6083 E. Silverspur Trail
APPLICANT: MILES REED
OWNER INFORMATION: CONTRACTOR INFORMA'nON:
. LOI/isJ Montero HOYr ROOFS . t.
6029 E Camino Manzano 1809 N ORANGETHORPE pARK
Anaheim,.CA 92807, ANAHEIM, CA 92801 DODD!
, , BUSINESS PHONE: 714 n:C 1820 ,
JOe DESCRIPTION:Tear off existing roof and repl~ce with 1,9 squares of eagl'tte tile ICElOtl 4660.
VALUATION: 8,000.00 . . ,I PROCESSED BY: MSM
I OWNER-BUILDER_QE~LARATION
I bereby affirm under pena_ltY' of perjury that lam exempt from the Contractor'~ Lic;::~n-s~ Law for the following reason (Sec. 1031.5 Bi.ts:nes.s and
Professions Code: any City or county which requir:es a permit to c~trlJct, alt;~_r, -improve. demolish or repai~ 8f1Y struct~re. prior to, it.<; i,ssuance, also.
requires the applicant for such permit to file a signed. statement that-he is lice:\l$.~ Jj;)rsuant to the, pltJvisions of .the Contractor's License law (Chapter
9}(commencing with Section 7000 of Division 3 of ,the 'Busines's and Professj(~""!:il Cede) c"rtt;tat he is exempt therefrom 'and the basis'for the alleged '
exemption. Any violation of Section 7031.5 by any applicant.for a perrnitsut>.;ects the applicant fJJ' a dvU j)eooltv of not more than five hundred doUsrs-
tjO?)~s.~ner ofproperty; o~ my e~o~ees with wages as t~eij' sole comp,L~~a1iC;), wili do, the work, and the str~otur~ ;8 not intended or ~ffered for'
sale (Sec. 7044 Business and ProfeSsions Cod~: The Contractor's licens'e',-::,~..,,, does-not apply to an owner of prv.peliy who builds or improves
thereon, and who doeS such work l)imself or herself or,ttlrough hi$; or her'_ow'/ 6lTlployaes, provided that such irnprovement~ are flat intended or
offered forsale. "If, howevel\- ihe bUi~lngorimprovementis sold with on_e ye:!t of n,1:nptetion, the owner.b~lilder willt'tave the Durden of proving that,he'
did not bu,i1d or improve'for the pUlpose'of sale). .' . 't . .. . ,'.', .
o I. as the -owner of the property, am exdusi~'e~' contra,cUng with licenst"Q !L..-;ntraL1.0rs to construct ~l1e !:r~lect (8(;:,-:. 7044 Business and Professions
Code' 'The Contractor's lIcense law does not i.isPrt to an owner of propert> 't:~lt) bu~(.1S or imoravE's thereon, and who ca,1tr-aots for -;ul"'.tl projects with
~.contractcr($} licensed pursuant fJJ the Contractor's license Law). d "
LJ I am exempt under Sec. , 8 & P C. f{)j thIS reason: _ _____~___
Date: OWner: ;).__
I , WORKER'S COMPENSATION DECLARAflON t:.__,~_J f' LICENSED CONTRACTORS DECLARATION J
!;~erebY affirm under penalty of perjUry one of t~e fOliowing declarations: 1 ,I hereoy aftlil.l under penalty of PE!~Jury that I GlI11
o I have and will ~intain a certifrcate of oonsent to self~insure for worker:, ""'0r>lpen$~t:on l'tcenS3U t1 cr provis!Oos{)f chapter 9 (commencing
as provided for by Section 3700 of the Labor Code, for the rerformanre (lfth '. ';;crk fljj 'NhlCih
~.S permit is issued. 1
r: have and will maintain worker's compeo.'iation insurance, as reqUl~c! ,;;' !.::$:::tioii 3700 of I
the bar Code, for the performance of the work for which this permit IS iSSUJ,.1. My 'Non~e:'~ I
Compensation Insurance carner and policy are:
Carrier: STATE FUND PolICY Number. 1700471 ":'~
This section need not be comPleted if tl)e pennit is fpr one hundred dollars ($1()Ci~-r less.
~" ,I certify that in:the performance of the work for w hic;h,this_permit is i~tlf',:i~,~.:~':-Sha!!TlCit I
m oy any person in any manner so as to become subject to the worker's cdYtc'er.sation :aws
df Califomia, aod agree that ifl should becomesu~ct to the wo.rker's com~h~ation
provisions of Section 3700-ofthe abor C ~ !.shaD forthwith comply wi th-hl% pi"ovisiGns. Construcion rvpes:
__/ . ~: - , , :{';':,. v N, .
Date: 2/8/2005 Applicant: . J ~~'. ;; F'ire Sprtnklered?
WARNING: FAILURE TO SECU WORKER'S COMPENSAT!ON COVER4"~E IS
UNLAWFUL. AND SHALL SUB CT AN EMPLOYER TO CRIMINAL PENALTiES AND CIVIL
FINES UPTO ONE HUNDR THOUSAND DOLLARS ($100,000), IN ADDi;iON TO THE
COST OF COMPENSATIO' , DAMAGES AS PROVIDED FOR ,IN SECTION ~?oa OF THE
LABOR CODE, INTERES, AND ATTORNEY'S.FEES.
I . CONSTRUCTION LENOING AGENCY
Itlf?:rf.t;v _3ffinn\,-lnder PEmalty of periury .that Jht3r.3 JSJ:l..!xmstn.lctionlem1in:l F.I':S!'1f.:'.Y J;Jr.tbe
periotm3"n,Ce.;;tth-e~work tOr whiCh this perrnit js:jssued ($ec;:3097~Ci.....C):- < '..
Lend~r's Information:, .',
BUILDING PERMIT NO, BL02005-00353
.
lYPE OF PERMIT CITY
Reroof
DATE: 218/2005
JOB ADDRESS: 6083 E SILVERSPUR TRL
LEGAL DESCRIPTION: N'TR.10800 LOT 39
BUiLDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REOUEST LINE:
(714) 765- 4626
CENSUS CODE: 555
QUARTER SECTION: 192
ARCHITECT/ENGINEER INFORMATION:
EXPIRATION-DATE.
12/31i2006' .
C39
.~:
I certify .that I have -read this application and state that the above information IS correct.' J
agree to comply with all city ordinances and state laws relating to buU.ding construction. and
he y_au 0 ize representives ot'this city to enter upon the above mentioned property for
insp io pur ses.
I
, . Date: 2/8/2005
Signature of Applicant or Agent
The p mit shall expire by limitation and become null and void if the building or
work as not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue Work.
NO
-,----.-------.-----
,
Fees paid for ~ermit:
TOlal:
160.91
, INSP~CTION RECORD
, " INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipel
Electrical Ground ElectrOde/lifer ','
SetbacklFormsfTrenches (FC)()tings) ,
Do not install subfloor or pOUr floor slab until the
following applicable items have been signed:
Plumbing lWater Pipe.Sprinkler valves) , "
Mechanlcal(GroundwOrk) , ,
Electrical (Un(jergrouna Conduit) , '
Ip.re-slab (Compaction/Membrane.Rein!.
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the ,
following appH9able'items have been signed:
1 st Floor Shear ' ' ,
Firesprinkler(RQugh) , , ,
2nd Floor Shear ~",'
~athi hragrnlFrame) 11IJt>10r
MaS ry ReinfJBond BeamlPre-Grout) , / '
Rough Plumbing' (Top Out) /
Rough Mechanical, , ,
Rough l:Iectncal aliI, ,
Rough Electrical ' ,
Framing 'IOnlyaher PIbg,. Elec.. Mech.. and FifE) ..
Insulation (SoIlndlEnergy) , , ,
"
Do not tape or plaster until the following applicable,
items have been signed:' , ,
Drywall " , ,
Penetrations (Fire Rated)'Electrical
Penetralions (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing , , ,
Interior Lath , ,
Exterior Lath "
, GENERAL ITEMS' "
Exterior Plast,er (Brown Coat)
T -Bar Electrical
T-Bar,Mechanical " ,
T-Bar Structural "
Sewer
Water Engineering Backflow
Water ServiCA ,
FINAL INSPECTIONS " Date ' ,~nspeclor
Electrical Final .- " "
Plumbing Final ,
Mechanical Final ' ,
Gas Test , .' ' .. " '
Engineeril!!J/Grading Final, 765-6126
Fire Dep\. Final 765-4040, "
Water Engineering 765-5268 " ,
Sub List/Business License 765-51,9 ,
Zoning 765-5139 ,
Building Final ~ast Inspection- on'~11 12 ~ ,(.1- ;.,
, fter Above Complete - _
PARTIAL INSPECTIONS
Buildina Inspections
, Mechanicallnspectioils
Plumbina Inspections
. ElectricallnsDections