1922 W. Sloop Ave.
TYPE OF PERMIT CITY
Reroof
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714)765.5153
INSPECTION REQUEST LINE:
(714) 765.4626
CENSUS CODE: 555
QUARTER SECTION: 43
BUILDING PERMIT NO. BLD2005-00719
DII, TE: 3/15/2005
JOB ADDRESS: 1922 W SLOOP AVE
LEGAL DESCRIPTION: N TR 3247 LOT 5
.APPlICANT: EMMA CANO'
OWNER INFORMATION: CONTRACTOR INFORM.^;T:ON:
Andres l Cano-,
1922 W Sloop Ave
Anaheim, CA 92804
JOB DESCRIPTION: Re-rool24 squares 01 composition shingles over exisling (1) jayer.
VALUATION: 5,000.00
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
. . OWNER.BUILDER DECLARATION . '..
I hereby affirm under penalty of perjury that I am exempt frqm _he ContractQf'~,;License La~ for the following reason (Sec. 7031.5 Business and
Professions Code: any city orcountyw/:1ich requires a permit to construct, c;it?r, improve, demolish or repair any structure, prionoits issuance, also
requires the applicant for such permit to file a $igned statement that he is Iiceri'.:;ed pUrsuanfto the provisions of the Contrsa.or's License law (Chapter
9)(commencing with Section 7000 of Division'3 of the. 8usiness and Professi~:ns ~OCIe) or that" he is exempt therefrom and the basis for the alleged
eXemption. Ariy Violation of Section 7031.5 by any applicantfor -3 permit sul)J~c;ts the applicant to a.dvU'Penalty of not more than' five hundreddollars
($500). . . . ., .' '. .
o I, as owner of property, or my employees with'wages as their $Ole C01"lp~hsation, wi>> do' the work, and the structure is nOt intended or offered for
sale (Sec. 7044 Business and Professions Code: The'Contractor's License (<:1,W does not apply to an owner of property who builds or.improves
thereon, and who does sum work himself or helSelf Qr through his or her OWT', '3'mploYfl:es, provided thai-such improvements are not intended or
offered for sale. If, however, the building or improvement is_solei with one .yet,r:of ~mpletion, the owner-builder will have the burden of proYing that he
!notbuUdor improYe for1he purpose of sale>. ~ . "5' . '. ..
. I, as the ow.ner .of the property, am exdusivelycon1rac:ting Wit. h licensed P'I..,.'.lfractors to construct the project (Sec. 7044 Busjl1e~s and ProJessions
. e: The Con~ractor's License Law does not apply to an owner of property,;',::o builds or improves thereon, and who oontrac:ts for such projects with
ontr-actor(s) licensed pursuant to the Contractor's License Law). L' .;
I am exempt under Sec. & P:C. for this reas n: . :'1' '. .'
Date: Owner:'" fA../ _,.._ .
WORKER'S C NSATION DECLARATION _ic__---1 LiCENSED CONTRACTORS DECLARATION I
I hereby- affirm under penalty of per} ry one of the-following declaratIons:' I hereby affirm under penalty of perj\lry that I a"'ill"'
o "have and will ma'intain a certificate of ronsent'to self-insure for'worker'~<';ompensation, licerlsed under provisions of chapter 9 (commencing
as' provided for by 'Section 3700 of the Labor Code, for the perforllY2mce of th~..h~crK for which With Section 7000) of Divsion 3 of the Business and
this permit is-issued. . . Professions Code. .
o .1 have and will maintain worker's compensatioh insurance, as reqlJ\rz.d b;i';39c~ion 3700 of 3/15/2005
the Labor Code, for the ~rformance of the work for whichch is permit is :~lle'::f..' My \t\'o:-ker,'s Date: Contractor
Compensation insurance carrier and policy are: . i '
Carrisr: Policy Number: NUMBER EXPiRATION DATE
isection need not be completed if the pennit is for one hundred dollars ($100; 'or less. .
. I'certify'_that in the perfonnance of the work for w~ichthis permit is jssue(i~ j shall not .
loy any personin any manner so as to become subject 10 the wo'!<eis c'Y.'1pensation laws
. of Califomia, and agree that if I should become subject to the worker's compef:s:arion), .
~royjsions of Section 3700 of the Labor de. ., shan forthwi,."mply with H"'~-,~e provisions..
Date: 3/15/2005 APPUcaY~ ~.'
WARNING: FAILURE TO SEc~k~ORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALLSUBJECTAN EMPLOYER TO CRIMINAl PENAi..T1ES AND CiVIL
FINES UP TOONE HUNDRED THOUSAND DOLl.ARS ($100,000), IN "'DDmON TO THE
COST OF CQMPENSATION, DAMAGES AS PROVIDED. FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
L CONSTRUCTION LENDING AGENCY ._
J hereby affirm under penalty'of perjury that there is a construction-Iending- agd'lcy for the
performance of the work for which .thls permit is issued .(Sec.3097 .Civ .C): _~
- ,t;9:laer';:: i!1tor:-,1~tivr:. - <.-,,,.
TYPE
Construcion Typ_es:
VN, ,
I certify that I have read this-application and state that the above information i:; correct. ,
agree to comply with all city ordinances and state laws relating to building construction, and
hereby authorize representives f this city ~o enter upon the above mentioned property for
inspeCtj~urposes. .
'. ,... ;b' ~ Date: 3/15/2005
. Signature ql Applicant or Agent .. .
he permit shall expire by limitation arid becollle null and void if the building or
work !1as not passed final inspection 365 days from the date of permit isSUll/lCe. A
new permit is required to commence or continue work.
Fees paid for Permit:
Total:
235.33 .
INSPECTION RECORD
. iNSpECTION , . 'DATE INSPECTOR'
r emporary Power Pole . . .
Plumbing (DrainMlaste Pipe) . .
Electrical Ground Electrode/lifer .
SetbacklFormsfTrenches (Footings).
00 not install subflqor or. pour floor slab until the
following applicable items have been signed:,
Plumbing (Water Pipe.Sprinkler Valves) . .
Mecihanical(Grou ndlNork) . . .
Electrical (Underground Conduit) "
PIe-slab (CompactionlMembr_.Reinf, .
UnderpinninglFloor Joist/Girders)
Do not cover or conceal the work below until the
following apP'li.c~t>le items hav~ .be~n signed: . . .
1st Floor'Shear.. . . . .
Firesprinkler (Rough) '. , '.
2nd Fioor'Shear . .~ /} / /
Roof (SheathinalDiaphragrnlFrame) . ~h~lo)
Masonry (ReinfJBond BeanJPre-GfO\It) .
Rough Plumbing (Top Out)
Rough Mechanical . ..
~ugh l:IectriCaI ( II)
Rough Electrical .
Framing (Only after Plbg. Elee.. Moth an.9 Fire)
InsulatlonlSoundlEnergy) .
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 !-lith
. . GENERAL ITEMS
Exterior Plaster (BlOWn Coat) .' .
T -Bar Eleetrical
T-Bar Mechanical '.
T'BarStructural . .
Sewer
Water Engineering Backflow
Water Service
FINAL INSPECTIONS Date Inspector. :
Electrical F.inal . .
Plumbirig Final . ....
Mechanical Final .
Gas test . . .
Engi"""ringJGrading Fin;ll 765-5126
Fire Dept. Final 765'4040 . .
Water E,ngineering 765~5268 .'
Sub List/Business License 765-519 ',. .
Zoning 765-5139 . .
Building Final *ast Inspectio:n- Onty , ~b':; 1;;... f/
fler Above Complete) ~
PARTIAL INSPEC TIONS '. .... ....
Buildina Inspections
Mechanical Inspections
'. Plumbina Inspections
.,
. Electrical Inspections