570 S. Scout Trail
BUILDING PERMIT NO. BLD2005-03953
TYPE OF PERMIT CITY
Reroof
DATE: 12/13/2005
JOB ADDRESS: 570 S SCOUT TRL
LEGAL DESCRIPTION: N TR 9750 LOT 65
APPLICANT: DAMON MONTGOMERY
OWNER INFORMATION:
RAMESH PATEL
1132 N BROOKHURST ST
ANAHEIM, CA 92801
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 186
CONTRACTOR INFORMATION:
DAMON ROOFING INC
1001 APPLING
PLACENTIA, CA 92870 0000
BUSINESS PHONE: 714577-0457
JOB DESCRIPTION:Tear off existing roof, fill in sheathing and replace with 33 s:juares of gerard metal shingles ICBO#423.
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 12,000.00
I OWNER-BUILDER UECLARATION
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, alte:, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant for such permit to file 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
($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 I~mployees, 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 exclusively contracting with licensed contractors 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
a contractor(s) licensed pursuant to the Contractor's License Law).
o I am exempt under Sec. , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
D 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
~hi permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
e Labor Code, for the performance of the work for which this permit is issued. Myworker's
ompensation insurance carrier and policy are:
arrier: STATE FUND Policy Number. 1731965-03
PROCESSED BY: MSM
This section need not be completed if the pennit is for one hundred dollars ($1 00) or less.
o I certify that in the performance of the work for which this permit is Issued, I shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of California, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of th a r Co e, hall forthwith comply with those provisions.
Date: 12/13/2005 Applicant:
WARNING: FAILURE TO SECURE ORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED TH USAND DOLLARS ($100,000), IN ADDIl10N TO THE
COST OF COMPENSATION, DAMAGES AS PROVI DED FOR IN SECTION 3706 OF THE
LABOR CODE, I NTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm t.:r:dsr p.2r.u!tycf perjury that thsra is a construction :anding agEi'ticyfor the
performance of the work for which this permit is issued (Sec.3097 .Civ.C):
Lender's Information:
I certify that I have read this application and slate that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereb authorize representives of this city to enter upon the above mentioned property for
~ n purp s.
Date: 12/13/2005
Signature of Applicant or Agent
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 issull1ce. A
new permit is required to commence or continue work.
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 e.
12/13/200
Date:
NUMBER
420695
TYPE
Contractor
EXPIRATION DATE
4/3012007
C39
Construcion Types:
V N, ,
Fire Sprinklered?
NO
Fees paid for Permit:
Total:
320.24
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches IFootinosl
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valvesl
Mechanical (Groundwork)
Electrical (Underground Conduitl
Pre-slab (Compaction/Membrane Reinf.l
Underpinning (Floor JoisUGirders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough) ,
2nd Floor Shear 1/
Roof (Sheathing/Diaphragm/Frame) ~~'l1.. ..jA.d ~C.J ~I
Masonry (Reinf./Bond Beam/Pre-Groutl 1/ 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 .
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control (714)765-4280
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub LisUBusiness License 765.5194
Zoning 765-5139
Building Final (Last Inspection - Only )-)7-tJ(, ~~
After Above Complete)
PARTIAL INSPECTIONS
Buildinq Insoections
Mechanicallnsoections
PlumbinCl Insoections
Electricallnsoections