810 Swallow Way
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 210
BUILDING PERMIT NO. BLD2005-00081
TYPE OF PERMit
Reroof
DATE: 1112/2005
JOB ADDRESS: 810 S SWALLOW WAY
LEGAL DESCRIPTION: TR 9465 LOT 40 POR OF LOT
CONTRACTOR INFORMAnON:
HOYT ROOFS
1809 N ORANGETHORPE PtRK
ANAHEIM. CA 92801 0000
. BUSINESS PHONE: 714 773.1820 '. .
JOB DESCRIPTION:Tear off existing shakes, instaU 30 squares of U.S lile Cia'0nax at 5.9Ibs. ICBO #3523 and 112" sheathing, two 30 Ibs felt iayers,
VALUATION: 11,500.00 ,j PROCESSED BY: ENO '
I .,' OWNER-BUILDER '~C'-ARATION , .'
I hereby affirm under penalty of perjury that I am exempt from the contractor'(ucense law for the following reason (Sec. 7031.5 Business and.
Professions Code: any dty or county which requires a permit to construct, att9r, improve, demolish or repair any structure, priOr to its issuance, also
requires the applicant for such permit to file a signed statement that he i~ licE:":s~d pursuant to the provisions of the Contractor's'Ucense law (Chapter'
9)(commencing with Section 7000 oJ Division 30f the Bllsinessand Pr6fesSiQbs Code) or that he is I5!xemot therefrom and the basis for the alleged
exemption. Any -violation of Section 7031;5 by any appl\cant for a permit :')ubj~cts the applicant to a civil p'enaltyof not more than five hundred dollars
~~ ' ,1 .
o I, as owner of property, or my employees with wages as their sole comp~,'i1~ation, win do the work, and the structurs is not intended or offered for
sale (Sec, 7044 Business and ProfessionS Code:" The Contractor's License l'ol,w does not applytci an cWlwr.of property who builds or improves
thereon, and who does such work himself or herself or through his or her owrlemployees, provided that such improvements are "not Intended or
offered for sale. 1(, however, the buildiryg or ilTlprovementis SOld' with one ydr. of completion, the owner-builder will hElve the burden of proving, that he
did'not build or. improve for the pUlpose of sale). ~.
o I, as the owner Of the property, am exdusively contractin~ with licensed f-.)i";tradors to construct the projeci (Sec., 7044 Business and Professi~(';s
.Code: The Contractor's License Law does not apply to an owner of property 1vho bu!rds or improves thereon, and who contracts for such projects '!"lith
~ontractcr(s) licensed pursuant to the Contractor's License Law). '
U I am exempt under Sec. '-, B & P ,C. for this reason:
Date: Owner:-
L-. WORKER'S COMPENSATION DECLARATION i
I hereby affirm under penalty of perjury'one of the following declarations: \:
o I have and will maintain a ~ertificate ofcxJnsent to self-insure ior worker'X'~6miJensatjon.
as provided for by Section 3700 of the tabor Code, for the performance ofth!:\'.Iorklor whim
this permit is issued. 1
....i8 I have a nd wi" maintain worker's compensation insurance, as required b~~ Section 3700 of
the Labor Code, for the performance of' the work for which this permit.is i8Su...~d." My worker's
. Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 1700471~b2
APPLICANT: MILES REED
OWNER INFORMATION:
La F De
810 S Swaliow Way
Anaheim, CA 92807
ARCHITECTIENGINEER .INFORMATION:
l
UCENSEDCONTRACTORSDECLARATION
I hereby affirm under penalty of perjurl that tam
license under provisions of chapter 9 (commencing
with Se n 700 of ivsion 3 of the BIJsineS:s and
Professio G e. -.. ~~
./~~,t6I&
. .
'\!lis, section need not be .completed if thepennit is for one hundred'dollars ($1 Oo;;>r Jess.
~I certify that In the perfolTflanceoftne ~ork rwhich this permit is issue::~" I shaUnot
. employ any person in a ny man r so as to b ,?me subject to the worker's cOiJ'ipensation laws
of Califomia, and agree that if I hautd bee subject. to the woTker's.con1Pf;.nsation
provisions of Section 3700 ofth:. Labor de; I shail fbrthw!" comply with t"h~~se provisions
Contractor
EXPIRATION DATE
121311.006
C39
Date: 1{1212005 Applicant:
WARNING: FAILURE TO SECU WOR COMPENSATION COVER\GE IS
. UNLAWFUL,AND SHALL'SU~' CT AN EMPLOYER TO CR.IMINAL PENAI,....iE. SAND CIV. IL
FINES UP TO ONE HUNDRE THOUSAND DOLLARS ($100,000), iN ADDiTION TO THE
COST OF COMPENSATIO ,DAMAGES AS PROVIDED FOR IN SE'CTION 3(06 OF THE'
LABOR CODE, INTERE'ST, AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY'
.I Jl~.repyaffirm !Jnder p. natty of Derj~ry that thGre isrl construction lendinG acincy far the
performance of the work for: whidl this permit is issued (See. 3097 .Ctv .C): .
Lerde~slnforrnation:
Canstrucion Tvpes: .
VN, ,
Fire Sprink!ered?
NO
Date: 111212005
Fees' paid for Permit:
Total:
235,98
Signature of Applicant or Agent
pe it shall expire by iiinitation and become null and void if the building or
wo. has nlit 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 (DrainiWaste Pipe). .
Ehlctrical Ground Electrode/lifer .
SetbacklFormsITrenches (Footings)
Do not install subfloar or pour floor slab until the
fo11owing applicable items. have been signed:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Grounctwork)
Electrical (Underground Conduit)
J>re-slab (Compaction/Membrane.Relnf. .
Underpinning (Floor Joist/Girders) _n -,-
~ not cover or conceal the work below until the .
following applicable items have been signed: .
1 stFloor Shear
Rresprinkler (Rough)
2nd Floor Shear . .. .4 .
Roof (Sheathing/Diaphraam/Frame) 1- '41-~
Masonry (ReinfJBond BeamlPre-Grout) .
Rough Plumbing (Top Out)
Rough Mechanical .
. .HOugh f1ec:trical au)
Rough electrical. .
Framing (Only aker Plbg., EIec.. Mech.. and Fire)
Insulation (SoundlEnergy) . . .
po 110llape or pla~ter. until the foHowing applicable
.tems have been. sIgned: . ,..
.Drywall .
penetrations (Fire Rated) Electrical .
Penetrations (Fire Rated) Mechanical . .
Penetrations (Fire lbIted) Plumbing .
Interior Lath
Exterior Lath . ... , . . :-
n 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
Engineering/Grading Final 765-5126 c.
Fire Dept. Final 765-4040 .
Water Engineering 765-5268
Sub list/Business License 765-519<
Zoning 765-5139 . , . '
Building Flnalj}astlnspection. Only . ~-tI $"' '74,. ; ",(/"'- J
, .. fter Above Completej .
PARTIAL INSPECTIONS.
Buildinalnspections
..-----. .
Mechanical Inspections
Plumbina Insoections
ElectricallnsDections