157 W. Margate Dr.
BUILDING PERMIT NO. BLD2003-02697
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TYPE OF PERMIT
Repair
DATE: 7/6/2003
.JOB ADDRESS: 157 W MARGA TE OR
LEGAL DESCRIPTION: N TR2090 LOT 42
BUILDING DIVISION
200 S. ANAHEiM BLVD.
(714)765.5153
INSPECTION REOUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 86
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APPLICANT: GLEN HOLMES
OWNER INFORMATION: CONTRACTOR INFORvlATION: ARCHITECT/ENGINEER INFORMATION:
Miet,ael Pallas CERTIFiED RESTQR!\r10N SERVICES
157 W Margate Dr 4368 CENTRAL AVE,
Anaheim, CA92605 . RIVERSIDE, 92506 0000 CA . .
JOB DESCRIPTIONfrre damage repair, 24 sq. 25 yr camp. rewire garage;:r & i,:garage rafters, 150 s.f TOof sheathing, fkewaUln garage 5/8"
~ - . . .
V.A,LUATION: 8,000.00 PROCESSED BY: CAL
r . '. . . OWNER-2UllOERO:::CLARATION . .' .
I hereby affirm under ~nalty of perjury tnat I am exempt fr.em the-Contr~cf.;)!'~s UcenSt:! Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires 'C' permit to construct, c!ft~r.irrfplove, deniC)lish Qr repair anY-structure, priQr 10 i1s issuance;',alsQ ,
requires the applicant for suc.1-J permit to fila a signed $ta1ement t~at~,ej~l:celised pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Profe.ssions Code) OT that he is exempt therefrom and the 'oasis forthe alleged
exemption. Ariyviolation of Section 7031.5 .by ::lny apolicar.t for a 'permi(~iJbjects the applicant to a civil penalty of not more than five hundred dollars
($500):. . . .'.' .' . . .'
o !, as owner of property, or my employees with wages as tr:.;.i(soJe combensation, wii! do _the work, and the structure is not-intended 'or offered for
3aie (Sec. 7044 Business and Professior')s Code: Ttle Contractor's"Ucenie~'..awdoes rtotapplyto an oWf')el of property who builds or improves '
thereon, and who does such work himself or herself o-r thr0ugn his O'r her 6wru~rnployees. provided that such Improvements ;;Ire not intended or
offerE'd for sale. If, however, the building or improvement isso!d with one--f/t:a$.of CJmpletfon, the owner-b!Jilder will have the: burden of proving that.he
did not build or impr?ve-for the purpose_of sale). ~'.. - .
[] I: as the owner of the property, amexdusively confracting with IJcensqci' .:.,:)ntractors to construct the project (Sec... 7C4~. Busine::;s and ProfeS&ion~
COde: The Contrflctor's License Law does. not _apply to all owner of .properlywho builds or improves thereon. and who oontractsforcsLlch projects -.vith
a contrador(s) licensed pursuant to the Contractor's License Law}~.:
0, I am exempt under Sec. __ . E & P.C. TOr this reason:
Date: Owner:
r-- WORKER'S COMPENSATION DEClll.RATION . .' :::=:J r
I hereby affirm under penaity of perjUlY one of the following declarations'~:. :':! _ I'
o ,'have and will maintain a certificate of.consentto .self..,illSlJre fO:-'1orke::'seo-";per.sation, !
as provided for'by Sedfon 3700 of the Labor Code, for the perfCfmall(;ei;"~(i\''\<~'NOrl< for which I
j11l;iS rmil is issued. . . ..:,:,':'-,,/. .
. - \ ,tt'....ve and wilt m~intain worker':; compensatiqn insur~nce. as rt:qu'ifJ'~~_ t'~"S~~tk>n 370Q of
. h I abor Code, for the:: performance'of the work for .......hich this pt')mljt)s!~l'j1:C: '.My workl::r's ,
Com~enf>9.tion insur'floce carrier and poiicy ere: --._' '::::;), -
Carrier: STATE COMPENSATION INS FUND Policy Number. C4:6~,03~~012635
LICENSED CONTRACTORS DECLARATIONl
I hereby affirm under penaltybf perjury that I ~m':
licensed under provis s o{cha !f.r (commer:cing.
-with SeetiN\ 7000):. j" n 30" ~fJess and ,
prnfes~ions*.. '. ,.\~.
7/8/2003. .
Date: . Contractor
NUMBER
723266
TYPE'
TYPE
Construcion Tvpes:
VN, ,
Fire Sprinklered?
. (~~, ',11\'. .ld't::.
J certify that I have.tead this application and state that the above information is correct. t
a. gree to mply,wfth fle.it _ 0 dina and state laws relating to building construction, and
hereby a tho' erep nil of i city to enter upon the abOve mentioned.property for
inspe' u s. '
. .' . Date: 7/8/2003
: Signature of Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
work has not passed finalinspection.365 days from the date of perm,i issuance. A
new p'ermit is required to comm!!llce or continue work. .
EXPiRATION DATE
5/3112004
B
Hie
NO
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Fees paid for Permit:
Total:
176.26 .~:
INSPECTION RECORD
. INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (D/3in/Waste Pipe)
Eklctrical Groun.d ElectrodelUfer . '
SelbacklFormslTrenches (Footings),' '.
00 not'i,nstall subfloor or pour floor slab until the
following applicable it.ems have been signed:
Plumbing (Water Pipe.Sprinkler Val)les)
Mechanical (Groundwork) .
Eklctrical (Underground.Conduit)' .
Pre-slab (compactlonlMembrane,R~m.J
Underpinning (Floor Joist/Girders) i
~ not cover.or conceal the work below until the ,
follOWing apphcable Items have wen signed: , ,
1st FlOOr Shear
Firesprinkler (Rough)
, .2nd Floor Shear' ' "
Roof (SheathinlllDlaphragm'Frarne)
Masonry (RelnfJBond SelWltlPreoGrout)
Rough Plumbing (Top Out) ,
Rough Mechanical ' ' ,
Rough Bectrlcallury wall)
Rough 'Electrical
Framing (Only after Plbg" Elec,:Mech, and Fire) ,
Insulation (SoundlEnergy) ,
Do not tape or plasier until the following applicable
items have been signed:' .
Drywall
peneirations (Fire Rated) Electrical
Penetrations (Fire Rated) MechaniCal
Penetrations (Fire Rated) PllIIJIbing
Interior Lath .
Exterior Lath .. .
, , GENERAL ITEMS . '
Exterior Plaster (Brown Coat) ,
T -Bar Electrical
T -Bar Mechanical
T -Bar Structural .
Sewer ,
Water Engineering Backflo,", '
Water Service "
, . .,.
FINAL INSPECTIONS Date ,. lnsp~ctor
EI,ectrical Final . .
Plumbing Final . .
MechaniCal Final , ,
Gas Test' , ,
Engineering/Grading Final, 765.0126 .
Fire Dept. Final 765-4040 .
Water Engineering 765-5268' .,
Sub list/Business License 765-519 ,
,
Zoning 765-5139
Building Final ~ast Inspection. Only
. ' 'fler Above Complete)
PARTIAL INSPECTIONS
Buildim~ Inspections
Mechanicallns';'ections
Plumbina Inspections
Electrical Inspections
PERM\T EXPIRE\}
\NSPECTION
NOT COMPLETED
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