2657 Yale
BUILDING PERMIT NO. BLD2005-03621
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REOUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
TYPE OF PERMIT
Residential Remodel CITY
DATE: 11/15/2005
JOB ADDRESS: 2657 W YALE AVE
LEGAL DESCRIPTION: N TR 3007 LOT 52
APPLICANT: ROSA PEREZ
OWNER INFORMATION: CONTRACTOR INFORMATiON:
FEDERICO RODRIGUEZ
2657 W YALE AVE
ANAHEiM. CA 92801
JOB DESCRIPTION:Replace wood siding with stucco: 136 square feet
VALUATION: 1.500.00
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt rom t e Contractor's License Law for the to lowing reason ( eo. 7031.5 Business and
Professions Code: any city or county which requims 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 licem18d pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 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 any applicant for a permit subjei~ts the applicant to a dvn penalty of not more than five hundred dollars
($500).
Et I, as owner of property, or my employees with wages as their sofe comper'Sation, will do the work, and the structure is not intended or offered for
~ale (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed ccintractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
illfontractor(s) licensed pursuant to the Contractor's License Law).
U I am exe pt under Sec. B & P,C. tor i$ reason:
Date: . Owner: .
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the fol/owing declarations:
p I have and will maintain a certificate of consent to self-insure for worke r's compensation,
as provided tor by Section 3700 of the Labor Code, for the performance of the wort< for which
this permit is issued.
o I have and will 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 issued. My worker's
Compensation insurance carrier and policy are:
Carrier: Policy Number:
LICENSED CONTRACTORS DECLARATION
I hereby affIrm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
11/15/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
This section need not be completed if the pennit is for one hundred dollars ($1 OO} or less.
@ I certify that in the performance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the wort<er's compensation
provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.
Date: 11/15/2005 Applicant: I
WARNiNG: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES 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 (8eo.3097 .Civ.C):
Lender's Information:
TYPE
Construcion Tvpes:
VN, ,
I certify that I have read this application and state that the above information is correct. f
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
inspection purposes. 0
/ ~O- 1 e.'(Q.. Date: 11/15/2005
t Signature of Applicant or Agent
The permit shall 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.
Fees paid for Permit:
Total:
113,63
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporarv Power Pole
Plumbing IDrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbackfFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing IWater Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical IUnderground Conduit)
Pre-slab (Compaction/Membrane Reinf.l
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry (Reinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
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 1II-H"4/)1 'Tr/
GENERAL ITEMS ,
Exterior Plaster (Brown Coat) ~
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
Cross Connection Control (714)765-4280
Engineering/Grading Final 765.5126
Fire Depl. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765.5139
Building Final (Last Inspection M Only n-Iuh 1,.-0-1
After Above Complete) .7 ~
PARTIAL INSPECTIONS
G,~e..
L...---,,, ~
Bui/dinq Inspections
Mechanical Inspections
Plumbinq Inspections
Electrical Inspections
BUILDING PERMIT NO.
!~~;;'3:"t: .:'0)
. I :'.. I-A.._ '\ -'~"~' .,.,.4\
CITY ~~~~~~~rEIM
.~ '~-"N:;:i;:'i'i\ >>0'. " ;/
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<tj~E30<~/ -
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765 -5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
TYPE OF PERMIT
Reroof
DATE: 10/27/2005
JOB ADDRESS: 2657 W YALE AVE
LEGAL DESCRIPTION: N TR 3007 LOT 52
APPLICANT: ROSA PEREZ
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
FEDERICO RODRIGUEZ
2657 W YALE AVE
ANAHEIM, CA 92801
JOB DESCRIPTION:Tear off exisiting material, re-sheat, install 18 squares of 3~J year shingles to house and attached garage.
VALUATION: 4,000.00 PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason {Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alte'r, 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 licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and ProfessJo~ls Code) or that he is exempt therefrom and the basis fOT the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subje:cts the applicant to a civil penalty of not more than five hundred dollars
-~ .
fl.1, as owner of property, or my employees with wages as their sole compe~1Sation, will do the work, and the structure is not 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 does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale). , _
o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertyVo;ho bu~ds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursu nt)q the Contractor's License Law). '
U I am e emRt nder Sec..y P.C. for thJs eason:
ate; Owner:
WORKER' COMP NSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations;
o I have and will maintain a certificate of consent to self-insure for worker'scompensation,
as provided for by Section 3700 of the labor Code, forthe performance of the. wo rk for which
this permit is issued. '
o I have and will 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 issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: Policy Number.
This section need not be completed if the permit is for one hundred dollars ($100) or less.
a I certify that in the perfonnance of the work for which this permit Is issued, I shall not
employ any person in any manner so as to become subject to the worket's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of t e Labor Code, I shall forthwith comply with those provisions.
Date: 10/27/2005 Applicant. . eo>.::; 0 Po
WARNING: FAILURE TO SEC RE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL S JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUND ED THOUSAND DOLLARS ($100,000), iN ADDITlON 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:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencin'g
with Section 7000) of Divsion 3 of the Business and
Professions Code.
10/27/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,.
Fire Sorinklered?
NO
--
I certify that I have react this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby uthorize representives of this city to enter upon the above mentioned property for
ion oOOS.
Date: 10/27/2005
Fees paid for Permit:
Total:
170,20
Signature of Applicant or gent
The permit shall 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 issuMCe. A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
DATE
INSPECTOR
INSPECTION
Temporary Power Pole
Plumbing (DralnJWaste Pipe)
Electrical Ground Electrode/Ufer
SetbackIForms/Trenches (Footings)
Do not Install sublloor or pour 1I00r slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves) .
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Relnf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear ~
Roof (SheathinglDiaphragmlFrame) ~
Masonry (Reinf.lBond BeamJPre-GrouW . ...
I
,.I.~
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (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 ITEMS
Exterior Plaster (Brown Coat)
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 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub LlstlBuslness License 765-5194
Zoning 765-5139
Building Final (La'tln,pectlon - Only "IIO!Q; /' r -r
After Above Complete) J/
~-
roe-...., ~
PARTIAL INSPECTIONS ~ ~
Building Inspections
Mechanical Inspections
Plumbing Inspections
ElectricallnsDections