5424 Snow Wood
TYPE OF PERMIT
Reroof
CITY
A~'~;~~7"'~~~\ .
'f . JHi)HEIM
.~;/1
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765-5153
. INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: . 555
QUARTER SECTION: ,-n
BUILDING PERMIT NO. . BLD2005-00883
DATE: 4/1/2005
JOB ADDRESS: 5424 E SNOW WOOD CIR A
LEGAL DESCRIPTION:
CONTRACTOR INFORM,\TION: ARCHITECT/ENGINEER INFORMATION:
CAL COAST ROOFING & AAINGUTTERS
8329 VALLEY VIEW ST
BUENA PARK, CA 90620oxio
BUSINESS PHONE: 714827.5371
.JOB DESCRIPTION: Tear offexisting.and.re~roof 44 squares of composition 'St~i(\gtes for units A-D.
VALUATION: 8,700.00
I ciWNER-BUILDER-OECLARA TION
I hereby affirm under penalty of perjury that J am exer:npt fro~ t~e Contractor'?Ucense law for th~ following reason (Sec. 703.1.5 Business and
,Professions Code: any city or county which requires a permjt to construct, C:l,ite,r, improve, demolish or repair any structure, prierto i~ issuance, also
requires t~e applicant for such per,!!it to file a signed statement that he is lic{:rised pursuant to the.provisionsofthe Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division:) of the Businessand Professk:ns Code) or that he is e~empt therefrom and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant,for a permit sl.il:r~cts ttJe applicant to a-evil penalty of not more than five hundred-dollars.
($500). . .'" _ .
o I, 'as owner of property, or my employees with wages as their sole cOlnp-{nsation, will do the work, and the structure is not in'tended or offered. for
sale (Sec. 7044 Business and Professions Code: The Contractor's Ucensel.aw does not apply to an owner of prqpertY who builds or' improves
thereon,and who does sum work, himself'or herself or through his or her own;empfoyees, prov1ded that such improvements are not intended or .
offered tor sale. If, however, the building or improvement is said with one ye~~t,of completion, the owner-bullder.wili have the burden of proving that he
did not build ~r1mprcv'e for the purpose.of sah:!). ," f": .
o I, as the owner Qfthe property, am exdu'sively contracting, with n~ensetl(.('lntractors to construct the project (Sec.' 7044 Business and Profe'~ions'
Code: The Contractor's License Law 90esnot apply to an owner of propertyivrno'builds or improves thereon, and who oontr,acts for sum projects with
L::::Jontractor(s) licensed pursuant .to the Cc:>~ractor's License- Law). ) : .
., I am exempt under Sec. . _, B & P.C. for this reason:. __,_--.
Date: . Owner: .
I WORKER'S COMPENSATION DECLARATION
I hereby affirm 'under penalty of perjuryone of. the following declarations:
o I have, and will maintain a certificate of consent to self-insure for work&r'~..'cc.mpensation,
as provided -for by SectiOR 3700 of. the Labor Code, for the performance ofth;~'wor'" for whid1
thi rmit is 'issued. :
I ve and.will maintainwoJker's compensation insurance, as required bi,Section 3700 of .4/1/2005
t e abor Code, fOHhe performance of the work for which this permit is issued. Myworker's D:ate:
ompensation insurance carrier and policy are: . ':
arrier: STATE COMP INS FUND Policy Number. 1759809
. his section need not be. cOmpleted if the penn1t is for one hundred dollars ($100jOr less._
D. I c.ertify thati.n the perfontlance of the ~ork.for which this permit is iSSue(j, I shall not
employ any person in'any manner so as_tobecome.subject to the workers compensation laws
of California, and agree that if I should become SUbject to the worker's compensation
provisions of Section 3700 of the Labor Code,I,s~all fort ith c. mply \-\lith t~'sa provisions.
APPLICANT: JqHN BATIOFF
OWNER INFORMATION:
Ana I :Recine's
5424 E ~riow Wood Cir #80
.Anaheim, cA 92807.
PROCESSED BY: ENO
LICENSED CONTRACTORS DECLARATION
, I hereby affirm under penalty of perjury that I am
licensed under provisidns of chapter 9 (co'mmencing
Wl.th:Sectio' 7.000) of ivsion 3 of the Business and
Profession
EXPIRATION DATE
12/31/2005
NUMB
.828394
TYPE
C39
Date: 4/1/2005 Appficant:
WARNING: FAILURE TO SECUR W RKER'S CO EN SA N COVER!'.GE IS
. UNLAWFUL, ANDSHALL'SUB T AN EMPLOYER TO CRIMINAL PENALTIES AN'D'CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDlflON TO THE'
COST OF COMPENSATION: DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE'
LABORCODE, INTEREST AND ATTORNEY'S FEES.
l' CONSTRUCTION LENDING AGENCY .
I hereby affirm under penaJtyof perjury tha~_ there is a c_onstrucUonle!1di!,\g;ag~;n~ytor th~
pF!ri(k!1"ri2Yl(;6..;)ft~:e.wor~.~-;or~,"<;'i'iio--,-1:-rbljsrnlifi:;; i::;:;Utfd (S€c.'30"g1;.Civ~C)~ --'--.' -
Lender's Information:
Construcion Types:
VN" .
I certify that I have read this application and state that the above information i~ cprrect. I
agree to oomply with all city ordinances and state laws. relating to building cor.struction, and
hereby authoriie representives of this city to enter upon the above mentioned property for
inspect. n .~urposes.
\ Date: 4/1/2005
Signature 0
The P mitshall expire by itatioIJ.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.
Fees paid for Permit:
Total:
385.14
INSPECTION RECORD
,
INSPECTION' , DATE INSPECTOR
Temporary Power Pole ,
Plumbing (DrainlWaste Pipe)
Electrical'Ground Electrode/Ufer "
SetbacklFormslTrenches (Footings) , , , ,
00 not install subfloor <)r pour floor slab until the
fOllowing appiicable items have ,been signed:
Plumbing (Water P1pe.sprin~ler Valves)
Mechanical (Groundwork) " , '
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reinf. ,
Underpinning (FlOor Joist/Girders) ,
00 not cover or conceal the work belpw until tne -
following applicable items have been signed: ,
1st Floor ShOar ' , , "
Firesprinkler (Rough) ,
2n~ear " ' I'I'I,IO'S" ervv
Ro i' aphragmlFrame)
Mas nfJBond BeamlPre-Grout) ,>
Rough'Plumbing (Top Out) " , "
Rough Mechanical , ; "
Rough BectrlCallDI'Y wall) , ,
Rough Electrical " ,
Framing (Only afier Plbg,; Elee.. Mech,.. and Fire) , "
Insulation (SoundlEnergy)
po not tape or pla~ter until the following applicable
Items have been signed: . . .
Drywall , \
: Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing , I;
Interior Lath ' , , I,
Exterior Lath
, , GENERAL ITEMS
Exterior Plaster (BlOINn Coat) ,
T -Bar Electrical ' ,
T -Bat Mechanical , , ' ..
T -Bar Struc:tural , ,
Sewer
Water Engineering BlIckflow ,
Water Service ' ,
,
FINAL INSPECTIONS Date " , Inspector ,
Electrical Final " ..
Plumbing Final, "
Mechanical Fi!lal. , ,
Gas Test .. .. "
Engineering/Grading Fino" 765-5126 '
Fire Dept. Final 765-4040 ,
Willer Engineering 765-5268 , ,
..
Sub List/Business'License 765-519
Zoning 765-5139 " "
Building Final ~asllnspection. Only Ml\\~ 1t,IJ.li' ,
, Iter Above Complele)
PARTIAL INSPECTIONS ./
, ~,~ ,
BuildinalnSDections
MechanicallnSDections
Plumbina,lnSDections
ElectricallnSDections