952 S. McCloud St.
BUILDING PERMIT NO. BLD200S.:o1139
TYPE OF PERMIT
Reroof
DATE: 4/20/2005
JOB ADDRESS: 952 S MCCLOUD ST
LEGAL DESCRIPTION: N TR2259 LOT 31
APPLICANT: DAN HILL
OWNER INFORMATION:
Obdulia D Mendoia
.952 S Mccloud St
Anaheim, CA 92805
ElM
BUILDING DNlSION
200 S. ANAHEIM BLVD.
(714) 765.5153
. . INSPECTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: 555
QUARTER SECTION: 105
)..-.9-
CONTRACTOR INFORMATION:
STEVE SUDDUTH CONSmUCTlON
3871 URIS CT
IRVINE, CA 926060000
BUSINESS PHONE: 949551.2130.
JOB DESCRIPTION:Tear of:t existing roof and replace with 10 squares of 30 year composition shingles and 10 squares of torch down.
VALUATION:
4,000.00
PROCESSED BY: MSM
ARCHITECT/ENGINEER INFORMATION:
OWNER-BUILDER DECLARATION
I hereby affirm -un er penalty of perJury that I am exempt from the-Contractor's. License Law for the following 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 issuance, also-
requires the applicanffor such permit to file a signed statement that he is liCensed pursuant to 'the plQvisions of the Contractor's License Law (Chapter
9)(comme:ncing with Section 7000 of Division 3 of the Business and Professions Code) or th~t he is exempt thereirom 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 penalty of not more than five hundred dolla-r~f
~~ . i ..
D J, as owner of property, or my employees with wages as their sole cqmpe(Jsation, will do the work, and the structure is not interided or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's Ucense Law does not apply to an owner of property who buildS; or improves
thereon, 'and who does s;uch work himself.or herself or through his or her own employees, provided that such improvements are not intended or
offered for ~Je. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve'forthe purpose of sale). '
o I, as the owner of the property, -am exclusively-contracting with licensed, cPntractors to construct the project (Sec. 7044 BU$iness a"nd Professions
Code: The Contractor's liCense Law does not apply to -an owner of property w:hO ,builds or improves thereon", and who cot:ltracts 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 reas~n:
Date: Owner:
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o Ihave and wiil maintain a certificate of consentto self-insure for worker's9ompelisation,
as provided for by-Section 3700. of the Labor Code, for the performance of the work forwhich
ii permit is issued. " . ,
, I' have a.nd will maintainworker's compensation insurance,- as requi,red by $. ection ;3700 of
. Labor Code, for ~he performance of the work for which this permit is issued. My y-Jorker's
ompensation insurance carrier and policy are: . . " '
Carrier: STATE FUND Policy Number. 16860252.
This section need not be completed if the Perinit is for one hL1ndred dollars ($100) or less.
D- I certify that in the performance of the work for wtlich this permit is issued; I shall not
employ any person in any manner so as to become subject to the worke"r's compensation laws
of Califomia; and agree that if I.should become ject to the worker's compensation
provisions of Section 3700 of the Labor Code, I II ~orth ith c 'mpty with those provisions.
Date: 4i20/2005. Applicant:
WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVERA(3E IS
UNLAWFUL, AND SHALL SUBJE TAN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL
FINES'UPTO ONE HUNDRED 1]40USAND DOLLARS ($100,obo),IN ADDlllON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTO.RNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury th.at 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:
Date: 4/20/2005
Signature of Applicant or Agent
Th permit $haIl expire by limitation and become null and void if the building or
work ha$. not pao;u;ed fi nElI i rn;pection 365 da}'$ from the date of permit i$$Uance. A
neW permit i$ required to commence or continue work.
LICENSED CONTRACTORS DECLARATION
I hereby affjrm under penalty of perjury that I am
licensed under provisionsof chapter 9 (commencing
with Section 7000) of D' ion 3 of e Business and
Professions Co e:
4/20/2005
Date:
NUMBER
746046 .
TYPE
TYPE
TYPE
EXPIRATION DATE
2/28/2006
B
C39
HIC
Construcion Types:
VN, ,
Fire $prinklered?
NO
Fees paid for Permit:
Total:
160.61
INSPECTION RECORD
. INS.PECTION . .. DATE . INSPeCTOR
Temporary Power Pole .. .
Plumbing (DrainlWaste Pipe) .
Electrical.Ground Electrode/Ufer
SetbacklFormsfTrenches (Footings)
Do not instal I. subfloor or pour floor slab until the .
following applicable items have. been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GroundWork)
Electrical (Underground Conduit) .
.. Pre-Slab (CompacbonlMembrane.Reinf,
Underpinning (FI~ Joist/Girders) . .
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear .
Firesprinlder (Rough) .
2nd Flo .. , /1 , / Ik
Roof lSheathi~aphragm/Frame) (h'iJ/"S- .~L~
Masonry vwml JBond BeamlPre-Grout)
Rough Plumbing (ToP Out).
Rough Mechanical. . . .
Rough l:IectrlCallDry wall) .
. Rough Electrical .
Framing (Only after Plbg., Elec.. Mech.. and Fire) .
Insulation (SoundlEnergy)
Do not tape or plaster until the following applicable' '
it&ms have- been signed: . - . . . .
Drywall . . .. .
Penetrations (Fire Ratl!d) Electrical' .
Penetrations (Fire Rated) Mechanical .. ,
Penetrations (Fire Rated) Plumbing
Jnterior Lath .
Exterior Lath
. ' . GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical .
T-Bar Mechanical . . .
.
T.Bar Structural . .' , '
Sewer
Water Engineering Backflow '
Water Service
FINAL INSPECTIONS Date .. Inspector
, Electrical Final . .
Plumbing Final
Mechanical Final .'
Gas Test . .'
Engineering/Grading Final 76505126 .
..
Fire Dept. Final 765-4040 .' , ,
Water Engineering 765.5268 ,
Sub List/Business License 765-519
Zoning 765-5139 . ..... "
Buildin9 Final' ~ast Inspection- Only ;t-7.6~ '11~~
fter Above Complete),
PARTIAL INSPECTIONS V
Buildina Inspections
MechanicallnsDections
Plumbina Inspections
Electrical Inspections '