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440 S. Paseo Bandera TYPE OF PERMIT' Reroof I {'om I CITY BUILDING DIVISION 200 S. ANAHEIM BLVD. (714) 765 - 5153 INSPECTION REQUEST LINE: (714) 765 - 4626 CENSUS CODE: 555 QUARTER SECTION: 186 BUILDING PERMIT NO. DATE: 6/17/2005 JOB ADDRESS: '440 S PASEO BANDERA LEGAL ~ESCRIPTION: f TR 8672 LOT 18 APPLICANT: ANANTRA SANATHARA OWNER INFORMATION: Anantray J Sanathara 440 S Pasee Bandera Anaheim, CA 92807 JOB DESCRIPTION: Tear off existing and re-roof 30 squares of "Eaglelite Tile; ICBO # 4660; 5.5Ibs. VALUATION: 9,000.00 CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION: PROCESSED BY: SAM OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that J am exempt from the Contractor's License Law for the following reason (Sec. 7031;5 Business an Professions Code: any city, or county which requires a permit to construct, alter, improve, demolish or:repair any structure, prior to its issuance, -a1s9 requires the app6cant 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 P.rofession,5: 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 p,ermit subjects the applicant to a'civil penalty of not more than five hundred dollars ($500). o 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 La~, does not a'ppJyto an owner of property who builds or improves thereoll', and who does such work himself or herself or through his or her own employees, provided that su.ch improvements are not jn,t~nded or offered for sale. If, however, the, building or improvemenr is sold with one year bf completion, the owner-builder will have the burden of proving .that h~ ~i ot build or improve for the purpose of sale). . '. ' . . , ,. . I, as the OWner of the property, 'am exclusively contracting with licensed cootractors to construct the project (Sec. 7044 Business and Professions' o : 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. ontracl.or(s) licensed pursuant to the Contractor's License ~w). ' ." , , . I am exempt under Sec. ,6 P . rt' reas' . . - . Date: Owner: WORKER'S COMPEN ;l\TION ECLA ATION I hereby affirm under penalty of peijury one:of the following declarations: o I have and Will maintain a certificate 'of consent to setf-:insure for worker's compen~ation, as provided f.or'by Section 3700 of the Labor Code, for the perf-ormance at the work for which this permit is issued. o I have and will maintain walkers. compensation insurance, as required by Section 3700 of the Labor-Code, for the performance of the work for which this permit is issu!9d. Myworker's Compensation insurance carrier and po"cy are: ' Carrier: . POliCY,Number.. ' ~' hi . tion need not be completed if lbe pennit is lor one hundred dollars ($1 00) pr less. , I certify that In the perform,ance of the work for which this permit is issu~d.1 shall'not m yany person in any manner so as to become subject to the w<?rker's compensation laiNs of,Ca mia, and agree that if I should become subject to the worke"r's compensation provisions of 'Section 3700 of the L e, I sha ~ort ith c Iy ith those. proy-isions. Date: 6/17/2005 pplicant: WARNING: FAILURE TO SECURE WORKER'S COMPENSA ION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES U P TO ONE HUNDRED THOUSAND DOLLARS ($100.000). IN ADDIllON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR III! SECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY '. I hereby affirm U1ider penalty of perjury that there is a construction lending agency for the pe'rformance of the work for which this permit is issued (Sec.3p97-=Ciy~C): Lender's Information: LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of chapter 9_(commencing with Section 7000) of Divsion 3 of the. Business and Professions Code, . . 6/17/2005 Date: Contractor NUMBER EXPIRATION DATE TYPE Construcion Tvpes: VN, , 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 -raws r.elating to building construction, and ~~~ntive:;.4:s city to enter upon the above mentioned property for . ,-?~jl,l~t;'~Plator:gent Date: 6/17/2005 The permit shall expire by limitation and become null and void if the building or work has ,not passed final inspection 365 days from the date of permit issuance. A new permit is required to commence or continue work. ,Fees paid for Permit: Total: 235.73 INSPECTION RECORD INSPEcnON . . DATE INSPECTOR Temporary Power Pole . Plumbi ng (Drain/Waste Pipe) . Electrical (;round Electrode/lifer . SetbacklFormsrrrenches(Footings ) . Do not install subfloor or Pelur floor slab until the. . following applicable items have been signed: Plumbing (Water Pipe.Sprinkler Valves) . Mechanical (Groundwork) Electrical (Underground Conduit) . . . Pre-slab (CornpaclionfMembrane.Reim.J Underpinning (Floor Joist/Girders) . Do not cover or conceal the work below until the . following applicable items have be.en signed: 1st Floor Shear Firesprinkler (Rough) 2nd Floor Shear I I . Roof(SheathingtDlIIPhra!lmlFranel. IUzII... ,IA)lbW~r Masonry (ReinfJBond Beam1Pre-Grout) I I Rough Plumbing (Top Out) .. I Rough Me.chanical . Rough BectrtCal (Dry Wall) Rough electriCal ' . . I I Framing.. (Only after Plbg.:Elec.. Mech.. and Fire) r./Z//2m'll oS A-).)O W<;,I.c.( Insulation (SoundlEnergy) :. I I 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 I Exterior Lath . . . . GENERAL ITEMS Exterior Plaster (Brown Coal) . . T -Bar Electrical . . . T -Bar Mechanical T -Bar Structural Sewer Water Engineering Backflow Wat..r S&rvice FINAL INSPECTIONS Date Inspector . Electrical Final . . .. . Plumbing Final . . . . Mechanical final Gas Test EngillHringtGracling Final 765-5126. .. . . Fir, Dep!. Final 7654040 . Wat" Engineering 765-5268 Sub List/Business Licen~e 765-519 . . Zoning 765-5139 . Building. Final . ~ast Inspection- Only 1 I Itj 0( 1= ;}.IJ1'olTl . . fler AboveCompletel PARTIAL INSPECTIONS BuildinQ Insoectio".s . .".-.-.. .ftl!~O'5 ~ If' .rlht-\~.. Mechanical. Inspections Plumbina Inspections Electrical Inspections.