1746 Sumac Ln.
TYPE OF PERMIT
Reroof
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765" 5153
INSPECTION REQUEST LINE:
(714) 765 " 4626
CENSUS CODE: 434
QUARTER SECTION: 50
. BUILDING PERMIT NO. BLD2005"002~ .
DATE: 1/28/2005
JOB ADDRESS: 1746 W SUMAC LN
LEGAL DESCRIPTION: .N TR 3258 LOT 9
APPLICANT: SEMi IOFI
OWNER INFORMATION: CONTRACTOR INFORMi:rION:
Dhansukhla Ratanjee JOFI ROOFING CO . J
2960 W Lincoln Ave #C 235 FINCH ST i.."
Anaheim, CA 92801 ANAHEIM, CA 92807000r,) .
BUSINESS PHONE: 714 57 ("0036
JOB DESCRIPTION:Tear off existing material Instal! 68 squares of 20 year ""'f'P\lSition "hlngles to bUilding and garage
VALUATiON: 11,200.00 r'. PROCESSED BY: MSM
I OWNER"BUILDER'OECLARATION
1 hereby affirm under penalty of perjury that) am eXi;mpt from the CCrltracto?~ Lic~nse Law for the following reason (See 7031.5 Business and
. Professions Code: any.dty or.countywhlch requires a permit to CQnstruct,.ai,;!~r, lmprove, ~emollsh or repair anystruc:ture,p.-ior to Hs issLlance, also
requires the applicant for such permit to ftle-a signed statement-that he isJjc~~sed pur:Nant to the provisions of the Contractor's License i..,aw (Chapter
9)(commencing with Section 7000 of Division 3 of-the Business a'nd Profes$i~ns Code},or that he, is exempt therefrom and the bc.sis fo"r the alleged,
, exemption. Any violation -of Section 7031.5 by any applicant for a permjt-~ut.;l~cts- the applicant to s_ dvi\ oenaltycf not more than five hundred dollars
($5<l0).. . .( . . . . . .
o I,as owner of property, or .my employees with. wages as their sole c'om}:;~i.lsatiQn, win do the work, _and the st:-uclure is n.ot interlded' ')f offered for
sa'e (Sec. 7044 Business-and Professions Code: The Contractor's Lic~nse, l~~w does not c:pply to'an owner of propertywt')o builds Of !mprOVes
thereon, and who does such work himse)f or herself or through his, or her P\l';r~':employees, provided that such improvements are not intended or .
offefed for.~le. If, howevfii!-'; the building or improve!'Ylent is~old with or-e yc.r of c...mpletino; lhe own~r-bujJder will have. ti1e hurden of pr':Ning that he
did ~,~b,l!.~~l)r~~pr9\1~\(orthe.purp"ose of sale). . .' . _,;1, .' '-. . .~..' . . " .
01, -as the 9wner.q! the propert}'. am exdl!sively, contracting with license(\' ?~'ntr.8::.:tors- to co:-:strllctthe project (Bet,;.. 7044 Business and P:-ofesslo"ns
Code:. The Contractor's License Law does not apply to an o\"':1er of propertY'Nho bui.~ds?r impro~sthereon, ana vlho c;ontr:.3Gtsfor such projects with
tJontracto;(s~ licensed pursuant to the Ccntractor~s U~~ ~aw).. : .
L,.I ?r(\ exempt under Sec. .: ,.p, & P.t,. fo, !;hIS reason. __-.,_~
Oate: OWner: . " ,
L WORKER'S COMPENSATION DECLARATION "':e~~=.i I liCENSED CONTRACTORS DEClfiRATION:"]
I hereby affirm under pen~lty t?fperju'l)'one of the fOI,lowing declarations: .:; / . ' . I hereby, affirm under penaity of penury that ISf1";
rn--, h. aye a. nd will. maintain.a certifICate of con$ent to seIf-insuni for w. or~.'(ei~{C. nmpert&dtion, f licens~d under provision::; of chapter 9 (:-:ommencing
I~'prov/ded for by Section "3700 of the Labor Code, for tho e performance Qf a~€:: 'NOIX fOI whi.:h 'I with Sec -n 7000 .f Oivsion 3 'of the:, Businli"..$s and
this permit is issued. . .' . l' . Professio :.e:Q . Q. .', _.--,.
o i have a.nd will maintain worker's compensation insurance,. as. required t.~.'. Secti6n 3700 of I ~- ~ L_-?
the lab.or Code, for the performance of the work for which this permit is :sst;;hi, r...,y worker's Contrac:tor .(.
. Compensation insurance carrier and policy are:" . ~
Carrier: NO EMPLOYEES . Policy Number. EXEMPT
. !
This seCtion .need' not be tXmpleted if the pennit is for one hundred doilai~ ($1 ~q IJrjess.
ISJ---I certify that in the pertOnnance of the work forwhir.h this peltYlit is iseue!(!,l$hai! not
~oy'any person'in any manner so as to become subject to the worker!: ~(:lrdpensaUon laws
of Califomia, and agree that if I ould b e subject to the worker's comp4r.sation
provisions of Section 3700 of the bo ode, sh'. rth~ith <::,p~y wi .1!->.cse 'rrcvjsit)~s.
Date: 1/28/2005 Applicant: .. ,
WARNING: FAILURE TO.SECUR WOR 'S COMPENSATION COVE ... . _ is
UNLAWFUL,AND SHALL SUBJE T AN EMPLOYER TO CRIMINAL PENALTiES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100.000},IN ADCiTlDN TO THE
COST OF COMPENSATION, D MAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST ANDIATTORNEY'S FEES.
j' . CONSTRUCTION LENDING AGENCY "___
I hF.:rebv.affirm 1..J!1(lerpenalfy.of perjury that thf:r':'! leo ::t(;O("i~tr'lctic('!,h'f)~ir.:1_a9.:?'ncyforthe__
performance of the work for which this permit is issued (Sec.3097..Civ.C): . "".' ..
Lender's Information:
. ARCHITECT/ENGINEER INFORMATION:
l
NUMBE
78546
TYPE
EXPIRATION DATe
10/31f2006
C39
Construe/dn Tvoes:
VN, ,
Fire'Sprinklered?
NO
'1 certify that I h'ave read this application and state that the above information is correct. I
agfee mply with all city ordinancesarld state I~w~s relating to building constructiori,.and
" ere y.authorlze'repmsentives of this city to enter upOn the above mentioned property for
in ion ~S) ~ ~'.
;:::> -. Date: 1/28/2005
Signature of Applicant or nt
ermilsha/I expire by Ii IOn and become null and void if the building or
has not passed final inspection 365 days tromt.he date ot permit issuance. A
ermit is required to. commence or continue work,
Fees paid for Permit:'
Total:.:
536.06
..
INSPECTION RECORD
> INSPECTION >>> > DATE > INSPECTOR
Temporary Power Pole >
Plumbing (OrainlWaste Pipe) > >
Electrical Grolind ElectrodelUfer
SelbacklFormsrtrenches (Footings) >> >
00 not install subflooror pour floor slab untilthe
fOllowing applicable items have been signed: > > >
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) > >>
> I Electrical (Underground Conduit)
I Ple-$Iab (Compaction/Membrane.Remf.
Underpinning (Roor Joist/Girders) > > >>
,> ~ notCQver or CQrt<:eal the>Work below> until the .
.' following applicable items 'have been signed: .
1 at Floor Shear .
Fil!!sprinkier (Rough)
2nd Floor Shear , /' ./>
. Roof (Sheathing/D1aphtagmlFrne) ,I,/Ir;>j .'~
Masonry (RsinfJBond' BeamlPre-Grout)
Rough Plumbing (Top Out) .
Rough Mechanical
Rough ElectrIC III) .>
Rough Electrical .
Framing (.Only after Plbg.., Elec.. MeclL and Fire) .
Insulation (SoundlEnergy) . > .
Do not tape or plaster until the following applicable
items have been signed: >' . >
Drywall .
Penetratiol1$ (Fil!! Ratedl Electrical .
Penetrations (F/I!! Rated) Mechanical .
Penetrations (Fil!! Rated) Plumbing
Interior Lath > .
Exterior U1th
.' GENERAL ITEMS
exterior Plaster (Brown Coal)
T -Bar Electrical
T-Bar Mechanical
T .Bar Structural . . ,.
Sewer .
Water Engin&ering Backflow . >.
Water Service >
FINAL INSPECTIONS . Date Inspector.
Electrical Final .'> > .
Plumbing Final. . >
Mechanical Final > >'
Gas Test . . .
Engineering/Grading Final 765-5126 . >
Fire Dep!.Final 765-4040' . > I
Water Engineering 765-5268 > .
Sub List/Business License 765.519< . > >> .
Zoning 765-5139 . .
Building Final ~.sllnspection' Only .... ',"'", . it. ,A_. .
fter Ab.ove Complete)
PARTIAL INSPECTIONS
BuildinQ Inspections
Mechanicallnspectiorts
. Plumbing Inspections
ElectricallnsDections