2985 E. Miraloma
TYPE OF PERMIT
Reroof
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153 .
INSPECTION REQUESTt:.INE:
(714) 765 -4626
CENSUS CODE: .555
QUARTER SECTION: 131
BUILDING PERMIT NO. "BLD2005-00101
",..".,.~. .
;..:.,
DATE: 1/13/2005.
JOB ADDRESS: 2985 E MIRALOMA AVE
LEGAL DESCRIPTION: P BK 146 PG 50 PAR 5
, " " \ '
CONTRACTOR INFORMt{J:ION:
CASTLEROCK ROOFING, SERVICE INC
760 N BATAVIA
ORANGE, CA 9286800001,
BUSINESS PHONE: 71462f!:0301
Tear off existing and reroot'295 squares with BUR {,:: .
, t
I
OWNER-BUILDEl'tfOECLARATlON
I hereby affirm underpenalty'of perjury that I am exempt from the Contractor!} License Law for the following reason (Sec; 7031.5 Business and
ProfessionS Code: any dty or countywhich requires a 'perm'it to construct, afH'r, improve, demolish qr repair any structure; prior to its issuance, also .
requires"the a, P, plieant for such permit to file a sign.ed statement that, he is licehsed PU, rsuant to the provisions of the .Contractor's licen,se:,La,W (Ch,a~ter
9)(commencing with Section. 7000 of Division 3 of the Business a nd Professi~"s Code) or that he is exe,mpt therefrom and the basis torthe alleged -'
~;;;;rXtion. Ary v, ,iolanon of section, 7,03,1.5 by.any applieanttor a permit SUb,'i,lb,_cts It,'; applicant toa civil penanYOf,no, t,mo',e I,han five hundred doHars
D I, as'ownerof property, or my employees with wages as their sole com~~lsatjOn, will do the worK, and tb.e structure js not intended or offered for,"
sale.(Sec. 7,044' Business and Profes.sions Code: The Contractor's License l;:~w does not appl"yto an owner of property-who' buitdsor improves'
thereon, arid who doe~ sudl work himself or herself or throug h his or 'her cw1~~mployees, provided that such improvements ~ renot intended or
offered fo~ sale. If, however, the building or improvement is sold with one yec~of completion, the ownl?r-buirderwill haye the burden of Proving that he
did not buHd or improve for' the purpose of sale). _ V ' . _ . '
.0 ~I, as the owner Qfthe property, am exdusively cont~rting with Iicenseri_~or.tractors to const~uct the. project (Sec. 7044 Business,and Prof.essions
Code: The Contractor's License ~w does not. apply to ,an owner of property,?,":hu builds or improves thereon. and who contrac~ for such projeCts with
~ontractor(s) licensed pursuanrto the Co"ntractOT's License Law). , H:,
. ~ "I am exempt under Sec. _ - _ - ,B ,& P.C. for this reason: ~.t
Date: Owner: { .
L WORKER'S COMPENSATION DECLARATION , ),
. _ ' ---r:---'
I' hereby affirm under penalty of perjury one of the following declaratiqns:, f .
D" I have and will ma.intain a certificate of consent to self-insure for WOrker\',~?mpensation,
" as provided for by Section ~700 ofthe Labor Cdtte, for the pelformallC6 of~h4'-worl< forwhidl
. t.his permit 15 issued. .. _ . 1',' '.
M.J, have a nd will maintain worker's compensation insurance, as required b~lSection 3700 of
:tftie-Labor Code, for'th~ performance of the work for which.this permit is issuefi. Myworker's
Compensation insurance carrier and policy are: . f
, Carrier: COMBINED SPECIA1Y Policy Number. 005-0002f040
This section need not be completed if the permit is foron'e .hundred dollars ($100}(or less.
o I certify that in the performance ofthe work for which this 'permit is, issue{ I shall not
employ any person in any manner so as to become subject to the worker's: cO~]jpensatiot1laws
of California, and agree.that if 1 should become subject to t work 5 co po,~lsat!On
provisions of Section 3700 of the Labor Code, I shall fort it co Iy wi ~hc:se provisions.
Date: '1/1312005 .. Applicant:
'WARNING: FAILURE TO SECUR WORKER'S COMP NSATION CO RAGE IS
UNLAWFUL, AND SHALL SUBJECTAN EMPLOYER TO CRIM INAL .PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100.000), IN ADDITION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES.
,I CONSTRUCTION LENDING AGENCY
I herE::D)' .aff:trm:u....:sr pcnii.dty.cf pe;jurj .1r..".:t-.th0r~ ..:s: a !:cn;:::tn.:~tlcr. leno :ng_:aYI-mcy fo-r~'t,1,'9,_
performarice of the wClrk for which this permit is issued (Sec. 3097 .Civ.C):
Lender)s Information:
APPLICANT: CHRIS LARSON
OWNER INFORMATION:
Trust Tweedt .
PO Box 10077
Santa Ana, CA 92711
ARCHITECT/ENGINEER INFORMATION:
JOB DESCRIPTION:
VALUATION:
30,000.00
PROCESSED BY: SAM
LICENSED CONTRACTORS DECLARATION' J
:. hereby affirm under penalty of perjury thctt I am
licensed Linder provisions o.f ch ter 9 mencing
with Sec-tiQn 7000) "of Di ion fth Bus' ess'and
Professions Code.
1/13/2005 .-J:.-
Date: (
Contractor.
NUMBER
767909
TYPE
TYPE
C39
HIC
EXPIRATION DATE
8/31/2005
Construcion Types:
VN, ,
.-
I. c'ertifythat 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.buiJding construction, and
hereby authorize repre Ves I city t9 enter uPon the above mentioned property for'
inspection P!Jrposes.
Date: 1/1312005
Fees paid for Permit:
Total:
,1.660.77
Sign. ture of Ap 'cant, or Agent
permit shall expire by limitation and become null and void if the building or
work hasnot passed final inspection 365 days from the date of permit issuance. A
new permit is required to commence or c'ontinue work.
INSPECTION DATE . INSPECTOR . Electrical Final . . .
Temporary Power Pole Plumbing Final
Plumbing (DrainlWaste Pipe) MeChanical Final
Electrical Ground .Electrode/lIfer . .
. S8tbacklFormslTrenches (Footings) . . . Gas Test .
DO 'notinstall subfloor or pour floor slab until the . .
Engineering/Grading Final 765-5126 .
following applicable items have been signed: Fire Dept. Final 7654040 . ..'
Plumbing (Water Pipe.Sprinkler Valves) . .
Mechanical (Groundwork) . . Water Engineering 765-5268 ,
. Electrical (Underground Conduit) Sub List/Busi'ness License 765-519
Pre-slab (Compaction/Membrane.Rei nt. . .
Underpinning (Roar Joist/Girders) Zoning 765.5139 .' . ...... . .
DO not cover or conCeal the work below until the Building Final !fast Inspection- Only :.r~.~ f~J~
following applicable items have been signed: fler Above Complete)
1 ilt Floor Shear PARTIAL INSPECTIONS U
Firesprinkler (Rough) .
2nd Floor Shear Buildina Inspections
Roof (Sheathina/DiaphraamlFrame) /-/!f<i . AF /./ :)) .
Masonry (ReinfJBond BeanlPre.Grout) .
Rough Plumbing (Top Out) . ..'
Rough Mechanical . . . . . .
.'
Rough l:IectrlCaI (Dry wall) .
. .
Rough Electrical . .
Framing . (Only after Plbg:, Elec" MeCh.. and Fire) . .' . ..
Insulation (SoundlEnergy) ..
po not tape or pla\'ter until the following applil;:able . . MechanicallnsDections
Items have. been Signed: ' . . .
Drywall . .' . .
Penetrations (Fire Rated) Electrical
Penetrations (Fire Rated) Mechanical '.
Penetrations (Fire Rated) Plumbing ..
Interior Lath
Exterior Lath . . . Plumbina Inspections .
GENERAL ITEMS' -c -c- . .
Exterior Plaster (Bl'll\Nn Coat)
T .Bar Electrical . . .
T.Bar Mechanical. . .
'. . . .
T -Bar Structural.
Sewer '. . .
. Waler Engineering BackfloY;'. . Electrical Inspections .
. .
Water Service . .
.'INSPECTION RECORD
FINAL INSPECTIONS
'r 0 e
Inspecior