2307 Manchester
CONTRACTOR INFORMAtlbN:
ROOF SAVERS INC
2323 N TUSTIN AVE #C146
SANTA ANA,GA 92705000,0
BUSINESS PHONE: 714835-7663
JOB DESCRIPTION:Tear off existing roaf and replace with 19 squares of torch Jewn.
, ,
VALUATION: . 3,000.00 I ,~~;
I' OWNER-BUILDER n~{:LARATION
I hereby affirm !.lnder penalty of perjury"that I am exempt from the Contracto..'{License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city Dr county which requires a permit to'construct, alte~, rrhprove, demolish o.r repair any structure, prior to. its iSSiJance, also.
requires the applicant for such permit to. file a signed statement that he is licer}sed'pursuant to. the provisions of the Contractor's License Law,(Cha'pter
9)(commencing with Section 7000 of Division 3 of the Business and Professio'!ls.~:ode) o.r that he is exempt therefrom and the basis for the allsi;ied
exemption. Any violation of S~ction 7031.5 by any ap.plicant for a permit subJctGts,the appiicant to a civil penalty of not more than five hundred do!lars
($500)" ," , :' ,
D I, as owner of property, or my employees with wages as thek sole compe;;sation, .......;11 do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License L2'-~' dOes not apply to an owner of property who builds or improves
- thereon, and who does such work himself or herself or througl:l his or her.own:f.\mployees,'provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one yea~ of rompletion, the owner-builder wi!: have' the burden of provii1g that he
did not build or-improve for the pu.p,ose of sale).'
o I, ,as the owner of the propertY, am exdusively contracting,with licensed ~.~..Ltracl.ors fa construct the project(Sec.7044 Business and Professions
Code: The Contractor's License_law does not apply to an owner of property..'~-h9buiJds or improves thereon, _and whdoontracts for such projects with
- ~ontra.ctor(s) licensed pursuant t~ the Contractor's License .l,aw). 1
U t am exempt under Sec. _ . , , B & P.C. for this.reason:, . -....I,..
Date: Owner: ..
I ' WORKER'S COMPENSATION DECLARATION [__-.1
I hereby affirm under penalty of pe~ury one of the foJlowing declarations: J[
o I have and will maintain a certificate of consent to self-insure for worker's'lcompensaflon,
'as provided for by Section 3700 of the labor-Code, for'the pelformance of thJwork for which
. this permit is issued. - . ' 1
~, I have a'nd win rt:1aintain worker's compensation insurance, as required bylSection 3:00 of
the labor Code, for the performance of the work for-which this permit is,issuer.,i_ Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND'
BUILDING PERMIT NO. j3LD2005-00104
TYPE OF PERMIT CITY
Reroof
DATE: 1/18/2005
JOB ADDRESS: 2307 S MANCHESTER AVE
LEGAL DESCRIPTION: P BK 78 PG 5 PAR 2
APPLICANT: RICHARD AVARD
OWNER INFORMATION:
Rental C Dewey
939 E Union St
Pasadena, CA' 91106
BUILDING DiViSION
200 S, ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 109
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provfsionsof chapter 9 (commencing
with Sect" 7000) of Divs: rr30fthe Business
Profession Cod .
1/18/2005
Date:
Policy Number. 1731428-93
NUMBER
752128
TYPE
TYPE
TYPE
This section need nOt be completed if the pennit is for one hundred dollars ($100) I)r feit-S.
m ',',', CO"
I certify that in _the perfonnance o,fthe work for which this permit is issuec;, I s:nalJ not
mploy any person in any manner so as to beconie subject to the.worker's CC'fhpe;09:ation I~ws
of Califomia, and agree that if I should become ubject to the worker's mpe,;.sati'o(l
provisions.ofSection-3700ofth labor 0 s II rthwithcQ Y - t ;"';~e_p~isions.
~-'
;J
Contractor
EXPIRATION DATE
7/31/2006
B
C33 PAIN
C39
Construcion Types:
VN, ,
Fire Sprinklered?
NO
Date: 1/18/2005 Applicant:
WARN ING: FAILURE TO SECU WOR ER'S COMPE ATION C
UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER TO. CRIMINAl, ENALI!ES'AND CIVIL
FINES UP TO ONE HUND RED 'rH OUSAND 'DOLLARS ($100,000), IN ADD"UON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION :!706,"OF THE
LABOR COOE, INTEREST AND ATTORNEY'S FEES,
I CONSTRUCTION LENDING AGENCY
i h>,;reby_affjcm_unQerp~nalty~oLperjury thgt th.ere Lc;;;;: Lon!Struction 1'7!1rling ar.;;,,:,ey.L;f ~h~..
performance of th,e work for which this permit is issued (Sec.3097 .Civ .C): .
lender's Information:
Date: 1/18/2005
. S. nature of Applicant or Agent
.Th permit sha expire by limitation l!OO b me null and void if the building or
wo k has not passed final inspection 365 ys from the date of permit issuance. A
ne permit is required to commence or continue work.
Fees paid for Permit:
. Total: -
160,74
I
. INSPECTioN RECORD
,
-
iNSPECTION . . '. Electrical Final
DATE INSPECTOR ~
Temporary Power Pole Plumbing Final . .
Plumbing (DrainilNaste Pipe) Mechanical Final . .'
Electrical Ground ElectrodelUfer
Setback/FormslTrenches (Footings) . Gas Test I.
Do not install subfloor Or pour toor slab until the Engineering/Grading Final 765-5126 .
following applicable .items have een signed: Fire Dept. Final 7654040
Plumbl ng (Water Pi pe;Sprinkle Valves) .
.
Mechanical (Groundwork) Water Engineering 765.5268 .
Electrical (Underground Cond it) .
Pre~lab (Compaction/Membrane.Reinf. Sub ListlBusinessLicense 765.519
Underpinning (Flper JoistlGirdllrs) . Zoning 765.5139 . "
Do not cover or conceal the work below until the . I.t'Yt0;#f~
following applicable items have 'een signed: . . Builcling Final \l-ast Inspection. Only
fte' Above Complete)
lst.Roor Shear pARTIAL INSPECTIONS
Firesprinkler (Rough) Buildinnlnsoections
2nd Floor Shear
Roof (Shealhil1li1DiaphragmlFr Ime) . J.IQ,c,<. ~.A'&-D'L ) . . .
Masonry (ReinfJBond Beam/Pr~rout) . .
.' '. . . .
Rough Plumbing (Top Out)
Rough Mechanical
Rough ElectrICal IDry WallJ '.
Rough Electrical'
.Framing (Only after Plbg.. Elec.. Mec "' and Fire) . . . '. .
Insulalion (SoundlEnergy) , '. .
Do not tape or plaster until th . following applicable . Mechanical. h1sDections
items haye been s.igned:.. . .
Drywall . . .'.
.
Penetralions .(Fire Raled) Elect Weal
Penetralions (Fire Raled) Mechanical - .
Penetralions (Fire Raled) Plum ing
Interior Lath . . c.
Exterior Lath' PlumbinalnSDections "
'. GENERAL ITEMS -,
Exterior Plaster (BraNn Coat) . ,
T -Bar Electrical .
T'Bar Mechanical . .
T 'Bar Structural .
Sewer
Water Engineering Backflow ElectricallnSDections
Water Service .' . .
. .
.
.
.
.
.
FINAL INSPECTIONS
. Date
Inspector