7600 Paseo Laredo
TYPE OF PERMIT
Reroof
l~ilr- . i'i~~~2\ .
CITY ~i~~.}iEIM.
'~~~~\~~~-.:~~~~j/ .
BUILDING DIVISION
200 S. ANAHEIM BLVD.
. (714) 765" 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 201
BUILDING PERMIT NO. BlD200S-00911
DATE: 4/5/2005
JOB ADDRESS: 7600 E PASEO LAREDO
LEGAL DESCRIPTION: N TR 7732 LOT 42
1Y
CONTRACTOR INFORMt-.T!ON:
HOYT ROOFS
. 1809 N ORANGETHORPE P.\r{K
ANAHEIM. CA 92801 0000
BUSINESS PHONE: 714713-1820
JOB DESCRlPTION:Tear off eXislin9 roof and replace with 22 squares of man. or lifelile rCB0#2656,
VALUATION: 10,000.00
I . OWNER-BUllDERi)ECLARATION
I hereby att:rm. under penalty of perjury that I am exempt from the- Contrac.tcr':'i License Law for the following reason (Sec. 703'\.5 BLlSii1ess and
Professions Code: any city or county which requiresa permit to.consirl..iC:t, a:t~r. improve, demo.lish or repair any stru~ture, prior to its issuance; also
requires the applicant for such Permit to file a signed statement that he is lk:e.1,soed pursuant to the plOvisionsof the Contract.or'sLicense LaV:' (Chapter
9}(commencing with Section 7000 of Division 3 of the Business a nd Professi::ns 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 slJ1iect.c: the applicant to.a dvtr penalty of not mqre than five hundred dollars
($500).
o I, a$ owner of property, or my employees with wages as their sole corriJ;~nsation, will do the work, and the structure is not intended o (offered for
sC:lte (S~c. 7044 Business and Professions Code: 'The Contractor's Licensa la'lj does not apply.to an owner of property who bullds O( improves
thereon, and-who does sLlch work himself br herSelf or through his or her. ON,o employees, provided that such improvements,are.not intended Or
,o.ffered for sale. If"however, the building or improvement is sold with ons'ye'-::.r of campieticn, the owne-r-bu"der wiil hav'e 1he burde~ of proving' that he.
did not build or improve for the purpose of sale). . . .
o I, as the owner bftrle p(operty, am exdusively contracting With nCei1S~..1 ,~nt,act0~3 to ~onstruct the project (Sec. ;-044 Business and Professior.s
Coda: The Contractor's License Lawdoes not apply to fl:n.oW!1er of propeoty'~....ho buiids orif!lproves thereon, and who oontrC\ctsfOl- such proje~ts with
Montrador(s) licensed pur~uant to~the Contracter's Lice~.se Law).
L... ! am exempt ur:der Ser.. .- 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;
[J I ha\ie arid wHl.rna intain a certificate of consent to self-insure for W0~ ~~f'I",. compensation;
88 provided for by Section.3700 of the Labor Code, for the performance efn:;:: 'Nod< for which
~$~rmltisissuec!. . - .' .., .
l!d' I have a nd will maintain work.er'scompensation i~surance, <:is .requiied t'-f Se'ction 3700 of
the Labor Code, for thP. performance of th€): work for which this permit.jg iS$u'::G. My work'3r's
Compensation insurance carrier and policy are:
Carrier: STATE FUND Policy Number: 17(04711)2
APPLICANT: BRIAN HOYT
OWNER INFORMATION:
Daniel Thome
7600 E paseo Laredo
Anaheim, CA 92808
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: MSM
.____=.1
LICENSED CONTRACTORS DECLARATION I
J hereby affirm under penalty of perjury that I am .
licensed under provlsion~of chapter 9 (commencing
with Section 70UO) of Divsion 3ofthi3 BuSiness and
Professio~s Code~
4/5/2005 .
Daw: Contracmr
This section need not be completed if the pennit is for one hundred dollars {$10C< Oi' less;
o I certifylhat in the performance ofthe work for which thi::; permi(is iSSUI.:.;!, I shall not
employ any -peison in any manner so as to become subJect to the worker's c-'mpensation-laws
of Califomia,.and agree that if r should, become .subject to the worker's corr:f--:nsa~ion
proviSions of Section 3700 of the Labor Code, I shall forthwith comply .with ~i'!~;$e pi"ovi:>ior:s.
Dale: ..115/2005. .; Appiicant: . I~ . .. ..
WARNING: i"AfLURE TO SECURE WORKER'S COM ENSATION COVER,IGE 13
UNLAWFUL, AND .SHALL SUBJECT AN EMPLOYER TO CRIMINAL .PENN....iES AND CIVIL
FINES UP TO ONE HUNDRED lHOUSAND DOLLARS ($100,000), IN AOO'TION TO THE
COST OF COMPENSATION, DAMAGES AS PROVIDED .FOR IN SECTION 3706 OF TI-iE
LABOR CODE, INTEREST AND ATTORNEY'S FEES,
I CONSTRUCTION LENDING AGENCY
., hereby affirm under penalty of perjury that there is a construction lending aQt-ncyfor the
performance of the work for which this permit is issued (Sec.3097 .eiv.c.):
Lender's Information:
NUMBER
606111
TYPE
EXPiRATION DATE
12/31/2006
C39
Construcion Tvoes.:
VN, ,
Fire Sprinklered?
~_ NO
I certify that I have read this application and state that fhe above' information is correct. .,
agree to comPlY with all city ordinances and state laws relating.to building construction, and
h~reby authorize re-presentives of this city to enter upon the'above mentioned property for
inspect.ipn pu\poses.
~. ,...-/ Dato: 4/5/2005
Signature of Applicant or Agent .
The permit shall expire by limitation and become null and void if the building or
work has not passed final il1specti.on 365 days from the date of permit issuance. A
ilew permit is required to commence or continue Work.
Fees paid for Permit:
. Tolal:
235.8~
INSPECTION RECORD
INSPECTION
DATE " 'INSPECTOR'
Temporary P,ower Pole,
Plumbing (DralnNVastePipe)
Electrical Ground Electrode/uter '
SelbacklFormsfTrenches (Footings) ,
, Do not install subfloor or pour floor slab until the
following applicable items have been signed:, ,
Plumbing (Water Plpe.Sprinkler Valves) ,
folec:hanical (GroundWork) , ,
Electrical (\Jndergrou"a Conduit)
Pre-slab (CompacticmlMembrat1e.Reinf.; ,
Underpi"ning (Floor Joist/Girders)
'Do not cover or conceal the wor!< below until the
following applicable items have been signed: '
1 st Floor Shear
Fil'llsprinlder (ROugh) ,,' '
2nd Floor Shear' , ' ri-f I/oJ I jJ If"
Roof{{She hlagmlFrame) ~,,~,
MasOl'l 0I'Id Beam/Pre-Grout)
Rough Plumbing (Top Out) , '
Rough Mechanical "
I Rough l:IectricallDrY waU) "
Rough Electrical
Framing (On~ after Plbg" Elec.. Mech.. and Fire)
,I"sulation (Soul1dlEnergy) ,
Do not tape or plaster until the following applicable
items have been signed: ' , ,
Drywall ' ,
Penetrations (Fire Raled)Electrical '
Penetrations (Fire Rated) Mechanical
Penetrations (Fire Rated) Plumbing
Interior Lath' ,
Exterior Lath .
, " GENERAL ITEMS
Exterior Plaster (Brown Coat) ,
T -Bar Electrical: '
T-BarMechanlcal '
T -Bar Structural '
Sewer,
Watllr ,Engineering Backflow
Water Service ' '
,
,
,
,
FINAL INSPECTIONS
Electrical Final
Plumbing Final ' , '
Mechanical Final ,
Gas Test
Engineering/Grading Final 165-S126
Fire Dept. Final 165-4040 ,',
Water Engineering 765-5268'
Sub List/Business Lic,ense 165-519
Zoning 165~5139
Building Final (Last Inspection- Only
, After Above Complete I
Date
, Inspector
,
,", /J///
l'Vds"" 1>~ ,
PARTIAL INSPECTIONS
Buildina Inspections'
Mechanical ,Inspections '
, ,
Plumbing Inspections
Electrical Inspections