743-745 N. Lemon St.
TYPE OF PERMIT
Reroof
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153
INSPECTION REOUESTLINE: .
(714) 765 - 4626
CENSUS CODE: 434
. OUARTERSECTION: 71
BUILDING PERMIT NO.
BLD20115-01325
..;
DATE: 5/9/2005
JOB ADDRESS: 743 -45 NLEMON ST
LEGAL DESCRIPIION: N TR 237 BLK A LOT 5
APPLICANT: AL SOUZA
OWNER INFORMATION:
Jeffrey. Barrett
132' S Anita Dr #200
Orange, CA 92868
ARCHITECT/ENGINEER INFORMATION:
VALUATION:
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from, the Contractor's l,icense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any ciwor c'Qun.tywhiCh requi,res a permit to construct, alter; .improve, demolish .or repair any structure, prior to its issuance! alse>
requires the applicant for such permit to file a signed statehlsnt thathe is licensed pursuant to theplOvisions of the Contractor's License Law (Chapter
9)(commencing with Section 700q of Division 3 of the Business and prOfession'_SCode) or ,t.hat 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 toa ciVil penalty of not more than five hundred-dollars
-~.. .;....
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 n'at apply to an owner of property who builds or improves
thereon, and who does such work himself or helSelf or through his or her own employees, provided that such improvements are not intend~d 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 h~_','
did not build or improve for the purpose of Sale). '. _- ."
D I, as the" owner of th,e 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 oi-improves thereon~ and who contracts for such projects with "
a contractor(s) licensed pursuant to the Contractor's License Law). .
D: I am 'exempt under Sec. " B & P.C. fo~ this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION
I hereby-affirm under penalty of perjury one of the following declarations:
0, I-have and will maintain ac~rtificate of conSent to'setf-:insure for w'Qrker's~ompensation,
as provii:led for by Section 3700 of the labor Code, for the performance of the work for which
this permit is issued.
r><\1 have and will fi1aintain worker's compensation insurance, as required by Sectio'n 3700 of
fueL~bor Code, for the periormance of" the work for which this permit is issued: Myworker's
Compensation insurance carrier and policy are:
Carrier: STATE COMPENSATION INSURANCE Policy Number. 1799501-2004
This section need "not be completed if the pennit is for one hundred dollars (S':! 00) Or less.
N' I certify that in'the perionnande of ttie work, for which this permit is: issued, I shall not
1inploy any person in any manner soasto become subject to the worker's compensation laws
of Califomia, arid-agre~ that if I should become subject to the wo r's compensation
provisions of Section 3700 of the bor Code, I ~,-II fO~it,h c ply with those provisions.
Date: 5/912005 Applicant: -X c. ,
WARNING: FAILURE TO SECURE VERAGE IS
UNLAWFUL, AND SHALL S!JBJECT i'\N . PLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TOONE HUNDREDTH, USAND DOLLARS ($100,000), IN ADDIllON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND A1TORNEY'S FEES.
CONSTRUCTION LENDING AGENCY " .
i hereby affirm under penalty of perjury that there is a construction lending agencyfo~ tne
performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's Information: .
1-
LICENSED CONTRACTORS DECLARATION
I hereby affirm, under penalty of perjury that I am
licensed der provisions of chapter 9 (commencing
with. Sectio 70 of ivsion 3 of t Business and
Professions e.
"--
Contractor
EXPIRATION DATE
. 8/31/2006
C39
Construcion Types:
V N, ,
Fire Sprinklered?
NO
;.",-...
:<<;,-
~ 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 orize representive of this city to enter upon the above mentioned property for
in ion purpo s.
I
" Signature of App'" ant or Agent"
e permit s I expire by limitation and become null and void if the building or
ork has not passed final inspection 365 days from the date of permit issuance. A
ew permit is required to commence or continue work.
Date: 5/9/2005
Fees paid for Permit:
Total:
.160.81.
INSPECTION RECORD
INSPECTION DATE INSPECTO~
Temporary Power Pole .
Plumbing (DralnlWaste Pipe)
Electrical Ground Electrode/lifer . .
SelbacklFormslTrenches (Footings) . .
Do not install !;ubfloor 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.Rei nt.
Underpinning (RoorJoistlGirders) .
Do not cover or co.nceal the work below until the
following applicable items have been signed. . .
1st Floor Shear
Firesprinkler(Rough)
2nd Floor Shear. .
Roof (Sheatl)lng/D1aphragJl\lFramel .r:;;[~ ~/)...I
Masonry (ReinfJBond BeamlPre-Grout) ..
Rou.gh Plumbing (Top Out)
Rough. Mechanical . . .
Rough ~ec:tricalluryyvall)
Rough Electrical
Framing (Only-after P.Jbg,;.EJec.. Mech.. and Fire)
Insulation (SoundlEnergy) . .
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 .
-
'FINA~ INSP.ECTIO.NS ..::
Date
Inspector
Electrical .Final.
Plumbing Final
Mechanical.Final
Gas Test
Engineering/Grading Final 765-5126
Fi.... Dept. Final 765-4040
Water Engineering 765-5268
Sub LlstlBusiness License 765-519
Zoning 765-5139
Buiiding Final .ILast Inspection; Only
... After Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
PlumbinQ.lnspections
Electrical Inspections