1333 N. State College Pkwy
it.
CONTRACTOR INFORMMfON:
STONE ROOFING COMPf~"Y INC
730 N CONEY AVE
AZUSA, CA 91702 DOOO
BUSINESS PHONE: 626 9i"i'~5~5
JOB DESCRiPTION: Tear off existing and reroof 160 squares with BUR roof
VALUATION: 28,000,00 , ., ' _,~ " ' PROCESSED BY: JNJ , " ,
I " "OWNER.BUIL.DER lECLARATION
l' hereby affirm under penalty of perjury that I'am-exempt from the Contractor'~;iUcense law for the following reason (See, 7031.6 Business and
ProfeSsions Code: any dty or county which requires a permit to-construct, alteif. improve. cemolish or repair any structure, priorto it<; -issuance, also
requires the applicant for such permit to file a signed statement that he i"s litedlsed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3.of the Busi.ness and Profe~svJ~sCode) Or thBt he!s exempt therefrom and the bc;sis for the alleged
, exemption. Any violation of Section 7031.5 by ~ny applicant for a permit SLli.:;;,l9ts ths'ap~!ic'ant 'to <'! dvlllJenaltyof r:oi more than five hundred dc!I,4:fs,
($500). , ", ' ", '
[J I, a~c>wner 9f property: or my employees ~ith wages as their $Ole:~orll!~€rsCltjOn, will UO, tile work, <;Ind the stpJctum is not intended O'r offerelj for-
sale (Sec. 7044 Businessand,Professions Code: The Contractor's Licer:se U~V''-does not apply to an Q,,"mer of orc.perty who buil9S or impro'v'es
thereon, and who does,such wo'rk himself or helSelf or through his' or h~ t)wnib:'npioy,*s, provided that sUch ;mprcvements~r~.nct Intended 0r
offf:-red for sale. If, however, the building OF improvement !s sold wit;' one ye<.:t':'If wrnpletion, the DINner-builder wiii have th~ burden of proving that h~
did not build or improve for the purpose of sa1.e). ~,~~ '. .. .
o ,i. as the owner of the property, 'am exdusively contracting with liceflsed (~jntr;3:c:tf)rS to construct the project (See. 7044 qusiness and Professions
C~e: The Contractor's License Law does not apply to ar. owner of prbPdrty,,~ho builds or i:11proveS thereon, and ......hoCL:ltra.ct$ for such projects W;Ul
Montractor(s) Hcensed pursuant to the Contractor's License Law). JF' '
U .! am exempt under Sec. . ,'. , B& P.C. for this reason: ~_______,b.
Date: Owner: <
L WORKER'S COMPENSATION D~CLARATION _=-'3..~_J
I heret:y affirm under penalty of perjury one of the following declarations: J ,:
'0 . I ,have and will maintain a certificate of 'consent to' seft-insure for wOiker'::;ib~"jpe!l3~lion,
as provided fo:' by Section,370G of the Labor Code, fer the performance oftn'~ '-1i(,-,1< for which
thiS: permit is issued. . ..
tzi:?i have and will maintainwort<er's compensation insurance, as required b'l Section ~?C() of
(the Labor Code, for the performance of the wqrk for whi.ch this permit is issueit M,: worker's' .
Compensation insurance carrier and pOH(,.y are:
Carri~r: STATE COMPENSATION FUND Policy Number. 0460C1~Z2i
This section need not be com'pletedifthe penn.it is for 'one hundred dQllars {$1!)~)'...,r ~~s.
D, 1 certify that in. the perforrnanc~ of the work for which this, permit is issue). .~. ~hsl1 not
employ any person in any manner so as to become subject to the worke:r's cd,'npensationlaws
of CaJifomia, and ag'ree that if I should become subject.to the worker's comp-:"r:sdtion
provisions of Section 3700 of the L~bor Code, I shan 'fa ith comply wllh ti1(.\~e 'provisions.
BUilDING PERMIT NO. BlD2004-04426
TYPE OF PERMIT
Reroof
DATE: 12/15/2004
JOB ADDRESS: 1333 S STATE COLLEGE PARK WAY
LEGAL DESCRIPTION: P BK 49 PG 43 PAR 7
APPLICANT: TOM J<ETTERLlN G
OWNER INFORMATION:
College P State
303 N Placentia Ave
Fullerton, CA 92831
"
BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 116
ARCHITECT/ENGINEER INFORMATION:
j
LICENSED CONTRACTORS OECLARAT10I!-J
! herer.y affirm under penalty of perJury. that i am
licensed under prcvi::.ions o'f chapter 9 (cc.:nmenclng
Wit, OS, eGtio.I1, ,70'00) of DiVS10r{!:, 3 of the BU3ir~ess and
Professions Code. ~ ~
17J15/2004, )C:> - _
Date: . . .' ontre-ctor
NUMBER
159149
TYPE
TYPE
Construcicr. Types:
VN,
Date: 12/1512004 Applicant: _".,..---__
WARNING: FAILURETOSECU WORJ<E 'SC MPENSATIONCOVE'"JiGEIS
UNLAWFUL, ANO SHALL SUBJECT AN EMPLOYER TO CRIMINAL p:;:NA',nES AND CIVIL
FINES UPTOONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDiTION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTI01;-:l706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES, '
i CONSTRUCTION lENDING AGENCY t
, ..
!hereby affirm under penalty of perjury thztthere is a constructi(Jn'lendingc<Q.~ncy for the
- -po'riO;-::nailGe' of'r:.t~'\-;'11(,,'t6rvv--rfinT"~"P'bliTi!:\JS.'1:S'SU'8'!j'\S--C<.:t3'J:Jt-':.Glv:c}:'-- 'i'"" .....,.-......'---. ...-
Lender's Information: .
I certify that I have read this application. and state that the above informatio.n,is correct. I
agree to oomply with all city ordinances and state laws relating to building cOllstructton, and
hereby authorize represent' es of this city to enter upon the above mentione:1 property for
inspection purpo
Date: 12/15/2004
Signa re 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. '
EXPIRATION DATE
5/31/2006
B
C39
Fees paid for Permit:
Total:
913,1?
INSPECTION RECORD
,
INSPECTION DATE INSPECTOR,
, Temporary,~ower Pole ' , ,
Plumbing (DraintWaste Pipe) ,
Electrical Ground Electrode/lifer "
, Setback/FormsfTrenches, (Footings) " "
Do not install sub floor or pour floor slab until the'
following applicable items have been signed: .
Plumbing {Water Pipe.SprinklerValves)
Mechanical (GrOUndwork) , ,
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Rei nt.
,Underpinning (Floor Joist/Girtlers)' , '
'Va not cover or conceal the work below until the
ifollowing applicable items have,been signed:
11sll'Ioor Shear
, Firesprinkler (Rough) ,
2nd Floor Shear' , , , ~ II
, Roof (ShealhinglDiaphraamlFrame) ~/t~h;~ ;7 L 1..1'1117
""'asonry (ReinfJBond BeanlPre-Grout) , 'f//
, Rough Plumbing (Top Out), .
Rough Mechanical ' .'
,
KOugn ElectrICal (Dry Walll
Rough Electrical "
, Framing . (Only atter Plbg.,-Elec.. Mech.. and Fire) ,
Insulllllon (SoundiEnergy) , , ,
: Do, not tape or ptasteruntil the following applicable,
items have been signed: , ' .
, Drywall ,
I;'enelrlllions (Fim Rllled) Electrical , ,
, Penetrlllions (Fim Rated) Mechanical
'I;'enetralions (Fire Rated) Plumbing , ..
Interior Lath "
Exterior Lath ' , , ' I
, I , GENERAL ITEMS
Exterior Plaster (Brown Coat) ,
, T-Bar Electrical,
, ,T-Bar Mechanical ,
T rBar Structural , '
Sewer, ' '
Water Engineering Back1\ow " , '
Water Service
"
.
,
,
-
"
,
FINAL INSPECTIONS 'Date Inspector
,Electrical Final , , ,
Plumbing Final
Mechanica,l Final
Gas Test
Engineering/Grading Final 765-5126 " ' '
Fire Dep!, Final 765-4040 , , I
Water Engineering 765-5268
Sub List/Business License 765-51,9 I
, ,
Zoning 765,5139 ' '
Building Final ~ast Inspection- Only,fr,f(J~ ~".
fter Above Complete)' ,
PARTIAL INSPl:CTIONS" , " ".
Building InActions
~~k,S- ,e, .~K'~
I I
-til/Z~)~ ·
Mechanicallnsoections
, Plumbina Insoections
Electricallnsoections .