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1585 Mells Ln. TYPE OF PERMIT C IT.Y Reroof , ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 1 BUILDING PERMIT NO. BLD2004-02166 DATE: 5/27/2004 JOB ADDRESS: 1585 W MELLS LN . . LEGAL DESCRIPTION: N TR 2446 LOT 72 CENSUS CODE: 434 QUARTER SECTION:5? APPLICANT: ARVN' ARYA OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: Arun MArya 1585 W Mells Ln Anaheim, CA .82802 JOB DESCRIPTIONJear off and Install31sq of composition shingles and change out 2 solar tubes. (HIH) VALUATION:. 8,525.00 PROCESSED BY: ENO OWNER-BUILDER DECLARATION hereby affirm under penalty Of perjury that I am exempt from the Contractor's License w for the following reason (Sec. 7031.5 Business and Professions Code: any city or county which requires a permit to construpt, alteri improve, demolish or repair qny.structure, prior to its issuance,. also requires the applicant for suchpermjUo 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 pi vision 3 of the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any viplation of Section 7031.5 by any applicant for a permit subjects the applicant' to a civil penalty of not more t~an five hundred dqllars . ~O~)~ owner of property, or my employees with wages as their sole compe~sation, Will do the work, and the structure j~ ~ot intended or offered ~or sale (Sec. 7044 Business and Professions Code: The Contractor's. License law does ,notappJy 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 /:)f Completion, the owne'r~builder will have the burden of proving that he did not build or improve for the purpose of sale). . '. .' . o I, as.theowner of the property, am exclusively contractinf:f with licensed contractors to construct the proje6t(Sec. 7044 Business and,Ptbfesslc>ns Code: The Cont'ractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with'. ~ontractor{s)' licensed pursuant to the Contractor's" nse Law:): L:J I aYl exe':f\ptunder Sec. , . B P: so . . b.~ \,\)< 0'. . WORKER'S CO '1. I .\ hereby affjrm under penalty of perjury one of the f UQ ing declarations: , o I have and,will maintain' 'a certificate 6t consent to selt~insure for Worker's compensation, as_providel",i for by Section 3700 of the Labor Code, .for the performance of the work for which this permit.is issued. .; . ! 0, I have andwHl maintain worker's c~mpensation insurance, as required by Section 3700 of 6/1/2005 the Labor Code', for the performance of the work for which this permit is issued.' MywGrker's Date: G9mpensation insurance canier a.nd 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. Contractor NUMBER EXPIRATION DATE This section need riot be completed if fhe pennit is fOr one hundred dollars ($10ll) or less. ~ I certify that in the performance of the 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 compensation laws of Califomia, and agree that -if I should become subject to ;DZ"wOrker'S comperis.,ation . provisions ~ Section 370~ of the Labor C , I shall ~~ lose provisions. Date: 611/2005 Applicant: WARNING: !'AILURE TO SECURE OR !tEN COVERAGE IS UNLAWFUL, AND SHALL SUBJE AN EM OYER 1'Q..Q IMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED OUSAND DOLLARS ($100,000), IN ADDITI.DN TO THE COST OF COMPENSATION, MAGES AS PROVIDED FOR IN SECTION 3'106 OF THE LABOR CODE, INTEREST A D ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that-there is aconstructian lending agency for the performance' of the work for which this permit is issued (Sec. 3097 .Civ._C): . - Lender's Information: - - -- . TYPE Construcion Tvpes: VN, , Fire Sprinklered? . 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 autho Jze repre'sentives of this ci to en e ove mentioned property for 'nspection rposes. Fe~s paid for Permit: Total: 0.85 INSPECTION RECORD ' , e;., INSPECTION DATE 'INSPECTOR , Temporary Power Pole Plumbing (DraiOlWaste Pipe) Electrical Ground Electrode/uter SelbacklFormsfTrenches (Footings) 00 not install subf/oOr or pour floor sJabuntil the following applicable item" have been "igned: ' , Plumbing (Water Pipe.Sprinkler Valves) Mechanicai (Groundwork) , Electrical (Underground Conduit) Pre-slab (CompactIonlMembrane.Reim. , Underpinning (Floor Joist/Girders) , , ! !Xl not cover.or conceal the !Nark below until the , following applicable item" hilve been "igned: ' " 1st Floor Shear , Firesprinklel' (Rough) 2nd Floor Shear, " Roof (Sheathing/Diaphragm/Frame) MasonrY (ReinfJBond Bearo/Pre-Grout) Rough Plumbing (Top Out) , , Rough Mechanical , ROugh I'::lectr 1111, , Rough Electrical , Framing , 10nly a.fter Plbg,. Elec. Mech, and Fire) Insulali,on (SOlIndlEnergy) Do not,tape or plaster until thefollo!Ning applicable items have been signed: ' ' D~all , , , Penetrations (Fire Rated) Electrical ' I Penetrations (FIre Rated)'Mechanical Penetr.lons (Fire Rated) Plumbing .Interior Lath, Exterior Lath GENERAL ITEMS Exterior Plaster (Brown Coat) T-Bar Electrical T -Bar Mechanical .. T-Bar, Structural .. $ewer , Water Engineering Backflow' : , Water'Service FINAL INSPECTIONS .Date' , Inspector Electrical Final , , Plumbing Final ,,' , " Mechanical Final ' , , Gas Test ' ' , EngineeririglGrading Final 765-0126 " Fire Dep!. Final 765-4040 , Water Enginellring 7lj5-5268 , " Sub List/Business License 765-519 . " , Zoning 765-5139 .. Building Final', ~astlnspectjon., Only t/7~f( A'~/ A , fter Above Complete) ,/ PARTIAL INSPECTIONS Buildina Inspections' J)L1N~ , , Mechanical Inspections PlUmbina Inspections, Electrical Inspections . ElM BUILDING DIVISION 200 S, ANAHEIM BLVD. (714) 765, 5153 INSPEqlON REQUEST LINE: (714) 765 '.4626 CENSUS CODE: 434 QUARTER SECTION: 57 BUILDING PERMIT NO. BLD2004-02166 TYPE OF PERMIT CITY Reroof DATE: 512712004 JOB ADDRESS: 1585 W MELLS LN LEGAL DESCRIPTION: N TR 2146 LOT 72 APPLlCAW: ARVN ARYA OWNER INFORMATION: A"m MArya 1585 W Mells Ln . Anaheim, CA 92802 JOB DESCRIPTION'rear off and insta\l31sq of composition shingles. (HIH) VALUATION: 8,525.00 I CONTRACTOR INFORMATI(:>N: ARCHITECT/ENGINEER INFORMATION: ".: , 'OWNER-BUILDER DkcLARATION IherebY_aff.ir~'under penalty of perjury.that I am exempt from the Contractor'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,)lmprOVe, 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 lk:ense 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 ~xemption. Any violation ,of Section 7031.5 by any applicant for a permit subjeqts the applicant to a civil penalty of not more than fiVe hundred dallars ($500)., , .' ~ I, as owner .of praperty, or my employees with wages as their sole compen$ation, will da the wqrk, and the structl,.Ire is not intende, d,or offered for ~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 hi"mself .or helSelf or through his or her own ~mployeesJ provided that such improvements are not intended or offered for sa.te~ If, however, the building or improvement is sold with one year?f completion, the -owner-builder will have the burden of proving that he:~ did not build or improve for the'pulpose of sale), , \', . [] I, as th~ owner of the prop'arty, am exclusively contracting with licensed CO/ltractors ~o 'construct the project' (Sec. 7044 ~sinessand Professions Code: The Coritr~ctor's l!CE!n.se Law does not apply to ari owner of property who builds or improves thereon,_ and who cont~acts for such projects with [jontractor(s) licensed pursuant to the Contractor' cense ,. I a exe pt)!Oder Sec. " te:.1; Own . WOR 'S A ON I hereby affi.rm under penalty of perjury one of the fol 9 declarations: o I' have and will maintain a certificate of consent to self-insure for worket'scpmpensation, ?is provided for by Section 3700 of the Labor COde, for the performance of the ~orkfor which this.permit is issued. ; o I have and will maintain worker's compensation insurance, as required by Secti?n '3700 of the Labor Code,. for the performance of the work,for which this.permit is issued.:, Myworker's Compensation insurance earrier and policy are: '. ~ Carrier: Policy Number. PROCESSED BY: JNJ LICENSED CONTRACTORS DECLARATION. I hereby affirm under penalty 0 perjury that .1 am licensed Linder provisions of ch~er 9 (commencing with 'seCtion 7000) at Divsion 3 of the Business and Professions Code. 5123/2005 Date: Contractor NUMBER EXPIRATION DATE This sec~on need not be completed i1 the pennilis lor one hundred dollars ($1 00) ~ less. ~I certify that in the performance of the work for which this permit is issued, 1 shall not effiP't6y any person in any manner so as to become subject to the worker's compensation laws of-California, and agree that if should bee bject to the worker's compensation provisian~ of Section 3700 of the bar. ode, I sh~ forthwi with those provisions. Date: 5/23/2005 Applicant: WARNING: FAILURE TO SEC E WORK EN N COVERAGE IS UNLAWFUL, AND SHALL SUB ECT AN EMPLOYER T IMINAL PENALTiES AND CIVIL FINES UPTO ONE HUNDR THOUSA'NDDOLLARS ($100,000), IN ADDITION TO THE COST OF CQMPENSATIO ,DAMAGES AS PROVIDED FOR IN SECTJON 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING ,AGENCY I hereby affirm under penalty of perjury that"there is a construction lending agency for-the pentormance of the work for which thi~ permit is issued (Sec.3097 .Civ.C): ~ai1der's informaiion: -- . ---, T,YPE Construcion Types: VN, , Fire Sprinklered? NO I certify that I have read this application and state that the above information is correct. I agree to comply wjth all city ordinances and state laws relating to building construction, and hereby thorize representives of this to enter upon the above mentioned property for ran purposes. Sig gent e permit shall ex e y iim' tio and become null and void if the building lir k has not passed final inspection 365 days from thil date of permit issuance, A ew permit is required to commence or continue work. Dale: 5/23/2005 Fees paid for Permit: Total: 0.85 INSPECTION RECORD INSPECTION , -DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) , , Electrical Ground Electrode/uter " SetbacklFormslTrenches (Footings) , Do not install subfloor or pour floor slab until the fqllowing applicable items have been signe,d: Plumbing (Water Pipe.Sprinkler Valves) MllChanical (Groundwork) , ' , Electrical (Underground Conduit) t'nHlIab (Compaction/Membrane.Reint. , Underpinning (Floor Joist/Girders) Do not cover or conceal the work below untrl the following applicable'ilems have been signed: 1 st Floor Shear ' , Firellprinkler (Rough) , 2nd Floor Shear Roof (Shealhing/lliaphragm'Frame) .h, Masonry (ReihfJBond BeamlPre-Grout) /' Rough Plumbing (Top Out) Rough Mechanical Rough BectriCal\UIY,yyall) , Rough Electrical' , Framing (On'ly atr~r Plpg;; E/eC.. rAeen.. and Fire) , .h$!l'allon (SoundlEnergy) , ' po not tape orpla~ter unti,1 the following applicable .tems have been signed: ' Drywall ' , Penetralions (Fire Rated) Electrical , Penetralions (Fire Raled) Mechanical Penetralions (Fire Rated) Plumbing , ' ' InteriorLalh , , , , 'Exterior Lath , , GENERAL ITEMS ElClerior Plaster (BJ'C7NI1 Coat) " T-Bar Electrical, - T -Bar Mechanical' " , T -Bar Structural Sewer Water Engineering Backflow Water !:ervi"e , FINAL INSPECTIONS Date Inspector , Elec;trical Final " " , . Plu'l'bing Final ',' , " , ' Mec/1anical' Final , " Gas 'Test .. ' Engh,eering/Grading Final 765-5126 , Fire'Dept. Fina1.165-4040 " , Water Engineering 765-5268 SUb List/Business License 765-519 , , Zoning 765-5139 , ' ",,' Building Final ~"st Inspeclion. Only (h fpr-. /~/ , ' fter Above Complele) " ,f " PARTIAL. INSPECTIONS Buildina InsDections JJLlIJ6; ,MechanicallnSDections Plumbing InsDections Electricallnsoections