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1906 Woodworth TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 434 QUARTER SECTION: 42 BUILDING PERMIT NO. BLD2005-02270 DATE: 7/20/2005 JOB ADDRESS: 1906 W WOODWORTH RD LEGAL DESCRIPTION: N TR 3882 LOT 20 CONTRACTOR INFORMATION: WESTMINSTER ROOFING CO INC 9612 SUTHERLAND WY GARDEN GROVE, CA 92844 0000 BUSINESS PHONE: 714541.5351 JOB DESCRIPTION:Tear off existing material, install 31 squares of Claymax TiI. al 5.8 Ibs per tile ICBO #3523 for house and attached garage. VALUATION: 12,500.00 PROCESSED BY: ENO OWNER-BUILDER DECLARATION I hereby affirm under penalty Of perjury that I am exempt from the on tractor's License Law for the tollowing reason {Sec. 7031.5 usiness and Professions Code: any city or county which requires a permit to construct, atter, 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 dollars ($500). o I. as owner of property, or my employees with wages as their sole camper-sation, 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 buRds or improves thereon, and who contracts for such projects with fU?ontractor(s) licensed pursuant to the Contractor's License Law). U I am exempt under Sec. ,8 & 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 oompensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permn is issued. I7(l have and will maintain worker's compensation insurance, as required by $ection 3700 of 1h8 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 FlJ NO APPLICANT: VINNY LE OWNER INFORMATION: ANDY K LEE 1906 W WOODWORTH RD ANAHEIM, CA 92804 ARCHITECT/ENGINEER INFORMATION: LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9 (commencing with Secti n 7 0) of Divsion 3 of the Business and Profession 712012005 Date: EXPIRATION DATE 8/31/2005 Policy Number. 285000001~74 NUMBER 694940 TYPE C39 e. action need not be completed if the pennit is for one hundred dollars ($1 00) cf less. ertify that in the performance of the work for which this permit is issued, I shall not mploy any person in any manner so as to become subject to the worker's compensation laws of Califomia, and agree that if I should bee me subject to the worker's compen~ation provisions of Section 3700 of the bar ,/ shall forthwi comply with thoS~ provisio Dale: 7120/2005 Applicant: WARNiNG: FAILURE TO SECURE 0 P ATION COVERAq.E is UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION 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 agertcyfor the performance of the work for which this permit is issued (8ec.3097 .Civ.C): Lender's Information: Construcion Tvpes: VN, , Fire Spnnklered? NO I certify that I have 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 th . representives of this city to enter upon the above mention d property for insp ion rposes. Date: 7/20/2005 Fees paid for Permit: Total: 310,80 ignature of Applicant or gent ermit shall expire by limitation and become null and void if the building or war has not passed final inspection 365 days from the date of permit issuance. A new oermit is relluired to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground Electrode/Uter Setback/FormslTrenches (Footings) Do not install subtloor 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 Reint.) Underpinning (Floor Joist/Girders) 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) 1.lr'J,1-o~ R. HI1ZBt.. t/ Masonry (Reint./Bond Beam/Pre-Grout) 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 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 ListlBusiness License 765-5194 Zoning 765-5139 Building Final (Last Inspection - Only 1/18-0, (2. () uJl8,d/ Alter Above Complete) PARTIAL INSPECTIONS Building Inspections Mechanical Inspections Plumbing Inspections Electrical Inspections