1706 E. Willow
TYPE 'OF PERMIT
Reroof
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BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
, CENSUS CODE: 555
QUARTER SECTION: 103
BUILDING PERMIT NO. ' BLD2'1.05-00827
"
, DATE: 3/28/2005
JOB ADDRESS: 1706 E WILLOW ST
LEGAL DESCRIPTION: N TR 1565 LOT 212
APPLlCANT:,JOSE BARRERA
OWNER INFORMATION: CONTRACTOR INFORMAi'!ON: ARCHITECT/ENGINEER INFORMATION:
Jo 5e L Barrera
1706 E Willow SI
Ariahelm.CA 92805
JOB DESCRIPTION: Tear off existing and reroof 39 squares wilh eagie lite lii~ ICBO #4660 @ 5.7 Ibs/sf
VALUATION: 9,500.00 PROCESSED BY: SAM '
I OWNER.BUILDER DECLARATION
I i)ereby affirm under penalty. of perjury that I am exempt from the Contractor:3 License taw for the f91lowing, reason (Sec. 703"1.5 Business and
Professions Code: any dty or county which n~quires a permit-to construct, a;t~r" tmplove. demolish or repair any structure. prior t~ its i~uance, also
requires the applicant for such permit to file ~ signed s.tatement th?t he;s iicf~r,::,ed pursuaflt to the provisions of the Contractor's LicE;!nse Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profes5i::i1s C::lde) OF that he i's ,exempt therefrom and the basis for the alleged
exemption. Any violation 'of Section 7031.5 by any applicant for a permit sUb.:ec;ts' the appllr.ant to a' dvir p"p.nalty of npt rr.ore.than five hundred dollars
mas.owner of prope~, or my employe~ with wages as th~jr sore comp~i1Sation, will do ~he work, and the struct~re is net intende(j'~r offered for
sate (See, 7044 Business and Professions Code: The Contractor's Licenst?- t:.1w daes not ap!=~yto an owner r)f pmperty whc builds or improves
thereon, and who does such work himself or herself or through his or her ow,~ ~rnp!o'Jees, provided that sqch-jmprove~ents CITe not intended or
offered for sale. If, however, the building or improvement IS sold. with on.e ye'.~f of completIon, the owner-builde; vim have the burden of proving that he
did not buil.d or improve for the purpose of sale). j . , . ..<. . .
o I, as the-owner of the property, am e us.~contractjng wlth,licensf:d' ecr;tractcrs-to cor.st":ucdJ~e proiect (S'ec. 7C44'Business and Professions
Code: The Contractor's License Law d not.ap Iy to an owne; of propert,,:!:/h::. buijds_~r improves tt:ie(~n,_ and whO. contracts for such projects with
~o~actor(s) licensed pursuant to t ontrac' License L~w). \ .
~ : arr:J~J ~Oepe~wner: ,B - for this reason: ---=-=~;~,__ ,....----=~--
WORKER'S Jr~-- l LICENSED CONTPJi,CTORS DECLARATION -,
I here~y affi~m un~~r penalty of p~ ry one.of the fOllowing declaratiOlis: .'{ I.hen"!by affirm under penalty of perjury that I am
~ave and will maintain a certifICate of consent to self-in.'5ure for worker) (o:--:lper.sation, licensed !.Jnderprovisk'ins of chapter 9 (commencing
, rovided for by Section 3700 of the Labor Code, for the perlormanceoftr,[ worJ{ for which with Section 7000)'of Divsion 3 Of the BUsines'S and
his permit is issued. ,; Professior!S Code.
, [J ! have and will maintain worker's compensation insuran.ce, as requi:B'j c.,' Sectlor. 3700 of 3/28/2005
the Labor Code; for the perforll1ance of the work for which this permit is 1S::;\1~-:d. My wor}<er's Date: 'Contractor
Compensation insurance carrier arid policy are:
Carrier:' Policy Number. NUMBER EXPIRATION DATE
This section need not be completed if the pennit is for one hundred dollars ($10{\} or less.
~ify'<that in 'the performance of the k.for~hjCh this permit is issU':.'c,.1 shall 'lot '
~p~~ any person in any manner so as te b come Ubiect,to the worke-r.s C')rrH~ensation laws
of.Califomia, and agree that if I should ec e'-sub.ct to the worker's cor!1pdns?.tion
provisions of Section 3700 ofthe Lab C e, I s I fort ith comply with those-proviSions.
Date: 3/28/2005 Applicant:
WARNING: FAILURE TO SEC R'S COMPENSATION COVEj<AGE IS
UNLAWFUL. AND SHALL SU8JE PLOYER TO CRIM INAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN !\Dr'ITlON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3"'06 OF THE
lABOR CODE, iNTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affir~ under pena-Ity of perjury that there is a construction lending a;jeri<;y for the
performa'1ce of the work for whim this pormit is issued (See 3097 .eN.G): .
lender's./nfarmation: .
TYPE
Construcion Tvpes:
VN" '
Dale:,3/28/2005
Fees paid for Permit:
Total:
310.50
gnature of Applicant or Agent
The pe tsh I expire by limitation and become null and void if the building or
work as not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or, continue work.
INSPECTioN RECORD
INSP!:CTION DATE ' INSPECTOR '
Temporary Powet Pole ,
Plumbing (Orain,waste Pipe)
Electrical Ground Electrode/lifer
SetbacklFormsrrrenches (Footings)
Do not install,subfloor or pour floor slab until the
followingapplicable,ilems have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) "
Eleclrical(Underground Conduit) ,
Pre-slab (CompactionlMembrane.Reinf.
Underpinning (Floor Joist/Girders)
Do not cover oroonceal the work below until the
following applicable items have been signed:
1 st Floor Shear ,
Firesprinkler (Rough)
2nd Floor Shear j'JAA/
Roof (Sheathing/Diaphragm/Frame) ":'~~ r ~ / "T'..
Masonry (ReinfJBond Beam/Pre-Grout) ( ./
Rough Plumbing (Top Out)
Rough Mechanical
Rougn l:IectrlCaI (Dry wall)
Rough Electrical
Framing (Only aftefPlbg., El.ec.. ~"lech.. and Fi're) "
Insulation (SoundlEnergy)
Do, not tape or plaster until the'following applicable
items have. been signed: , '
DryWall , ,
Penetrations (Fire Rated) Electrical {
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Ratedj"'umbing
Interior Lath ,
Exterior Lath "
" ' , ' , GENERAL ITEMS ' .
Exterior Plaster (Brown Coat)
T .Bar Electrical '
1:-Bar Mechanical ,
T .Bar Structural :
Sewer ,
Water Engineering Backflow
Water Service '
,
FINAL INSPECTIONS,.( " Date In,spector
Electrical Final ,
Plumbing Final , "
Mechanical Final ,
Gas Test ,
Engineering/Grading Final 765-5126 ,
, "
Fire Dept. ,Final 765-4040 , "
Water Engineering 765.5268
Sub List/Business License 765-519 " J
Zoning 765.5139 ' , , , /") ;
, '
,Building Final ~asllnspection. Only If -:3~{)~ r~
fter Above Complete)
PA T v: '
/ RIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections