7340 Stone Creek Ln.
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ElM
BUILDING DIVISION.
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REOUESTLlNE:
(714) 765' 4626
CENSUS CODE: 555
QUARTER SECTION:' 203
BUILDING PERMIT NO. BLD2005-01608
TYPE OF PERMIT CITY
Reroof
DATE: 5/31/2005
JOB ADDRESS: ,7340 E STONE CREEK LN
LEGAL DESCRIPTION: N TR 8560 LOT 48
APPLICANT: SCOTT JOHNSON
OWNER INFORMATION:
Trust Bauer
734 " Stone Creek Ln
Anaheim Hills, CA 92808
CONTRACTOR INFORMATION:
W"ST"RN ROOFING SYSTEMS -
2031 "C"FJRITOS AV" #7E
ANAHEIM, CA 92806-0000
. . BUSIN"SS PHON": 714/778-6294 . .
JOB DESCRIPTION:Tear off existing material, install 15 squares of metro meta(shingles ICBO#5626.
VALUATION: 4,000.00 PROCESSED BY: END
ARCHITECT/ENGINEER INFORMATION:
OWNER-BUILDER DECLARATION
I hereby affirm underpenarty 91 perjury that I am ex~mpt from the Contractor's License Law for the following reason Sec. 7031.5 Business and
PfOfessions COOe: any city or. county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
re~uires the appUcant for such permit to fite'a signed statement that.he is licensed pursuant to the provisions of the Contractor's License law (Chapter
9)(commencing with Seetlon 7000 of Division 3 of the Business andP,rOfessionsCode) or that he is exempt therefrom and the basis for .the alleged
exemption, Any violation. of Section 70$1,5 by any applicant fora-permit !;lubjects, the ~ppHcant .to ,8 ,civn penatl:y of not more than five hundred dollars
($500).
D I,as owner of property, or iny employeeswith wages as th'eir sole compensation, will do the work, and the structure is not intended or o.ffered'for
sale (See, 7044 Business and Professibns Code: The Contractor's license Law does no.t apply to. an owner of praperty who. builds or improves
tt:1ereon, and who does such wark himself ar herself_ ar through his or her awn employees, provided that such improvements are' not int~Ii~'fed or
affered for sale, If, hawever, the building or improvement is sold with one year af completion, the owner-builder wilfhave the burden of proving that he
did not build or _improve for the purpose'af sale). .
o -t, as the awner of the property, am exclusively contracting with licensed contractors to canstruct the project (Sec, 7044 Business and Professions
Code:' The Cantractor's License !-E.wdoes not apply to an awner of praperty who builds or improves thereon, and who contracts for such projects With
~ontractor(s)_ Hcens,ed pursuant to. the Cantractor's license Law). ' .
U I am exempt under Sec, ,~& P,C. for this reason:
Date: Owner: . .
. WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty Of perjury one of the following declarations:
o .1 have and will maintain a certificate of conSent to selHnsure fOT worker's compensation,
as pro"{ided'for by Section 3700 of the Labo.r Code, for the, perrorm.!;l:nce af the work far which
this permit is issued.
~ have and will ma.intain worker's compensatian ins'urance, as required by. Section 3700 af
rhe't:abor Code, for the performance af. the warkJor which this permit,is issued" My worker's
Campen sat ion insurance carrier and policy 'are:
Carrier: STATE FUND PoUcy Numbe" 1579948-2003
5/31/2005
Date:
This section need not be completed" the pe""it is for one hundred dollars ($100) or less.
~rtify that in the perfonnance af the work for which this permit is issued, I shall not.
emp~ny per50.'n in any manner so as to become subject to the worker's compensatian laws
of California, and agree that if should become SlIbject to th wolker's co nSation .
provisia,ns of S,ect!on 37~b ofth labor Cade,~orth ith Ose provisions.
Dale: 5/31/2005 Applicant: ./ /'
WARNING: FAILUR" TO S"CUR" 0 " COMPEN TION COV"RAGE IS
UNLAWFUL, AND SHALL SUBJ"9f AN EM Y R TO CRiMINAL PENALTI"S AND CIVIL
FINES UP TO ONE HUNDRED ;THOUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION"DAMAGES AS PROVi'DED FOR IN S"CTION 3706 OF THE
LABOR CODE, INTER"ST AND ATTORNEY'S FEES. .
CONSTRUCTION LENDING AGENCY
',hereby affirm unQer penalty of perjury that there is a construction lending agepcyfor the
performance of the work for which this permit is issued (Sec,3097,Civ.C):
Lender's Information:
NUMB"R
675902
TYP" HIC
TYP" C39
XPIRATION DATE
8/31/2005 .
Construcion Types:
V N, ,
Fire Sprinklered?
NO
I certify that I have read this application and state that the ab.ove information is correct. I
agree to comply jth all 'ty ardinances and state laws relating to building constructian, and
herebyauth e repre tives of thiS'city to enter upan the ab~ve mentioned property for
ectian urpose,
Date: 5/31/2005
Fees paid for Permit: ,
Total:
160.61
Sig ture af _ pplicant a ent
The ermit s I expire by limitation and become null and void if the building or
wor has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
I
FINAL INSPECTIONS
Date'
Inspector
, INSPECTION ' , DATE INSPECTOR Electrical Final I
TempQrary Power Pale ' Plumbing, Final ! , ,
Plumbing (DrainlWaste Pipe) , Mechanical Final I "
Electrical Ground ElectrodelUfer '
SetbacklFormslTrenches (Footings) , Gas Test I ,
Do not install,subfloor or pour floor slab until the Engineering/Grading Final 765.s126
, following applicable ilerns have been signed: I '
I ' . , ,
Plumbing (Water Pipe.Sprinlder Valves) , Fire Dep\. Final 765-4040 ,
I
Mechanical (Groundwork) , ' Water Engineering 765-5268 ' ' . ,
Electrical (Underground Conduit) , ' '
Sub List/Busines~ License765-519
Pre-slab {Compaction/Membrane.Keim., ' , , '
Underpinning (Floor Joist/Girders)' Zoning 765-5139!, ' 'J i~
Do not cover or conceal the worn below until Ine Building Final ,: ~aSllnspection. Only 7'l/6$'
following applicable items have been signed: , ' I ,fler Above Cpmplele) c:::..~
1st FIQor Shear . , , , !PARTIAL INSPECTIONS "
Firesprinkler, (Rough) ,
2nd Floor shaar "''' ,. Buildina Inspections ' ,
, , RoofJlSheath~aphragm'Frane) " -/ '"''> '\.0 ! ,
Mas ond BeamJPre-Grout) / I
Rough Plumbing (Top Out) , ' I
RQugh Mechanical ,
Rough ElectrICal Jury nail) ,', I , ' ,
Rough Electrical , ' ' /
Framing' {Only afterPlbg.. Etec" f...1ech..and Fire) ,
InsulaUon rSoundlEnergy) I " ,
po not tape or pla~ter' until the fQllowing applicable, Mechanical Insoections
Items have been Signed: ' , !
Drywall I , ,
Penetrations {Fire Rated) Electrical I ,
I
Penetrations (Fire Rated) Mechanical , , , '
Penetrations (Fire Rated) Plumbing I " .'
Interior Lath , , ,
.,
Exterior Lath PlumbinQ Inspections
, GENERAL ITEMS , : I.
exterior Plaster (Brown Coal) , I
T -Bar Eleetrical , , ' ,
T -Bar Meehanlcal ' ' , ' I , ' ,
,
T -Bar Structural " I
Sewer , , , ,
Water Engineering Backflow Electrical/Inspections " '
Water Service ' ,. ,
. '
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