2761 E. Standish
~:;O~~F PERMIT CITY
DATE: 5/26i2oo5
JOB ADDRESS: 2762 E STANDISH AVE
LEGAL DESCRIPTION: N TR3824 LOT 12
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714).765 - 5153
INSPECTION REQUEST LINE:
(714) 765 -4626
CENSUS CODE: '555
QUARTER SECTION: 123
,1'3
BUILDING PERMIT NO. "BL~O(;S-tl1S92
APPLICANT: JAMES RUVALCABA
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
"James Ruvalcaba
2762 E Standish Ave
Anaheim, CA 92806
JOB DESCRIPTION:Tear off existing roof and replac~ with 31 squares of 30 yearcomposilion shingies.
VALUATION: 6,500.00 PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
I bereby_ affirm under penalty of perjury that I ~ exempt from.the Contractor s License Law for the following reasori (Sec. 7 31-.5 Business and
Professions Code: any city of. county which requires a permit to construct, alter~jmprove, demolish or repair any structurEr, prior to its issuance, also
requires the app6cant for such permit to file a signed statement thathe is licensed pursuant to the provisfohs of the Contrac;tor's License Law (Chapter
9)(commencing, with Section 7000 of Division 3 of the Business and Professiont;Code) or that he is exempt therefrom and the basis' for the alleged
exemption: Any violation of SectIon 7031.5 by, any applicant fora permit subj~ts. the applicant to'a civil penalty of not more than five' hundred dollars
($500). '. . . .
o /, as' owner Of property, or my employees with_ wages as tl1eir sole compenSation, will do the work, an~ the structure is not intended or offered for
sale (8ec. 7044 Business and Professions Code: The'Contractor's-License Law does not apply to an owner of property who buHdso'r improves
thereOn, and who does such work himself orherself,or through his or her own employees, pro~ided that such improvements are not intended or
offered for sale; If; however, the building or improvement is sold with one-year,?f cOmpletion, th,e owner-:bu~der will have the burde:n of provi!Jg that he
~'d 6fbuild or improve forthe purpose of sale).'. ~
'..1, as' the owner of the property, am exclustvely C. ontracting with Ilcensed co~tractors to cons.truct the pro.lect (Sec. 7044 Business and prc)ieSSi.ons
oCle: The Contractor'~ License Law does not apply to an owner of pfopertyw!1o builds or improves thereon, and who contracts for.such projects with
. ,ontractor(s) licensed pursuant to the Contra r's Lice Law:' . . , .
I .' . m t under Sec. .' .C. f IS rea n: , .
Date: Owner:
WORKER'S C P SATION DECLARATION
I hereby affirm under penalty of pe~ury ohe'of the following declarations:
o I have and will maintain a certificate of conserlt to self':'insure far worker'scompensatfon,
as provided for bySectian 3700. of. the L$Jor Code, for the pertormance of the~ork for which
this permit is issued.
01 have and wi!l ma.intain 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 hot be, comple~d if the permit is for one hundred dollars ($1 00) J. less.
m I certify that in the performance of the work for which this permit is issued. I shan not
~plo'y any person in any manner so as 10 -become subject to the worker's compensation laws
of Califomia, and agree .that if.1 shoUld. become SLibject to the w rker's compensation .
provisions of Section-3700 of the Labor C shaU ; rthwit amply with those provisions.
Date: 5126i2005 Applicant:
WARNING: FAIWRE TO SECUR W RKEl'rs COMPEN'SATIONCOVERAGE IS
UNLAWFUL, AND SHALL SUBJE T 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 SE9TION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of th'e work for which this'permit is issued {Sec.3097.Civ.C):
Lender's Information:' '.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that lam
licensed under provisions of chapter 9 (commencing'
with Section 7000) .of Divsion 3 of the BUsiness and>
"Professions Code.
5/26/2005
Date:
Contractor
. NUMBER
EXPIRATION DATE
TYPE
Cbnstrucion Types:
VN, .,
Fire Sprinklered?
NO.
Icertify that I'have read this applicati-on ahd state that the-abOVe information is~correct. I
agree to comply with aU c' ordinances and state laws relating to bu~ding construction, and
hereby 8uth rize rep nUves of this city to enter upon the above mentioned proPerty for
insp cti' rpose
Date: 5/26/2005
. Fees paid for Permit:
Total:
310.20
Signature of Applicant or Agent
e ermit shall expire by limitation and become null and void if the bUilding or
work has not passed final inspection 365 days frQlll the date of permit issuance. A
new permit is required to oommence or continue work.
INSPECTION RECORD
.' . INSPE;CTION. DATE INSPECTOR.
Temporary Power Pole. . '. . . .
Plumbi ng (Drain /Waste Pipe) . .
Electrical Ground ElectrodelUfer . .
SelbacklformslTrenches (Footings) " .
'Do not install subfloor or pour floor slab until the
following applicable items have been signed: . ..'
Plumbirig (Water Plpe.Sprinkler Valves) .
Mechanicl!l (Groundwork)
Electrical (Underground Conduit) . . ,. .
. . Pre'Slab (CompactionlMembrane.Reinf.
Underpinning (Floor Joist/Girders)
Do. not cover or conceal the wo"' below untu too
following applicable items have been signed: .
1 st Floor Shear. : .
Rresprinkler (Rough) ....
. 2nd Floor.Shear ,
Roof (Sheathing/Diaphragm/Frame) . t,fol/^< V(}fJ; . thn
Masonry (ReinfJBond BeamlPre-Gl'OUt) . .If/(! . I
Rough Plumbing (Top Out) . .
Rough Mechanical
RougnBectrlcal (Dry Wall)
Rough Electrical .
Framing . (Only after Plbg.. Elec.. Mech. and Fire)
Insulation (SoundlEnergy)
p.o not tape or p'a~ter until the following applicable
Items hav~ been signed: . ' . .
Drywall . . .. .
Pen.etrations (Rre Rated) Electrical .
'Penetrations. (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing .
Interior Lath .
Exterior Lath . . .
. . GENERAL ITEMS
Exterior Plaster (Brown Coal)
T -Bar Electrical. . . .. ,
T-Bar Mechaj1ical . . .
T -Bar Structural
Sewer . . ..
Water Engineering Backflow
Water Service .
-
I
FINAL INSPECTIONs. . .... Date'
Electrical Final I
Plumbing Final !, .
Mechanical Final I
Gas Test I
Engineering/Grading Fina,/765.o126
Fire Dept, Final 765-4040 I
Water Engineering 765-5268
,
Sub List/Business Licen~e 765-519
,
Zoning 765-5139 I
Building Final (Last Inspection- Only /
. After Abov~ Complete) '<'Il!!)
PARTIAL INSPECTIONS
BuildinQ 'hspectio~s . .
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MeChanical,nspeciions '
I
1
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I
PlumbinQ Inspecti6nS
. I
I.
I
I
Electrica"lnspectic~ns'
1
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I
Inspector