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425 Manti Dr. BUILDING PERMIT NO. BLD2004-04162 TYPE OF PERMIT CITY. . Reroof . DATE: 11/16/2004' . JOB ADDRESS: 425 N MAJ',jTIDR LEGAL DESCRIPTION: N TR 5083 LOT 57 APPLICANT: FREDDIE . VAZQUEZ OWNER INFORMATION: Michael Turen ne 425 N Manti Dr . Anaheim, CA .92807 BUILDING DIVISION 200 $. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUESTLINE: (714)765 - 4626 CENSUS CODE: 555 . QUARTER SECTION: 167 ARCHITECT/ENGINEER INFORMATION: CONTRACTOR INFORMI~TION: FiRST QUALITY ROOFI~IG 906 S FIGUEROA ST: SANTA ANA, CA 92704060:0 BUSINESS PHONE: ',714 775-337<; JOB DESCRIPTION:Tear off existing roof and replace with 23 squares of 40 Yr, composilion shingles. VALUATION: 4,500.00 PROCESSED BY: MSM I . .' '. OWNER.BUILDE~: DECLARATION . , '.' . I hereby affirm under penalty of perjury that I am exempt from the Contractafs'Uccnse Law for the following reason (Sec. 7031.5 Business and . Professions Code: any city or county which requires a permit to construct, o::er, improve, demoll,shar repair any structure, prior to its issuance, also requires the applicant for such permit to fLlea siQned statement that he IS lic,;nsed pursuant to the provisions otttie Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business andProfessiops Code) orthat he is exempt therefrom and the basis for 'the alleged exemption, Any violation .of, Section 7~31,5 by any applicant for a permit St!9E:ctl; the applicant to a civil penalty of not mOre than five .hundred dolt~rs ($500).' , .,. . . o .1, aso~ner.of property, or my employees with wages as their sole Cbl'Y'l~BI~sation, will do the work, and the f.'tructure is not intended or offered for sale (Sec. 7044 Business and Professions Code:' The Contractor's License Law does not a pply to an owner of property whO buildsorlmprove~ thereon, and who does such work himself or herself or through his or her O'.,tl o;;!mploye~s, provided that such imprOvements are'not intended or offered for sale. If, however; the building or improvement is sold with one Yl?:=r c.f oompletion, the owner-builder will have the burden ot'proving that he did not ~ad or improve for-the purpose of sale). '. . ,','i'.... . '. 0 I, as the owner of the property, am-exdusively contracting with I-icen$ed'_:::ontiactors tocons'truct the project '(Sec. 7044 Bu'siness and Profe~'io.ns Code: The Contractor's License Law does 'not apply to.an owner of proper;.'tNho builds or improves thereon, and who contracts for sum projects 'With ~ontract?'"(s} license~ pUrsuant ~~ the c..ontraCtor's License Law). . U lam exempt ~nder Sec. . ,B & P.C. for1his reills'on: Date: 'Owner: ' ,I: I --. WORKER'S COMPENSATION DECLARATION~r____=:J I hereby affinn'under penalty of perjury one of the following declarations~ i. ." o I have and will maintain a certificate' of oonsentto self-insureforwork~r;5compensat\on, 8S provided for by Section 3ioo of the LaborCode, for the performance (\flh1e .v'orli. for which $1hi. permit is issued. ". " . . '" t have and will maintain wofker's compe~ation im:,uranc~, as requjre-d bV Section 3700 of he abbr Code, for the performance of the work for which this.perm!t is ise'l:)d. Myworker's Compensation in-surance carrier and polic.y are: . , Carrier: STATE FUND Policy Num~er: 002659~W20G4 This section need-not be compl_eted if.th'e pennit is fur one hundred do!lars ($1il~ or-less. o .1 certify' that in the performance of the work for which this permit is, :SSUt"~\!l:1 shalt -not employ any person in any manner ,so as to become $ubject to the worker's (;~;mpensation laws . of California. and agree that if I should become stIbject t9 the wor'r<er's con~p:;nsation provisions of Section 3700 'ofthe Labor Code I shall fi rt ith c~m y \lith t:'~Jse provisions. r NUMBER 771;969 TYPE TYPE TYPE . C3.9 C27 HIC Construcion Types: VN, , . Fire Sprinklered? NO Date: 11/16/2004 Applican WARNING: FAfLURE TO SEC EWO. UNLAWFUL, AND SHALL SUBJECT MPLOYER TO C;;RIMINALPr;NA:_TiES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AD[;rnON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION' 37U6 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. . I CONSTRUCTION LENDING AGENCY _ .-"-1 I hereby affirm under penalty .of perjury'that there is a constn.lction lendlng3!;R.r'I~Y for the . ! p.-;,.rr0T.".s>los ,:;yf thevrur-k-fof v'vTil\.I' {hl~~"Gfln;t tS h.s*,.J~cl (S1i:C.3097:-B-tv-:C}; Lender'$lnformation: I certify that I have read this a pplication and state that the above information is correct. I agr.ee to comply with 'all city ordinances and state laws relating to pu~ding- coostruction, and' hereb authorize representives of this citY'to enter upOn the above mentioned- property f?r ..iJJsp jon purpo r Date: 11/16/2004 235.33 Signatur~ of Applicant or The permit s, I expire by limitation a ecomenull and void if the' building or work has n ' passed final inspection 365 days from the date ofperntit issuance. A. riewpermit is required to'commence or continue work. . Fees paid for Permit: Total: - . INSPECTION RECORD FINAL INSPECTIONS .. Date . Inspector . Electrical Final . . INSPECTION ' DATE INSPECTOR . Temporary PQwer Pole " Plumbing Final . . ,. Plumbing (DrainlWaste Pipe) .' , Mechanical Final' , Electrical Grou,nd Electrode/uter ' ' . Setback/Formsrrrenches (Footings) Gas Test , I Do not install subfloor or pourfloor slab until the EngilM!9ring/G~ading Final 765,5126 , , following applicable items have been signed: Plumbing (Water Plpe.Sprinkler Valves) Fire Dept. Fina1765-40.40. Mechanical' (Grall ndwork) , Wate'r Engineering 765-5268, ' ., Electrical (Underground Conduit) , Pre-slab (Compaction/Membrane.Rei nt. Sub List/Business License 765-51,9' , Underpinning (Floor Joist/Girders) , Zoning 765.5139 /) , Do not cover or conceal the work below until the '. IIlu D~ ~Yd~ / , following applicable items have been signed: Building Final ~ast Inspection- Only fter Ailove Complete) 1 st Floor Shear , , ~ PARTIAL INSPECTIONS, Firesprinkler (Rough) . . / uildina Inspections 2nd Floor Shear' , . (/ /' RoOf (Sheathing/Diaphragm'Frame) \ ~ A'.r 11>..J "/ ., Masonry (ReinfJBond BeamlPre-Grout) ,f -c~ - , , Rough Plumbing (Top Out) , .. Rough Mechanical . , ',' Rough E1ectrlC,a! (Dry wall) C- , Rough Electrical, . Framing (Only Qfter Plbg.. Elec,. Mech.. and Fire) , Insulation (SoundlEnergy) , Mechanical Inspections 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 Plumbina Inspections GENERAL ITEMS , ' ' . Exterior Plaster (BlQWn Coat) , , 'T-Bar Electrical ' . , .. - . ' T ~Bar Mechanical, , , , ' T-Bar,Structural . . Sewer " , Water Engineering Backflow , Electrical Inspections Water Service .