6236 E. Woodsboro Ave.
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
. INSPECTION REQUEST LINE:
(714) 765- 4626
CENSUS. CODE: 555
QUARTER SECTION: 190 .
BUILDING PERMIT NO. BLD200S..Q0890
DATE: 4/4/2005
JOB ADDRESS: 6236 E WOODSBORO AVE
LEGAL DESCRIPTION: N TR 7449 LOT 69
APPLlCANT:.REYNALDO ESTRADA
OWNER INFORMATION:
Robert K Fitzgelald
6236 E -Woodsboro Ave
.Anaheim, CA 92807
CONTRAcTOR INFORM"-TION:
. KING ROOFING
1044 W ORANGE RD
SANTA ANA. CA 92706 OO~O
BUSINESS PHONE: 714542-0101
JOB DESCRIPTION: Tear off eXisting and reroof 33.5 squares wiih 30 year GQmposition shingle
I
8,000.00 !
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
PROCESSED BY: JNJ
OWNER.BUILDER'OECLARATION
I hereby affirm under penalty of perjury that I am exempt from the ontracto'r's License Law for the following reason (Sec_ 7031.5 Business and
Professions CodEl: a ny city or county which requires a permit to construct, slier, improve, demolish or repair an'y structure, prior to its ,issuance, - also
requires the applicant for such permit to file a signed-statement that he-is licQ'riscd pursuant to the' provisions of the Contractor's License LaW (Chapter
9)(comm~ncing with Section 7000 of Divisi9n 3 of the Business, and Profes:Sbns Code) orthat heis exempt therefrom and the basis for the alleged .
exemption. Any violation of Section 7031.5 by any applicant for a permit sub~ects the applicant to advB penalty of not more than five hundred dollars
~~.... . . ". ..
.0 -I, as owner of property, or my employees with wages as their sote com~~risation, will do the work, and the structure is-not intended or offered for
sale-(Sec. 7044 Business and Professions Code: The Contractor's Ucense L~w does not apply to an owner of property who builds or improv:es
thereon, and who does such work himself or hersel~ or through_his or her oV'hemployees, provided that such improvements are no.t intended or .
offered for sale, If, however; the building or improvement is sold with one ye'3f of rompletion, the owner-bUUder will have the burden of proving that he
did not bu aci or improve for the purpose of sale). .
o -I, asthe owner qfthe property, am exdusively contracting with licep.ss(ro:.:ntractors to construct \he proj~t (Sec. 1044 Business and Professions
Cod_e: The Contractor's License Lawdoes not apply to an -owner of propertywho builds or improves thereon, and who ron1radsfor suCh projects with
f!,..Qontrador(s) licensed pursuant to the"Contractor's License Law).
U I am exempt under Sec. - , B & P.C. for this Teason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm CInder penalty of perjury one of the following declarations:
01 have and will maintain a certifICate of consent to self-insure for worker':; ,:;ompensation,
as prOVided for by Section 3700 of the labol' Code" for the performance of t1~e work for which
""'this permit Is issued.
~ I have and wil,i maintain worker's compensation insurance, as required by Section 3700 of
the labor Code, for the performance of the work for which this permit is issu~, Mywo.rker's
Compensation insurance carrier and policy are:
Carrier:.. STATE COMPENSATION FUND Policy Number. 1627780,01
This section need not be completed if the penni! is for. one hundred dollars ($101' or I,;.s.
o I cert.ify1hatin the perfonnance ~fthe work for which this pe.rmi{is isSued: J shall not
employ any person in'any manner so as to become sl!bject to the workets c,)mpensation laws
of Catifomia, and agree that if I should become subject to the worker's comp;:nsation
proVis.ions.of Section 3:'00. of the L~.r. e,l shall forthwith comply with t~,,.e pro. visions.
. Date: 4/4/2005 APpiica,t -=:I(f'-7N A l 1><) f:51. I
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN. EMPLOYER TO CRIMINAL PENAL TIES AND CIVIL
FINES UP TO ONE HUNDRED il,iOUSAND DOLLARS ($100,000), IN ADDITlON'TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3166.0F THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
fhereby affiJm under penaity of perjury that there is a construction iendi:ig"dge.lCfrcr tha
performance of the work for Which this permit is issued (Sec.309? .Civ.C):
Lender's Information: . .
J
LICENSED CONTRACTO~S DECLARATION'
I hereby affirm under penalty oLperjury that I am
licensed under provisions of chapter 9 (commencing
with SectiOn 7000) of Divs' iness and
Professions C~e.
4/4/
.ate:
:::---..
Contractor
NUMB"R
m061
TYPE
TYPE
C39.
B
EXPIRATION DATE
2/28/2007
Canstrucion Tvpes:
VN, ,
r certify that I have read thi~ application and state th'at the above information is correct. I
agree to comply with all city ordinances anctstate laws relating to blJ"ding construction, and
hereby authorize representiv .. enter upon'the above mentioned" property for
insp dion pwrposes. ./
Signa ure 0 pp lean or en
permit shall expire by limitation and become null and void if the building or
ork has.not paSsed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
Daie: 4/4/2005
Fees paid for Permit:
Total:
310.35
INSPECTION RECORD
I . INSPECTION DATE INSPECTOR
Temporary Power Pole .' .
Plumbing (Dlliin/Waste Pipe) .
Electrical Ground Electrode/lifer .
Setb;IC:klFormslTrenc:hes (Footings)
Do not install s\lbfloor or pour floor slab untillhe
fOllowing applicable items have been signed: .'
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) .
Electric;d (UndergrO\lnd Condu it)
Pre-slab (Compac:tionlMembrane.R~nf.
Underpinning (FlQOJ' Joist/Girders)
Do not cover or conceal the work below until the
fOllowing applicable items have been signed:
1st Floor Sliear
Firesprinkler (Rough)
2nd Floor C>hM. '. . . . ~ . .
RoSiDAlfli'ap!illigm/Framel 0\
M infJBond BeamlPre-Grout) J
Rough Plumbing (Top Out)
Rough Mechanical
HOugh t:lectrK:a11
Rough Ele.ctrlcal
Framing (Only after P1bg.. Elec.. Med1.. and Firei .
InsulatJon (SoundiEnergy) .. I
po not tape or pla~ter until the following applicable
Items have been sIgned: .' '.
Drywall .
PenetratiQIIS (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical .
Penetrations (Fire Rated) P1uinblng .
Interior Lath
Exterior Lath .
.' .. . . GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical '. . .
T -Bar Mechanical
T -Bar Structural . . .
Sewer .' .'
Water Engineering Backflow .'
Wilter Service
FINAL INSPECTIONS Date. Inspector
Electrical Final . . . . .' .
Plumbing Final .
Mech,mical Final ".
Gas Test .
Engineering/Grading Final 765-6126
Fire O,ept. Final 765-4040 .
.
Water Englneering 765.5268 '.
Sub List/Business License 765.519- ..
. . . .
Zoning 765-5139 . .
Building 'Final jl;ast Inspection- Only 1,\& lor ~..'
fter Above Complete) '.
PARTIAL INSPECTIONS . ..' J---'.
BuildinCllnspections
Mechanical Inspections .'.
Plumbina Inspections
Electrical Inspections