2672 Stockton Dr.
TYPE OF PERMIT .
Reroof
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153 '
INSPECTIONREOUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
BUILDING PERMIT NO.
BLD2005-01269
.
DATE: 5/3/2005
JOB ADDRESS: 2672 W STOCKTON AVE
LEGAL DESCRIPTION: . N TR 2303 LOT 313
CONTRACTOR INFORMA110N:
COAST ROOFING
21681 IMPALA LANE
HUNTINGTON BEACH, CA 92646.0000
, BUSINESS PHONE: 714968-8754
,JOB DESCRIPTION:Tear off exisiting materiai, install plywood O.S.B., felt, and,21 squares of eaglelite Malibu tile ICBO# 4660.
VALUATION: 7,280.00 PROCESSED BY: ENO
OWNER-BUILDER DECLARAtiON
I hereby affirm untJer penalty of perjury that J am exempt from the Contractor's:Ucense Law for the following reason (Sec. 7 31.5 BUSiness and
Professions Code: any.city <;>r county which requires a permitto construct, alter, improve, demolish or. repair any structure, prior taits issuance, also
requires the appficant for such permit to file a signed statement that he is licenSed pursuant to the provisions of the Contractor's Ucense Law (Chapter
9)(com.mencing with Section 7000 of Di'Jision-S of the Business and Professions Code) or tl:1at he is exempt the.refrom and the basis for the alleged
exemption..- Any violation ofBection 7031.5 by any applicant for a permit subje);ts the applicant to a civil penalty of not more than five hundred dollars
~~. ""
o I, as owner of. property, or my employees with wages as their soJe compe~lsat;on, will do the work, and the structure }S notintendect .or (~ffei"ed for
sale (Sec. 7Q44 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 helSelf or through his or her own~mployees, provided that such impl'Ovements are not intended or:
offered for sale; If, however, the building'or improvement is sold with one yea~of completion, the oWner~builderwil1 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 (See. 7044 Business and Professions
Code: The.Contractor's license Law does'not app.!y to an owner of property w~o buUds or improves thereon, and who oontracts for such projects with
~ontractor(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 ., have and win maintain acertificate of .consent'to selHnsure 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. . . .,
fl(.. I have and will maintain worker's compensation insurance, as required by ;Section 3700 of
the'Labor Code, for the performa1lge of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number.. 1113190-94
. i . .
This section need not be completed if the penni~ is for one hundred dOllars ($100) or less.
& I certifY that in the performance of the work for whiCh this permit is iSSuedl! shall not
employ any person in any manner so as to become ~ect to the worke~s cOl\lpensation laws
of Califom-ia, and agree that if I should become Ject 0 the worker's compensation.
provisions of Section 3700 of the abor Code, aJl f ithwj~mply with'tholle provisions.
Date: 513/2005 Applicant: ~
WARNING: FAILURE TO SEC EWO ER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SU JECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .
CONSTRUCTION LENDING AGENCY
!;her.ebyaffirm _lInde.Ip,enafty_otpe-rjurYJhaUhere iRRconstruction lending age_"lcyf.or the ___ .
performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's Information: .
APPLICANT: FRANK GARCIA
OWNER INFORMATION:
Robert J Givney
2672 W Stockton Ave
Anaheim, CA 92801
ARC;-HTECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby 'affirm under penalty of perjury that I am
licensed undrprovisions apter 9.(commencing
with Section 000 D' ion of the Business and
Professions C e. ~
5/3/2005
Date:
Contra<?tor
EXPI RATioN DATE
.12/31/2005
C39
Construe ion Types:
VN, ,
Fire Sprinklered?
NO
Fees paid for Permit:
Total:
235.56
, ~ Date: 5/3/2005
Signature of Applicant or Agent
The perniit shf!ll expire by limitation arid become null and void if the building or
work has not passed final inspeCtion 365 days from the date of permit issuooce. A
new permt is required to commence or continue work.
I
FINAL INSPECTIONS
Electrical Final
Plumb'ing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-6126
Fire Dep!. Final 765-4040
Yiater Engineering 765-5268
Sub List/Business License 765.519
Zoning' 765.5139
BUilding' Final (Last Inspection. Only
, . After Above Complete)
i . PARTIAL INSPECTIONS'
I .
, '.
Buildinalnspectlons
INSPECTION RECORD
Date
. INSPECTION. . DATE INSPECTOR
Temporary Power Pole . .
Plumbing (DrainlWaste Pipe) . . .'
Electrical Ground electrode/Uter ,
.
SetbacklFormslTrenches (Footings) . .
DO not install subfloor or pour floor slab until the
following applicable items have been signed; .
Plumbing (Water Pipe.Sprinkler Valves) .
MeehanicaJ(Groundwork) .
Electrical (Underground Conduit) .
Pre-slab (Compaction/Membrane.Reim. .
Underpin~ng (Floor Joist/Girders) ..
. .
DO rlot cover or conceal the work below unlll the
following appJ!cable.items hav.e been signed; .' .
1st Floor Shear .' .
FireSprinkJer (Rough) .
2nd Floor Shear A :...----.
Roof (Sheathina/Diaphragrn/Frame) . 'rJ.!-pt;
Masbnry.(Reinf-IBond BeamlPre-Grout) .
Rough Plumbing. (Top Out)
Rough Mechanical
Rough l:IectrlCal\Dry wanl .
Rough Electrical
Framing (Only afterPlbg.. Elec..Mech.. and Rre)
Insulation (SoundlEnergy) '1
Do not tape or plaster until the foUClwing applicable
items have been signed;. .' .
Drywall .
Penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath . '. . . .
. Exterior Lath . . p
. GENERAL ITEMS
Exterior Plaster (Brown Coat) .
T -Bar Electrical
T-Bar Mechanical .
T -Bar Structural . . . .
Sewer .. .
Water Engineering Backflow E
Water Service
Mechanical Inspections
lumbina Inspections
lectricallnspections
Inspector