1259 N. Moraga St.
TYPE OF PERMIT
Reroof
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CITY a7:;'<?;ji'lHEIM
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BUILDING DIVISION
200 S. ANAHEIM BLVD..
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 30
BUILDING PERMIT NO. BLD2004-03496
DATE: 9/15/2004
JOB ADDRESS: 1259 N MORAGA ST
LEGAL DESCRIPTION: N TR 2288 LOT 60
APPLICANT: AUSTIN HAN
OWNER INFORMATION:
Vincent Moutard
1259 N Moraga 5t .
Anaheim, CA 92801
ARCHITECT/ENGINEER INFORMATION:
CONTRACTOR INFORMATION:
ACE ROOFING SYSTEi,i CO
1027 W ORANGETHORPE iWE
FULLERTON, CA 928:,5-OJOO
BUSINESS PHONE: 7.14811-9.923
JOB DESCRIPTION:Replace existing roof with 1 a squares of 30 year compos.tion shingles for house and 4 squares of. 30 year' composition shingies for
deta't~g&88'ge.
VALUATION:
I OWNER-BUILDE~ DECLARATION
I, hereby affirm under penalty of perjl.,lry that I am exempt frOll1 theContractor::; License Law fOithe following reason (Sec. 7031'.5 Business and
Professions Code: any dty or county which requires a permit to construct, a~er, improve, demolish or repair any structure, prior to its issuance, also
requ ires the appUca nt for such permit to file a signed state'ment tnat he is lid;nsed purs\..,ant to the provisions of the Contractor's License Law (Chapter
. 9)(commencing with Section 7000 of Division 3 of the Business and Professbns Code) or that he is exempt therefrom andtt)e basis fortha F1Jleged
.exemption. Any violation of Section 7031.5 by any applicant for a permit ~LJtjects the apolicant to a dvil penalty of not more than fi....:e hundred dollar::::
($500). . . :,'. . .
'0 I, as owner of property, or my ,employees with wages as th.eir sol") (;om~rnsation, wi!l~do the work, and the structure is 'not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License LC)'N dqes not apply to an owner of property who builds or improves '
thereon, and who does suCh work himself or helSelf or through his or her OW~h employees, provided that such improvemenfs are :lot intended or ,
offered for sale. If, however, the building or improvement is sold with one ye,:~r of completion, the owner-builder wi!! hay",=, the burden of proving that he
did not build or improve for the purpose of sale). . ~
o I, as the owner of the property, ani exdusively oontracting with Hc~ns.ed;C'')l"\tr~ct0r~ t6 ccnstructth'e project (Sec, 7IJM BiI~iness and Profession::>
Code: The Contractor's License Law does not apply to an owner of propcrt)':\v:;o builds0r ir:,proves thereon, and who. contracts for SLI('h.projects' with
~ontractor(s) licensed pursuant to the Contractor's License LaW),j
U I am exempt under Sec.. , B & P ,C. for this reason: --.Jl___
Date: Owner:;, _
I WORKER'S COMPENSATION DECLARATiON .' ~
I hereby affirm under penalty of perjury one of the following declarations: . r. I hereby affirm u~d~r p. alty of perjury that lam
o I have and will maintain a certificate of consent to self-insure for worke. ~ compensatron, licensed unde>r prov'3Kms
as prOVided for by Section 3700 of the labor Code, for the perfcrmant..8 of t!">,:, work. for wh\ch With Se~tlon 7000} of Oi .
~h permit's issued. Professlo $ ode.
I J nave and will maintam worker's compensation insur:=:tnce, as required 0/ SectIon 3700 of 9/15/2004
he labor Code, for the performance of the work for which this permit is rssv'o. My worl,er's Date:
Compensation insurance carrier and policy are:
Carrier: STATE COM~ .
PROCESSED BY: MSM .
Policy Number: .280-02 LNrr 0001124
NUMBER
679543
TYPE
TYPE
EXPIRATION DATE
10/31/2005
This section need not be completed if the ptlrmit"is for one hundred dol!Qrs {$10t:; or less..
o .1 certify that in the performance of the. 'Nark for which t 's Permit is jss~\;1d. i shaf! not
.employ any pers'on ina ny manner so as to become subjec 0 the worker's cc.mpensation laws
of California, and agree that if I should become subject to hie wprkef's comlX=r.sation
provisions of Section 3700 of the Labor Code, I shall fort th /'omply with th;)$sprov,isions.
Date: 9/15/2004 APPIi.bnt:
WARN ING: FAILURE TO S{CU WORKER'S CO
. UNLAWFUL, AND SHALL SUBJ CT AN EMPLOYER 0 CRIMINAL PENA1.T;ES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN AocnlON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION. 370:6 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. ' .
I CONSTRUCTION LENDING AGENCY __ . .
I hereby affirm Under penalty of perjury that there is a construction lending a~ef1cy forthe
performance of.the'"",ork for which this permitisi_s~ue:d (S_ec._3.Q9Z,Ciy.Ct.._ _~ .
. Lende'r'slnformation: -
C39
HIC
Ccnstrucion Types;
VN, .
Fire Sprinklered?'
NO
I
I certify that I have read
agree to oomply with
hereby a1,Jthorize rep
ins ction purposes.
s pplication and s.tate that the above information is correct. I
rdin'ances and state laws relating to building cOilstruction, and
s of this city to enter upOn the above mentioned property for
fees paid for Permit:
Total:
235.33
Dale: 9/1 5/2004
$ignatu of Applicant or Agent
The permit shall el\pire by limitation and become null and void if the building or
work has not pasSed final inspection 365 days from the date of permit issuanoe. A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION' , ' , [lATE " INSPECTOR
Temporary Power Pole
Plumbing (DrainIWaste, pipe)
E,lectrical Ground Eleclr\>delUfer ' "
SetbacklFormsfTrenches (Footings)" "
Do not install sublloor or pour 1I00r slab un!il the
following applicable itel1,1s have be'en signed:
Plumbing (Water,Ape.Sprinkler Valvlis)
liIechanical (Groundwork) "
Electrical (Underground Conduit)
Pre'Slab (Compaction/Membrane .Reinf.
Underpinning (Floor Joist/Girders) , 1
Do not cover or conceal the worK below until the
following"apRIi.cable items have been'signed:"'
1st Floor Shear ' " , ,
Firesprinkler (Rough), ,
2nd Floor Shear , ,
,Roof (Sheathing/Diaphragm/Frame) ll\lr 1..tL(J/\
Masot\ry (ReihfJBond Beam/Pre-Gl'O\It) .J
Rough plumbing ftop Out) , 'I
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical " ,
Framing (O~ly afterPlbg.. Ele6.. Mech arid Fire)-
Insulation (SoundlEnergy)
DO,not tape or plaster ,until the following applicable
items have been signed: '. . . '. .
Drywall ,
Penelrations(f'ire Rated) Electrical ,
Penetrations (f'ire R~d) Mechanical ' '
Penetrations (f'ire Rated) Plumbil1ll
Interior Lath , ','
Exterior Lath ' ..,
GENERAL ITEMS i
Exterior Plaster (Brown Coal)
T -Bar Electrical , , ,
T .Bar Mechanical ' ' , , '
T -BarStructUI'llI , , ,"
Sewer' : ' ,
Water Engineering Backflow ,
Water Service' ' ,
FINAL INSPECTIONS ' Date Inspector
Electrical Final , ' , " '
Plumbing ,Final "
Mechanical Final
Gas, Test . "
Engineering/Grading Final 765-5126 ,
Fire Oep!. Final 765-4040
Water Engineering 765-5268 ,
Sub list/Business License 765-519
Zoning 765-5139 , ,"
Building Final ~ast Inspe~lion. Only , 1/1't-1.,6 >-y V'f --
, ' , fter Above Complele) r, ~'
PARTIAL INSPECTIONS
Buildina Inspections
">-'.".,,',::
Mechanical Inspections
;.,
''''..,
,Phimbina Inspections
, Electrical Inspections