1752 Landfair
TYPE OF PERMIT
Reroof
LD2004-04164
CITY
/;=;;~-;~:_';~~,
',r;. ~'::~':'?'';''':'~,~,:t:,~:,~,
#'~'''' ", m,A..
Il;Vt;'.,. ..: '-,.~O\
,~r~(:ii "~i"r!li':'~~f#.:;'~'\H ElM
~-' "{ ,-'
IV " ,- -. -~ _ 0 - -i
\ \~ _n_~.~.,.._",-.;j! I;
^.\ ;:-{f;t!>:.W ;
\, \, .~_. > \'j."f.:!? i
' ~I(o, _~~_~-O/;"l.l
~:{~~JI~~1i}:>'
BUILDING DIVISION
200 S, ANAHEIM BLVD,
(714) 765 - 5153,
, INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE:, 555
QUARTER SECTION: 138
BUILDING PERMIT NO,
CONTRACTOR INFORMATION'
LEWIS & SONS CONSiRUCTJON INC
310 S MAPLE ST #E
CORONA, CA 928820000
BUSINESS PHONE: 909273-0901
JOB DESCRIPTION;Tear off existing roof and replace with 22 squares of 30 ~'r. composition shingles.
, VALUATION: 5,800,00
I OWNER-BUILDEP DECLARATION,
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Lic~nse,:I.:_i;iw for the fol/owing reason (Sec. 7031.5. Business and
ProfeSsions Code: any city Qr county which requires a permit to construct,a~tsr, jmpro\'~,_d,einqlish or repair any structure. prior to its,issuance, also
requires the applicantfor such permit to file a signed statement that he'ls-U{,,;:osed pursuanfto, the provisions of the Contractor's License Law (Chapter
_ 9)(.commencing with Section 7000 of Qivision 3 of the Business and Profes$lons Cude)orthat he is exempt therefrom and the ba::>!s fOr the alleged
exemption. Any vio'/ation of Section 7031.5 by any applic:ant for a permit sU~jects the applicant to 8 dvU Mnaltyof not more than fivt:: ~u.ndred dollars
~~, ,I ' '
O' I, as owner of property, or my employees with wages as their sole comi~~nsation, will do the Work, and the shucture Is not intended or offered for'
sale (Sec. 7044 Business and Professions Code: The Contract9r's License Law does not apply to an owner of property w;:.o builds or improves
thereon, and who does such work himself or herself,or through his or he:". o\(,-: employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one 'i1:~rof completion, the'owner-builderwill have the burden of proving-thC-lt tie
did not bu ijd or hnprove for the purpose of sale),. "(." _
o i, .asthe owner of the property,am exdush/ely contracting with !k:::enst?Q"contra-ctors to construCt the project (Sec. 7044 .8uslne$s and' ProfesS!o~
Code: TheContrac.tor's License Law doe!:,: not apply to a~ owner' of propert\i whobu;lds or improves thereon, and who oontracts for such projects yvith,
i2-Qontractor(s) licensed pursuant to ~he Contractor's licem~e law). 1
U : am exempt under Sec. ' -;-8 & P.C. for this reason: ;
Date:. Owner: '
I WORKER'S COMPENSATION DECLARATION :_-.:..~
-1 here~y affirm under penalty of perjury one_o~th'e.following declC;l:ldtions:, '
o I have and will maintain a certit1cate of~n~nt to seff~in&ure forworker;S:.compensaaon,
as provided for by Section 3700 of thelabgr.Code;'.for thepenofmance of rr.;e work fer which
jrhi permit is issued,' :.: " \
I have and will maintain worker's compensation insurance,as required ~y SeciJor. 3-{OO of
the labor GOde, for the performance of the wor.k for which this permit_is issl{::-d. Myworker's
Compensation insurance carrier and policy are:
Carrier: EXEMPT Policy Number. EXEMPT
DATE: 11/16/2004
JOB ADDRESS: 1752 N ~DFAIR ST
LEGAL DESCRIPTION: ' TR 5623 LOT 71
APPLICANT: KYJ+ LEWIS_ ,
OWNER INFORMATION:,
Kie L Soohoo
1'115 N Partridge SI
Anaheim, CA92806
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MSM
LICENSED CONT
1 rereby affirm
licensed under pro'
with'Section 70
Professio C
TORS DECLARATION I
r penalty of perjury that I am
s of chapter ~ (commencing
i ;on'3 ofthe Bus[ness and
Contractor
iih- section need not be completed it the pennit is fOr. one hundred dollars ($10C;} or less.
I certify that iri" the performance of the wor (I which this permit is issUfU, I shaii not
employ any perS,on in any manner so as to be e subject to the wOf~er's qompensation Jaws
of Califomia, and agree that if I should bee e bject to the worker's comp'~nsation
pro"isions of Sectio~'3700 ofthet,abor C ,shall forthwith comply with t~()se provision$.
Date: 11/1812004 Applicant
WARNING: FAILURE TO SECU ERKER'S COMPENSATION COVEF:AGE is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENf,l TiES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADf;1TION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR,IN SECTIO~: 3706,'OF THE
, LABOR CODE, INTEREST AND ATTORNEY'S FEES,
I CONSTRUCTION LENDING AGENCY
I hereby affirm under pennlty of perjury thAt there is3 construction ienc!:rtQ ~;~ncy for the
performance of the work fQr which this permit is issued (5eo.3097 .Clv .C):
Lender's InfOmiation:
NUMBER
416525
TYPE
TYPE
EXPIRATION DATE
4/30/2006
B
C39
Construcion Types:
VN, , '
Fire Sprinklered?
NO
L
I CertifY, that I have r,
agree to oomply wit
h~~ author" , r
jn~ion pur
his application and state that the above information IS correct. .1
city-ofdinetnces and state laws relating to buKding construction, and
ntives of this city to enter upon the above mentioned property for
Date: 11116/2004
Fees paid for Permit:
Total:
235,41
Signature of Applicant or Agent
The perm" shall expire by limitation and become null and void if tha buildingor
work has not 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 (DrainJWaste Pipe) .
Electrical Ground Electroctl!l'Ufer .
SetbacklFotmslTrenches (Footings)
Do not install subfloor or pour floor .slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanic;d (Groundwork) .
Electrical (Underground Conduit) .
Pre-slab (l;ompactionlMembrane.Reinf.
Underpinning (Floor Joist/Girders)
Donat cover or conceat the wor1< below -until the
folloWing applicable items have been signed: .
1st Floor Shear
FiresprinkJer (Aough)
2nd Floor Shear . . .
Ro atftiRltlDiaphragmlFrame) . ,dlil1~ J.t.<MR
Malomry ,,,,,infJBond BeamlPre-Grout) / .
Rough Plumbing (Top Out) .
Rough Mechanical
I KOUQn l:IectrlCaI ,II) . .
Rough Electrical
Framing .-(Only after Plbg., Elec.. r,,1ech.. and-Fire) .
. Insulation (Soui1dlEnergy)'
00 not tape or .plaster until the following applicable
item.s have been signed: .
Drywall . .
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical .
PenetraJions .(Fire Rated) Plumbing
Interior it.lith .
Exterior Lath '. '. .
GENERAL ITEMS
Exterior Plaster (Brown Coat) . .
T -Bar Electrical.
T'Bar Mechanical . . .
T -Bar Structural
Sewer . .
Water Engine!lringBack~ow
Water Service
FINAL INSPECTIONS.' Date Inspector'
Electrical Final . . .
Plumbing Final .
Mechanicaf Final .' "
Gas Test . .'
. . .
Enginooring/Grading Final 765-5126
Fire Dept. Final 765-4040 '.
WalerEngineering 765-5268 .
Sub List/Business License 765-519
Zoning765~5139 '. .C' .
Building Final ~ast Inspection- Only 1~4--..c~ ~:z.
fter Above Complete) ~ .
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
ElectricallilsDections