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831 Yvonne Pl. 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: 61 BUILDING PERMIT NO. BLD2005-01121 DATE: 4/19/2005 JOB ADDRESS: 831 N YVONNE P.L LEGAL DESCRIPTION: N TR 2855 LOT 7 APPLICANT: jbSE QUEZADA OWNER INFORMATION: CONTRACTOR INFORMATION: JOSE QUEZADA 831 N.Yvonne PI Anaheim, .CA .92801 JOB DESCRIPTION: Tear off existing and reroof 48 squares with asphalt shingies VALUATION:. 5,100.00 ARCHITECT/ENGINEER INFORMATION: PROCESSED BY: JNJ OWNER-BUILDER ilECLARATION I hereby affirm under penalty of perjury that I am exempt from the COhtractor'~, License Law-for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requjres a permit to construct, alte r, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to fife a signed statement that he is l,icer,sed pursuant to th~ provisions of the Contractor's License Law (Chapter 9)(commencing with Section 700001 Division 3 of the Businessand Professions Code) or that he is exempt therefrom and the basis for the alleged' exemption. Any, violation of Section 7031.5 by any applicant fora permit subjects theapplic<;lnt to a 'civil penalty of not more than five hundred dollars ($500).. . . .. g::I>as owner of property, ormy employees with wages as'their sole compensation, will do the work, and the structure is not intended.or offered for sale (Sec. 7044 Business ~nd Professions Code: Th~ Contractor's License L~w does not apply to an ~wner of property who builds or improves thereon, and who does such workhimseff or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, howeve-r, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he d[d not build or improve for the purpose of sale). , . D I, as the owner of the property, am exclusively contracting with licensed oJntractors to construct the project (Sec. 7044 Business and Professions Cod~:- The Contractor's License Law does not a~1y to an owner of p pertywho builds or imprmies thereon, and who contracts fcirsuch projects with ~ontractor(s) licensed pursuant to the Contractor's License Law)., " ' U ~ am exempt under Sec. , B & P.C. f r as . ,: ' ' Date: ~ Owner: '-- WORKE CO SATION DECLARATION I I)ereby affirm under penalty of perjury 0 of ttie following declarations: . ~ave and willrnaintain a certific e of- consent to seff-insurefor worker's_~ompensation, as provided for by Se.ction 3700 of the Labor Code, for the performance of the work for which this perm it is is.sued. o I h~ve and will maintain worker's compensation insurance, as required by Section 3700 of 4/19/2005 the Labor Code, for the performance'of the work for which this'permit is iSsued. Myworker's Date: ' Compensation insurance carrier and policy are: Carrier: . LICENSED CONTRACTORS DECLARATION I t)ereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commenQing with Section 7000) of Divsion 3 of the Business and Professions Code~ Contractqr Policy Number. NUMBER EXPI RATiON DATE as.;...~n need not be .completed if the penni! is for one hundred dollars ($100) or'less. ify that in the perfC;>,rmance of the work for which this permit is issued; I shall not employ-any person in any manner so as to beconie subject to the worker's compensation laws of Califomia, and agree that if,l should become subject to the worker's compe ation provisions of Sect!on 3700 of the Labor COde,'I'sh forthwith c Iy with e provisions. Date: 4/19/200?' Applicant: WAflNING: FAILURE TO SEC. E WORKE UNLAWFUL, AND Si-IALLSUBJECT AN EM OYER TO CRIMiNAL PENALTIES AND CIVIL FIN.ES UP TO ONE HUNDRED ll-IOUSAN DOLLARS ($100,000), iN ADDlllON 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.agencyfor the performance of the work for which this permit is'issued (Sec.3097.Civ.C):..._ Lender's Info'rmation: -, ~ TYPE Construcion Tvpes: VN, , 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 stat laws relating to building construction, and hereby-authori-?e representives of this-city to en r upor:t the above mentioned property for i spec1ion purpo . Date: 4/19/2005 Fees paid for Permit: Total: 384.78 Signature of Applcant or gent, The permit I expire by Iimi1ation and become null and void if the building or work has riot passed final inspectiOn 365 days from the date of permit issuance. A new permit is required to commence or continue work. INSPECTION RECORD , .' INSPECTION DATE INSPECTOR Temporary Power Pole ' Plumbing (DrainlWaste Pipe) " , Electrlcal'Ground Electrode/Ufer , " SelbacklFormslT,enches (Footings) , Do,not install subflQOror pour floor slab until the following applicable items have,been signed: Plurribinli (Water Pipe.Sprinkler Valves) Mechanical (Groundwork) Elec;trlcal (Underground Conduit) Pre~lab (comp,actionlMembtane.Reinf. , Underpinning (Floor Joist/Girders) , , , Do not cover or conceal the work below until tne , , following applicable items have been signed: . , 1st Floor Shear " Firesprinkler (Rough) , 2nd Floor Shear I , Roof ISheathing/Diaphra!lmlFrane) i~ Ii'" Masonry (ReinfJBond BeamlPre-Grout) Rough Plumbing (Top Out) , Rough Mechanical ' , Rough B!lCtr 'wall) , Rough Elec1rical , Framing, (.Qnlyafter Plbg.. Elee.. r..1ech.. and 'Fire) InSOlation (SoundlEnergy) .' Do not tape or plaster until the fOllowing applicable items have been .signed: .'. Drywall '. , , , Penetrations (Fire Raled) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing InterlC)r Lath , , Exterior Lath - " GENERAL ITEMS -, Exterior Plaster (arownCoat) 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-S126 , ' Fire Dep1.Fina1765-4040 Water Engineering 765-5268 , Sub List/Business License 765-519 , , Zoning 765-5139 , ' Building Final \l:3stlnspection. Only 5--12.-os' .s'i2..~..A:> ' , ' fter Above Complete) PARTIAL INSPECTIONS' Buildina Inspections Mechariicallrispections Plumbina Inspections Electrical' Inspections