178 Starlight
BUILDING. PERMIT NO. BLD2005-00367
ElM
BUILDING DIVISlbN
200 S. ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714)765 - 4626 .
CENSUS CODE: 555
QUARTER SECTION: 174
TYPE OF PERMIT C IT. Y
. Reroof
DATE: 2/9/2005
JOB ADDRESS: 178 S STARLIGHT DR
LEGAL DESCRIPTION: N TR 8949 LOT 12
CONTRACTOR INFORMt.TION:
STEVE SUDDUTH CONS:RUCTION
3871 URIS CT
. IRVINE, CA 926060000 .
BUSINESS PHONE: 949 55' -2130
JOB DESCRIPTION:Tear off existing roof and replace with 73.5squares of moniersplit.shake tile ICBO# 2656.
VALUATION: 28,000.00 ... . i.. PROCESSED BY: MSM
I . . . . . . OWNER-BUILDE~PECLARATION. .. . . .
I hereby affirm under penalty of perjury that I am exempt from the Contre,ct6r:;:; Ucense Law for the following_ reason (Sec: .703'1.5 Business and
Professions Code: any city or county which requires a permit to construct, a It!! r, 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'licer~d pursuant to the provisions oithe Contractor's License Law (Chapter
9)(commencingwith Section 7000 of Division 3 of the Business and Professio1s Code) or that he is exempt therefrom and the basis for thealleged.
exemptio'n. Any Violation of Section 7031.5 by any applicant for a permitsub]ects the applicant to a .QviJ penalty .of not more than.five hundrecfdol1ars .
~~. , . . . . .
.0- I, as owner of propertY., or my. employees wlth.wages..as their sole cornp.:,msation, will do the work, and the strucWre is. not intended or offere.9 for
. sale (Sec. 7044 Business.and Professions COde: The Contractor's license i~w does notapply.to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or,her cwo employees,. provided that such imp'Overrie!"lts are not intended or
offered for sale: If, however,.th~: building or improvement is sold. with ooe ye'.1f of complet!on, the owner-builder will have the burden of proving that he
did not build or. improve for the purpose of sale). . ~. _."
..0 .1, as the owner afth.e property, am exclusively contractil19with licensed h:>ntractors to construct the project (See. 7044 Bu~inessand.Professians
Cod~: The Contractor's License Law does not apply_ to an owner of propdri~' who builds or improves.thereon, and,who contractS for such projects with
P-QontFaqor(s) li~ensed pursuant to the Contractor's License Law).. j .
U I am exempt under Sec. ',8 & P.C. for this reason:
Date:' Owner:" .
'1 WORKER'S COMPENSATION DECLARATION
I hereby affirm uflder penalty of pe~ury one,of.the follOWing declarations:, .
o .1 have aQd will maintain a certificate. of consent to self-insure for work~(.-; fompe~satjon,
as provided for by Section 3700 of the Labor Code, ''for the performance ~f t!~:,:: \j..o:k for which
J~ permit is iss,!ed. . . (
~ I have'and will maintain worker's compensation insurance, as required br Section 3700 of
" the labor Code, for the performance of thE;! work for which this per'mil is issu(od. Myworker's
Compensation insurance carrier and policy are: _ ~
Carrier: STATE FUND . PolicyNumber. 16860251~
.This secti~n ne~ not be "comPleted;f tile pennit is ~or ~ne hundred dollars ($1 oJ: ~t" iess, .
o I certify that in ,'the performance of the work for which this permit'.isissuJj, I shall not
emploY any person in any manner so" as to become subject to the worker's ct'l1pensation laws
of Califomia, and agree that if I should become s . 'ed to the worker's comp!~ns'ation
provisions of Section 3700 of the Labor Code, sh I forth Ith omply with th...,s~ provisic>os.
APPliCANT: DAN HILL
OWNER INFORMATION:
Hwa M.Lee
178 S Star1ight Dr
Anaheim, CA 92807
ARCHITECT/ENGINEER INFORMAT(ON:
LICENSED CONTRACTORS DECLARATION
'hereby affirm under penalty of.perjury thati am
licensed under'provisions of chapter9 (commencing
with Section 1000) .of 'vsiol1' 3 0 e Business and
Professi ns Code.
21912005
Date:
NUMBER
746046
TYPE
TYPE
TYPE
EXPIRATION DATE
212812006'
B
C39
HIC
Date: 21912005 . . Applicanl\l-:
WARNING: FAILURE TO SECUF{E'wOR R'S COMPENSATION COVER."GE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAi.TIESAND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDiTION TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE.
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY .
I hereby affirm under penalty of perjury that there isa'canstruction lendingC:<!le(lcyfor the
performance oft,he work for which this perl;nit is issued (Sec.3097.Civ.C):
Lende(slnforrn~ljon:
Construcion Types:
VN, .
Fire Sprinklered?
NO
I.c~rtify that I have read this application and state that the above information is correct. I
agree to comply with a ity ordinances and state laws relating to building construction, and
hereby authorize rep tives of this city to enter upon the above mentioned property for
in8p, ion purpose- . .
Dat.: 2/912005
Fees paid for Per~it:
Total:
611.23
ig ure A licant or Agent
The permits hall 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 permii is required to commence or continue Work.
. .
FINAL INSPECTIONS
INSPECTION RECORD
'INSPECTION DATE INSPECTOR , Electrical Final ,
Temporary Power Pole . Plumbing Final
Plumbing (DrainlWaste Pipe) , , Mechanical Final
Electrical Ground Electrode/Ufer . ,
SetbacklFormsfTrenches (Footings) Gas Test ,
.' Do not install subfloor or pour floor slab until the Engineering/Grading Final
following applicable items have been signed: . .
Plumbing (Water Pipe.Sprinkler Valves) F.ire Dept. Final 765-4Q40
Mechanical (GroundWork) . , Water Engineering 765'526
Electrical (Underground Conduit) Sub 'List/Business 'License
Pre-slab (CompactionlM~brane.Rei nt.J ' . "
Underpinning (Roar Joist/Girders) . . Zoning 765-5139
Do not cover or conceal. the work below untJI tne Building Final ~ast Inspect;
following applicable items have ,been signed: , . fter Above C
1 st FlOOr Shear, . PARTIAL
FiresJSrinkler (Rough) Build;n.. '.......ections
2nd Floor Shear . . I 'Il
Roof=iril:i'l1laPlllaQrn'Frane) ~J()/i '. , :'
Mao infJElQfld BeamJPre-Grout) I . . '
Rough Plumbing (Top Out) " ,
Rough Mechanical .
Rougn l:IectrlCaI (Llry waltl
Rough Electrical
Framlng.-, (Only afterPlbg., Elee., Mech:. and Fire) , ,
Insulation.(SoundlEnergy) . .
Do not tape or plaster until the following applicable MechanicallllSDectio
items have been signed: .' . '. ,
Drywall ' . ' ,
peneirations (Fire Rated) Electrical . ,
Penetrations (Fire Rated) Mechanical,
Penetrations (Fire Rated) Plumbing
Interior Lath Plumbina InSDection
Exterior Lath
, GENERAL ITEMS ,
exterior Plaster (Brawn Coat) , . ,
T -Bar Electrical .' , .
T.Bar Mechanical ,.
, , ' .
T.Bar Structural, ,
Sewer
Water Engineering Backflow Electric'allnSDection
Water Service
Dale
'l,nspeClOr.
765-5126
8
765-519
on- Only
omplele) .
INSPECTIONS . C, L.....,..II-e."
'ns
S
S