1603 E. Willow
BUILDING PER.r.Al.T~O. BLD2005-01549
./
,
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 -5153
INSPECTION REQUESTlINE:
(714) 765 . 4626
CENSUS CODE: 555
QUARTER SECTION: 103
TYPE OF PERMIT CITY"
Rerool
DATE: 5/24/2005
JOB ADDRESS: 1603 E WILLOW ST
LEGAL DESCRIPTION: N TR1770 LOT 99
APPLICANT: GEORGE CARRALEJO
OWNER INFORMATION:
LongT Le .
1 062 Sumrriitri~ge Dr
Diamond Bar, CA 91765
i
CONTRACTOR INFORMATION: .
GEORGE & SONS ROOFING
8218 PEPPER CIR
BUENA PARK, CA 906200000
BUSINESS PHONE: 714952-4958
JOB DESCRIPTION: Tear off existing and reroof 20 squares with timberline shingles
VALUATION: 4,000.00 \
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I hereby affirm under pena yof perjury that I am exempt from the Contractor's License Law for-the fol OWing-reason (Sec. 7031.5 Business and
Professions Code: any city or county which requil'e;s a permit to construct, alter, improve, demolish or repair any structure, prior to its issuaric~, also
requires the applicant for such permit to file a signed statement that he is lice~sed pursuant ,to thE;'l provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professi~s 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 subj'octs 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 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, and who does such work himsetf ot herself or through his or her own)employees, provid_ed that such improvements are hot intended or
off~~ed 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.
djd not build or improve for the pUJpose of sale). ' .' -1 .' .
o I, as the owner of the property, am -exclusively contracting with licensed eontractors toconst,ruct the p"roject (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyvlho 1;luilds or improves thereon, and-who contracts for such projects. with
~ontraC?tor(s) .licensed pursuant to the Contractor's License Law). ! . .
U I am exempt under Sec.. , B & P.C. forthis reason:
Date: Owner:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following de9larations: .
o I have and will maintain a certificate <:if consent to self-insure for worker's compensation,
as,provided f.or by Section 3700 of the Labor Code, for the pertormance of thework for which
this permit is issued. '.
gJ:::i have and ~Hl maintain worker's compensation insur~nce, as required by :Section 3700 of
the Labor Code, for the performance of the work for which fhis permit is issued. My worker's
Compensation insurance carrier and policy,are:
Carrier: P()licy Number: EXEMPT
This sec:lion need not be completed il the peOllit is for one hundred dollars ($1 00) or less,
o 1 certify that in the performance of the work for which this it is issued, I shall not
employ -any person in any manner so as to become s'ubjec 0 the arker' compensation laws
of Califomja, .and agree that if I should becci e bject t the wo er's mpansation
provisions of ~ection 3700 oftha Labor Cod aU fo hw;t I}: ith those provisions.'
NUMBER
443547
TYPE HiC
TYPE C39
E:XPiRA TION DATE
7/31/2005
Date: 5/2412005 Applicant
WARNING: FAILURE TO SECURE WOR R'S CO NSAT COVERAGE IS
UNLAWFUL,AND SHALL SUBJECT AN EMPLOYER TO GRI NAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND 'DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMI'ENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,
CONSTRUC.TION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending age~yfor the
performance of the work for which this permit is issued (Sec. 3097 .Civ.C):
Lender's Information: .
Construcion Tvpes:
VN, ,
that the above information IS correct. I
Date: 5/2412005
Fees paid for Permit: .
. .Total:
160.61
. ignatur 0 Applic r Agent
The permit shall expire by Iim' tion and become null and void if the building or
work has not passed Ii 081 inspection 365 days from the date of permit issuance. A
new permit is. required to <;'Ommence or continue. work.
INSPECTION RECORD
INSPECTION 'OATE INSPECTOR
Temporary Power Pole ,
Plumbing (OrainlWa$le Pipe)
Electrical Ground Electrode/uter .
Setback/I'ormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicableilems have been :signed:. ' .
Plumbing (WaterPlpe.SprinklerValves) .
Mechanical (Groundwork)
Eleclrical(Undergroun(l Conduit) .
Pre-slab (CompacllonlMembrane.Reinf.
Underpinning (Floor Joist/Gilders)
Do' not cover or corn:ealthe work below until the
following applicable ilems have been signed:
1 st Floor Shear , . .
Firesprinkler' (Rough)
2nd Floor Shear" ' . . .
Roof (Sheathing/Diaphragm/Frame) .",-
Masonry (ReinfJBond BeamlPre-Grout)
Rough Plumbing (Top Qut)
Rough Mechanical . I'
. KOugn l:IectrlClIIllJry wall)
Rough Electrical' '
Framing {OnlyafterPlbg.. EJec.< Mech..and Fire}
Insulation (SoundlEl1ergy)
00 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 Coal)
T -Bar Electrical . .
T-Bar Mechanical
T -Bar Structural .
Sewer "
Water Engineering Backflow
Water Service
FINAL INSPECTIONS .. .. Date ., ,lrn;peclor
Electrical Final .
Plumbing Final . .
Mechanical Final '
Gas Test .' ,
Engi~ringlGrading Final 765-5126 .
Fire Dept. Final 765-4040
Water Engineerinil 765-5268
Sub List/Business License 765,-519
Zoning 765-5139
Building Final ltasl Inspection- Only 6~- <5 "1~/~ ,
fter Above Completel
PARTIALINSPEqTIONS C/
BUil~ Ins~ections '. "
'~ .r 0 ,~ J ~If"
/Jz~J (~4/,
Mechanical'lnspections
Plumbing Inspections,
ElectricallnsP8ctions