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1932 W. Sloop TYPE OF PERMIT CITY Reroof DATE: 11/14/2005 JOB ADDRESS: 1932 W SLOOP AVE LEGAL DESCRIPTION: N TR 3247 LOT 7 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REOUESTLINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 43 BUILDING PERMIT NO. BLD2005-03608 CONTRACTOR INFORMATION: ADAMS ROOFING 3435 S SILVERSPUR SANTA ANA, CA 927040000 BUSINESS PHONE: 714 965-0245 JOB DESCRIPT10N:Tear off existing roof and replace with 10 squares of bUilt-up roof and 15 squares of 30 year composition shingles with' 2 layers of 15 VALUATION: lb. fe~:oOo.oo PROCESSED BY: MSM APPLICANT: ADAM THORIN OWNER INFORMATION: NEAL L KAPP 1932 W SLOOP AVE ANAHEIM, CA 92804 ARCHITECT/ENGINEER INFORMATION: OWNER-BUILDER DECLARATION I hereby a irm un er penalty of perjury that I am exempt from the Contractor'sUcense Law for the following reason (Sec. 7031.5 siness and Professions Code: any city or county which requires a permit to construct, altet, 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 Division 3 of the Business and ProfessiDr)sCode) 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 subjects the applicant to a civil penalty of not more than five hundred dollars ($500). o 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 helSelf or through his or her own l~mployees, 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 purpose of sale). o I, as the owner of the property, am exclusively contlactlng 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 who builds or improves thereon, and who contracts for such projects wnh ~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 hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the Work for which ~. permit is issued. I have and will maintain worker's compensation insurance, as required by S.' ection 3700 of e Labor Code, for the performance of the work for which this permit Is istwed. Myworker's ompensation insurance carrier and policy are: Carrier: STATE FUND Policy Number. 1300240-02 Thisseolion need not be completed if the pennit is for one hundred dollars ($100) or less. o I certify that in the performance 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 workers compensation laws of Califomia, and agree that if I should become sub' ct to t~e w rker's compensation provisions of Section 3700 of the~r Code, I s I forthwith amply with those provisions. Date: 11/14/2005 Applicant. WARNING; FAILURE TO SECU WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED ,'!HOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lenc~ing agency for the performance of the work for which thIS permit is issued (Sec.3097 .Civ.C): Lender's Information: LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapt;rr 9 ( ommencing with Section 7000) O~OhJSiO 3 of the usiness and profe$si~S ode. 11/14/20 Date: Contractor NUMBER EXPIRATION DATE 524341 2/28/2006 TYPE C39 Construcion Tvpes: VN, , Fire Sorinklered? NO I certify that I have read this application and state that the above information is correct. I agre to comply with all city ordinances and state laws relating to building construction, and here authorize rep sentives this city to entei upon the above mentioned property for ion purpose Dale: 11/14/2005 Fees paid for Permit: Total: 226.77 Signature of Applicant or Agent The permit shall expire by limitation and become null and void if the building or work has not passed final inspection 365 days from the date of permit issuance. A new permit is required to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground Electrode/Ufer SetbacklFormsrTrenches (Footinas) Do not install subfloor or pour floor slab unlilthe following applicable items have been signed: Plumbina IWater Pipe/Sprinkler Valvesl Mechanical {Groundworkl Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Reinf.\ Underpinning (Floor JoislfGirders) Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear Firesprinkler (Rough) 2nd Floor Shear A I Roof (SheathinglDiaphragm/Frame) '~/;...o( I/'n z. Masonrv (Reinf./Bond 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 Coat) T -Bar Electrical T -Bar Mechanical T -Bar Structural Sewer Water Engineering Backflow Water Service FINAL INSPECTIONS DATE Electrical Final Plumbing Final Mechanical Final Gas Test Cross Connection Control (714) n;S-42$O Engineering/Grading Final 765-5126 Fire Dept. Final 765-4040 Water Engineering 765-5266 Sub List/Business License 765-5194 Zoning 765.5139 Building Final (Last Inspection - Only After Above Complete) INSPECTOR PARTIAL INSPECTIONS IZ}~ l-r;;) /, :J]L ;-i/ BUildin;> Ins;ections {:. '7rf flY'?':" 17 I Mechanical Inspections Plumbina Inspections Electrical Inspections