4200 E. Summer Creek Ln.
TYPE OF PERMIT CITY..
Patio Cover
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUESTLINE:
(714) 765.4626
CENSU~ CODE: 434
QUARTER SECTION:
BUILD.ING PERMIT NO, BLD2005-01713
DATE: 6n12005
JOB ADDRESS: 4200 E SUMMER CREEK LN
LEGAL DESCRIPTION:
~.
APPLICANT: SCOTT BERMAN
OWNER INFORMATION:
CONTRACTOR INFORMATION:
ROOMS N COVERS ETC
840 S ROCHESTER AVE #C
ONTARIO. CA 917610000
MISSION VIEJO. CA 92692.1136 BUSINESS PHONE: 909390-0555
JOB DESCRIPTION: BuUd 360 sq. ft. palio cover ICBO #2621 P.
VALUATION: 5,249.00
ARCHITECT/ENGINEER INFORMATION:
SUMMER CREEK HOLLOW HOMES
21911 ONTUR -
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm un erpenaltyof perjury that I am exempt from the Contractor's License Law for the follo.wing reason (Sec. 7031.5 Business and
Professions .Code: any city or county which requires a pannit 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 Professions Code) 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 subj~~ts the applicant to a CivU penalty of not-more than five hundred doljars
($~OO). . . .. ...
o I, as owner of property, or my employees withwl?ges as their sole comper,sation, will do, the work, and the structure is not intended or offered for
sale (SeC. 7044 BusinesS and Professions Code: The C'ontractor's Ucense La\!.J does not apply to an owner of property who builds or imprqves
thereon, and who does such "work hims~1f or herself or through his or her own f:mployees, provided that such impft>vements are not intended or
offered for sale~ If; however, the building or improvement is sold with one yearof completion, the owner.builder will have the burden of proving that he
did not build or improve for the PlJlpose of sale). :
o I, as the_"owner of the property,"am ,exclusively contracting with ficensed cOntractors to construct the project (See: 7044 Business and ProfessiOns
Code: The Cqntractor's licenSe Law does not' apply to an owner of-property wllo builds or improves thereon, and who cdntracts for such projects with
~ontr~or(s) I~nsed pursuant tothe Contractor's License Law). ' . - '
U lame?temptunderSec... ,B&'P.C.forthisreason:
Date: " Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of pe~ury one of the following decraratlons:
o I have and win.inalntain a certificate of consent to self~jnsure for worker's compensation,
as provided for by Section 3700-of the Labor Code, for the performance of the work. for which
this permitis"issued. "
~have and will maintain worker's compensation insurance, as required by Section 3"700 of
th .or Code, for the perlon:nanceof:the work for which this permit is issued. Myworker's
C mpensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 1606080-2.003
I
LICENSED CONTRACTORS DECLARATION
I hj3repy affirm under penalty of perjury that I am
licensed under provisionS of Chapter 9 (commencing
with Section 7000) of . n 3 ot the. B ss and
Profession Code.
6f7!2005
Date:
EXPIRATION DATE
913012005 .
Thi~ sectiol1 need nol be completed if. the pennit is for one hundred dollars ($100) or less.
~Icertify that in the perfonnance of the wor.k for which this permit is issued, I shall not
~y any person in any manner so as t6. be_come subject to the worker's compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3,700 of th bar de, shall forthwlt mply with those provisions.
NUMBER
517575
TYPE
TYPE
TYPF
C47
C39
HIC
. Date: 6/712005 Applicant: .
WARNING: FAILURE TO SECU W KER'S COM ENSATION COVERAGE IS
UNLAWFUL, AND SHALL S,UBJ CT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($1QO,000), IN ADDIl10N TO THE
COST OF COMPENSATION. AMAGES AS PROVlpED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
~..hereQy.J~ffInn under penalty of periury_that there is a construction lending ,",gFJ'~'JQr the_
perf9rmance ofthl?work for which this permit is issued (Sec.3097.Civ.C):
Le6der's Information:
Construcion Tvp~s:
VN. .
"Fire Sprinklered?
NO
I certify that j have ~ead this application 'and state th<;it the above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
herebyauth epresentives is city to enter upon the above mentioned property for"
.nspe. purposes.-
Date: 6/7/2005
Signatur of Applicant or Agent " ,
permit shall expire by limitation and become null and void.if the building or
work has not paSsed fi 001 inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
652.65
INSPECTION RECORD'
.
INSPECTION . DATE . INSPECTOR
Temporary Power Pole . . .
Plumbing (DrainlWasie Pipel .
Electrical Ground Electrodell)fer . . .
SelbacklFormsrrrenches (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-slilb (lOOnipactilll\lMembrane.Reinf:
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
following ,applicable i~ems have beeh signed:
1st Floor Shear . . . .
Fhesprinkler (Rough) . . . . .
2nd Floor Shear .
Roof (Sheathing/DiilphragmlFrame).
Masonry (ReinfJBond Beari1JPr~lOUt)
Rough Plumbing' (Top Out) . .
Rough Mechanical '.
Rough Electrical II) . .
Rough Electrical. . . ,
Framing (Only after PI~fl-.'Elec.. t"lech. and Fire) . .
.
Insulation (SoundiEnergy) . .
Do not tape or plaster until the following applicable '.
items hav.. bllensigned:'. . .
Drywall . .
Penetrations (Fire Rated) Electrical
Penetrlllions (Fire Rated) Mechanical
Penelrlllions (Fire Rated) Plumbing . .. . .
Interior Lath .
Exterior Lath .' . ..
. . GENERAL ITEMS . .
Exterior Plaster (Bl'C7Nn 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 Final 765.0126
Fire Dept. Floal 765-4040 .
Water Engineering 76S-5268
Sub ListlBusiness license 765-519
Zoning 765.5139
Building Final (I.ast Inspection-Only
After Above Complete) .
PARTIAL IN SPEC
Bui/dina Inspections '.'
'7~ 7- 0 s-1~.f{h
. Date. Inspector
<-IZ . tJ IIMI
o n
Mechanical Inspections
Plumbina Inspections
Electrical Inspections