1000 Monterey
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: 31
BUILDING PERMIT NO. BLD2005-03398
DATE: 10/24/2005
JOB ADDRESS: 1000 N MONTEREY ST
LEGAL DESCRIPTION: N TR 1202 lOT 111
CONTRACTOR INFORMATION:
FI RST QUALITY ROOFING
906 S FIGUEROA ST
SANTA ANA, CA 927040000
BUSINESS PHONE: 714775-3375
JOB DESCRIPT10N:Tear off existing and reroof 15 squares with 3D-year composition shingles and 4 squares BUR
APPLICANT: FREDDIE VAZQUEZ
OWNER INFORMATION:
ADAM G MC
1000 N MONTEREY ST
ANAHEIM, CA 92801
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 4,890.00
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 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 thebasis 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 compen~ation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License La~.does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, 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 purpose of sale).
D I, as the owner of the property, am exclusively contracting 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
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
this permit is issued.
~~ have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is issued. Mywarker's
Compensation insurance carrier and policy are:
Carrier: STATE FU ND
PROCESSED BY: JNJ
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that' am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsio f the Business nd
Professions Code.
Policy Number. 0026599-2004
NUMBER
776969
TYPE
10/24/2005
Date:
This section need not be completed if the pennit is for one hundred dollars ($100) 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 la
of California, and agree that if I should become subje 0 the worker's compensation
provisions of Section 3700 of the Labor Code, I sh fo hwith co I with ase provisio s.
C39
Date: 10/24/2005 Appllcanti>=
WARNING: FAILURE TO SECURE WORKER'
UNLAWFUL, AND SHALL SUBJECT AN EM
FINES UPTO ONE HUNDRED THOUSAND D LARS ($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:
V N, ,
I certify that I have read 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 authorize re ntives of this city to enter P. the above mentioned property for
inspection purpo s.
Date: 10/2412005
Fees paid for Permit:
Total:
170,20
Si nature of Applicant or Agent
expire by limitation and beco n and void if the building or
work has n passed final inspection 365 days from the date of permit issuance, A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground ElectrodeJUfer
Setback/FormslTrenches (Footings)
Do not install subfloor or pour floor slab unlilthe
following applicable items have been sIgned:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 at Floor Shear
Firesprinkler (Rough)
2nd Floor Shear / /
Roof (Sheathing/Diaphragm/Frame) bin!. " _L^,\~ .
Masonry (Reinf./Bond BeamlPre-Grout) /
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 unlilthe 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)
ToBar 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 LlsllBuslness License 765-5194
Zoning 765-5139
Building Final (Lastlnspeclion 0 Only ~ l.A
Aller Above Complete) .
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PARTIAL INSPECTIONS
Building InsDections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections