6108 E. Paseo Rio Verde
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 191
BUILDING PERMIT NO. BLD2005-02633
DATE: 8/2312005
JOB ADDRESS: 6108 E PASEO RIO VERDE
LEGAL DESCRIPTION: N TR 7786 LOT 47
APPLICANT: GLEN BRINAGH
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
TOM SCHRODI ADAMS ROOFING AND CONTRACTING
6108 E PASEO RIO VERDE 1572 MARSHALL LN
ANAHEIM, CA 92807 CORONA, CA 917190000
BUSINESS PHONE: 951 279-0472
JOB DESCRIPTION:Tear off existing foof and replace with 10 squares of torch down.
VALUATION: 2,400.00
I OWNER-BUILDER DECLARATION
J hereby affirm under penalty of perjury that I am exempt from the Contractor's,Ucense 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 the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil pena~y of not more than five hundred dollars
~~. .
D I, as owner of property, or my employees with wages as their sole compeQsation, 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 9f property who builds or impr-oves
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 burdeil"ofproving 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)Nith
a contractor(s) licensed pursuant to the Contractor's License Law). /;,
D 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 fallowing 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 pertormance of the work for which
~hi permit is issued. ..
I have and will maintain worker's compensation insurance, as required by Section 3700 of
t Labor Code, for the periormance of the work for which this permit is issued. My worker's
ompensation insurance carrier and policy are:
arrler: STATE COMP INS. CO. Policy Number. 285-02 UNIT 0002071
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 fa who h this permit is issued, I shall n6t
employ any person in any manner so as to beco ject to the worker's compensation laws
of Califomia, and agree that if I should become s je to the worker's compensation
provisions of Section 3700 of the Labor Code, forthwit~ lth those provisions.
Date: 8/23/2005 Applicant: ( J
WARNING: FAILURE TO SECUR W K 'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALLSUBJ N EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, "'MAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST A D ATTORNEY'S FEES.
e NSTRUCTION LENDING AGENCY
I hereby affirm und~r pe fty of perjury that there is a construction lending agency for the
periormance of the wo for which this permit is issued (Sec.3097.Civ.C):
Lender'S Information:
PROCESSED BY: MSM
. ";~.;:
r
LICENSED CONTRACTORS DECLARATION,' -
I hereby affirm under penalty of perjury that I am
licensed under provisio s of chapter 9 (commenCing
with Section 7000) of vsio of the Business<-and
Professions de.
,
Ir..
t.
,~
8/23/200
Date:
NUMBER
652470
TYPE
TYPE
,
EXPIRATION DATE
8/3112006
B
C39
Construcion Types:
VN,
. klered?
NO
I certify that I have re
agree to oomply with
hereby authorize rep
inspecti purpo
Date: 8/23/2005
Fees paid for Permit:
Total:
170.20
Si ure of Appli ant or Agent
The per It s expire by limitation and become null and void if the bui
work has nol 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
Setback/FormslTrenches (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 Conduil)
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:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear }
Roof (Sheathing/Diaphragm/Frame) <g,L, / 1 A_H' \'<;u.
Masonry (Reinf./Bond Beam/Pre-Grout) 1/ I
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulalion (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penelrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath
Exterior Lath
GENERAL ITEMS
Exlerior Plaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
TaBar Structural
Sewer
Waler Engineering Back/low
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 , I
Building Final (La.lln.pecllon - Only I'%%~
After Above Complete) ~Al-lD \lJ'S1L1
I
PARTIAL INSPECTIONS
Buildina Insoections
Mechanical Insoections
Plumbina Inspections
Electricallnsoections