721 Verona
.'
BUI.WING PERMIT NO. "BLD2005-00842
TYPE OF PERMIT C I'TY
Reroof
ElM
BUILDING DIVISION
'. 200 S. ANAHEIM BlVD.
(714) 765 - 5153 .
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 21
DATE: 313012005.
JOB ADDRESS: 721 S VERONAST
LEGAL DESCRIPTION: N TR 2874 LOT 110
. APPLICANT: RON SELL
OWNER INFORMATION:
CONTRACTOR INFORMI'TION:
SELL ROOFING COMPANY
18032 LEMON
YORBA LINDA, CA 92886 0000
BUSINESS PHONE: 71452€-1758
.JOB DESCRIPTION:Tear off !lxisling material, install 31. squares of composilio.1shingles:
VALUATION: 7,900.00 PROCESSED BY: ENO
I . . OWNER-BUILDER DECLARATION .
I hereby affirm under.penalty,of perju&that I ~m exempt from the Contractor':;, License law for the following reason (Sec. 7031.S Business,and
Professions ~e: any city or county which requires:a permit to construct, all~f, 'improve,-demoJish or repair any structure, prior toHs iss!-,ance, also
requires the applicant for such.permlt to file a signed statement that he is liCCilsed, pursuant to the provisi.ons ()J the Contractor's license law (Chapter
9)(commencing with Section, 7090 of Division, 3 of. the Business and Professic,ns Code) or that-h,e-is exempt therefrom and the'basis for the alleged"
exem'ptioli. Arty-violation of Section 7031.5 by any applicant for a'permit SUbj9Cls the applicant to a civil penaftyof not more than five hundred dollars -
($500). . . '.'.. .
o I, as owner of property, or my employees with wages as their sole compt\llsation, will do the work, and the structure, is not intended or offeredfor
sale (Sec. 7044 Business and Professions Cpde: Th~ Contractor's ltcense .l;~w does not apply to an owner of property Who builds,or improves
thereon; and who does surn_ work himself or ~eJSelf or through his or her OWfremployees, provided that such improvements are not inten~_ed_ of "
offered for ~Ie. If, however, the- building or improvement is sold with one-ye::.t of compl.etion, the owner~builder wIll have the burden'of provirig th~t,he
did not build or improve for the purpose of sale). " ( \' ' . , ' , ,: .:'
o -', as the owner of the propertY,:am exdusively contracting, with licer.-sed \,-::r,1ractors to construct the project(Sec. 7044 Busines:s and Profe,$sions'
Code: The Contractor's license Law does not a'pply to an owner of property \lth.o buUds or improves thereon, _ and who contracts for,such proj~cts with
~ontractor(s) licensed pursuant tothe Contractor's License Law)" I," ;"'\ -" '
U I am exempt under Sec: .' , B & P.C. for this reason: " :i
Date: . Owner: ' d_
I WORKER'S COMPENSATION DECLARATION ~
I hereby affirm under penalty ,af perjury one Of the following declarations:
o I haVe and will fna'intain a certlf16ate' of consent to setf-insure for worker';;,~Ol11pensation,
as p~ovided fOr by Section, 37'0'0 of the Labor Code, for the performance of-th:e\Work for which
~j ermit is Issued. . ' ';.: '
. ha. _ ve andwill'inaintain Wo~~r'$ '~ompensation insuren,? e, as required b~.'.' .sectio. n 3700 of
abor Code, for the- perft;)rmance of the work for which this permit is "issued:' MY'N.orker's
ompenSation insurance eanier and policy are: " "
airier: STATE FUND' . Policy Number. 1066554-2004
This sectio~ need not be completed if the pennit i~ lor one hundred dollars ($109) or Ie.s.
0-1 certify that in the perfonna,nceofthe work for which this-permitis jssued~ tshaU,not
employ any person in any manner so as'to become subject to the workef's'~coHlpensation laws
of ,Califomia, and agree that if I shoukf'become subject to the worker's 'compensation
provisi~s o(Section:,HOO' ofthe labor Code, I sha!ffo wi comply ith h ' a provisio~s.
ARCHITECTIENGINEER INFORMATION:
HI' TRAN
I .
I
LICENSED CONTRACTORS OECLARATION
I her€!Qy affirm'under penalty of, perjury that I am
licensed under provisions of chapter 9-(commencing ',,<<-
with Section 7000) Of~Di .. 3 Of.~' siness nd
Professions f'?"". -, ' .
313012005 ~ .
Date: I.. Contractor. .
NUMBER
323842
TYPE
TYPE
EXPIRATION DATE
1013112006
HIC
C39
bate: 3/30/2005
Applicant:
Construcion Types;
VN, ,
Fire .Sprinklered? '
NO
I certify that I have read this application and statelhattheabove information is correct. I
agree to comply wi,th all city ordinanceS and state laws relating to buUding constru,ction, and
hereby authorize represe $. of this "tY to enter upon the'abave mentioned property for
inspection purposes.
Date: 3130i2005
Fees paid for Permit:
Total:
310.34
Sign ureol Applicantor Age t
Th permitshall expire by limitation and become null ~dvoid if the building or
work .has not passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work. .
INSPECTION RECORD
INSPECTION , DATE INSPECTOR
Temporary Power Pole ,
Plumbing (DrainiWaste Pipe) ,
Electrical Ground Electrode/Uter
SetbaekfFormsfTrenches (Footings) , ,
Do not install subfloor or pour floor slab until the ,
following applicable ilems have been signed: .
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) ,
Electrical (U/1derground Conduit) . ,
Pre-slab (CO!TIPactionlMembrane,Remf.
Underpinning (Floor Joi$tJGirtlers)
Do not cover or coilcealthe work-below unllllhe
following applicable items have be,en signed: '
1st Floor Shear . .
Firesprinkler (RoUgh) ., " ,.
2nd Floor Shear , .. , }
Roof (Sheathing/D1aphmgm'Frame) . , 1/
Masonry (RelnfJBond BeamJPre-GlOUt)
Rough Plumbing (Top Out)
Rough Mechanical, ' , ,
K9ugn l:IectrlCaI all)
Rough Electrical . ' '" ..
FramIng {Only after Plbg.; flee.. Mech.. and Fire} "
Insulation (SoundlEhergy) .. .
po not tape or pJa~ter until the following applicable
Items have been sIgned: ' .
Dl')'Wall ,. ,.
Peneltalions (Fire Rated) Electrical ,. , ,
Peneltallons (Fire Rated) MechanIcal '.' ,
Penetrations (Fire Rated) Plumbing
Interior Lath'
Exterior Lath
GENERAL'ITEMS ,
Exterior Plaster (BlOINn Coat) .
T -Bar Electrical' . .
T -Bar Mechanical
T -Bar, Structural ' . . '.
SIlwer , .
Water Engineering BackflC1w
Water Service ' '
FINAL INSPECTIONS ' Dale Inspector
Electrical Final . . . .
PlumbilJg Final
MechalJlcal Final .
, ,
Gas Test , ,
Engineering/Grading Final 765-5:128 .
Fire Dept. Final 765-4040 "
Water Engineering7~5-526~ ..
. .
Sub List/Business License 765-519 .. ,
Zoning 765-5139 , "
Building Final ~ast' lnspeclion- Only 4N~~ '10,,,1 '
fter Above Complete).' ~,
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections '
Electrical Inspections