1906 Woodworth
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: 42
BUILDING PERMIT NO. BLD2005-02270
DATE: 7/20/2005
JOB ADDRESS: 1906 W WOODWORTH RD
LEGAL DESCRIPTION: N TR 3882 LOT 20
CONTRACTOR INFORMATION:
WESTMINSTER ROOFING CO INC
9612 SUTHERLAND WY
GARDEN GROVE, CA 92844 0000
BUSINESS PHONE: 714541.5351
JOB DESCRIPTION:Tear off existing material, install 31 squares of Claymax TiI. al 5.8 Ibs per tile ICBO #3523 for house and attached garage.
VALUATION: 12,500.00 PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty Of perjury that I am exempt from the on tractor's License Law for the tollowing reason {Sec. 7031.5 usiness and
Professions Code: any city or county which requires a permit to construct, atter, improve, 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 Business and Professions 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 subjects 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 camper-sation, 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 himself or herself or through his or her own employees, provided that such improvements are not intended or
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 or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who buRds or improves thereon, and who contracts for such projects with
fU?ontractor(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. ,8 & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to self~insure for worker's oompensation,
as provided for by section 3700 of the Labor Code, for the performance of the work for which
this permn is issued.
I7(l have and will maintain worker's compensation insurance, as required by $ection 3700 of
1h8 labor Code, for the performance of the work for which this permit is issued. My worker's
'Compensation insurance carrier and policy are:
Carrier: STATE FlJ NO
APPLICANT: VINNY LE
OWNER INFORMATION:
ANDY K LEE
1906 W WOODWORTH RD
ANAHEIM, CA 92804
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Secti n 7 0) of Divsion 3 of the Business and
Profession
712012005
Date:
EXPIRATION DATE
8/31/2005
Policy Number. 285000001~74
NUMBER
694940
TYPE
C39
e. action need not be completed if the pennit is for one hundred dollars ($1 00) cf less.
ertify that in the performance of the work for which this permit is issued, I shall not
mploy any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should bee me subject to the worker's compen~ation
provisions of Section 3700 of the bar ,/ shall forthwi comply with thoS~ provisio
Dale: 7120/2005 Applicant:
WARNiNG: FAILURE TO SECURE 0 P ATION COVERAq.E is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agertcyfor the
performance of the work for which this permit is issued (8ec.3097 .Civ.C):
Lender's Information:
Construcion Tvpes:
VN, ,
Fire Spnnklered?
NO
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby th . representives of this city to enter upon the above mention d property for
insp ion rposes.
Date: 7/20/2005
Fees paid for Permit:
Total:
310,80
ignature of Applicant or gent
ermit shall expire by limitation and become null and void if the building or
war has not passed final inspection 365 days from the date of permit issuance. A
new oermit is relluired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Uter
Setback/FormslTrenches (Footings)
Do not install subtloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reint.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) 1.lr'J,1-o~ R. HI1ZBt.. t/
Masonry (Reint./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg" Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do 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 Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765.4040
Water Engineering 765-5268
Sub ListlBusiness License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only 1/18-0, (2. () uJl8,d/
Alter Above Complete)
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections