1515 S HARBOR BLVD (456)Permit Types
BIL _
ELE
MEC
PLM
V
X
Permit Number: BLD2010-00259
Issued: 01/28/2010
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 76
Site Address: 1515 S HARBOR BLVD (DCA - Hollywood)
Legal Description:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
Project Description: Mechanical for Tenant Improvement: Convert existing 4,397 sf. ABC kitchen to Central Entertainment
Atmosphere talent dressing rooms. Bid. #306 (Ref: BLD2009-04223)
Valuation:
Construcion Types: VA.
Fire Sprinklered? Yes
Cool Roof No
Total Fees paid for Permit: 490.20
People Associated with Project
Owner WALT DISNEY WORLD CO 1313 S HARBOR BLVD ANAHEIM CA
Contractor CRITCHFIELD MECHANICAL INC OF SOUTH 130 MCCORMICK AVE #106 COSTA MESA CA 92626 0000
Permit Applicant DAN HUFFSTETLER
Type Electrical Fixtures Qty Type Plumbing Fixtures Cry Type Mechanical Fixtures Oty
V. A. V. Unit 4
Commercial Systems per 1,000 sq ft 4
Ventilation Fan - <= 300 ctm on single duct 1
Air Handling Units 1
Processing, Special or Hydronic Piping per 1
100 ft.
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. !N1 os'm't mmR'
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 applicabIs items have been signed:
Plumbing (Ground/Underfloor Drain Waste)
Electrical Ground ElectrodelUfer
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the follwing applicable items have
been signed:
Plumbing (Groundlunderfloor Water)
Underfloor Rough Gas
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre�slab (Compaction/Membmne Relnf.)
Floor (JoistlGirders)
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/Diaphragm/Frame)
Masonry (Reinf.lBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Duct (Mechanical)
Rough Mechanical
Rough Electrical
Framing (Only after Plbg., Ele., Mac. & Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable items have been signed:
Drywall
Drywall Penetrations (Ele., Mac. & Plbg.)
Interior Lath
Exterior Lath
GENERAL ITEMS
Electrical Service Meter
Exterior Plaster (Brown Coat)
T-Bar (Struct., Ele., or Mec.)
Sewer
Water Engineering Backgow (Testable Only)
Water Service
All applicable items below must be signed before utilities A be released.
FINAL INSPECTIONS
DATE
INSPECTOR
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control n14)7 s 280
Engineering/Grading Final prpreuize
Fire Dept. Final (714) 765.5041
Fire Sprinkler Final (714) 765.5041
Water Engineering (714) 765.4591
Sub List/Business License (714) 765-5194
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
MIMAi
1 1 2
Plumbing Inspections
Electrical Inspections
Permit Backs Master-2008.xis
Permit Types
BLD
ELE
MEC
PLM
e
X
Permit Number: BLD2010-00259
Issued: 01/28/2010
INSPECTION REQUEST LINE:
(714) 765 - 4626
Quarter Section: 76
Site Address: 1515 S HARBOR BLVD (DCA - Hollywood)
Legal Description:
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
OWNER - BUILDER DECLARATION:
I hereby affirm under penalty of perjurythat I am exempt from the Contractor's License State Law for the following reason(s) indicated below by the
checkmark(s) I have placed next to the applicable ftem(s) (Sec. 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 requiresthe applicant forthe perndtto file a signed statementthat he or she is
licensed pursuant to the 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 lioensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit sublects the applicant to a civil penaftv of not more than five hundred dollars ($SOD).
--- I, as owner of property, or my employees with wages as their sole compensation, will do (__J 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 if ft 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 issubmdted or at the following Web site: hfto://www.leginfo.ca.aov/calaw.html.
Bymy 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:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO
CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUN DRED 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 penalty of perjury one of the following declarations:
have 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: EVERESTNATIONAL INSURANCE
Name of Agent:
Phone No.:
Policy N ..
60000217B091
Expiration t("2010
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 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. \
tz�,� �, ,
Si ature of Applicant D.te
Permit Number: BLD2010-00259
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 perjurythat I am licensed under provisions of chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code, and my license is in full force and effect.
\� i 1 /z2/)o
Co tractor Signature Dat
NUMBER EXPIRATION DATE LICENSE TYPE (S)
842973 7/31/2010 C20 HTAC
The permit shall wpire 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.
Anew permit is required to commence or continue work.
fold permit combo declare