1251 S. Sunburst Wy.
. BUilDING PERMIT NO. BlQ2005-00603
TYPE OF PERMIT
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CITY Qt,1i~l\R.':~4.'''liEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153'
INSPECTION REQUEST LINE:
(714) 765' 4626
CENSUS CODE: 555
QUARTER SECTION: 116
DATE: 3/8/2005
JOB ADDRESS: 1251 S SUNBURST WAY
LEGAL DESCRIPTION: N TR 9375 LOT 13
APPLICANT: fmY NGUYEN
. OWNER INFORMATION: CONTRACTOR INFOR!l.l,'TI<:lN: ARCHITECT/ENGINEER INFORMATION:.'
ROY NGUYEN
1251 S, SUNBURST WAY
ANAHEIM, CA 92805
JOB DESCRIPTION: Tear off existing and re~roof 27 sQuar:es of 30 year .composition shingles.
VALUATION: 5,500,00
~ OWNER'BUllDERPEClARA nbN
I hereby affirm under penalty ~f perj~1)' that I am ex.empt from the Contra_dot's License,_Law for the following reason (Sec. 7~31.5 Business and .
Professions Code: any city or county which requires a permit to con~truct, a!';").f, , improve, demolish or repair any $tructurs, prior to \ts issuance, also
requires the app"cant for such permit to file a signed statement thathe is Jjt:e~';$kI pUl'~"l1ant to the provisionsof.the Gontl"ador'!=; Licen:;.e law (Chapter
9)(commencing'with,section 7000 of Division 3 of the Business a np professir;ns Code) ,o,r that he is exempt therefrom a;"ld the basis for the alleged
exemption, MY violation of Section 7031.5 by any app1icant for_a permit s':;::,jec~s the applicant to a dvil penalty of not mo're tnan five hundr~d dOllars
~?)~s owner of p~o~ertY-, ?~ 'my e~I.Oyees with ~ages as th~. ir Sole cbm",.;;iation,Wili~~ t~e work; aM the Siructu. ra !~ nc~ !,ntend~ or offered for
~ (Sec, 7044 Busmess and ProfeSSIons Code:. 1 he Contr.actor's LlcerlSe'Lt;w does not apply to an OWllsr of property who bUilds or Improves _
thereon, ~nd who does such work himself or heme!f or'througi') his or her ow, fenlpJoyee.s, provided tha~ such irr.i:Hoven-'onts are not _intend-C:d or .
offered torsale. If, however, the: buikling or imprO'vement is !?old wHn oneYl~i,- of w!'nplE::tion, ti""18 owne r-bu Hd'3r will hav~"": the burden 'ot proving that he
did notbuitd or improve 'for the'putPoseof sale), . . ',' . _.. " .
C I, 35 'ihe-owner of the prop.arty, am exC'Jusivelycontracting with :lcen$&~)ontr2ctors to construct the project (sec. 7044 Business and Professions
Code; The Contractor's l i~rise la~ does net apply to' an oyvner af property';!/;jo) bund~ or irnpmV€3 ther~..m. ar:d IJ'!110-(:ontracts f0r such pro.iects with
~o!itractor(s) lice'nsed pur nt e C9 actor's Ucen~e., Law), .
[_J I a! u er Sec. :C. for this' reason:
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WORKER'SCL._--,J I,
I hereby affirm under penally of perju . one of the following decl..lratiorls; . ; ;
. .... ' - . -'.. ....1'
~~- 1 have cmd will maintain 3 ce _ ficate of oonseritto self~inslJre'for wortr,"~r?-c~lr.p,;:,:nsat;on,
as provided for by Sed Ion 3700 of the Labor' Gode. ,for tt)e perfonnflOGe of t~~~,: .,varl<. f(H whkil
this permit is issued. i.
o 1 have and will m.aintain worker's compen~atiol1 insurance, as re~uit'ed b~".Sectic.n 3700 of
. the l,.abor Code, for the performance of the work for which this pen:nit is iSSlli;:":. Mywor!(er's
Compensation insura nee ,carrier and policy are: '.
Carrier: Poiicy Number.
PROCESSED BY: SAM
';,"
. lICEN~EO CONTRf-CTORS DECLARATION. I
, I herenY-offirm un-jl'}rpenalty of perjui"ythat I_am.
liCensed ';,.mder pi'OvisiOns of chapter 9 (commencing
with Section 7000) of Divsion :3 ('If the Butines:,,: :'lna
ProfeSSions 'Code.
3/8/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
This section ne~ not be completed if the permit is for one hundred ~onars {S1 C:7~"" less. " .
.en ,I certify that in the perfarrnance of the work for which tht>:> permit !s ,i3SU.-1e;J, I. .shallnat
'~ploy any person in <?lny mannersa as ~o. orne subject to the w()rker'~ _,,?\.i!np~nsatiof1.law$
of Califomia" and agree that if I should bee me subject to the worker's COmpF'1Sation
provisions of Sectil:m 3700 ofth~ abor C e, I all forthwIth compiy with t.l',,",-se,P'rovisior.s.
TYPE
Date: 3/8/2005 Applicant:
WARNING: FAILURETO'SECUREW
UNLAWFUL,AND SHALL SUBJECT . EMPLOYER TO CRJMINAL PENALilESAND C!VIL
FINES UP TO ONE HUNDRED 1HO SAND DOLLARS ($100,000). IN ADOmON TO THE
COST OF COMPENSATION, DAM GES AS PROVIDED FOR IN SECTIOI' 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,
I . CONSTRUCTION lENDING AGENCY ..____~
! hereby affin:n under penalty of perjury ~hat there is a constructkm lending 8g~ncyfor ~he
perfor:'rranceoftheworkfor which thiS p_~rm;t is issued-'~~c..:....309! CjY.Gl~' " .
L;:.;;ue{;:;.. mfun:i;:.!.iU'l: -. - ~. -. - . . .
Construcion Tvpes:
V Nt ,
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 r.elating to building cor.-;truction, and
here authorize representives' of this city to enter upon the above mentioned property for.
i ion pur s.
Fees paid for Permi.t:
Total:
235,38
Date, 3/8/2005 .
Signat e of Ap can or Agent
The .mil 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 issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION' , DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain/Waste Pipe) ,
Electrical GrOUnd Electrode/lifer
SelbacklFormsfrrenches (Fo<>tings) ,
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 (Col1lpactionlMembrane...."'m. ,
Underpinning (Root Joist/Girders)
Do not coveror conceal the work below until the
follOWing appilcable .te",s have been s'gned:' , ,
1st Floor Shear ,
F"e~rinkler (Rough)
2nd Floor Shear , , . '.
Roof (SheathiIl!llDlaphragmFrame) , '7\ In ".b~ '
MaSonry (ReinfJBond BeamlPre-Grout) " III! ,
Rough plumbing (Top Out).. , , ,
Rough Mechanical '
Rough Bectrlcal II) , ,
Rough Electrical, ' ,
Framing {Only after Plbg'.: EJec.. Mech., and Fire)
Insulation (~rKllEnergy) ,
po not tape orpla~ter until the following applicable
,tems have been slgne~; , ,
Drywall
Penetrations (Fire Rated) Electrical ' ,
Penetrations (FIre Rated) Mechanical
Penetrations (Fire Ratl'd) Plumbing
Interior Lath
Exterior Lath ,
GENERAL ITEMS
Exteriot PlaSler (B~n Coat)
T .Bar Electrical' , ,
T .Bar Mechanical , ,
T -Bar Structural
Sewer
Water Engineering Backflow ,
Water Service
"
FINAL INSPECTIONS '
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading,Flnal 765-6126
, '
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-519
"
Zoning 765-5139
Building Final ILast Inspection. Only
After Above Complete)
. Date
Inspector '
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PARTIAL lNSPEC IONS,
Buildina Irtspections
*~'~',~d
~
Mechanical Inspections
Plumbin!:! Inspections'
Electrical Inspections '