1414 E. South St.
BUILDING PERMIT NO, BLD2005-00540
.
.
TYPE OF PERVon' C IT'Y
Reroof
DATE: 3/2/2005
JOB ADDRESS: 1414 E SOUTH ST
LEGAL DESCRIPTION: N TR 3371 LOT 111
APPLICANT: MIKE CARSON
OWNER INFORMATION:
Joseph J Shingle
1414 E South St
Anaheim, CA 92805
CONTRACTOR INFORMATION:
CARSON ROOFING AND.WINlJOWS
141 N LOHRUM LN
ANAHEIM, CA 92807000fY ,
BUSINESS PHONE: 714635491:<
JOB DESCRIPTION: Tear off existing and reroof 24 squares with 30-year COiTlpositibn shingle.
BUILDING DNISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
1NSPECTION'REOUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 104
fr:/-
ARCHITECT/ENGINEER INFORMATION:
P,ROCESSED BY:. JNJ
VALUATION: 3,800.00 i !
I OWNER.BUILDER \J!:CLARATION
~ hereby affjrm onder~nalty of perjury that I am .exempt from the. Contracto:-'f, Lichnse Law-for the folfowing reason (Sec. 7031.5 Business and
ProfessionS ,cod~: any city or county which requires a.permit to constn;ct, a!t~.;-. i(i{prove,"oemolish or repair any structure, prior taits issuance; also.
requires the appli.cant for such permit to file a signed statement that he i$lk:eAsedJpureuant to the provisions of the Contractor's license Law (Chapter
9)(commencing withSection 7000 ofDivisiQn.3 of the Business and ProfeSsi,";~i:; COlie) or that he is exempt therefrom and the basis for the aHeged '
~xemption. Any violation of Section 7031.5 by any'applicant for a permit SUbr~cts\he applicant to a civU penalty of not-more than five hundred dollars
($500).' . .... '1 " .'
o !, as owner of property, or my employees with wages as ,their Sole compens';a'=;ol1,wiU do the work. and the structure is 110t intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License L~'N r;?eS not apply to an owner of property who builds or improves
the-reon,'and who does such work himself or herself or through his_ot 'herown}.?f[l.p~oyees, provi_aed that such improvements are'not intended,or
, offered for sale. If, however, the build'ing or improvement is sold w:ith _one y~,~:; of._Ccrr:p1etiof), the owner-builder will h,ave the purden of proving,thalhe "
didnotbu~dor'!mproveforthepurposeofsale).. '"I,':' . '. ,
. O. I,'as the owner of the property, am'eXdusively contracting with Iiceneed (biifr.3dcrs to construct the project (See. '1044 Business and Professions
Code:, The Contractor's License Law doeS not apply to an owner of'proporty -;';!lYJbGilds_Ol irl1proves thereon, a~ who contracts for sum projects with
~ontractor(s) licensed pursuant to the co'ntractor's. License Law}..
L-.J I am exemptul"!derSec. .", B & P.C. for this reMan: __~,,__,
Date: Owner:
I.. WORKER'S COMPENSATION DECLARATION ::'~C'::::"""'_.J
I hereby affirm under penalty of perjury one of the fqllowing de~l_aratjons: . 1.
o I have and will maintain a certificate of ronsent to self-insi.lre fur workGr's;toriipensatiQn, ,
,as provided for by Section '3700 of the Labor Code, for the perfOtmance of1h&;'-;"'-:)'~.( for-which ,
isr;,.mij is Issued. . . ." ! : .
ve and will maintain worker~s compensation ir:surance, as reqUired by ~~.:::tion 3700 of
the labor Code, for the 'performance af the work for which this permit is i3SiJp.d, My worker's
CompensatiOn insurance carrier and policy: are:
Carrie~: STAT,E FU,/'JO ,Policy Number.' ~354537 ,
This seetion need not be completed if the pennit is for one hundred dollaffl. ($1 OD} ;r)ess.
o I certify that In toe. perfo-rmance of the'work for which this permit is' i~'uedtj'shall not
employ any ~rsqn in a ny man ner so as to become subject to the worker~ COfl':ipensation laws
of Califomia, and'agree that if I should become subject. to the'w mer's compcrifation
provisio~s of Section 3700 ofthe labor Code, I shaD forthwit lilply wit;} tt-JO>j~ provisions.
LICENSED CONTRACTORS DECLARATION .;
,I hereby a irm under penalty, of perjury ,that I am
licensed under provisions of chapter 9 (commencing
with Section70 ) of Divsion 3 of. the Business and
Professions G e.
3/212005
Date: ~-
NUMBER
661526
TYPE
.,
. Date: 3/212005 Applicant: ./
WARNING: FAILURE TOSECU WORKER'S COMPENSATION COYE,RA.qE IS
. .UNLAWFUL, AND SHALL SUB CT AN EMPLOYI:R TO CRIMINAL PENAl.1.:ES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDlr ON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3.'06 OF TH.E
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY.. '.__
i l1si'et.y-af~irm .Unoe:r-pena!ty of. perjurY-lhal:rflere~'a,,"Qi'l:s>-tr;j6~b';;:ri-~';;~!'~~-:l~::.i....~~Y-f:;'~ -~~e'
performance of the work for whichlhis permit'is issued (See. 3097 ,Civ ,C): '
lender~s Information:'
Construcion Types:
VN. .
I qertify that. I have read this application and state that the above, information is correct. I
agree to comply-with all city ordi ces and state laws relating to 9 construction, and
he eby authorize representiv' this city to enter u a \Ie mentioned property for
i spection purposes.
Contractor
EXPIRATION DATE:
12131/2006
C39
"
Date: 3/2/2005
235.33
Sign _ re of Applicant 9r Agent . .
The permit shill I expire by limitation and become null and void if the bunding or
work has not passed final inspection 365 days from the date of permit issuance, A
. new permit is required to coinrnence or continue work,
Fees paid for P19rmit:
Total:
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe) , I' '
-Eiectrical Ground Electrode/tHer ,
SetbacklFormsrrrenches (Footings)
Do not install subfloor or pour floor slab until the ,
(ollowingappliCable items have been signed: '
Plumbing (Water Pipe.Sprinkler Valves) ,
Mechanical (Groundwork) , ,
, Electrical (Underground Conduit)
Pre-slab (l.OompactionlMembrane.Reinf. , , '
Underpinning (Roor Joist/Girders) "
Do not coverQr conceal the war!< below ,until too
fOllowing applicable ilems have been signed:
1st Floor Shear' , , , "
Firesprinkler '(Rough)
~ " , .-.: , d.
Roof athi . aphragnvFrane)' , '!,Ph;' ~'b<-tG1l
Masol1l'Y " ondBeanJPre-Grout)
Rough Plumbing (Top Out) ,
Rough Mechanical -
, Rough 6ectr oil)
Rough Electrical ,
Framing (Only afterPlbg., Elec.. "'.ledt, and Fire) .
Insulation (SoundlEnergy} , "
po ,not tape or pla~ter until the fo/lowingapplicable
Items have been sIgned: , ,,' , ,
DrYwall ' ' ,-
Penetrations (Fire- Rated) Electrical
Penetrations (Are Rated) Mechanical ','
Penetrations {Ale Rated) Plumbing ,
Interior Lath
Exterior Lath ,
, ' GENERAL ITEMS
Exterior Plaster, (Brown Coat) , , -
T -Bar Electrical ,
T-Bar Mechanical "
T-Bar Structural ,
Sewer ' , " .
Water,Englneerlng Backflow ,
Water Service
FINAL INSPECTIONS,
Electrical, Final
Plumbing Final,
Mechanicall=lnal
Gas Test
Engineering/Grading I=lnal 765-5126
Fire Dept. Final 165-4040
Water Engineering 165~5268
Sub List/Business License 165-519
Zoning 165-5139
Building Final (Last Insl'"!'lion. Only'
, After AboveComp~te)
PARTIAL INSPECTIONS
Buildina Inspections
Date 'Inspector
.'
, .
, MechanicallnSDections '
, Plumbina InSDections
ElectricallnsDections