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316 Starling Wy. TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 167 BUILDING PERMIT NO, BLD2005-02385 DATE: 811/2005 JOB ADDRESS: 316 N STARLING WAY LEGAL DESCRIPTION: N TR 5332 LOT 22 APPLICANT: RON SELL OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: CLURE G MC SELL ROOFING COMPANY 316 N STARLING WAY 18032 LEMON ANAHEIM, CA 92807 YORBA LINDA, CA 928860000 BUSINESS PHONE: 714528-'1758 JOB DESCRIPTION:Tear off existing and reroof 29 squares with 3D-year composition shingles VALUATION: 6,900.00 I OWNER-BUILDER DECLARATION 'hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code: any city Dr county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permlt 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 buildsor improves thereon, and who does such work himself or helSelf 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 contracts for such projects with a contractor(s) licensed pursuant to the Contractor's License Law). o I am exempt under Sec. , B & P.C. for this reason: Date: Owner: I WORKER'S COMPENSATION DECLARATION ! 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'sC'ompensation, as provided lor by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ..JTr I have and will maintain worker's compensation insurance, as required by Section 3700 of iFie Labor Code, for the performance of the work for which this permit is issued. Myworker's Compensation insurance carrier and poricy are: Carrier: STATE FUND Policy Number. 1066554-2Q04 PROCESSED BY: JNJ LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Dr 3 of the siness and Profession{'Code. 8/1/2005 ~ Date: Contractor This section need not be completed if the permit is for one hundred dollars ($100) or less. o I certify that in the perfonnance 01 the work for which this permit is issued, 1 shan not employ any person in any manner so as to become subject to the worker's compensation laws of Califomia, and a.gree that if I should become subje to the work r's compensation provisions of Section 3700 of the Labor Code, I s I fa hwith co ly wit ose provisions. ?1A NUMBER 323842 TYPE TYPE EXPIRATION DATE 10/3112006 HIC C39 Date: 8/1/2005 Applicant: r- WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINESUPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITlON 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 perlunl. that there is a construction lending agel~cyfor the performance of the work for which this permit is issued (Sec.3097 ,Civ.C): Lender's Information: Construcion Types: VN, , 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 hereby authorize re~re n as of thi city to enter upon the above mentioned property for i~ion purposes /' Date: 8/1/2005 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. Fees paid for Permit: Total: 235,52 City of Anaheim Building Division FINAL INSPECTIONS DATE Electrical Final Plumbing Final Mechanical Final Gas Test ngineeringlGrading Final 765-5126 re Dept. Final 765-4040 ater Engineering 765.5268 ub List/Business License 765-5194 oning 765-5139 uilding Final (Last Inspection. Only After Above Complete) INSPECTOR INSPECTION RECORD INSPECTION DATE INSPECTOR E Temporary Power Pole Fi Plumbing (Draintwaste Pipe) W Electrical Ground Electrode/Ufer S SetbacklForms/Trenches (Footings) Z Do not install subfloor or pour floor slab until the B following applicable items have been signed: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (Compaction/Membrane Rein!.) B Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1 st Floor Shear Firesprinkler (Rough) 2nd Floor Shear r? Roof (ShMlfhI hragm/Frame) r4A"'\ A~A Masonry (Reinf./Bond Beam/Pre-Grout) M Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele., Mec. And Fire) Insulation (Sound/Energy) Do noltape or plaster unlilthe following applicable items have been signed: PI Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath GENERAL ITEMS Exterior Plaster (Brown Coat) EI T-Bar Electrical T-Bar Mechanical T-Bar Structural Sewer Water Engineering Backflow Water Service Patte PARTIAL INSPECTIONS uilding Inspections echanicallnspections umbing Inspections ectricallnspections