3155 Stonybrook
APPLICANT: ROBERT J PINSON
OWNERINFORMA TION:
ROBERT JPINSON
3155 W Stonybrook Or
Anaheim, CA 92804. .
JOB DESCRIPTION: In81a\l130 lineal feet of 6 ft. high block wall.
VALUATION: 7,800.00 PROCESSED BY: SAM
. L- . _ . . OWNER-eUILDE=3.peC\-ARATION. . .
I hereby aff~rm under penalty of perjury that I am ex~mpt .from the Contrc::do,-v Ucens0 lflw for the fcllowing I'eason (Sec. 7031.5 8usiness and
Profe~sions Code: any dty or county which require~ a permit to constiuct, ~!'~J~ i;nprov-e, demolish or repuir any structure;, prior t~ its issuance, also
requires the appncant for such permit to file a signed stafe(l1ent that he is UCE:H:S~d purs~a\1t to the provi~on3 of the Contr?ctor's License l;lW (Chapter
9){commencif'lg with Section 7000 of Division 3ofthA,8ustness and Prvf€'~;~idm~.C6Je) ('r that he fs exemot"therefrom cmd the basis for the alleged ~. .
~$;.:::tn. An. Y Violation of Section 703.1.5 by anyappliGant fer". perrr:i\ 5ULi'.'o.t~ tho;; D'ppllcant to a dvil p~~a:ty o(n~. t "'are than five hundred dollars
~~~s l1'.-\'n~r of property, 0; my employees with wages as their ~ecomp:~r.satiO~"*:, .....'ill do the work, Dnd the s!iuctureis n('lt intended 0( offered for
s~r~ (Sec.' 7044 Business andprofesslor,s Code: Ti16 Contractor's Uc.~nse !..~t";"'doc's !wt apply to an owner,of propi.-:lfty who build,,,> or irrljJroves .
thereon, and who doe.., such work himself or her.self or through his Cl her Oi.V;~!~'JlP;cye.;s, provided that .such impl'O'Jcments are l'lQt il1tended or .'
offer~ for sale. If, however, thoe building or improvernef'11. is soid with 0~~~ ye!1';-;;+ completion, the owne,-t:uilder w:lI have the burden of proving that r.e
did /19t builqor,irnprQve for th~:purpos8 of,:xtle)., . _ .' . 1 . . , , .
O' 'l"as,.t.he owner of th~ property, am-'e)(:d'Jsive,iYcon~::'c;l(1jng with !jceli~et! .~lltrn:.tor~ to construct th~ {J(o.ie<;t {Sec. 7044 Bllsiness and .Protessions.
Cede: TheContrador's license 'raw does not 'a{lpfy to 81'1":0- . r of pr0pr::rtv.,}-.'hC buiids or'iml-,'ro\les t.he.r~or., a.,d who cc'ntractt. for such'projectf'> with
f,~Ol'ltf;)r:tor(s).licensed pursuant to the Contr~dor's Ucen .... L w). .1
,L~amexemPtundersec.. .. ;. . forth. ason: -:-\_.~_____
~ . Owner:. .
L '. . . . WORKER'S COMPENSA ON DECLARATiO~___. _ i UI~SE~ CCNTR'l,CTGRS DE<;L~AATION
I hsreby affirm under penalty of perjury one of the (ollowing declalations: l i r:erehy c..ffi~:n under pef'calty of perjury that I am
OJ have ana will maintain a certificate of consent-to self,..insure 1"of'\,';jorker'~';0nJp~$E-tjon,' It licsnsoQ uneer provisiar,!'; of charter."9 (commencing
3B provided for by Section 370Dof the labor Code, for the perf<)rma:1cc ofthf.;",v\I(t-i. to;, Whid1V'Jith 5,,=~tion 7000) of DivskHi3 of the Bvs!ness and.
this permit is issued. .. ,; - I Profe~sior.::; Code.
r] I have and wilf.maintain wO(1<.er's com~en5'C!tion insuranc;:e, as reqL!ij".-)d b~' S':;C,:i0n1700 ~f I 1'2/17/2004,;
the Labor Code, for the performance of the work for which this ~rir"it loS ii'::->~;t{\.l._ ~jil'jvo(ker'~ I Dat.o:
CQ~pensatioi1 insurance carrier and policy are: . ,. - J' I,
Carris..: POlicy Numbe;: . ,: . NUMBER
.' " r
This sp-cti9t'l neEld not be completed if the pemtitis for one 'hundr dcilC:;.S{$10ci or l~:;. I, _yp" .
. I I ..
0..1 certiff that in-the perforrnanceofthe work forwhk;t1 is pe mot I':; 'l.g~:et, ! ~!)aU net
employ 301 person in any manner $0 as to b.ec~me sub' ct toth \..."rK~~H'5 ccmoB!)~;,"<lth.:m laws r
o( Califomia,' ano agree that if I should become subje to thaw .er's co:np'liJ.:;:a~!b'l1 T_'" '
provisions of'Seotion 3700 of the Labor Cod ~all orthwith omoJy wHh ft-.f!':8 P;~V'$lont:;. Consl.luc:t.'IJ1 Type~:
" ,~VN, ,
Date: 12/17/2004 Applicant: ' ~.;<_ ~~_I
. WARNING: FAILURETO SECiJRE;WOR. '$ SATIONC?VERt,G;oo:~' ~ ,
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINA~'PENA'-in;:~'ANO CIVIL I
FINES UP TO ONE HUNDRED 1HOUSAND DOLLARS ($100,OOO},;IN.ADC.r;'OttTO THE
COST OF COMPENSATION, DAMAGES AS pROVIDED FOR IN SECTION :1706 OF'T.HE'
LABOR CODE.INTEREST'AND AnORNEY'S.FEES. . o.
f . ..... . CONSTRUCTION LENDING AGENCYd -r:..,
I hereby affirm under penalty,of perjury that there-.is a constructiG\1lending ~';f.nc~"t~ir th~
performance of the wqrk for which this permit"is issued (Se;:>..3097 .C:v.C): .'::'.-
lc!!d~r's :nr"ormation:
BUILDING PERMIT NO. BLD2004-G4450
TYpE OF PERMIT
.Blockw~1I1 Columns
DATE: 12/1712004
JOB ADDRESS: 3155 W STONYSROOK DR
LEGAL DESCRIPTION: N TR 7241 LOT 55
CONTRACTOR INFOHMATION;
BUILDING DIVISION
200 S. ANAHEIM BLVD.:
(714) 765.5153
INSPECTION REQUEST LINE:.
(714)765.4626
CENSUS CODE: 434
QUARTER SECTION; \0
ARCHITECT/ENGINEER INFORMATION:
lu
J ~____
I certify that I have read this _application and state that the above information is correct. t
agree to comply with all city ordinanoes and state laws relating to building construction, and
hereby authoriZe repre~ntives of this city to ent!=T upon the above mentioned property for
ins~ion 'purposes. . .
I' .., Date: 12117/2004
Signature of Applicant or Agent.
The permit shall expire by limitation and become null and void if the building or
work has not pasSed finallnspection 365 daYl! from the date of permit issuance. A
new permit is required to commence or continue work.
Contractor'
EXPIRATION DATE:.
_.._--~_.__.._-"._~---~------_.-...:.:._~&-,' ,
Fees paid for Permit:
Total:
184.03
,'{
INSPECTION RECORD
. INSPECTION DATE INSPECTOR
Temporary .Power Pole . .
Plumbing (Drain/Waste Pipe) .
EleclricalGroul)d Electrode/Ufer ^
SelbacklFormSrrrenches (Footings) iZRil-<:>i 5<'J......Uik\:.-
Do .no.l instaUsubfloor or pour floor slab until the
lollowing applicable items. have been signed: .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Rein!. ..
Underpinning (Floor Joist/Girders) .
Do not cover or conceal the work below until the
following applicabfe items have been signed:
1st Floor Shear' . .
Firesprinkler (Rough)
2nd Floor Shear . .
Roof (Sl1eathinglDiaphrallmlFrame) ~
Masonry (ReinfJBond Eleam/Pre-Grout) I'?S"-o;~
Rough Plumbing (Top Out) .
Rough Mechanical . .
I KOugh ~ectric3llury wall) .
Rough Electrical . .
framing", {Only after Plbg.. Elec.. Mech.. and Fire;
InsulatIon (SoundlEnergy) . " .
po not tape or pla.;ter until the lollowing applicable
,tems 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 .
Waler Engineering Backflow
Water Service
FINAL: INSPECTIONS Date . Inspector
Electrical Final
Plumbing Final . . c '.
Mechanical Final ~
Gas Test .
EngineeringlGrading Final 765.s126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business Licen$e 765.519 . ..
.
Zoning 765.5~ 39 '. . ,
. ;~. ~/J ./1
Building Final \kast Inspection- Only 9-/1-0,,-
. fter.Above Complete) :("/7.
. PARTIAL INSPECTIONS
Buildina Insoections
-.
Mechanicallnsoections .
PlumbiJia Insoections
Electricallnsoections
l?s- .3
-~
PLANNING DEPARiMENl
OAT A~~~~? .
Bye;;.~N ~ _T'~_~)
,.:".ia.l$}
FLOOD ZO -~---
....----.-- -
HIS Ie DISTRICT' ,-W:
NIt. Se(; st3mp ::-,~~ '-~e
~ cie ttne tin 2-.bc\Je \\n~
SEE BUILDING F'ERM1T FOR
ANY COf\lC"'!'T!ONS
O~~ \0' V\\<[\ UOL ~
wq\\ ~..$~ .
W'i:<;THAu'i.V
LI ReL-E
... :.. :.... ..........
.. .. .. .. .. .. .. .. .. .. .. .. .. ..
..... .. e.- .... ....
... ..: ....
... .. .- .. ..
.. .. ..
. .
. . .
.. .. .. ..
.. .. ...
.. .
. .
... : .. ... ..
.. ......
.... :.: :.: ... .. ..
e.- .. ...::
.. .. .. ..
6L; 0
.. .. .. ..
... ....
.. .. ......
: :: .... ...
.. ... :.- -.-
( ./" <:0
(j1~-Cf/"3~11
<) OJ'v)' If Nr:fYC I)
5'
t-+
~pr.p~ ISOSU.;NC, OF tHIS PERMIT ODES NOT
R ve VI9,l~.,I~:-!. O~ ANY OF i\o\E
6UILDlbIG,92,o",- .', ,:'",~I, y, THE HOLDER
OF TK\" "... .,: _ ." ,. "-1' o'lm RISK
DEe 1 ,- 2IJ04-
BUILDING DIVISION OF ANAHEIM
13\..-0200.-1- APPROVED It
BY EM
OUl(SO
0\ 5 S V\f, S--tv1lj b-r ov l- \)1-
,---s Lo cJ< 1;U A LL