127 Midway Manor
>
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 85
BUILDING PERMIT N"O. B,L,D2005-01575
,.
TYPE OF PERMIT CITY
Reroof
DATE: 5/26/2005,
JOB ADDRESS: 127 W MIDWAY MANOR
LEGAL DESCRIPTION: N TR 1602 LOT 4
APPLICANT: ELIZABETH ALQUISIRA
OWNER INFORMATION:
Fernando Soto
127 W Midway Mnr I .
Anaheim, CA 92805 i
JOB DESCRIPTION:Tear off existing materia'l, install 22 squares of 30 year tim~rJjne shingles.
VALUATION: 2,000.00!
CONTRACTOR '~FORMATION:
ARCHITECt/ENGINEER INFORMATION:
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION .
I hereby a irm u sr penalty Qf perjury that I am exempt from the Contractor's 'J-icense Law for the following reason (Sec. 7031.5 Business and.
Professions Code: any cltyor county which require,s a permit t9 construct, alte~.~i'mprove, demolish or repair any structure..priorto its issuance, alsq
requires the applicant for such permit to file a signed statement that lTe is licensed pursuant to the provisions of the Contractor's_license L;;l.w (Chapter
9)(commencingwith Section 7000 of, Division ,3 of _the Business and Profession~ Code) or that he is exempt therefrom and the basis for the-alleged
exemption. Any violation of Section 703.1.5 'by any applicant for a permit sllbjefts the applicant to a chi~ penattyof not more thanjive hllndre~ dollars
~O?)~s owne'r of prop~rty, or my .employe~ with wages as their 'SOJ~ compe~~tion, will d6the work" and the structure is not intend~ or offered for
t:re. (Sec. 7044 Business and Professions Code: The Contractor's License Layv does not applyto'an owner of property who builds_or mproves
thereon, and who d9SS such work himself or herself or through his or her own ~mployees,providedthat such improvements are-not intended or "
offere9 for sale. If, however, t~e building or improvement is sold with oneyear;of pompletion, the' owner~builder will have the burden of proving th~t~e.
did not build or improve for the purpose of sale). _:/ " ,
o I, as the owner of the property, am exclusively cqntracting with licensed c6ntractors to construct the project (Sec. 7044 Business and Professions .'
Code: . The Contractor's License Law does not apply to an owner of property wpo builds or improves thereon, and who contraots for such projects with
ontractor(s) licensed pursuant-to the Contractor's License Law}. ,( ,
I am e empt oder Sec. ' " & P. . for t~is reason: i
te: .' 5'" 0 . '.
. WORK R'S PENSA N DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:'
o I have and will maintain a certificate of consent to self-insure for worker's60mpensation,
as provided for by Section 3700 of the Labor Code, for the pertqrmance of the wolk for wtiich .
this permit is issued. .
D' -I' have and will maintain worker's compel)satlon Insurance, as required by E)ection 3700 of
the Labor Code, for the .performanceof the work'for which this permit is is&uedJ My worker's
'Compensation insurance carrier andpoUcy are:' I .
Carrier: Policy Numb,er.
This section need nOt be completed if the pennit is for one hundred dollars ($100) or less. '
~ I certify that in ui~, perionnance of'the work_for which this permit is issued,)1 shaH not '
~y any person in any manner so as to become subject to the worker's cQrnpensation laws
of California, and agree that if J should become subject to the worker'scompens,ation
provisions of Section 3700 of the bor C e, I shall forthwith comply with those provisions.
LICENSED CONTRACTORS DECLARATION
I hereby affirm unde~ penalty of.perjury.that I.am
licensed under provisions Qf-chapter'9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
5/26/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Date: 5/26/2005 Applicant:
. WARNING: FAILURE TOSECU PENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJ TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO. THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S. FEES. .
CONSTRUCTION LENDING AGENCY
[hereby affirm .under penalty of perjury that there is a construction lending age~cyfor the
performance of thefiork fOJ which this permit is issued (Sec.3097.Clv.C):
'Lender's-~nformatjort~--- ' ;.-.-------.. ' .
Construcion Types:
VN, ,
Fire Sprinkle red?
. NO
'certify that I have read this appJlcation and state that the above inforrriation is correct. I
agree to comply with all city ordinances and srate laws relating to building.construction, and
hereby auttlorize representives of this city to enter upon the-above mentioned property for
. ,~e on purpo (
Date: 5/26/2005
Fees paid for Permit:
Total:
235.33
Signatur f Applican~ or Agent
The ermit shall expir by limitation and become null and void if the building or
wor has not passed Ii nal inSpection 365 days from the date of permit issuance. A.
new'permit is required to commence or continue. work.
INSPECTION RECORD
.
INSPECTION. DATE INSPECTOR.
Temporary Power Pole .
Plumbing (DrainlWaste Pipe) . ..
Electrical Ground Electrode/Ufer
. SetbacklFormsfTrenches(Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed: .
. Plumbing (Water Pipe.Sprinkler Valves)
Mechanical' (GroundWork) '. ..
Electrical (Underground Condu~)
Pre-slab (Compaction/Membrane.Reinf.
'Underpinning (Floor Joist/Girders) . .
Do not cover or conceal the'work below unlillhe
following applicable items have 'been signed: .
1st Floor Shear '. .
Aresprinklllr (Rough)
2nd Floor Shear. . Il c
Roof (Sheathing/Diaphragm/Frame) . '1-). -0'
Masonry (RIiinf.JBond Bea'lllPre-Grout)
Rough Plumbing (Top Out) . .
Rough Mechanical .
Rough l3ectr II)
Rough Electrical , ..
Framing (Only after Plbg., Elec.. Mech.. fnd Fi~ej
Insulation (SoundlEnergy)
po not tape or pla~ter until the following applicable . ..
Items have bee.... slgned:- . .' - . .
Drywall . .. .
Penetrations (Fire Rated) Electrical . .
Penetrations (Fire Rated) Mechanical
Penetrations. (Fire Rated) Plumbing
Interior Lath .
. Exterior Lath
.' GENERAL ITEMS.
Exterior Piaster (Brown Coat) c-
T -Bar Electrical .
T.BarMechanlcal. . . . .
T -Bar Structural
Sewer . .
Water Engineering Backtlow
Water Service . . .
FINAL IfIISPECTIONS . Date. Inspector
.-
Electrical Final ._-}. '.
Plumbing Final
Mechanical Final .
Gas' Test . .. '.. .
Engineer,ing/Grading Final 765..5126.. . .'
Fire Dept. Final 765-4040 .
Water Engineer.jng 765-5268 . ..
Sub List/Business License 165.519 ..
Zoning 765-5139. . .
.. A
*asllnspeclion. Only ojtj~) ~7v~ ,
Building Final fler Above COl!lplete)
PARTIAL INSPECTIONS
Buildina Inspections
.. rl.~j .. )~A'7'~ /Vb
U:-W./t<:f -
1?jd7ff
.
Mechanical Inspections
. Plumbina Inspections
Electrical Inspections