509 N. West St.
BUILDING PERMIT NO. BLD2003-04204
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
. INSPECTION REQUESTL!NE:
(714)765 - 4626 .
. CENSUS CODE: 434
QUARTER SECTION: 62
TYPE OF PERMIT C.ITY
. Reroof
DA TE:10/23/2003
JOB ADDRESS: 509 N WEST ST
LEGAL DESCRIPTION: N TR 4248 LOT 4
APPLICANT: MAR!A MONTALVO
OWNER.INFORMATION: CONTRACTOR'INFORM.mON: ARCHITECT/ENGINEER INFORMATION:
E!ias Monta!Vo
509 N West St
Anaheim, CA 92801
JOB DESCRIPTION:Tear.offwood.shingles and install 40 squares of 30y"", oOmp. shingles.
VALUATION: . 5.500.00 PROCESSED BY: ODC
1 OWNER.BUILDI;f~!)ECLARATION
I hereby, affirm under penalty of perjury that I 'am exempt from the _Contractr:;:'$ License Law for the following reason (Sec. 7031.5 Business arid
Professions Cod e: a nydty .or county which req uires a perm it to construc.<"'\ ,~~ r, improlJ_e, demolish or repa ir any structure, prior to its. issuance;' also
requires the applicant for such 'permit to file a signed statement that he is 1,;cJnsect 'pursuant to the provisions of the Contractor's license Law (Chapter
9)(commencing with Section7000 of Division 3 of the Business and Profe~':::;:Jns 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 su ~;ect.~ the applicant to a dvil penalty of not more than five hundred dollars
($500). '. .' ....! . .' . .
. 0 I~ as owner of property, or my employees with wages as their: solecorn~:\:msati6n, wilt do the work, arni,:the structure is not intended or .off~red for
sale, (Se'c: 7044 ,Business and Professions Code: The Contractor's Ucensu l~dW does not applyt().an o~'r of property who builds or i~proves
thereon, and who does such. work himself-or herself or through hiS 'or her C/",1 employees,_ provided .that'such improvements are not intended or, .
. ~ffered for . If, however, the building or' improvement is sold with one y,~\;r of oompletion, the' owl-:ier-.builder will have the burden of proving that" he
idno~ldorjmproveforthepuipose,ofsale) '" " ",', '.. . . .
I,' as the owner of the property, am ~xdusively contracting with IicensE:u:contractors to constructthe project (Sec. 7044 Business and Professions
Code: The Con'tractor's L,cense Law does not apply to an owner of propert/whobuilds or improves thereon, and who, contracts for such projects with
ontractor(s) licensed pursuant to the Contractors licen.ose Law).. .. l - -. .'
.1 m em t under Sec. B& P.C. for this reason:'
Dale: ;Z b Owner: . _~'D
WORKER'S CO ENSATION DECLARATION
I heteby affirm under pe'nalty of.pe~uiy one of the following declarations: : ,
o I have and wili-ilia-intain a-certificate ofconseritto self-insure'for,work6;".'=-r.cmpensatiori,
as provided for by_Section 3700 of.the Labor Code, for the performance,ot t:l:J work for which
this permit is issued.
01 have and will maintain worker's compensation insurance, as required b-:SE::ction 3700 of
the Labor'Code, fat: the performance of the work for which this permit is is3i..:.d.. Myworker's
.. Compensation insurance carrier and policy are:
Carr.ier: Policy Number.
LICENSED. CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that Lam
licensed under provisions of chapte~ 9 (commencing
with Section 7000) of Divsion 3 .of the Business and,
Professions' Code: '
10/23/2003
Date:
Contrclctor
NUMBER
EXPIRATION DATE
This section need 'not ,be completed if the pennitis for one hundred doUar$ {$i~'~: Of h*-s.'
D I certify that in the perfarmance of the work for which this pe'rmitis issl1e~. "shall_hot .
~mploy any person in any manner.so as. to become subject to the worker~ c(.m'pen~ation laws
.of Ca:ifomia,. and agree, that if I should become ~bject t.o the worker's cOrnPt'~~:atjan ,
provisions of Sectian 3700 .of the Labor ode hall farthwith comply W.ittt~'h~d~'provisians.
Date: 10/23/2003. Applicant: ...,.
WARNING: FAILURE TO SECURE WORKER'S COMPENSATIONCOVE,R~(;E'IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PEN"'l'n~s AND CIVIL
FINES. UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN ADl;'T(0N TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR !N SECTlor-; 3106 OF THE
LABORCOOE, INTEREST AND ATTORNEY'S FEES. "..
.1 CONSTRUCTION LENDING AGENCY .
I hereby affirm under penalty .of perjury that there is a constructi.on lendir.g ag~ncyfor t,e
performance of the work for which this permit is issued (Sec.3097 .Civ.C)~~
Lender's Infonna.tion: .
- ..
TYPE
Construcion Types:
V-N, ,
Fire Sprinkle red? NO
t J have readthis,application,and state that the above informatio"n i3 cdrrect I
agreet.o' mply with lEY .ordinances and state laws relating to building construction, and
. here,by . uthor" 'presentives of this 'city to enter upon the above mentioned property for
insp' rpose~. '
Fees paid for Permit:
Total: 153.06
Date: 10/73/2003
Signature of Applicant 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 issual!Ce. A
new permit Is required to !Xlmmence or continue work. .
INSPECTION RECORD
INSPECTION .' . '. DATE INSPECTOR
Temporary Power Pole . ".
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter . . . '. '.
SetbacklFormsfTrenches (Footings) . . . . . . ..
Do not inStall sub floor or pour floor slab until the ..
fOllowing applicabie ilems have been signed: . .
Plumbing (Water Pipe.Sprinkler Valves) ..
Mechanical ,(Groundwork) , .
Electrical (Undergfound Conduit) .
. Pre-slab (Compaction/Membrane.Rei m., .'
Underpinning (Floor Joist/Girders) .'
Do not cover or conceal the work below until the
followirm c;lpplicable itemsJ1ave bee~ signed: .
1 st Floor Shear .
Firesprinkler(Rough)
2nd Floor Shear '. . . . .:
Roof (Sheathing/Diaphragm'Frane) . .
Masonry (ReinfJBond Beam/Pre-Grout) .
Rough Plumbing (Top Out) . I
Rough Mechanical . .
Rough Bectrical (Dry Wall)
Rough Electrical '. .
Framing" . (Only after P'lbg... Elec.. Mech. and Fire) '. .
Insulation (SouncllEnergy) .'
Do not tape or plaster until the following applicable
Items have 'been sfgned:' . .,
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 lI'lsp'ector '.
Electrical Final '.
:Plumbing Final. . . .' ' . . .
Mechanical F!naf ' .' . . . .
. .
Gas Test.. . .
Engineering/Grading Final 765-5126 .
Fire.Dept. Final 765-4040 .
Water Engineering 765-5268
Sub List/Business License 765-519 . . . I. .
Zoning 765.5139 . . . .
Building Final .!}asl inspection. Oniy !
. .' fter Above Complele) . '.
PARTIAL INSPECTIONS
. . '. . ;
BuildinQ Inspections
. . '
Mechanical Inspections
Plumbina Inspections '.
Electricallnsoections
~:
PERMlTfXPIREiJ
. 'I~J('Dr-(\TION . ..', .
1:'101 _v " ""J
NOT COMPLETEd
DA TE:.ll::.'C{-D~
,
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