2009 S. Waverly Dr.
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; 58 ,
.BUILDING PERMIT NO. BLD2004.03981
DATE;, 10/28/2004
JOB ADDRESS: 2009 S WAVERLY DR '
LEGAl DESCRIPTION; N TR 6792 LOT 11
APPLICANT: AUSTIN HAN
OWNER INFORMATION;
Hyun C Kim
2009 S Waverly Dr
Anaheim. CA 92802
CONTRACTOR INFoRwtnON:
ACE ROOFING SYSTEM Co
1027 W ORANGETHORPE liVE.
FULLERTON, CA 92835-0100
BUSINESS PHONE: 7148';,1-9923
JOB DESCRIPTION:Tear off existin9 roofand OSS plywood and replace with ;\4 squareso! composition shingles,
. ,
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 4,890.00 PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION ~
I hereby affirm under penalty of perjUry that I am exempt from the ContrF.lctQr's License Law for the foUowing reason (Sec. 7031.5 Business and
Professions Code: any dty or county which. requires a permit to constrlJct, a ltk r, lmptove;-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 Basiness and Profes$lbns Code) or that he is exempt therefrom and the basis for the all.eged
exemption. Any violation of Section 7031.5 by any apPlicant for a permit stlt.lects: the appllcant to a civil penalty of not more thaI"'! five hun"dred dollars
($500). " :, .
"0 I, as owner of property, 'or my employees with wage-sas their s0Je com~ellsatjon;' will do the work, and' the structure is not intendedorcffered fer
sale (Sec; 7-044 Business and Professions Code: The Contractor's License Jaw does not apply to an owner of property who builds or improves'
th_ereon, 'and who does sum work himsetf or herself or through his or. her ow.) employees, provided that such !rt:lPlOvem~nts are not intendedor _ "
offered.for sale. If,"however, the building or improvement is sold with one year, of completion, the owner-builder will have the burden of proving "that he
did not build ot improve for the purpose of sale). ;; , " "', " ,
o -I, astrle owner ofth:e property, am eXdUsiv&ly contrncti'ng with Iice!iSer-jfcoi1tractors to construct the project (Se-c. 7044 Business and ProfessirJns
Code: The Contractqr's License Law-does not apply to- an,owner of prOpelf'lt...,oO bliilds or improves thereon, and who oontractsfor-'sudl projects with
~ont~actor(~) Iicens~ pursuant to the Contractor's License Law). . I
U I am exempt und~r Sec. ' ~ B & P.C. for this reason:
" Date; Owner: --.---J
I WORKER'S COMPENSATION DECLARATION _...i
: I hereby affirm under penalty of perjury one of the following"declaratlons: i
o I have and wili maintain a certific~te of,oonsent to seff-insure for wcrkef',~ c~mpensa"tion,
as provided for by Se_CtiOn '3700_of the LabOi Code" for the perfoff!lailcs of th~ wo-':k for which
this permit is issued." ' '; "
f>(f""'1 have and will maintain worker's compensation ins~ranc~, as re.q~r~d b( Section 3700 of 10/28/2004
~abor Code, for the performance of the work for whIch thIS permit IS rssll:..d"- My worker's" Date:"
"COmpensation insurance carrier and policy are: : '
Carrier: STATE COMP Policy Number. 285-G2 !..;illlT 0001124 .
, --,~;,
Thi~ sectiort need not be completed if the pennit is for one hundred dollars ($,!(.Itfb'r 'less.. "
M"I certify that in the performance of the work for whic?lthis permit is isS'<J~~.' I_s~all not.
h"nGIOY any person in any manner so as to become subj at to the worker's (;.~irnPensation laws
of California, and agree that if !_should become subject 1)1e worker's comPimsation
provisions of Section 3700 of the Labor Code; I-shaH fa 'i n'comply withtr.b: !..provisions.
,
LICENSED CONTRACTORS DECLARATION
I hereby affirm under pena of perjury that I am
licensed u nde;- prOvisions otc pt~r 9 (commencing
with Section 7009) of Divs' the Business'and
Professions Code.
~ntractor
NUMBER
679543
TYPE
TYPE
, HiC
C39
EXPIRATION DATE
10/31l2005
Date: 1 Ol28l2 004 Applicant:
WARNING: FAILURE TO SECURE vVORKER'S'CO
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYE CRIMINAL PENA~TIES AND CIVIL
FINES UP TO ONE HUNDRED 1H OU SAND DOLLARS ($100,000), IN ADt;!TION TO THE
COST OF'COMPENSATlON, DAMAGES AS PROVIDED FOR IN SECTion 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. >
I ' CONSTRUCTION LENDING AGENCY' ,_ ;- '
_ I h,W_by affirm under_Density of pE::riury that _there is acor,~ruction lendjn~ 8~i,-:~r:cyforthe_ :__
perforrriance of the work for which.this permit is issued (Sec.30S7 .Civ,C): '
Lender's Inform'ation: "
~
~s application and,state that the above information is correct. I
~\W ordinances and state laws relating to building cOi1Struction, and
tj~-es of this city upon "the above mentioned property for
Construcion"Tvpes:
VN, '.
Fire Sprinklered?
NO,
Date: 10/28/2004
Fees _paic:t for Permit:
Total;
235.33
Sig ufe' of Applicant or Agent
, The permi~ 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.
. '.
INSPECTION RECORD
, INSPECTION ' 'DATE, INSPECTOR
, Temporary Power Pole ' ,
Plumbing (DrainlWaste Pipe) " ,
Electrical Ground Electrode/uter ' .
SetbacklFormslTrenches (Footings), "
Do not install subfiooror pour floor slab untii1he
following applicable items have been'.signed:
Plumbing (Water Pipe.Sprinkler Valves) ,
~echanical (Groundv.torkj .
Electrical (UndergroundConduit)
Pre-slab (CompactionlMernbrMe.Reinf. ' "
Underpinning (Floor JOistlGirders)
Do not cover or conceal the work below until the
fol/owing app.li,c<;J'ble items ,have. been signed: . ,
1 st Floor Shear ' ,
Firesprinkler ' (Rough)
2n~,' '
Ro hi ' hragm'Frane) ~fjff(oa--
M infJBond BeanlPre-G~t) t. ,
, Rough Plumbing (Top Out) /
,
Rough Mechanical,
, Rougn ~ectriCaI (Dry waU)
Rough Electrical
Framing (Only after Plbg.. Elec.:M.ech and Fire) , ,
. Insulation (SourKllEnergy) "
00 not tape or pJaster,, until the following applicable ,
items h~ve been signed:': . ",' .
DlY\YaU "
, Penetrations (Fire Rated) Electrical ,
Penetrations (Fire Rated) Mechanical
,Penetrations (Fi", Rated) Plumbil19
, Interior Lath '
Exterior Lath
, GENERAL ITEMS
exterior Plaster (Brown Coal\" ,
T -Bar Electrical
,. -Bar Mechanical
T -Bar 'Structural
Sewer ' ,
, Water Engineering Backflow
Water Service ,
, pC" P !Iff I T' , EV t) r R '-D
I..- 1 \ I VI 1\ I I \ C. .
.INSPECTION
nOT COMPLETED
DA T E:J I.; 2-OS
FINAL INSPECTIONS Dale Inspector
Electrical F,inal
Plumbing Final ,
Mech,anical Final "
. ,
Gas, Test , '
EngineeringtGrading'FinaI765-5126,
Fire Dept. Final 765-4,040 ,
.. . '
Water E,ngineering 765-5268 " ,
Sub l.IstlBusinessLicense 765-519 ' ,
, ,'.
Zoning 765-5139 , , , "
' ' "
Building Final Itast inspection- Only ,
, " fter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina<,lnspections '
Electricallns~ctions