1303 N. Merona St.
TYPE OF PERMIT CITY
Reroof
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
1714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 434
QUARTER SECTION: 91
~;2
BUILDING PERMIT NO. BLD2005-00956
DATE: 4/8/2005
JOB ADDRESS: 1303 N MERONA ST
LEGAL DESCRIPTIOIIi, . N TR 2249 LOT 5
APPLICANT: MIGUEL CRUZ
OWNER INFORMATION: CONTRACTOR INFORMAT)ON: ARCHITECT/ENGINEER INFORMATION:
Miguel Cruz
1"303 N Merona 8t
Anaheim,CA 92805 .
JOB DESCRIPTION:Tear off existing material, install 15 squares of 30 year timberline composition shingles.
,
VALUATION:
4,000.00
PROCESSED BY: ENO
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt iTom the Contractor's.. icenseLaw for the following reasan (Sec. 031.5 Business and
Professions CO:de: any city'or county which requhes 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 ~jcen$ed pU'rsuant to. the provisions of the Contractor's License Law (Chapter
9)(commencing with Section 7000 of Division 3 of the Business'and Profession~Code) or that he is.exempt therefrom and the basis for the alleged
exemption. Any violatioll of Section 7031;5 by any apPlicant. for. a permit sUbieC[.ts the. applicant to a civil penalty of not more than five hundred dollars
($500), . . .. .
~. 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 Professio~s Code: The Contractor's License. L8W- does not 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 ~mployees, provided that such improvements'are not intended or
offered for sale.. If, however, the building <?r improvement is sold with one yeac'pf .completion, the owner-builder will have the burden of proving that he
did not build or improve for the 'purpose of sale); . ,j .
o I, as the owner of the property, am exclusively contracting with licensed cdntractors to construct the project (Sec. 7044' Business and' Professions ~,
Code: The Contractor's License Law does not apply to an owner of" property WJ10 builds or improves 'thereon, and who contracts for such projects with
o.ntra~or(s) licensed pursuant to the Contr:'actor's License Law).! .
I am exempt under Se .& .C. for this reaso. /--'
ate: ~ ,~ Owner:
WORKER' SATION DEC~ RATION
I hereby affirm under penalty of ~ury one of the following declarations: !
D, I have and will maintain a certificate of consent to self~insure for worker'sd.ompensation,'
as provided for by Section 3700 of the Labor Code, for the performance of the iNork. for which
this permit is issued.
o I have and will maintain ~Orker'S compensation insurance, as required by $ection3700 of 4/8/2005
the Labor Code,_for the performance of the ,work for which this permit is issued: Myworker's Date:
Compensation insurance carrier and policy are: ;
Carrier: Policy Number:
LICENSED CONTRACTORS DECLARATION
I, hereby affirm under penalty of perjury that lam
licensed u'nder provisions of chapter. 9 (commencing
with Section 7000)_of Divsion 3 oft~e 'Business and'
Professiqns Code.
Contractor
NUMBER. .
EXPIRATION DATE.
This section need not be completed if the permit is for one hundred dollars ($1 00) Qr less.
B" I c~rtify that in the performance ojth~ work for which this permit is issued'l' shall not
employ any person in any manner so as to become subject to the worker's cOITlpensation laws
of Califomia, and agree that "if I should b me subject to the worker's compensation
provisions of Section 3700 of'the bar ode, I shall fa with comply with thos~.provisions.
Date: 4/8/2005 Applicant: .'
WARNING: FAILURE TO SECUR W KE' COMPENSATI OVERAGE 18 .
UNLAWFUL, AND SHALLSUBJE TAN EMPLOYER TO CRIMINAL PENALTI.ES AND CIVIL
FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITION TO THE.
COST OF COMPENSATION, 1IMAGES.ASPROVIDED 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 lendi~g age~cyfor the
,pertormance of .the work 10J whjchthispermit is issued (Sec. 3097.Civ.C): J'
Lender's" Information:
TYPE
ConstruCion Types:
VN, ,
'Fire Sprinklered?
NO
. .
- -- --------- ----~~----"_.,,-------~
Date: 4/8/2005
Fees. paid for Permit:
Total:
160.61
ature f Applica.nt or
The per it I expire by Iimitati . ecome null and void if the building or
work s not passed Ii 001 inspection 365 days from the date of permit issulnce. A
new p mit is required to commence or continue work.
INSPECTION RECORD
INSPECTION DATE , INSPECTOR
Temporary Power Pole , ,
Plumbing (DrainlWaste Pipe) "
, Electrical Ground Electrode/lifer
SelbacklFormsfTrenches (Footings) "
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 Condull) , , ,
Pre-sla~ (Compaction/Membrane.Reim.
Underpinning (Floor Joist/Girders)
Do not cover or conceal the work pelow until the
following applicable items have been signed:
1st Floor Shear ' , , ,
Firespri,nkler (Rough)
Znd Floor Shear , " ^ nltJ,^
~ Roof (SheathingfDiaphragmlFrame) 'Y ;':f..~ Jk
Masonry (RainfJBond BeamlPre-Grout) ,
Rough Plumbing (Top Out)
Rough Mechanical
Rough t:IectrlCallDry wall) ,
Rough Electrical, ,
Framing (Only aflerPlbg., E:lec.. Mech.. and Fire)
Insulation (SoundlEnergy) , ",
Do not tape or plaster until the fol/owing applicable
items ha~e been signed: :
Drywall
Penetrations '(Fire Rated) Electrical ' ,
Penetralions(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 BacldloYl
Water Service ,
FINAL INSPECTIONS .
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
EngineeringfGrading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering' 765-5Z68
sub list/Business License 765-519
Zoning 765-5139
Building Final fLast Inspection- Only
After Above Completel
, PARTIAL INSPECTIONS
ections
Inspector
Date
d . #~l..'J"
Mechanlcallnsoections
Plumbina InsDections
ElectricallnsDections