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1000 Monterey TYPE OF PERMIT CITY Reroof ElM BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 31 BUILDING PERMIT NO. BLD2005-03398 DATE: 10/24/2005 JOB ADDRESS: 1000 N MONTEREY ST LEGAL DESCRIPTION: N TR 1202 lOT 111 CONTRACTOR INFORMATION: FI RST QUALITY ROOFING 906 S FIGUEROA ST SANTA ANA, CA 927040000 BUSINESS PHONE: 714775-3375 JOB DESCRIPT10N:Tear off existing and reroof 15 squares with 3D-year composition shingles and 4 squares BUR APPLICANT: FREDDIE VAZQUEZ OWNER INFORMATION: ADAM G MC 1000 N MONTEREY ST ANAHEIM, CA 92801 ARCHITECT/ENGINEER INFORMATION: VALUATION: 4,890.00 I OWNER-BUILDER DECLARATION I hereby affirm 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,. 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 licensed pursuant to the provisions of the Contractor's License Law (Chapter 9)(commencing with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom and thebasis 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). D I, as owner of property, or my employees with wages as their sole compen~ation, will do the work, and the structure is not intended or offered for sale (Sec. 7044 Business and Professions Code: The Contractor's License La~.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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold with one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). D I, 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 property who 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 WORKER'S COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for worker's compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ~~ have and will maintain worker's compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Mywarker's Compensation insurance carrier and policy are: Carrier: STATE FU ND PROCESSED BY: JNJ LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that' am licensed under provisions of chapter 9 (commencing with Section 7000) of Divsio f the Business nd Professions Code. Policy Number. 0026599-2004 NUMBER 776969 TYPE 10/24/2005 Date: This section need not be completed if the pennit is for one hundred dollars ($100) or less. o I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the worker's compensation la of California, and agree that if I should become subje 0 the worker's compensation provisions of Section 3700 of the Labor Code, I sh fo hwith co I with ase provisio s. C39 Date: 10/24/2005 Appllcanti>= WARNING: FAILURE TO SECURE WORKER' UNLAWFUL, AND SHALL SUBJECT AN EM FINES UPTO ONE HUNDRED THOUSAND D LARS ($100,000), IN ADDITlON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED 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 lending agency for the performance of the work for which this permit is issued (Sec.3097.Civ.C): Lender's Information: Construcion Types: V N, , 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 authorize re ntives of this city to enter P. the above mentioned property for inspection purpo s. Date: 10/2412005 Fees paid for Permit: Total: 170,20 Si nature of Applicant or Agent expire by limitation and beco n and void if the building or work has n passed final inspection 365 days from the date of permit issuance, A new permit is required to commence or continue work. City of Anaheim Building Division INSPECTION RECORD INSPECTION DATE INSPECTOR Temporary Power Pole Plumbing (DrainlWaste Pipe) Electrical Ground ElectrodeJUfer Setback/FormslTrenches (Footings) Do not install subfloor or pour floor slab unlilthe following applicable items have been sIgned: Plumbing (Water Pipe/Sprinkler Valves) Mechanical (Groundwork) Electrical (Underground Conduit) Pre-slab (CompactionlMembrane Reinf.) Underpinning (Floor Joist/Girders) Do not cover or conceal the work below until the following applicable items have been signed: 1 at Floor Shear Firesprinkler (Rough) 2nd Floor Shear / / Roof (Sheathing/Diaphragm/Frame) bin!. " _L^,\~ . Masonry (Reinf./Bond BeamlPre-Grout) / Rough Plumbing (Top Out) Rough Mechanical Rough Electrical (Dry Wall) Rough Electrical Framing (Only after Plbg., Ele., Mec. And Fire) Insulation (Sound/Energy) Do not tape or plaster unlilthe 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) ToBar 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 LlsllBuslness License 765-5194 Zoning 765-5139 Building Final (Lastlnspeclion 0 Only ~ l.A Aller Above Complete) . - PARTIAL INSPECTIONS Building InsDections Mechanical Inspections Plumbing Inspections Electrical Inspections