7880 Woodsboro Ave.
TYPE OF PERMIT.
Reioof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 200
1,/
BUILDING PERMIT NO. BLD2005-01557
DATE: 512412005
JOB ADDRESS: 7880 E WOODSBORO AVE
LEGAL DESCRIPTION: N TR 7417. LOT 85
APPLICANT: LEW FERGUSON
OWNER INFORMATION: CONTRACTOR INFORMAlION: ARCHITECT/ENGINEER INFORMATION:
Trust Hawley MCCOHMACK ROOFING CO
7880 E Woodsboro Ave 4091 E LA PALMA AVE #T
Anaheim, CA. 92807 ANAHEIM, CA 928070000
. . . .. . . BUSINESS PHONE:. 714630-5543 .
JOB DESCRIPTION:Tear off existing roof and replace with 20 squares 01.30 year composition shingles and 3 squares of built-up roof.
VALUATION: 4,600.00 PROCESSED BY: MSM .
OWNER-BUILDER DECLARATION
hereby affirm under penalty of perjury that lam exempt from theContractor'sUcense Law for the following reason (Sec. 7031.5 sinses and
Professions Code: any city Or county which requires a permit to construct, alter. 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 licensedpursuaht to the plOvisionsofthe Contractor's License Law{Chapter
9)(commer:tCing with Section 7009 of DiV!sion 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 anyapplicantfor a permit subj6(~ts the applicant to a civil- penalty of not more than'five hundred.dollars
($500).' . .'
o I; as o~ner ot"pr9perty, or my employees with wages as their sole compensation, will do the work, and the s'tructure isnot 'intended or offered for
sale (Sec. 7044 Business and Professions.Code: The Contractor's License Law does not apply to an owner of property who builds or improves
thereon, and who dbes-such work himself or herself or throu':;)h his or her own emp~oyees, provided that such improvements are not 'Intended or
offered for sale. ,If, however, the building or improve.ment is sold with one yearof completion, the-owner-builder will have the burden of proving that he.
did not build or improve forthe pU/pose of sale). , .'. , .
o I, as .theowner of the. property, am excll,JSively contracting with licensed contractors: to c~struct the project (Sec. 7044 Business and Profe'SSiOn$ .
Code:' The Contractor's L.icense Law does not apply to an owner 6f propertywl1o builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to.the Contractor's L,icense Law).
O. I am e~empt under,Sec, . , B &, P.C. for"thjs reason:
Date: Owner:
WORKER'S COMPENSATION DECLARATION
I' hereby affirm under penalty of perjury one of the follawing declarations:
o I have and will mairitain a certi.ficate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance- of the wOIk for which
~hi permit is issued,' .. , .
. .1 have and will maintain worker's compensation insuran.ce, as required by Section 3700 of
t e Labor Code, for the performance of the work for whic~ this permit is issued.. Myworker's
.ompensatian insurance carrier and policy.are: .
Carrier: AMERICAN INTERNATIONAL GROUP Policy Number. WC0701040200001
This section ileed not be completed if the penni! is for one hundred dollars ($1 00) or less.
o I certifY ~hat in the performance of the ~ork for which this permit is issued,' shan not
employ any person in any manner: so as to become subj'ect to the worker's compensation Ic~.ws
of Calito.mia, and agree: that if I should.pecome subject to the worker's compensation
provisions of 'Section 3700 of the Labor Code shaK fo ith mply with those provisions.
LICENSED CONTRACTORS DECLARATION
I hereby affirm !,lnder penalty of perjury that I am
. licens~d under provisions of chapter 9 (commencing
with Sectipn 7000) of . .iV5ioz.n 3 of .8 B.usineSs and
Professions . .
5/24/20 Ji _. -
Date:
NUMBER
643700
. TYPE
C39
EXPIRATION DATE
6130/2~
Date: 512412005 Applicant:
WARNING: FAILURE TO SECURE
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMIN ALTIES 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 agency for the
performance of the, work for which this permit is issued (Sec.3097.Civ.C):-
Lender's Information:
Construcion Types:
VN, .
Fire Spri~klered?
NO
I certify that I have read this application and state that the above information jscorrect. I
agree to comply with all city ordinances and state laws relating to building construction, and
~ereby .author.ize.repre. seZ. tive of thi-S.City to enter upon the above ment!oned property far
10 Ion purp ,So . .. __._ ..
. . Date: 512412005
Signature of Applic nt .or Ag nt
The permit shallexpire by Iimitatio i'id become null and void if the bililding or
work has not passed final inspection 365 days from the date of permilissuance. A
new permit is required to Commence or continue wOrk. ' .
Fees paid for Permit: .
Total:
'160.61
/
.. INSPECTION RECORD
INSPEcnON . DATE INSPECTOR
Temporary Power Pole. . .
Plumbing (Dl3inNVaste Pipe) .
.Eledricaf Ground ElectrodelUfer .
SelbacklForlllSlTrenches. (Footings)
Do not install subfloor or pour floor slab until the ..
following applicable. items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) .. .
Eledricaf (Underground Conduit) . . .
Pre-slab (Compac:tionlMen)brane.Reinf. .
Underpinning (Floor Joist/Girders)
Do not cover or conceal .the worll below until toe
followmg apphcable .tems have been Signed: . :.
1st Floor Shear
FiresprinkJer (Rough) .
2nd.Flo r . . @ot
.Roof ./Sl1eathIPtllDlaphl3gmlFrame) 'I
Mas lnf./Bond BeamlPre-G/out)
Rough Plumbing (Top. Out) . I
Rough Mechanical .
Rough BectrlCaI (Dry. wall)
Rough Electrical . .. I
Framing . (Only aher Plbg., Elec., Mech.: aM Fire)
Insulation (SoundlEnergy) .
Do not tape or plaster until the fOllowing applicable
items have been signed: ' ' .
Drywall .. ,
Penetrations (Fire Rated) Electrical .
Penetrallons(FIIll Rated) Mechanical .
Perletrations (Fire Rated) Plumbing
'"terlor 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
Electri.cal Final
. Date
Inspector.
Plumbing Final
Mechanical Final
Gas Test
EngineerlnglGnidlng Fina' ,765.s126
Fin. Dept: Final 765-4040.
.
,
.... , ...
Water Engineering 765-5268
Sub List/Business License 765-519
Zoning 765.5139 :. J V"I t/J J. .
Building Final ILastlnspecticn- Only f1' J <d./ ~> ~-//J /J,
After Above Completel/'-r.o e,~
PARTIAL INSPECTIONS It. (/(LJ/.. ~V'
. .
Buildinalnspections.
.. MeehanicallnSDections
Plumbina Inspections.
Electrical-lnsDections