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228 N. Starfire St. /B'l' ~ P VVZOO4. - OL:OOS; BUILDING PERMIT NO. BLD200S-02137 TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUESTLINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 167 DATE: 7/11/2005 JOB ADDRESS: 228 N STARFIRE ST LEGAL DESCRIPTION: N TR 5332 LOT 36 APPLICANT: LYNN ROGERS OWNER INFORMATION: BEENA NAIR 228 N STARFIRE ST ANAHEIM, CA 92807 CONTRACTOR INFORMATION: CONEX ROOFING COMPANY 2011 N BATAVIA ST ORANGE, CA 928650000 BUSINESS PHONE: 714520-5207 JOB DESCRIPTION:Tear off existing roof and replace with 23 squares of lifetim13 grand sequoia composition shingles and 1/2" cdx. ARCHITECT/ENGINEER INFORMATION: VALUATION: 9,000.00 I OWNER-BUILDER [IECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construct, atter, 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 Professions Code) 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). D 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 herself or through his Or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one yeal of completion, the owner-builder will have the burden of proving thafhef did not build or improve for the pUlpose of sale). o I, as the owner of the property, am exclusively contracting with licensed omtractors 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 with a contractor(s) licensed pursuant to the Contractor's License Law). D 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 se~-insure for worker's Gompensation, as provided for by Section 3700 of the Labor Code, for the pertormance of thewor1< for which ~i permit is issued. I have and will maintain worker's compensation insurance, as required by Section 3700 of t e Labor Code, for the performance of the work for which this permit is issuec'. Myworker's ompensation insurance carrier and policy are: Carrier' STATE COMPENSATION INSURANCE Policy Number. 1799501-.004 PROCESSED BY: MSM LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty at perjury that I am licensed under provisions of chapter 9 (commencing with Sectio 7000) of 0" ion:!;f the Business and Profes .on Code._ / This section need not be completed if the pennit is for one hundred dollars ($100) or less. D I certify that in the perionnance 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 worker's conpensation laws of Califomia, and agree that if I should become subject to the worker's comperlsation provisions of Section 3700 of the Labor Code, I all fo with comply with tho;e provisions. NUMBER 753053 TYPE EXPIRATION DATE 8/3112006 C39 Date: 7/11/2005 Applicant: WARNING: FAILURE TO SECU ENSATION COVERAGE IS UNLAWFUL, AND SHALLSUBJ A EMPLOYE TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED SAND DOLLARS ($100,000), IN ADDl'lON TO THE COST OF COMPENSATION, 0 AGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COD E, I NTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 .Civ .C): Lender's Information: Construcion Types: V N, , Fire Sprinklered? NO , I certify that I have read this application and state that the above information is correct. I agree to comply with all city ordinances and state laws relating to building construction, and her y authorize r resentives of this city to enter upon the above mentioned property for in io pur s. Date: 7/11/2005 Fees paid for Permit: Total: 235.73 ig a re of Applicant or Agent per ts all e ire by limitation and become nutl and void if the building or w r as 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 Setback/FormsITrenches (Footings) tHU/,- IrrUJ w Do not install subfloor or pour floor slab unlilthe following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical IUnderground Conduill Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below unlilthe following applicable items have been signed: 1st Floor Shear b/4ro/,,\ 1;r~LA Firesprinkler (Rough) 2nd Floor Shear t I(~/.) f7Ai- lb I ~f (J Roof (Sheathing/Diaphragm/Frame) Masonry (ReinfJBond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough MeChanical Rough Electrical (Dry Wall) Rough Electrical ) ,I 1Vv(, l(? Framing (Only aft.r Plbg., .,.., Mec. And FI..) .~ Ql ~ (fi l0 Insulation (Sound/Energy) '1, 7nJ" I1AJAtF Do not tape or plaster unlilthe following applicable items have been signed: . "'mw 1l}w1,{ fltt/w (~ Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath I!JJN 11/ t<<.-tk GENERAL ITEM Exterior Plaster (Brown Coat) T -Bar Electrical T-Bar Mechanical T-Bar Structural Sewer Water Engineering Backflow Water Service FINAL INSPECTIONS DATE INSPECTOR Electrical Final I Iii /, 'liA/, ,... Plumbing Final ) (, )jf Mechanical Final I... ) ij 1 A/I " Gas Test , Engineering/Grading Final 765.5126 Fire Depl. Final 765-4040 Water Engineering 765-5268 Sub List/Business License 765-5194 Zoning 765-5139 Building Final (Last Inspection - Only Z/1f,r j)~ After Above Complete) PARTIAL INSPECTIONS Buildina Insoections Mechanicallnsoections Plumbina Insoections Electricallnsoections BUILDING PERMIT NO. BLD2004-02005 r;t!~.bF PERMIT Residential Addition CITY DA TE: 5/26/2004 JOB ADDRESS: 22B N ST ARFIRE ST LEGAL DESCRIPTION: N TR 5332 LOT 36 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765.. 5153 INSPECTION REQUEST LINE: (714) 765.. 4626 CENSUS CODE: 434 QUARTER SECTION: 167 APPLICANT: GOPI NAIR OWNER INFORMATION: CONTRACTOR INFORMATION: BEENA NAIR 228 N STARFIRE ST ANAHEIM, CA 928070000 JOB DESCRIPTION;Family room, bath and laundry addition. 544 s.t. VALUATION; 36,600.00 ARCHITECT/ENGINEER INFORMATION; PROCESSED BY; ENO OWNER-BUILDER DECLARATION I here y affIrm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 usiness and Professions Code: any city or county which requires a permit to construct, alter, 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 Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation 01 Section 7031.5 by any applicant for a permit SUbjects the applicant to a civil penalty of not more than five hundred dollars ~OO). LJ I, as owner 01 property, or my employees with wages as their sole compensation, win do the work, and the structure is not intended or offered tor 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 herself or through his or her own employees, 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 contracting 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 oontracts for such projects with ,a..Qontractor(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: o 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 this permit is issued. o 'have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's Compensation insurance carrier and policy are: Carrier: Policy Number. This section need not be completed if the permit is for one hundred dollars ($100) or less. D I certify that in the performance of the work for which this permit is issued, I shan not employ any person in any manner so as to become subject to the worker's compensation laws of Califomia, and agree that if I shOUld become subject to the worker's compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. LICENSED CONTRACTORS DECLARATION I I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Oivsion 3 of the Business and Professions Code, 12/8/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Date; 12/8/2005 Applicant WARNING; FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED 1HOUSAND DOLLARS ($100,000), IN ADDI1l0N TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. I CONSTRUCTION LENDING AGENCY I hereby affirm under penalty 01 perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097 ,Civ.C): Lender's Information: Construcion Tvpes: VN, , Livinq Area: 544 1 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 tobuiJdir.g coo,:;fl'uction, a:1d hereby authorize representives of this city to enter upon the above mentioned property for inspection purposes. Fees paid for Permit: Totar: 75,19 Date: 12/812005 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 issuau:e. A new permit is required to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainIWaste Pipe) Electrical Ground Electrode/Ufer SetbacklForms/Trenches (Footings) l4/zrJlk Dn. /4 Do not install subfloor or pour floor ,flab until the following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduitl Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear ICn/r.li) J)7w tp Firesprinkler (Rough) , I 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) /7 If "fif illA" t6 Masonry (Reinf./Bond Beam/Pre-Grout) . I 1 Rough Plumbing (Top Out) g V I' Rough Mechanical I f( /c1 1 V Rough Electrical (Dry Wall) , '.' Rough Electrical 1'1,/71" \ Vl2.11J Framing (Only after P1b9., Ele., Mec. And Fire) Ill/Vi / V / Insulation (Sound/Energy) Iq_ 7/J -<!, Phv (,b Do not tape or plaster until the following applicable !I/ i IY \.L- items have been signed: lo/f-p)- O1MA N:' Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath j )b-I~' fINd>> GENERAL ITEMS Exterior Plaster (Brown Coat) T -Bar Electrical T-Bar Mechanical T -Bar Structural Sewer Water Engineering Backflow Water Service FINAL INSPECTIONS DATE INSPECTOR Electrical Final )-z.-1A)- , Plumbing Final \ .1/ fh I L, Mechanical Final V , v'V Gas Test Cross Connection Control (1141765-4280 Engineering/Grading Final 765-5126 Fire Dept. Final 765-4040 Water Engineering 765.5268 Sub List/Business License 765-5194 Zoning 765-5139 Building Final(Last Inspection. Only IJlf1tr p~ After Above Complete) PARTIAL INSPECTIONS Buildina Inspections Mechanical Inspections Plumbina Inspections Electrical Inspections