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981 S. Siet Pl. TYPE OF PERMIT Residential Remodel CITY DATE: 6/27/2005 JOB ADDRESS: 981 S SIET PL LEGAL DESCRIPTION: N TR 3706 LOT 25 ElM ,BUILDING DIVISION 200 S, II,NAHEIM BLVD, (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 125 BUILDING PERMIT NO. B,LD~ilo5.01877 APPLICANT: YOLANDA HUAPAYA OWNER INFORMATION: CONTRACTOR INFORMATION: MCCORMACK ROOFING CO 4091 E LA PALMA AVE #T ANAHEIM, CA 928070000 BUSINESS PHONE: 714630-,,543 JOB DESCRIPTION:Re~pitch existing flat roof to 4/12 and re-roof remaining 19 squares of existing roof with Gerard Metal shakes 1.4 p/sq. ft. NER42 to VALUATION: hou~~,l18g,8arage, PROCESSED BY: ENO I OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law forthe following reason (Sec. 7031.5 Business and Professions Code: any city 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 licen:~d 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 sUbje'~ts 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 8usinessand 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 helSe!f or through his or her own omployees, 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 thaHii3 did not build or improve for the purpose of sale). D I, as the owner of the property, am exclusively contracting with licensed C{,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 I hereby affirm under penalty of perjury one of the following declarations: o I have and will maintain a certificate of consent to se~-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the ;NOI1<. for which this permit is issued. 1)(J I have and will maintain worker's compensation insurance, as required by ~3ection 3700 of ~abor Code, for the performance of the work for which this permit is issued, Myworker's Compensation insurance carrier and policy are: Carrier: AMERICAN INTERNATIONAL GROUP Policy Number. WC070104020Q001 ARCHITECT/ENGINEER INFORMATION: CHARLES A JOHNSON JR P,O, BOX 6284 GARDEN GROVE, CA 92846 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) Divsi n 3 of e Business and Professio s This section need not be completed il the pennit is IO!' one hundred dollars ($100) cr less, ~ certify that in the perfolTYlance 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 corrpensation laws of Califomia, and agree that if 1 should become subject to the worker's compensation pro.visions of Section 3700 of the abor C I aU rth i comply with those provisions. Date: 6/27/2005 Applicant: WARNING: FAILURE TO SECU UNLAWFUL, AND SHALL SUBJ CT FINESUPTOONE HUNDRED 0 AN COST OF COMPENSATION, AMAGE PROVIDED FOR IN SECTION LABOR CODE, INTEREST D ATTORNEY'S FEES, CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending age'lcyfor the performance of the work for which this permit is issued (Sec.3097.Civ.C): Lender's Information: NUMB 643700 TYPE EXPIRATION DATE 6130/2006 C39 Construcion Tvpes: VN, , Fire Sprinklered? NO ~.L I 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 construction, and hereby authorize presentives of this city to enter upon the above mentioned property for in ecti rpo Date: 6127/2005 Fees paid for Permit: Total: 601.38 null and void if the building or City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbino IDrain/Waste Pipe) Electrical Ground ElectrodeNfer SetbackfFormsrrrenches (Footings) Do not install subfloor or pour floor slab until the following applicable items have been signed: Piumbing (Water Pipe/Sprinkler Vall/es) Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1 st Floor Shear F/resprinkler (Rough) 2nd Floo~ar ~eathidalDiaOhragm/Framllo{~ Masonry llfEiinf Jaond Beam/Pre-Grout) Rough PlumbIng (TlIP Out) Rough Mechanicat <!"Ie.,.l ~ V~) 7t3-oC ~/... Rough Electrical.lDrv Wall) / Rough Ele<;Ifica(. ~fyll' W ~-IJ .~ 2, Framing (olo!{.'tt~~~'~.AndF""1 '/ 7-/)--'" (:--'1 Insulation (Sound/Energy) Do not tape or plaster unlllthe following applicable items have been signed: Drywall Penetrations (Fire Rated) Eleclrlcal 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 Backflow Water Service '- f..~ FINAL INSPECTIONS Electrical Final Plumbing Final Mechanical Final Gas Test Engineering/Grading Final 765-5126 Fire Dept. Final 765-4040 Water Engineering 765-5268 Sub List/Business License 765-5194 Zoning 765-5139 Building Final (Last Inspection - Only After Above Complete) DATE INSPECTOR PARTIAL INSPECTIONS Mechanical Inspections 7,-/l-D'>~ f "Cr/l/:f (- i/ ,'(2 1li.".-kJ( 6. ..f-~I '-4 Plumbina Inspections Electrical Inspections