710 S. Sherrill St.
TYPE OF PERMIT
Residential Addition
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ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REOUESTLlNE:
(714) 765.4626
CENSUS CODE: 434
QUARTER SECTION: 21
BUILDING PERMIT NO. BLD2005-01984
DATE: 6/28/2005
JOB ADDRESS: 710 S SHERRILL ST
LEGAL DESCRIPTION: N TR 2874 LOT 81
CONTRACTOR INFORMATION:
D'AMBRA.INC
7752 WARNER AVE
HUNTINGTON BEACH, CA 926470000
BUSINESS PHONE: 714848.,668
JOB DESCRIPTION:Add family room 300 square feet
VALUATION: 20,400.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter; 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 Profession:s 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 subjects the applicant to a civil penalty of not more than five hundred dollars
($500).
D I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's license law 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 employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving thatt1e'
did not build or improve for the purpose of sale).
D 1, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's license Law).
o I am exempt under Sec. , 8 & 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.
f'Jc:o::l have and will maintain worker's compensation insurance, as required by Bection 3700 of
me-labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FU NO
APPLICANT: DENNIS D'AMBRA
OWNER INFORMATION:
Augusti ne Martinez
710 S Sherrill St
Anaheim, CA 92804
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
wit ection 70 . ion 3 of the Business and
Profe io
Policy Number. 0014867-2006
EXPI RATION DATE
2/28/2007
This section need not be completed if the pennit is for one hundred dollars ($100)-or less.
~ J certify that in the perfonnance of the work for which this permit is issued,'1 shall not
~oy any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should om subject to the worker's compensation
provisions of Section 3700 of th labor onhwith comply with those provisions.
Date: 6/28/2005 Applicant
WARNING: FAILURE TO SECU E WO R'S COMPEN ATIO VERAGE IS
UNLAWFUL, AND SHALL SUB CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRE THOUSAND DOLLARS ($100,000), IN ADDIT,ON TO THE
COST OF COMPENSATIO ,DAMAGES AS PROVIDED FOR IN SECTION 3'106 OF THE
LABOR CODE, INTERES AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm underpenalty 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:
B
HIC
Construcjon Types:
VN, ,
Occuoancv Groups:
R2.3, , , ,
livinQ Area:
300
"
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
hereb authorize representives of this city to enter upon the above mentioned property for
insp
Date: 6/28/2005
Fees paid for Permit:
Total:
856.48
Signa pplicant or Agent
permit shall expire by Iimi1ation and become null and void if the building or
ark has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbina/Drain/Waste Pipel
Electrical Ground Electrode/Ufer ~
SetbacklFormslTrenches (Footings) 7'1~/d
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing /Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Reinf.) At"
Underpinning (Floor Joist/Girders) lite ;/
Do not cover or conceal the work below until the
following applicable items have been signed;. /
1 st Floor Shear Vvf VlIr./,fV'A. JO\
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Dia!,hragrnlFrame) rf.o~ ~/'v "jlJ
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out) ,
Rough Mechanical <61,0( ...
Rough Electrical (Dry Wall) ?: ," "--
Rough Electrical /f
Framing (Only after Plbg., Ele., Mec. And Fire) '1! wr~ -" :-f
Insulation (Sound/Energy) gl I~I", :\..---'
Do not tape or plaster until the following applicable
items have been signed:
Drywall ~/!o/~ :/?/b.uU'
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath 311?t&? 7L/ht4r
GENERAL ITEMS 52
Exterior Plaster (Brown Coat) ~/l-.,,"'lS
T -Bar Electrical
T -Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final ID r
Plumbing Final ~ ~~
Mechanical Final Ilt!r( /0 \..
Gas Test
Engineering/Grading Final 765.5126
Fire Dept. Final 765-4040
Water Engineering 765-5266
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Lasllnspeclion - Only loflg(Q .<:: If; A
After Above Complete) ..- '-
G~c.
PARTIAL INSPECTIONS ~ ~
ID!jldina InsDe~. C/r(" __
-'7h-1/'D'O U~...,... ......~JI ,..~ ~
MechanicallnsDections
Plumbina InsDections
ElectricallnsDections