2116 S. Spinnaker St.
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CITY ~< "'i:i~~HEIM
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BUILDING DIVISION
,2ooS,ANAHEIM BLVD,
(714) 765 - 5,153
INSPECTION REQUESTLINE'
,(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 99
. BUILDING PERMIT NO. BLD2004-02365
TYPIO OF PERMIT
Reroof'
DATE: 617/2004
JOB ADDRESS: 2116 S SPINNAKER ST
LEGAL DESCRIPTION: N TR 2691 LOT 37
APPLICANT: FERNANDO ANDRADE
OWNER INFORMATION: CONTRACTOR INFORMAiioN: ARCHITECT/Ef'lGINEIOR INFORMATION:
Fernar1do Andrade
21168 Spinriaker St.
Anaheim, CA 92802' , ,', ";' ," ' "
'JOB DESCRI~TION: Tear off exi.sting wood shakes.~ reJoof 22 sqwithcomp~~iti6n shingles & 1 sq BUR ov~r house entrance.
VALUATION: 3.300.00 PROCESSED BY: MJF
,I ' ' , , , ',',', ", OWNIOR-BUILDEj?DECLARATION.' " ,',', ' , " ,
I hereby affirm under penalty of perjury that I am 'exempt from theContra<;to(s ~ic.ense Law for Ui~ following reason (Seq,' 7031.5 Business and
. Professions Code: any city,orcountywhich requires a permit to c9nstruct,.ali?,r, improve., demolish or repair any structure, priortoits' issuance, also
requir'sthe appllcantfor such permit to mea signed statement-that he is lic1rsed pUl:s~ant to the provisions of the qont.ractor's License Law (Chapter
9)(c mmencing with Section 70no of Division 3 of the Business and Pr\>.fess;,)ns Code) 6rt~at tle 1$ exempt therefrol}l.and the basis fqr.the.alleged
ex plion. Any viOfationof Section 7031.5 by any <;lppUcarit for a p'ermit 5uqlAlcts the applicant ~.')'a (.!vii pehalty of not more than five hundred dollars
($ 0), , ' 'j ,,' ," , '.,'
~, as owner of property, or my. employees'with wages as their solecom~}nsation, will do the:wprk, and the structure is not intended Of offered Tor
sale.(Sec.7.044 Busine.ss and Professions Code: The Contractor's License !Jaw does not applytq an owner of property who bui,lds or improves '.
thereon. and who does suerl work himself or hersetfor thrCligh his or her ow:~ employees; Provid.ed that such improvements are no~ intended or
<?ffered:fo~ sale. If, however, the' building or if'!lprov:8ment'is sofd with one :(e'?rof oompletion, the ovmer-builder.willhave the.burden of:pr~)Ving that he
did-'1otbuildor-'mprove.for~epurposeofsale). . 'i . -. _,. .
o I, ~s the owner o(the property, am exdusively' contracting with licensed 'fX>ntractors to coostruct the project (Sec. -7044 Business and'professior1s
Code: The Contr;3ctor:s license Law does not appfy to an owner of propelty_~vho buMs or improves thereon, and wht? contracts for sum projects with
~ntract.or(s) licensed pur?uant to-the Contractor's '.Licens~ w): ~ .
U Ja xempt under Sec. . ,B&P.C.t [h. r n' _~
ate: 0 OWner: I
[ WORKER'S CO 'ENSATION DECLARATION!
I 'hereby affirm under' penalty of perjury 'one of t!1e following declarations: ..1
0, I have. and wilt maintain a certificate of oonsent to _selt-i'ns~re fOJ worker~ comp!Jnsation.
as provided for,by Section 3700 of the ~abor Code, for the performance, ofth.~ work fo"r which
this permit is js~(Jed.
o I have and:.will maintain worker's compensation insura':lcej as required btSection 37aO of
the Labor Code, Tor the perfor.mance of the work for which this permit is issu1d, Myworker's'
Compensation in$Ura1')cs ca rrier and policy are:. '. I '
Garri r: Policy NUrflber:
. .. . . . - ~ . .
Thi .section need not ~ completed if the permit is for one.hundred dollars ($10Cj or iess.
':.1 certify that.in the Pertorrnance of the work for whi~h this permit ~ issUE,lj, ,fshan oot
employ any persanin a ny manner so as to become subject to" the worker's cf~,mpensation iaws
, of California,' and agree that if I should become subje~ to the worker'scomp.~:n~ation
.provisions of Sectiory 3700 of th.e Labor'Code, I shaU forth ith c I with n;:~~~e rroVi~ons,
, Date: ,617 12004 Appli~nl:
WARN ING: FAILURE TO SECURE W, , '
, UNLAWf.UL, AND SHALL SUBJECT AN MPLOYER, TO CRIMINAL PENI\I.TIES AND CiVIL
, FINES UP TO ONE HUNDREDTHOUSAND DOLLARS ($100.000), IN ADD:TION TO}:HE
,COST, OF-COMPENSATION, DAMAGES AS PROViDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,: '
l ' CONSTRUCTION LENDING AGENCY, .
I hereby affirm under penalty of perjury that"there is a construction lending <;~._i;rlcy.forthe
performance ofthe work for which;thi~ permitjs issued (Sec...3097.Civ.C)::.' ',. .
. ~U-\.~\;.,-'s :r,i"ciTr,ation: - -_. ~,~-~ -"'_.,._'-_:~ -..' ~::.\;~;~:;.;;: '~~;~.
I
LICENSED'CONTRACTORSDECLARATION
I 'hereby affirm under penalty of perjury_ that I ani
licells'3d under provisions of chapter-g (commencing
with Section 7000). of Divsion 3 of the Businp.ss an.d
Professions Code.
6/7/2004 '
Date:
., Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion' Types:
VN, ,
-.^,,-><'-''-
I certify.that I have, read. this application and state that the. ab.ove information is correet. ,
agree to oomply with all city ordinances and state laws relating to building construction, and
hereby authorize representives this city to enter upon the above mentioned property'for
inspeCtion pU'rpo~s..
i::::, '.Date: 6/7/2004
. Signa re of Applicant r Agent _
permit shall expire by limitation and become null and void if the buil ding or
work hall not passed final inspection 365 day!! from the date of permit issuance. A'
newpermit is n'quired t<1 commence or continue W'<>rk.
E::ees paiq for Permit: .
Total:
124.85
INSPECTION RECORD
, ...
iNSPECTION' . DATE . INSPECTOR
Temporary Power.Pole . .
Plllmblng(pl3inlWaste Pipe) .. . . .'
Electrical GrOund ElectmclelUfer. '. '. '. . . .
Selbac;klFormsrTrenChes (Footings) .
po riot install subfloor or pour floor slab until the . .
following applicable items have been signed:
PII,lll1blng (Water Pipe.Sprinkler Valves) . . . . . .
r.1echanical (GrOundwork)' ." '.
Electfk;al (Undergr<>und Conduit) . . . . .
Pre-slab (CornpactionlMembrane~Reinf.
Underpinning (Floor JoistlGlrderll) . . '. . . ..
.DO ilbt COvel' or conceal the work. below 'until the
'.f6Iiowingapplic;3ble items have. been signed: :. .' .
1 stFloor Shear .' . .' . '.' .
Firesprinlder. (Rough) .' . . .
2nd Floor Sheaf' '. . ..,,4'.,
R!:ict ISheathltlglDiaphJagm/Frame)' ~v.-~ . ~/'
MliSonry(Rl!infJBond BeamiPre,(3lOllf) \.
Rough PlumbinQ (Top Out) '. . '..
Rough Mec:hanlcal . .'. ....
ROugh actrlC ' vvall' . . - . ..'
Rough Electrical .... I" .' . .
Framing .(Only afterPlbg::'Elec.. Mech and'Fire) . '.
InlJUlation'(SbuncllEnergy) ,.
po not tape or.pla~ter' ul11i1 the 101l0..,,;IIg applicable .
Item.s have been sIgned:'. . .'. . . .
DrYlYall ' . .' . . ."
.' .
i Penetrations (Fire Rated) Electrical. . . ."
;Peroetrations (Fire Raled)M8chanical. '.
I Penetrations (Fire Rated) Plumbing . '.. .
ilnteriorLath. .'. . . .'
. Exterior Lath . . .
. , GENERAL ITEMS .
Exterklr Plaster (Brown Coat) , .
,T .Bar Electrical. . . .
T.Bar Mechanical . . .
T.Bar Structural' . .' . . .
Sewer . .
Water Enginelllring Backflow '. .
Water Service .
. . . . .'.
FINALINSPECTlONS . .', pal, In,spector
. .
Electrical Final '. . .' ." ~""'~
.' ". .',
Plumbing Final . . . . . .' . .'
.
Mechanical Final .
Gas Test .' .
. . . . '.
Englneerillg!Grading Final 76505126 . '. .
. .
Fir~ Dept. Finai 765-4040 '. . . ,
Water eiigineerinll765.5268 , ....
.
Sub List/Business' License 765-5.19 . . .
Zoning 765.5139'. . '. ,
Building Final . ~aSI InspectiOn. Only l-I~\ lor{ ft~&r~
' . fter Abov,e Complete).
. PARTIAL INSPECTIONS
Buildinalnspections '.
--------- .
. Mechanical Inspections
Plumbinq Inspections. .
"
Electrical Inspecti'ons