949 Mohican
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 45
BUILDING PERMIT NO. BLD2005-01788
DATE: 6/1312005
JOB ADDRESS: 949 N MOHICAN AVE
LEGAL DESCRIPTION: N TR 2396 LOT 5
CONTRACTOR INFORMATION:
HEIDT ROOFING CO.
544 N EARLHAM
ORANGE, CA 92889-0000
BUSINESS PHONE: 714997-9729
JOB DESCRIPTION:Re-rooi over 2 existing layers with 29 squares of 30 year composition shingles,
APPLICANT: MARK HEIDT
OWNER INFORMATION:
Robert E Lauder
949 N Mohican Ave
Anaheim, CA 92801
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 2,900.00 PROCESSED BY: MSM
I OWNER-BUILDER DECLARATION
I hereby affirm under 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 applicant for such permit to file a signed statement that he (s 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).
D 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 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own employees, provided that such implOvementsare 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 purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed contractors to construct the project (See. 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
a contractor(s) licensed pursuant to the Contractor's License Law).
o 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:
D I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
WhO permit is issued. '
! have and will maintain worker's compensation insurance, as required by Section 3700 of
t e Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number: 508-2002
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the usiness and
Professio s C de.
6/13/2005
Date:
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o I certify that in the performance 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 worker's compensation laws
of Califomia, and agree that if I should become subject to the or1<er's compensation
provisions of Section 3700 of the Labor Code, I shall forthwith amply w. those provisions.
NUMBER
471812
TYPE
EXPIRATION DATE
4/30/2007
C39
Date: 6/1312005 Applicant:
WARNiNG: FAILURE TO SECURE OR ER' COM NSATION COVERAGE IS
UNLAWFUL, AND SHALLSUBJEC AN EMPLOYER TO CRIMiNAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDlllON 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
pertormance 01 tne work for which this permit is issued (Sec:-3097.Civ.C):
Lender's Information:
Canstrucion Tvpes:
V N, ,
Fire Sprinklered?
NO
I certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinanc s and state laws relating to building construction, and
here.. authorize representives of thi city to enter upon the above mentioned property for
insp ion purpose .
Date: 6/13/2005
Fees paid for Permit:
Total:
235.33
Signature af A plicant or Agent
The permit shall expire by limitation 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 Dermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbackIFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
PlumbinQ (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:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof~hin~DlaPhragm/Frame) / /..// Z/)~
Mas einfJBond Beam/Pre-Grout) .
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg" Ete., 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 E!ectricBI
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 (Lastlnspeclion - Only & .//019 /1~A"2:,
After Above Complete) f'/v
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections