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2648 Stonybrook TYPE OF PERMIT CITY Reroof DATE: 11/15/2005 JOB ADDRESS: 2648 W STONYBROOK DR LEGAL DESCRIPTION: N TR 2874 LOT 10 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 21 BUILDING PERMIT NO. BLD2005-03634 APPLICANT: DOUG STILES OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: K D STILES 2648 W STONYBROOK DR ANAHEIM, CA 92804 JOB DESCRIPTION:Tear off existing and reroof 25 squares with Asphalt Shingles and 5 squares with BUR VALUATION: 7,000.00 I OWNER-BUILDER DECLARATION r hereby affirm under penatty 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 ProfessionsCocIe) 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). f;f'-'!, 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 ~e (Sec. 7044 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 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 purpose of sal . o I, as the owner of the property, am x ively contracti 9 with lice e co jractors to construct the project (Sec. 7044 Business and Professions Code: The Contractor's License Law do no ply to an 0 ner of prop It w builds or improves thereon, and who contracts for such projects with ~ontractor(s) licensed pursuant to the ontra t s License L Jw), U la exemptun~Sec, ,8& tIS' Date' - - ~ Owner:__ WORKER'S COMPENSATION DE ARATION I hereby affirm under penalty of pe~ury one of the following d c rations: g I have and will maintain a certificate of consent to self~ sure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the petformance of the walk for which this permit is issued, o I have and will maintain walker's compensation insurance, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My worker's Compensation insurance carrier and poncy are: Carrier: PROCESSED BY: JNJ LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsion 3 of the Business and Professions Code. 11/23/2005 Date: Contractor Policy Number. NUMBER EXPIRATION DATE This section need not be completed if the permit is for one hundred dollars ($100) or less. TYPE o I certify that in the performance f t employ any person in any manner so of Califomia, and agree that jf I shou b provisions of Section 3700 of the La r Co Date: 11/23/2005 Applicant' WARNING: FAILURE TO SECURE WORKER'S CO ENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOY 0 CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL S ($100.000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PRO ED 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.CN.C): Lender's Information: ued, I shall not compensation laws pensation those provisions. Construcion Types: VN, . s te hat the above information is correct. I te ws relating to building construction, and te pan the above mentioned property for Date: 11/23/2005 Fees paid for Permit: To1al: 245.07 Sr ature 0 A plicant 0 Agent The permit shall expir limitation and become null and void if the building or work has not passed fi I inspection 365 days from the date of permit issuance. A new Dermit is reauired to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR T emporarv Power Pole Plumbing /DrainIWaste Pipe) Electrical Ground Electrode/Ufer SetbacklFormslTrenches (Footings) Do not install subfloor or pour floor slab until the following applicable items have been signed: Plumbina lWater Pipe/Sprinkler Valves} Mechanical/Groundwork} Electrical/Underground Conduit) Pre-slab (Compaction/Membrane Reinf.l Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear Firesprinkler (Rough) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) ,11-../ Masonrv /Reinf./Bond Beam/Pre-Grout) Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing(On'y after Plbg., Ele., Mec. And Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been signed: Drywall Penetrallons (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 Cross Connection Control (714)165-4280 Engineering/Grading Final 765.5126 Fire Depl. Final 765-4040 Water Engineering 765-5268 Sub List/Business License 765-5194 Zoning 765-5139 Building Final (Last Inspeclion - Only ~,l,,) ~ After Above Complete) PARTIAL INSPECTIONS G".~"""" [;-....-., '7 Building Inspections Mechanicallnsoections Plumbing Inspections Electrical Inspections