381 S. Silverbrook
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:. 180
BUILDING PERMIT NO. ' BL0200S-01402
DATE: 5/13/2005
JOB ADDR.ESS: 381 S SILVERBROOK DR
LEGAL DESCRIPTION: N TR 8783 LOT 85
APPLICANT: JONATHAN ACOSTA
OWNER INFORMATION:
Darrell White
381 S Silverbrook Dr
Anaheim, CA 92807
CONTRACTOR INFORMATION:
HOYT ROOFS
1809 N ORANGETHORPE PARK
ANAHEIM, CA 92801 0000 ,
BUSINESS PHONE: 714 773'~820
JOB D,ESCI=lIPTION:Tear off ex,stlng root and replace With 34 squares of 61b. nionler Iifellle ICBO# 2656.
VALUATION: 14,000.00 PROCESSED BY: ENO
OWNER-BUILDER 'ECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's;Ucense Law for the following reason ( ee: 7031.5 Business and
Professions Code:-any city or county which requires a permit to construct, attef'J improve, demolish- or repair any structure, prior to its issuance, also .
requires the applicant tor 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 Professlo~s 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
($500). ' . .,.
o I, as owner of property, or my employees with wages as their sole compensation, will do the work, .and the structure.i$ 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 Sl.!ch, 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 yea~of completion, the owner-builder wilt have the burden of proYing 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 cpnstruct the project (Sec. 7044 Business and Professions
Code: The Contractor's U~nse 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). i
o I am exempt under Sec. " , B & P .C. for this reason: ;
Date: Owner;
ARCHITECT/ENGINEER INFORMATION:
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 conserifto self-insure for worker's 4ompensation,
as provided for by.Section 3700 of the Labor Code, for the performance-,of the. Work for which
~h' permit is issued. ." :
. I have and will maintain wolker's compensation insurance, as requimd by Section 3700 of
Labor Code, for the performance of the work for which this permit is issued. My worker's
ompensation insurance carrier and policy are: ,_ ,:. .
Carrier: STATE RJNP' Policy Numbec 1700471-02
This section need not be completed if the pennil is for one hundred dollars ($100) or 'less..
o I certify that in the performance of the worK for which this permit is issued,~1 shaH not
employ any person in any manner so as to become subject to the worker's c0mpensation laws
of Califo'mia, and agree that if I should becom subject to th.e worker's compen$ation
proYisions of Section 3700 of the Lab Cod, shall forthwith . rovisions.
Date: 5/13/2005 Applicant:
WARNING: FAILURE TO SECUR . W
UNLAWFUL, AND SHALL SUBJECT EMPLOYER TO CRIMINAL PENALl'lES AND CIVIL
FINES UPl'O ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION 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 .eiv.C):
Lender's Information:
LICENSED ,CONTRACTORS DECLARATION
I hereby airm under pena~ of perjury that I am
licensed under provisions of chapter'g (commencing.
with Section 7000) Divs"ion 3 of the: Business and
Professio od
Contractor
EXPIRATION DATE
12/311200&
C39
Construcion Tvpes:
VN, ,
Fire Sprinklered?
NO
I certify that I have read this appHcation and state that the above Information IS correct. I
agree to comply with all city ordinances and state laws relating to buildtng construction, and
hereby author e epresentives of. this ctty.t enter upon the above mentioned property tor
IW lonp p
Date: 5/13/2005
Fees paid for Permlt:._
Total:,
310.95
ture of Applicant or Agent
The per shall expire by limitation and become null and void if the building or
work s not passed final inspection 365 days from the date of permit Issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
. INSPECTION DATE INSPECTOR
TemporartPower PQle
Plumbing (DrainlWastePipe) .
Electrical Ground Electrode/Uter
SetbacklFormsrrrenchllS (Footings)
. 00 not. install subflpor or pour floor slab until the
fol1owing applicable items have been signed:
Plumbing (Water Plpe.Sprinkler Valves)
Mechanical (Groundwork) . . .
Electrical (Underground Conduit)
Pre-slab (CompactionlM8l11brane:Keinr.
'Underpinning (Floor Joist/Girders)
00 not \:Over or conoeaHhe work below until the . . . ,
following applicable items have been signed: .
1st Floor Shear
Firesprinkler (Rough)'
2nd Floor ~
Roof ( . aphragrn'Frame)
Masonry (RelnfJBond Beam/Pre.Grout)
Rough Plumbing (Top Out) .' . .
Rough Mechanical . .
ROugh t:lectric all)
Rough Electrical
Framing (Only after Plbg., Elec.. Mech.. and Fire) .
lnsulallon (SoundlEnergy) .
po not tape or pla~ter until the following applicable
Items have been signed: . ".
Drywall
, PeitetrationS (Fire Rated) Electrical ,
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing . . .
Interior .Lath '. . .
Exter/orLath . .
GENERAL ITEMS
Exterior Plaster (Brown Coal)
T-Bar Electrical . I
T -Bar Mechanical . . .
T -Bar Structural'
Sewer .' '.
Water Engineering Backflow .
Water 'Service
FINAL INSPECTIONS . . Date Inspector
Electrical Final . . "
Plumbing Fin.al " ".
Mechanical Final .
Gas Test .
. .
E:ngineeringlGrading Final 765-5126 . . .
Fire Dept. Final. 765-4040 ,
.
Water Engineering 765-5268
Sub List/Business License. 765-519
Zoning 765-5139 ' './ I . /J / ~/
Building Final Itas! Inspection. Only Y3t/ I'l ~- (f;;;J~
. . fter AboveCOlT)pletel
. PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina.lnspecti6ns
Electricallnsbections