1239 S. Silver Star Way
CONTRACTOR INFORMATION:
CREATE A SCAPE
4962 VAN BUREN ST
YORBA LINDA, CA 92886 0000
BUSINESS PHONE: 714524-0157
JOB DESCRIPTION:Build 72 sq. ft. patio cover per city specifications.
VALUATION: 3,000.00
I OWNER-BUILDER DECLARATION
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, atter, 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 Djvision 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 subjeGts the applicant to a civil penalty of not more than five hundred dollars
($500).
D 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,employees, 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 pUlpose 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 w~o 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
r;h eby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to se~-insure for worker's compensation,
s provided for by Section 3700 of the Labor Code, for the performance of the work for which
~hiS rmit is jssued.
I ave and will maintain worker's compensation insurance, as required by Section 3700 of
e Labor Code, for the periormance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: EXEMPT Policy Number. 853317
BUILDING PERMIT NO. BLD2005-03483
TYPE OF PERMIT CITY
Patio Cover
DATE: 11/1/2005
JOB ADDRESS: 1239 S SILVER STAR WAY
LEGAL DESCRIPTION: N TR 14193 LOT 24
APPLICANT: RUSS ROTH
OWNER INFORMATION:
JEFFREY KRIJAKIN
1239 S SILVER STAR WAY
ANAHEIM, CA 92808
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 227
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: ENO
This section need not be completed if the pennit is for one hundred dollars ($100) or less.
~I certify that in the perionnance 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 worke~s compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor Code, I orth amply with those provisions.
-=:---
Date: 11/1/2005 Applicant:
WARNING: FAILURE TO SECURE ORKER'S COMPE SATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED USAND DOLLARS ($100,000), IN ADDlllON TO THE
COST OF COMPENSATION, DA AGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AN ATTORNEY'S FEES. >
C' STRUCTION 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.Civ.C):
Lender's Information:
I certify that I have read this application and state that the above information is correct. t
a~ to comply with all city ordinances and state laws relating to building construction, and
h<\reby authorize reple(\'n2es ~f ity to enter upon the above mentioned property for
inspecti purposes.
Date: 11/1/2005
Signature of Applicant or Agent
ermit shall expire by limitation and become null and void if the building or
wo has not passed final inspection 365 days from the date of permit issuance. 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 Di\lSion 3 of the Business and
ProfessioQ(' Code. rv "I::> <=...
11/112005 "~~
Date: - Contractor
NUMBER EXPIRATiON DATE
853317 11/30/2006
TYPE C27
Construcion Tvpes:
V N, ,
Fire Sprinklered?
NO
Fees paid for Permit:
Total:
319.77
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Ufer /
SetbacklFormsfTrenches (Footinasl /! .z-u') Ii'h -
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 Conduit) /! 1-2.-tJ\ //. ,
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:
1st Floor Shear
Flresprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame)
Masonry IReinf.lBond Beam/Pre-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 Coati
T -Bar Electrical
T-Bar Mechanical
T-Bar Structural
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS DMEt I INSPECTOR
Electrical Final IAn , -./'1, I
Plumbing Final I! /
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 List/Business License 765.5194
Zoning 765.5139 ,
Building Final (Last Inspection. Only '/~ .lAI)D~{
After Above Complete)
I
PARTIAL INSPECTIONS
Buildina Insoections
Mechanicallnsoections
Plumbina Insoections
Electricallnsoections
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Detail
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SIDE VIEW SECTION
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Footings:
Posts:
Headers:
Rafters:
Solid Roof:
Lattice Cover:
12" a.c.
13' -0"
19'-0"
20' -0"
20' -0"
20' .0"
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(9'
. Header span
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Overall span
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Building Division Approval
12"
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f.'" .,~
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FRONT VIEW ELEVATION
-1b.. inches square x 12 inches deep
~"x~"
(or) two "x___"
"x~"spaced~"oncenter OR
Two _" x "spaced " on center
J _" Rated plywood sheathing with exl. glue
_" x olid wood sheathing
With
roof covering
_" space~ _" on center
RAFTER SPAN: #2 Douglas Fir
Lattice or solid roof.
Rafter
Size
2x4
2x6
2x8
2xl0
2x 12
Rafter Spacing
16"o.c. 24"o.c.
Max. span of
rafter with a
2' overhang
MAXIMU)\'( HEADER SPAN AND FOOTING SIZE
~~~~2:; .~~~2~i(':;;E~' ;1~1~tk ;~8~;<~~iz~~; ':~i~li: ;~!f~;:i'
32"o.c.
8' .0"
THE ISSUANCE: OF THIS PERMIT DOES
NOT APJ:"~OVC: 'JloLATION OF ANY OF
THE eUILOING (lootS OF THE. CITY.
THE HOLCe:f't of>' THIS PERMIT
PAOOe.e:DS AT HIS OWN RISK.
I BY
1 FLOOD ZONE ~
I
I HISTORiC DI.;;TRICT n~VIE'.N:
! ____i:!l c. ~':'~_::.~:-_:.:::::_~.:_ p.?.~.1)
J SEE C~~!t~L;~(~\,;i ;~;~;i~e FOR
t A.NY CC~,'I)1T!G,\JS
ll"iti..i~l
NOV 0 1 2005
BUILDING DIVIS~DN OF A A
APPRO
BY
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.pi~ipiiUi:i.sq:';;.5'feel.
j,;~;~:t.~' . :'ti;:~?:t ::*i,~~~f~;:t :I?1~~iIi~"'.
: 5~.~~7 (8',f6.n:~;. ?:~p;~..8;r\\ P!.~:,:
Up to 14 ft. 6'~3" 9'-3" 12>.3,,2 <:"lS;:O~:1.<
Up to 20 ft. dfg;:~1':4 ...~'~;:!;i::;: ';0!i:~tiL: J::H~~Z;":~
SIZE OF FOOTING: 12 inches square and 12 inches deep unless otherwise noted per footnotes:
1. May set on existing 3 112" slab. 2. IS" square - 12 inches deep. 3.21 inches square.. 12 inches deep.
Up to 8 ft.
11' - 6"
9' -6"
17' -0"
13' - -9"
12'-0"
15' - 3"
18' - 6"
20' -0"
20' -0"
17' - 6"
20'.0"
20' -0"
20'-0"
20' -0"
Date: 1/
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