2104 E. Vermont
BUILDING PERMIT NO. BLD2005-00267
TYPE OF PERMIT CITY
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BUILDING DIVISION
200 S. ANAHEIM BLVD:
(714) 765- 5153
INSPECTION REQUEST LINE'
(714) 765 - 4626
CENSUS CODE: . 555
QUARTER SECTION: 114
DATE: 1/31/2005
JOB ADDRESS: 2104 E VERMONT AVE
LEGAL DESCRIPTION: N TR 2350 LOT 54
APPLICANT: SEAN GURNEA
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
SUSAN BROWN WEATHERLlNE ROOFING, INC.
2056 LEMON HEIGHTS 1013 E WALNUT ST
SANTA ANA, CA SANTA ANA, CA 92701 (-COO
BUSINESS PHONE: 714 73<3425
JOB D~$CRIPTION: .Tear off existing and 'fe-roof 25 squares of 30-year compostlorr sNngles.
VALUATION: 4,000.00
I OWNER-BUlLDEI1:CECLARATION.
I hereby affirm under penalty of perjury. that. I am exempt froO) the Contr~c'tor's License Law for the tollo\NJing reason (Sec. .7031.5 Business and
Professions Code: any dty or-county which requires"a-permit to cO(lstruct. altf:r, improve, demolish o~ repair any structure, 'prior to.,its issuance, also
requires .the applicant forsucll permi' to file asigned statement that he is liCr.l~sed .pursLiant to the provisions oftha Contractor's license La'll (Chapter
9)(commencingwith Section 7000 of Division 3 of.the Business and Profess';c:.s Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 703~.5 bY any applicant fora permit Z"uJ.j'scts the appiicant to a dvR. penaltycf not more than five nundred <follars
-~. ... ..... ... ... . ..
01, as owner of property" or my emptoyeeiwith w~ges as their sole ccmr.insation, wiii do the work, 'and thestructure is not intended or offered Jor
$aJe (Sec. 7044 Business and Professions Code: The Contractor's Lice'lseL~'N.dot:ls not apply to an. own~r of property who builds or improve~
thereon, and'w.ho does such work himself-or herself or through his or her pW~Br:nP!oyees, .provided that such im"prcvements are notintended or
offered for sale, If, however, the bUilding or improvement is sold with one y~;::.r of completion, the owner~blJiider wiii have .the burden oi preving'that he'
didnotbuildori01prov~,/6rthepurposeofs8lek ... . i. .. " .' .. .
[J I, as the. owner of the propertyl .am exclusively contracting wiih licensed (:~Jntractor.s to construct thd pfcl~ct (Se~.7044Busii1es8and Profession...>
Code: The Contractor'~ License ,Law dOes not apply 10 an owner of property i,/110 bu~ds or improves thereon, and wl1o,cantracts for SOm projects with
,d..qontraCtor(s) I~cens~d pu~suarit to the Contract6r~s Lice/lse Law), .
L'.J'1 amexemptunde:r Sec. . B & P.C. fo(this reason: _n_
DiJte: Owner:.
PROCESSED BY: SAM
I
i WORKER'S COMPENSATION DECLARATION
_I hereby ~.ffirrry ll~der penalty of perjury one of the following declarations:
LJ 1 have and will ma.intain a certificate of mnsent to self-inslJrefor WorkCi'~ :.o,nper.~atjon.
.::::!S ~rovided fqr by Section 3700 of the Labor Code, .for the performi:m-ce l;fi.l:~- wer'", fer which
this ermit is iSsued.
[ I have and wii! maintain worker's.compensation insuranCE":, al';; reqUired t:-y' Section ;3700 of
t . bor Code, lor the,performance of the work for which this.permit is issu~d.Myworker's
oml'ensation insurance carner andpolicy,are:.
'arrier: ,STATE FUND Policy. Number: 163596~-92
This section need not be ~mpleted if the penn,t is.for one hundred dollars ($1 C!~!: '{i.;!~s.
0' certifyth~t in the performance, of the work for whic~this perl1'}it is iS$ui:::;!/.(-_~'1all not ,
. employ any person in a ny manner so as to become subject to.fhe.worker's.g(~'TlP.?ns8t1oil laws.
of Califomia, and agree that if I should becom I bjed to the worker's Cctrioe,1~aticn .
provisions of Section 3700 ofilie' labor' e~ rail-forthwith comp! ,. . t.ho:;:~:pr-J'.'isjof1s':
:___-:::J
LICENSeD CONTRACTO_RS [)1:CLA~~j
I heret.y affirm under pen<y of pF.'rjury _that I am
lir.:ensed under provisions .of c:hi:>pter!1 (c.oiomencing
. with Section 7000) 0 . n 3 oflhe Busi "ar,d
Profession!';; Code.
1/31/2005
Date:
Contractor
.NUM
129560
TYPE
EXPIRATION DATE
'11/30/2Ci06 .
C39
Date: 1/31/20"05 . Applicant:
WARNING:FAILURETOSECUREW. . ...
UNLAWFUL, AND SHALL SUBJEC' ~ PLOYER TO CRIMINAL PENALTlESAND CIVIL
FINES UP TO ONE HUNORED TH USAND DOLLARS ($100,000), IN ADDiTION' TO THE
COST OF COMPeNSATION, DAMAGES AS PROVIDED FOR IN SECTION 370e. OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . ..
I COt<!STRUCTION LENDING AGENCY
ii';efebl aftllm Linder penailY of pe,ju'Y.ih..-ti. ihu;;;: :s a -~O;;~t.:ih;:iJ:) i:::.,ji''--d'::::b';.,~.':i.f:)f t."'~
pE;!rforrilanceofthework for which this permit is issued (Sec.3097 .Civ.C): .
lender's Information: .
I Constrileion TVDes.
VN, ,
'.>'
of icanfor Agent
't shall expi limitation and become null and void if the building or
w k has nofpassed final inspection 365 days from the date of permit issuance. A
Vi permitis required to commence or continue work.
Fees paid for Permit:
'Total:
235.33 '
Date: 1/31/2005
INSPECTION RECORD
. .
.... INSPECTI.ON . DATE INSPECTOR
Temporary Power Pole. . .
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/uter .
SelbacklFormsfTrenches (Footings) .
Do not install subfloor or pourfloorslab until the.
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechank;al (GrOUndwork)
Electrical'(Underground Conduit)
Pre-slab (Compactilll1lMembrane,Reinf.! .
Underpinning (Floor Joist/Girders) .
Do. not cover or conceal the work below until the
foIJ9wing 'applicableilems have been signed:. .
1 st Floor Shear . .. .' .
Firesprinlder (Rough) .
2nd Floor Sl!ear . .' . .' .
Roof (Sheathing/Diaphragm/Frame) t.,"}.oC' n L
Masonry (RelnfJBond BeamlPre-Gll)Ut) 1//
Rough Plumbing (Top Out) - .
Rough Mechanical . .
I KOugn l'.IectrlCalllJI'y wall) .
Rough Electrical .
Framing (Only after Plbg.; Elec.. f..1ech,. and Fire) .
Insulation (SoundlEnergy) .
Dl) nQt tape Qr plaster until the fQllowing .applicable . . I.
items have b~en 'signed:, . '. .
Drywall . . .
Penetrations (Fire Raled) Eiectrical .
Penetra/ions (Fire Rated) Mechanical .
Penetrations (Fiie Rated) Plumbing .
Interior Lath .. .
Exterior Lath " .
GENERAL ITEMS . .
Exterior Plaster (Brown Coat)
T.Bar. Ele~rical
T .Bar Mechanical . .
T.Bar Structul'!ll
Sewer . .
Water Engineering BackfJQw .
Water Service .
f
FINAL INSPECTIONS '.D;3te Inspector.
Electrical Final . . . .,
Plumbing Final .' . .
Mechanical Final .
Gas Test. .
I
Engineerlng/Gradinll Final 765,5126 . '.
Fire Dept. Final 765-4040 .
Water Engineering 765-5268
Sub List/Business License 765.519' I
ZQning 765-5139 . '.
.' . .
Building Final. ~ast Inspection. Only ~/'s~r''vn ./1 ^
.fter Above Complete)
PARTIAL INSPECTIONS . fJJ
*
Buildina Insoections
f( ~ ~.~ A:J:..1t,
Mechanical Inspections
PlumbinQ Inspections'
Electrical Inspections
."