6079 E. Silverspur Trail
. TYPE "OF PE~MIT .
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: .555
QUARTER SECTION:. 192
BUILDING PERMIT NO. BLD200S-00048
DATE: 1/10/2005
JOB ADDRESS: 6079 E SILVERSPUR TRL
LEGAL DESCRIPTION: . N TR 10800 LOT 40
CONTRACTOR INFORMA'nON:
HOY!" ROOFS
1809 N ORANGETHORPE P"-RK
ANAHEIM, CA 928010000 :
BUSINESS PHONE: 714 773~1820
JOB DESCRIPTION: Tear oflshake and re-roof 15 squares of "Eagleiite Tile" (ii,5IbS,) ICBD# 4660,
VALUATION: 7,000,00
I., OWNER-BUILDER OECLARATION
-, hereby affirm under penalty of perjury that I am exempt from the Contractor~ License Law for the following reason. (Sec. 7031.5 Bus-iness and
. Professions Code: any PtY or county which requires a permit ~o constr.uct,att~r. improve, demolish or repair any structure, prior to its issuance, also
requires the applicantfor such permit to file a signed statement that he is Iicepsed pursuant,to the provisions of the Co:ntrador's license Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and ProfeSsiQ;1S Code) o/that he is exempt therefrom and the basis for the alleged
~xemption. Any violation of Section 7031.5 by any applicant for a permit slIbi:acts the applicant to a dvn penalty of not more tha n five hundred dollars
($500). . . . . .il . .
.0 I; as owner of property, or my employees with wages as their SOle com):{-rsation. will dothe work"and the structure_ is not intended or offered for
sale (Sec. .7044 Business a nd Professions Code: The Contractor's License U..w does not apply to an owner of property who builds or improves"
. thereon, and _who does.such work hi.~elf or herself or through his or her o'JJ1t,employees. provipecl that sUch improvements are not intended or
'offered'torsale. If, however, the building or improvement is sold with one yei,.' of completion, the owner-builder will have' the burden of proving that he
did not build or improve tor the pljrpose of sale). .' I ' '
[J J,as the owner of the property, 'am exdusive!y ~ontracting with licensed tontractors to construct the project (Sec. 7044 Business and Professions
Code: The COl1tractor's License Law does not-apply to- an owner af property ~...ho bunds or improves thereon, and who contracts for such projects with'
f.LQontractor(s) licensed pursuant to the Contract?'"'s License Law). . '
U I am exempt under Sec. :. '. .B&P.C.forthisreason: ____
Date: Owner:
I WORKER'S COMPENSATION DECLARATION '
I hereby affirm under penalty ,of perjury one of the following <;feclarations. ,
o I have and wili ma intain' a certificate of Consent to self-insure for work.e)'~ compensation,
as provided for by Section 3700 of the Labor Code, for the performance of th~"woTk for which
\~hjs permit isissu'ed. " '1
.pt} ", have and. will maintain wofker's compensation insurance, as required. t:~ Section 3700 of
~aQor,Code, for the performance of the work for which this permit is isSU4.t Myworker.s
Compensation insura nee carrier and policy are: '
Carrier: STATE FUND' Policy Number: 17004714,0;2
~ '..'
This section neO<! not be completed if the pennil is for one hundrO<! dollar. ($1 J~.or less.
& r c~rtjfy that in the performance of.the work for which this permit is iSsue::i. (shan not
~oy any. person inany manner so as to becomesub,ject to t~e worl<ers_'~drtlpensationla~s
of Califomia. and agree that if I.should become subject to. the worker's com~%ation '
provisions of S~tion 37000 ~ Labor de. I sha~ fa IWith~~ with t.hfse PrOVisions." SO~:t~cion Tvpes:
Date: 2/8/2005 ~ .
WARNING: FAILURE TO. SEC EW R'S COMPENSATION COVER>\GE IS
UNLAWFUL, AND SHALL SU JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUND 0 THOUSAND DOLLARS ($100,000), IN AO/iJ;l1ON TO THE
COST OF COMPENSATt ,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNE;Y'S FEES.
I CONSTRUCTION LENDING AGENCY _
.J hereby_affirm underpenatty.:_of perjury thaUhe!"~ is a constructlonJ.enQ.inQ aF~~ncy for the
performance of the work-for which this permit is issuecHSec. 3097,Civ.C):
Lenderslnforrnation:
APPLICANT: MILES REED
OWNER INFORMATION:
GEORGE MIOL
"6'079 E. Silverspur Trl
Anaheim, CA 92807
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MSM
---1
LiCENSED CONTRACTORS DECLARATION
I hereby affirm under: penalty of perJury that I am
licensed IJnder provisions of chapter 9 (commencing.
with Seer n 7000) of .':.vsion 3 ot the Business and
'Professio . Code. .
2/8/2005
Date:
NUMBER
606111
TYPE
EXPIRATION DATE
12/31/2006 .
I certify that I have read this application and state that the above information is correct. I
agree.to comply wjth all city ordinances and 51.ate laws relating to buDding construction, and
er y authorize representiVes of this city to enter upon the above mentioned property for
eclion purposes. . ~ /::? ."', .
~, . Date: 2/8/2005.
- Signature of Applicantor Agent ..
per hall expire by limitation and become null and void if the building or
rk has not passed final inspection 365 days from the date of permit issuance.' A
w permit is required to commence or continue work.
Fees paid for Permit:
Tala':
365.49'
INSPECTION RECORD
. INSPECTION DATE INSPECTOR.
Temporary Power Pole
Plumbi ng (DrainlWallte Pipe) . .
Electrk;al Ground Electrode/Ufer
Setback/FormslTrenches (Footings I .
Do not install subfloor or pour floor slab until the
folloWing applicable .items have been signed:.
Plumbing (Water Plpe.Sprinlder Valves) . . .
Mechank;al (GroundWork)
Electrical (Underground Conduit) . .'
Pre-slab (compactiOl)lMembrane.Reim. .
Underpinning (Floor JolstlGirders)
Do not cover or conceal the work belOV\' until the .'.
following applicable items have been signed:
1st Floor Shear .
Firesprinkler (RoUgh) .
2ndFI -riuJ. .
Roftf (She aphlllgm'Fr3Jle) YJ~fO'\ ,
Masonry (ReinfJBond BeamlPre-Grout) /
Rough Plumbing (Top Out) . . /
Rough Mechanical. .'
I~ec III)
Rough Electrical .
Framing (Only after Plbg.. Elec.. MeeD., and Fire)
Insulation (SoundlEnergy)
po not tape or pla~ter until the following applicable
Items have been signed: . .' .
Drywall . . ...
Penetrations (Fire Rated) Electrical
Penetrations (FIle Rated) Mechanical . .
Penetrations (FlIll Rated) Plumbing
Interior Lath .
Exterior Lalh .
GENERAL ITEMS
Exterior Plallter (Brcmn 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 . .. .
: .
Engi.-ringlGrading Final.765-G126 .
Fire D\lpt. Fina/165-4040 . .'
. . '.
Waler Engineering 765-5268 .
Sub List/Business License 165-519.
Zoning 165-5139 J' .
Building Filial ~ast1nspeclion. Only' t:z,t15 ~ ,"" J J .
'. . fter Above Complete) -
PARTIAL INSPECTIONS
Buildinq Inspections
. Mechanical. Inspections
PlumbillQ Inspections
Electrical Inspections