1333 Marlboro Ave.
BUILDING PERMIT NO. BLD2005-01565
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 51
~:~O~~F PERMIT CITY,
DATE: 5/25/2005 .
JOB ADDRESS: 1333 W MALBORO AVE
LEGAL DESCRIPTION: N TR 1994 LOT 33
APPLICANT: MATT MILLEN
OWNER INFORMATION:
Ronald R Graeff
1333 W Malboro Ave
Anaheim, CA 92801
CONTRACTOR INFORMATION:
ALL PRO RCJqFING
905 S CALICO CIR
. ANAHEIM, CA 92804 0000
BUSINESS PHONE: 714226-0747
JOB DESCRIPTION:Tear off existing roof and repl~e 20 squares of 30 ye.ar co:nposition shingles and 4 squares of torch down.
ARCHITECT/ENGINEER INFORMATION:
VALUATION: .
5,457.00
PROCESSED BY: MSM
OWNER-BUILDER I)ECLARATION
I hereby affirm under penalty of perjury that I am exempt from theContractor's:_ License Law for the foHowing reason (Sec. 7031.5 Business and
Professions Code: any. city or county which requires-a permit to construct, alter, improve, demolish or repair any structure, prior to its: issuahce, also.
requires the applicant for such permit to file a'signed statement that he is Ibmsed pursu~nt to the' provisions'of the' Contractor's License Law (Chapter
9)(cQmmencing 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 subjects the applicant to a civil penatty of not more than five hundred dollars
($500).
o _I, as owner Of property, 'or my employees with wages as their sole compensation, will do .the work, and the structUre is not intended.or offered for
sale (Sec. 7044 Business and ProfessiOns Code: The Contractor's-license l~w does not apply to an owner'of property who builds or improves
thereon, and who does such work himself or herself or through his,or her oWn'!3mployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one yea~ of compl~tion, the owner-builder will have the burden of proving that he ,
did not build or improve for the pUlpose,of sale). .
o \, as the owner of the property, - am exclusively contracting with licensed contractors, to construct the project (Sec. 7044 Business and Professions
COde: The Contractor's License law does not apply to an oWf\er of property who builds or improves thereon, and who'contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. .. , B & P.C. for this .reason:
Date: Owner:
: WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
0, I have and will maintain a cert.ificate of consent to SE;llf-insure for workel$,compensation,
as provided for by SeGtion 3700 of the Labor Code, for the performance of the,Work for which
~i per!l1it i,s issued. .'
-il. have a'ndwill maintain worker.'s cOmPen.s8tioo insurance, as required bY,S. ection 3700 of
t e Labor Code, for the performance of the work for which this permit is issueq. My worker's
mpensation insurance carrier and policy are: .
Carrier: STATE FUND Policy Number. 0000517-1005
This section need not be completed if 1f1e permit is for one hundred dollars ($1 00) ~r less.
o I certify that in the performance of the work for which this permit is issued;-'_ shall not
employ any person in any manner sO as to become subject to the worker's cortlpensation laws
of Califomia,and agree that if. I should become SUbject to the worker's compensation
provisions of Section 3700 of the Labor ode shall hwit comply wi.tht~e provisions.
LICENSED CONTRACTORS DECLARATION
I hereby's irm \,lnder penalty of perjury that I am .
licensed under provisions of chapter 9 (commencing
with Section 00) of Oivsion 3 ,of the Blisiness and
Professions e.
EXPIRATION DATE
9/3012005
5/25/2005
Date:
NUMBE
768511
. TYPE
C39
Dale: 5/25/2005 Applicant:
WARNING: FAILURE TO SECURE ORKER'S COMPE SATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO .ONE HUNDRED TH SAND DOLLARS ($100,000), IN ADDI110N TO THE
COST OF COMPENSATION, DAM GES AS PROVIDED FOR IN SECTION .706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONST.RUCTIONLENDING 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 Tvpes:
VN, ,
Fir~ Sprlnl<lered?
NO
I cert.ify that I have read this appllcation 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 authorize representives of this city to enter upon the above mention.ed property for
insp purp
Dale: 5/25/2005
Fees paid for Permit:
Total:
160.66
Signature of Applicant or Agent
The p 't shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the.date ot permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (OrainM'aste Pipe)
Electrical Ground Electrode/Uter
SelbacklFOl'msfTrenches (Footings) ,
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf.J ,,'
Underpinning (Floor Joist/Girders)
Do not cover or conceal the WQrk below untrl tne
following applicable items have been signed:
1st Floor Shear
Firesprinkler (Rough) , , " '
2nd Roar Shear . ' " I
Roof (Sheathing/Oiaphragm'Frame) !'J}>I/e,
Masonry (ReinfJBond Beam/Pre-Grout) .r I
Rough Plumbing, (Top Out)
Rough Mechanical , ' ,
"I ROugh 6ectrlC1lI, luor ..,oI'J
Rough Electrical
Framing (QnlyafterPlbg., Elec.. Moot. and Fire)
Insulation (SoundlEnergy)
Do not tape orplastllr until the following applicable
items l1ave been signed: " ' '
Drywall ,
Penetrallons(Fire Rated) Electrical ,
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Raled) Plumbing
Interior ,lath "
Exterior Lath , , ,
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical "
T -Bar Mecl1anical
T-Bar Structural
Sewer , ,
Water Engineering Backflow , .
,
Water Service
, "
FINAL INSPECTIONS Date Inspector
Electrlcal"Final , , "
Plumbing Final ,
"
Mechanical Final ,
Gas Test
Engineering/Grading Final765-l;126
Fire Depl. Final 765-4040 , , '
Water Engineering 765-5268 . . ,
,
Sub List/Business license 765-51,9
Zoning 765-5139 , A/l
Building Final ~asllnspeclion- Only', ~.Pf ,/Jf ;(7:;h "J:
, , fter Above Complete) . ./v~,
PARTIAL INSPECTIONS '
. BuildinQ Inspections
Mechanical Inspections ,
Plumbina Inspections
Electrical Inspections