320 N. Park Vista St. 61
. .
CONTRACTOR 'INFOR~f'itlON:
HOMESTEAD EXTERIOfl$
3302 GARFIELD AVE . ".
COMMERCE,CA 90040G:!9.0
BUSINESS PHONE: 88850;8764
JOB DESCRIPTION,ear olf existing compo and install 24 squares of 30 yea':''omp shingle.
VALUATION: 5,000.00 PROCESSED BY: AEM
,'. . '. .._ ---"--'qWNER-BUILDE;:,DECLARATION. . .
I hereby affirm under penalty of perjury thr:t! am e;.(.;:;,mp~ from the ContrC!lcto:s License Law for the following reason (Sec. 7031.5 Business and
Pro.fessions Code: any City" or ccuntY'.."hic.;", ,i:quire3 a permit to construct.- a!:Er, improve, demolish or repair any structure, prior to its issuance. also
requires the applicar.t for" SUefl permit tofH~.; ~! signed statement that he is !ic~:r:sedpursuant to the provfsions of the Contractor's License Law (Ch~pter
9)(commencing with S'Ji:;'~iuI1700a of Division 30f the Business and Profcssb'tls'Code) or that he is exempt therefrom and the basis for the alleged'.
'. .exempti'on. AnyviolaU)i"l of SoctiOil7031.5 by anyapplicantfor a permitsu._!:;ects the"applicant to a dvil penaltyot notmore tha'n five hundred dollars
-~ .. . ... '. .
D I, as owner of property, or my employees with wages as their ~Ie cQm~..1nsation, will do the work" and the structure is not intended or offen~d for
sale- (Sec. 7044 BusineSs and Professions Code: ,The Contractor's Uce-nse :,:'3-.v does not apply toan owner of property who, builds or improves ,<
. thereon. and who does such work himself or herself or through his or her o.~,,~ ~11')p1oyees, pfOvjd~that such improvements are net ir:teildedpr
offered tarsale. -If,'rowever, the building or irrprovemef"lt is s:Jid'vVith.one l:t.,~ of r.c;:n::'-;f!tj~)." the owner~builder.will h?ve the burden of proving that he
did,r.otbuilciorimpro~forthepurposeofsale). " :'..,.' . .
0_ I, as the owner of the property, am exClusively contracting with Iicensed~,r.c:~tradors to cOl1struct the project (Sec.. 7044 Business and. Professions
Cod,e:, The Contractor's License law doesriot"apply to an owner of p;-opertY\'/ho builds or improves thereon, and who contracts for sudl p'roiects with
~ontn:.lC!:o~(s) licensed pursuant toO-the Contractor's License law).
U I am axempt "nder Sec. ... ,B & P.C. for this reoson:
Date: . . Owner:
I WORKER'S COMPENSATION DECLARATION
I hareby affirm under penalty of perjury one of the following declarations:
. 0 'I h2\ie and will maintain a certificate of mnsent to self~insure fot 'No(:<er'~: cor:npensation.
a's provided for by Section 3700 of the labor Code, for the performance uft!,:;~ work forwhid'l
~iS' _lmit{sissued. , . ..."
I have 'a nd will maintain wor\5er's'compenSatiQn insurance, as required :~.~-. ~3ection 3700 of
labor C>J~e. for the performance.cf the work for wh'ich,this 'permit. is issi..I.,.J t\l1y worker's
Comp.ensatidn insurance carrier and IXllicy are:. .
Carrier: ,STATE Fl)ND PoliO{ Number.:..16921~'::.2003
''-.',,,'
"
BUILDING PERMIT NO, BLD2003-04467
" ~~. ~
TYPE OF PERMIT. CIT. V.
Reroof
DATE: 11/1712003
JO~ ADDRESS: 320N PARK VISTA ST 61
LEGAL DESCRIPTION:
. APPLICANT: RUDY MIRANDA
OWNER JNFORMATION:
GORDON GARDNER
320N PARK VISTA ST SP61
ANAHEIM, CA. 92806-3727
· BOILDJNGDI\ti~I&N'
200S/,Af'.!AHE!MBLVD;
(714) 76$- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 1'33
ARCHITECT/ENGINEER INFORMATION:
NUMBER
786911
TYPE,.
TYPE
TYPE
- , , '
This section need not be completed if the Pe~it~s ~'~,~und~}:fO~~~ (~~~fj or 1,'355.' "
0, I certifY that in the performallce of the wj' 11' hiqhthis pefrnitIs j~~<.>~1 'I sh':lI.I,~t..
employ any person in any manner so as to.,beco sub1ect to the workers_c"lTlpensation,laws
of Califomia. and agree that if I should becqme, 1ed to the worker's comp-'.!risation,"~~_
provisions of Sectjon 3700 of the. labor C,ode, . all forthwith.~omply"With tr::!se~~Ovisions. "
~ ,"",
'-'"," ,/~ '
Date: 11/17/2003 Applicant:>> '_,.
WARNING: FAiLURE TO SECURE ER'S COMPENSATION COVE;ft\<3E IS.;;,.
UNLAWFUL, AND SHALLSUBJE I AN ':';MPLOYER TO CRIMINAL PEN..::n~S AND CIVIL
FINESUPTO ONE HUNDREDA'HOUSAND DOLLARS ($100;POO), IN AQG'D.!?,N to';THE
COST.OF COMPENSATION, DAMAGES AS PROVIDED FOR'. IN SECTION 31050FTHE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. 'f;", -. ....'" .;-
I .... .... . CON~TRUCTION LENDING AGENCY I . {h,f{\ii;/>:,,'.., .....
I h . b If' d .1lY < . '"-j jh .. "~,,,,". . .. -!IP't;"W'~' >1"""", "'10(
___ _~1L~,_'lJLJ(m_ U('l, ~r.p~n2 J_ _01, ~'eaury.~;,;< _ "e[Q 1S~.c.:mmr.~I'Cfl_.,bOlljr:(L::>f".:. !-!,,('y-. _01" _~~e'_:':' : -"-,,!.f. '.: .,~~ _ ',:,
psrformanCl,:lofthelliork forwhidl this'permit-isissued (Sec..3097.Civ.C): . . ,.~ '
ler.cer's Informa~' ,
I certify th~t (.'ve rJ:d thlJ applic~tion and state that the above information';s correct. I
agree to: mply w: tall ci ordinanc~and state laws r~lating to buDding copstr~ction. and
hereby thorize ~re . -s ofttlis city to enter upon the above mentioned property for
In IOn' pur
Date: 11/17/2003
Signature of Applicant or Agent
The per . shall expire by limitation and become null and void if the building or
work has not passedfinal inspection.365 days from the date of peril-.it issuance. A
new_permil-is required to 'comme~e or continue work. '
Cqntractor
EXPI~110N DATE
11/30/2004 .
B
C33 PAIN
HIC
ConS[ru'cion' Types:
VN,c,
Fire Sprinklerect?
.NO
~.'-.""
,iO.;';;',
'..'..'\
Fees paid for Permit:
Total: .
138.93
INSPECTION RECORD
, INSPECTION " " DATE INSPECTOR
Temporary Power Pole ' "
'Plumbing (DrainlWaste Pipe) ,
EJect,rical Ground Electrode/Ufer ' ,
SetbacklFormsfTrenches (Footings)
Do not installsubfloor or pour floor slab until the
(ollowing applicable items'have been signed: , ,
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit) ,
Pre-slab (Compaction/Membrane.Rei nt. ' ,
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below unlll the
following applicable items have been signed:
1st.Floor Shear , ,
Rresprinkler (Rough)
2nd F,loorShea. '
Roof (Sheathing/Diaphragm/Frame) , ,
Masonry (ReinfJBond BeamlPre-GlOut) ,
Rough Plumbing (Top Out) ,
Rough Mechanical , ,
Rough ElectrICal (ury Wall)
Rough Electrical ,
Framing (Only after Plbg.. 'Elec.. r..1ech "and Fire) ,
Insulatioi'l'(SoundlEnergy) , , , '
po not tape or pla~ter un-til the following applicable
Items have been signed:, " ,
Drywall , , "
Penetrations (Fire Rated) Electrical ,
Penetrations (file Rated) Mechanical
Penetrations (Fire Rated) P'umbing
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 I, '
,
Engineering/Grading Final 765-5126
Fire Dept.FinaI765'4040
Water Engineering 765.5268
Sub List/Business License765.519 , ,
"
Zoning 765.5139 ,
"
Building Final ~ast Inspection- Only , "
f1er Above Completel '
PARTIAL INSPECTIONS
Buildina Insoections
Mechanical Inspections
Plumbina Insoections
ElectricallnsDections