503 N. Whittier St.
;,-.
TYPiOOFPiORMIT' CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD..
(714) 765 - 5153
INSPECTIONREOUEST LINE:'
(714) 765 -.4626
CiONSUS CODiO: 555
QUARTiORSECTION: 112 d- 3.
BUILDING PERMIT NO. BLD2005-01077
DA TiO: 4118/2005
JOB ADDRiOSS: 503 N WHITTIER ST
LiOGALO'iOSCRIPTION: N TR 2492 tOT 8
CONTRACTOR INFORMAT.ION:
PLATINUM BEST VALUE ROOFING CO
22365 EL TORO RD #297
LAKE FOREST; CA 92630 0000
BUSINESS PHONE: 949 ml-7663
JOB DESCRIPTION:Tear"off E;;!xisting roof and replace with 29 squares of lifetim:e composition shingles.
)" .
10,000.00
APPLICANT: MIGUEL ENRIQUEZ
OWNiOR INFORMATI.ON:'
Chester K Phillips
503 N Whittier 81
Anaheim,CA 92806
ARCHITiOCT/iONGINEER INFORMATION:
VALUATION:
PROCESSED BY: MSM
OWNER-BUILDER OECLARATION
I hereby affirm u~ eT penalty of perjury that I all) e~emp1from the Contractor'~ License Lawforthe-forlowing reason Sec.70 1.5 Business and
Professions COde: any city or. county which requires a.permit to construct, cHte:.: 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 licen'sed pursuant to the provisions of the Contractor's License .Law (Chapter
9}"(commencing with Section 7000 of DI,yi.si1:in 30f the Business and PrafessionsCode} 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 subl~ts the ap'plicant to a civil penalty of not more than five hundred dollars- .
~~.' .' ! ....
o J, as .owner of property, or my- employees with wages as-their sole compensation, will do the' work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Oontractor's License LB.W do.es not apply toan owner of praperty who builds or impraves
thereon, and who does such wor~ hims~1t or helSelf orthraugh his or her own fmP1oyees, provided that _such improver;nents are not intenqed or,
.offered. for sale. If, however, the building or improvement is sold with one year,of completion, the owner~builder wiUhave the burden of pravil1gthat he
did n6t build.ar improvf) for the purpose of sale}. . , 'i. . ';,
[J I, as ,the .owner of the property, am exclusively contracting w,ith licensed O>ntractors ta canstruct the project (Sec. 7044 Business' and. ProfeSsions
Code: The Contractor's Lil?€lnse Law does not apply ta an owner of propertYWj'hO builds or improves thereon, and who contracts for such'proj~ls: with
oontractor(s) licensed pursuant to the Contractor's Ucense Law). . . _. ... . ,. . o. .,
, lamexemptunderSec.. , ,<B&P.C..forthi~reasan: . J . - ' ... .'. . . '.
Date:' Owner:
I WORKER'S COMPENSATION DECLARATION ,j
I hereby affirm under penalty of perjury .one of the following declarations:- o'~ ' .
o I have and will 'maintain a certificate of consent to sett-insure for worker'slompensation,
as provided for by Secfian 3700 of 'the Labor Code, ~or the pe~ormance ofthe~work for which
ff1hi permit isis5ued. . - .;j
I have and will m-aii"!tain wO-rker's compensation insuranc~, as requi're.d bY.~ ection 370.0 .of
e abot Code, far the performance of the work for which this permit is issued. My worker's
ompensation insurance carrier and palicy are: . . i
Carrier: STATE FU ND Policy Number. 17331 n -21)04
This seclion ne~ not be compleled if tile po';"it is for one h~red dollars ($100) ~ less.
o ,I certify that in the pertorrnance of the work far which this permit is issued'l shall nat '
employ any.person in any manner so as to became subject ,to the worker's con\pensation laws
.of Califomia, and agree, that if I shau 1(1. become su bject to the wa rker's comperjsation
provisions of. Sectian 3700 of th.e Labor C~de, I shall forthwith comp!y'with those provisions.
LICENSED CONTRACTORS DECLARATION
I ereby affirm under penalty of perjury that t am
licensed LInder proVisions .of chapter 9 (cammendng
with Seetio 7000) .of Divsion 3 at"the Business and
Professi n :Code. 0 .
4/18/200
Date:
Cantractor
NUMBER
753512
TYP.E
TYPE
EXPIRATION DATE
8/31/2006
C39
HIC
Date: 4/18/2005 Applicant:
WARNING: FAILURE TO SECUR W R'S COMPENSATION COVER,,-GE IS
UNLAWFUL, AND SHALL SUBJE AN EMPLOYER TO CRiMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED I OUSAND DOLLARS ($100,000), IN ADDITION TO THE'
COSl: OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '.
CONSTRUCTION LENDING AGENCY
l'her.eby affirm under penafiy-of perjury that there is a constructian lending agency for the
performance of the work for which this permit is issued'{Sec.3097.Civ,C):
Lender's lnfannatian: .
Canstrucian Tvpes:
VN, ,
Fire Sorinklered?
NO
I certify th?t I have read this application and state that the, above infarmationOiscorrect. 1
agr to comply with all city ordinances and state laws relating to building construction, and'
r authorize representiv~s of this city ta enterupan the abave mentioned property for
in ion purpases.
,
Date: 4/18/2005
Fees-paid for' Permit:
Total:
235.83 .
Signature 0 ant .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 permit is required to commence or continue work.
INSPECTION RECORD
...
INSPECTION
Temporaryo!'ower Pole
Plumbing (DrainlWaste Pipe)
o Electrical Ground Electrode/outer
Selb<ICklFormsrrrenches (Footings)
Do not install. subfloor or pour floor slab until the
following applicable items have been signed:
· Plumbing (Water Pfpe.Sprinlder Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab(CompactlonlMembrane.Reim.
Underpinning (Floor Joist/Girders) 0 .
Do not cover or conceal the wor1< below untit the
following applicable items have. been signed:
. 1st Floor Shear ..
Firesprinkler. (Rough)
2nd Floor Shear 0
.
ROof (Sheathing/Diaphragm/Frame) ~J~l kr T<I
Masonry (RelnfJBond BeamlPre-Grout) 0 0 1/)
. Rough Plumbing (Top Out)
Rough Mechanical
ROugh !':Iee!r
.0 Rough Electrical .
Framing . (Only after Plbg., Elec.. Mech.. and Fire~
insulation (SoundlEnergy) .
po not tapeoor pla~teruiltil the following applicable
.tems have been sIgned: 0
Drywall .
P4!Iletrations (Fire Rated) Eleetrical
Penetrations (Fire Rated) Mechanical
P4!Iletratlonli (Fire Rated) Plumbing
Interior UUh
. Exterior Lath
DATE
I
.
.
.
II)
.
... GENERAL ITEMS
Exterior Plaster (Brown Coal) . 00
T -Bar Electrical 0 .
. T -Bar Mechanical
T.Bar Structural..
Sewer
Water Engineering Backflow
.0. W"ter Service
.
.
.
INSPECTOR
.
. n
.
.0
.
FINAL INSPECTIONS
Electrical Final
Pfumbing Final
Mechanical Final
Gas Tesf 0
Engineering/Grading Final 16s-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-519
Zoning 765-5139
Building Final fLast Insp~clion. Only
. 0 After Above Complete) 0
PARTIAL INSPECTIONS
Buildina Insoections
Inspector
Date
MechanicallnSDections .0
Plumbing InsDections
ElectricallnSDections 0