875 S. Philadelphia St.
DATE: 1124/2005
JOB ADDRESS: 875 S PHILADELPHIA ST
LEGAL DESCRIPTION: NTR 1871 LOT?
BUILDING DIVISION
2DD S. ANAHEIM BLVD.
(714) 765- 5153
INSPECTION REQUEST LINE:
(714) 765-4626
CENSUS CODE: 555
. QUARTER .SECTION: 85 .
. BUILDING PERMIT NO. BLD200.5-1l0197
TYPE OF PERMIT CITY
. Reroof
CONTRACTOR INFORMt.TION:
THE ROOF GUY
9781 EASTWOOD CIRCLE J,
VILLA PARK. CA 928E)1 DooD
BUSINESS PHONE: 71492j.1500 .
JOB DESCRIPIION:Re-roof' Overlay 38 sq: oi.zo yr. composition shingle ovc<i.(1) existing layer of oomp..
VALUATION: . 3,300:00, PROCESSED BY: ENO
I OWNER-BUILDER DECLARATION
I hereby affirm under penalty of perjury that J am exempt from the Contractor'.sc License Law for the following reason (5ec.7031.5 Business and
Professions Code; any city or county which requires a permit to cOl)s~ruct, a~ith_,r,. imRrove, demolish or repair any structure, prior to its issuance. also
requires tne applicant fo~ such permit to file a signed statement that lie is liC~!7;sed pursuant to the provisions 6fthe Contractor's License l.aw (Chapter
9)(commencingwith Section 700~ of Division 3 of the Busin'ess and Profess*~ns Code) or that h.e is e.xempt~therefrom and the basis .for the alleged
exemption. Any violation of Sel:;tion 7031.5. by any applicant fora permit sub;ec~ the C1_pplicant to.a dvU penalty of not more than five hundred dollars
. ~O~.>~S owner of prope~, ormy employees with wages as thei; ~Ie com~1.nsation, will do,the work, a~d the structure' is no't intended or offered for
sale (Sec. 7044 Business and Professions Code: The Contractor's Uc~nse ,,~w 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 ow'l';.employees, provided that such improvements are not intended or
offered for sale. If. however, the building or improvement is sold with one yebr of completion, the ownerwbuilder will have the burden of proving-that he ~
didDotb~i1d.orimproveforthepurposeofsale). . . _ .' "\_ ' ,-. .
D-' t, as.theowner of the property, am exdusively' contra ding with licens,edf~ntractors to constNct the project (Sec. 7044 Busin~s and -Professions
Code: The Centractor's license Law does not apply to an owner of prope~y\vho buUds or improves 1hereon, ahd who contracts for suCh projects'with
. . l'
fU(ontrad:o~{s) licensed pursuant to the Contractor's license law). ;, _'. . . .. . . '. . '.
U I am exempt under Sec. , B & P.C. fer this reason: ,;:1' '. . . '. ~
Date: . Owner: . {:"
I WORKER'S COMPENSATION DECLARATION ..
J hereby affirm under penalty. of perjury one of the following declarations: ."I,i~,
'01 have-and will maintain a certificate .of consent ta self~insure for worket').:;ompensation,
.as provided for by,Section 3700 of the, Labor Code, for the performance, ofth) woo( for which
~h' permit is issued. . , . .' . "
f have and will maintain worker's compe.' ns~tic,: insurance;_as re'quired bY<~ectio. n 3700 .of
,h Labor Cade, far the performance of tHe wor\( for which this permit is issu~'d. My worker's
ompensation insurance ,'carrier and policy. are:
Carrier: STATE COMPENSATION FUND poncy Number. 1713793
This section need not be oompleted if the permit is for one hundred dollars ($100; or less.
o I cert!fythat inthe perfOf!l1ance .of the work for which this permit is issued,:c'_shall not
em play any person in any manner so as to become subject to the warker'~~'cornpensatio aws
.of Califomia, and agree that if I shOUld become subject; ta the worker's cori:iP.';,risatio
provisions of Section 3700 'of ~tle labor Cod-e,,'! s~all forthwith mply Witht~1S rovisions.
APPLICANT: JOHN SHEATZ
OWNER INFORMATION:
Monarch Manor
989. Soott St
San Diego, CA 92106
ARCHITECTIENGINEER INFORMATION:
LICENSED CONTRACTORS DECLARATION
I hereby affirm unde( penalty of perjury that I am
licensed under proVisions of chapter 9 (commencjng
with Section 7000) of Divsion 3 of the' Business and
prafesSiF -,.~~...
1/241200 . ~ -;::-~ .
Date:. .,. Cantractar
. NUM~E. EXPIRATION DATE ..
638593 2/2812006
TYPE C39
Date: 1/24/2005 Applican .
WARNING: FAILURE TO SECUR WORKER'S OM SAT ON COVERAGE IS
UNLAWFUL, AND. SHALL SUBJE T AN EMPLOYER TO. CRIMINAL PENALTIES AND CIVIL
FINES UP TO ONE HUND.RED CUSANO DOLLARS ($100,000), IN ADDiTION TO THE
COST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTloN.'3706 OFTHE
LABOR CODE, INTEREST AND ATTORNEY'S FEES. '
I CONSTRUCTION LENDING AGENCY
I her~by affirm under penalty .of perjury that there is a construction lending ag,:mcy far the-
performance of the work for which this permit is issued (Sec.3097 .Civ.C): .
!.. c~:der's lr.forI'J"l3ti(jn:
Construcion Tvpes:
VN. , .
Fire Sp~inklered?
NO
I celiifytha'i I have read this appli~ation and state that the above information is cortect. )
agreeta oompiy with all city ordinances and state laWS rel,ating to buRding construction, and
her by authoriZe representives of this city to enter upon the abave entioned property far
'.n ection 'purposes. .. ,
Date: 1/24/2005
Fees paid for Permit:
'Total:
310.05
SIgn re of ppli t or A t
The permit shall expire by limitation and become null and void if the building or
work has not passed final inspection 365 days frOJJl the date of JlE'rmit issuance. A
new permit is required to commence or continue work.
INSPECTION RECORD
FINAL INSPECTIONS Date Inspector
Electrical Final , ' , ,', "
Plumbing Final ' , , ,
Mechanical Final
Gas Test , "
,
Ellgineering/Grading Final 765-5126 ,
,
Fire Dept Final 765-4040 ,
,,'
Water Engineering 765-5263 ,
, " '
Sub List/Busin,essLicense 765-519 , , , , I,
Zohlng 765.5139 " ,
" "
Building Final ' \tastlnspection. Orily , - (;1"-06 "F~I
fter Above Complete) , , l<..
PARTIAL INSPECTIONS' '-, p
. .- .
- ' INSPECTION' ' , ,
. , DATE ' INSPECTOR
Te,mporary Power Pole " "
Plumbing (DrainNVaste Pipe)
Electrical Ground Electrode/Ufer
Setbackll'orrnslTre-nches, (Footings) ,
Do not install subfloor or pour floor slab u'ntil the
following applicable items have been ,signed: ' '
Plumbing (Water Pipe.Sprinkler Valves)
Mechanical (Groundwork) , c
Electrical (UndergrGUnd Conduit) -,
Pre-Slab (CompactiontMembrane.Reinf. ,
Underpinning (Floor J~tlGlrders) .
Do not cover or conceal the worK below until the
following applicable items have been signed: ' ,
1st Floor Shear ,
Firesprinkler(Roughj
2nd Floor,Shear , ,
Roof (Sheathi hragmlFranel ' , -/ -oK.' ----fJ/v' PA...
Masonry (ReinfJBond BeamJPre-GroUt) ........,-
Rough Plumbina' (Top Out) L./ '
Rough Mechanical ,
KOugn t:IectrlC ...."1 '
Rouan EI&ctriCliJ " -
Framing' .(On~after~lbg,:Elec" Mech,: and Fire)
Insulallan (SoundlEnergyj , ,
Do nottape or plaster, until the following applicable ,
items have been signed: '
Drywall ' , ' " , ,
Penetrations (Fire Rated) Electrical "
penetrations (Fire Rated) Mechanical
Penetratiom; (Fire Rated) Plumbing ,
Interior Lath "
Exterior Lath , '" . ,
GENERAL'ITEMS ','
Exterior Plaster (Brown Coal)
T -Bar Elec:tr.lc:al
T-Bar M&chanlc;il ' ,
T -Bar Structural ' , --e'
Sewer
Water, Engineering Backflow
Water Service ' ' ,
BUlldmalnsDectlons
Mechanical Inspections
Plumbina Inspections
Electrical Inspections