336 S ANAHEIM BLVDBLD
Permit Types
ELE MEC
X
PLM
Parmit Number: BLD2010-04117
Issued: 11/03/2010
INSPECTION REQUEST LINE:
(714) 765-4626
Quarter Section: 84
Site Address: 336 S ANAHEIM BLVD
Legal Description: KONIG SUB LOT 1 TO 4 INC CALICITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765-5153
Project Description: Plumbing and Electrical for Foundation Only: Install new concrete foundation in existing building (1,580sq.
ft.) for future TI "Anaheim Brewery" REF BLD2010-02023
People Associated with Project:
Owner ANAHEIM REDEVELOPMENT
BURGE CORPORATIONContractor
Permit Applicant GARY HAUN
Type
Valuation:
Construcion Types:N/A.
Fire Sprinklered?
Cool Roof
Total Fees paid for Permit:
No
No
421.80
PO BOX 3222 ANAHEIM CA 92803-3222
981 CALLE NEGOCIO #200 SAN CLEMENTE CA 92673 0000
Electrical Fixtures Qty Type Plumbing Fixtures Qty Type Mechanical Fixtures Qty
Conduit and Conductors - per 50 ft.4 Kitchen Sink 2
Repair/Drainage Alteration/Vent Piping 1
Floor Drain 4
Water Distribution (modify existing)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
F ANAHEIMC
OF AN CA
L
I
F
City of Anaheim
Building Division
FOUNDED 18
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 DATE 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 Reinf.)
Floor (Joist/Girders)
Underfloor Insulation (Raised Foundation Only)
2nd Floor (Floor Nailing)
Do not cover or conceal the work below until the following applicable items have
1st Floor Shear
Firesprinkler (Rough) (Fire Dept.)
2nd Floor Shear
been signed:
Roof (Sheathing/Diaphragm/Frame)
All applicable items below must be signed before utilities will be released
FINAL INSPECTIONS
Final Gas Test
Electrical Final
Plumbing Final
Mechanical Final
Cross Connection Control (714) 765-4280
Engineering/Grading Final (714) 765-5126
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
DATE INSPECTOR
INSPECTION must be approved by the Building Division.
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
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
Plumbing Inspections
Electrical Inspections
FINAL
1192/12/21Permit Backs Master-2008.xls
Permit Types
BLD ELE MEC PLM
X
Rermit Number: BLD2010-04117
Issued: 11/03/2010
INSPECTION REQUEST LINE:
(714) 765-4626
Quarter Section: 84
Site Address: 336 S ANAHEIM BLVD
Legal Description: KONIG SUB LOT 1 TO 4 INC
OWNER - BUILDER DECLARATION:
OR
ANAHEI
M
CALIFO
CITY OF ANAHEIM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765-5153
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 thecheckmark(s) I have placed next to the applicable item(s) (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit toconstruct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement
that 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 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 alicensed 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 licensedcontractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this applicationis submitted or at the following Web site: http://www.leqinfo.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-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 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 provided for bySection 3700 of the Labor Code, for the performance of the work for which this permit is issued.
く 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: DELOS INSURANCE COMPANY
Name of Agent:Phone No.:
Policy No.:04DKRM12000409 Expiration Date: 7/1/2011
_ 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
worker's 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.
Signature of Applicant
PRODEO M66
BUREE CORP 11/03/10
Date
Permit Number: BLD2010-04117
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 theBusiness and Professions Code, and my license is in full force and effect.
Contractor Signature
PROSEOT мълBORGE C
11/03/10
Date
NUMBER EXPIRATION DATE LICENSE TYPE (S)338554 10/31/2012 B A
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