2653 W. Yale Ave.
TYPE OF PERMIT
Blockwall / Columns CITY
DATE: 9/7/2005
JOB ADDRESS: 2653 W YALE AVE
LEGAL DESCRIPTION: N TR 3007 LOT 53
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUESTLtNE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 19
BUILDING PERMIT NO. BLD2005-02806
APPLICANT: DAVID TARAVELLA
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
DAVID L TARAVELLA
2653 W YALE AVE
ANAHEIM, CA 92801
JOB DESCRIPTION:Build 80 lineal feet of 6 foot high block wall per city specifications.
VALUATION: 5,000.00 PROCESSED BY: MSM
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor'~'License Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, altef, 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 licen:sed 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
ex ption. Any violation of Section 7031.5 by any applicant for a permit subjebts the applicant to a civil penalty of not more than five hundred dollars
0).
, as owner of property, or my employees with wages as their sole compel.1sation, will do the work, and the structure is not intended or offered for
s e (Sec. 7044 Business and Professions Code: The Contractor's License La.w does not apply to an owner of property who builds or improves
th reon, and who does such work himself or herself or through his or her own ;,mployees, provided that such improvements are not intended or
off red 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 ot build or improve for the purpose of sale).
o ,-as the owner of the property, am exclusively contracting with licensed c<mtractors to construct the project (See. 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...!(ontractor(s) licensed pursuant tothe C ntractor's License Law). '
U I ~e pt nderSec. B --. .C. fqr iSr~so.J?-" ~'};.,
Date: l 7. Iff, Owner: J':~- --I~....c.
WORKER'S OM NSATION DECLARATION
I hereby ffirm under penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for worker's compensation,
as provided for by Section 3700 of the Labor Code, for the performance of the 'Nork for which
this permit is issued.
D I have and will maintain worker's compensation insurance, as required by~3ection 3700 of
the Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: Policy Number.
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
91712005
Date:
Contractor
NUMBER
EXPIRATION DATE
~section need not be completed if the pennit is for one hundred dollars ($100) or less.
I certify that in the performance of the work for which this permit is issued, I shall not
loy any person in any manner so as to become subject to the worker's compensation laws
f California, and agree that if I should become subject to the worker's compensation
p ovisions of Section 3700 of the Lab C~e, I Sh~lI fo,th :rPly with th e provisions.
Date: 9/7/2005 Applicant: I ~ . "";0, >t...
WARNING: FAILURE TO SECUR WORKER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJE AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, D AGES 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:
TYPE
Construcion Types:
VN, ,
Fire Sprinktered?
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
her authorize representives oa;this ity to enter upon the above mentioned property for
n I n urpose-s.
"'" Date: 9/7/2005
Signature of Applicant 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 Irom the date of permit issuMCe. A
new oermit is reauired to commence or continue work.
Fees paid for Permit:
Total:
133.28
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION
DATE
INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer , 1.1/ ..,fA
SetbacklFormslTrenches (Footings) r'/;..Iorl~// /
Do not install subfloor 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 Reinf.)
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)
Masonry (Reinf./Bond Beam/Pre-Grout) n.~.O
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:
.
--p /r;>~
D"
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 List/Business License 765-5194
Zoning 765-5139 / J
Building Final (Last Inspactlon - Only ,#
After Above Complete) ti5 J AJ) ..vSV-\
PARTIAL INSPECTIONS
Building Inspections
~
Mechanical Inspections
Plumbing Inspections
Electrical Inspections
~:_~~:~--~---Q,Q'. \'\
PLAI'JclIfH:; D[J'!\f~TMENT I
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DATE _",,/1,"1 fJ16__ I
BY _:''j",I~G "",ON ( ~~
FLOOD ZONE )(
(1;litial'"
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Irc\e one on above line
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THE; HOLDER OF THIS PERMIT
f:lRGCEEQS AT HIs GWN RISK.
SEP 0 7 2005
BUILDING DIVISION OF ANAHEIM
APPROVEP
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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: 19
BUILDING PERMIT NO. BLD2005-03056
DATE: 9/23/2005
JOB ADDRESS: 2653 W YALE AVE
LEGAL DESCRIPTION: N TR 3007 LOT 53
APPLICANT: HAKAN NAMMARSTROM
OWNER INFORMATION:
DAVID L TARAVELLA
2653 W YALE AVE
ANAHEIM, CA 92801
CONTRACTOR INFORMATION:
ABSOLUT ROOFING CO
18903 SAN CARLOS
FOUNTAIN VALLEY, CA 927080000
BUSINESS PHONE: 800655..2231
JOB DESCRIPTION:Tear off existing roof ant1 replace with 25 squares of 30 year composition shingles.
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
6,000.00
PROCESSED BY: MSM
OWNER.BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the on tractor'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 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 L~w 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 tor sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving thathe
did not build or improve for the pu rpose of sale).
o l, as the owner of the property, am exclusively contracting with licensed c:mtractors 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.Qontractor(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 for by Section 3700 of the Labor Code, for the performance of the work: for which
this permit is issued.
ti I have and will maintain worker's compensation insurance, as required by Section 3700 of
.~ Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE FU ND
9/23/200
Date:
Policy Number 1581550-01
NUMBER
761118
TYPE
TYPE
EXPIRATION DATE
2/28/2006
This section need not be completed if the pennit is for one hundred dollars ($1 00) ," less.
o I certify that in the performance of the work for which this pe mit is issued, I shall not
employ any person in any manner so as to become subject to t worker's compensation laws
of Califomia, and agree that if I should become s 1ect to the rker's ompensation
provisions of Section 3700 of the La or 0 ,I an rthwit y with tho:~e provisions.
C39
HIC
Date: 9/23/2005 Applicant:
WARNING: FAILURE TO SECURE,wORKER'S P NSATION COVERAGE IS
UNLAWFUL, AND SHALLSUBJEO'r AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED ]40USAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, D;'\MAGES 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 thjs permit is issued (Sec.3097.Civ.C):
Lender's Information:
Construcion Tvpes:
VN, ,
Fire Sprinklered?
NO
nd stat~ that thl'J above informa~ion !e.eorrect. I
and state laws relating to building construction, and
er upon the above mentioned property for
Date: 9/23/2005
Fees paid for Permit:
Totai:
244.97
ignature 0 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 issuance. A
new Dermit is reaulred to commence or continue work.
City of Anaheim
Building Division
INSPECTION RECORD
I INSPECTION DATE INSPECTOR
ITemporary Power Pole
!Plumbing (DrainlWaste Pipe)
I Electrical Ground Electrode/Ufer
ISetback/FormslTrenches (Footings)
i Do not install sub floor or pour floor slab until the
I following applicable items have been sillned:
Plumbing (Water PiDelSprinkler Valves)
Mechanical (Groundwork)
Electrical (Underground Conduit)
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:
1 st Floor Shear
Firesprinkler (Rough)
2nd Floor Shear
Roof (Sheathing/Diaphragm/Frame) ~-1l/:.,,," III? /1
Ilk.
Masonry (Relnf JBond BeamlPre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only Qfter 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 list/Business License 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only 11'f ~~
Alter Above Complete)
PARTIAL INSPECTIONS
BuildinQ Inspections
Mechanical Inspections
PlumbinQ Inspections
Electricallnspectioils