883 S. Philadelphia St.
TYPE OF PERMIT C I.TV
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. BLD2005-00199
DATE: 1/24/2006
JOB ADDRESS: 883 S PHILADELPHIA ST
lEGAL DESCRIPTION: N TR 1871 lOT 5
CONTRACTOR INFORMATION:
THE ROOF GUY
9781 EASTWOOD CIRCLE .,
VILLA PARK. CA '92861 0000
BUSINESS PHONE: 714921-1500
JOB DESCRIPTION:Re-roof - OVerlay 38 sq. of 20 yr. composition s~in9le over (1)e~isting iayer of compo
VALUATION: 3,300.00 PROCESSED BY: ENO
I.. .. OWNER.BUILDERDECLARATION '.
I hereby"affirm under penalty of perjury that I am exempt fro~ the Contract~~sLicense Law for the following reason (Sec. 7031.5 Business and
Professiqns Code: any city or county which requjre~ a permit to construct,',alte'r, improve, demoUsh or repair any structure, prior to its issuance. also
. -requires the applicant for such permit to file a signed statement that heis lie"rinsed pUi,5uant.to the plt).visions of the Contractor's ticens-e Law ,(Chapter
9)(commencing with-Section 7000 of Dlvision 3 of the Business and Profess~'nsGode) or that he is exempt therefrom and the basis for the alleged
exemption.. Arty violation of Section 7031.5 by anyapplica'nt for a permit su'i::jec~s the ?fpplicant to a dvU penalty of not more than five hundr~d dollars
($500). .. '. .' . . i .
o I, as ownef of property. or my employees with wages as their sole901T!~$nsation. will do'the work, and the structure is not intended o,roffered for
sale {Sec. 7044 Business and Professions Code: The Contractor's UcenseTaw does not app~y to an owner of property who builds or Improves.
thereon, and who does such work himself orhemelf or through his or. her ov/, employees. provided that such improvements are not_intended or
. o!fered 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 buij'd or improve for the purpo,se of sale}. ,1. '
o ,1. as the owner of the property, am exdusively contracting with licensed":contractors to construct the project (Sec. 7044 ~usiness and' Professions
Code: The Contractor's license laW does not apptytO an 9wner of property:who buijds or improves thereon, and who contracts for sum projects with
EJontractor{s) licensed pursuant to the C6ntractor"sLf~:.n~ ,Faw). ,~; c .
". I, am exempt under Sec. . ~ B & P.C. for this reasoll: .~
Date: . . Owner:' .;.('i .
I WORKER'S COMPENSATION DECLARATION ~.:'"
I hereby affirm under penalty of perjury one'of.lhefoiiowingdeclaralions: "j:' .
o -'I hav~and will maintain a certificate of consent to se-If-lnsure for worker'~ ~ompel'lsatian, .
as provided for by Section 370Q,of the Lakx;>r Code, for-the pe"rformance aftK~ work for which
!h.' permit is issued. . . ';7~~''; " .
,.' J have and will maintain worker's com. pensationinsurance, as reqUire.:~,:b~./. Section 3700 of 1/24/2005
the Labor Code, for the performance of the work for which this permit is IssU(d. Myworker's Date:
Compensation insurance canier'and policy are: . v';
Carrier: STATE COMPENSATION FUND . Poiicy Number. 1713793
This section need not be completed if the pennit is for one hundred dollars ($1 OOi or less.
.0 I certify that in the performanc~ of the workfor which thi.s permit is i~ud';;" I shaD,,;ot
employ any person inany manner so as to become subject to the wQrker's.~sdr;npensation laws
of California, and agree.that if 1 should become SUbject to the worker's coml:>f.nsation
provisions of Section ~700'ofthe labor Code. I shall forthwith com 'Iy withlnbse provisions.
APPLlCANT:JOHN SHEATZ
OWNER INFORMATION:
Monarch Manor-
989 Scott St
San Diego. CA 92106
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
r hereby affirm under penalty of perjury that') am
Iicensed:under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business artd
Professions e.
Contractor
NUMBER
638593
TYPE
EXPiRATION DATE
2/28/2006
C39
Date: 1124/2005 Applicant:
WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVER"GE IS
UNLAWFUL. AND SHALL SUBJE T AN EMPLOYER TO CRIMINAL PENAI,TIES AND CIVIL
,FINES UP TO ONE HUNDRED. THOUSAND DOLLARS ($100,000), IN ADD1TlON 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 lending agency for the
Performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's,lnforma.tion: "
Construcion Types;
VN, .
Fire Sorinklered?
NO
I certify that I have read this application_ and state that the above information is correct. I
agre~ to comply with ,all city ordinances and. state laws relating to buU'ding construction, and
hereby authorize representlves of 'this city to enter uP9n-the above mentioned 'property for
ins ection purposes. ..,..'.
Date: 1/24/2005'
Fees p.aid for Permit:
Total:
310.05
Signalure of Applica r Agent
The permit shall expire by Iim' tion and become null and void if the building or
work has not passed final inspection 365 daYs from the date of permit issuance. A
new permit is required to commence or contInue work.
INSPECTION DATE ' ,INSPECTOR , E
Temporary Power Pole , P
Plumbing (DrainlWaste Pipe) " M
Electrical Ground Electrode/Ufer " , ,
SetbacklFormsfTrenches (Footings) G
,Do nOt install. subfloor or pour floor slab until the E
following applicable items have been signed:
Plumbing (Water Plpe.Sprink/erValves) , Fi
Mechanical (Groundwork)
Electrical (Underground Conduit) " c
Pre-slab {CompactionlMembrane.Reinf.1 S
Underpinning (Roor JoistJGirders) , , Z
I)() not cover or 'corn;ealthe work belOlN unfirthe , B
following appliCable items have been signed:
1st Floor Shear " ' ,
, Firesprinkler (Rough)
, -
2nd Floor Sheilr - B
Roof (Sheathlng/OIaphfilllmlFramel -t ~..( , '
Masonry (Reinf.IBond BeamlPr.Grout) " ,/J'
Rough Plumbing (Top Out) 'v
Rough Mechanical ,
'I Rough ElectrICal (DrY walll '
Rough EleCtrical " , ,
Framing (Only after Plhg, Elec.. Mern" and Fire) ,
Insulation (SoundlE,.rgy) , "
90 ,not tape or pla~ter ,until the following applicable M
Item,s have been Signed: .. . ' ,
Drywall ' ' , , " ,
Penetrations (Fire Rated) Electrical
PenetratiOns (Fire Rated) MechaniCilI
PeoetratiOns (Fire Rated) Plumbing
InteriQr La,th ,
Exterior, Lath , PI
GENERAL ITEMS
ExteriQr Plaster (Brown CQaI) "
T .Bar Electriclll ,
T.Bar ,Mechanical "
T"~r Structural , ,
Sewer ..
Wilter Engineering Backflow EI
Water Service ' ,
INSPECTION RECORD
FINAL INSPECTIONS
lectrical Final
tumbing Filial
eChanical Final
as Test
rigi.-rlng/Grading Final 765-5126
re Depl. Final 765-4040
Water Engineering 765-5268
ub ListJBusiness License 765-51
Qning 765.5139
uildlng Final iLast Inspection- Only ,
After Above Complete)
PARTIAL. INSPECTIONS
uildinalnsPflctions'
Date
Inspector'
echanicallnSDections
urribina Inspections'
ectricallnsoections