5859-5861 Mountain Loop Trail
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:
BUILDING PERMIT NO. BLD2005-03727
DA TE: 11/23/2005
JOB ADDRESS: 5859 E MOUNTAIN LOOP TRL 14
iI!
LEGAL DESCRIPTION:
CONTRACTOR INFORMATION:
BIENEK ROOFING CO
22622 LAMBERT ST #303
LAKE FOREST, CA 92630 0000
BUSINESS PHONE: 949 951-37~J8
JOB DESCRIPTION:Tear off existing. replace 112" OS8 as needed, and reroof 28 ~quares with EalgeJJte tile ICBO 4660 @ 5.8; includes the address range
VALUATION: of 585~688~bMountain Loop Trail PROCESSED BY: JNJ
APPLICANT: PAUL GREGROW
OWNER INFORMATION:
FREDERICK KELLOGG
5859 E MOUNTAIN LOOP TRL
ANAHEIM, CA 92807
ARCHITECT/ENGINEER INFORMATION:
OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that r am exempt from the Contractor's Ucense Law for the allOWing reason (Sec. 7031.5 usiness 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 fife 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 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).
D 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 efTIployees, 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 propertywhc, builds or improves thereon, and who contracts for such projects with
~ontractor(s) licensed pursuant to the Contractor's License Law), )
U 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: !
o I have and will maintain a certificate of consent to self-insure for worker'sco;'npensation,
as provided for by Section 3700 of the Labor Code, for the performance of the w(1l1< for which
this permit is issued. '
~I 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, .V1y worker's
Compensation insurance carner and policy are:
Carrier: STATE FUND
Policy Numbec 1691621-20C3
NUMBER
651509
TYPE
C39
This section need not be completed if the pennit is tor 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 laws
of Califomia, and agree that. ome 'ect to the worker's compensation
provisions of Section 3700 f the bar Co, I fa with 0 I ith those provisions,
Date: 11/23/2005 Applic t.
WARNING: FAILURE TO SECUR
UNLAWFUL, AND SHALL SUBJECT A MPL
FINES UP TO ONE HUNDRED THOUSAND D LL S ($1 ,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
I hereby affirm under penalty of perjury that there is a construction lending agency for the
p13rformance of the wcrk for Which this permit is issued (8ec.3097 .Giv.C1:
Lender's Information:
Construcion Types:
V N, ,
Date: 11/23/2005
Fees paid for Permit:
Total:
244.93
nspecti 365 days from the date of permit issuance. A
mmenc or continue work.
City of Anaheim
Building Division
FINAL INSPECTIONS DATE INSPECTOR
Electrical Final
Plumbing Final
Mechanical Final
Gas Test
Cross Connection Control (714)765-4280
Engineering/Grading Final 765-5126
Fire Dept. Final 765-4040
Water Engineering 765-5268
Sub List/Business License 765-5194
Zoning 765-5139 I
Building Final (Last Inspection - Only 'it~L
After Above Complete) J/aj,,,,) 9t. (
{
INSPECTION RECORD
INSPECTION
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/Ufer
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water PipelSprinkler 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
Roof (SheathingJDiaphragm/Frame)
Masonrv IReinf.lBond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele.. Mec. And Fire)
DATE
INSPECTOR
I /
1/'/41:,
I
j A-lJo..;S"L (
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
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections