870 S. Philadelphia St.
BUILDING PERMiT NO. BLD2005-00195
TYPE OF PERMIT. CITY
Reroof
DATE: 1/24/2005
JOB ADDRESS: 870 S PHILADELPHIA ST
LEGAL DESCRIPTION: N TR 1871 LOT 9
APPLICANT: JOHN SHEATZ
OWNER INFORMATION:
Monarch Manor
989 Scott SI
San Diego. CA. 92106.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REOUESTLlNE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 85
ARCHITECT/ENGiNEER INFORMATION:
CONTRACTOR INFORM'.\TION:
THE ROOF GUY. .
9781 EASTWOOD CIRCLE i
VILLA PARK. CA 92861 OGOO
BusiNESS PHONE: 7149;z!;'1500
JOB DESCRIPTION:Re-roof - Overlay 38 sq. of 20 yr. composition shingleov~r (t) existing layer of comp..
VALUATION: 3,.300.00'[" PRQCESSEDBY: ENO
OWNER-BUllDE ,DECLARATION
I hereby a irm under penalty of perjury that! a,m exempt from the COf)tractoi,s License.Law .for the followU:tg reason (Sec. 7031.5 Bu~iness and
Professions Code:: any dty or county which requires a permit to c~n~truct, a~~r. iroprove, demolish or repair any structure, prior to-its h%uance, ~Iso
requires the-applicant forsuchpermlt to-file a signed statement that he is Hc::lhsed pursuant to~the provisions of the Contractor's License Law (Chapter"
. 9}{commencing with SectiOn 7000 of Division -3 of the Business and' profeS'st! ns Code) odhat he is exempt therefrom and the basis for the alleged
. e.xemption. MY violation of Secti..on 7031.5 by. any applicant for a permit su', .ects the apPI.icant to a civil penalty of not more tha n five hundred d~J1ars.
($500). . . . ! .
o I, a~'owner of property, ~r my emplOy. ees with wages as t.helr Sale. (;om~\ensation,.wm.dO the work, and the structure is not intended oroffe~ed for
sale (Sec. 7044 Business and Professions Code: The Contractor's License~.. a'w does not apply to an owner of property who buildsqr improves
. thereon, and who does surn work himself or herself orthrdugh his' or her OWt: employees, provi~ed that such improvements are not intended or
f,offeredfot sale. If, however, the building or improvement is sold with one ye~r of comPte,tion, the owoe.r~builder'w>>1 have the burden of proving_ that he
.did not buifa or imprC?ve for the purpose of sale). ~~_ ' , ' -
0, I,as the owner of the property, am exdusively contrading with jjcensedj~oontractors to construct the project (Sec. 7044 Business and ProfesSions
Code: _ The Contractor's License Law does not.apply.to an owner of propert~~Nhb buildS or improves thereon, and who contracts for' such projects with
~ontrador(s)"IiGensed p~rsuant [0 the Contractor's Lice. nse LaW).,!t .. ,
U I am exempt under Sec. . . B & P.C.forthis reason:.
Date: > Owner.: ~
I . WORKERfS COMPENSATION DECLARATION L-~
./ hereby affirm under ~enalty of perjury one of the foil owing declarations: - i .
o I have and will maintain a certificate of conserit to self-insure for-worker's,compensation.
as provid~ for by Section .3700 of the Labor,Code, for the performance Ofth~_~f.'ork for.whlch
'!Ihl permit is issued, . . , . . '. F....
.1 have and wdl mal.ntaln. WOrker's. compensation lns~ranc.~, as re.q~l~d b:r~ect!C'J1370~ of 1/24/2005
. . e labor Code, forthe performance of the work for whIch thIS permit IS Issu4d. Myworkers . Date:
ompensation insurance canier and policy are:'. . . 1 .
Carrier: STATE COMPENSATION FUND' . Policy Number. 17137931 '
This sectio~' ne~ not be '~Pleted if ~'e pennit i~ for one hundred dollars ($10~\ or less.
.- '. ... t
o I certify thalin-the performance oft~e work for which this permit is iS$ut;:~, I shall not
employ any..person in any manner so as to become subject to the worker's C!/mpensation laws
of Califqmia, and agree tt:lat if I should become Subject to the worker's comp.:-~sation .
provisions of Section 3700 of the Labor Gode, I shan forthwith co ith ft-iJSe provi.sions.
. LICENSED CONTRACTORS DECLARATION
I hereby a irm under penalty of perjury that I am
licensed under proVisions of chapter 9 (commencing
with Section 7000) of Divsion'30fthe ass and
Professio sad. "
NUMBER
638593
TYPE
C39
Construcion:Tvpes:
VN, ,
Fire Sprinklered?
NO
Date: 1/24/2005 Appiicant:
WARNING: FAILURE TO SECURE ORKER'S C
UNLAWFUL, AND SHALL SUBJEC AN EM ER T CRIMINAL PENALTIES AND CIVIL
FINESUPTO ONE HUNDR.ED THOUSAND DOLLAR ($100,000), IN ADD;TIONTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION:3706 OF THE
LABOR CODE, INTERESt AND ATTORNEY'S FEES. i;
I CONSTRUCTION LENDING AGENCY,'
I hereby affirm under penalty of perjury that..there is a construction lend ing a~:'~ncy for the
performance; of the work for which this permit is issued (Sec.3097.Civ.C): '
~I'.sJ.nfoJmatiC,~: .
. .
___~__ ___~_ _____ __n._ __~_--'-_.__~.____ _0 _ ____".._____.
I certify that I have read this application and-state that the above information.is correct. I
'agree to comply with all city ordinances and ate laws relating to building' construction; anq
hereby authorize representives of this city enter upon the above mentioned property for
i ~ction purposes.
" Date; 1/24/2005
Signature f Appli
The permit shall expi by Iim' tlon and become null and void if the building or
work has not final ins action 365 days from the date of permit issuance. A
new permit is required to commence or continue work. .
Fees paid for Permit:
Total:
310.05
INSPECTION RECORD
" INSPECTION DATE' INSPECtOR
,
Tempor;lry Power Pole ,
Plumbing (DrainlWaste Pipe) , ,
EleclriC;lj Ground ElectroclelUler ,
Setback/FormsfTrenches (Footings} ,
Do not install subfloor or pour floor slab until the '
following applicable items have been signed: '
Plumbing (Water Pipe.SpriJikler Valves) , ,
Mechanical (Groundwork) , , ' ' ,
Electrical (Undergrollnd Conduit)
PI&-Slab (compactlonlMembrane.Retnf. ,
Underpinning (F'oor JoistIGirders) , ,
Do not ,cover or conceal the work below until the '
following'applicable items have been signed: '
1st Floor Shear .
Firesprinkler (Rough) , , /
2nd Floor Shear " , /
Roof (ShealhingfOiaphragmlFramel" -I-<>S' 17--7#1
Masonry (ReinfJBond BeamlPre-Grout) / 7,
Rough'Plumbing (Top Out} ........
Rough Mechanical , ,
Rougn l:Iectrical (l.lI'Ywall,
Rough Electric;l', ,
Framing (Only after Plbg.. Elec;. Mech.. and Fire)
Insulation (soundlEnergy) , ' ,
Do not tape or pl;lster until the following ;lpplicable
items have been signed: ' ' ,
Drywail " '.
Penetrations (fire Rated} Electrical , ,
Penetrations (Fire Rated} Mechanical
Penetrations (Fire ,Rated) Plumbing , ,
Interior Lath ,
Exterior Lath ,
" , GENERAL ITEMS
Exteripr Plaster (BRM/n Coat}
T.Bar. Electrical - , i
T.Bar Mechanical
T -Bar Structural' "
Sewer
Water Engineering Backflow ,
Water SerVice " ,
FINAL INSPECTIONS Date Inspector'
Electrical Final ' ',' , '
Plumbing Final , '
Mectlanical Final , , , ,
Gal! Test , '
Erigineerlilg/Grading Final 76505126 .
Fire Dept.. Final 765-4040 .
Water Engineering 765-5268 " '
Sub ,List/BOsiness License 76s..51g, .:" ,
Zoning 765-513,9
Building Fi,nal Jl:astln~ection. Only , ~,?:.o~ 'tr~
fter A ve Complele)
PARTIAL INSPECTIONS G
. . .
BUlldlOa Inspections
. .. .
, '
, Mechanical Inspections
Plumbina Inspections
Electrical Inspections '