5773 E. Santa Ana Canyon Rd.
BUILDING PERMIT NO. 6LD2004..()3360
TYPE OF PERMIT
Reroof
DATE: 9/1/2004
JOB ADDRESS: 5773 E SANTA ANA CANYON RD
LEGAL DESCRIPTION: DOMINGUEZ ESTATE LOT 4 POR OF LOT.
APPLICANT: MARTHA. RICHTERS
OWNER INFORMATION:
Imperial Properties
2424 SE Bristol St #100
Newport Beach, CA 92660
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 555
QUARTER SECTION: 185
ARCHITECT/ENGINEER INFORMATION: .
CONTRACTOR INFORMhTION:
. SAN MARINO ROOF COMPANY INC.
2187 N BATAVIA
ORANGE, CA 928650000
BUSINESS PHONE: 71497..-3070
JOB DESCRIPTION: -rear off existing & reroof 100 sq with 30 yr composition shingleS for Strip Mall.
VALUATION: 28,000.00
I OWNER-BUILDER,DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contracto(s license Law for.the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, ;3'Jl.a.r, il'!lprove, -demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file a signed statement t,hat he IS lic(-,nsed pursuant to theprov!sions of the Contractor~s License Law (Chapter
9)(commencing with, Section 7000 of Oivision-3of the Business and Profess:a:l$ Code) or that he is exempt th~refrom and the basis for the alleged
.exemption. MY violation of Section 7031:5 by al')Y applicant for a permitsut'iects the .applicant to a dvii oenaltyof not more tha.n five h~ndred dollars'
~~ . ... . ..... .. . . . .
0' I"as own.er~fproperiy-, ~rmy employees with wages as their SOleCOIn~E:nscrtion, 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 af property who buildsor improves
thereon, am who'dces sud1 work himself or hecsel.f or through his or her OW;.l employees, provided that5uch improvements are not intended or
offered tor .sa. Ie , If, however, the building arimprovement is sold with one ye.!ai of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale). . , .. . .
[J .1, as the owner of the property, amexdu-sively 'contracting With licE-.l1sed.\:ontradors to construct the project(Sec. 7044 Business and Professions
Code:' The Contractor's License law does not apply tean owner of property:,who.builds-or improves thereon, and who oontracts" for,$uch projeCts ...;ith
}L~ontractor(s)}icensed pursuant to the Contractor's License Law.).
U l,amexemptunderSec. ,B&P:C.forthisreason:.
. Date-; OWher:
I
PROCESSED BY: MJF
LICENSED CONTRACTORS DECLARATIQ[]
I hereby affirm under penalty of perjury tnat I am
licensed under provision pter 9 {commencing
with Sectio 00) wion. of e Business and
Prof ,ion 'e.'
,
WORKER'S COMPENSATION DECLARATION.
I hereby affirm under penalty of perjlJry one of the following declarations:
o .1 have"and wHl maintain a certiflCat~ of consent to self.lns.ure for wor"er~ c~mpensat:on,
as provi d for by. Section 37.00 of the LabOr Code, for the performa'1ce oftrie work for which. ,
this mit is issued. . . ;'
I have aoo will maintain worker's comp~nsation lns~rance, asrequjredJ~Y Section 3700 of
the "labor Code, for the performance of the work forwhich this permit is iSS!I:3d. Myworker's
Compe'nSDtion insurance earrier \3nd poli,cy are: ,. ' .
Carrier: LUMBERMEN'S MuiuA~ CASUALTY Ccl'oliOj Number. 39AI64':29-00
This section ne~ not be completed if the pennit is for one hundred dollars ($10.:,) or Jess.
0.1 certify thatln the perfonnance of the work for which this permit is j::;suJd; I shall' not
employ any person in any manner so as to I:>ecome subject to th ers o:mipensation laws
of Califomia, and agree that if I shoul ecome_ d to the orker's ornP'J'nsat;on
. p~ovis;ons of Section 3700- ofthe La 0 fartl1 i c itfi: i.l'O~.e provisions:,
NUMBER
249559
.TYPE
TYPE
Construdon Types:
VN, ,
Dale: 9/1/2004 Appli t: .
.WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVEFUIGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENf,L TIES'AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND,[)OLLARS ($100,000), IN AD'~l1iON TO THE
COST OF COMPENSATION, DAMAGES AS p,ROVIDED FOR IN SECTION 3'106 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S,FEES. ..
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that:there is a construs-tion le-ndjng:"a'Jehc'yf~r th~. .';.
,- .perfOi'~I'rdn-ce.orth~ work IOI.....ihicii-lhf::> plar:,iit i~:fi3-sue-d (S.E;/c.3.o97:Civ.C~:- .~-
Lender's Information: '
,
, I certify that I have read this application and state that the abovs.information is correct. I
. agree to comply~with 'all city ordinan 5 a _state laws relating to buildIng construction. and
her~by' authoriZe_repre tives 0 is city ~r, upon the above mentioned. property for
inspectIon purposes, .
, Date: 9/1/2004
Signature 0 Applicant gent
The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days from the date of permit issuance.. A
new permit is required to commence or continue work.
Contractor
EXPIRA nON DATE
7/31/2006
C39
HIC
Fees paid for Permit:
Tota":
763.75
INSPECTION RECORD
, INSPECTION 'DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe) ,
, Eledrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footings) , , ,
00 not install subf/Qor or pour floor slab until the
, following applicable items have been signed: "
Plumbing (Water Plpe.Sprinkler Vawes) ,
~hanical (Grounct,N"rk)' " , '
Eledrical (Underground Conduit) ,
, Pre-$lab (Compacti'!fllMembrane.Reinf. "
Underpin(ling (FI(lOI' Joist/Girders)
00 not cover or conceal the work below ,unt.1 the
lollowingap!!Iicat>le,ilems have been signed:"
, 1 5t ,Floor Shear ' ,
, Firesprinlder (Rough)
2iid Floor Shear : ,
Roof (Shealhing/OiaPhragnv"Frane) ~,II;
Masonry (RelnfJBoncl Beam/Pr~l"O\It) , ~ " ' "
Rough Plumbing (Top Out)
Rough Mechanical
IKOugn l:IectrlCallOry Wall) : ,
Rough Electrical
,: Framing {Only after Plbg.. Elec,. fAech ,and FIre} ,
Insulation (SounlflEnergy)
, 00 not tape or plaster unti' the following applicable
items have been, signed:, '
Drywall , ,
Penetrations (Fire Rated) Electrical ,
Penetrations (FireRaled) Mechanical ,
Penetrations (Fire Rated) Plumbif1!l
',' Interior Lath '
Exterior Lath
, ' GENERAL ITEMS
Exterior Plaster (Brown Coat) , ,
T -Bar Eledric:al ' ' .- ,
T.Bar Mechanical , '
T -Bar 'Structural
Sewer' . ,
Water Engineering Backflow , ' ,
Water Sen/ice "
P.EF(MIT EXPIRED
INSPECTION
NOT COMPLETED
, ,
. .. .
DATE:J:)-d1--OS'
~
}
FINAL INSPECTIONS, ' Date Inspectof '
, Electrical'Final
, Plumbing Final , , ,,'
, ,
Mechanical Final
Gas Test ' " " ,
Engineering/Grac:\il1l1 Fil1al 765-5126 ,
Fire Dept. Final 765-4040 ' ", ' , ,
Water Engineering 765-5268 , " .
Sub lJstlBusinessLicense 765-5t9
Zoning 765'5139 , , ' ,:-
Buildil1g Final ~.st Inspection.'Only " ,
fter Above Complete) , ' ,
, PARTIAL INSPECTIONS
BuildinQ IhSpections
Mechanical Inspections
. Plumbina Inspections,
Electrical Inspections