1737 Woodwind Ln.
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: 165
BUILDING PERMIT NO. BLD2005-03582
DATE: 11/10/2005
JOB ADDRESS: 1737 N WOODWIND LN
LEGAL DESCRIPTION: N TR 5989 LOT 19
CONTRACTOR INFORMATION:
RON PAVELOFF ROOANG
18666 BUENA VISTA AVE
YORBA LINDA, CA 92886 4926
BUSINESS PHONE: 714931-3157
JOB DESCRIPTION:Tear o,ff existing, resheat, and reroof 34 squares with 30-year composition shingles
APPLICANT: RON PAVELOFF
OWNER INFORMATION:
L1VIO T PINTERPE
300 MASSACHUSETTS LN
PLACENTIA, CA 92870
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
7,775.00
PROCESSED BY: JNJ
OWNER-BUILDER DECLARATION
I hereby affirm under pena of perjury that I am exempt from the Contractor's License Law for the following 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 subjects the applicant to a civil penalty of not more than five hundred doUars
($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 ot 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
a contractor(s) licensed pursuant to the Contractor's License Law).
o 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 tor by Section 3700 of the Labor Code, for the performance of the work for which
this permit is issued.
:::Err have and will maintain worker's compensation insurance, as required by Section 3700 of
the Labor Code, for the performance of the work for which this permit is issued. My worker's
Compensation insurance carrier and policy are:
Carrier: STATE COMPENSATION FUND
11/10/20
Date:
Contractor
Policy Number. 1652988
NUMBER
786691
TYPE
TYPE
EXPIRATION DATE
10/3112006
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 shan not
employ any person in any manner so as to become subject to the worke(s compensation laws
of Califomia, and agree that [f I should bee bject to the womer'!;> compensation
provisions of Section 3700 of the Labor C e, I rt 'th comply wit those provisions.
Date: 11/10/2005 Applicant: L
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDIllON 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:
C39
HIC
Construcion Tvpes:
VN, ,
I certify that I have read this application and state thatthe above information is correct. I
agree to comply with all city ordinances and state laws relating to building construction, and
hereby aut ize re sentives of this city to enter upon the above mentioned property for
inspecti pur
Dale: 11/10/2005
Fees paid for Permit:
Total:
319,82
Signature of pp I ant 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 issuMCe. A
new permit is required to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temoorarv Power Pole
Plumbing tDrainlWaste Pioe)
Electrical Ground Electrode/Ufer
SetbacklForms/Trenches (Footings)
Do not install subfloor or pour floor slab unlilthe
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler Valves)
Mechanical/Groundwork)
Electrical/Underaround Conduitl
Pre-slab (Compaction/Membrane Reinf.)
Underpinning (Floor JoistlGirders)
Do not cover or conceal the work below until the
following applicable items have been signed:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) IJffl7/v, r;n d-/
Masonrv (Reinf./Bond Beam/Pre-Grout!
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Eleol Mec. 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
Cross Connection Control 1'14)7&$.4280
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4041>
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only 1rf/ ha.(e
After Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections