111 S. Panorama Drive
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REOUESTlINE:
(714) 765.4626
CENSUS CODE: 555
QUARTER SECTION: 179
BUILDING PERMIT NO. BLD2005-02134
DATE: 7/11/2005
JOB ADDRESS: 111 S PANORAMA DR
LEGAL DESCRIPTION: N TR 9616 LOT 11
CONTRACTOR INFORMATION:
MCCORMACK ROOFING CO
4091 E LA PALMA AVE #T
ANAHEIM, CA 928070000
BUSINESS PHONE: 714630-5543
JOB DESCRIP,lON:rear off existing and reroof 24 squares with gerard canyon shake leBO # NER423 and 2.5 squares of built-up roof.
APPLICANT: YOLANDA HUAPAY A
OWNER INFORMATION:
FRANK R WEIDLER
111 S PANORAMA DR
ANAHEIM, CA 928070000
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
6,800.00
PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's license Law for the following reason ( ee. 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)(commenclng 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 doUars
($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 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 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 bu~d or improve for the pu rpose of sale). .
o 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 Ucense Law).
o I am exempt under Sec. , B & P .C. for this reason:
Date: Owner:
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 self-Insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
~hi permit is issued.
\. .~il have and will maintain worker's compensation insurance, as required by Sec1ion 3700 of
t e Labor Code, for the performance of the work for which this permit is issued. My worker's
ompensation insurance carrier and policy are:
arrier: AMERICAN INTERNATIONAL GROUP Policy Number. WC0701040200001
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that am
licensed under proviso nsof chapter 9 (commencing
with Section 7 00) 01 ivsion of e usiness and
Professions
This section need not be completed if the penn!t 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 workers compensation laws
of Califomia, and agree that if I should become bject to the wo r's compensation
provisions of Section 3700 of the L or. 0 ,I all fa with 0, ly with those provisions.
Date: 8/26/2005 Applicant:
WARNING: FAILURE TO SECURE
UNLAWFUL, AND SHALL SUBJECT
FINES UP TO ONE HUNDRED 1l-IOU
COST OF COMPENSATION, DAMAGE ROVIDED FOR IN SECTION 37
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction rending agency for the
performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
8/26/200
Date:
EXPIRATION DATE
613012006
C39
Construcion Tvpes:
VN, ,
1 certify that I have read this application and state that the above inforrm:.~ic:1 iscorrsct. I
agree to comply with all city ordinances and state laws relating to buffding construction, and
hereby authorize presentives of his city to enter upon the above mentioned property for
Inspe . n rpo I
Date: 8/26/2005
Fees paid for Permit:
Total:
330.83
me null and void ifthe building or
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches (Footings)
Do not install sublloor or pour IIoor 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)
00 not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear I
Roof (Sheathing/Diaphragm/Frame) {- ?,,( rfW1buU~' ,
Masonry (Reinf./Bond Beam/Pre-Grout) v
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Me(:. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywali
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
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 (Last Inspection - On I
After Above Comple rz,.
DATE
INSPECTOR
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections