1781 Partridge St.
TYPE OF PERMIT
Reroof
DATE: 6/6/2005
JOB ADDRESS: 1781 N PARTRIDGE ST
,~+
CITY
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD,
(714) 765 - 5153 '
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: ' 555
QUARTER SECTION: 130
BUILDING PERMIT NO.
BLD2005-01702
;;'~
LEGAL DESCRIPTION: N TR 9149 LOT 17
APPLICANT: DAN WilCOX
OWNER INFORMATION: CONTRACTOR INFORMATION: ARCHITECT/ENGINEER INFORMATION:
Nadeem Siadiqui AMERICAN FAMILY HOME! "
1181 NPartlidge St 22734 LAKEWAY DR #344.
Anaheim, CA 92806 , ,DIAMOND BAR, CA 917650000
JOB DESCRIPTIONRemove existing wood shake roof, install new 7/16" asb. 2 layers ot ASTM, Westlle ICBO No. 4200 (5.8Ib/s.!.) at 25 squares.
o . , .
VALUATION: 8,000.00 ~PROCESSED BY: eDL
OWNER-BUILDER DECLARATION ..
hereby, airm, un r pena y 0 perjury at! am exempt rom the: ontractor'sUcense Law or t 8. oj owing reason ec. 7031.5 slness and
Professlons Code: any city or county whIch requires a pe~mit to construct, altai, imp(oVe'J~emoUsh orrepa,ir any structure, prior to its issuance, also
requires the applicant fo'r such permit to file a sig'ned statement that he is licenSed'pursuant to the provisions of the Contractor's License Law (Chapter r
9)(commencing with Section 7000 of Division 3 of the Business and Professio'ls Code) or that be 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.
~~. "
o I, as owner of property, or my employees with wages as their sole compei~ation, will do the work, and the structure is riotintended 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 il)1proves.
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;ofcompletion, the owner-builder will have the burden of Provi09 that he
did-not build or improve for the purpose of sale).' .
o I, as the owner of the property, am exclusively c'ontracting'with licensed ctntractors toconstructthe project (Sec. 7044 Business and Professions
Code: The.Contractor's'license Law does rot apply to an owner of property who builds or improves thereon; and who s::ontracts for such projects- with
,a.qontractor{,s).licensed pursuant to the Contra~tor's license Law). , . .
U I am exempt under Sec. ,8& P.C. for this reason: '
'Date: Owner:
I WORKER~S COMPENSATION DECLARATION
I hereby affirm under penal.ty of perjury.one of the following declarations:
o I have and will maintain acertif~ate of consent to self-insure for worker's compensation,
as provided for by Section 3700 ,0Une Lapor Code, for the-petforrriance of the work for which
f;thi permit is issued. . : . .',i. ',"' ,
rhave and willt!laintain worker.'s ciJmpensatiol) insurance, as required by Section 3700 of
he Labor Code, for the performance of the work for which this permit is issued. Myworker's
Compensation- insurance carrier and policy'are: .
Carrier: NO EMPLOYEES Policy Number. EXEMPT
6/6/2005
Date:
~ section need not be oomph.\ed lithe pennlt is lor one hundred dollars ($1 00) Or les~. '
I certify that in the perforrriance of the work for which this permit is issued,1 sh~lf ~ot
,employ any person in any manner so as to become subject to the worker's compensation laws
ofCalifomia, and agree- that if I should beyome subject to th~ er's compensation
provisions of Section 3700 of the Labor Co I shall forth .th c ply with those provisions.
Date: 6/612005 Applicant: )!
WARNING:, FAILURE TO SECURE WORKER'S COMPENSATION CO ERAGE,IS.
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUNDRED THOUSAND 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
I hereby affirm under penalty of perjury thpt there is a construction lending agencyfpr the
performance of the.' work for which this permit is is'sued (Sec. 3097 .Civ.C):
Lender's Information: .
NUMBER
415052
, TYPE
EXPIRATION DATE
8/31/2006 '
C39
Construcion Tvpes:
VN, ,
Fire Sprinklered?
NO
I certify that I have read this application and state.that the abov~ information is correct. t
agree to comply with all city ordinances and state laws relating to building constructior'l, and
.hereby thorize re rase \/es 'of this city to enter upon the above mentioned property for
.inSPr purposes.
, Date: 6/6/2005
Fees paid for Permit:
Total:
235.53
t or Agent
The permitshlIIl expire by 11m tionand become null and void if the building or
work has not pasSed final inspection 365 days from the date of permit issulWlCe. A
new permit is required fo commence or continue .work. .
.'NSPI;CTION DATE iNSPECTOR '-
Temporary Power Pole - - -c- _
Plumbing (DrainlWaste Pipe) - - -
Electrical Ground Electrode/Ufer -
SelbacklFormSfTrenches (Footings) -
Do not inStall subfloor or pour floor slab until the ---
-following applicable ilems have been signed: -
Plumbing (Water Plpe.Spr.inkler Valves)
Mechanical (Grouridwork) - - -
Electrical (UndergroundConduil) ,
-- Pre-slab (CompactionlMembrane.Reinf. -
Underpinning (Floor Jmst/Girtlers) -- -- -
Donat cover or conceal too woll< below untTICthe --
following applicable items have been signed:
1st Floor Sheat
FiresprinkJer (Rough)
2nd Floor Shear - - .4
Roof (Sheathing/Diaphragm/Frame) - 1._
Masonry (Reinf.l8oncl BeamlPre-Grout)
Rough Plumbing (Top Qut)
Rough Mechanical - --
Rough EJectrlcal(Dry wall)
Rough Elllctrical -
Framing (Onry.afterPlbg.. Elec..:Mech.. and Fire}
Insulation (SoundlEnergy} - --
Do not tape or plaster until the following applicable
items have been signec;f: . .
Drywall - - -
Penetrations-(Fire Rated) Electrical
Penetrations (Fire Rated} Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath -
exterior Lath - -
.. GENERAL ITEMS - -
Extetiot Plaster (Brown Coal) -
T -Bar Electrical : -
T -Bar Mechanical - -
T -Bar Structural -
Sewer
Watllr Engineering Backflow
Wat..r Service
INSPECTION RECORD
FINAL INSPECTIONS Date Inspector
Electrical Final - -
Plumbing Final --
Mechanical Final - -
Gas Test
Engineering/Grading Final 765-5126 -
. -
Fire Pep!. Final 7654040_ --
Water Engineering 765-5268 --
Sub List/Business License 765-519' --
-
Zoning 765-51~9 I- --
Building Final \(-asl Inspection- Only,-_, '--/~{)(" ~.. //<j
fter A~ove Complete)
PARTIAL INSPECTIONS
Buildina InsDections
MechanicallnSDections _
Piumbina InsDections
ElectricallnSDections -