1764 Sallie Ln.
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: 555
QUARTER SECTION: 50
BUILDING PERMIT NO. BLD2005-03754
DATE: 11/29/2005
JOB ADDRESS: 1764 W SALLIE LN
LEGAL DESCRIPTION: N TR 2722 LOT 5
APPLICANT:
OWNER INFORMATION:
JUVENAL GARCIA
902 ASPEN ST
CORONA, CA 928790000
JOB DESCRIPTION:Tear off existing material, instatl20 squares of eaglelite tile ICBO #6034P; REFBLD2005.03129
VALUATION: 6,000.00 PROCESSED BY: JNJ
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's license Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter,improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to fire a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars
~O).
~J)I, as owner of property, or my employees with wages as their solecompen~ation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Lavl does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such implOvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year 9f completion, the owner-buiJder will have the burden of proving that he
did not build or improve for the purpose of sale). ' .
o I, as the owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law do n to an owner of property who builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to t ntractor~_~_~ nre Law).
U I am exempt under Sec. -"-" C. r tl1 reason:
Date: t-Z -os. Ow
WORKER' P SA N DECLARATION
I hereby affjrm under penalty Of pe~ury one 0 the following declarations:
AD-)I have and will maintain a certificate of consent to self-insure for worker's C1)mpensation,
~provjded for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
o I have and will maintain worker'S compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier:
CONTRACTOR INFORMATION:
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
11/29/2005
Date:
Contractor
Policy Number.
NUMBER
EXPIRATION DATE
This section need not be completed if the pennlt Is for one hundred dollars ($1 aO) or less. TYPE
tvl I certify that in the performa.nce of the wo k for which this permit is issued, I shall not
~ploy any person in any manner so as to be ome subject to the worker's compensation laws
of Califomia, and agree that if I should be su e .. __ ..~e worker's compensation
provisions of Section 3700 of the eel . l-Slialr 0- wi mply with those provisions. Construcion Types:
V N, ,
Date: 11/29/2005 Appli nf:
WARNING: FAILURE TO SECURE ORKE ENSATION COVERAGE is
UNLAWFUL, AND SHALL SUBJECT A 0 CRiMiNAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND LARS ($100,000), IN ADDI1l0N 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):
Lend~r\s Information:
I certify that I ha
agree to
he
inspecti
Iication and state that the above information is correct. J
in es and st~~g1,Ns relating to buiJding construction, and
of 'ty to enter upon the a.bove mentioned property for
Date: 11/29/2005
Fees paid for Permit:
Total:
77.49
Sign t re of Ap
The permi hall ex' by Ii ation and become null and void if the building or
work has not . spection 365 days from the date of permit issuMce. A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/FormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves!
Mechanical (Groundwork)
Electrical (Underground Conduit!
Pre-slab (Compaction/Membrane Reinf.!
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear I I
Roof (Sheathing/Diaphragm/Frame) 10/#76, \ ANOWSV.....l
Masonry (Reinf./Bond Beam/Pre-Groutl I / '
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg" Ele., Mec. And Fire)
Insulation (Sound/Energy)
Do not tape or plaster until the following applicable
items have been signed:
Drywall
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior lath
Exterior lath
GENERAL ITEMS
Exterior Plaster (Brown CoatI
T -Bar Electrical
T -Bar Mechanical
T -Bar Structural
Sewer
Water Engineering Backflow
IWater Service
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control {114)765.4280
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub list/Business license 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only
After Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
DATE
INSPECTOR
Mechanical Inspections
Plumbina Inspections
Electrical Inspections