2225 E. Standish Ave.
TYPE OF PERMIT CITY
Reroof
DATE: 7/29/2005
JOB ADDRESS: 2225 E STANDISH AVE
LEGAL DESCRIPTION: N TR 2317 LOT 28
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 113
BUILDING PERMIT NO. BLD2005-02373
APPLICANT: AL SOUZA
OWNER INFORMATION:
ROBBIE L BURNS
2225 E STANDISH AVE
ANAHEIM, CA 92806
CONTRACTOR INFORMATION:
M R ROOFING SERVICE INC
10657 STANFORD
GARDEN GROVE, CA 928400000
BUSINESS PHONE: 714 636-$679
JOB DESCRIPTION:Tear off exisiting material, install 1 layer of 30 Ibs felt and 28 squares of 30 year compositions shingles to house and attached garage.
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
5,000.00
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's icense Law for the following reason (Sec. 7031.5 Business 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 th'e alleged
exemption. Any violation of Section 7031.5 by any applicant tor 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 compersation, will do the work, and the structure is not intended or offered for
sare (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 omployees, 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 cClntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with
,gJ(ontractor(s) licensed pursuant to the Contractor's Ucense 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:
E;J-I have and will maintain a certificate of consent to self-insure for worker's compensation,
~s)rrovjded for by Section 3700 of the Labor Code, for the performance of the 'Nark for which
this permit is issued.
o I 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. Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 0002399-05
~ection need not be completed if the pennit is for one hundred dollars ($100) or less.
.o~ertify that in the perfonnance 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 California, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labo ode, I shall forthwith co ly with those provisions.
<--t:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Sect! n 7 Divsion 3 of the Business and
Professjo ad. ~/
7/29/2005 ' /-., <
Date:
EXPIRATION DATE
6/30/2007
NUMBE
765080
TYPE
C39
Date: 7/29/2005 Applicant:
WARNING: FAILURE TO SECUR ORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJ T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED. OUSAND DOLLARS ($100,000), IN ADDI710N 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 lending 8gencyfor the
performance of the work for which this permit is issued (Sec. 3097 .Civ.C):
Lender's Information:
Construcion Types:
VN, ,
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
hereby a thorize representive of this city to enter upon the above mentioned property for
in - n pur _se~_
f" - Date: 7/29/2005
Signature of Applicant or Agent
permit shall expire by limitation and become null and void if the building or
ork has not passed fi nal i nspeclion 365 days from the date of permit issualCe. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
235,33
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (CompactionlMembrane Reinf.)
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
Roof (Sheathing/Diaphragm/Frame) ',f d-<~b --/1
Masonry (ReinfJBond 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 Backllow
Water Service
FINAL INSPECTION.S DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765.5126
Fire Dept. Final 765-4040
Water Engineering 765.5268
Sub List/Business License 765-5194
Zoning 765-5139 / J
Building Final (Last Inspecllon - Only rzis-
After Above Complete) J AdJQ~1J-1
/
PARTIAL INSPECTIONS
BUildin; Insp~.
~ J~, .-
Mechanical Inspections
Plumbing Inspections
Electrical Insoections