2043 W. Minerva Ave.
TYPE OF PERMIT CITY
Reroof
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 41
BUILDING PERMIT NO. BLD2005-03473
DATE: 10/31/2005
JOB ADDRESS: 2043 W MINERVA AVE
LEGAL DESCRIPTION: N TR 2711 LOT 63
APPLICANT: FREDDIE VAZQUEZ
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
FRED H ABHOLD FI RST QUALITY ROOFING
2043 W MINERVA AVE 906 S FIGUEROA ST
ANAHEIM, CA 92804 SANTA ANA, CA 92704 0000
BUSINESS PHONE: 714775-3375
JOB DESCRIPTION:Tear off existing and reroof 28 squares with 30-year composition shingles
VALUATION:
6,000.00
PROCESSED BY: MSM
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's ldcense Law for the allowing reason (Sec. 7031.5 Business and
Professions Code: any city or county which requires a permit to construct, alter,~'jmprove, 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 Profession~ 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 Law 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 e'nployees, provided that such improvements are not intended or
offered for sale. If, however, the building or improvement is sold with one year i)f completion, the owner-builder will have the burden of proving that he
did not build or improve for the purpose of sale). ,
o 1, as the owner of the 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 propertywto builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant to the Contractor's License Law),
o I am exempt under Sec. , B & P,C. for this reason:
Date: Owner:
I
This section need not be completed if the pennit is for one hundred dollars ($100) or less.
o I certify that in the performpnce of the work for which this permit is issued, i shaft not
employ any person in any manr\er so as to beeo s bject to the worker's compensation laws
of Califomia, and agree that if I should becom bj to the worker's com ensation
provisions of Section 3700 of the Labor Cod ,I sha forthwith com Iy wi hose ovisions.
10/31/2005
Date:
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 c.')mpensat;on,
as provided for by Section 3700 of the Labor Code, for the pelformance of the ~iork for which
this permit is issued. .:
~ave and will maintain worker's compensation insurance, as required by S,ection 3700 of
~Labor Code, for the performance of the work for which this permit is issued.: My worker's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number. 0026599-2004
NUMBER
776969
TYPE
Date: 10/31/2005 Applicant:
WARNING: FAILURE TO SEC .WORKER' COMPENSATIO COVERAGE IS
UNLAWFUL, AND SHALL SUBJ CT AN EM OYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED OUSAN DOLLARS ($100,000), IN ADDITION TO THE
COST OF COMPENSATION, AMAGE S PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AN 'ATT NEY'S FEES.
CON UCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending age~pyfor the
performance of the work for which this permit is issued (Sec.3097.Civ.C):
Lender's Information:
Construcion Types:
V N, ,
Fees paid for Permit:
Total:
244.97
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
Setback/FormslTrenches (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 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 /L
Roof (SheathinglDiaphragmlFrame) "/:,/,.,,, J' /7....--"
Masonry (RelnfJBond Beam/Pre-Grout) -/
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ere., 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 I I
Building Final (L.sllnspacllon - Only I{~~
After Above Complete) y~ ~5 ..\Al-hC<.X!.!.1.
/ I
PARTIAL INSPECTIONS
Building Inspections
Mechanical Inspections
Plumbing Inspections
Electrical Inspections