609 Peralta Hills Dr.
BUILDING PERMIT NO. BLD2004-03799
~~6~~F PERMIT CITY.
DATE: 10/12/2004.
JOB ADDRESS: 609 S PERALTA HILLS DR
LEGAL.DESCRIPTION: TR 59 LOT 30 POR OF LOT -INC POR
APPLICANT: MILES REED
OWNER INFORMATION:
Frederick C Heitman
609 S PerE:lIta" Hills Dr
A.naheim, CA 92~07
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 . 4626
CENSUS CODE: 555
QUARTER SECTION: 168
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 24,750.00
I OWNER-BUILDE(t DECLARATION
J h.ereby affirm under penalty of perjury that I am exempt from the Contr3cto(s License Law for the following, reason (Sec. 7031.5 Business and
Professions Cod e: a ny city or county which req uires a permit to construct, ,;;i(!er, improve, demolish Or repair any structure, .prior to its issuance, also
"requires the applicant for sl:lchpermit to file a signed statement that he is1idfnted 'pursuant to the provisions of the Contra'ct'or's License Law (Chapter
9)(commehcing with Section 7000 of DiVision: 3 of the Business a nd PiOfes~bns Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violatiqn of Section 70.31.5 by' any applicant tqr a peri.1it.sU\'ijectsJhe applicant to a dvil pena_ltyof no-t more than five hundred dollars
~~. .. ! .
D I, as owner of property, or my employees with wages as thei:-' sole cornf~ensation, will do the: work, and the structure is not intended or offered for
sale (Sec.'7044 Business and professions Code: The Contractor's Ucen!;;E::~~w does not apply to an owner of property who builds or i~proves"
thereon, and Who does such work himself or herself or through_his or he'r oVih"employees, provided that such improvements are'notintended or
offered for sale. If, however, the building or improvement is sold with one.~,.~kr of completion, the owner-bui!der will have. the burden. of proving ihat he
.did not build or improve for th~-purpose of sale). ~ .
01, as the owner of the property, am exdusively contracting with ficenszckontradors tc construct the project (See. 70.44 BU3iness and Professions
-Code: The Cohtractor'sLicense law does not apply ban o'Nnerof pr()pert::::~ho builds or i~Droves thereon,and who oontracts for-such projects with
~on.trador(s) licensed pursuant to the COCltractor's License LaW). .
LJ . I am exempt unde; Sec. , B & P .C. for this re~son:
Date: Owner: .
I WORKER'S COMPENSATION DECLARATION
. I hereby'affirm under penalty of perjury one of the following declarations:
D 'I have a~d will maintain a certificate of oonsent to self-insure for worke/s compens'ation,
-as provided fqr by Section 3700. of the Labor Code, for the oerformance cf !te work for which
ikhi ermit is'issued. . ....
I have and will maintain worker's 'compensation insurance, as required tv Section 3700 of
tJ e Labor Code, for the performance of the work for which thiS permit.is i~t.:,:d. Myworker's
Oompensation insurance carrier and policy are:
Car.rier: STATE FUND
CONTRACTOR INFORM.\TION:
HOYT ROOFS
1809 N ORANGETHORPE PARK
ANAHEIM, CA 92801 0000 ,
BUSINESSPHONE: 714 T!3.1820
JOB DESCRIPTION:Tear off eXIsting roof and r.eplace with 90 squ~res of MOi;ier cedarlite tile (ICBO# 2656).
PROCESSED BY: MSM
l
LICENSED CONTRACTORS DECLARATION I
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (comm~ncing
WIth Section 70.00) of Divsion 3 of the Business and
Professio~C~/
10/12/2004 / .
Date: (, Contractor
Policy Number:,_ 17004" I~02
NUMBER
606111
TYPE
This secti"on need 'ncrt be completed if the pennit is for one hundred dollars ($10'l) or less.
o I certify that in the. performance of the work for which this permit is is'5~'.i?I.,~hal! 110t .
employ any. person inany manner so as to become'subject to-theworker's .::mnpensation laws
of Califom:a, and agree-that if I sho~ld become subject to the worker's cOfDl..<<insation.
provisions of Section 3700 oOhe Labor ode, I shall forthwith comply with t~??se'prdvision.s.
Date: 10/12/2004. Applicant:
WARNING; FAILURE TO SECURE WORKER'S COMPENSATION COVEr:-i'GE)S .
UNLAWFUL, AND SHA~L SUBJECT AN EMPLOYER TO CRIMINAlPEN,<,i,TI;;:9 AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000),'IN ADSIJIO,N TO THE
cosT OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEClIC~ '3706 OF THE
LABORCODE, INTEREST AND ATTORNEY'S FEES. ,. H.', .
I. CONSTRUCTION LENDING AGENCY..'
.1 heceby_affkm.under_.oer"alty oLp~rjury that.th~r~ 5 a C('lI1!':.tnJ(~tion !pad;nG'?'_~_:f'r.~fC!rtr.p-
performance of the work for which this permit is issued (See.:3097 .Civ .C):
Lender's Information: .
Construcicin Tvpes:
VN. .
Fire Sprinklered?
r certify that I have read this application and state t/1at the above information is correct. I
, agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the-above mentioned property for
;~;o~~~ Date. 10/12/2004
Signature of Applicant or Agent
The permit shall expire by limitation and. become null and void if the building or
work has not.passed final inspection 365 days from the date of permit issuance. A
new permit is reqUired to com~ence or continue work.
EXPIRATION DATE
11/30/2004
C39
NO.
Fees paid for Permit:
Total:
685.63
INSPECTION RECORD
" INSPECTION ' ' , INSPECTOR
' DATE,
Temporary Powerpole,'
Plumbing (Drail'lIWaste Pipe) " ' " ,
Electri,cal Ground Electrode/uteI'
SelbacklFormslTrenches (Footings) , ' "
Do not install subflqoforpour..fJoor slab until the"
following applicabl'~items have be"en sig-ned: .
Plumbing (Water Pipe.Sprinkler Valves) ,
Meehan,ical (Groundwork)
Electrical (Underground Condutt)
Pre-slab (Compaction/Membrane.Rei nt.
Underpinning"(Floor Joist/Girders)
Do ootcover, or conceal the work below until Hle .
following' app'li.CCiQle itenis have been signed: ".
1 st Floor Shear " , " "
Firespiinkler (Rough) . ' , ' ,
2nd Floor Shear' ,
Roof (Sheathing/Diaphragm'Frame) ,
" Masonry (ReinfJBond BeamlPre-Gl"O\It) , , ' ,
Rough Plumbirig(Top Out) , ' ",
Rough Mechanjcal
, KOugn ElectrICal (ury wall)
Rough Electrical
Framing (Only after Plbg.. E!ec" MecH . and Firel
Insulation (SoundlEnergy)
Do not tape or plilster until th,e following applicable
items have been signed: ' "' ' , ,
Drywall ,,' ,
Penetrations (Fire RlIled) Eleetrical '
Penetrations (Fire Rated) Mechanical ' ,,' ,
Penetrations (Fire RlIled) Plumbing , ,
Interior L.ath ' ,
Exterior Lath ,
,GENERAL ITEMS '
Exterior Plaster (Brown Com) ,
T -Bar Electrical ..
T ,Bar Mechanical
T -Bar 'Structural
Sewer
Wilter Engineering Backflow , '
Water Service ' '
FINAL INSPECTIONS, ' Date Inspector
Elec,trical F,i"al ' , , .
Plumbing Final, "
,
Mechanical Final ,
.
Gas Test ' '
"
Engineering/Grading Final 765-5126 ,
, " , "
, " "
Fire Dept. Final 765'4040 , "
WaterE,ngineering 765.5268 ,
Sub List/Business License 765-519
Zoning 765-5139 "
Building Final ~ast Inspeclion. Only , 47lor /' I,'
fter Above Completel
,PARTIAL INSPECTIONS ^~[ ./ '
. .
Bu=a:;e~"~.e.\,^ckl. ..,tJ
Mechanicallnsoections
, PlumbinQlnsoections
,
Electricallnsoections
fSTRUGTURE
CONSULTING ENGINEERS
;;",;-,-:,~::<
ENGINEER
ARCHITECT
OWNER
JOB SITE
,'",-
2199 N, BATAVlAAVE., STE. F
ORANGE, CA 92865
T 714 998 6.441
T 7 1 4 998 3,~ 0 3
f
Kjell A. Bo
Hoyt Roofs
Heitman Residence
. .
609 Peralta Hills Rd., Anaheim Hills, CA.
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REGARDING
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On December 22,'2004 , I Visited 609 Peraita Hills Rd.,
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AnahelllJHills, CA,lIndiD'spected the rooil:oi~ling
installation. I certify that the roof covering has
been installed as required by the Uniform
Building Code, 1997 edition, the Manufacturer's
Installation Instructions and the City of
Anaheim Hills Ordinances.
SHEET
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