130 Woodrose Court
TYPE OF p<<RMIT
Reroof
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CITY QJ~ifj(,jf~ ElM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765' 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SEOTION: 191
BUILDING PERMIT NO. BlD2004-04077
DATE: 11/8/2004
JOB ADDRESS: 130 S WOODROSE CT
LEGAL DESCRIPTION: N TR 8409 LOT 18.
CONTRACTOR INFORMATION:
STAR COURSE ROOFING CO
8902 SAllPORT DRIVE
LAGUNA HILLS, CA 926530000
BUSINESS PHONE: 714/962.2203
JOB DESCRIPTION: Tear of existing and re-roof 23 squares of composition shingles:'
VALUATION: 3,450.00
I OWNER-BUILDER,:1ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor':;. License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county_which requir'es'a permit to construct, aliA,r, implove, demolish or repair any structure, poor to its issuance, also'
requires the applicant for such permit to file a signed statement that he is lice;r:sed pursuant to the provisions of the Contractor's License Law (Chapter
. 9}(cornmencing with section ?:OOO of Division 3 of the Business and Professic.;IS Code) or that he is exempt therefrom and the basis for the alleged
. exemption. Any v.iolation of Section 7031.5 by any applicant for a permit subj-;!cts the applicant to a civil penalty of not lJ10re than five hundred dollars
~OO)., '. . . .
U I, as owner afpraperty, army employee3 with wag~s as their soIG corn;x;nsation, will (10 the' work. and the structure is not intend ed or offered for
sale (f:""'c. 7044 Business ~nd Professions. Code: The Contractor's Licet"lse l~~w does not apply to an ....wfler of prcperty \\110 builds or improve5
thereo,';, an.d who does sum work hin~self or herself or through his or her o'.vn.;~~mpioyees, provided t,h...~ such improvements are not intended or
offered for sale. If, however, the building or improv.ement is sold with one ye~;- of ccll1pleticJO, the pwner-builder will have the burden a~ proving that he
did not bu~d or improve fol' the purpose of sale). ,I, ,"
o I, as the owner of the :property, am exduslvely contrad:ing with licensed t'Ontractors ~o construct the f1roject (Sec.' 7044- Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyw:1c bUllos or lmprov~s thereon, and wno rontracts for such projects with
. ,
~ontractor(s} lrcensed pursuant to the Cont,actor's Llce~se Law). :
U I am exempt under Sec. . B & P.C fOl thiS reason. __ .
Date: Owner:
I
APPLICANT: TRACIE FAUBURT
OWNER INFORMATION:
CarloS.AHiquelme
128 E Amerige Ave
Fullerton, CA 92832
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
WORKER'S COMPENSATION DECLARATION ----.l
I hereby affirm under penalty ofperjurj ene of the following decJ~ration3:
o I have and will maintain a certificate of consent to self-insure for worker'~'C0mpeneation.
~s provided for by Section 3700 of the labor Code, for the pelformance Oqht~'NC'r'" for whid1
'this rmit is issued.
ve a lid will maintain worker's compensation insurance, as required by.:Section 3700 of
Je labor Code, for the performance of the work for which this permit is issuE.(;. f\.f1y w;:;rker's
Compensation insurance carrier and policy are:
Garrier,:',STATE FUND Policy Number. 1379163..02
This section 'need not be completed if the nnit is for one~' undred dollars { $1 00) '~)riess.
0' certify that in the perfonnaO<?eof he! work for wt ch:thiS permit is issued;,1 shall not
employ any person in any manne. r'so s ,td ~ecome su je t to the workers COi~.'.?;Jensation laws
of California, and agree that if I should b. i~:ome subject t the worker's compei:'tSation
provisions of Sec,tion 3700 oftha Labo ode,.1 sl'lall {..' hwith c mply wi" th :..e provisions.
,
l
11/8/2004 _
Date:
NUMBER
532778
TYPE
EXPIRATION DATE.
6/3012006
C39
Date: 1.1/812004 Appllcan
WARNING: FAILURE TO SECU
UNLAWFUL; AND SHALL SUBJ T AN EMPLOYER TO CRIMINAL PENAL ~IES ,~ND CIVIL
FINES UPTO ONE HUNDRED7HOUSAND DOUARS ($100,000), tN ADD,-,.,ON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 2706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES: ..
I CONSTRUCTION LENDING AGENCY '"~
1 hereby affirm unde'r.~e.na!tyof periljry that thE-iS is J c.on<;truction le!1djnqbg.c.>.ll,~yJorthfL.
pertorma,nce of thj3 work for which this permit is issued (Sec.3097.Civ.C);
Lende(slnforrnatio:
I certify that I hav read thiS a~tlon and slate that the above informatIOn iscorrec!. I
ag ee t mply ith all city or '~~ces and state laws relating to building construction, and
~er authoriz repre~tive Of:;:JhlS cit to enter pon the above mentioned property for
msp nr s.
Date: 11/8/2004
Si ature of Ileant or Agent
The er shall expire by limitation and become null and void if the building or
work has not passed tinalinspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work,
Construcion. Types:
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Fees paid for Permit:
Total: 235,33
INSPECTION RECORD'
FINAL INSP,I;:CTIONS
trical Final
mbing Final
hanleal Final
Test'
neering/Grading 'Final 765-5126
Dept. Final 7654040
er Engineering 765-5268
LJstlBusiness License 765-519
Date
Inspector
, INSPECTION , ' DATE, INSPECTOR Elee
Temporary Powe'r Pole Plu
Plumbing (Dl3inlWaste Pipe) , Me"
Electrical Ground ElectrodelUter
Gas
SetbacklFormslTrenches (Footings),
Do not install subflqor or pour floor slab until the " Engi
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves) , Fire
Mechanical (GrOUnclwork) , Wat
Electrical (Underground Conduit) " .
Pre-slab (CompactionlMembrane.Reint , Sub
,
Underpinning (Floor JoistlGirdel's) , Zoni
Do not cover or conceal the work below Until the , Sui!
following applicable items have been signed: ' , " '
1st Floor Shear
FireSprinkler (Rough) Bui/
2~or Shear ' ,
Ro heathi . hragm'Frlme) ,
M Inf./BondBell11/Pre-Gf'O\It) ,1'
Rough Plumbing (Top Out) , ,
Rough Mechanical .. ' ,
I KOugh E1ectriCaI\Or'y Wall)
Rough Electrical ,
Framing (Only after Plbg.. Elec.. Mech and Fire} .
Jnsulation (SoundlEnergy) Mec
Do,not tape or plaster, until the fOllowing,applicable .
.tems have been Signed: , . , .
Drywall "
Penetrations (Fire Rated) Electrical ,
Penetrations (Fire Raled) Mechanical
Penetrations (Fire Rated) Plumbing , '
Interior Lath ,
Exterior Lath , , " Plu
, . GENEAAllTEMS ' "
Exterior Plaster,(Brown Coat) "
T -Bar Electrical "
T-Bar Mechanical', ,
T-BarStructural
Sewer ,
Watlir Engineering Backflow , ", Elec
Water Service ' , , " , " .
ng 765-5139
ding Final (last Inspection. Only
After Above Compietel
PARTIAL INSPE
dina Insoections
hanicallnsDections
mbina Insoections
tricallnsDections
. ,