7466 Woodsboro Ave.
CONTRACTOR INFORMATION:
MCCORMACK ROOFINd CO
4091 E LA PALMA AVE #T
ANAHEIM, CA 92807 OOO~
BUSINESS PHONE: 714520-5543 .
JOB DESCRIPTION:Tear off the existing roof and replace with 29 squares of 30 year composition shingles and 6 squares of BUR
VALUATION: 7,500.00 PROCESSED BY: MSM
I OWNER-BUILDE,;.DECLARATION
I hereby affirm ul1der penalty of perjury that I am exempt from the Con~r:!ctcr's License Law for the following reason (Sec..7031.5 Business and
Professions Code: any city or county w hicn requires a permit to construct, alt~r, !mprove, demolish or repair any structure, prior to its issuance, also
requires the' applicant for such permit to file a signed statement that-he is Ib'msed pursuant to the plOvisionsoUhe Contractor's License Law (Chapter
. 9}(commencing with Section ~OOO of DiVision 3 of the Business and Profess;~'~ns Cor:le) or that he is exempt therefrom and the,basis for ~he allegect
exemption. Any violation of Section 7031.5 by any applicant for a permt sub;ects the applicant to a dvil penalty of not more than five hundred dollars
($500). .
D I, as owner of property; .or my employees with wages a~ their'sole com~;'~nsation, will do the work, and the structure is not intended or offered for
.sale (Sec. 7044 Business and Professions Code: The Contractor's Licsnss i.'aw does not apply to an,owner of property who builds or improves
there.on, and who does sudlwo'rk himself'or herself or through his or her O:v"".~ employees, provided that such improvements are not intE!.ndecl or
. offered'for sale. If, .however, the building-or improvement is sold with one-yc:;'ir pf completi~n, the owner-builder will have the burden of proving, that he.
did'notbuild or improve for the pUTposeof-sale).' . .
o I, as the owner of the property,-am exdusively contracting WithlicenseJ' ;xntra'?lors to construct the projec~ (See. '7044~usines's and ProfessJons
Code: The Contractor's License Law-does not apply to an owner ofpropert1",'!"/hO iJuilds,or'imprQves thereon, and who rontracts for sucIJ projects with
FU(ontractor(s) licensed pursuant to theCo,ntractor's. License L~w). . .
.LJ I am exempt under See, ,B & P.C. for this reason:. . _.,~_
Date: ' OWner:
I
BUILDING PERMIT NO. BLD2005-00797
TYPE OF PERMIT CITY
Reroof
DATE: 3/24/2005
JOB ADDRESS: 7466 E WOODSBORG AVE.
LEGAL DESCRIPTION: N TR 7666 LOT 61
APPLICANT: LEW FERGUSON
.OWNERINFORMATION.:
Raymond A Hernandez
7466 E Woodsboro Ave
Anaheim, cA 92807
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 195
SI
ARCHITECT/ENGINEER INFORMATION:
',-----= _ .:..J
LICENSED CONTRACTORS DECLARATION'
I hereby affirm under penalty at perjury that I am
licensed under provisions'ot-chapter 9 (commencing:
.with Section 7000) of 'vsior; 3 f the Business and
PlOfess' ns ode:'
3/24/2005.
Date:
WORKER'S COMPENSATION DECLARAT10fJ
I hereby affirm under penalty of pe~u'ry one of.th.e' following declarations:
o lhave,and will"maintain a certificate of conSent to seW-insure forworker:s compensation,
as provided for. by Section 3700 of the Labor Code, for the performance of thev/ork for which
~hipermit is_issued. ..' !'
. I, have and will maintainwork.er's compensation insurance, as .required by Section 3"100 of
labor Code, ~or the performance of the work for which this permit is issu:~d Myworker's
ompensation insurance carrier and policy are: . , _j .
Carrier: AME.RICAN !NTERNATIONAL GROUP Policy Numb.er. WC070',J4U20OQ01.
ThiSS~tion'n~ed not be completed if the pennit Is for one hundred dOllarS-{$10(~) or less.
'0 I certifY that in the perfqnnance of the work fO!: which this permit is issu~d, ! shall not
employ any person in any manner so_as to become subject to the worker's c;>rr:pensation laws
of Califomia, and ,agree that if I should become subject to the worker's comJ:;~nsation
. provisions of Section 37qO of the Labor Code, I all forthwith comply with tf ase provisions.
. NUMSER
643700
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
Date: 3/24/2005 Applicant:
WARNING: FAILURE TO SECURE ORKER'S COMPENSATION _F~AGE IS
UNLAWFUL. AND SHALL SUBJECT EMPLOYER TO CRIMINAL PEW,LTIES AND CIVIL
fiNES UPTO ONE HUNDRED THO SAND DOLLARS ($100,000), IN ADD!TION TO THE
. COST OF COMPENSATION,. DAMAGES AS PROVIDED. FOR IN SECTIOr'; 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I herepy affirm under penalty of perjury th~t there is a ,construdio,n lending acency for the.
performance ,of the work'for which this permit is issued (See. 3097 .Ci....C):
Lender's l.nformation~ .
I certify ~hat I have read this application and state that the above information is correct. I
'~re to. 00 mpty. w~h all city ordinances and state laws relating to building cens., ti"Uction, and
he., authorize, representives of this city to enter upon the above mentioned property for
ins ion purpo , , ~
. '. - eX..<< Dat.: 3124/2005
'Signature of Applicant _or A ent
The permitshall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days. from the date Of permit issuance. A
new permit is required to commence or continue work. .
EXPIRATION DATE
6/30/2006
C39
NO
Fees paid for Permit:.
Total:
235,58
..INSPECTION RECORD
,
INSPECTION . DATE INSPECTOR
Temporary Power Pole I. .'
Plumbi ng (DraintWaste Pipe) .
Electrical Ground Electrode/uter .
SetbacklFormsfTrenches (Footings) . .' '" .
Do not .install subfloqr or pour floor slab until the .
following applicable items have been signed: . .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GroundWork) .
ElectriCal (Underground Conduit) ,
Pre-slab (CompactionfMembrane.t(eim. 1 '.
Underpinning (Floor Joistlqirders) .
Do not cover or conceal the work llelow until the. .
following applicable items have been signed:
1st Floor Shear .
Firesprinkler (Rough) . . .
2nd Floor Shear . , . ~ Ir /,'
Ro lIlhlrig/OiaphragmlFrame) .' '111'110> '-".,
Mas ond BeamlPr~rout)
Rough Plumbing ITopOut) " .
Rough Mechanical .
Rougn t:IectrlCaI wry wail) . ". .
Rough Electrical , " . . . .
Framing (Only after Plbg"Elec.. r..1ech..and Fire)
Insulalion (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 Rated) Plumbing . .
Interior Lath '. . .
Exterior Lath . . . . .
. . GENERAL ITE.MS 1
Exterior Plaster, (Brown Coat) . 1\
T -Bar Electrical .
T -Bar Mechanical . '.
T -Bar Structural . .
Sewer . . .
Waler Engineering Backflow .
Water Service
FINALlNSPECTIONS bate Inspector
. Electrical Final
Plumbing Final. . '. '.
. .
Mechanical Final '. . .
Gas Test
"
Engineering/Grading Final 7'65-5126: .
Fire Dept. Final 765-4040' . . .'
.
Water Engineering 7~5-5268 . . ' .
Sub List/Business Lice!)s;' 765-519 .
Zoning 765-5139 I .
Building Final lkast lnspection- Only ~\O) 1'~,
. fter Above Complete)
. PARTIAL INSPECTIONS .6...L ~l
..~ "
Buildina Inspections
Mechanical Inspections .
Plumbina'lnspections
Electrical Ins~ctions