618 S. Pine St.
)
TYPE OF PERlIifL:L
Reroof .
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD:
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 71 \'\
BUILDING PERMIT N
BLD2005-00816 .
DATE;: 3/28/2005
JOB ADDRESS: 618 SPINE ST
LEGAL DESCRIPTION: N TR 2237 LOT 13
CONTRACTOR INFORMATION:
. C F ROOFING
PO BOX 98
STANTON, CA 90680
BUSINESS PHONE: 714537-.8283
JOB DESCRIPTION: Tear off existing and re-roof 29 squares.of composition s~ingies.
VALUATION: 8,300.00
I' OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031._5 Business and"
Professions Code: any city_or county which requires a permit to construct, '?tt~!r. improve, demolish, or repair any struCture, prior:to its issuance, also
requires the applicantfor such permit to" fife a signed statement that he is tice:{lsed pursuant to the p'rovisions of the Contractor's License Law (Chapter
9)(cOmmenqing with Section'7000 o'f Division 3 of the Business and Professic..~s 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 subj~cts the applicant to a civil penalty of not more than five hundred dollars
~~ .... .... . .... '.
D I, as oWne~ of property, or my employees with wages as their sole com~;nsation, will do the work, and the structure is not intended'or offered for
sale (Sec. 7044 Business and Prof6$sions Cod.e: The Contractor's License L;~w does not apply to an owner of property who builds or improves
thereon,_ and who does sud1 work himself or herself or through his or her ow!'{employees,. provided that such improvements are not intended or .
offered for sale. If, however, the building or,improvement is sold With one yei:i,bf completion, the owner-builder will have the burden of proving that he
did not build-or improve for-the purpose of sale).' . . t .
o I, as the owner of the property, am exdusively contracting with licensed fen tractors to con~truct the project (See. 7044 Business and Professions
Code: The Contractor's License Law does not apply to -an owner of property \\tho builds or improves thereon, and who - contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law}. .
U I am exempt under Sec. __, B & P.C. for thi~ reason:
Date: Owner: ,
I WORKER'S COMPENSATION DECLARATION
I hereby affirm .under penalty of pedl:ll'Y one ofth~ following declarations:
o I have and will maintain a certificate of wnsent to self-insure for worker'd-compensation,
as provided for by Section 3700 of the Labor Code, for the performance pfthiwork for which
thi rmit is issued. ' .
have and will maintain worker's compensation insurance, as required by Section 3700 of
t bor Code, fqrthe performGlnce of the work for which this permit is issue-d, Myworker's
.C mpensation insurance carrier and policy are: -
C rrier: NO EMPLOYEES . Policy Number. EXEMPT
APPLICANT: CARLOS FLORES
OWNER INFORMATION:
Francisco V Alcala
618 SPine St
Anaheim, CA 92805
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chaplerS'(commencing
with Section 7000) of Divsion 3_ofthe BusineSs and
Professions ~ ~. .'. .
3/2812005 . - ~ ~ c:1;: ./.d;f' ...-
Date: J on tractor
. .
. .
. .
This s_ection _need not be completed if the pennit is for_one hundred dollars(~100) or less. .
o {certify that in the perfonnanceofthe work for which this permit is issU:::d; I shall not .'
employ any person in any manner so as to become subject to the worker's c'omp~nsation laws
of Caljfo~ia, and agree that if I s~ould.become subjedto the worker's CO".1pelis2ltipn .
provisions of Section 3700 of the Labor Code, I shall forthwith comply with thGse provisions.
. Date: 3128/2005 Applicant:
WARNING: FAILURE TO SEC R
UNLAWFUL, AND SHALL SUB AN EMPLOYERTO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDi'IlON TO THE
. COST OF COMPENSATION, DAMAGES AS'PROVIDED FOR .IN SECTION'J706 OF THE
LABOR CODE, INTEREST.AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGE.NCY
J hereby 2ffir!Tll!f1~er peP.2~'- of re~Jl'!Y tt>.at th-,;,re is a c:c~st"t.!ction !,=n'd:ri0.-Br~o,:,yfo,. the
performance of the work for which this permit is issued (Seo.3097 .Civ.C):
. Lender's Information: ..
NUMBER
81.1726
TYPE
639
EXPIRATION DATE
813112006
Construcion Types:
VN, ,
, .
I certify that I have read this'application and state that the above information is correct. I
agree tc? comply with all city ordinahces and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
ihspection purposes. .
Date: 3/28/2005
Fe~s paid for Permit:
Total:.
235:66 .
.~ Si nature of Applicant or Agent
T permitshaJl expire by limitation and become null and yold if the building or
work has not passed final inspection 365 dayS from the date of permit issuance. A
new permit is required to com'mence or continue work.
INSPECTION RECORD .
IN$PECTION . DATE INSPECTOR.
Temporary Power Pole .
Plumbl ng (DrainlWaste Pipe). ..
Electrical Ground ElectrodelUfer ..
SetbacklFormsrrrenches (Footings) .
Do not install subfloor or pOUr floor slab until the
following appiicabie items have been signed: . .. . .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork). . . .
Electrical (Underground Conduit) . . .
Pre-slab (CompactionlMembr8/l!l.Rei nt. .
Uncferpinni"g (Floor Joist/Girders)
Do not cover or. conceal the work below until the
following.applicable items ha.ve been signed:
1st Floo~ Shear. . , .
Firesprinkler (Rough)
2nd~ .. , ,.
Roof athi 'aphragmlFrarnel :3/.3c/,,~ a. L€.Vo<I k
Masonry ( infJBood BearnJPre-Grout)
Rough Plumbi"g (Top Out)
Rough Mechanical : . . .. ,
Rougn l:Jeckical al.) .
Rough,Electrical
Framing {Only after Plbg., Elec.. Mech and Fire; I.
Insulation (SoundlEnergy)
Do not tape or plaster until the foUowing applicable
items have, been signed: ."
DrywaU
Penetrations (Fire Rated) Electrical .
Penetrations (FIre RatedJ Mechanical
Penetrations (Fire Rated) Plumbing. .
Interior Lath.
.ExteriorLath .
. 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 . .
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040 ,
..
Water Engineering 765-5268 . ,.
Sub List/Business License 765-519
Zoning 765-5139
BuildIng Final \l:ast Inspeclion. Only AI))""- ~~.
fter Above Complete)
. PARTIAL INSPECTIONS . f:l'\<rW
Buildina Insoections
Mechanicallnsoections
Plumbina Insoections
Electricallnsoections