2533 E. Seville Ave.
BlilLDING PERMIT NO. 6LD2004-01298
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BUILDING DIVISION
200 S ANAHEIM BLVD..
(714) 765 - 5153
INSPECTION REQUEST LINE'
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 122
TYPE OF PERMIT C' ITY
. Reroof
bATE: 4/21/2004
JOB ADDRESS: 2533 E SEVILLE AVE
LEGAL DESCRIPTION: N TR 2767 LOT 46
APPLICANT: DANIEL VILLICANO
OWNER INFORMATION:
Daniel R Villicano
2533 E Seville Ave
Anaheim, CA 92806 .
JOB DESCRIPTION:Replace existin9 camp with 25 year camp shingie. 43 sq'""res. (HIH)
VALUATION: 5,100.00
I OWNER-BUILDE!i.oECLARA TION
I hereby_affirm under penalty of perjury that, am exempt from the Contractq!,~ License Law for the following reason (Sec. 7031.5 Business and
. Professions Code: any dty ,or county which requires a" permit to construct,'Cll~;~r, improve, demolish or repair any structure, prior to its iss~ance, also
requires the app/fcant for such permit to fil~ a signed statement"thathe is !i~B-~sad pursuant to the provisions of the Contractor's License Law (Chapter
9)(comm~ncjng with Section 7000 of Djvi~ion 3 of tile Business and Profes~;~;nsCode)odha~ he is exempt therefrom ann the basis. for the aJJeged
exemption.. Any violation" ofSe<::ticn i03t5 !;Y;olny ~p'pJicant for a permit sur;Jscts the appltcant"to a civ~ penalty of not more than five hundred dollars
($500).' . . '.. . : .
': ~sowner of p~cperty. ~r my em~:oY'ee3 wlt.hwages as their so:€ ~Ofi\!)'!,ns_ation. wi.H de the work, and ~he, structure is noti.ntend~d qr C'ftered for
qai~ (Sec.. 7044 Bi.m!n~Ss anti ProfeSSIons Code: The Contractor's License !/~\tl rioes nnt flp~Jyto an-cwner of property whqbuJJds or Improves
therecT":, nnd wf1c dop.s ~ljch work -himself or: herselforthrough his 01 hel, o\\lr!employees", provided that such improvements.are not intendedcr .
offered for s'-)!e. If, :-ll)~rtev?r, the building or improvement is sold ,with oneye:"r of completion, the owner-builder will have: ,the burdefl of preving that he
did not bulle or improve:forthepurpose.of saie). " r . .
o I, as the own'er of the property, ~m exdusively contracting with Ilcense~~x)ntraCtors to COlisiruct the project' (See. 7044 BusineS3 and Professions
Code: The Contractor's License Law does notappfyto an owner ofp(bpa;tv':~(ho builds or impro.{t3s thereor" and who contracts tor such 'projects with
,a..qontracl:or(s}.Jicemse~ pursuant .to the Contractor's License awl. ;.'. .
U . I am-exempt und.er Sec. _ ' . B.C., . ~ '911: ~_,: _
Date: Owner:
WORKER'SC NSATION D LARATION -'~[~-.J
I hereby affirm under penaltY of pe~ury one-of the followi 9 dec:arations: '; _
o I have and will maintair. a certificate of-oonsent toself~jnsure for worker':-\ CCil1pensati!Jn,
as: provided for by Section 3700 of the labor Code, for the perlormance of th'~ 'vork for which
this permit is issued.
C thave'and will maintain wdrker's'cornpensation insurance, as required--~:: Section 3700 of
the Labor_Code,_farthe performanc.eof the work for which, this permit is ISSU:;!. Myworl<~r's
Compensation inSUrance carrier and policy are: ,
Carrier: Policy Number.
CONTRACTOR INFORM/TlON:
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: CAL
LICENSED CONTRACTORS DECLARATION I
! her.ebyaffirm under penalty of perjury that I am
ItcenseJ under provisions of chapter 9 (e,;ommencing
with Sectiof170(0) of DivSion 3 of the Business and
Professions Code.
4/21/2004
DabJ:
, Cohtractor
NUMBER
EXPiRATiON DATE
. .
.~ection need not be compl,eted if the- permit is ~r one hundred dollars ($1 Ui.f"or less.
~ eE:F'tiff that in ~he performance of the work 'for whi~h this permit is i.s~:I.;.:'.:,_I. I shall ~ot
_ employ any person,ln any manner 50 as to become subject to ,the wor!<ei'~J:c~pensatlon laws
of CaJif6mia, and agree that if I should beyom S\J., bject to the,.worker's C9I!i~!'::nsation .
provisions of Section 3700 of the la bor Co , I .sb ' : 'fll'YSe provisions.
, ' .,-- ./'
Date: 4/21/2004 ' Applicant: "
WARNING: FAILURE TO SECU. ,RKER'SCOMP SATlON COVE"AGE 1$
UNLAWFUL; AND SHALL SUBJECT AN EMPLOYER 0 CRIMINAL PENAL ,;ESAND CIViL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADD'HONTO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIO~: 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I. CONSTRUCTION LENDING AGENCY "
I hereby ctffirm under penalty of perjury that tl1ere is a construction len,di!1!J a;:)"~Y for..the
performance of the work for which this permit is issued (Seq:3091.Gfv.C): ___,
::;:;-:;':;...j';:, ;(;;'crd:",itca: . .
TYPE
Construdon Types:
VN, ,
I certify that 1 have read this application and state that the above information js correct I
agree to COm~,IY ., all city o. rdinan,ces. and ,stat.e. Jaws relating to building,corrStruc:tion, and
hereby auth, or' , ,ry:.p~sentiV~li.PO...tl::l. " e"ter upon the'above mentioned property for
inspection ~ ; . / -
I" . Date: 4/21/2004
, -Signature Q ;b.pplicant 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 issuance. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
0.51
INSPECTION RECORD
INSPECTION !>ATE' INSPECTOR
.Temporary Power Pole . .'
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter.
SetbacklFormslTrenches .(Footings) .
Do not install subfloor or pourftoor slab until the
following applicable items.have been signed:
Plumbil1g (Water .Pipe.Sprinkler Valves) .
Mechanical (GroUndwork)
Electrical (Underground Conduit) .
Pre-slab (CompactiorfMembrane.Rei nt.
Underpinning (Floor JoistlGinlers) .
00 not cover or conceal the wor1<. below until the .
for/owing applica~le items have been signed: .
- 1st Floor Shear.' - . ...: . '.
Fires.prinkler (Rough) . . . .
. 2nd Floor Shear - .... .
Roof. (Sheathing/Diaphragm'Frane) .
Masonry (ReinfJBondBeanJPre-Grout)
Rough.Plumbing (Top out)
Rough Mechanical .
Rough l:Iectric3! (DrY Wall)
Rough Electrical. .
Framing (Only after Plbg.. Elec.Mech and Fire), '. -
Insulation (Sound/EnerllY) . . -
Do nOt tape Or plaster until the'following applicable
items .have been signed: .., .
Drywall . . .-
. Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetratiol1S(Fire Rated) Plumbing
Interior 4th
Exterior Lath . . . . -
'. . .' . .GENERALITEMS -c
Ext~"ior.Plaster (Brown Coat) .' -
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 . .
EngineerlngJGrading~inal 765-$126 '.
Fire Dept.Final 765-4040 . -
Water Engineering 765-5268 . '
Sub List/Business License 765-519
Zoning 765-5139. . .' .'. ,"
Build'lng Final. \tast Inspection. Only '. " .
, fter Above Complete)
PARTIAL INSPECTIONS
BuildinQ Inspections
Mechanical Inspections
Plumbinq InsDections
. ElectricallnsDections
PERM\1 E'J,P\RED
, \~~SPEC1\ON'
\ r:lrD
N01 COMPL\-t.. ..'
. . ^-,r-:'. q \
Or; \ c...
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: 122
BUILDING PERMIT NO. BLD2005-02739
DATE: 8/31/2005
JOB ADDRESS: 2533 E SEVILLE AVE
LEGAL DESCRIPTION: N TR 2767 LOT 46
CONTRACTOR INFORMATION:
M R ROOFING SERVICE INC
10657 STANFORD
GARDEN GROVE, CA 928400000
BUSINESS PHONE: 714636-5679
JOB DESCRIPTION:Tea' off existing roof and replace with 25 squares of 30 year composition shingles.
VALUATION: 4,800.00 PROCESSED BY: MSM
APPLICANT: AL SOUZA
OWNER INFORMATION:
DANIEL R VILLICANO
2533 E SEVILLE AVE
ANAHEIM, CA 92806
ARCHITECT/ENGINEER INFORMATION:
OWNER-BUILDER DECLARATION
I hereby a irm 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 dty 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 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) o( 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 ',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 La'w 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 (~mployees, provided that such improvements are not intended or
offered for sale. It, 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 buRd or improve for the purpose of sale).
D 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
~ontractor(s) licensed pursuant totheContrsctor's License Law).
U 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:
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
Whi permit is issued.
II have and will maintain worker's compensation insurance, as required by Section 3700 of
t Labor Code, for the performance of the work for which this permit is issued. Myworker's
C mpensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 0002399-05
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions 01 chapter 9 (commencing
with Section 7000) of Divsion 3 of th Business and
Professio~ e. -/.."
8/31/2005 II .
Date:
Contractor
ThiS section need not be completed if the pennit Is for one hundred dollars ($1 DO) Of 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 Califomia, and agree that if I should become subject to the worKer's compensation
provisions of Section 3700 of the La r Code, I shal forthv{ comply with those provisions.
NUMBER
765080
TYPE
EXPIRATION DATE
6/3012007
C39
Date: 8/31/2005 Applicant:
WARNING: FAILURE TO SECUR WORKER'S COMPENSATI N COVERAGE IS
UNLAWFUL, AND SHALL SUBJE AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDI110N TO THE
COST OF COMPENSATION, DA AGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereo-j affirm under penalty of perjury that there is ~ construction lending ag<3r_"yfor the
performance of the work for which this permit is issued (Sec.3097 .Civ.C):
Lender's Information:
Construcion Tvpes:
VN, ,
Fire Sprlnklered?
NO
r certify that I have read this application and state that the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construct jon, and
h eb authorize representives of this city to enter upon the above mentioned property for
.00 purposes.
,---t'.. Date: 8/31/2005
ignature of Applicant or ent
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 Dermit is reauired to commence or continue work.
Fees paid for Permit:
Total:
244.87
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour 1I00r 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 JoisVGirders)
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
Roof (Sheathing/DiaphragmfFrame) IHof {l.floJi1&t 11
Masonry (Reint.lBond BeamlPre-Grout)
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 Coat)
T.Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Back/low
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
EnglneeringlGrading Final 765-5126
Fire Dept. Final 765.4040 I
Water Engineering 765.5266 ..
Sub LlstlBusiness License 765.5194 I
Zoning 765-5139 I . I
Building Final (Last Inspection - Only 9 7
,. I
After Above Complete) 1/ 'll" JAJJol.)~\ I
I
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections