837 N. Yvonne Pl.
-'
TYPE OF PERMIT
Reroof
CITY
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BUILDING DIVISION
200 S. ANAHEIM BLVD,
(71.4) 765 - 5153 .
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 61
BUILDING PERMIT NO. llLD2004.Q4024
DATE: 11/212004'
JOB ADDRESS: 837 N YVONNE PL
LEGAL DESCRIPTION: N TR 2855 LOT 8
APPLICANT: RICARDO MORAtES
OWNER INFORMATION: CONTRACTOR INFORM.', nON:
Vickie Gamarra UNIVERSAL ROOANG ,.:
837 N Yvonne PI 6675 PALMA CIR
Anaheim, CA 92801 YORBA LINDA, CA 92886 0000
. BUSINESS PHONE: 714 M3 0724' .
JOB DESCRIPTlON:Tearoffexisti,ng roof and replace with 25 squares of 40 y?ar composition shingles,
. ,
- VALUATION: 3,750.00 PROCESSED BY: MSM
I -.' . . . . OWNER-BUILDE.!!, DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractcn'sLicense Law for the following reason (Sec;-7031.5 Business and
Professions Code: any city or-county which requires a permit to construc( alief', improve, demolish or repair any structure, prior to its issl.\ance, also
r.equ'ires the applicant for such permit to file a signed statement that he is nC,;!::1sed pursuant to the. provisio,ns of the Conlractor's License Law (Chapter
9}(commencing with Sect-ion.7000 of DiVision 3 of the Business and Profess;:';fls Co,oe) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section r031.5 by any applicantforapermit sutjects the apiJlicar.t to a dyU penalty of not more than five hundred doll,ars
~o?)~s ~ner of p~operty,~r my employees with wages as their sole com;~en$ation; will do thd'wor~, a~d the structur~ is not intended or Off~rE::~.for
sale (Sec. 7044 Bt.isin~ss aYld Professions Code: The Contracibr'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 thrlJugh his or ner 0\\';1 employees. provided that $"uch improvements are not intended or
offered for sale. If, however, the building or improvement is sold with on~ ya3:Gf completion, the owner-builder will have the burden of proving that he
did not I::lU~,d or improve for the purpose.of sale).: . , . . .. ' '_
D. t, as the owner of the property, :afTI exduslvely contracting ~ith !!CGr.'s<.:d;contfC':ctors to construct the project (Sec. 7044 Business and ProfessiOns
Code: The Contractor's license law does not apply to an owner of prc.i)e:tjwho builds or improves th,ereon, and who rontracts fer sum projedswith
~~6ntradof(s) licensed pursuant to the Contractor's license Law), \
U l?m exempt under Sec. . , B & P,C, for this reason'
Date; Owner:.
r- WORKER'S COMPENSATION DECJ.ARATION ::-::---1
'I hereby affirm lJnder penalty of perjury one of the folloJwing-declaration.s: I
O. ! h~ve and will maint~in a certiflcat~ of consent to. self-insure for worker'~compensation,
as provided for by Section. 3700 of the l.abor Code, for the performanCE::! of thp work for whim
~h' .permit is .issued. '.. .i '
.'have and will maintain worker's compensation insurance, as required t,~'. Section 3700 of I
t elaborCode, for the performance of the work for which this permit is iS3U;~d. Myworker's
ompemsation insurance carrier and policy are: '0 I
. Carrier: STATE FUND. Poli"1 Number. 164386$-02 . NUMBER
~ 765451
This section need not be completed if the pennit is for one hundred dollars {$1 11(} or lass. TYPE
o I certify that in the performance of the work forwhrch this oermlt is iSSL:c,j, I shal! not TYPE
employ any person in any manner so as to become subject to the worker's c(~mpensation laws
of Califomia! and agree that If I should become Subject. to the worker's c0I11p::nsation .-
pcovislOnsof Secti0f13700 ,of the Labor Code, I shall forthwith comply wi;;h t1~ose provisiuns. Construcion Types'
! VN, , '
Fire $prinklered?
ARCHITECT/ENGINEER INFORMATION:
-
r-ucENSED CONTRACTORS DECLARATION
I hereby affirm under penalty-of perjury that I am
ticensed under provisions of chapter 9 (commencing
'witn Section 7000) of Divsion.3 of the. Business and
prcfessionf-e~
111212004
Date;. . . Contractor
EXPIRATION DATE
713112005
HIC
C39
Date: .11/212004 Applicant:
WARNING: FAILURE TO SECURE
UNLAWFUL, AND' SHALL SUBJE AN EMPLOYER TO CRIMINAL PENh_TIES AND CIVIL
FINES UPTO ONE HUNDRED 1HOUSAND DOLLARS ($100',000), IN ADCIT!ON TO THE -.
COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION, 2706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . --
I CONSTRUCTION LENDING AGENCY __
I h,ereby a<<:jrm_,un~e,r _pe~alty of perjury,that there is a constructi_?~ !_eildi,19 af,t6l)cy for_th~
periormanceotthe\.vorKlor'wnidlmispermlt"\5!s5uedrdec.;JOOI:c-1v.(;): . ~ ' ..
lel.1der's Information:
NO
.'.
I certify that I have read this application .and state that the above information is correct. I
agree to oomplywith all city ordinances and state laws relating to buUdlng cO:lstruction, and
hereby authorize representivesof this city to enter upon the above mentione,l property for
~'~SP.djOn.pu~. ..., ....-' .' '. .
~ Dalo:11/2I2004
, .. . . Signature of Applicant or Agent
The permit shall expire by Iimit~tion and b.ecome 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.
Fees paid for Permit:
Tolal:
235.33
INSPECTION RECORD
FINAL INSPECTIONS
lectrical Final
lumbi.ng Final
Mechanical Final
as Test
ngineeringlGrading Final 765-6126
Ire Dept. Final'765-4040
Water Engineering 765-526~
ub List/Business License 765-519
oning 765-5139
uilding Final (Last Inspection-Only (f/I ^,'
After Above Complete) I U~
PARTIAL INSPECTIONS
uildina Insoections
Date
Inspector
.. INSPECTION DATE INSPECTOR E
.
Temporary Power Pole . . P
PlUmbing (DrainJWaste Pipe) .... . .
Electrical Giound Electrode/Ufer
SelbacklFormslTrenches (Footings). G
Do.not install subflooror pour floor slab until the. E
following applicable items have been signed: ' .
Plumbing (Water Plpe.Sprinkler Valves) F'
Mechanical (Groundwork)'
. Electrical (Underground Conduit) .
Pre.slab (Compaction/Membrane.Keinf. S
Underpinning (Floor Joist/Girders) . Z
Do not cover or conceal the work Oe/ow until the. B
following applicable items have been signed:
1st Floor Shear , ' . . '.
FiresPrinkler (Rough) B
2nd Floor Shear .' A . .
Roof (Sheathing/Diaphragm/Frame) , t!, -?-6,<I ~
Masonry (ReinfJBond BeamlPre-GroCIt) . "
Rough. Plumbing (TopOutl . .
Rough Mechanical .,
I Rpugh f1ectrical (Dry Wall) " .
Rough Elec;trical
Framing (On!,. after Plbg.. Elee.. Mech.. and ~ire)
In$lllation (SoundlEnergy) M
Do not tape or plaster. until the following applicable
items have been signed: .
Drywall . . . . '. .
Penetrations (Fire Rated) EI.ectrical , " .
..
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Ratedl Plumbing , .'. .
Interior Lath .
Exterior Lath . , . PI
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T .Bar Electrical
.T.Bar Mechanical .
T .Bar Structural I
Sewer . . ' .
Water Engineering Backflow . .' . EI
Water Service
.
-
echanicallnsoections
umbinCl Insoections
e<:tricallnsoections .