
Permit Types
BUD
ELE
MEC
PLM
;'-
e
X
Permit Number: BLD2010-00182
Issued: 01/21/2010
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 72
Site Address: 525 N PINE WAY
Legal Description: N TR 2237 LOT 32
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 Lawforthe following reason(s) indicated below by the
checkmarKs) I have placed next tothe applicable Rem(s) (Sea 7031.5 Business and Professions Code: any city or county which requires a permit to construct,
after, Improve, demolish or repair any structure, priorto 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 Iicensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
perrnit 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 Contractor's State License Law).
I am exempt from Iicensure under the Contractors' Stale 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 request
when this application is submitted or at the following Web site: htto://www.lecinfo.ca.gov/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 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-identrfied property for inspection purposes.
Signature of Property Owner or Authorized Agent
WORKER'S COMPENSATION DECLARATION:
WARN ING: 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 ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
ave and will maintain a certificate of consent to self -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 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: SEA BRIGHT INSURANCE COMPANY
Name of Agent:
Phone No.:
Policy NP.B1081632
Expiration 8A(8011
I certify that in a 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 i compensation la of California, and agree that, if I should become subject to the worker's compensation provisions of Section
\ 3,7Do of the Labor Code, I shall fort with comply with those provisions.
Sig1pature of Applicant a
Permit Number: BLD2010-00182
DECLARATION REGARDING CONSTRUCTION LENDING AGENCY:
I hereby affirm under penally 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 .i er the penalty erjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the
B ass and Professions Code, a my license is in full force and effect.
Con rector Signature Da
NUMBER EXPIRATION DATE LICENSE TYPE (S)
679698 11/30/2011 C36 C20 HTAC
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.
fbld permit cornbo declare