108 E. Wilken Way
. .
BUILDING PERMIT NO.
..
TYPE OF PERMIT
Reroof
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: gg
BLD2005-01556
,-
. .
DATE: 5/2412605
JOB ADDRESS: 108 E WILKEN WAY
LEGAL DESCRIPTION: N TR 2683 LOT 17
CONTRACTOR INFORMATION:
PETERSEN & DEAN, INC.:
2191 S DUPONT DR :
ANAHEIM, CA 928060000 :
BUSINESS PHONE: 714628.9670
JOB DESCRIPTION:Tear off existing roof and replace with 37 squares of 3Q year composition shingles and 1 square of torch down.
VALUATION: 10,724.00 ! PROCESSED BY: MSM
I . . . OWNER.BUILDER DECLARATION . '.' .'
I hereby affirm. under penalty of perjury that I am exempt from the Cbntractor's[-License Law for the following reason (Sec. 7031.5 Business and , '
Professions COde:. any city or countywhich requires a permit to construct, after, improve, demolish or repair any struc,ure, prior to its issuance, also
requires the app<<cant for such permit to file_ a signed statement that he is/icEm"sed pursuant to the provisions of the Contractor's License Law (Chapter'.
9)(commencing with Section 7000 at-Division 3 of the. Busiriess and Professiorys Code) or that he is exempt therefrom and the basis for the all!3ged
exemption. AnyYiolation of Section 7031.5 by any applicantfor a'permit subje;cts the applicant to a dv" penalty of not more than five hundred dollars
~~ ..: . . .'.
o I, as owner of property, or my employees with wages as their sole compehsation, will do the work, and the structure is natintended or offered for
sale (See,. 7044 .Business arid Professions Code: The Contractor's License L~w does not 'apply to an _owner of property who builds or improves ,<
thereon,. and who does such work himself or helSelf or through his ar her own employees, provided that such improvements "are not intended or.. .
offered for sate. If, however, the building or improvement is sold with one year. of completion, the owner-builder Will have the burden of' proying thathe.
did not buRd-orimprove for the pUlpose of sale).' '. ~ . . . .
o I, as-th'e owner of the prop,erty, 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.bulldS or improves thereon, and who contracts for such projects with
Montractor(s) Iicer"!Sed pursuant to the Contracto~'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 haver and wm maintain a certificate of consent to setf~jnsure for worker's tompensation,
as proVIded for by Section 3700 of the La'bor Code, for the performance of the \.vork. for which
~i ermit is issued. . - "
, I' have and wiU maintain ~orker's compensatio. n insurance, as required by ~ection 3700 of
e Labor Code, for the performance of the work for Which this permit is issued, My worker's
ompensation insurance carner and policy are:. .' ' ..'
Carrier: ZURICH AMERICAN INS CO Policy'Number. WC0399213602
APPLICANT: RANDY CARTER
OWNER tNFORMATION:
Sally T Gruber
3606 Catamaran Dr
'Carona Del Mar, CA 92625
ARCHITECT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
'1 hereby affirm under penalty of perjury that' am
licensed under provisions of chapter 9 (commencing
With. section70~. . iVSio6n3 ,.Of the BU. sine.ss and
Professions Cod,e. i . /i'l---..
5/24/2005 \ cb C. , .J,>. -
Date: . .. l .,. Contractor. .'
NUMBER EXPIRATION DATE .
468117 1/31/2007
TYPE' C39
Construcion Types:
VN, ,
Fire 8orinklered?
NO
I certify that I t}ave read this application and state that the above information is correct. I
agree to comply with all city.'ordinances and state laws relating to building construction, and
hereby a~. . represen. tives Of.thiS.City to e!1ter upon.the abov~ mentioned property for
inSf'ji n purp ses~- '. .
\ \ / '. . ". Date: 5/24/2005
. . Signaf 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 permitissumce. A
new permit is requi~ed to .commence Or continue work.
'Fees paid for Permit:
Total:
310.62
. .. .. . " '1"0
.'. . Electrical Fillal .. ;\ :
.INSPECTION. . .. DATE INSPECTOR . .
Temporary Power Pole . '. . Plumbing Final
Plumbing (DrainiWaste Pipe) . Mechanical Final
Electrical Grciund Electrode/uter
. '.
SelbacklFormsrrrenChes (Footings) Gas Test
Do.not install subfloororpQUr.floor slab until the Engineering/Grading Final 765.0126.. .
following applicable items have been signed: . '. .
Plumbing (Water.Pipe.Sprinkler Valves) '. .' Fire .Dept. Final 765,4040
Mechanical (GrQUndwork) . .' Water Engineering 765.5268
Electrical (Underground Conduit) I . ..
Pre-slab (C9fI1PactionlMembrane.Reillf. . '. Sub List/Business License 765.519 ....
Underpinning (Floor Joist/Girders) Zonirig 765-5139 '.
Do not cover or conceal the work below until the Building Final ~ast inspection- Only' ~J? H~A.
following 'applicable items have been signed: '. Iter Above Complete) ,'-"-" .
1st Floor Shear . .' . .PARTIAL INSPECTIONS;;"
.p '"
Flresprinkler (Rough) . . . .~ . "
2nd. Floor Shear . . . . LL ,Buildina Insoections
Roof (SheathilllllDiaphragmlFramel h~7-o'S" ~-A" II ,,"- . .
Masonry (ReinfJBond BeamlPre-GlOUt) .
Rough Plumbing (TopOut) I
Rough Mechanical '. . . . . . . . .
KOugn ~ectflCal , II) . .
. . '. '. '
Rouah Electrical .. . .
Framing' (On~ afterPlbg., EJec.. Mecn.. and Fire) .
InsulatiOn (SoundlEnergy) . ' . .
00 not tape or plaster until the following applicable . Mechanicallnsoections
;t~ms have been signed: - - " ,
Drywall . .
. . . ." .
Penetrations (File Rated) Electric;al . .
. .
Penetrations (File Rated) Mechanical .
Penetrations (File Rated) Plumj)ing
Interior Lath '.
. '.
Exterior Lath . Plumbina InsDections
. . GENERAL ITEMS . '.
Exterior Plaster (BlOWn Coat) . .
T.Bar Electrical . . '. .
T -Bar Mechanical . '. . .
", .
T.Bar Structural' .
S.ewer . .
WlJter Engineering .Backflow . Electricallnsoections .'
Water Service
INSPECTION RECORD
FINAL INSPECTIONS
Oatt' "'rlS ector