427 S. Westridge Cir.
TYPE OF PERMIT
Reroof -.,
CITY
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BUILDING DIVISION .
200 S. ANAHEIM BLVD.
(714) 765c5153
INSPECTION REOUESTUNE:
'(714)765.- 4626
CENSUS CODE: 555
QUARTER SECTION: 180
BUILDING PERMIT NO. . BLD2004.01140
DATE: 4/12/2004
JOB ADDRESS: 427 S WESTRIDGE CIR
LEGAL DESCRIPTION: N TR 7569 LOT 1.0
CONTRACTOR INFORM\TION:
UNIVERSAL ROOFING
6675 PALMA CIR
, YORBA LINDA, CA ,928860000
BUSINESS PHONE: 7146930724 ,.
JOB DESCRIPTION:Repla"" ,;xistlng shake with Eaglelitelile. ICBO # 4660. 6,8 Ibs. 29 squares. Includes attached garage.
VALUATION: 6.000.00 PROCESSED BY: CAL
I ' , , OWNER-BUILDER DECLARATION
I hereby affirm under penalty,of perjury that.! am exempt from the Contract0t':s Uj:ense Law for, the following reason (Sec. 7031..5, BUsIness and I
P.rofessionsCode: any.dty on?ountywhich requires, a permit to construct,alier, improve, demolish-or.repair any structure, prior to its issuance; also
requires th,e appli~nt for such permit to file a,sign.ed_statement that he j,s licf:r"\sed pursuant,to the plOvisions of the GontradQr's License'Law (Chapter
9)(cOmmencing with Section 7000 of Division 3 of_the Business and Professi,:;ns Code) or that he is exempt 'therefrom and the basis for the aHeged
exemption. Any violation of Section 7031,5' by any applicant for a pert1}it su::'}':?cts the applicant to a dvn pen?llty of not more than five hundred dollars,
~~, , " ,
01, as owne-r of property, or my employees with wages as-their:sole com;:e:nsation, will do the work, a~ the structure is not intendedorofferedfor
sale (Sec. 7044 Business and Profess_kms Code:: The Contractor's Ucens~ l..~w does not apply to an Gwf)er of property "",ho builds or improves
thereon, and who does such w:ork himself or helSelf or' through his or her ow.:' employees, provided t.hat such implOvements are not intended or
offereq for sale. ,If; however, the ,-building ~rimprcvement is sold with one ye,tr of completion, the o~ner.:buUder will have th~ burden of proving that he
dJdnot build or impr.oye-fcrthe purpose:of-sale). '. '. _ " .
o l,as~e owner. of the'-property, arnexdusively ~ontr:acting with-licensed;oontraCtors to const.ruct the project.(Sec. 7044 Susiness ar1d Professions
Code:.Tfle Contractor's li~nse Law dOes not apply to an owner of property'who builds or'improves thereon, and who contracts for such projects. with
F!J1ontra~or(s) Iicensed- pursuant 1~the-Contract?('s ~jcense Law): . , .
U lamexernptundetSec. . ,B & P.C. for this reason:
Date: oWner; .
I WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following ,declarations:
o lhave and wHl maintain a certiflCate_ of con5l;nt-tbself-insure-for worker's compensation'-
as provided for by Section 37oo.of,the labor Code, for the performance of ttJe work for whi?1
~hiSitiS issued: ,'. . :
. '.- t ,have. and w. ill maintain'WO,.rkerlS compensation ins. urance, as.fe. quired b! Section'_3700 of
. e.. bor Code, for the ,performance of the work for which this permit is icsucd. My worker's
pensation insurance'carn.er and policy are: " , " .
Carrier: STATE FUND , ',. PoliCy Number. 1643866,02 '
ThissfJCtion need not:be completed if the pennit i~ fOr one hUildreddollarS 1$101.:) or-less. .
0, _' certify that in the ,perfdrrnance of the work for which this perm;"t is i~sw3j,,'1 shall not .
.employ.any person i~.any, manner so as t() bec9,me subject to tne w6rke(s c(lr'rlpensation laws.
of_Calffomia, and agree that if I should.become subject t9 the worker's comp:,'il,s"a'tion
,provisions of SeCtion 3700 bfthe L,ab9r Co~e, I shallfosthwith comply with those provisions.
, "
Date: 4/1212004 Applicant:
WARNING: FAILURE To.SECU KER'S COMPENSATION COVER;~GE IS .
UNLAWFUL. AND SHAlLSUBJ cr AN 'EMPLOYER TO CRIMINAL PENALTIES AND CML
FINES UPTO ONE HUNDRED '!HOUSAND DOLLARS ($100.000), IN AIlC',TION TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR INSECT10~' 1706 OF; THE
LABOR C'ODE, INTEREST AND ATTORNEY'S FEES.' ,
I . CONSTRUCTIONLEN.DING AGENCY
I.hereby affirm under penaltv o( oeriurv_that there is a construction !'?nd in(1 ;:I':'-"'l"lr.yf~~r -th~
performance ofthework for.which thiS permit is l$sued,(Sec.'3097,Civ.C): -.
Lender's Information: ' .
APPLICANT: RICHARD 0 MORALES
OWNI;:R fNFORMA TION:
Joseph.R Colagrossi
4628 Westridge'-Cir
Anaheim, CA 92807'
ARCHITI;:CT/ENGINI;:ER INFORMATION:
~
LICENSED CONTRACTO~S DECLARATION,
I hereby affirm under penalty of perjury' that I am
. licensed under provisions cif chapter9 (cpmmencing
with Section 7000) of DivsiOn 3 of the Busfness and,
Professions Code,' '.' :
4/1;;;;;:~:':~ '
D:~~ . . ." ExPlRA~:~:a;:~E
765451 7/31/2005 '
TYPE C39
TYPE HIC
Construcion'Types:
VN, . '
I certify'that I have: read this apPlication and state th.st the above information 'is correct. I
agree to CorJlPly with all city ordinanceS and 'state laws relating to building cO:'lStruction. and
hereby authorize. representives,of this city to enter upon the abo)/e mentionecl property for
'Inspe~rpose~~ .b--.-'" ...' D.te4l1212004
: ' - . , Signature of "A"'pplicant or Agent
The permit shall expire by limitation and beCome null and void if the building or'
work has not passed final inspection 365 days from the date of permit issuance. A
new perinit is required to commellCe or contillUe work. '
Fees paid for Permit:
Total:
0.60
, INSPECTION RECORD
INSPECTION, ' , DATE INSPECTOR
Temporary,Power Pole " ' , .
PlumbIng (Drain/Waste Pipe) , " ,
E"'ctrlcal Ground Electrode/Uter ' , ' , '
SelbacklFormsrTrenches(Footings I "
Do not install sub floor or pour floor slab until the
following applicable items' have been signed:
Plumbing (Water Pipe:Sprinkler Valves) , , ,
Mechanical (Groundwork) , "
E"'ctrical (Underground'Conduit) ,
Pre-slab (Compaction/Membrane.R,einf.)
Underpinning (FlOor Joist/Girders) ,
Do not cover orconceal.the wor!< below until tne '
f91lowing applic?:ble Items, nave been s,igned:. .
1 Sl Floor Shear
Firesprinkler (Rough) ,
2nd Floor Shear , ' " ,
Roof (Shealhing/DiaphragmlFrll11el ~~1'-
Masonry, (ReintJBond BeanlPre-Grout) , "
Rough Plumbing (Top Out) , " " " "
Rough Mechanical'
Rough Bectrlcal (Dry wall)
Rough Electrical" , , . ' ,
Framing {Only after Pfbg., Elee.. Mech.. and Fire! ' , "
'lnl!lllaliim (SoundlEnergy) , , ,
.po not tape orpla~ter until'the following applicable
.temshav!l 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 Engineering Backflow
Water Service , " ' ,
FINAL INSPECTIONS Date Inspector
Electrical Final, :,', , , ' ,
, '
Plumbing Final , I '" ,
, " ,
Mechanical Final " , '
,
Gas Test , ' , "
Engineering/Grading Final 765.0126 ' I ,"
Fire Oept. Final 7654040 ' " ,,' , ' ,',
Waler Engineering 765-5lt68' ,
Sub List/Business License 765-519
ZC)ning 765.5139 ' ' " "
Building Final ~astlnspection. Only ,:
' fle, Above ,Complete)
PARTIAL INSPECTIONS
BuildinQ InsC)ections
Mechanical'lnSDections
PliJmbinQ InsDections
Electricalll1sriections
PERMIT. EXPI R"ED
INSPECTION
f-lOT COMPLETED
DATE: I J.-.q