874 S. Philadelphia St.
TYPEOFPERMIT CITY
Reroof
ElM
.. BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765- 4626
CENSUS CODE: 555
QUARTER SECTION: 85
BUILDING PERMIT NO. BLD2005-00194
DATE: 1/24/2005
JOB ADDRESS: 874 S PHILADELPHIA ST
LEGAL DESCRIPTION: . N TR 1871 LOT 10
. CONTRACTOR INFORMATION:
THE ROOF GUY :
9781 EASTWOOD CIRCLE !
VILLA PARK, CA 92861 00<:)0
BUSINESS PHONE: 714921:1500
JOB DESCRIPTION:Re-roof - Overlay 38 sq. of 20 yr. Composition shingle ov~((1) existing layer of compo
VALUATION: 3,300.00 I PROCESSED BY: ENO
I OWNER-BUILDERiDECLARATION
I hereby affirm' u.nder penalty Of perjury that I am exempt from the ContractorIs,License Law for the following reason (Sec. 7031;5 Business and
P'rofessions Code: any city or county which requires a permit to construct, alfe:~i, improve, demolish or repair anystructure, prior to its iss.uance, also
r~quires the" applicant for suCh permit to file a signed stateme nt that he is Jicf-n-sed pursuant to the provisions of the Contractor's license Law (Chapter.
9}{commencin9.with S'ection ZOOO of Division:3 of the Business and ProfesS;9p,s Code) or that heis exempt therefrom arid the basis for the alleged
exemption. Any violation of S~ction 7031.5 by any applicant for a permit subi?cts the applicant to a civil penalty of not mpre than five hundred dollars
($500). .. . I_ ..' .
o I, as owner of pr?pe~" or my ernploy~es 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 Professions Code: The'Contractor's License:~Saw does notapplyto an owner of property who builds or improves . .
thereon, and 'Who does such work himSelf or herself or throughh(s or,her owNemployees, provided that such improvements are not intended or
offered (or sale. If, however, -the bui'lding or improvemehtis sold with one ye'fr of completion, the owner-builder will have the burden cif proving that he
did not bu!ld or !mprove forthe'purpose of sale). . , . . ._ ~
o . 1', as the owner of the property, am exdusively contracting with licensed :contractors to construct the projept (Sec.. 7044 Business and Professions
Code: The Conti-aptor's License Law does not apply to an owner of property,whc builds or Improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant'to the Contractor's Li~Ii~. Law). -- .
U I am exempt under Sec. ' ,B&P.C.forthisreason: ~,
Date: Owner:'i
I ' .WORKER'S COMPENSATION DECLARATION
I hereby affimrunder penalty of perjury one of the following declarations: l
o rhave 'a~d will maintain a certificate of ~nsent to ~If-insure for worke'r,1 'Compensation,
as provided for by Section 3700 of the Labor Code, for the performance ofth~":work for which
this permit is issued. . .,' .
~' I have and.will m'aintain worker'~ compensation'ins~rance, as required,:b~ .section 3700 of 1/24/2005
he Labor Code, for the performance of the work for which this permit is issued.' Myworker's Date:
Compensation insurance ca:rrier and polioj are: , ;
.Carrler: STATE COMPENSATION FUND Policy Number. 1713793
APPLICANT: JOHN SHEATZ
OWNER INFORMATION:
Monarch Manor
989 Scott St
San Diego, CA 92106
ARCHITECT/ENGINEER INFORMATION:.
I
LICENSED CONTRACTORS DECLARATION
I hereby affIrm under penalty of perjury that I am
licensed under provisions'of chapter 9 (commer,cing
with Section 7000) of bivsion3 of the Busi sand
Professi Coder ___~~
Contractor
This section need not be completed if the pennitis for one hundred dollars ($100: ~ less.
o I.certify that in the perfonnance of the work for which this permit is i~1Je.:t, I shall not
employ any person in any manner so as to become sl..!bject to the yvorker's'..9ci1!pensation laws
of California; and agree that if J should become subjedto the worker's com~~ation
. provisions of Section 3709 of the Labor Code hall ~~ith tho~.~_ provisions.
--- --- "'...-:/.
NUM R
638593
TYPE
EXPIRATION DATE
2/28/2006
.C39
Date: 1/24/2005 Applica .
WARNING: .FAILURE TO SECU WO ER'S MP- ATION COVER\GE IS
UNLAWFUL, AND SHALL SUBJECT.AN EMPLOYER 0 CRIMINAL PENALTIES AND CIVIL
FINES.UP TOONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDJl10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION-3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . .
CONSTRUCTION LENDING AGENCY
I hereby affirm,under penalty of perjury that there is a construction lendingag~ncyfor the
periormance of the work for Which this permit is issued (Sec.3097 .Civ.C):
Lender's Information: .
Construcion Types:
VN, ,
Fire Sprinklered?
NO
,',',""-:,,,,,..
'~'---'-"
I certify that I have read this application and state that the above informatiqn is correct I
agree to comply with all.c;ity ordinances and state laws r~lating to building construction, and
hereby authorize representives of this dty to enter upon the a bove mentioned property for'
~'ns dion PU~pOses., - ~ /:
.' . . .' .---- //~ Date~ '1/2412005
_ :'. 'Signature 0 ppli t 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 perlTjt issuance. . A
neW permit is required to commence or continue work.
Fees paid for Permit:
Total:
310.05
, , " , I'DATE
INSPECTION ' INSPECTOR
Temporary Power Pole , , ' "
Plumbing (DraintWaste Pipe) " , ,
,
Eledrical Ground Electrode/Ufer ,
SetbacklFornisfTrenches (FoQtings)' ,
Do not install subflooror pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.SprinklerValves) ,
Mechanical (Groundwork) . ,
Eledrical (Underground conduit) , ' I,'
,
Pre-slab (Compaction/Membrane.Rei nt., , ,
Underpinning (Floor Joist/Girders) , "
Do not coverorcollcealthe work be,low until the
follOWing applicable Items have been sIgned: .
'1st Floor Shear .
Firesprinkier (Rough) . )
2nd' Floor Shear , _.AA'
Roof (SheathingfDiaphra9m1Frame) ~-(~" /JI'" ;'h.../'
, Masonry (ReinfJBond BeamlPr~rout) //
Rough Plumbing (Top Out) V
Rough Mechanical ,
ectrlCallU<Y nail) . , . ,
Rough El,ectrical" .
Framing, '(On~ after Plbg.. Elec.. Mech.. and Fire) ,
.Insulation (SoundlEnergy) ,
Do not tape or pla.ster until the following applicable
items have been signed: ,
DryI!I/ail , "
Penetrations (Fire Rated) Electrical', ,
Penetrations (Fire Rated) Mechanical
Penetralions(Fire Rated) Plumbing
Interior Lath ' ,
Exterior Lath " ' '
, GENERAL ITEMS, " ' 'C
Exterior Pl<Ister (Brown Coal) "
T .Bar Electrical
T -Bar Mechanical, ,
T .Bar Strlldural ,
Sewer , ,
Water Engineering ,Blickflow
Water Service ,
INSPECTION RECORD
FINAL INSPECTIONS Date Inspector '
Electrical Final , , "
Plumbing Final ' , ',', .
,
Mechanica.l Final ,
GlIsTest " , ,
EngineerirlgtGrading Final 76509126 ' ,
,
Fire Dept. Final 765-4040 ,
, ,
Water Engineering 765-5268
Sub List/Business License '765.519 , ,
Zo!,ing 765.5139 , -'- I,
Building Final jpst Inspection, Only 2 -T~e>~ -;v.. U'../
" fter Above Complete) 1"/"',
PARTiAl INSPECTIONS .(/
. . .
BUlldlna InSDectlons
MechanicallnSDections
Plumbing InsDections
ElectricallnsDections