125 N. Syracuse St.
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765 - 5153
INSPECTiON REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
BUILDING PERMIT NO. BLD2005-Q1350
DATE: 5/10/2005
JOB ADDRESS: 125 N SYRACUSE ST
LEGAL DESCRIPTION: SEC 12 T 4 R 11 2.50 AC M/L IN S1/2
CONTRACTOR INFORMATION:
CELOSEAL ROOFING, INC
2323 N BATAVIA
ORANGE, CA 926650000
BUSINESS PHONE: 7149982990 '
JO~ DESC?RIPTION:Remove existing rock roaf, In5tall.32 squares-of 'new rock I'oof to carports 43.70.
VALUATION: . 16,265.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty 01 perjury that I am exempt from the Contractor's license Law for the following reason (Sec. 7031.5 Business and
Professions Code:,any,city or'c0untywhich requires a permit to construct, atter, improve', demolish or repair any structure, prior to its issuanCe, also.
requires the applicant for suQh permit to file a signed statement that he is licen'sed pursuant to. the provisions of the Contractor's License Law-(Chapter
9)(cammencing with Section 7000 of Division 3.ot the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged .
exemption~ Any 'violation of Section 703-1.5 by any applicant for a permit subjt.'Cts the applicant to a civil penalty of not more than five hundred dollars
($500). .
D I, as owner of p'roperty, 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; arid who does such work himself or herself or through his or her,ownemployees, 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 that he:
did l')ot build or improve for the purpose of sale). "
D I, as'the owner of the property,am,exclusively contracting with licensed contractors to construct the project" (See: 7044 Business and Professions
Code: The Gontractor's License Law does not apply to an'owner of propertyvJho builds or improves ,thereon, arid. who contracts. for such projects with
a contractor( s) I icensed pursuant to the Contractor:'s Lice nse ,Law). "
o I am'exempt,undersec. . ,B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I herebyaffinn under penalty of perjurY one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for worker's~ompensatibn,
as provided for by Section 3700 of ttie Labor Code, for the performance oftha woridor which
.this permit is issued. , : .
ri(r- have and will maintain worker's compensation insural')ce, 'as require.d by'Section 3700 of
,(fie-Labor-Code, for.the performance of the work for which this permit is issued, My worker's .
Compensation insurance carrier and policy are:
Carrier: STATE FUND. ' Policy Number. 467-0000614
APPLICANT: BILLY KENNEDY
OWNER INFORMATION:
The Normandy
PO Box 19528
Irvine, CA 92623
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provision"sof chapter.9 (commenCing
with Section 700 f Divsion 3 of the si ss a
Professi s C e. .
NUMBE
263519
TYPE
TYPE
EXPIRATION DATE
11130/2005
This section need not be completed if _the pannit is for one hundred dollars ($1 00) or less.
'i><tTcertify that in the performance of the work for which this permit is issued, I shall not
~'any person in any manner so as to become SUbject to the worker's compensation laws
of California,' and'agree that if.1 ould become subject to the worker's compensation
provisions' of Section 3700 of the' ,I shall rthwit 0 ith those provi .ons,
~L/.""
Date: 5/10/2005 Appl' nl: , V7t!- .
WARNING: FAILURE T ECUREWORKER'S COMPENSATION COVERA E IS
L SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE NDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPE SATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OFTHE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
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):
~ender's Information:
C39
B
Construcion Types:
VN, ,
Fire Sprinklered?
NO
Pi( Date: 5/10/2005
. Signatul'i of Applican or nt
permit shall expire by limitation and become null and void if the building or
w has not passed final inspection'365 days from the date of permit issuance. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
268.48
INSPECTION RECORD .
.. ..
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbi ng (DrainMlaste Pipe). . .
Electrical Ground Electrode/Ufer .
SelbacklFormslTrenches (Footings) . .. .
Do not install sllbfloor or pour floor slab until the .
following applicable items have been signed:' , ,
Plumbing (Water Pipe.Sprinkler Valves) .
Mechanical (Grouridwork) . . ..
Electrical (Underground Conduit) .
Pre-slab (Compaction/Membr~.Reinf.
Underpinning (Floor Joist/Girders) .
Do l'Iot cover or conceal the work below until the
following applicable ilems have been signed: .
1 st Floor Shear . . . .
Firesprinlder (Rough),
2nd Floor Shear L>A ,
RoOf (Sheathing/Diaphraarn'Frame). 1VJ1~' .~ I>
, Masoriry(RIllnfJBOnd BeamlPre-Grout)
Rough Plumbing (Top Out)
~ough Mechanical . .
Rougn eectrlClII (Dry Wall) ...
Rough Electrical .. . .
Framing (On~ after Plbg.:Elec.; Mech,.and Fire)
Insulation (SoundlEnergy) .
Do not tape or plaster until the following applicable .
items have been sign.ed: .. . . '
Drywall . ..
Penetrations (Fire Rated) Electrical . .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing .
,Interior Lath
Exterior Lath .. '
GENERAL ITEMS
Exterior Plaster (Brown Coal)
T .Bar Electrical . .
T .Bar Mechanical ,.
. .T .Bar Structur:al .
Sewer.
Water Engineering Backflow ;.
Water Service . .. . '
FINAL INSPECTIONS Date Inspector
Electrical Final
Plumbing Final ' . .
. .
Mechanical Final I. . .
. .
Gas Test .1 .
.
Engineering/Grading Final 765-5126 . .
..
Fire Dept. Fina1765-4040 ..
Water .Engineering 765'!i268
Sub List/Business License 765-519 .' . ,
Zoning 765-5139. ..
Building Final' ~aSllnspection. Only ~"700/?J .~A -/
. . . fter Above Complele) X
PARTIAL INSPECTIONS
Buildinci Inspections
Mechanic:allnspections
Plumbina Inspections
Electrical Inspections
CONTRACTOR INFORMA-ION:
EM & MS PROFESSiONAL CARPET S
2509 S BROADWAY
SANTA ANA, CA 92707 0000
BUSINESS PHONE: 714434,6577
JOB DESCRIPTION:Repair fire damage to existing carport.
VALUATION: 20,000.00 PROCESSED BY: MSM
I OWNER-BUILDER pECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'.., LICense Law for the follOWing reason (Sec. 70 1.5 usrness 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 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,cts the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compe1sation, will do the work, and the structure is not intended or offered for
sale {Sec. 7044 Business and Professions Code; The Contractor's Ucense low does not apply to an owner of property who builds or improyes
thereon, and who does such work himself or herself 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 that he
did not build or improve for the purpose of sale).
D I, as the owner of the property, am exclusively contracting with licensed C:,)ntracfors to construct the project {Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyV\'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. ,8 & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury of\e of the following declarations:
o I have and will maintain a certificate of consent to sefHnsure for worker's compensation,
is rovided for by Section 3700 of the Labor Code, for the performance of the work. for which
t s permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
he labor Code, for the periormance of the work for which this permit is issuec', Myworker's
Compensation insurance carrier and policy are:
Carrier: CALIFORNIA INSURANCE COMPANY Policy Number. 460034340101
BUILDING PERMIT NO, BLD2005-D2035
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TYPE OF PERMIT CITY
Repair
DATE: 711/2005
JOB ADDRESS: 125 N SYRACUSE ST
LEGAL DESCRIPTION: SEe 12 T 4 R 112.50 AC MIL IN Sl/2
APPLICANT: MINGO VELEZ
OWNER INFORMATION:
The Normandy
POBox 19528
Irvine, CA 926230000
ElM
BUILDING DIVISION
200 S. ANAHEiM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: 438
QUARTER SECTION: 19
ARCHITECT/ENGINEER INFORMATION:
SHAWN NIKJOO CE36969
4883 E LA PALMA AVE
ANAHEIM, CA 92807
I;
This section need not be completed if the pennlt is for one hundred dollars {$100) or less.
o I certify that in the pertorrnance of the work for wh}ch th ermit is issued. I shall not
employ any person in any manner so to become subject b worker's compensation laws
of Califomia, and agree that if I should ome subje to t e er's compensation
provisions of Section 3700 of the Labor de, I n fa h ith c ply with tho:3e provisions.
Date: 7/1/2005 Applicant:
WARNING: FAILURE TO SECUR OR R'S COMPENSAT N COVERAGE is
UNLAWFUL, AND SHALL SUBJECT AN PLOYER TO CRIMINAL PENALTiES AND CIVIL
FINES UP TO ONE HUNDRED THOUSA DOLLARS ($100,000), iN ADDITION TO THE
COST OF COMPENSATION, DAMAGES S PROVIDED FOR IN SECTION <1706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency tor the
performance of the work for which this permit is issued (8ec.3097 .eiv.C):
lender's Information:
I ha\ll;l re8.d thjS~P ic tion al1ds!ate_that the above i.'1forfT'..ation l~'::orrect. ~
ply with all citY. ord a es and state laws relating to building construction, and
rize rep[)"ti es of th city to enter upon the above mentioned _property for
poses
Oate: 7/1/2005
ignature of Applicant rAge
TIle permit s I expire by Iimitatio f1d become null and void if the building or
work has n passedfinallnspecti 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
NUMBER
804679
TYPE
TYPE
EXPIRATION DATE
2/2812006
B
.C15
Construcion Tvpes:
VN, ,
Fire Sorinklered?
NO
Fees paid for Permit:
Total:
536.81
City of Anaheim
Building Division
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final i<:\(l't
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub Llsl/Business License 765.5194
Zoning 765-5139
Building Final (Last Inspection - Only lq,~ Jl..
After Above Complete) /' -
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/FormslTrenches (Footin s) "
Do not install subfloor or pour floor slab until the
followin applicable items have been si ned:
Plumbing (Water Pi e1Sprinkler Valves)
Mechanical (Groundwork)
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:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
-
Roof (Sheathin Diaphra m/Frame)
Masonry (ReinfJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (SoundlEnergy)
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) 10
T -Bar Electrical
T-Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow
Water Service
PARTIAL INSPECTIONS G.~~I
.
7
\ -e.r
MechanicallnSDections
Plumbina InSDections
ElectricallnsDections