715 & 715 1/2 S. Philadelphia
CONTRACTOR INFORMATION:
HOYT ROOFS
1809 N ORANGETHORPE PARK
ANAHEIM, CA 92801 0000
BUSINESS PHONE: 71417.3-1820
JOB DESCRIPTION: Tear off existing and reroof 10 squares with 30-year C""'position shingles
VALUATION: 2,000,00 . ,PROCESSED BY: JNJ
I. . OWNER.BUILDERiDECLARATION. .
I hereby affirm under penalty of perjury that I am exempt from the Contracto:~s License Law for the -following reason (8ec..7031.5 Business and .
Professions Code:' any dty or county which requi~sa permit to construct, ali~r, improve, demolish or repair any structure, prior"to its issuance, also
requires the applicant for such permit to file a signed statem~nt tha~ he is licensed pursuant to the provisions of the Contractor's. Lie'ense Law (Chapter
9)(commencing with Section 7000 of-Division 3 of the Business and Professi:?nS Code) or ~hat he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section-7031.5 by.any applicant for a permit slIblects the applicant to a civil penalty of not mare th_a n ,five hundred dollars
($500), . . . . .1. . .. . . .... . .
o I, as .owner of property, or my empl,oyees with wages as their sole camtJensation, will do the wark, and the structure is nat intended .or .offered far
sale (Sec. 7044 Business and.ProfeSsions Code: The Contractor's Ucense"~3w does net apply to an owner of property who builds or. improves
therean, and who does such w-or.k himself or'herself or through his or her O\.;,~ employees. provided that such improvements ;:l:re not'intended or
.offered for sale. If, however,' the b!Jilding or improvement !ssoldwith one ye~t of completion, the ownE;lr-builderwill have the burden qf pr.oying that he
did not build or'improve for the purpose of sal-e). . '0;1 . .
D I, as the owner of the property, am exdusively contracting with iicensed',lxmtractors to constroctthe project (5ec.1044 Business and Professions
Code: The Contractors License law does-not apply' to an owner of propertY,Iwho buil(ls or improves thereon, and '~ho contracts for surt: projects with
~ontractor(s) licensed pursuant to the Contracto~'s license-Law). i
Lj I am exempt under-Sec. ,8 & P.C. for this reason:
Date: . Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of peljuryone of the fOllowing declarations: 1
D. ,I have and will maintain a,certific;:ate ofoonsentto self-insure for workf=:(s-colnpensatipn,
as provided for by Section 3700 of the labor Code, for the p'erfon:nance of tr.,h work for whid1
this ~is issued. '. i . .
[Y/"I have and will maintain workeris compensation insurance, as required .';V Section 3700 of 4/5/2005
the labor Code, for the. perform.ance of the work for which this permit is jssu~,d. .Mywor:ker's Date:
Compensation insurance carrier and policy are: ~ -J .
Carrier: STATE FuND Policy, Number: 1700471r02
:
BUILDING PERMIT NO.
BLD2005.00917
~
. ..
TYPE OF PERMIT
Reroof
.
CITY
DATE: 4/5/2005
JOB ADDRESS: 7151/2 N PHILADELPHIA ST
LEGAL DESCRIPTION: N TR 158 BLK BLOT 19
APPLICANT: BRIAN HOYT
OWNER INFORMATION:
Glen E Mcdoud
755 Hillsbore PI .
Fullerton, CA 92833
ElM
BUILDING DIVISION.
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:.
(714) 765- 4626
CENSUS CODE: 555
QUARTER SECTION: 82.
ARCHITECT/ENGINEER INFORMATION:
---,
~
This section need not be completed if the pennit is tor one hundred dollars ($1 Gei. or less.
D I certify that in the performance of the work for which this permit is issu~.j, I shall not
employ any person in any manner so as to becqme subject to the worker's (:{)mpensation :aws
of Califomia, and agree that if I should become subject to the worker's com::l~;l1sation
provisions of Section 3700 of the labor Code, I shall forthwith comply with tnpse pr9visions.
Date: 4i5/2005".. Applicant: . . .l/\~'.. .
.. WARN.ING: FAILURE TO S.ECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA;.TIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADQ;TJON TO THE
Co.STOF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
.1 h.ereby affirm under penalty of perjury that there is a construction lend ing aGency for the
,performance of tlie work for which this 'permit is issued (See.309? .Civ.C):
lender's Informatio.n: .
I certify that I have react this application and state that the above information is correct. I
agree to comply with all city ordinances and. State laws relating tobuilding construction,_and
hereby authorize representives of this city to enter upon the above mentioned -property for
inspection pLirpose~. 1.-'"'\ . ~
:....!~ Date: 4/5/2005
o ~ignature of.Applicant or Agent
The permit shall expire by limitation and become null and void if the building or
work has riot passed final inspection 365 days from the date. of permit issuance. A
new permit is required to commence or continue work. .
LICENSED CONTRACTORS DECLARATION I
I hereby affirm ~nder penalty of perjury that jam
. iicensedunder provisions of chapter 9 (c'ommencing
with Section 7000) of'Oivsion 3 of the Busines:s and
Professions Code. .
~
Contractor
NUMBER
606111
TYPE
EXPIRATION DATE
12/31/2006
C39
Construcion Types:
VN, ,
Fees paid for Permit:
Total:
160.61
'. Ele
.' '. INSPECTION DATE INSPECTO~
Temporary Power Pole' . . Plu
. Plumbl ng (DrainlWaste Pipe) . Me
Electrical Ground Electrode/Uter .
SetbaeklFormslTrenches . (Footiilgs ) Ga
Do not. install subfloor or p()Ur floor slab until the E
following applicable iiems have been signed: .
Plumbing (Water Pipe.Sprinkler Valves) . . Fir
Mechanical (Gr()UndWOrk) I Wa
Electrical (U~rground Conduit) . .'
Pre-slab (Compaction/Membrane.Rei nt. . . Su
Underpinning (Floor Joist/Girders) Zo
Do not cover or conceal the work below until the B.ui
following applicable items have been signed:
1st Floor Shear . .
Firesprinkler (Rough) .... Sui
2nd 'Floo'r Shear .' . ,
.ROof (Shealhing/Di;jphragmlFrMle) ~ f!.I2 ~ ...--'
Masonry (ReinfJBond BeamJPre-Grout) . . .
. Rough Plumbing (Top Out)
Rollgh Mechanical '.
ROugh ElectrICal ,II) .
Rough EleCtrIcal . -,-
Framing (Orily,after.,Plbg., Elec.. Mech.. and Fire) .
Insulation (SoundlEnergy) .
Do not tape or plaster' until the following applicable Me
items'have been'signed:- ...,'
Drywall . . . .
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath . "
Exterior Lath." . ". Plu
. . . . GENERAL ITEMS .' '. .
Exterior Plaster (BI'OIII/n Coal) .
T -Bar EleCtrical .
T -Bar Mechanic.al . .' . .
T -Bar Structllral . .
Sewer . .
Water Engineering Backflow Ele
Water Service. . .
, INSPECTION RECORD
FINAL INSPE.CTIONS
etrlcal Final
mbing Final
chanical Final
s Test
ngineering/Grading Final 765-5126
e Dept,- Final 765-4040
ter Engineering 765:5268
b List/Business .License 765-519
ning 765-5139
Idi,ng FinallLast Inspection- Only
. After Above Complete) .
PARTIAL INSPECtiONS
Idina Inspections
OC::e" .'Inspector
~
'\
chanical Inspections
mbina Inspections
ctrical'lnspections .