3156 W. Stonybrook Dr.
BUILDING PE.RMIT NO. BLD2005-00377
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: .10
TYPE OF PERMIT
Miscellaneo.us C ITV
DATE: 2/10/2005
JOB ADDRESS: 3156 W STONYBROOK DR
. LEGAL DESCRIPTION: N TR7241 LOT 67
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APPLICANT: GREGORY STAYTON
OWNER INFORMATION: CONTRACTOR INFORiV:ATION:
HassanKAwad . ACCURATE AIR & ELEc:iRICAL
" " I
3156 W Stonybrook Dr 1480 DOMINGUEZ RANCH. i' '.'.0
Anaheim, OA 92804 CORONA, CA 92882000CL
JOB DESCRIPTION: Install new salar photavaltaic systam an roof: ELEZ005b193
." . ~
VALUATION: 15,04300 ii PROCESSED BY: JNJ
r . OWNER.BUlLOEriOECLARATION . ._~
I hereby affirm under penalty of perjury-that l am exempt from the Contracto:l's License LawJor the followIng re3son (SeQ. 703'!.5.Buslnessand.
Professions Code: any city or county which requires a permit ~o ~o~truct. ;),1~r,:jmprOl'e,'demoiish or repairany slructure; priorto,il.;;'issuance, also
require!) the applicant' fer such pennit to file a signed statement t/-{at he l,g Ii~~hsed purSlJ~nt_,to thE'! pro"lsions ,of the Contractor's__licen~_e '-a.~ (Ch~pt0r
9)(cQmmencing with Section 7000 of Division 3',of the Bus_iness and Profess~)n,S Code) ()i that he is exempt therefrom and theba$isfor'the alle9~-'"
exemption. Aryy violation of Section 7031.5 by any applicant for a permit sul,~s:?t3' t.~e eppr~ant to g dvU penalty of not more than five hundred d~l~rs
($500). . .:,.t.... . ..' . . . ".. .
[] .1, as owner of property, or my employees with wages as their,:'$0le ~Orn.~Sns2tion. wiifdo the w~rk, and the strlJcture is nct intend ed ~r offer,ed for
eate {S~c:7044 Business and Professions Code: The Cqntractorls llc,ense EWdoes not apply to an:o",:'ner of prope.rry 'J.;ho'bu!lds';)'j !!11proves ' ,
thereon,~r1d whO. dot?~ such work iJimserr or hstSelf or through hi's Dr her 9;.1,- . employees, provided that such ifl1proveme;'ftsar~ f10t intended.or
offeredfbfsale. If. howe"\f~r, the building or in1provemenf !''":; sold ~-lit." onl'3 'r _, of oomp!Atio:1, ~he owner-bl'Uder will have the b,urcel1 of provrng !hat.he
didno-t.biJildor~~p-"oveforthepui"poset'fsalp.)-:, '{'. .' . .' ".,-' ...:' ,.,.c,""
[J :~:,a~:th~ o"'JI1er of the pr9perty: ?m exclusively <:ont;ading wnh !jC€~"t~~flw~t:"?GlO;s to _construct the_ project fS~C.,}'Of14 Ousine.,~s'anJ professic,ns
Ct)ds_:,The-,Cc~t!~~tor's Ucen.$e Law~Qes: not apply tc all c'Nnerof poop6rt,~f;v:'IO bu1!ds U1 ImprovE'~ t/ierec~, anrl ~i;ho 'oontrf:ctsrOi suCh p:,oJe-:t';',with
F-~t'IHrat.i;or(~lHcen$t:d pV:-Sl!~nt to tiie CorrtTClctcr's License law)~: J) '. .
___.J I a~llexempt!JnderSec. ___.-:... ,B & P.C. fortl;ls reat>o:n:' .._.~J:___...:.-:.-..____ ~___,
C::;.:- WOR~:~ COMPENSATiOti.~CM:Mf!Q~~"'b=~ . _=:1 . F- LlCSNSED:;;NT~~roRs;EcL4RAi!oU
I n0f'.:by affirm under pe:lzitY'0f.perjury one of the following dedaratiot1s:. .-J' . ! hereby Q.ffir~ onder f.\f..l12.lty ,)f fJujvry that I am
O' I have .oct 'Nit! maintain a certinO",. af consent to self.ins,,,. fer wmk';& c"",;>sneatiun, I :ic"""ed undar provisioos oi chap"", (.o<nm~l1o;og . .
a.S prov!fietl for by Saction 37:)0 of thP.: Lebor Cede, fOithe perf:Jrmalloo Gft({~ wo:i-: for which 'I v/l'ih S~)~tion.rO.OO) Q U BUSIness a!"\C!
this permit isis,sued., ,. 'k-- " I ProfeSSIOn.,> COd
'EV1 hav:e an. d.' will maintain wO!1<er's 90n!pensation insura.nce, as ffiqtli~:d !~"-v S.~dion ::rioo (if I 2f10f2005
. ~tt Labor- Code, for the performance of "ihe wor'~ for which this per:-nit i$ ii:.::;\.!~,-L My worker's' Oate:
Compen~tion in~urance carri~randPO.liCY are: '.' .t . -I
Carrier:. Policy Number: EXEMP; . NUM8E~
This section, "I!l'ed not be .-compl~ted ~f'lli:~'p~"!"it is tor'one hundred dol!Q"s ($~~:~r~ f~~~: ' 1 8.f~~~3
~certifythatin the performance of the work; for whiCh this p~rn:-!it:s i~u':~d, I shall not' I TYPE
ttm.Ployany 'person in allY manner,so as to ber:ome subject tc.tt;';! lN9rJ:<E;!r'5tt:.mpaf:S~ti?'," laws.
of Califomia, and agree that if I should become subject to thew9rker' .... !r~r.s?-lio:r. ,
provisions of Section '3700 of the labor Code, I shaU forth\: ith c- 'IY,\ :' 1.T~cse provJ3!6ns. Constn..lcion 1ypes:
. . '. VN,
Date: .2/10/Zer05 . Applicant: .' )~- I
WARNING, FAILURE TO SECURE WO KER'S CO PEN' TI d COV!O;;i\GE is''
UNL"WFUc, AND SHALL SUBJECT AN EMPLOYERTO'C ~\iNAL PEI~Ai:TIES /\1'10. CIVIL
FINE~JjP TO ONE HuNDRED THOUSAND DOLLARS ($100,OOO):IN 1\~"(lnO" Tb'j'HE I
COST 'OF COMPENSATION, DAMAGES A$ PROVIDED FOR IN SECTIO:".37()6 OF'n'IE
LABOR CODE, INTEREST AND ATTORNEY'S FEI:S:' '. ,
I.. .. .... CONSTRUCTION LENDING AOENCY . ,Z='
,.\ _ht:fflo:vaffir01. .~md~r p:en8ltypfJ,~(,ury_ that th~!;~ :"l,<;\.~ :90J.,~t~u9,~i0f!_lendi('Uj;:!:3~~~Zl6( th~~
performance of the wcrk foJ which..this permit is i$'sued' {S:ec;j:097- GI\i ;-G~'" '~'-', , . __ .,
Lender's"lnformation:
ARCHITECT/ENGINEER INFORMATION:
EXP~RATiON DATE
12/~1i20n6
. (;20 HTAC
C10
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I certify ~hat I have read this application and state that the above information is cortect. I
agree to comply with all city ordinances. nd state laws relating to buDding ccnstruction, and
hereby authorize representives of .s ty to enter uPolJ the abovemention.:>d property'for
inspection purpose '
Fees paid for Permit:
Total:
112.74
Dal.: 211012005
Signatur pin or gen
The permit shall expir it tion and become null and void if the building or
work has not passed al inspection 365 days from the date of permit issuance. A
new permit is required to epmmence or continue work. .
INSPECTION RECORD
.
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (Drain,waste Pipe)
Electrical Ground Electrode/uter '
SetbacklFormsfTrenches (FootingS)
Do not install subfloor or pour floor slab until the.
following applicable items have been signed:
'.' Plumbing (Water Pipe.Sprinkler Valves) .
Mechanical (Groundwork) . ,
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane.Reim.j
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below untlllhe
following applicable.ilems have been signed:
1 st Floor Shear
Fitesprinkler (Rough),
2nd Floor Shear .
Roof ISheathina/Olachragnv'Franel
Masonry (RelnfJBondBeaijt(ete-Grout) .
Rough Plumbing (Top Out)'''' ,
Rough Mechanical' . ' '. . '
ROugh l:IectrlCaI {ury VY;l1l1
Rough Electrical. ,&~:> .
Framing (Only after Plbg" Elec., Mech" and Fire) ..\/
Insulation (Sounc:llEnergy)
po not tape or pla~ler until the folloWing applicable
Items have been SIgned: '.
Drywall . .
Penetrations (Fire Rated) Electrical . .
Penetratiort$ (Fire Rated) Mechanical
Penetrations (Fire Raled).Plumbing
Interior Lath. .
Exterior Lath .
GENERAL ITEMS
Exterior Plaster (Brown Coat)
T -Bar Electrical
T .Bar Mechanical .
T -Bar Structural
Sewer
Water El1gineerl"g Backflow
I Water Service .
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Engineering/Grading Final'7$!i-6126
Fire 'Oept. Final 765-4040
Water Engineering 765-5268
Sub Ust/Business License 765-519
Zoning 765.5.139
,Building Final, ILast Inspection. Only
After Above Complete)
PARTIAL INSPECTI
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electricalln~.o... ns
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