879 S. Philadelphia
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
. INSPEcTION REQUESTLINE:
(714) 765: 4626
CENSUS CODE: 555
QUARTER SECTION: 85
BUILDING PERMIT NO. BL02005-00198
DATE: 1/24/2005
JOB ADDRESS: 879 S PHILADELPHIA ST
LEGAL DESCRIPTION: N TR 1871 LOT 6.
CONTRACTOR INFORMMION:
THE ROOF GUY
. I
9781 EASTWOOD CIRCLE ' .
VILLA PARK, CA 928610C'OO
BUSINESS PHONE: 714 921.1500
JOB DESCRIPTIO!'l:Re-roof - Overlay 38 sq. of 20 yr. composition shingle ov" (1) existing layer of compo
VALUATION: 3,300.00 . , PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
) hereby affirm under penalty of perjury that I am exempt from the Contract~~~ license law for the following reason (Sec. 7031.5 8usines~ and.
Professions Code: any dty or county which-requires a permit to construct, a:rr~:r. improve, demoJish or repa ir any structure, prior to its issuance, also
requires the applicant for such. permit to file a signed statement that he is /icdnsed pursuant to the provisio,ns of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and ProfessIJ~n1S qode) or that he is exempt therefrom and the basis forthe alleged
exemption, Any violation of Section 7031,5 by any applicant for a permitsubiect$ the applicant to a dvil penalty of not more than five hundred dollars
~~ . ..... t ". .
. 0 I, as'owner 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 Professions Code: The Contractor's license!\pw does not apply to an owner of property who builds or improves .
thereon, and who does sudl work himself or hen;elf or through his or her owilJ:employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is' sold 'with one ye:~r of completion, the owner-builder will have the burden of proving that he
did not build or improve for the pUlpose of sale).~1 .' .
o I,as "the owner of the property, am exdusively contra'ding with Iicense~\60ntractors.to const(uct the project (See. 7044 Business and Professions
.Code: The Contractor's license Law does not apply to an owner of propedy who builds or improves the~ecn, and who contracts for such projects with
FU?ontrador(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. ,B & P.C. for this reasori:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION I
I hereby affirm under penalty of perjury one of the following declarations:- :.1
o I have' and will' maintain a certificate ofoonsent to self-insure for worke~';~,~compensation,
as'provided for by Section 3700 9f -the labor Code, for the performance,oftH? w,ork fer which
~.. r~;: = ~~S;i~,d~aintain worner's compemsat.ion insurance, as reQUired'-t".t... ~~ction 3700 of
. h labor Code, for the performance o.f the work for which this permit is issu~jd. Myworker's
ompensation insurance carrier and policy are:. , . J
Carrier: STATE COMPENSATION FUND . PoliO} Number. 1713793 .
APPLICANT: JOHN SHEATZ
OWNER INFORMATION:
-Monarch Manor
989 Scott St
'San Diego, CA 92106
ARCHITECTJENGINEER INFORMATION:
I'
This section need nOt be completedJfthe pennit is for one hundred dollars {$10D:: or less.
o I certify thatiri the perfmmanceofthe. work for which this permit is'issu.ed.' shall not /'
employ any person in any manner so as to become subject to the worker's 'cC'm.oensatioR'raws
of Cal~omia, and agree that if I should become subject to the woiker's compt::I1:S'ati.O~
provisions of Section 3700 of. the labor Code, I shall. forthwith comply wit J~provis!'ons.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjUry that I am
licensed under provisiOns of chapter 9 {commencing
_~~f:S:~~b~n~7000) of OiVSion3~ftheBusi~-~--
1/24/2005 ~
Date: . . Contractor . . .
NUMBER EXPIRATION DATE' .
638593 212812006
TYPE C39
Date: 1/2412005. Applicant:
WARNING: FAILURE TO SECUR
UNLAWFUL, AND SHALL SUBJE AN EMPLOYER TO CRIMINAL PENAj.T!ES AND CIVIL
FINES UP TO ONE HUNDRED TH.OUSAND DOLLARS ($100,000), IN ADDm.oN TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTI0N13706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending ag'1ncyfor the
performance of the work for which this permit is ,issued(See.3097 .Civ.C):
__Lendels;' lnformation:__
Construcion Types:
VN"
Fire 8prinkrered?
NO
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 state laws relating to building constru~tion, and
hereby authorize representives of this city to enter upon the above mentioi'iec' property for
.~'n!'P ionpu~
~~? Dat6:.112412005 .
Signature ow"~,,t or ~nl
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 Qfperrnit issuance. A
new permit is required to rommence Qr cQntinue Wl>rk.
F~es paid for Permit:
Total:
310.05
INSPECTION RECORD
INSpeCTION . .' DATe INspeCTOR
Temporary Power Pole. .
Plumbing (DralnlWaste, .Pipe)
Electrical Ground Electrode/Uter
SetbaeklFormsfTrenches (Footings)
Do not installsubfloor or.pour.floor slab ,until the
following applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valyesl
Mechanical (Groundwork)
.' I:lectriCal (Underground Condu it) '.
Pre-s/ab (Compaction/Membrane.Reinf.)
Und!!rplnning (Roor Joist/Girders) "
~ not cover or conceal lI!e wOl1< below until the
following applicable items have been signed: .. :
.1stFloor Shear
Firesprinkler (Rough) /
2nd Floor Shear . ... .... A
Roof (SheathlnglDiaDhragm'Framt) ;../-o.~ "'"pi -..r.-h /
Masonry (ReinfJBond BeanlPre-Grout) . /}
Rough Plumbing (Top Out) .' . -(/
Rough Mechanical .
.' Rough eectrlCaI (DrY wallJ
Rough Electrical . .
Framing., (QrtlyafterPlbg., Elec.. Mecn., and Fire)
Insulation (SoundlEnergy)
Do not tape or plaster until the following applicable
items have been "igned:. . '. .
Drywall "". . . . .. '., .
Perletrations (Fire Rated) Electrical "
Penetrations (Rre Rated) Mecllanical . .
Penetrations (Fire Rated) Plumbing :
Interior Lath '.
.
Exterior Lath' . .
.'. GENERAL.lTEMs' --. .'
exterior Plaster (Brown Coat) . .
T.Bar Electrical
. T~Bar Mechanical .
T -Bar Structural . .
Sewer
Wale; Engineering Backflow
Water Service
FINAL INSPECTIONS
Electrical Final
Plumbing'Final
Mechanicai Final
Gas Test'
Engineering/Grading Final 765-1i126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business License 765-519
Zoning 765-5139 ' .
Date
Inspector
Building Final ILast Inspection- Only
After Above Complete)
y-qS
PARTIAL INSPECTIONS'
Buildina Inspections.
Mechanical Inspections
Plumbina Inspections. .
Electricallnsoections