8072-8092 E. Santa Ana Canyon
BUILDING PERMIT NO. BLD2005.01709
TYPE OF PERMIT C
Tenant Improvement (Limited) ITY
DATE: 7/13/2005
JOB ADDRESS: 8072 -8092 E SANTA ANA CANYON RD
LEGAL DESCRIPTION: PM 255-1 PARS 11 & 17 POR. OF
APPLICANT: THOMAS KOO
OWNER INFORMATION:
OTR
18818 TELLER AVE
IRVINE, CA 926120000
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 437
QUARTER SECTION: 207
CONTRACTOR INFORMAT-ION:
THOMAS K CO i
2509 S BOLAR AVE
HACIENDA HEIGHTS, CA 91745 0000
BUSINESS PHONE: 626236--0404
JOB DESCRIPTION:renant improvement, 2382s1 existing retail space into health spa for 8082 E. Santa Ana Canyon Rd.
ARCHITECT/ENGINEER INFORMATION:
MICHAEL M KIM
5161 BEACH BLVD
BUENA PARK, CA 90638 0000
VALUATION:
50,500.00
PROCESSED BY: SAM
OWNER-BUILDER DECLARATION
I ereby affirm under penalty of perjury that I am exempt from the Contractor's:Ucense Law for the following reason (Sec. 7031.5 usiness and
Professions Code: any city or county which requires a permit to construct, atter. improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement that he is licenSed pursuant to the provisions of the Contractor's License Law (Chapter
9){commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subje;ets the applicant to a civil penalty of not more than five hundred dollars
($500).
o l, as owner of property, or my employees with wages as their sole compet"lsation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La"'", does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own bmployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one yea~of completion, the owner-builder will have the burden of proving that he
did not build or improve for the pu rpose of sale).;
o I, as the owner of the property, am exclusively contracting with licensed C<"mtractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyw,ho builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law). .\
U I am exempt under Sec. , B & P.C. for this reason:
Date: OWner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to self-insure for worker's compensation,
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 $ection 3700 of
t e Labor Code, for the performance of the work for which this permit is issued. My worker's
ompensation insurance carrier and policy are:
Carrier: Policy Number. EXEMPT
This section need not be completed if 1I1e pennit is for one hundred dollar. ($1 00) or less.
o 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 Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor Code, l~%:h:ith comply wit~ provisions.
Date: 7/13/2005 Applicant: ~ I' ~
WARNING: FAILURE TO SECURE~ER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT MPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED TH SAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOn-CODE;INTEREST AND ATTORNEY'S FEES. . -~
I 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 Information:
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspection purposes. .--/ _. /
.~ ("?-'7~~ Dale: 7/13/2005
Signature of Applicant or Agent
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 issu.....ce. A
new Dermit is reouired to commence or continue work.
LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that I am
licensed under proviskmsof chapter 9 (commencing
with Section 7000) o!." {VS.5'h3 of the Busi"". and
Professions CodX ~ [4-
7/13/2005
Date: ( Contractor
NUMBER
600329
TYPE
TYPE
EXPIRATION DATE
6/30/2007
B
C33 PAIN
Construcion Types:
VN, ,
Occupancy Groups:
S, , , ,
Fire Sprinklered?
T.I.Area:
YES
2,382
Fees paid for Permit:
Total:
1.339.98
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole ~ ,/
Plumbing (DrainlWaste Pipe) ~ /
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork) / J
Electrical (Underground Conduit) , ~ ,
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical 11
Rough Electrical (Dry Wall) :f5 II/~-t>~ LI. " j
Rough Electrical f ,4
Framing (Only after Plbg., Ele., Mac. And l='lre)~ ;;q"O\ k.1,. -'A A
Insulation (Sound/Energy) /
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business License 765-5194
Zoning 765.5139
Building Final (Lasllnspection. Only
After Above Complete)
INSPECTOR
"'\
1""...
~
PARTIAL INSPECTIONS
B~i!ding InS$-~. ~ ~.....Ih
'g'"-~{)S- - (). ~. FPA--1'-I6 -('-1
a ~Ck?. ~S / . :lL--L-
Mechanical Inspections
Plumbing Inspections
ElectricallnSDections