7682 Paseo Laredo
TYPE OFPERMIT"
Reroof
CITY
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BUILDING DIVISiON
200 S. ANAHEIM BLvD.
(714)76~'5153
INSPECt;ON REQUEST LINE: .
(714) j~~: 4626
~~ - ~,;.-
BUILDING PERMIT~~6.
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BLD20li3-04625
DATE: 12/1/2003
JOB ADDRESS: 7682 E PASEO LAREDO
. LEGAL DESCRIPTION: N TR 7732 LOT 32
CENSUS.CGDE: . 434
QUARTER SECTION: 201
"
CONTRACTOR INFORM/lTION:
. RONALD 0 ADAMS .
941 SBOONE'CIR .
. ANAHEIM, CA 9280700C.)
.'/"
BUSINESS PHONE: 7142::0-1861
JOB DESCRIPTION,ear off wood 'shake and instaU 25 squares ot 30 year co"'~ shin9le.
VALUATION: 6,500.00
I OWNER.BUILDEt:DECLARATION
I hereby,affirm uncler pemrlty of perjury.that I am exempt from the Contractc.;'e license Law .for the .following reason .(Sec.'7031.5 Business and
Professl,ons' Code: any dtyor county whichreq uires 8: perm.it to conl?truct, z.:'!er, lmprQve, demolish or repair any structure, prior to its issoance. also
requir~.the applicantfQrsuch'permit to file a signed statement that he is j;d'~(lsed pursuant to the RlOvisions of the Contractor'$ License law (Chapter
'g){commencing with Section 7000 of Division ,3 of the Business and Profesr:.:grl~_Code) or that he is exempt therefrom and the basis for the alleged -,
exemption. A.."ly violation of Section 7031.5 by any applicant for a permit S);~fj\;cts the applicant toa dvn penaltYQf not mor13 than five hundred dollars
($500). .' .': . . . .'
DI, as owner of property, or my employees with wages as their soJe com:~nsation, will do the work, and the structure is notintended or 9ffered for
"sale (Sec. 7044 Businessand PrQfl?5sions Code: The Contractor's license ~aw does not apply to an owner of property who builds or improves
. thereon, and who does sudl: work himself or herselforthrough his or hei Oi.~h_ employees, provided that such ims:. lOve ments are 'no~ intended or
offered for sale..If,howeve'r, the bLiilding or improvement is sold with one y~1.pr of ccmj)letion, the owner-builder will have the' burden of proving that h13
did not biJild or improve for the purpose Qfsale). _ .' 1:' :'.' . ','
D I, as the owner of the property; am exdusivety'contracting with Iicensed)conlractors to consi-ruct the project (See; 7044 B.usiness and Professions
<;OOe: The Contractor's license Law does not applY to an owner of propert~\who builds or improves thereo\l, and who ccintracts fors"Och projects with
jl..Qontractor(s) licensed pursuant to the Contractor's license Law). . :\
U I am exelTlptunder Sec.. ' , B & P.C. for this reason:
Date: Owner:
I WORKER'S COMPENSATION DECLARATION -,;"
i
I _ hereby affirm Under penalty of perjury one of the following declarations: ~
o I h,ave and will maintain a certificate of oonsentto self-insure forworkc:r~scomp_ensation,
as provided for by Section 3700 of the Labor Code, for the penormar.ce ofti,:ework for which.
this permit is issued. . (-
.0 I. have and will mai~inworker'scompensati6n insurance, as require.d f/.. Se~ti;:;n 3700 of
the Labor Code, for the performance of-the work for which this permit is is':.:~~d. My worker's
Compensation insurance carrier and policy are:
Carrier: NO EMPLOYEES Policy Nu mb.er. EXEMP',
APPLICANT: RON ADAMS
OWNER INFORMATION:
James .Cox
7682 E Paseo Laredo
Anaheim, CA 92808
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: AEM
I
)2/1/2003
Date:
Contractor
. Thin tion neednot be completedlfthe pennil isJor one hundred dollars ($10../'....less.
certtfythat in the perfonnance of the work for which this permit is issut''d, I shallllot
loy any" person in any manner so as, to become subjecl to the worker's ~~}rnpensation laws
o alifomia, and agree that if I should beeo .ect tQ th'e worker's' corr.p~H.I.sation
pro.vision~ of Section 3700 of the l~Ode, I sh forth~i comp '. tbse, provisions.
, y~ ........
Date: 12/1/2003 . AppliCant. .
WARNING: FAILURE TO SECURE WORKER'S COMPENSATION COVE>..\GE"IS--
UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIM INAL PHIA!.tIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN"AD['I'n ON TO THE
COST OF.CGMPENSATION, D.AMAGES ASPROVIDED FOR IN SECTlm.:1706 OF THE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. .Y .
'1' '. CONSTRUCTION LENDINGA~ENCY "1-,,"'-'
'1'.h(i:,~;:;Y, o.ii-;rrrr'L-1...j:;i.j: ::i1.0 lrj G~ :;:.::;1u~j. t: ;;;.:t";.~;::;_~"':; :;: :;;.Z::,~~~~'::';-::~;'~~-;j.;tll-~~' f.:.:.'~;-;.;;
performance ofttlework for w:hidl this permit is issued ($e0..:3097 .Civ.C): ..
Lender's Infonnation:' .
NUMBER
792255
TYPE
.TYPE.
EXPiRATION DATE
3/31/2005
B
'HIC
Construeibn Types:
VN, . .
Fire Sorinktered?
NO
-.' .
I 'certify that I have read this application and state that, the above information is correct. I
agree to comply with all city ordinances arid state laws relating to building -construction, and
hereby aut~OFrze represent! s' thiS . to enter upon the above mentioned property for
i nsp eq.;cri pu rpq
Fees paid for Permit:
Total:
167.24
Dale: 12/1/2003.
19na ure Qf Applicant or Agent
The permit shall expire by limitation and become null and void ifthc. 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. .
,
, INSPECTION RECORD
, INSPECTION DATE INSPECTOR
, ,TernporaryPower Pole " " ,
Plumbing (DrainlWaste Pipe) "
Electrical Ground Electrode/lifer , I, ,
, SetbacklFormsfTrenc!l~ (Footings)
.00 not install subflOQr Dr pour floDr slab unt; I the
, following applicable items have been signed: ' ,
Plumbing (Water P1pe~Sprinkler Valves)
Mechanical (GrDuridwork) , "
Electrical (Undeiground CDnduit) " ,
Pre-slab (Compaction/Membrane.Rei nt. , ,
Underpinning (Floor Joist/Girders)
Donat cover Dr conceal the WDrk below until the ,
following applicable items have been signed:
, 1 st FloDr Shear ,
Firesprinkler(Rough)
2nd Floor Shear " , , '
Roof (Sheathing/Diaphragm/Frame) )ot. ILC~, 1\.L1.,
Masonry (Reinf./SoildBeamlPre-Grout) ,
Rough Plumbing (Top Out)
Rough Mechanical, , ,
Rough ~ectrlcal (
Rough Electrical , ,
Framing . (Only"after Plbg., Elet:. r....~ech. and Fire)
Insulation (SoundlEnergy) ,
Do nDltape or plaster' until the follDwing applicable
items n~vebeen signed: '. ,.'
Drywall ' - " 1
Penetrations (Fire Rated)-Electiical
Perietrations (Fire Rated) Mechanical
Penetrations (Fire ,Rated) Plumbing
Interior Lath " - '
Exterior Lath' -- , ' , , ,
GENERAL ITEMS,
Exterior Plaster (Brown Coat) ,
T -Bar Electrical ' '
T -Bar Mechanical 1
T -Bar Structural , ,
Sewer "
Water Engineering Backflow , ,
Water Service - '
.
-,
FINAL iNSPECTIONS Date " Inspector-
Electrical Final , , , ,
Plumbing Final , ,
Mechanical Final " , -
,
Gas Test ' , , ,
, ' , "
Engineering/Grading Final 765-5126 ' ,
,
Fire Dept_ Final 765-4040
Water Engineering 765-5268
,Sub List/Business License 765-519 ,
Zoning 765-5139 ' ' ,
Building Final ~ast Inspection. Only
" fter Above Complete)
PARTIAL INSPECTIONS
Buildina Inspections
Mechanical Inspections
Plumbina Inspections
Electrical Inspections
PERMIT EXPIRED
'N!~PfCr~@~p
"NOT' CdMPLETErY
OATE:3k(()~- "