1735 Partridge St.
1/1:; I'V AU )lk~""lV/lD'
BUILDING PERMIT NO. BLD2005-01448
TYPE OF ,PERMIT
Reroof
DATE; 5117/2005
JOB ADDRESS: 1735 N PARTRIDGE ST
LEGAL DESCRIPTION: N TR 9149 LOT 8
CITY
ElM
BUILDING DIVISION
200 S, ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS. CODE; 555,
QUARTER'SECTION; 130
APPLICANT; DAN WILCOX
OWNER INFORMATION; CONTRACTOR INFORMATION: , ARCHITECT/ENGINEER INFORMATION:
Michael Knutson AMERICAN FAMILY HOME
1735 N Partridge SI 22734LAKEWAY DR #344
Anaheim. CA 92806 , DIAMOND BAR, CA ,91765 0000
JOB DESCRIPTION:Tear off existing roof and replace 25 squares of 50 year presidential composition shingles,
VALUATION: 5,000.00 PROCESSED BY, MSM
WNER-BUlLDER DECLARATION
, erebya Irm un ef penalty 0 perjury t at am exempt rom the on tractor s u;ense law for the oj owing reason' ec. 7031.5 Business and
Professions Code: any city or countywtiich: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 provisionsof 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 ~nd the basis for th~ 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 Business and Pro~essions 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 thrbUgh his o~ her own employees, provided th;3.t 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 IJe.
did not build or improve for the purpose of sale).. ,
o I, as the .owner of the property, am exclusively contracting WITh licensed ~ntractors 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
p...qantractor(s) licensed pu.rsuant to the Contractor's License Law). '
U I am exempt under Sec. "B & P.G. for this reason:
Dat~: 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 certiflcate of consent to setHnsure for worker's'compensation,
as provided for by Section 3700 of the Labor Gode,'forthe perfoririance of the wol1< for which
~hlS ermit is issued. . '
) ~ave and will maintain worker's ,compensation insurance, as ~quhed by Section 3700 of 5/17/200
tabor Code, for the performance of the work for which this permit is issued. Myworker's Date:
ompensatlon insurance carrier and policy are: " , '
Carrier: NO EMPLOYEES Policy Number. EXEMPT
LICENSED CONTR
ere y a "m un r pena
licensed under provision f chapter 9 (commencing
with Section 7000 f Divsion of the Business and
Profes?' ns ode
Contractor
~'S section nee(! not be completed if tile pennit is for one hundred dollars ($100) or less.
I certify that in:tt)e performance of the work"fpr whiCh this permit is IsSued; I shall not
ploy any per,son in any manne,r so as to become subject to the W,orker'S,cor\lpensation laws
of Calffomia, and agree that if I should beco subject to th worker's compensation
prOVisions of Section 3700 of the labor Cod , shall fortlWv ,comply with thm~e provisions.
, ,
NUMBER
415052
TYPE
EXPIRATION DATE
8/31/2006
C39
Date: 511712005 Appiicant:
WARNING: FAILURE TO 'SECURE ORKER'S COMPENSATi N COVERAGE IS
UNLAWFUL, AND, SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTOONE HUNDRED THOUSAND DOLLARS ($100,000); IN ADDI110N TO THE
, COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR'CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
") 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 Tvpes:
VN,; .
Fire Sprinklered?
NO
1 certify that 111ave read thlsapplical.lon and S1ale-lha,'l11e above information is Icorrecl. 1
agree to' comply with all city ordinances and st~te laws relating to building construction, and
herebyauth ize represent' s of this city to enter upon the_above mentioned property for
in ection p. oses. -
\ .'
Date: 5117/2005'
Fees paid for Pe.rmit:
Total:
, 235.33
Signa ure of Applican or Agent .
The permit shall expire by limitation and become null and void if the building or
work has not passed fi 001 inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
. INSPECTION DATE INSPEcrOR
Temporary Power Pole. . . .
Plumbing (DrainIWaste Pipe)
Electrical Ground Electrode/lifer .
SetbacklFormsrrrenches(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-s.lab (Compaction/Membrane.Remf. .' .
Underpinning (Floor Joist/Girders)
I Do not cover or conceal the wall< below until the
following applicable items have been signed: .'
1st Floor Shear .. . . . .
Firesprinkler (Rough) ".
2nd Floor Shear , . .
Roof (Stieathii1alDiaphraamlFrame) l-l'llY/~ 1D7 II (-6.
Masonry (ReirifJBond BearnlPre-Grout) I'.
Rough Plumbing (Too Out)
Rough'Mechanical .
ROugh eectrlcal,ury vvall)
Rough E;lectrical .
Framing IOn~ after Plbg.. Elec.. Mech.. and Fire) . '.
Insulation (SoundlEnerav) .
Do not tape or plaster until the following applicable
items have been signed:. .. . . .
Drywall .
PenetrationS (Fi!'! Rated) Electrical, . .
Penetrations (Fire Rated) Mechanical.
Penetrations (Fire Rated) Plunlbing
interior Lath
Ex1erior Lath .
GENERAL ITEMS
E;xlerior Plaster (Brown Coat)
T -Bar Electrical
T -Bar Mechanical . .
T-Bar Structural .
Sewer.
Water Engineering Backflow
Water Service
.'-,.
FINAL INSPECTIONS Dale . . Inspectqr
Electrical Final' .'
Plumbing Final .
Mechanical Final .
Gas Test '. . . .
Engillll8ril\g/GradingFinal 765-6126 .
.'
Fire Dept. Fina1'765-4040 .
Water Engineering 765-5268
.Sub ListlBuslOl;SS License 765-519
Zoning 765-5139
Building. Final ~astlnspection: Only W1/I/I~ "f)\flU
. . Iter Above Complete}
PARTIAL INSPECTIONS
Buildinq Inspections
. .
Mechanical Inspections
Plumbh\q Inspections
Electricallnsoections