845 S. Verde
BUlLDI"'G PERMIT NO. BLD2005-00451
.
TYPI::OFPERMIT CITY.
Reroof
DATE: 2123/2005
JOB ADDRESS: .845 S VERDE ST
LEGAL DESCRIPTION: N TR 2205 LOT 58
APPLICANT: DAN HILL
OWNER INFORMATION:
OskarT Zimmermann
1426 E Cortney PI
. Anaheim. CA. 92805
BUilDING DIVISION
200 S. ANAHEIM BLVD.
(714)765.5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 555
QUARTER SECTION: 104
ARCHITECT/ENGINEER INFORMATION:
CONTRACTOR INFORMATION:
STEVE SUDDUTHCONSmUCTION
3871 URIS CT
IRVINE, CA 926060000,
BUSINESS PHONE: 9495::1..2130
JOBDESCRIPTION:Tear off existing roof and replace with 25 sqaures of 30.Y~.{f composition shingles and 3 squares ofbLiilt.up root
VALUATION: 5,000,00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty-of perjury that I am exempt from the Con1racl:Di.'s;Ucense law for the following reaSon (Sec. 7031.5 Business and
. . Professions Code: any city or county which requires a pel mil to construct, arer. improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for suCh permit to file a signed stat~ment that heis licensed oUf~uant to the previsions of th,e Contractor's -License law (Chapter
. 9)(cor(lmencing with Section 7000 of Division 3 of the Business and Professis'ns Code) or that he is exempt therefrom and the basis for the alleged
~xemptiori: Any violation of Section 7031.5 by any apJi>licant for a pen1iit S~W~cts the a pplicant to ,a dvit penalty of not more than five hundred dollars
~50~,>~~ owner of property; or my employees with ~ages as their sole com/\e'-~sation, will d~ the work, and,t~s'truc~re is -n~t intend'eeI or offered ~r
sale (Sec. 7044 Business and Professions Code: The Contractor's Ucens~ ,I.a'w does not apply to an owner of prop6rty who buUds or, improves
thereon, anr,i who does such work himself or't'lerself or through his or her o~~I[i,~rnployees. provided that such improvemer.t:s are not intended or . _~:; '::
offered fO. I' sale. If, however, the bUild.in9' or improvement is sold, W. ith one Y<:rr.-of co. mp!etion, th. e owner-:-bU.i1der Will have th.e burd. en of prOVing1h~_~...he.. ;.-:
did nct bu"dor improve for the purpose of sale). .' . F " '. ,"" ...... :'~'
o kas,the owner of the property, am eXd'US!Vely contracting With licenseti'lconlradors fo construct the project (Sec. 7044 Business and PTofEj!ssions:;
Code: . The Contract~r's license Law <;toes not apply to an owner of propert~'jWho budds or improves thereon, and who rontracts for such -projects with .:'
ji.Qontractor(s) lice~ed pursuant to. the Contractor'~ License law)." .
U I am exempt untier See.- , B & P.C. for th,is reason: ; ,
Date: . Owner: 1
. , WORKER'S COMPENSATION DECLARATION r= 1
I hereby affirm under penalty of perjuw one of the folloWing declarations: 1._'
o '" have and will maintain a certificate ofronsent t6 self-insure for w~rY..ei'kCOmD3'nt,aticn,
as provided for by'-SeCtion 3700 of the Labor Code, for the performance of td~,wo~' for which
~'hi permtt is issued. . . I
I nave and will, maintain worker's compensation Insurance, as required ty Section 3700 of 2123/2005
'. e' Labor Code, for the performance of the work fo'r whiCh this permit is,i,,*,u.~d, Myworker's Date:
Compensation insurance carrier and policy are: .' -~ '
, Carrier: STATE FUND Policy NU,mber.1686025;'l
Thiss~on need not be completed if the pennit is for one hundred dollars {$1t.~~ or less. .
o I certify_that in the perfonnance ofth~ work for which this permit is issu~d, ! shall f"!Ot
employ any person in any- mariner so as to become subject to the worker's (").mpensation laws
of Califomia, and ag'ree- that if I should become subj ct they.Jornei's CO/r;p~ilsation'
provisio!1s of Section 3700 of the Labor Code, I all hWith c ply wi '-;tt:6s.e provisions.
. PROCESSED BY: MSM
I
LICENSED CONTRACTORS DECLARATION ,
J hereby affirm under,penaity of perjury that lam
licensed, under preVisions of ctlspter 9 (commencifW
witb Section 7000) of Di ~. 030ft eBusinessand
Professio 900
NUMBER
746046
TYPE
. TYPE
TYPE
EXPIRATION DATE
2/28/2006
B
. C39
HIC
Construcion Tvpes:
VN, .
Fire Sprink!ered?
NO
Date: 2123/2005 Applicant: -i-'
WARNING: FAILURE TO SECUREW RKER'S. COMPENSATION COVERAGE is
UNLAWFUL, AND SHAll SUBjECT EI\lPlOYER TO CRIMINAl.PENALrJESAND CIVil
FINES UPTO ONE HUNDRED THO. SANO DOllARS ($100,000), iN ADl'iT10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR iN SECTlo,'; 3706 OF THE
'. LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY.
I hereby affirm unde'r penalty of perjury that there is a cpnstruction lending sqency for the
performance of the work -for which this permiUs issued (Sec.3097 .Ci~,C}: ~.
Lende(s Information;
I certify that I have read this application and state that the above'information is correct. I
agree,to cpmply with all cityo'dinances and state laws relating to building construction, and
~ereby authorize r sentiv of this city to enter upon the above mentioned property for
insp ion pur~
Dato: 2/23/2005
Signature of Applicant or Agent'
TIle permit shall 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 permit is required to commence or continue work.
Fees paid for Permit:
Total:
235,33
INSPECTiON RECORD
',NSPECTION, ,,' DATE INSPECTOR
Temporary Power Pole , , '
, Plumbing (OrainlWaste Pipe) ,
E1eetrlcal Ground Electrode/Ufer
SetbacklFormsrrrenches (FCIOtings) ,
Do not Install subflClOr or pour floor slab until the ,
foll,owlnq applicable items have been signed:
, Plumbing (Water Pipe.Sprin,kler Valves)
.M~hanical (Groundwork)
, Eleetrical (Underground Conduit) ,
Pre-slab (CompactionlMembrane.Reinf. , ,
Underpinning (Roar Jbist/Girders) ,
Do not cover or conceal the work below until tl]e , ,
following applicable items have been signed:
1 st Floor Shear ,
Firesprinkler (Rough) " " -
2nd Floor'Shear ' " ,
RoOf ISheathlllQ/D1aphraamfFramel ' ' .z.~~~ '
Masonry (ReinfJBond BeamlPre-GlO\lt) , I'
Rough Plumbing (Top Out) , ,
Rough Mechanical ' '
Rougn t:IectrlCaI\ury 1IY811'
,Rough Eleetri,cal ,
Framing (Oflly after Plbg.. Elec..~Aech:. and Fire) "
Insulation (SoundlEnergy), ,
Do not tape or plaster Ulltil the following applicable ,
,ite(Tls have been signed: , ' '
Drywall " ' , ,
Penetrations (Fill! Rated) EI~trical '
Penetrations (Rre Rated) Mechanical'
Penetrations (Fire Ratedl Plumbing , ,
Interior' Lath
Exterior Lath ,
GENERAL ITEMS
Exterior, Plaster (Brown Coat),
T -Bar Electrical' ,
T-Bar Mechanical
T -Bar Structural ' '
Sewer ,
Water Engineering Backflow
WalerService ,
FINAL INSPECTIONS., I Date Inspector, '
Electrical Final <\ ,
Plumbing Final " '
Mechanical Final "
,
Gas Test
Engineering/GraclingFlnaI7SS:S,26 " ,
Fire Ollpt. Final 1654040 . "
Water Engineering 765'-5268 ,
Sub List/Business Licllnse 765.519
Zoning 765-5139 ,
,
Building Final ~ast In'pection- Only l).tJ5 ~[, "
, , ' !ter'Above Complete) 'AA~
PARTIAL INSPECTIONS
Buildina Inspections
<,
MechanicallnsDections
Plumbinalnspections
Electrical Inspections