2010 Waverly
BlJlLDING PERMIT NO.' BLD2004-03274
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CITY €);It<<,i\NI\"H EI M
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BUILDING DIVISION
200 S. ANAHEIM Bl.VD
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 58
TYPE OF PERMIT
Reroof
, DATE: 8/26/2004
JOB ADDRESS: 2010 S WAVERLY DR
LEGAL DESCRIPTION: N TR 6792 LOT 17
APPLICANT:
OWNER INFORMATION: CONTRACTOR INFORMP,TiON:
Lupe Garcia RAY'S ROOFING CO
, 2010 S Waverly Dr 14571 HIGHCREST CIR
Anaheim, CA 92802 , IRVINE, CA 926040000
JOB OESCRIPTIONReroofwilh lear-off new 7/16 OSB and Eagle-liletlle roofir,g 5.7 pst ICB0#4660
VALUATION: 9.000,00 '
J OWNER-BUILDEIlDECLARATION
I hereby affirm,under penalty C?f perjury that I am exempt from the C;;ontr"actots License-Law for the following reason (Sec, 7031.5 Business and
Professions CQde:any dty or county which requires a permit to cQns~rlJct, aihr, imp'rove, d~'m()lish'or repair any s.tructure, piior to its _issuance, also
requires the_ applicant for such permit to file a .signed s.tatement that he is Hce;-lsed pursuant tf) the provisions of the Contra~cr's License l.:aw(Chapter
9)(commencing with Section 7000' of Division 3 of the Business a nd professhns Code) or that he is .exempt therefrom and the basis for the _alleged
exemption. Any violation of Section 7031.6 by any applicant for a pE:rmit suble.cts the c.:p-plicant to a civil penalty of not more than'five h'undreddoll<=1rs
~~ ' '.
o I,.as owner ofpr~perty, or my employees with INage'sas U'ieir sole Cb!"ll!.)'~r'.sation: will do the work, and the struc~ure is not in.tended or' offered for'
sale (S~C. 7044 Business and Professions Code: The ContractN'S' licenSE: '.)IW does not apply to an owner of property who builcls or improves
thereon, and who does such work himself or herself or through hi" or her o...v~ employees, provided that such improvernetlts are'not intended or'
offered for sale'. If, however, the building or improvement is sold with one yei::r of comp!etion, the owner-bu'ilder will have the burder: of proving that he
dJd not build or jmprove for the purpose of sale). ' - _ . .
o I,.as the owner of ~he property, am exdusively contracting with licensed .':Ontractors to construct the:project (See. 7044 Business 2nd Professions
Code: The Contractor's License Law does not apply to an owner of prope-ftYllho builds or improves thereon, .and who oontracts for such projects with
a contrador(s) licensed pursuant to the Contractor's licenSE: Law}.
o I af11 exempt under Sec. __ ,B & P.C. for this mason: __
. Date: OWner:
r _ WORKER'S COMPENSATION DECLAHATION - .l.____~
-, !-lemby affirm under. penalty of perjury on-e of the following declarations:' I
O' '-have and,wiU maintain a,.certificate. of ronsent to ~If.in'sure for worker'", compensation,
as ProVidbd,. fOr, by ,Se~ion 3, 700 of the, L, abor Code" fC?rthe performsn, ce Ofth~," ~ork for W, hich I
this permit is issued. .' : '
o I hav_e and will maintain worker's compensation insurance, as requirud b:t Section 3700 of I
the Labor Code, forthe performance of th~ YJork forwhich this permit is iss~::::.d. Myviorker's
Compensation insurance carrier and policy are:, .' .:- . I
Carrier: NO EMPLOYEES ,Policy Number: EXEMP r: I
This section -need not be completed if t,he pennitis for one hundred doll;;:rs ($1 onj Or less.
o I certify that in the performance of the work for which this permit is 1ssued,'l ~hall not
employ any person in a ny manner so as to become subject to the w'orl<.el's ccn~p.ensatio;l laws
of California, and agree that if., should become subject to the worker's'compe-nsation
provisions of Section 3700 ofthe Labor C e-,l shaH forthwith comply with cr.-he prcvi::;iol1s.
Dale: 8/26/2004 'Applicant&' ','_
WARNING: FAILURE TO SEC\Jr&WOR ER'S COMPENSATION COVEft'.GE IS
UNLAWFUL, AND SHALLSUBJECT AN EMPLOYER TO CRIMINAL PENAL TIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDITION TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN S:=CTION 3706 OFTHE
LABOR CODE. INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a con~tru,c_~!on lending agency-for 'the
pe.rformance of the work for which this permit is issued (See. 3097 .CivlC): . "
-Lender'S Information.' -" -'.~'
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: DOR
LICENSED CONTRACTORS DECLARATION I
.( hereby affirm under penalty of perjury that I am
licensed UDder provision,:, of chopter 9 (commenc:ng
with Section lODO) of Divsion 3 of the Business and
:/~;~;;~:~C~~~~
Date: ' Cootractor
NUMBER
361042
TYPE
TYPE
EXPIRATION DATE
7/3112006
C39
HIC
Construcion Types:
V N, ,
_ Fire Sprinklered?
NO
I certify that I have read this application and state that-,the above infOrmation is correct. I
agree to oomplywith all city, ordinances and state laws relating to building construction, and
hereby authorizerepreseritives of this city to enter upon the above mentioned property for
inspection poses.
Date: 8/26/2004
Fees paid for Pem-lit:
Total:
235.73
Signature_ of Applicant or Agent
The permit shall eJlpire 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.,
"
. . INSPECTOR. Electrical Final . .
INSPECTION . . . PATE. ,
Temporary Power Pole .' Plumbing Final. .
Plumbing (DrainlWastePipe) . . . . Mechanical Fin'al
Eklctrical Ground Electrode/lifer
SetbacklFormsfTrenChes (Footings). Gas Test. .
. . .
Do not install sUbflQOror pour floor slab until the En!!i neeringlGrading.l'inal
following applicable items have be.en s'gned:
Plumbing (Water Pipe.Sprinkler Valves) Fire Dept. Final 7654040
Mechanical (Groulidwork) . .' . Water .Engineering 765-526
Electrical (Underground Conduit) i / .
.' Sub List/Business License
Pre-slab (Compaction/Membrane.Reinf. . . . .
Underpinnil)g (Floor Joist/Girders) . . . . . Zoning 765-5139
Do not COver or conceal the work beloW ul)til the . Building Final ~astlnspedi
following appJicaqle ilems have been signed:' .' fter Above C
1 st Floor Shear . . . .' ,-
PARTIAL
Firesprinkler (Rough). Buildino Inspections
2nd Floor Shear .~ J/f
RQof (Sheathing/Diaphragm/Frame) 'X ~ 1-0'-1" .~. . .'
Masonry (ReinfJBOnd BeamlPre-Gl"O\Jt) .' . .
Rough Plumbing (Top Out) . . .
Rough. Mechanical. .
ROugh E1ectroeal (Dry Wall) . .
Rou'gh Electrical . . . .
Framing (Only after Plbg:. EJec" Mech and Fire} . .
Insulation (SoundlEnergy) . Mechanicallnspectio
po nClttape or pta~ter until the following applicable
Items, have been signed:, . '.' '. . .
Drywall. . ..... .' . .' '. .
.
Penetrations (Fire Rated) Electrical '. .. ..
Penetrations (Fire Ratedl Mectlanical
Penetrations (Fire Rated) Plumbif!ll . -. .
"nterior Lath . .' .
Exterior Lath Plumbina Inspection
. . GENERAL ITEMS . .
. .'
Exterior Plaster (~l'C7Nn Coat) . . . .
T.BarElectrical .
T.B.ar Mechanical '. . '. .
T .BarStructural' . .
Sewer .
Water Engineering Backflow Electrical Inspection
Water Service .' '. .
. .
INSPECTION RECORD
FINAL INSPECTIONS
Date . Inspector
765-5126
8
76.5-51
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