2673 Stockton
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
BUILDING PERMIT NO. BLD2005-02911
DATE: 9/14/2005
JOB ADDRESS: 2673 W STOCKTON AVE
LEGAL DESCRIPTION: N TR 2303 LOT 33
APPLICANT: FRANK GARCIA
OWNER INFORMATION:
ROLAND R BARRERA
2673 W STOCKTON AVE
ANAHEIM, CA 92801
CONTRACTOR INFORMATiON:
COAST ROOFING
21681 IMPALA LANE
HUNTI NGTON BEACH, CA 926460000
BUSINESS PHONE: 714968-8754
JOB DESCRIPTION:Tear off existing roof and replace with 20 squares of 50 year composition shingles to house and attached garage.
ARCHITECT/ENGINEER INFORMATION:
VALUATION: 6,590.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense 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 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).
o 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 bunds or improves
thereon, and who does such work himself or herself 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 pUlpose 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 prope rty 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
I hereby affirm under penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
ih. permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
t e Labor Code, for the perlormance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number: 1113190-04
PROCESSED BY: MSM
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions hapter 9 (commencing
with Section7 00) of 0" i n 3 o~ Business and
Professions' e. ~
9/16/2005
Date:
Contractor
This section need not be completed If the pennit is for one hundred dollars ($100) or less.
o I certify that in the perlormance of the work for which this permit is issued, J shaJJ not
employ any person in any manner so as to become ject to the worker's compensation laws
of California, and agree that if I should become ~e to the worker's compensation
provisions of Section 3700 of the Labor Code, I all,} /rthwi~mP1Y with those provisions.
Date: 9/16/2005 Applicant: ,,- ~
WARNING: FAILURE TO SECURE 0 KER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJEC AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDlllON 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 agency for the
performance of the work for which this permit is issued (Sec. 3097 .Civ.C):
lender's Information:
NUMBER
450393
TYPE
EXPI RATION DATE
12/31/2005
C39
Construcion Types:
V N, ,
Fire Sprinklered?
NO
I certify that I have read ii1is appiication and state that the above informatbn- is correct. 1
agree t comply with ci ordinances and state laws relating to building construction, and
~ereby a thorize r rese ives~f s city to enter upon the above mentioned property for
In 0 purp s. _
Date: 9/16/2005
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 issuMCe. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
247.85
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DralnlWaste Pipe)
Electrical Ground Electrode/Uler
Setback/FormsfTrenches (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) '/../. \lI.uD'^"iLl
Masonry (Reinf./Bond Beam/Pre-Grout) I
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 Backflow
Water Service
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Depl. Final 765.4040
Water Engineering 765-5268
Sub ListlBusiness License 765-5194
Zoning 765-5139
Building Final (LaS1lnspectlon - Only 1l~ C IT --"
After Above Complete) "
&r::iY-_A
PARTIAL INSPECTIONS ~-"\ v--/
Building Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections