2501 Sandalwood
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"~iJlj;"D1NG PERMIT NO. BLD2005-03302
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TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 111
DATE: 10/1212005
JOB ADDRESS: 2501 E SANDALWOOD CT
LEGAL DESCRIPTION: N TR 3168 LOT 29
APPLICANT: DAVID GARCIA
OWNER INFORMATION:
RUSAMBRICH T PREJIDO
2501 E SANDALWOOD CT
ANAHEIM, CA 92806
CONTRACTOR INFORMATION:
COAST ROOFING
21681 IMPALA LANE
HUNTI NGTON BEACH, CA 926460000
BUSINESS PHONE: 714968-8754
JOB DESCRIPTION;Tear oft existing material, install OS8 plywood, felt and 20 squares of timberline composition shingles to house and attached garage.
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 5,770.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's icense aw for e following reason ( ec. 7031.5 Business and
Professions Code: any city or county which requiffis 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 theffifrom 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
($500).
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Law 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 improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner.builder 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 ~xclusiveJy contracting with licensed cc.ntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the fol/owing declarations:
o I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
~ have and will maintain worker's compensation insurance, as required by Hecticn 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: STATE FUND
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Di 3 of the Business and
Professions ode.
Policy Number. 1113190-0.j
This section need not be compleled if the pennit is for one hundred dollars ($1 DO) cr less.
1sa-Tcertify that in the performance of the work for which this permit is issued, I shall not
~Ioy any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor , I shall forthwith comply with those provisions.
NUM R
450393
TYPE
EXPIRATION DATE
12/31/2005
C39
Date: 10/1212005 Applica
WARNING: FAILURE TO SEG E RKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL S JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUN ED THOUSAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSA ON, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTER ST 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.J097 .Civ.C):
Lender's Information:
Construcion Tvpes:
VN, ,
Fire Sprinklered?
NO
I certify that I have read this application and state that the above information is correct. I
gree to comply with all city ordinances and state laws relating to building construction, and
he aut rize resentives of this city to enter upon the above mentioned property for
inspectio urp s.
Date: 10/1212005
Fees paid for Permit:
Total:
170.28
Signatur 0 Applicant or Agent
The p mit 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 permit issuance. A
new oermit is reauired to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (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 (CompactionlMembrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1st Floor Shear
Firesprlnkler (Rough)
2nd Floor Shear I I
Roof (SheathingIDlaphragm/Frame) loIl1!.: JA:~cl{):s.1L1
Masonry (ReinfJBond Beam/Pre-Grout) I I
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
Insulation (SoundlEnergy)
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 Piaster (Brown Coat)
T-Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DATE
Electrical FInal
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Buslness License 765-5194
Zoning 765-5139
Building Final (Last InspectIon - Only
Alter Above Complete) i I
INSPECTOR
PARTIAL INSPECTIONS
Building InsDections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections