1763 Siva Ave
DATE: 6/3/2005
JOB ADDRESS: 1763 W SIVA AVE
LEGAL PES9RIPTION: . N TR 2377 LOT 194
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153.
INSPECTION REQUEST LINE:
(714)765 - 4626
CENSUS CODE: 555
. QUARTER SECTION: 48
BUILDING PERMIT NO. BLD2005-01668
"TYPE OF PERMIT CITY
Reroof
CONTRACTOR INFORMATION:
HOYT ROOFS .
1809 N ORANGETHORPE PA~K
ANAHEIM, CA 928010000 j,
BUSINESS PHONE: 714773-1820
JO~ DESCRIPTION: Tear off exi~ting and reOrool 19 squares of composition shi~gres.
V ALUATION:4,000.OO
I OWNER-BUILDER DECLARATION
I hereby affirm'urider penalty of perjury that I am exempt from the Contra_clor's'License Law for-the following reason (5,60. 7031.5 Business and
P'rofessions,Code: any city or county which requires a permit'to construct; alter) improve, demolish or repair any structl:l,re, prior to its ,issuance, also
requires'the applicant for such permit to file a signed statement that he is licenSed pursuant to th.eprovisions of the, Contractor's License Law (Chapter
9.Hcommencing with Section 7000 of Division 3 of the Business and Profession~ 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 sUbjedts the applicant to'a civil penalty of not more than five hundred doltars
($500). .. .... . !,' . .. . . . . .
D I, as owner of property, or my employees with wages as their sole compen~ation; will do the work, afld th~ structure is not int~nded or offered for
sale (Sec. 7044 Business and ProfesSion'S Code: The Contractor's License 'La~ does not apply to an owner of property who builds or improves
thereon, a:~d who does such work hrmself or herself or through .his or her own employees, provided that such improvements are not intended-o~
off~red for sale~ 'If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving tliat he
did not build or improve for the purpose of sale). I
D' I, as the owner of the property, am exclusively <?ontractlng with licensed eo;htractors10 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). . ;1" .
D. 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: i
D. I have and I'!III maintain a certificate of oonsent to seff-insure for workefs cOmpensation,
as provided fo~ by Section 3700 of the Labor Code, for the pelformance of the ,#ork for which
~i permit is,issued. . ~ ..
"-have and wiil 'maintain wor1<er's compensation insurance; as required by Section 370q of
t:le Labor Code" for th~ performance of the work for which this permit is issued,:, Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE R.JND Policy Number. 1700471-02
APPLICANT: JONATHAN ACOSTA
OWNER INFORMATION:
Barbara Giglio
1.763 W Siva Ave
Anaheim, CA 92804
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with ection 7000) of Divsion 3 of the Business and
Profes .. ns C
Thlssecti"on need not be completed if the permit is for one hundred dollars ($100) 01' less.
~ertify that in theperfonnance of the work for.v.:hich this p~rmit is issued, i shall not
employ any person In any manner so as to become subjecHo.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 the bot Cod~e, ~II fo.rthWith~Se provisions.
Date: 6/3/2005 Applicant:
WARNING: FAILURE TO SECU WO 'S COMPENSATION COVERAGE IS
'UNLAWFUL, AND SHALL SUB CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRE lHOUSAND.DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR COO.E, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
, hereby affirm under penalty of perjury that there .is a construction lending agen.cyfor the.
performance of the work for which this permit is issued (Sec.3097',Civ.C):
lender's Information:
Contractor
EXPIRATION DATE
12/31/2006
C39
Construcion Types:
VN"
Date: 6/3/2005
$ignature of Applicant or Agent , . ,
ermit shaJ'lexpire by limitation and become null and void if the building or
war has not passed final inspection 365 days from the date of permit issuance. A
new' permit is required to commence or continue wOr~
Fees paid for Permit:
iotal:
160.61
INSPECTION RECORD
, , ,INS'PECTOR '
INSPECTION " DATE
Temporary Power Pole
Plumbing (DrainlWaste Pipe) ,
,Electrical Ground Electrode/Ufer ,
SetbacklFormslTrenches (Footings) ,
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
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 sl. Floor Shear ,
Firesprinkler (Rough) ,
2nd Floor Shear , , / /'
Roof (SheathinglDiaphragmlFranie) 1-;;
Masonry (ReinfJBond BeanlPre-Grout)
Rough Plumbing (Top Out) , ,
Rough Mecl!anlcal, ' , ,
Rough Electrical (Dry wall)
Rough Electrical ,
. ,Framing (Only after Plbg... Elec.. Me(::h. and Fire)
Insulation (SoundlEnergy) ,
po not ,tape or pla~ter. until the ~ollowin9 applicable
Items have. been signed:. .'
Drywall
PenetraticlIls (Fire Rated) Electrical ,
Penetrations (Fire Rat\!d) Mechanical ,
Penetrations (Fire Rated) Plumbing ,
Interior Lath "
Exterior Lath ,
, , GENERAL ITEMS
Exterior Plaster (Brown COat)
T.Bar Electrical '
T.Bar Mechanic,al
T ',Bar Structural
Sewer ,
Water Engineering Backflow
Water Service
FINAL INSPECTIONS . Date Inspector '
I;lectrical Final , ,
Plumbing Final
Mechanical Final ,
Gas Test . . ' . ,
,Engineeri!'QIGrading Final 765-5126 ' .
Fire Dept. Final 765-4040
Water Engineering 765.5268 ' ,
,sub List/Business License 765.519 ,
Zoning 765-,5139 " , ~,
BuildlngFinal ~ast Inspection: Only, 7j;1o~ VJ /~
, 'fter Above Complete) ~ '
- --,.
PARTIAL INSPECTIONS J)L/~?:;
, Buildina InSi4ctions /
, t* Z ,'tt.~K t'iIJ?r" ?y JhikI ;;.J()rJY
Mechanicallrisoections ,
Plumbina Insoections
Electricallnsoections