133 S. Monument
TYPE OF PERMIT
Reroof
CITY-
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BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765- 51,53
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 27
BUILDING PERMIT NO. BLD2005-00527
DATE: 3/1/2005
JOB ADDRESS: 133'S MONUMENT ST
LEGAL DESCRIPTION: N TR 1940 LOT 40
APPLICANT: JOHN BATIOFF
.OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
Carolyn L Wyatt CAL COAST ROOANG & RAINGUTTERS .
, I
841 N Frederic St 8329 VALLEY VIEW ST j
Burbank, CA .91505 BUENA PARK, CA 90620 ~;l00
, '. BUSINESS PHONE: 714827,.5371.. '
JOB DESCRIPTION: Tear off existing and reroof 26 squares with' 3D-year co~;.po.sition shingle; includes detached garage
VALUATION: 6;300.00 '1' PROCESSED BY: MSM
I . , '. . OWNER-BUILDE~ DECLARATION . .... ,. .
I hereby affirm under penaltyofp"erjury.that I am exemp~.fromthe- Contractor(" License Law for the, following ref.l.son.(Sec. 7031.5 Business and . .
Professions Code: any city or county which requires a permit to c'onstruct, aller, improve, de_molish or repair any structure, ,prior to its issuance, also
requires the appliCant for: such. permit to file a signed stateme_nt that he _is li;;{nsed pursuant to the provisions of the Contractor's License Law (Chapter
9)(commencing \."lith Section 7000 of Division 3 of the Buslries.s.and Profes~ilns Code) or that he is exempt therefrom and the basis for the all~ged
exemptio'n. ,Any violation of S:ection 7031.5 by any applicant for a permit ':>lltllects the applicant to a dvil penalty of not more than ftve hundred dollars.
($500). . . '. .
o , I, as owner of property,' ormy employees with wages as_their ,sole c0fl1~6nsation. wHl do the work, and the structure IS not intended or.offer!SdJor
sale (Sec. 7044 Business and Professions Code:- The Contractor's Licen5:eYLlwdoes not apply to an owne:r of property who'bLiildsorimproves
there:on, and -who does such work hill1Setf orhe~_elf or through his. or l1er 011 employees, provided that such .improvements are not intenqed or
'offeredfor sale. If, however, the building or !mprovement is sold with one ye:;r of,rompleticn, the owner-builder will have the burden of proving that he
. did not bu~d or improve for the'pu !pose of sale). l .
o I, as the owner of the property, am exdusively contmcting"with licel1SCd ':6ntraciors to construct the project (Sp.c, 7044 ,Business and Professions
Cqde~ The Contractor's LicenSE;l'Law dO,es .not apply to an awper-of'property who builds or improves thereon, and who rontracts.for such ,projects with
S,LC1ontract.or(s) ,licensed pursuant to the Contractor's License Law}.' .
I~ 12mexemptunder.Sec.' _ ,B&P.C.forthJsreason:
Date: '. Owner:
I WORKER'S COMPENSATION DECLARA1ION
I herebyafffrm under p~nalty of perjuiy ,one of the following decla~ations:
o 'Ihave'artd will maintain a certificate of ronsent to self-insure for worker"::; ~Qmpensation,
as provided for by Section 3700 of the Labor Code, fo; the performance of t~ work for which
this rmit is issued. . I"
I-have andwill maintain wo.rker's compensation insurance, 'as required ~/ Section 3700 of I'
the labor Ceide, for the performance of the work for whIch this permit is i~u(~. Mywcrker's
Compensation insurl;lnce.car~er and policy are:
Cprrier: STATE COMP INS FUND Policy Nu mber. 1759809
. I
LICENSED CONTRACTORS DECLARAT~.
I hereby affirm under penslty of perjury that I am
. licensed u'nder provisions of chapter 9 (commencing
with Section 7000) of Divsion 3 of the Business and
PlUfessions;;:.. ~
3/1/2005, ~ ~ ,
. /
Date. ontractor
" '. " . . -,'
This s"ection "need not be-completed if the pennit is for one hundred tlollarS t$1q~~i 'or :ess.
o '.certify, that in the- perfonnance of the work for which this permit 1s isS~1~~-, I sharr no"1:
~/TlPloy any person in a ny manner soas to b~come subject to the worker's corr~,pensatio!1 laws
of .califomia"and agree that if I should become subject to the worker's tomp-:;n$atiol1
pr4visionsof Section 3700 of "the Labor Code shC!1I forthwith cClmpiy with!~1Se pj"ovisions~
Date: 3/1/2005 APPlicant:~
WARNING: FAILURE TO SECL,-REWORKE OMPENSATION COVEf'.Af:3E is
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPEN,'.LTlES AND'CiVIL
FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN Aq,OITlQN TO'THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. . . .
I' . .' ..' CONSTRUCTION LENDING AGENCY _-'__ ' .
I hereby, affirm under penalty of perjury that there is a c<onstructionlend:'~.::! 3reytcyJor"the....". '.,"- .'--
.lpe:f0rrr.;J,:')C<J- cf..th::!- w,j'-:~"fQI~y;hic..h !I"ir-.,ryp~mit-is issued -(Sec.-:-iOOi.'Civ.(;): .' .
Lenqer's'lnfcrmation:
NUMBER
828394
TYPE
EXPIRATION DATE
12/31/2005
C39
Construcion Types:
VN. I
I certify that I have read this a pplication and state that the abqve information i.s correct. I
agree to rom ply with all city ordinances and state laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
in OOion pur s.
Date: 3/1/2005
Fees paid for ~ermit: .
Total:
235.46
S nature of Applicant or Agent
he permit shal pire by limitation and become null and void if the building or
. work has. not passed final inspeciion365 days from the date of permit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
INSPECTION , 'DATE' , INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste ,Pipe)
Electrical GroundElectrodelUfer
Setb,acklFormslTrenches (Footings)
, Do not install subfloor or pour floor slab until the ,
following applicable items have been signed: '
Plumbing (Water"Pipe.Sprinkler Valve$) ,
Mechanical (Groundwork) ,
Electrical (Underground Condu ill
, Pre-slab, (Compaction/Membrane.Rei nt., "
Underpinning (Roar Joist/Girders) "
Do not cover or conceal the woJj< below until the
following applicable'items have been signed:
1 st Floor Shear ,',
Flresprinkler (Rough) "
2nd Floor Shear " , " . ." , ~
Roof (Sheathing/Dlaphraam/Frame) ? f.ffCl'i
Masonry (ReinfJBondBeamlPre-Grout) ,
Rough Plumbing (Top Out) .
Rough, Mechanical .'" " ,
Rougn l::IectrlCal (DrY wall) , ,
Rough Electrical ,
Framing . (Only after Plbg.. Elec,: Mech.. and Fire)
Insulation (SoundlEnergy)" ,
Do not tape "or plaster until the following applicable
i~ems.h.ave b.een Signed: .
Drywall ' ,
Penetrations (Fire Rated) Electrical' .. , ,
Penetrations (File 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
Wat"r Engine"ring Back1low .. ,
Water Servic" ..
. .-.
FINAL INSPECTIONS
Electrical Final
Plumbing Final
Mechanicai Final
Gas T "st
Ehglneering/Grading Final 765.0126
Fire Pept. Final 765-4040 '
Water Enginl!erlng 765.5268
S'ub List/Busin"ss License 765.519
Zoning 765.5139
Building Final (Last Inspection- Only" 1 S
, 'After Above Complete) - :U?
PARTIAL' INSPECTIONS
Buildina InSDec~ions
Date' inspector
MechanicallnSDections
"0
PlumbirialnSDections:
ElectricallnsDections