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2427 Westport TYPE OF PERMIT CITY Reroof DATE: 12/16/2005 JOB ADDRESS: 2427 E WESTPORT CIR LEGAL DESCRIPTION: N TR 4717 LOT 26 ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 113 BUILDING PERMIT NO. BLD2005-03998 APPLICANT: OWNER INFORMATION: CONTRACTOR INFORMAl'ION: ARCHITECT/ENGINEER INFORMATION: THOMAS F FLADING PROTECT ROOFING COMPANY 2427 E WESTPORT CIR 622 E STEARNS AVE ANAHEIM, CA 92806 LA HABRA, CA 90631 0000 BUSINESS PHONE: 562691-1948 JOB DESCRIPTION:Tear off existing roof and install 29 squares of 30 year composition shingle VALUATION: 6,400.00 PROCESSED BY: CJR OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for t e following reason {Sec. 7031.5 usiness 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 Contracl:or'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 subjekts the applicant to a dvil penalty of not more than five hundred dollars ($500). o I, 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 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 contractors to construct the project (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 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 10r by Section 3700 oi the Labor Code, for the performance of the work for which this permit is issued. -, ~ I have and will maintain worker's compensation insurance, as required by Section 3700 of f!!e Labor Code, for the perlormance of the work for which this permit is issued; Myworker's Compensation insurance carrier and policy are: Carrier: STATE COMPENSATION FUND Policy Number. 285-0002201 12/16/2005 Date: This section need not be completed if the pennit is for one hundred dollars ($100) or less. o I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worker's compensation laws oi Califomia, and agree that if 1 should become subject the worker's compensation provisions of Section 3700 of the Labo I all f hwith comply with those provisions. NUMBER 772205 TYPE TYPE EXPi RATION DATE 1213112007 C39 HiC Date: 12/16/2005 Applicant: WARNING: FAILURE TO SECURE ORKER'S PENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDlllON TO THE COST OF COMPENSATiON, DAMAGES AS PROVIDED FOR IN SECTiON 3706 OF THE 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 Tvpes: VN, , Fire Sprinkrered? NO I certify that I have read this application and state that the above information is correct. I agree to comP:l ity ordinances and state laws relating to building construction, and hereby aut rize repre nlives of this city to enter upon the above mentioned property for inspe ion urpo Date: 12/1612005 Fees paid for Permit: Total: 245.01 Signature plicant or Agent The permit shall expire by limitation and become nUll and void if the building or work has not passed Ii 001 inspection 365 days from the date of permit issuance. A new permit is reQuired to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temeorarv Power Pole Plumbina lDrainlWaste Pipel Electrical Ground Electrode/Ufer SetbacklFormslTrenches (Footinas) Do not install subfloor or pour floor slab until the following applicable items have been signed: Plumbina IWater Pipe/Sprinkler Valvesl Mechanical (Groundworkl Electrical IUnderaround Conduitl Pre-slab (Compaction/Membrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1st Floor Shear Firesprinkler (Rough) 2nd Floor Shear Roof (Sheathing/Diaphragm/Frame) '')dX).1J '~ ~D Masonrv IReinf.lBond Beam/Pre.Groutl Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical framing (Only after Plbg., Ele.. Mec. And Fire) Insulation (Sound/Energy) Do not tape or plaster until the following applicable items have been sic ned: Drywall Penetrations (Fire Rated) Electrical Penetrations (Fire Rated) Mechanical Penetrations (Fire Rated) Plumbing Interior Lath Exterior Lath GENERAL ITEMS Exterior Plaster IBrown CoatI 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 Cross Connection Control (714)765-4280 Engineering/Grading Final 765-5126 Fire Dept. Final 765-4040 Water Engineering 765.5268 Sub List/Business License 765-5194 Zoning 765-5139 / I, BUilding Final (Last Inspection - Only 1/j{~ After Above Complete) , \,AI.lDWsKl I PARTIAL INSPECTIONS Buildina Insfect~ns - t*!. 'J' ~-"?t ~f?D bd 5"t}t1' MechanicallnsDections Plumbina InSDections EJectricallnsDections