950 Mancos Pl.
TYPE OF PERMIT CITY
Reroof
.~'.
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION; 124
q;'
BUILDING PERMIT NO. BLD2005-00369
DATE: 219/2005
JOB ADDRESS: 950 S MANCOS PL
LEGAL DESCRIPTioN; NTR 3825 LOT 14
APPLICANT; LORRAINE ROMO
OWNER INFORMATION:
JerryV Romo
950 S Mancos PI
Anaheim, CA 92806'
JOB DESCRIPTION: Tear off ex.isting and reroof 24-squares with 2O-year .compqsition shingles
VALUATION; 6,000.00 PROCESSEDBY; JNJ
L '. . OWNER-BUILDER'DECLARATION .. .
I hereby affirm under penalty of perjury that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5 Business and
Prof~ssions Code: any city or countywhich requires a permit "to construct, alth, improve, del"QOlish or repair any structure, prior to its i.Ssuance. also
requires the_applicant for such permifto file a signed statement that he is lice~sect pursuant to~the provisions of the Contractt:?r.'s UcenseLaw {Chapt~r
9)(commencing wi'th Section 7000 of Division 3 at the Bu_siness ar..d Professi()"s Code} or,tha: he is eX!9mpt therefrom and th~ basis for tt)e allege<;!
exemption. Any violation of Section 7031.5 by any applicant for a permit sut.:.::cts the: a pplicaht- to -a civil penalty of notfr:ore than five 'hllndred doUats
~~. ... .
[J I~ as owner of. property, or myemployee:s with wages ,as their sole comphnsation; will do the work, and It!e structure is net intendedar~ffered far
sale (Sec. 7044 Business and Professions Code: The Contractor's L!ceJ1se ~;aw does not apply to an oWner of property who t.uildsor improves
thereon. and who does such work himself or herself or through his or herovJ~ employees; provided that such irr,iJlOvsments are not intended or
offered for sale. -If. however, the building or hpprovement is-sOld with o;;e Yt~)r of-COmpletion, the oWfler-builder ~'ViH haVe the bl~rdenof,proving that he
oid not buUd or improve for the pUTposeof Sale)" . ,i. - . ., .
~s the owner of the property, ~m exduslvely contracting with Hcensed' iJ>ntractors to construct the projecf(Sec..; 7044 Business and Professions
.~ The Contractors License Law does.not apply to an ownsrcf prope!t,; ~'Vho builds or improves thereon. and who contracts for such p;"ojecfs with
fiJ(Ontractot(s).licensed pursuant ~otheCantrClctor's License Law).. i.:
u lame~emptunderSeco ". ,B&P .f9rt~1 re son: .. '. _~.' , .,.
Date: "'9-:05 .owner: 'c . =f!$E&t--D
r-r WORKER'SCO PENSATlON DECLARATION L~.-.J
I hereby affirm under penalty of perjury one of the following declarations: ,',
D. i have and wi!! maintain. a certificate of consentto self':';nsure for wO:'"kerJf: compen,s~tion.
as provided for by Section 3700 of the Labor Code, for the perforniance at th:e wcrk for ',vh;ch
this permit is .issued. . . i' ..
~. ." . have and witlmaintain worker's'~ompensation insurance, as requi~d bi,.,! Section 3700 of
e Labor Code, for the performance of the work f~r which this permit is iss:J.~ct. .Myworker's
Compensation insurance carrier and policy are: .. ,. .
Carrier: .. . Policy Number: NUMBER
This section need not be completedifth.e pennit is for one ~undred dollars ($1 Or) or less. I TYPE
~ertlfy that In the performance of the work for whicn this permit IS issue:d. J shall ntJt
~ploy any person in any manner so as to become subject to the worker's c::mpensatJoll laws
of Califomia, and agree that if I should become subject to the worker's COl1";J--r.satloll
provisions of Section 3700 of the labor Code, T shfll forthwith cOr!1ply with !1""-.oo;6 proviSions. Construcion Types:
VN, ,
CONTRACTOR INFORMP.TION:
ARCHITE;CT/ENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION i
I herehy affirm under per:alty of perjury that i am
licensed under provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
Professions Code.
2/9/2005
Date:
Contractor
EXPIRATION DATE
Date: 2/912005 Applicant: :';Wc
WARNING: FAILURE TO SECUREW RKER'S COMPENSATION CO E;:.AGE: IS
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO. CRIM IN/'Il PENALTIES AND CIVIL
FINES UPTO ONE HU'NDRED THOUSAND DOLLARS ($100.000), IN Ai.J;:,,'TiON TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIW 3706. OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
I CONSTRUCTION LENDING AGENCY ..
I hereby affirm under penalty of perjury that there_ is a constru~!ion !er,pir.g.ci;ency for the
;}~~:;:-r~:::;;ce of!h ::::.\..!~:,-!<.,Jc:: '.;'J,~i::-:'~:~~~~~p'..::!~!t:5 [~.;:;;:..~")1.!. {-S~.~2C:;:7;,cf.....;<.)},
Lender's Information:
(certify thaf I have read this application and state thatthe aboveinformatior: is correct. I
agree'to rornply ~lth all city ordinances and state laws relating to building cnnstruction, and'
hereby authorize representives of this city to enter upon the above mentioned property .for
inspection pur &.
Fees paid for ~ermit:
Total:
235.43
Oak 2/9/2005
Signature of Ap Iicant or Agent
he 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 perrtlit issuance. A
neW permit is required to commence or continuework.
INSPECTION RECORD
INSPECTION , , DATE I,' INSPECTOR
, ' ,
Temporary Power pole ' ' ,
Plumbi ng (DrainlWaste Pipe) , ,
EledricaJ Ground Electrode/uter ,
SetbacklFormslTrenches (Footings) ,
Do notinstall subfloor Or pour floor slab until the
following appllcableilems have ,been signed:
Plumbirig (Water Pipe.Sprinkler Valves) ,
MechanicaJ:(GrOUnclwQrk) ,
EledricaJ (Underground Condu it) , ,
Pre-slab (Compaction/Membrane.Rei nt. , '
Underpinning (AoorJoist/Girders)
Do not cover or conce,al the work below until the
following applicable itemS have, been signed:
1st Floor,Shear , ,
FiresprlnkJer (ROugh) , ,
2nd Floor Shear , ' ' "
Roof/Shealhlng/DiaphragmlFrame) !<llo"l In,' 11"121' "
f,IIasonry (Reinf.JBond BeamlPre-Grout) , ,
Rough Plumbing (Top Out) , ,
Rough Mechanical, ,
Rough ~ectrlCallDI'Y Wall) "
Rough Electrical
Framing' (Only after Plbg.. Elec,: 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 ,
Penetrat,ions (Fire Rated) Plumbing "
Interior Lath
exterior Lath
GENERAL ITEMS
Exterior Plaster (Brown Coat) "
T .Bar Electrical ,
T -Bar Mechanical ' ,
T .Bar Strudural , "
Sewer , ,
Water Engineering Backflow , ' , ' ,
Water Service
FINAL INSPECTIONS Date' Inspector
Electrical Final
Plumbing Final , "
Mechanical Final ,
Gas Test
EngilJll8ring/Grading Final 765-5126 " ,
Fire Dept. Final 765-4040
Water Engineering 765.5268 ,,' " "
Sub List/Business License 765.519
Zoning 765-5139 " '. Ii
I '" ; i
Building Final ~ast'lnspection' Only ,"'I'(M-- y;!:~V~
fter Above Complete) C. u.,;..,/ (c.
PARTIAL'INSPECTIONS
Buildina Inspections
, Mechanical Inspections
Plumbinalnspections
Electrical Inspections