1614 Morava Pl.
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: .104
0-;)..-.
BUILDING PE ~LTNO'. BLD2005-01643
DATE: 6/2/2005
JOB ADDRESS: 1614 E MORAVA PL
LEGAL DESCRIPTION: N TR 3371 LOT 74
CONTRACTOR INFORMATION:
WESTMINSTER ROOFING CO INC
9612 SUTHERLAND WY
GARDEN GROVE. CA 92844 0000
BUSINESS PMONE: 714541-5351
JOB DESCRIPTION: Tear off existing and re-roof 16 squares of 'Claymax Tile: IOBO#3523. 5.81bs and 3 squares of BUR over attached garage.
VALUATION: 7.000.00 PROCESSED BY: SAM
APPLICANT: ViNCENT LEE
OWNER INFORMATION:
Ngon Nguyen
'1614 E Morava PI
Anaheim, CA 92805
ARCHITECT/ENGINEER INFpRMATlON:
OWNER-BUILDER DECLARATION
.1 hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7 31.5 BUSiness and
P.ro~essions Code: any city or county which requiresa permit to construct, after, improve, demolish or repair_an.ys~ructur~, prior to its issuance, also
requjres 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 Sect!on 7000 of Division 30f the Business and Professions 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 appncant to a civ~ penalty of not more than five hundred dollars
~~. .
o I, as owner of propertY, or,my employees with wages as their sole compeni:;atIOn, wilt do the work, and the' structure is not intended or offered for
sale (Sec. 7044 Business and Professions Code: The Gontractor's License La\N does not applytoan owner of property who builds or improves
thereon, and who does such work hJmself or.helSelf or through his or her own employees, provided that such improvements are not intended or
ofte"red for sale. If,however, the building or improvement is sold with one year :~f co~pleti(;>n, the owner-builder will have the burden of proving that he
did not build or improve for the "purpose of sale).' .
o I, as the" owner of the property, am exclusively contracting with licensed contractors to construct the project (See, 7044 Business and Professions
Code: The Contractor's license Law does not apply to an owner of propertywtK) builds or improves thereon, and who contracts for such projects with
a contractor(s) licensed pursuant t()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 ofthe following declarations:
o I have and. will maintain a certificate of consent to selHnsure fo'r worker's compensation,
as provided f-or by Section 3700 of the Labor Code, for the pertormance of the work for which
this permit is issued, '
ve and wH!, maintain worker's compensation insurance, as required by Section 3700 ,of
th . or COde, for the performance of the work for which this p~rmit is issued.:. My worker's
mpensation insurance carrier and policy are:
C rrler: STATE FUND Policy Number. 285000001374
This section need not be,completed if the pennit is for one hundred.dollars ($100) or less.
o I ce~fy that in the performance of the work for which this permit is issued, ! shall not
employ any person in ~ny manner so as to become subject to the worker's compensation IqwS
of Califomia, and agree that if I should become subject to the worker's compensation
provisions 01 Section 3700 "of the labor Gode 'shall forthwith comply with those' provisions.
Dale: 612/2005 Applicant:
. ,
WARNING: FAILURE TO SECU ER'S COMPENSATION COVERAGE IS
UNLAWFUL, AND SHALL SUBJECT AN .EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES U P TO ONE HUNDRED 1HOUSAND 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.
CONSTRUCTION LENDING AGENCY
t Qex.eby_a1!irrn under pena.1ty of perjury .that there is a construction lending ag€_nny for the
performance of the work fprwhich thisperl:nit is issued (Sec,3097,Civ.C):
Lender's Information:
LICENSED CONTRACTORS DECLARATION
I hereby. affirm under penaltyof perJuryt at I 'am
I.Jcensed tinder proyisions of chapter 9 (commencing
with Section 7000) of Divsio.n 3 of the Business and
=/:~e:;~ons~ . .~.
Date: . { . - Contractor
NUMBER EXPIRATION DATE
.694940 8131/2005
TYPE"' . C39
Construcion Types:
VN, ,
I certify that I have read this application a'nd 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 representives of this city to ent~r upon the above mentioned property for
inspection rposes.
\
Date: 6/2/2005
Fees paid for Permit:
Total:
.160.81
. Signature of Applicant or gen.
permit shall expire by limitation and become null andvoid if the building or
work has nol passed fi 001 i nspecli!!n 365 clays 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 l='ipe) , ,
Electrical Ground ElectrodeJUfer
SetbacklFormsrrrenches (Footings)' "
Do not install subfloor or pour floor slab until the
following applicable items have been 'signed: .
Plumbing (Water Pipe.SprinklerValves) ,
Mechanical (GrC)undworkl
Electrical (Underground Conduit)
I Pnl..slab,(CornpactionlMembrane.Reinf. ' ,
Unde!'pinning (FIC)C)r JoistlGirtlers) ,
Do nol cover or conceal the work 'below until the
following "ppl.icabl,e items have been signed: '
1st.Floor Shear
Firesprinkler (Rough) "
2nd Floor Shear , ' /)/1 ~ /
'Roof (ShealhinalDiaphragmfFr;me) r,.J^- 'r),
Masol1ry (ReirlfJBond BeamJPre-GlOUt)
Rough Plumbing (Top Out) " ,
ROllgh Mechanical
Rought:lectrical (Dry wall) , ,
Rough Electrical ,
Framing .-(Only after Plbg., Elec.. Mech" and Fire).
Insulalion (SoundlEnerllY) , ,
po nol tape or plaster until the follOWing applicable ',:'
Items have been sIgned;.. '. ' .
Drywall " ,
Penetralions (Fire Raled) Electrical, , ' ", ,
Penetrallons (Fire Raledl Mechanical , "
Penetrations (Fire Raled) Plumbing
Interior Lath
Exterior Lath .
,', " GENERAL ITEMS
ExteriQl' Plaster (Brown Coal)
T -Bar Electricel, , ,
T -Bar Mechanical
T -Bar, Structural , ,
'Sewer ,
Water Engineering Backflow "
Waler Service ,
""
FINAL INSPECTIONS
Electrical Final
Plumbing Fil1al
Mechanical Final
Gas Test
El1gi.-ring/Gradil1g Fiool 765-5126
Fire Dept. F:il1al 765-4040
Waler Engineering 765-5268 '
Sub ListlBusiness License 765-519
Zoning 765-5139
Building Final (Last Inspection. Only,
,After Abov,e Completel
,PARTIAl- INSPECTIONS'
Buildina Inspections,
'nspector ,
Date
Mechanical Inspections
Plumbina Inspections
Electrical Inspections