483 S. Paseo Serena
BUILDING PERMIT NO. BLD2005-02202
TYPE OF PERMIT CITY
Reroof
DATE: 7/14/2005
JOB ADDRESS: 483 S PASEO SERENA
LEGAL DESCRIPTION: N TR 8220 LOT 72
APPLICANT: ISRAEL BERBER
OWNER INFORMATION:
DAVID A HEARLEY
483 S PASEO SERENA
ANAHEIM HILLS, CA 92807
ElM
BUILDING DIVISION
200 S. ANAHEIM BLVD.
(714) 765 - 5153
INSPECTION REQUEST LINE:
(714) 765 - 4626
CENSUS CODE: 555
QUARTER SECTION: 198
CONTRACTOR INFORMATION:
R B ROOFING
1615 MINNIE ST
SANTA ANA, CA 927070000
BUSINESS PHONE: 714836.8364
JOB DESCRIPTION: Tear off existing and re.roof 21 squrares of BUR.
VALUATION: 8,500.00
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's Ucense Law for the following reason (Sec. 7031.5 Business and
Professions Code: any city or cQuntywhich requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also
requires the applicant 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 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 subje-::ts 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 employees, 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 property who 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
ARCHITECT/ENGINEER INFORMATION:
PROCESSED BY: SAM
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
D I have and will maintain a certificate of consent to self-insure for worker's(;ompensation,
as provided for by Section 3700 of the Labor Code, for the performance of the work for which
this it is issued.
I ha and will maintain worker's compensation insurance, as required by Section 3700 of
t or Code, for the performance of the work for which this permit is issued. My worker's
ompensation insurance carrier and policy are:
Carrier: STATE COMPENSATION FUND
Policy Number. 046-02 UNIT 0006419
This section need not be completed if the pennit is for 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 worke~s compensation laws
of Califomia, and agree that if I should become subject to the worker's compensation
provisions of Section 3700 of the Labor C e, I sh II forthwit comply wi those provisions.
Date: 7/14/2005 Applicant:
WARNING: FAILURE T ECU
UNLAWFUL, AND SHALL S JECT I'. E PLOYER TO CRIMINAL PENALTIES AND CIVIL
FINES UPTO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDI1l0N TO THE
COST OF COMPENSATION, DAMAGES AS PROVI DED FOR IN SECTION 3706 OF THE
LABOR CODE, INTEREST A~lD ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec. 3097 .Civ .C):
Lender's Information:
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 laws relating to building construction, and
hereby authorize representives of this city to enter upon the above mentioned property for
insp~~A".4 l~A"// Date: 7/14/2005
, 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 inspection 365 days from the date of permit issuance. A
new permit is required to commence or continue work.
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
Professio 5 Code.
7/14/2005
Date:
NUM ER
772680
TYPE
TYPE
Contractor
EXPIRATION DATE
12/3112006
HIC
C39
Construcion Tvpes:
VN, ,
Fees paid for Permit:
Total:
214.33
City of Anaheim
Building Division
INSPECTION RECORD
INSPECTION DATE INSPECTOR
Temporary Power Pole
Plumbing (DrainlWaste Pipe)
Electrical Ground Electrode/uter
SetbacklFormslTrenches (Footings)
Do not install subfloor or pour floor slab until the
following applicable items have been signed:
Plumbing (Water Pipe/Sprinkler 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 ,
RooHSlleathirMvOiaphragm/Frame) ~()~ '1. l~\~()II'~"-
Masonry (Heinf./Bond Beam/Pre-Grout)
Rough Plumbing (Top Out)
Rough Mechanical
Rough Electrical (Dry Wall)
Rough Electrical
Framing (Only after Plbg., Ele., Mec. And Fire)
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 Back1low
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 765-5194
Zoning 765-5139
Building Final (Last Inspection - Only .~II~ i:~
After Above Complete)
PARTIAL INSPECTIONS
Building Insoections
Mechanicallnsoections
Plumbing Insoections
Electricallnsoections