2112 Ward Terrace
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 112
BUILDING PERMIT NO. BLD2005-02678
DATE: 812612005
JOB ADDRESS: 2112 E WARD TER
LEGAL DESCRIPTION: N TR 1843 LOT 21
CONTRACTOR INFORMATION:
MCCORMACK ROOFING CO
4091 E LA PALMA AVE #T
ANAHEIM, CA 928070000
BUSINESS PHONE: 714630.5543
JOB DESGRIPTION:Tear off existing roof and replace with 20 squares of 30 year composition shingles ICBO# 5443.
APPLICANT: YOLANDA HUAPAYA
OWNER INFORMATION:
PAUL BECKMAN
2112 E WARDTER
ANAHEIM, CA 92806
ARCHITECTIENGINEER INFORMATION:
3,000.00
PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
I hereby aff rm under penalty of perjury that I am exempt from the on tractor's Ucense Law for the fol owing reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter, 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 licensed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) 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 subkcts the applicant to a civil penalty of not more than five hundred dollars
($500).
o I, as owner of property, or my employees with wages as their sole compe1Sation, will do the work, and the structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale).
o I, as the owner of the property, am exclusively contracting with licensed c)ntractors to construct the project (Sec. 7044 Business and Professions
Code: The Contractor's License Law does not apply to an owner of propertYVltho builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law).
U I am exempt under Sec. , 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 I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
~hi permit is issued.
I have and will maintain worker's compensation insurance, as required by Section 3700 of
Labor Code, for the periormance of the work for which this permit is issued~ Myworker's
ompensation insurance carrier and policy are:
Carrier: AMERICAN INTERNATIONAL GROUP Policy Number. WC07010"0200001
LICENSED CONTRACTORS DECLARATION
I ere y affirm under penalty of perjury that I am
licensed und r provisions of chapter 9 (commencing
with Section 00 f Oi ion 3 of e Business and
Professio e
812612005
Date:
EXPIRATION DATE
613012006
This section need not be completed if the pennit is for one hundred dollars ($100) or less.
o I certify that in the perfonnance of the work for which this permit is issued, J shall not
employ any person in any manner so as to become subject to the worker's compensation laws
of Califomia, and agree that if I should bec e subject to the orker's compensation
provisions of Section 3700 of the Lab JJ 0 13, I shal orthw t amply with those provisions.
NUMBER
643700
TYPE
C39
Date: 812612005 Applicant:
WARNING: FAILURE TO SECUR
UNLAWFUL, AND SHAULSUBJEC
FINES UPTO ONE HUNDRED TH
COST OF COMPENSATION, DAMA S PROVIDED FOR,IN SECTI
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec. 3097.Civ.C):
Lender's Information:
Construcion Types:
VN, ,
Fire 8prinklered?
NO
I certify that I have read this application and state that the above information is correct
:agree to comply with a!! city ordinax6s i<iid state laws j,slati.tg to bu~dir,y (;0, ~~, \.\Clion, and
hereby autho ' e rep sentiv s this city to enter upon the above mentioned property for
in pu sas.
Date: 812612005
Fees paid for Permit:
Total:
170.20
Signature of A plicant 0
shall expire by limitation b null and void if the building or
work s passed final inspection 36 day from the date of permit issuance. A
new perlnlt is required to commence or co ue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Uter
SetbacklFormsfTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work below until the
tollowlng applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (SheathinglDiaphragmlFrame)
Masonry (ReintJBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mee. And Fire)
Insulation (Sound/Energy)
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 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
Mechanical Final
Gas Test
Engineering/Grading Final 765-5126
Fire Dept. Final 765.4040
Water Engineering 765-5268
Sub List/Buslness License 765.5194
Zoning 765-5139 n
Building Final (Last Inspection. Only j 1Vl~
After Above Complete) \ v. '"
PARTIAL INSPECTIONS ~
BUiE~ns:?!onf;, G -.- .
o ~ ~CI?=~~
Mechanical Inspections
Plumbing Inspections
Electrical Inspections