2021 W. Minerva Ave.
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 41
BUILDING PERMIT NO. BLD2005-02882
DATE: 9/12/2005
JOB ADDRESS: 2021 W MINERVA AVE
LEGAL DESCRIPTION: N TR 2711 LOT 59
CONTRACTOR INFORMATION;
MILES GALLA-RINI
346 E MEADOWBROOK AVE
ORANGE. CA 92865-0000
BUSINESS PHONE: (714) 974-6424
JOB DESCRIPTION;Tear off existing material, Install 31 squares of 30 year composition shingles to house and garage.
VALUATION; 10,955.00 PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense 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 applicant for such permit to tile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
"9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom 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 dollars
($500).
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 6usinessand Professions Code: The Contractor's License Law does not app/yto an owner Of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own l~mployees, provided that such improvements are not intended or
offered for sale. 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 for the pUlpose of sale).
o I, as the owner of the property, am exclusively contmcting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
o I have and will maintain a certificate of consent to selHnsure for worker's (;ompensation,
as provided for by Section 3700 of the Labor Code, for the performance of the WOIK for which
this perm it is issued.
r)(/ have and will maintain worker's compensation insurance, as required by Section 3700 of
tfiebborCode, for the periormance of the work for which this permit is issued, Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 285-0001656
APPLICANT: JOHN BATIOFF
OWNER INFORMATION:
HELEN R CAMPBELL
2021 W MINERVA AVE
ANAHEIM. CA 92804
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penatty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 700 of ivsion 3 of the Business and
Profession C e.
9112/2005
Date:
B
C39
This section need not be completed If the pennit is lor one hundred dollars ($100) or less.
.&!' certify that in the pertol1Tlance of the work for which this permit is issued, I shall not
employ any person in any manner so as to become subject to the workers compensation laws
of Califomia, and agree that if I sho Id become su ject to the worker's compensation
provisions of section 3700 of the La rae, I sh 0 h ith comply with those provisions.
NUMBER
663983
TYPE
TYPE
Date: 9112/2005 Applicant:
WARNING; FAILURE TO SEC E WORKER'S C PE ATION COVERAGE IS
UNLAWFUL, AND SHALL SU OECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDR THOUSAND DOLLARS ($100,000), IN ADDITlON TO THE
COST OF COMPENSATiON, DAMAGES AS PROViDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that 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:
Construcion Types:
VN, ,
Fire Sprinklered?
NO
I certify that I have react this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby horize rep sentives of this city to enter upon the above mentioned property for
sp Jon purposes.
Date: 9112/2005
Fees paid for Permit:
Total:
320.14
plicant or Agent
permit shall expir II itation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance. A
new Demlit is rellUired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodefUfer
SetbacklFormslTrenches (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 Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable Items have been signed:
1 st Floor Shear
Flresprinkler (Rough)
2nd Floor Shear ~
Roof (Sheathing/Diaphragm/Frame) ,,\W\US -. ",". I
Masonry (Reinf./Bond Beam/Pre-Grout) f
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing {Only after Plbg., Ele., Mec. And Fire)
Insulation (Sound/Energy)
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
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 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Lastlnopectlon - Only "(.;.G'O, f2.(JVX;S' .,If
After Above Complete)
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing InsDections
Electrical InsDections
!"#$%& '
()*,),+,- )+
8 9:$';$+"+,- .
! "#$! % & '"
<=>?@A$"B?C=>D$()*./012//314
())$&*$+"+,- .$ %!*
5''6 78#09.:9./01
/0123$045$6$5157
5;< ,-$5=;#>,?@,<$#)5;,8
A40BC#41:#2#B1.1
?6D " #< E"!FG8#B0
&@A=$+MM>=HHD$#./.0#I#+5;,>JK#KJ,
=EFG$!=HI>@JA@KLD#;#$>#.400#)=$#:H
N'OP-OQ&$8'.<-"&+9 '"$!-8 +O+9 '"D
IK>;5;L8#MK5)@>,#$=#<,-@>,#I=>N,><O#-=+ ,;<K$5=;#-=J,>KL,#5<#@;)KIM@)P#K;*#<QK))#<@(R,-$#K;#,+ )=S,>#$=#->5+5;K)#
,;K)$5,<#K;*#-5J5)#M5;,<#@ #$=#=;,#Q@;*>,*#$Q=@<K;*#*=))K><#AT0//P///CP#5;#K**5$5=;#$=#$Q,#-=<$#=M#-=+ ,;<K$5=;P#*K+KL,<#
K<# >=J5*,*#M=>#5;#<,-$5=;#34/1#=>#$Q,#)K(=>#-=*,P#5;$,>,<$P#K;*#K$$=>;,SO<#M,,<U
5#V W%#DXX! #6G7 #& GDY"%#FX#& Z6 %#FG #FX#"V #XFYYF\[!G\\#7 EYD D"!FG'8
5#VD\] #DG7#\[!YY# D!G"D!G#D#E "!X!ED" #FX#EFG' G"#"F#' YX2!G'6 #XF #\[F ^ O'#EF & G'D"!FGP#!''6 7#W%#"V #*! E"F #FX#5G76'" !DY#> YD"!FG'#D'#& F\]!7 7#XF #W%#
< E"!FG#34//#FX#"V #)DWF #-F7 P#XF #"V #& XF DGE #FX#"V #\[F ^#XF #\[V!EV#"V!'#& !"#!'#!''6 7U
b5#VD\] #DG7#\[!YY# D!G"D!G#\[F ^ O'#EF & G'D"!FG#!G'6 DGE P#D'# _6! 7#W%#< E"!FG#34//#FX#"V #)DWF #-F7 P#XF #"V #& XF DGE #FX#"V #\[F ^#XF #\[V!EV#"V!'#
& !"#!'#!''6 7U#+%#\[F ^ O'#-F & G'D"!FG#!G'6 DGE #ED ! #DG7#&FY!E%#D 8
-D ! 8K-,#K+,>5-K;#5;<@>K;-,#-=+ K;S FY!E%#;F8>I--B`:3H:14,a&! D"!FG#*D" 80/9/09./01
;D #FX#K\\ G"8 VFG #;F8
5#E "!X%#"VD"#!G#"V #& XF DGE #FX#"V #\[F ^#XF #\[V!EV#"V!'#& !"#!'#!''6 7P#5#'VDYY#GF"# &YF%#DG%#& 'FG#!G#DG%# DGG #'F#D'#"F#W EF #'6WZ E"#"F#"V #
\[F ^ O'#EF & G'D"!FG#YD\['#FX#-DY!XF G!DP#DG7#D\\ #"VD"P#!X#5#'VF6Y7#W EF #'6WZ E"#"F#"V #\[F ^ O'#EF & G'D"!FG#& F\]!'!FG'#FX#< E"!FG#34//#FX#"V #
)DWF #-F7 P#5#'VDYY#XF "V\[!"V#EF &Y%#\[!"V#"VF' #& F\]!'!FG'U
(,$Q#$Q=+ <=;09.:9./01
,Y E" FG!E#<!\\GD"6 #FX#K&&Y!EDG"*D"
8-"&-!$8'"9O+89'O&$!-8 +O+9 '"D
5#V W%#DXX! #6G7 #"V #& GDY"%#FX#& Z6 %#"VD"#5#D #Y!E G' 7#6G7 #& F\]!'!FG'#FX#EVD&" #H#AEF GE!G\\#\[!"V#< E"!FG#4///C#FX#*!\]!'!FG#3#FX#"V #
(6'!G ''#DG7# FX ''!FG'#-F7 P#DG7# %#Y!E G' #!'#!G#X6YY#XF E #DG7# XX E"U
(@>N,#,),-$>5-#5;-09.:9./01
,Y E" FG!E#<!\\GD"6 #FX#-FG" DE"F *D"
;@+(,>,b 5>K$5=;#*K$,)5-,;<,#$S ,A<C
%%% !" !# $
9R=$J=>?@A$HRFGG$=SJ@>=$CT$G@?@AFA@KL$FLM$C=IK?=$LBGG$FLM$UK@M$@V$AR=$CB@GM@LE$K>$WK>X$RFH$LKA$JFHH=M$V@LFG$@LHJ=IA@KL$745$MFTH$V>K?$AR=$MFA=$KV$
J=>?@A$@HHBFLI=*$$+$L=W$J=>?@A$@H$>=YB@>=M$AK$IK??=LI=$K>$IKLA@LB=$WK>X*