603 W. South St. (2)
APPLICANT: BENJAMIN ROSAS
OWNER. INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
Benjamin Rosas
603 W Seuth 5t
Anaheim, CA 92805
JOB DESCRIPTION:Tear eff existing reef and replace with 20 squares ef 5.7lb, capistrano. eaglelite tile ICBO# 4660.
VALUATION: 5,000.00 PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason Sec. 7031.5 Busiflsss an
ProfessionsCod.e: any city or countywhith requires a perniit 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 licel1:3ed pursuant to the provisions. of the Contractor'~ Lie,snse Law (Chapter
9)(commencing with Section 7000 of. Division 3 of the Business and Professions Code) or that he is exempt therefrom,andthebasis for the al,leged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the ?pplicant to a civil penalty of not more than five" hundrec;J dollars'
-~ .. . .' .'. .
1rYJ.. I,as owne'r of property, or my employees 'with wag. es as their sole c. om pens. aUon, will do the work, and the structure is not intended or offered for
~fe (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an 9wner of property who builds or'improves
tHereon, and who does s.uch-work himself or herself or thro~gh his or he~ 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 wHI have the burden of proving that he:.
did not builder improve fer the purpose of sale). . ..
o I, as,the owner of the property, am exclusively contracting with licensed CQntractors to construct the project (See: 7044 ~usiness and Professions'
Code:' The Contractor'S License Lawdoes not apply to anowner of property who builds or improves thereon, and who contracts for such' projects with
~ontractor(s) licensed pursuant to the Contractor's License Law).
U I ,e?,E}[l1pt under. Sec. , B & P. for this reason:"
Date: ! 't - J. -0'8- Owner: '
WORKER'S MPENSATlON DECLARATION
I hereby affirm under penalty"of perjury-one of the foHowing declarations: I
D I have and will maintain a certificate of consent to self-insu're for worker's~omperisation,
as provided fer by Sectien 3700 ef the Laber Code, fer the pertermance of thewOIj<for which
this permit is issued. ". " .' \ .
D I have and Will mainta,in worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this'permit is issued. Myworker's
Compensation insurance carrier and policy are: ' .
Carrier: . POl,icy Number.
i-. _s~tion.need n~ be completed if the 'pennit is'for one hundred-doll~s ($100) r less.
1 certify- that in the performance of the. work for which this permit is' isSued; I shall not
em loy any person in any manner so as to .become subject to the worker's con"pensation laws
of Califomia, and agree that if I should become subject,to the worker's comperisation
provisiens of Sectien 3700 of the. Laber Code, I sh I forthwilh comply w~rovisiens.
Date: 4/27/2005 Applicant:' ;
WARNING: FAILURETOSECUR WORKER' CO PEN5ATIONCOVERAGEIS
UNLAWFUL, AND SHALL SUBJ T AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED. bUSAND DOLLARS ($100,000), IN ADDI1l0N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under pena,1ty of perjury that there is a construction lending agency for the
performance oftlie work for whid1 this permit is issued (Sec.3097.Civ.C): .
'Lender's Information: .
BUILDING PERMIT NO, BLD2005-01215
TYPE OF PERMIT .CITY
Reroef
DilTE: 4/27/2005.
JOB ADDRESS: 603 W SOUTH ST
LEGAL DESCRIPTION: N TR 1453 LOT 43
I certify that-I have react this-a'pplication and state that the,above information-is correct. I
agree to comply with all city ordinances and state laws relating to bLiilding construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
in ion P. oses.
Date: 4/27/2005
SignaWre of Applicant or Agent . .
The permit shall expire by limitation and become null and.void ilthe building or .
work has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence' or continue WOrk.
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765.5153
INSPECTION REQUEST LINE:
. (714) 765.4626
CENSUS CODE: . 555
QUARTER SECTION: 74
13
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury t at I am
licensed under provisions of chapter,9 (commencing,
with Section 7000) of Divsion 3 of the Business and
Professions Code. "
4/27/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Tvpes: .
V N, ,
Fire Sprinklered?
NO
Fees paid for Permit:
Total:
160.61
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power' Pole ' ,
Plumbing (DrainNVaste Pipe) ,
Electrical Ground Electrode/Ufer
SelbacklFormslTrenches (Footings)
Do notinstali subfloor or pour floor slab until the " ,
following applicable items have been signed:
'Plumbing (Water Pipe,Sprinkler Valves) , ,
Mechanical (Groundwork) " ,', , ' '
Eledrical(Underground Conduit)
Pre-slab (Compaction/Membrane.Rei nt., ,
Underpinning (Roar Joist/Girders) , ,
Do not cover or conceal the work below until the ,
following applicable items have been signed:
1 st Floor Shear
Aresp~Rough)' , ' , " ,
2ndFlo ar ' ,,', , ," I/) I I/. A
ROof ~heal:hIOO1Oi;iphrag""Frame) 5/<.(/(fl ~,., '" ; {h,...tk
Masonry (ReillfJBond BeanilPr&oGrout)
Rough Plumbing (Top Out)
Rough Mechanical ' ' ,
ROugh ElectriCal, all)
Rough Electrical
Framing , (Only after Plbg., EJec.. Mech.. and Fire)
Insulation (Soul1dlEnergyl
00 not tape or plaster' until the following applicable,
items have been signed: ' '
Drywall '
Penetrations (Fire Rated) Electrical,
Penetrations (Fire Rated) Mechanical ,
Penetralions(Fire Rated) Plumbing
Interior Lath ,
Exterior ,Lath
, GENERAL,ITEMS
Exterior Plaster (Brown Coat) ,
T -Bar Electrical .
T -Bar Mechanical ,
,T-Bar Structural,
Sewer' " , . ,
Water Engineerirjg Backflow , ' ,
Water Service
"
FINAL INSPECTIONS Date' Inspector
Electrical Final ,
Plumbing F:lnal , " " ,
Mechanical Final ,
Gas Test .'
Engineering/Grading Final 765'5126 , "
-c- ~ '
Fire Dept. Final 765-4040
, Water Engineeiing 765-5268
Sub List/Business License 165-519 ,
Zoning 165-5139 , ' ?'\
Building Final ~ast Inspection- Only I I ~' //7
fter Above Complete) , <;;/ /71t>J
,,/ "
PARTIAL. INSPECTIONS
,Build/no Inspections
iJL r,A)C,'
Mechanical Inspections
Plumbino Inspections
ElectricallnsDections
<,
TYPE OF PERMIT
Reroof
DATE: 4/27/2005
JOB ADDRESS: 603 W SOUTH ST .
LEGAL DESCRIPTION.: N TR 1453 LOT 43
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
BUILDING PERMIT NO.BLD2005-01215
CENSUS CODE: 555
QUARTER SECTION: 74
APPLICANT: BENJAMIN ROSAS
OWNER INFORMATION:
Benjamin Rosas
603 W South St
Anaheim, CA 92805
JOB DESCRIPTION:Tear off existing roof and replace with 20 squares of 5.7 lb. capistrano eaglelite tile to house and patiQ covers ICBO#
VALUATION: 4660~~W'6'bmentaI5/12/05) . . PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and. .
Professions Code: any city or county which requi'resa permit to construct, alter; improve, demolish or repair any structure, prior to its issuance; also .
requires the applicanffor 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 ~nd 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 subjects the applicant to a civil penalty of not more than five hundred dollars
a~ . _ ' . . .
L:J I, as owner of property, or my_employees with wages as their sole compen,sation, will do the work, and,.the structure is not intended or offered for
sale (Sec. 7044, Business and Professions Code: The Contractor's License La\V does not apply to an owner of property, who builds or improves
thereon, and who does'such work himself or herself o.r'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 ~earbf completion, the owner-builder will have the burden of proving ttiat he
did not build"or improve for the purpose of sale). . .,.:' ' " ..
o I, as the owner of the property, am exclusively contracting with licensed ccntractors to construct the project (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 contracts fqrsuch projects with
,a.Qontractor(s) licensed pursuant to the Cqntractor's License Law). . .
W I m e m Y(lder Sec. ,:- & P,C. r this reason:
P Owner:
. WORKER'S 0 SATION DECLARATION
I hereby affirm underpenafty of rjury one of the following declarations: . 1
o I have and will maintain a certificate ofeansent to self-i~sure for worker'sdompensation,
as provided for bY,Section 3700 of the Labor-Code, for the performance of th_e \vork for which
this perm it i~ issued. . 1
D I have andwill maintain worker'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 policy are:
Carrier: . Policy Nl!mber:
This section need not be completed If the penni! is for one hundred .dollars ($1 00) or less. .
ha--I certify that in the performance 9f the work for which this permit is issued, 'I shan not '
~y any person.in -any manner so as to become subject to the worker's compensation laws
6f Califomia, and agree that if Is uld become subject to the worker's compensation
provisions of seetion 3700 of the or Code JI forthwith comply with those provisions.
Date: 5/12/2005 ' Applicant: -g , .
WARNING: FAILURE TO SECURE OR'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALLSUBJE AN EMPC ER TO CRIMINAL PENALTiES AND CIVIL
FINES U P TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, :<IMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST D ATTORNEY'S FEES.
ONSTRUCTION LENDING AGENCY
I hereby affirm under pe tty of perjury that there. is a construction lending agencyforthe
performance of thewQrk for which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
CONTRACTOR INFORMATION:
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Di\iSion 3 of the Business and
professions Code.
5/12/2005
Date:
Contractor
NUMBER
EXPIRATION DATE
TYPE
Construcion Types:
VN, ,
Fire Sprinklered?
NO
.. ,
I certify that I have read ~his application and state that -the above information is correct. I
agree to mply with all citY ordinances and state laws relating to building construction, and
ereby uthorize representives of this city to'enter upon the above mentioned property for
i ion pur oses.
Date: 5/.12/2005
Fees paid for Permit:
Total:
271:09
Signature of Applicant or Agent
111 permit shall expire by limitation and become null and void if thebjlilding or
wor has not passed fi nal inspection 365 days from the date of permit issuance. A
new permit is required tQ commence or continue work.
INSPECTION RECORD
.INSPECTlON . '. DATE INSPECTOR
Temporary Power Pole .
plumbing (Drain/Waste Pipe)
Electrical Ground Electrode/Uter
SelbacklFormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the. .;
following applicable items have been sign~d:
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (GrO\lndwork) .'
Electrical (Underground Conduit)
pre-slab (CompactionlMembrarie~Reinf.
Underp!nning (Floor JOist/Girders) : .
Do not cover or conceal the work below until the
following applicable items have been sign~d:
1 st Floor shear .
Fireliprinkler (Rough) .
2nd Floor Shear . .
Roof (Sheathina/DiaphraarnlFrame) .
Masonry (ReinfJBond BeamlPr~rout) -
. .
Rough Plumbing (Top Out)
Rough Mechanical
I !<<jugn l:IectrlCaI all) .
Rough Electrical .
Framing (Only after Plbg., Elec.. Mech. and Fire) .
Insulation (SoundlEnergy)
Do not tape or plaster until the following applicable
items have- been signed: . . -, . ... .
Drywall .
Penetrations. (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 Structurlll .'
Sewer
Water Engineering Backflow .
Water Service .
FINAL INSPECTIONS Date ,Inspector
'Electrical Final .
Plumbing Final. . . .' .
Mechanical Final . . .'.
Gas Tllst . . . .
. .
Engi"""rinlilGrading Final 765-S126
Fire Dept. Final 765-4040 .
Water Engineering 765-5268 .
Sub List/Business License 765-519 . . .
Zonirig 765-5139 . . /""\
Building Final ~ast Inspection. Only .5/I7~J ./ J /0.'.
fter Above Complete)
PARTIAL INSPECTIONS '. '/.
Buildina Inspections
!>LJ.-JC, .
Mechanical Inspections
Plumbina Inspections
Electrical Inspections